Just Another Manic Monday: Lists of Then and Now to Fight My Anxiety and Depression

At the weekend I planned to write a piece on authenticity. As a business woman I am exploring what this means. We all have our work personas, and our others. One of the most interesting things I've read is that we can change - we won't stay the same and shouldn't expect other people to either. It's part of our evolution. That's why we do performance development and change management. Because we need to change. However, one thing that isn't going to change is my list making...(see below!)

I don't believe we have to show everything to be 'authentic', but at the same time, being able to be honest about the part of me that has depression and anxiety.

Today I'm feeling really unwell, so this is what I can do. I'm hoping to write more on authenticity - especially in business. For now, here is a blog about how I've made changes to try and combat Monday morning anxiety.

Five years ago, if you asked me what Sunday night looked like, I'd say this:

Just to avoid misinterpretation, no, dear reader, I am not George Clooney.

1. I would pack my suitcase for the week ahead, make a note of all the things I needed to remember to do (that I hadn't remembered to make a note of on Friday)
2. I'd look forward to a cold, crisp glass of sherry and a delicious Sunday dinner.
3. I knew I probably wouldn't sleep well because I'd be thinking of all the activities ahead of me (which despite taking careful note of, were whirring around my little head like a carousel whirring and blurring at 100 MPH).
4. I'd be aware of the earlier-than-normal time I needed to wake up to ensure I got the train to wherever work was taking me, and this would mean my sleep would be broken - I'd wake up half a dozen times to watch the clock, even though I would have set an alarm.
5. I might have dreams about work - often - and I might think of new things to add to that to do list. All in all, I'd have a fairly rough start to the week, which I'd treat with a bottle of diet coke (or two), a fair breakfast bought at the station and a blurry Monday trying to get through various meetings whilst not falling asleep or seeming manic because of the amount of caffeine I'd consumed to make Monday working even a possibility.

Overcaffeinated? Yep.

What has changed? It's Monday morning.  I woke up feeling horrific, but now I know that I can employ various things to try to ease this and help me get through the day.

I feel terribly anxious after a nightmare-filled broken night of sleep where I dreamed of a wider to-do list including both life things (like trying to sell the house, tidy the flat, clean, and a long list of work activities). This means that I'm feeling physically sick, with bile present in my chest and rising in my throat.

There is nothing I can do about that, or my bad dreams if I've practised healthy behaviours before bed. Here are my best behaviours. I try to do these every day.

1. I go to bed in time to be awake for a decent amount of time getting comfortable in bed and 'finishing' the day in my head. 
2. I drink water with my tablets and only drink water (and plenty of it) after bed and beforehand. I don't drink any caffeine at all but I used to not drink any after 2pm
3. I read something that is not too challenging and not upsetting before bed on my Kindle, on the lowest possible light setting that I can manage during the dark. I find that looking at my ipad or iphone before bed can disturb my brain with the backlighting and make it harder for me to get to sleep.
4. I put on a programme to listen to before sleep which my brain will focus on (meaning not on the 1000 alternatives possible) and this concentration relaxes my brain and usually is the magic silver bullet to make me go the f*** to sleep.

You can buy this excellent book here.

Having done these last night, I'm feeling just as tired as I would have been five years ago, and have a list in front of me that I'm crossing things off from. A list is helpful to me for these reasons:

1. It helps me to realise that it's unlikely I've forgotten something, and stops my mind from racing around trying to repeat the things I have to do the next day / in general again and again. 
2. When I cross things off (even if it's just writing an email) I feel like I'm making progress and it makes me feel more in control. (And yes, I am one of those people who even puts things already achieved onto that list...it's good to remember that you've achieved something already!)
3. I can build on it throughout the week and decide to allocate some of the items to other later days depending on how my health is.

On the other hand, I didn't have anything to drink on Sunday night (or at any time on Sunday in fact); I didn't have a suitcase to pack because currently I don't have to work on client work away from home, because of the project types I'm working on. I didn't eat a Sunday roast.

I went to bed at around 6-7pm because I wasn't feeling at all well. I also now have a host of drugs to try to help my depression and anxiety and the medication that I take to allow me to take that medication, that is, to help with side effects of insomnia, restless leg syndrome and, yes, anxiety.

