How to make the most of 2 weeks of mental health leave?
August 16, 2021 3:15 AM Subscribe
In another, non-pandemic time, I might seek help in a residential center, or travel somewhere. But I am in a covid hotspot, and those aren't options. How can I best support my medication changes and get some semblance of my life back with 2 weeks off work?
I am dealing with bipolar depression that has defied my usual maintenance medication, and I'm working closely with my doctor, but there has only been a little progress in the past few months. Complicating things, I developed a sensitivity to my round-the-clock pain med for chronic pain, and I am dealing with breakthrough pain and withdrawal with a new med. It's become increasingly obvious that I need to take some time off. I am in the US and so 2 weeks is being offered, and part of me is grateful and the rest of me thinks that isn't nearly enough and nothing will change (probably also the depression talking).
What can I do to help things along? My ideas are: be stricter about bedtime and waking up (though I'm pretty good at that already, I usually plan to get at least 8 hours); make a point to leave my apartment every day; take at least an X-minute walk every day outside (it is very hot here so this takes planning). Keep exercising. Keep avoiding alcohol. Maybe try to read a book? Bake? I don't know. Part of what is making this hard is that my depression is telling me that everything is pointless. Note: because I have been so stable for so long on medication, I don't have a therapist anymore or a formal mental health support system, just my GP managing my bipolar maintenance meds.
Do you have ideas for this stay-at-home mental health leave? Keep in mind that everything is really hard right now. I am very fatigued and sad from the depression, and I am nauseated and in pain from the pain med switch. It's starting to feel like a lot of pressure to get fixed ASAP, instead of a break from the stress of work.
I am dealing with bipolar depression that has defied my usual maintenance medication, and I'm working closely with my doctor, but there has only been a little progress in the past few months. Complicating things, I developed a sensitivity to my round-the-clock pain med for chronic pain, and I am dealing with breakthrough pain and withdrawal with a new med. It's become increasingly obvious that I need to take some time off. I am in the US and so 2 weeks is being offered, and part of me is grateful and the rest of me thinks that isn't nearly enough and nothing will change (probably also the depression talking).
What can I do to help things along? My ideas are: be stricter about bedtime and waking up (though I'm pretty good at that already, I usually plan to get at least 8 hours); make a point to leave my apartment every day; take at least an X-minute walk every day outside (it is very hot here so this takes planning). Keep exercising. Keep avoiding alcohol. Maybe try to read a book? Bake? I don't know. Part of what is making this hard is that my depression is telling me that everything is pointless. Note: because I have been so stable for so long on medication, I don't have a therapist anymore or a formal mental health support system, just my GP managing my bipolar maintenance meds.
Do you have ideas for this stay-at-home mental health leave? Keep in mind that everything is really hard right now. I am very fatigued and sad from the depression, and I am nauseated and in pain from the pain med switch. It's starting to feel like a lot of pressure to get fixed ASAP, instead of a break from the stress of work.
What about some kind of telehealth intensive outpatient or partial hospital program? This might help give you some structure, and these places are often very good at setting you up with "aftercare" i.e. they can refer you to a new therapist and/or psychiatrist and other resources.
posted by litera scripta manet at 4:07 AM on August 16, 2021
posted by litera scripta manet at 4:07 AM on August 16, 2021
I think structure would be helpful. Could you do a daily yoga class, and/or learn to knit class? Something distracting but not too taxing. I agree with others that seeing if you can access therapy remotely would be a good idea
posted by plonkee at 5:27 AM on August 16, 2021 [4 favorites]
posted by plonkee at 5:27 AM on August 16, 2021 [4 favorites]
Can you get an anti nausea prescription? I have chronic pain that sometimes causes it and take metoclopramide, it makes such a difference to my mood when I don't feel sick. Journaling helps me too.
posted by ellieBOA at 5:29 AM on August 16, 2021 [1 favorite]
posted by ellieBOA at 5:29 AM on August 16, 2021 [1 favorite]
I was in your shoes a bit over a year and a half ago. I was extremely depressed, suicidal, the whole deal. Three weeks off of work was all I could manage given my other commitments. Like you, I was dubious that the time off would do anything, but that doubt proved to be the depression talking. I was no means even close to back to my old self at the end of it, but those weeks saved my sanity. They gave me the space I needed to pull my reserves together. As a result, I had the energy I needed to make and implement the decisions that I needed to, and though I still struggle at times, the worst of it is behind me and I'm doing a lot better now.
