What should I be doing all day?

September 12, 2017 5:49 AM

I've somewhat unexpectedly been signed off sick from work due to mental health issues. How can I best spend the time to maximise recovery?

On Friday afternoon I had an emergency appointment with my GP. I have long-term issues with depression and anxiety that I can usually manage on my own, but things had been going downhill for several months and had come to a crisis. I thought I would come away with a prescription for an SSRI (which I wasn't too happy about, since I always experience bad side effects) and maybe a referral to counselling if I was lucky. Instead, the doctor signed me off work till the end of the month. I'm also being referred for CBT, which hopefully will start during the time when I'm off, though it depends on demand at the clinic that delivers it.

Before the appointment, I'd been looking at a month jam-packed with deadlines, meetings, trips, on-call shifts, etc., etc. Now suddenly I have nothing much to do for three weeks. My energy is quite low at the moment and my concentration is not great, but I'm well enough to leave the house and get some tasks done, albeit at a slow pace. I'm wondering how I can use this time in a way that will help my recovery without putting any counterproductive demands on myself.

I've exercised for at least 20 minutes a day for years, so I will continue doing that. I also try to spend time outdoors every day that weather permits. I've found meditation helpful in the past, but recently whenever I sit and do nothing, I either start silently berating myself, or I feel like I'm going to cry (but can't actually do so).

A few traps I'm worried about falling into are: spending my time mindlessly surfing the Internet; fretting endlessly about abandoning my work projects and leaving my colleagues in the lurch; or deciding that I'm going to use this time to sort the rest of my life out - finishing a writing project, decluttering my flat, etc. - and then feeling like a failure if it doesn't happen.

Has anyone else been in this position? What did you find was the best way to use the time? How did you avoid the sort of traps I mention?

One more question - before all this kicked off, I'd booked tickets to a few classical music concerts later in the month. Would it still be OK to go to these? I find music to be therapeutic, but a little voice in the back of my mind keeps saying: "If you're too sick to go to work ...."

Thanks for your help!

posted by Perodicticus potto to Health & Fitness (19 answers total)

Best answer: One more question - before all this kicked off, I'd booked tickets to a few classical music concerts later in the month. Would it still be OK to go to these? I find music to be therapeutic, but a little voice in the back of my mind keeps saying: "If you're too sick to go to work ...."

There is a huge difference between being too sick for the stress of work and being too sick to enjoy a concert.

Think of it this way - if you broke your leg and couldn't work, would you feel guilty about inviting a friend over to spend quality time? Of course not, because you're healing your injury and the friend has no impact on the healing itself. Injuries you can't see are no different than ones you can.
posted by notorious medium at 6:13 AM on September 12, 2017 [20 favorites]

Not everyone finds meditation to be helpful, but sometimes meditative activities can be instead. For me, these would be things which take up enough brain space that I can't go off in my own thoughts too much - such as making something out of clay, gardening, or cooking.

If you're not into making art, and don't have a garden, cooking might be ideal. Perhaps you could plan one "big cook" per week and make something that takes a bit of extra time, preparation and/or concentration. Memail me if you want some ideas for big cook nights!
posted by greenish at 6:18 AM on September 12, 2017

Try to get out of the house everyday, preferably for at least 30 minutes. Go to the park, get some coffee, do errands, see a movie, take a project to a cafe, get lunch, go to a museum etc. I've been home all day for long stretches of time and it has a very negative impact on my mood. I think getting some fresh air could keep you even.
posted by starlybri at 6:19 AM on September 12, 2017 [2 favorites]

Best answer: As someone with anxiety, I feel for you. I'm not sure if you can see this, but you are wound up with anxiety about how you will handle treatment for your anxiety. To the best of your ability, don't worry about doing treatment "right." Whatever you do for the next 18 days will be right for you, whether that means structured outdoor activities or browsing Reddit or making art or something else.

The very exercise of this Ask is feeding your anxiety in a really unhealthy way. It's probably best to work on this stuff in therapy, rather than asking the internet to help you design the perfect time off. If getting into CBT is going to take a long time, would you be interested in something like 7 Cups or Talkspace to tide you over?
posted by schroedingersgirl at 6:31 AM on September 12, 2017 [8 favorites]

Maybe try to up your exercise, at least a few days a week. I find that when I do vigorous exercise, my anxiety quiets down.
posted by coppermoss at 6:39 AM on September 12, 2017

Best answer: The weird thing about time off for mental health stuff like this is that basically the opposite of the usual advice when you're sick applies. Staying at home in bed is likely to make it worse; going out and doing stuff is likely to make it better.