What else do I do to make myself feel better? There are quite a few things that I know can work (even though they don't always). Here is a view of what I do to try to combat anxiety and depression and allow myself to work and get through the week ahead. Let's start with work things:

1. I decide to work from home (or I give myself the option to do this). I know this is not possible for everyone, and I feel that my current employer KPMG is absolutely essential to allowing me to do look after myself when I'm feeling really unwell. For some of the #selfcare activities I'll need to do, working from home for me is - today and on many other days - the difference between being able to work and having to take the day off sick. I'd much rather work if possible, especially because I enjoy my work and work is a welcome distraction from feelings of depression and the ruminating / worrying voices in my head, so, for me, this is the best possible outcome.
2. I make the list (hahaha, now you know I make lists!) (see above) both for work and for my non-work activities. It's really important to me that I set up my teams for success and that I set myself up for success (in spite of mental illness) by making a plan which I can put in place to support everyone I work with through the week, and enable me to be useful, work effectively, and not hold people or projects back (which would make me feel worse).
3. I am open with my colleagues about how I'm feeling. Today, for example, I can't take phone call after phone call as the constant contact might increase my anxiety levels, so I've made some calls and rescheduled others for tomorrow, ensuring we still make progress but not to the detriment of my health.
4. I arrange some critical meetings face to face for tomorrow, so that I can prepare for useful meetings on one day, in a reasonable (2/3 day) space of time to give me breaks to sit alone, quietly and have food and water between these. I need breaks to enable me to keep going.
5. I use technology (which is my business anyway!) to help myself to stay connected with colleagues and support them: Skype for Business (which allows desktop sharing and collaboration on group calls between India, USA...the world). I can review many of my fab team's work products through our online document storage options and lots more. It's good for my mental health if I can stay in touch with everyone - stay connected - and feel a part of my team even if I'm not well enough to go into the office.

And on the non-work front, here are the things that I have done (and do) to try to help myself feel as well as I can:

1. I get up and go for a run. My energy levels are better in the morning and if I manage to complete a run then, that's the best chance I'll be able to do exercise because after a day of work I'll be shattered.
2. I don't drink caffeine of any kind except very, very rarely (I've had 6 diet cokes this year). Caffeine can have an impact on my medication and make me high / then low after the post-caffeine crash. It's a mood altering drug so I'm avoiding it to try to give my medication the best change of working. This might mean I am more tired than normal in the day, so if I am shattered, I build in breaks (as above). 
3. I make myself (or buy) juice from breakfast (beetroot, carrot, apple and ginger). More from the Mayo clinic on anti-anxiety nutrition guidelines here. 
4. I drink plenty of water all the time. It's great that I don't like coffee, tea etc. but I do miss diet coke. I love the no added sugar fizzy drinks from Marks and Spencer and I certainly am not a perfect diet person - it's just some things I can do, but I'm not a paragon of nutritional virtue - far from it.
5. I eat nutritious food, but also nice food. Crisps are a non-negotiable. I also can't give up bread. I. Love. Bread. And I will eat cookies too. Refined sugar might not be the best thing, but it tastes nice.

It's only 12.03 and I've got a lot more hours to get through. So here goes. But I hope for anyone reading this and wondering how they're going to get through the next few hours. Me too.

Food For Thought. Life (or Life With Mental Health) is Like a Box of Chocolates... #VictoriaLIVE

It’s been a busy week in the media for mental health, which is very positive as far as I’m concerned, but also gives me pause to, well, pause, because I’ve been involving myself in many of the discussions going on and probably need to take a break and make sure I’m taking care of myself.

Monday morning was a bit like Christmas in the world of mental health, and my present was a whole one hour and a half programme on BBC two dedicated to the discussion of many aspects of mental health. If you missed it, the Victoria Derbyshire programme featured both a panel of medical experts and celebrity-come-mindfulness-expert Ruby Wax, and is available on BBC iPlayer for the next month.

Victoria and me. Unfortunately this was the one shot I got.

I look happy. She...not so much

I knew what was coming when Mind contacted me about potentially appearing. An eye wateringly) (more like eye-rubbing-ly) early start and no make-up artists to make me look like I hadn’t been up since 5. Imagine for a moment if you arrived at the airport ahead of your long haul transatlantic flight, only to find that a film crew was waiting to catch your (eye) bags and pallid, pre-holiday complexion. Now imagine that being broadcast to thousands of viewers. And now imagine that you have anxiety and depression, which manifests itself as feeling hyper self-conscious of everything about you that is visible and invisible.