The point is: this time might really help. It's not pointless. I'm really glad you've created this space for yourself. You can do it, even if it doesn't feel like it right now.
Some things I did that were helpful:
1. Give yourself a project to do with your hands and body. I did a massive clean of my house and painted a few rooms, but it could be anything: gardening, an absorbing craft, cooking, whatever. If you're in pain, you could draw or write on paper. What you want to do is tap into the creative, joyful part of you that you probably feel is completely buried or even gone. It's in there. A project will also force you to spend a lot of time living in the now rather than in your head. It doesn't feel like progress to just be living in the now, but a lot of depression involves endless rumination. Part of how to make progress is to pop your brain out of that a little.
2. As much as possible, stay away from the computer or screens. If you can't entirely, at least stay away from the news and social media as much as you can. That shit is the scourge of joy even for the most robust of us.
3. Be gentle with yourself. Allow yourself to sleep as much as you need. Be lazy. Pamper yourself.
4. Within the constraints of the guidelines above, try to take a little time to actively think about the things that you think are the root of your depression. (Actively thinking is very different from endless depressive rumination, and when you're not actively thinking, try not to dwell). Are there issues you keep ruminating over? Make lists, try to see them from a different perspective, brainstorm things you can try to knock yourself out of the rut or actions you could take that might help. If something seems big and unsolvable, break it down into tiny steps. You don't have to do those steps, just give yourself a plan of action. Gently.
5. Reach out to people. I talked the ears off of a couple of friends during this time. Without them, I don't know what I would have done. I hope you have some people you can turn to. Even if you don't have anyone super close, human connection of any sort -- a friendly coffee, a conversation over zoom to catch up with someone you've missed -- those things remind your brain of why life is worth living. Even if you're so depressed you don't feel the joy of them right now, that's okay. They're still filling your bucket.
Good luck, friend. You can make it through this.
posted by sir jective at 5:52 AM on August 16, 2021 [14 favorites]
The point is: this time might really help. It's not pointless. I'm really glad you've created this space for yourself. You can do it, even if it doesn't feel like it right now.
Some things I did that were helpful:
1. Give yourself a project to do with your hands and body. I did a massive clean of my house and painted a few rooms, but it could be anything: gardening, an absorbing craft, cooking, whatever. If you're in pain, you could draw or write on paper. What you want to do is tap into the creative, joyful part of you that you probably feel is completely buried or even gone. It's in there. A project will also force you to spend a lot of time living in the now rather than in your head. It doesn't feel like progress to just be living in the now, but a lot of depression involves endless rumination. Part of how to make progress is to pop your brain out of that a little.
2. As much as possible, stay away from the computer or screens. If you can't entirely, at least stay away from the news and social media as much as you can. That shit is the scourge of joy even for the most robust of us.
3. Be gentle with yourself. Allow yourself to sleep as much as you need. Be lazy. Pamper yourself.
4. Within the constraints of the guidelines above, try to take a little time to actively think about the things that you think are the root of your depression. (Actively thinking is very different from endless depressive rumination, and when you're not actively thinking, try not to dwell). Are there issues you keep ruminating over? Make lists, try to see them from a different perspective, brainstorm things you can try to knock yourself out of the rut or actions you could take that might help. If something seems big and unsolvable, break it down into tiny steps. You don't have to do those steps, just give yourself a plan of action. Gently.
5. Reach out to people. I talked the ears off of a couple of friends during this time. Without them, I don't know what I would have done. I hope you have some people you can turn to. Even if you don't have anyone super close, human connection of any sort -- a friendly coffee, a conversation over zoom to catch up with someone you've missed -- those things remind your brain of why life is worth living. Even if you're so depressed you don't feel the joy of them right now, that's okay. They're still filling your bucket.
Good luck, friend. You can make it through this.
posted by sir jective at 5:52 AM on August 16, 2021 [14 favorites]
The one striking thing missing from your list is human contact. Which amid covid and with depression might seem impossible and un-tempting, but even if you can persuade someone to join you on your walk sometimes for undemanding chat, that can help give your brain something to focus on other than yourself. Even if you live with other people, having someone else be happy to spend time with you is good for the soul.
