What are you going to do when you feel a bout of depression or mania starting to arrive?
That was the question my therapist asked me this week, and I did not have a good answer for her, so I started to think one up.
I think I already started developing my own wellness plan before I knew what to call it, but I think it is equally important to know how to navigate a depression swing with as little collateral damage as possible.
Here are the things that make up my “oh no your mood is swinging!” plan.
Talking to Friends
The first thing I do when I feel my mood swinging is I let my inner circle (spouse, mom, siblings) know how I am feeling. I do this so they can calibrate their expectations for the actions that follow.
When I am manic, I come up with grandiose thoughts like moving to a foreign country, retiring early, and many other fun past times. Letting my inner circle know in advance that I am starting to have these thoughts allows them to let the wave of manic creativity and energy go by, while also watching to make sure I don’t act on the thoughts at the expense of others or myself.
Depression swings bring lots of irritability, and a desire to be alone (not so easy with two young kids). This is a time where my helping around the house goes down and the burden on my significant other becomes more ..significant.
If you have ever stood on a beach and tried to use your body to resist an incoming wave, that is how I feel trying to fight the depressed mood to keep up my normal routine. It takes a lot of effort to do the things you normally have no problem doing (dishes, laundry, etc). Communicating hopefully brings understanding and patience to those affected. My favorite mantra during a depressed cycle is “These feelings are temporary. They will pass”, which is true as well for the decreased productivity.
Once your confidants have watched you go through a couple of cycles, they will also be able to help when you have a mixed episode of both mania and depression.
Your Care Team
In addition to your support network, I consider my therapist and psychiatrist the final legs of my care team.
If you currently don’t see a therapist or see one through your main health plan, I would seriously recommend looking into whether your employer offers an Employee Assistance Program. According to the International Employee Assistance Program Association:
In the US, over 97% of companies with more than 5,000 employees have EAPs. 80% of companies with 1,001 – 5,000 employees have EAPs. 75% of companies with 251 – 1,000 employees have EAPs. Source
If I used my main provider instead of the EAP at work, I would only see my therapist once every couple of months instead of the weekly appointment we have now. I used to do bi-weekly appointments, but so much can change so rapidly that one week appointments seems to be what I need, and is only possible through EAP.
In addition to regular meetings, something I recently started doing is sending my therapist and psychiatrist a short email or voicemail to let them know that something has changed. In the past, these calls led to a moved up appointment and/or a medicine re-evaluation.
A free resource for those suffering from depression is the (US Based) National Suicide Prevention Line. This is a 24/7 phone or chat based service that you can turn to. Their number as of this writing is 1-800-273-8255 or you can chat with someone by visiting their website.
Self Care
During a mood wing, even though it may feel like resisting a wave of water, it is important for me at least to keep up with self care.
I am a person that is hugely affected by changes in sleep patterns. I need a consistent sleep routine to help keep my moods in check. When mania keeps me awake, I fight back with over the counter sleeping pills. When depression makes me the bear that just wants to sleep I double down on my vice.. caffeine! Obligatory note: I have been told in the past that caffeine is not good for your mood, but we are not going for perfect here we are going for what works.
Discovering walking as an exercise has been a godsend. I have had trouble sticking to exercise routines in the past, but walking is enjoyable when you have a good Pandora station, podcast, or audiobook to listen to. I now average a 2-mile walk each day of the work week (about a half hour walk at lunch). After a good walk I feel my mood go up a couple points on the self reporting scale. I would be interested in hearing what exercise you find works for you (comment below).
Other tools
Music is a dangerous double-edged sword. Wielded incorrectly and it can send your mood plummeting.
On the other hand, when I feel my thoughts wandering during a manic episode, or abnormally negative during a depressed episode, I have found that listening to music loud enough that it doesn’t allow me to think is very helpful. Normally I am the kind of person that needs dead-silence to concentrate, but for some reason I can do my work with Disturbed screaming in my ear. I am less suggesting you go deaf and more recommending that you find whatever music works for you and rock out. Rock out to the point where you cannot resist air drumming or singing along 🙂 (I obviously rock out in private – your milage may vary).
Summary
Your plan will probably differ from mine and that’s great, do whatever works for you. The point of the plan is to help you during a destabilized mood so that your actions don’t swing too far either direction.