Unfortunately society has a messed up understanding of this. I felt very similar pressure when I was signed off for similar reasons a few years ago - very ashamed of doing stuff like going out for dinner with a friend (because I was meant to be sick and what if someone saw me), when actually that was the best possible stuff I could be doing because it was keeping me connected with life and the world and people (which was pretty much the opposite of what I felt like doing at that point). So yes, definitely go to the concert. The fact that you are interested to any degree in something artistic/aesthetic is a good thing and you would do well to feed that interest.

It might be helpful to think of the time as a break that will get you in a better position to eventually get well, rather than as the specific amount of time you have allocated in order to become well. Two weeks off in 2014 did not magically cure my mental illness - I'm doing a lot better now but it took the majority of the time between then and now and lots of therapy to get there. The goal is orienting yourself towards a future in which recovery is possible, not recovering right now. And don't worry if "orienting yourself towards a future in which recovery is possible" sounds just as impossible as recovery itself - the break will do you good even if you feel lousy the whole time (and you probably will, that's the nature of the disease) and don't feel like you've made any progress at all while you're actually living through it.

I found it helpful to meditate looking at a lit candle during that time - it's just enough movement and interest that you can bring your attention back to it and try to keep focused but it's not just you and your brain.

Honestly the most helpful thing about this kind of leave for me was being able to take a break by force that I hadn't felt able to ask for by choice, and opening up the conversation with my employer about my mental health, accommodations, how to make it work etc. I have a powerful need to pretend everything is 100% fine when my mind is falling apart, including clamping down on obvious symptoms when I'm around other people/need to get a job done. Being signed off meant I didn't have to keep that increasingly-impossible act up for a few weeks, and when I went back it was into a situation with a lot more understanding about what had been going on, where I was able to be more honest about how much I could reasonably take on in the state I was in. I was definitely not fixed or healthy when I went back to work, but the time off was valuable anyway.

I don't know if this helps with anxiety/perfectionism at all, but it's nearly impossible to screw up a break of this nature. Even if you feel you've done nothing and achieved nothing, you've still had a break from a major source of stress. A lot of the days I was off, I counted it as a success if I'd been outside and done a small amount of physical activity, eaten something nourishing and done a small amount of journaling. I felt crappy the whole time, but I was going to feel crappy no matter what I did at that point. If you do manage to do stuff that feels helpful, that's great! And if you don't, you will almost certainly be better for having had the break anyway.
posted by terretu at 6:48 AM on September 12, 2017 [7 favorites]

Best answer: When I was recovering from similar issues, I made a deal with myself that I would do at least two positive healing-related things every day, and one of them had to be taking my medication; then I let myself off the hook for any "have to's" for the rest of the day. Some days, taking my medication plus showering was what I counted, and I spent the rest of the day watching crappy reality-tv reruns on my laptop. Other days, I took my medication and did a big hike and shopped for and made dinner and spent time with people. The idea was learning to listen to myself about what I could handle each day, and taking pressure off myself for having to achieve anything other than my basic safety and hygiene.

I'm not sure if you can see this, but you are wound up with anxiety about how you will handle treatment for your anxiety. To the best of your ability, don't worry about doing treatment "right."

Also very much this. And also don't beat yourself up for beating yourself up. Just notice it's happening, take a breath, and see if you can step out of the self-judgment for a beat.
posted by lazuli at 6:49 AM on September 12, 2017 [4 favorites]

Puzzles can be great when you're in this kind of head space--easy-ish, not just staring at a computer, and you can see progress as you go along. (I think I read that tip here on MeFi.)
posted by needs more cowbell at 6:51 AM on September 12, 2017

Do fun stuff! Think of it as an enforced vacation. We take vacations for the sake of our mental health, right? To give us a break from the daily grind and allow our spirits to open and grow, to remind ourselves of what it is to be a human rather than just an employee? To create pleasant memories that will sustain us through duller times ahead? To give ourselves a chance to heal from the numerous slights and knocks that we constantly endure during our usual day-to-day?