Best of luck.
posted by penguin pie at 7:34 AM on August 16, 2021 [1 favorite]
Best of luck.
posted by penguin pie at 7:34 AM on August 16, 2021 [1 favorite]
Things that I have found helpful are watching enjoyable and fairly light TV shows-- The Good Place, Brooklyn 99, Gilmore Girls while engaging in small craft-type activities-- knitting for the most part. The shows take my mind to a (temporarily) nicer place and the knitting gives me a feeling of small but ongoing accomplishment. I also downloaded the Breathe app to my phone and use it for 2-5 minutes first thing in the morning and right before bed. You sound wise and measured in your post but I know that these things feel almost unbearable. You are handling this so well and you are going to get through this.
posted by jeszac at 8:07 AM on August 16, 2021 [1 favorite]
posted by jeszac at 8:07 AM on August 16, 2021 [1 favorite]
i don't know where you are but when I lived in hot steamy Florida and Georgia I took my daily walks around dawn and it was always cool enough. Bonus if you can walk to a place where you can see the sun rise. Figure out what time the sun rises where you are and set your alarm for an hour before. If you can, walk in green spaces, either in parks or on quiet tree-lined streets, or by water.
Do you swim? An hour every couple of days in a cool indoor pool feels great. If you can swim in the ocean or in a lake, even better. I go to my local Y and they have excellent covid prevention rules in place so I feel safe swimming there.
Sometimes re-arranging your furniture can help with re-arranging your life.
I hope it all goes well for you.
posted by mareli at 10:28 AM on August 16, 2021 [1 favorite]
Do you swim? An hour every couple of days in a cool indoor pool feels great. If you can swim in the ocean or in a lake, even better. I go to my local Y and they have excellent covid prevention rules in place so I feel safe swimming there.
Sometimes re-arranging your furniture can help with re-arranging your life.
I hope it all goes well for you.
posted by mareli at 10:28 AM on August 16, 2021 [1 favorite]
I spent the last year in your shoes; bipolar type 2 over here with crippling depression and anxiety. I had more time off than you as I’m a teacher with a summer break, but I did manage to pull myself out and here’s how I did it:
-a change of scenery. Idk about you, but when I’m depressed my house falls to shit. I forced myself through a deep clean and decamped to my parents, and then sister’s house. I live alone so the company also helped. Even if you can get away for a weekend, i bet it would be a help.
-added an antidepressant to my usual meds. My shrinks have always been hesitant to prescribe due to risk of mania, if you’re not on one push for it.
-yoga everyday. Like you I suffer from chronic pain and I go to gentle yoga and it helped so much with both the depression and pain. Lots of YouTube videos, I recommend jessamyn Stanley, or, if you can get to a studio and covid isn’t ravaging your area, the in person classes were also really good for human contact. I always thought yoga was just stretching and kind of woo, but I can’t overstate what a difference it has made.
Rooting for you; it’s so so hard, be kind and gentle with yourself and know that it will, eventually, pass.
posted by nancynickerson at 11:45 AM on August 16, 2021 [3 favorites]
-a change of scenery. Idk about you, but when I’m depressed my house falls to shit. I forced myself through a deep clean and decamped to my parents, and then sister’s house. I live alone so the company also helped. Even if you can get away for a weekend, i bet it would be a help.
-added an antidepressant to my usual meds. My shrinks have always been hesitant to prescribe due to risk of mania, if you’re not on one push for it.
-yoga everyday. Like you I suffer from chronic pain and I go to gentle yoga and it helped so much with both the depression and pain. Lots of YouTube videos, I recommend jessamyn Stanley, or, if you can get to a studio and covid isn’t ravaging your area, the in person classes were also really good for human contact. I always thought yoga was just stretching and kind of woo, but I can’t overstate what a difference it has made.
Rooting for you; it’s so so hard, be kind and gentle with yourself and know that it will, eventually, pass.
posted by nancynickerson at 11:45 AM on August 16, 2021 [3 favorites]
Consider - and seriously don't do this if you think it will be bad for you, and also do roll in some kind of phone or text check-in a couple times a day with someone if you do it - setting aside 1-3 days early in your time off to engage in real neurological rest. Like, concussion-recovery-style relative rest:
Relative rest, which includes limiting activities that require thinking and mental concentration, is recommended for the first two days after a concussion. However, complete rest, such as lying in a dark room and avoiding all stimuli, does not help recovery and is not recommended. In the first 48 hours, you should overall limit activities that require high mental concentration — such as playing video games, watching TV, doing schoolwork, reading, texting or using a computer — if these activities cause your symptoms to worsen.
