Your fears, anxiety, depression and grief are not going away magically even if you are in treatment! Waiting for them to disappear before you start “living” again is like waiting for pigs to break into a chorus of songs!
There is no magic bullet in psychiatric treatment, the treacherous road to recovery has many pot holes and setbacks. Perseverance and patience has to be your flotilla to cling to.
I know this truth, not only as a therapist, but living with my own depression and most currently intense grief.
In some ways, I have had to be my own psychiatric nurse in dealing with my own afflictions. Just because I know what to do, does not make it any easier for me to follow through.
Perhaps that is one of the reasons I have a lot of compassion for my patients, trying to climb out of deep caverns of despair, that can be paralysing.
I can look at myself and see my treatment plan in front of me as easily as for a patient.
Acceptance, Diagnosis, Treatment, Treatment Goals, Reintegration and Maintenance.
Reintegration back into “living” when you still have symptoms is difficult to start, but it is an essential part of the treatment process.
I am writing this post not only for someone who is suffering from mental illness and or grief but also for the family members who suffer along with their love ones going through the slow and tedious path of recovery.
What is does take for anyone, especially me is the discipline, because I cannot depend on having the energy or motivation to initiate getting out or taking on a chore.
Waiting for when you want to or have the needed energy is counterproductive, because waiting for life to change without you making some effort to help the process alone is rather futile.
I have never had the personality of nurse Ratched, thank God, but with myself, I have to be cajoling firm but kind. My ailing self is generally trying to bargain with me out of doing this and that.
That is just part and parcel of the suffering. Expect and accept it with gentleness, but with non compromise to the treatment goals.
The bottom line is that despite whatever emotional suffering you are having right now, that is keeping you on the sideline, it cannot be used as an exclusive excuse to not at least try to get back into living.
Basically it comes to the stark recognition that your emotional and psychiatric suffering is a real affliction, as much as any physical disease. Some illnesses are totally curable, and some conditions are not; but you must learn to live with it and despite it.
Just as the stroke victim, and post cardiac infarct patient have to slowly reintegrate doing things they use to do, the psychiatric patient has to do the same.
A major problem is that with the psychiatric patient, the motivation is either non existent or so low, or so fear provoking, that even getting started seems impossible.
Coupled with the severe symptom of total loss of energy, any attempt to do anything becomes a major undertaking requiring herculean efforts!
This low motivation, plus loss of energy is one of the reasons that psych patients are a real challenge to the therapist, their families and obviously to themselves.
Even during the rough early stages of treatment, measures of rehabilitation have to be initiated. This is not that much different that getting a post surgical patient out of the bed walking the first day.
Getting a severely depressed person out of the bed is like pulling teeth. Getting them to do basic self care is likewise difficult.
This is much easier accomplished in a hospital setting as making family members responsible for doing this puts them in a tough situation of being the mean rule master.
Getting an anxious, fearful person to commit to try to do whatever they are fearful of doing is likewise a monumental effort for the therapist as well as the patient.
Exposure therapy for panic or OCD patients should never be started though, until some of the “fire” of anxiety is turned down by medication, or you will risk building up even more resistance.
Besides medication, psychotherapy, nutrition, and sometimes meditation, the treatment regime must always include reinserting the patient back into his/her life as soon as possible.
A lot of times, especially with panic and anxiety patients, they are also fearful of how they appear to others. Many are convinced that others can “see” their anxiety.
This is ludicrous as the vast majority of people are too wrapped up in the own thoughts and concerns to be able to discern someone else.
Depressed people might be easier to be noticed only because of their vacant facial expression and down trodden way of carrying themselves if in a small group by observant trained others, but generally they too go unnoticed.
People with fractures sporting casts or on crutches are certainly going gain more notice, but because they are physical afflictions a patient sees no embarrassment in plodding forth.
If you are a family member of a depressed or anxiety ridden person in treatment, you need the patience of Job in dealing with them.
Always encourage them to come along with you and remind them that getting out in part of the treatment needed for them to get better.
Sometimes, you have to let them know that a “no” is not an option, any more than it would be in a hospital setting.
One thing that I can guarantee to anybody, including myself, is that taking a walk outside regardless of the weather, will never make you feel worse, but will give you the opportunity to feel better.
The truth is the vast majority of time, you will come back feeling a notch better and even with a tad more energy.
Over time these outings, however tiring and difficult to initiate will become imprinted in your brain as something good and beneficial to feeling better.
It is not any different that retraining the brain after a stroke. The brain does indeed have neuroplasticity, thank goodness, but it just takes time and going through the motions.
Energy begets energy and effort leads to increasing effort on your part. Can you remember not wanting to start some household chore and then when you finish accomplishing it, find yourself beginning another before you even notice it?
It is the same principle. Not much different that priming the pump and launching the pendulum in swing. Eventually some sort of momentum will start to occur will greater ease of tackling it.
The bottom line is that by taking your anxiety, fears, depression and grief along with you is a way to pave the road to recovery. Just do it, has to be the motto.