That's what you need right now. The best, most responsible thing you can do in order to feel better and get yourself ready to go back to work is enjoy yourself. Spending your sick leave being anxious about how you're not being serious enough is totally counterproductive. You need to have fun, to relax, to nourish your spirit. As a friend of mine once said, "Slip off the academic gown and on with the antic pants!" It's the responsible thing to do.
posted by Anticipation Of A New Lover's Arrival, The at 7:06 AM on September 12, 2017 [3 favorites]

Do you have access and insurance coverage to enroll in an Intensive Outpatient Program (IOP) for depression? If that's an option for you over the next 2-3 weeks, I'd highly recommend it. It's structured time that includes many modalities of therapy, but you still sleep at home in your own bed every night. Your GP can probably refer you, if he was kind enough to see you for an emergency appointment.
posted by juniperesque at 7:33 AM on September 12, 2017 [2 favorites]

The obvious answer is "whatever your therapist tells you". But aside from that, I find being in nature quite soothing. Go for a hike as often as you can. Just getting outside is helpful, but the further you can get from civilization, the better. When you're home, set up controls on your computer and TV to prevent you from using them at certain times. And then focus on small accomplishments, like cooking or working out - remind yourself that you're still capable of getting things done.

And yes, absolutely go to that concert.
posted by kevinbelt at 7:39 AM on September 12, 2017 [1 favorite]

Best answer: I've found meditation helpful in the past, but recently whenever I sit and do nothing, I either start silently berating myself, or I feel like I'm going to cry (but can't actually do so).

And when either of those things happen, your work is to note them without declaring them unacceptable, and return your attention to the breath.

You know the drill. Anything other than attention to the breath is a distraction, and your job is to notice that it has happened, observe it, then return your attention to the breath.

Being ill will certainly raise the frequency of internal distractions, but the fact that you spend more of your sitting time responding to distractions than you would have done if you were well takes nothing away from the value of that time. A big part of the point of meditation is to practice, over and over and over again, that very process of noticing that you have become distracted, quietly observing the distraction, then putting it aside; and if your present illness is giving you more material to work with there, that's actually a good thing.
posted by flabdablet at 7:55 AM on September 12, 2017 [1 favorite]

I find music to be therapeutic

Sounds like you definitely should go to these concerts. Are there any other things that you do that feel therapeutic? Maybe do those as well, to the extent that you are up for it.
posted by salvia at 9:22 AM on September 12, 2017

I took three months off work a couple of years ago because of depression and anxiety. YMMV but the best thing more me ended up being to just sleep and read. That helped the most, and then we found the right meds change and I felt much better to the point where I was bored and I felt ready to go back to work. Also, if in three weeks time your doctor says you are not ready to return, please listen and be compassionate with yourself. I also thought I'd be off for only three weeks.
posted by kitcat at 9:22 AM on September 12, 2017

Also: the single best thing that you can do unaided for your own mental health is get enough good sleep.
posted by flabdablet at 9:31 AM on September 12, 2017 [2 favorites]

"...try to spend time outdoors every day that weather permits." - get a better rainsuit and hat - no umbrellas - and go for an 8 hour excursion. Or build up over these 3 weeks to an 8 hour excursion. Also proper shoes, gloves....
posted by at at 9:45 AM on September 12, 2017

Reading later comments, this part of your original post stuck out to me:

"I either start silently berating myself, or I feel like I'm going to cry (but can't actually do so)."

I'll suggest reading The Inner Game of Tennis by Timothy Gallwey to help with this. A big part of the book is teaching you not to beat yourself up. It's standard meditation stuff, but applied in a concrete way to a familiar situation. Even if you don't play tennis, it's worth a read - the lessons are easily transferred from tennis to other contexts.
posted by kevinbelt at 10:14 AM on September 12, 2017 [1 favorite]

I'm off for six weeks.

I got a therapist. The therapist referred me to a health clinic to work on my aches and pains and to break the cycle of stress and anxiety with the sympathizer nervous system. So I am trying this approach, it involves acupuncture and active release therapy.

I also went on vacation, am trying yoga again, cleaning house, went to farmers market and ate all the fruits and vegetables, and worked on parenting. Also I am hiring a new lawyer for my divorce. I get out of the house every day.

I am halfway through my break and it's the best thing I have done for myself in a long time. Three weeks was too short.

Take care
posted by crazycanuck at 4:10 PM on September 12, 2017

I am disabled and have depression and anxiety. One thing that's very helpful for me is to do one productive thing each day and one entertaining thing each day. "Productive" is anything from a household chore or errand on a good day to washing my face or throwing away two pieces of trash on a bad day, as long as I can say that I accomplished something. At times, I've planned my activities out for a full werk; that was very helpful when I was anxious.
posted by epj at 9:05 PM on September 12, 2017