Literally, avoid thinking too hard or processing stimuli, especially electronic. No TV, music, podcasts, books or audiobooks. You'll have to decide for yourself how much sitting still you can stand, maybe interspersed with walks. As much as I believe in the connection power of the internet, I think everyone could use the deep brain rest of not looking at screens and not being busy for a long enough stretch of time to count as real rest, ideally including several nights of sleep without screen stress in your brain and body.
I think a lot of people get this kind of rest inadvertently when doing stuff like camping, where it's acceptable to keep lightly busy with survival chores and otherwise just sit and stare at a lake or trees or something. Would something like that be possible for you? Could you go camping nearby, rent a cabin/yurt/tiny house/stationary trailer, borrow a friend's lake house? Or maybe get a hotel room with a view or just an airbnb house with a pleasant yard (that isn't yours, doesn't need chores done, and is low on distractions)? Just go away from your stuff, so there's not a lot to do/pressure to do chores and things, where you are able to just watch clouds or listen to birds and do nothing more than make basic meals, walk, maybe rake some leaves or carry some firewood, rest or nap as the mood strikes you, and still sleep well overnight? Maybe read, depending on how your brain seems to be. You don't need to go FAR, just not in your house and ideally somewhere nice to look at, which should be feasible with limited human contact. You don't need to do this for the whole two weeks, but 2-3 nights at least and probably early on in your break, to set the tone.
posted by Lyn Never at 11:45 AM on August 16, 2021 [4 favorites]
Relative rest, which includes limiting activities that require thinking and mental concentration, is recommended for the first two days after a concussion. However, complete rest, such as lying in a dark room and avoiding all stimuli, does not help recovery and is not recommended. In the first 48 hours, you should overall limit activities that require high mental concentration — such as playing video games, watching TV, doing schoolwork, reading, texting or using a computer — if these activities cause your symptoms to worsen.
Literally, avoid thinking too hard or processing stimuli, especially electronic. No TV, music, podcasts, books or audiobooks. You'll have to decide for yourself how much sitting still you can stand, maybe interspersed with walks. As much as I believe in the connection power of the internet, I think everyone could use the deep brain rest of not looking at screens and not being busy for a long enough stretch of time to count as real rest, ideally including several nights of sleep without screen stress in your brain and body.
I think a lot of people get this kind of rest inadvertently when doing stuff like camping, where it's acceptable to keep lightly busy with survival chores and otherwise just sit and stare at a lake or trees or something. Would something like that be possible for you? Could you go camping nearby, rent a cabin/yurt/tiny house/stationary trailer, borrow a friend's lake house? Or maybe get a hotel room with a view or just an airbnb house with a pleasant yard (that isn't yours, doesn't need chores done, and is low on distractions)? Just go away from your stuff, so there's not a lot to do/pressure to do chores and things, where you are able to just watch clouds or listen to birds and do nothing more than make basic meals, walk, maybe rake some leaves or carry some firewood, rest or nap as the mood strikes you, and still sleep well overnight? Maybe read, depending on how your brain seems to be. You don't need to go FAR, just not in your house and ideally somewhere nice to look at, which should be feasible with limited human contact. You don't need to do this for the whole two weeks, but 2-3 nights at least and probably early on in your break, to set the tone.
posted by Lyn Never at 11:45 AM on August 16, 2021 [4 favorites]
Yes, I have been thinking about your question and had come back to talk about taking a few days to do what Lyn Never suggests above. I didn’t know it had a name like relative rest! I don’t have to deal with bipolar depression but I do have to deal with depression and a constellation of other things. Even though it seems like it’s not going to do anything, for me it kind of makes a break in the cycle and lets me mark time from the period of rest onward as a place I began to make progress again. It also makes a lot of room for mindfulness, which is annoying to talk about but helpful in practice.
Here are some possible ways to do that:
- Stay by a beach or lake. Rest in the shade, listening to the water. Bring actual books to read, but only books you already know and enjoy, or completely frothy vacation reading. Have a check in with a friend once a day. If you are lucky enough to live near a body of water, schedule a full day of visiting it, bring a picnic lunch.
- Spa weekend. This might be difficult because of the pandemic but I know some places in cities are doing their best. Big bonus here is platonic physical touch, which we all need and many of us are sorely lacking these days. Explain about your pain ahead of time.
- Sleep in a different room. If you have a guest bedroom, become a guest in your own house. It seems silly but just a small shift in location can help, especially if you have fancy guest things (towels, soap, sheets) that have gone unused for over a year. Plan beforehand and have groceries delivered that don’t need prep and order predetermined delivery for a couple nights.
After two or three days of something like this, I find it a lot easier to kickstart my executive functioning and do stuff like contact doctors or pay bills or clean the kitchen. It doesn’t make me like, suddenly not depressed or anything because I looked at some waves, but it does seem to make the subsequent stuff more effective, somehow.
posted by Mizu at 1:06 PM on August 16, 2021 [1 favorite]
Here are some possible ways to do that:
- Stay by a beach or lake. Rest in the shade, listening to the water. Bring actual books to read, but only books you already know and enjoy, or completely frothy vacation reading. Have a check in with a friend once a day. If you are lucky enough to live near a body of water, schedule a full day of visiting it, bring a picnic lunch.
- Spa weekend. This might be difficult because of the pandemic but I know some places in cities are doing their best. Big bonus here is platonic physical touch, which we all need and many of us are sorely lacking these days. Explain about your pain ahead of time.
- Sleep in a different room. If you have a guest bedroom, become a guest in your own house. It seems silly but just a small shift in location can help, especially if you have fancy guest things (towels, soap, sheets) that have gone unused for over a year. Plan beforehand and have groceries delivered that don’t need prep and order predetermined delivery for a couple nights.
After two or three days of something like this, I find it a lot easier to kickstart my executive functioning and do stuff like contact doctors or pay bills or clean the kitchen. It doesn’t make me like, suddenly not depressed or anything because I looked at some waves, but it does seem to make the subsequent stuff more effective, somehow.
posted by Mizu at 1:06 PM on August 16, 2021 [1 favorite]
What about setting a few minutes aside each day for light therapy? Spending time outside is ideal, of course, but if you get a "happy light" it won't matter how miserably hot it is outside.
I honestly thought the people who recommended that I try light therapy just didn't really understand depression, but after trying one for a few weeks, I'm a convert.
I hope you find your two weeks fruitful and rejuvenating. Take care of yourself!
posted by easy, lucky, free at 7:29 PM on August 16, 2021
I honestly thought the people who recommended that I try light therapy just didn't really understand depression, but after trying one for a few weeks, I'm a convert.
I hope you find your two weeks fruitful and rejuvenating. Take care of yourself!
posted by easy, lucky, free at 7:29 PM on August 16, 2021
spend time in nature or the closest approximation you have access to
walk a lot
posted by Jacqueline at 8:38 AM on August 17, 2021 [1 favorite]
walk a lot
posted by Jacqueline at 8:38 AM on August 17, 2021 [1 favorite]
I'm currently on my own 1.5 weeks of sick/stress leave.
What I decided to do to help myself was:
- Allow myself to rest a LOT. My body and mind are exhausted.
- 1-week detox of Reddit, Tik Tok, and weed. Three vices that steal a lot of my time and generally make me feel worse overall.
- Not planning any big projects, trips, or putting any expectations on myself. Just time to rest and everything else is a bonus.
- Doing very small things with rewards such as finally crossing off a few minor things on my to do list, grabbing coffee with a friend, and going for a walk.
- Working towards getting my fridge and groceries in order so that I can start eating more/better. This one still feels kind of overwhelming though so haven't quite gotten there yet.
posted by EarnestDeer at 10:29 AM on August 17, 2021
What I decided to do to help myself was:
- Allow myself to rest a LOT. My body and mind are exhausted.
- 1-week detox of Reddit, Tik Tok, and weed. Three vices that steal a lot of my time and generally make me feel worse overall.
- Not planning any big projects, trips, or putting any expectations on myself. Just time to rest and everything else is a bonus.
- Doing very small things with rewards such as finally crossing off a few minor things on my to do list, grabbing coffee with a friend, and going for a walk.
- Working towards getting my fridge and groceries in order so that I can start eating more/better. This one still feels kind of overwhelming though so haven't quite gotten there yet.
posted by EarnestDeer at 10:29 AM on August 17, 2021
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Two weeks may be too short to get better, but it’s definitely long enough to take the first steps towards getting better, and professional support beyond your GP can be one of those steps.
posted by nat at 3:22 AM on August 16, 2021 [6 favorites]