Me - in taxi at 6am and on set at 8am. 

Purple and Pink Hair meets Purple set and shiny forehead

(Plus, can you tell I'm depressed? See, I am, but you can't tell...)

I talk about my experience. And am shiny. You can watch the full show here:

Oh, the fun we had! 80 people with some kind of lived experience of mental health, lined up in the BBC café area (not open), drinking coffee, tea and eating chocolate biscuits. I like drinking juice as much as the next person, but there’s nothing like an instant shot of cheap chocolate covered refined sugar.

The master biscuit. I salute you.

Following that, I also contributed to a forthcoming Buzzfeed article – watch this space for that – and also then attended a workshop with @LatimerGroup to discuss ideas for a new advert for Time To Change. It’s so good to meet people who do and don’t have lived experiences of mental health and share our ideas for what would work as a concept to help people to seek help or just find out a bit about what mental health means.

It has been a great week for mental health, but I felt down as early as Tuesday and at that point I knew I had to make adjustments to make things work. I felt tired on Tuesday morning so benefited once again from my “reasonable adjustments” at work, choosing to work my full day from home instead of in the office, which helps me avoid a three hour roundtrip commute. I took a 1 hour thirty minute lunch break so I could have a midday nap.

(Note, this is against doctor’s orders, I’m not really meant to nap during the day.) I got to the end of the day. I got to my workshop, despite still feeling tired and starting to feel low because of the tiredness added to the things that make me sad from time to time – loneliness, stress, negative thoughts about friends, hating my body, hating my stupid illness, and so on. Love the thought process of depression. Really I do. I made it back in time for bed and slept. (And I had eaten four sliced of Domino’s for dinner. Carbs help with sleep. But if you’re reading this for health tips for eating, this is not the post for you!)

The pizza was healing.

I don't care what they say about additives.

These slices were just what I needed.

Sleep, enough medication and, yes, pizza, helped put paid to my anxiety and depressive mood in time for Wednesday, so I made it through the day with a run, full day of work, therapy, dinner and a movie (at home, though, I was pretty tired again!). And I ran again on Thursday and went into work (with cupcakes (see comment above. Not the healthiest week), had a (near) fight with a guy in IT who tried to order me around. (Note to all: this is never a good idea! Cue Jessica death stare con 5. That baby doesn’t usually emerge outside the classroom when year seven need to know to stop. To stop right now.) I had a series of good meetings (that’s because the team I work with are all so lovely) and then came home and rested again.

Mini oreo cookies. Small things come in beautiful 

(sometimes with gooey icing) packages

I have to try to take breaks even when my head is all over the place and when my body feels twitchy all over from the medication side effects or whatever else is going on. I don’t feel like doing it. I feel like stepping outside my body and outside my mind. How bad I feel changes from episode to episode, but this week I never reached the terrible place, not quite, because I was able to recognise enough in the calendar to see I really did have to stop frequently. Otherwise that terrible place might be here again. And it might come without my help, so I’ll do everything I can. And Forrest Gump’s mother was right about the box of chocolates, too, in case you’re wondering.

You said it Sally

It sounds so simple, take a break. (Have a KitKat. Oh, I don’t mind if I do!) If I’m honest, though, I’m just not good at taking breaks. I tell myself, go on, keep going, you can do it, just a bit more, just another hour, just another email, just another half a mile, just another phone call. All those “just anothers” add up to a whole lot of “too much” if I’m not careful.

Just another half a mile. Just another juice. Just another 'just'

On the flipside, I wrote an email to a good friend today where I expressed my frustrations at the things I can’t do:

“I remark on the things I still don’t do – like cooking for example – which I used to love and now find little energy left for after managing with work…”

Kind of ironic. I clearly haven't lost interest in food if this blog is anything to go by. But I reflect and I see that there are positives and negatives. Balance. It's about balance.

Details of this poem are here

I’ve said it before and I say it today: cognitive behavioural therapy is for me, in part, a constant process of trying to be more reflective and mindful of what I’m doing. It’s a double edged sword. I have to do this to get better; but doing it makes me feel terrible. If I can take joy in small things, I will. If I can notice that I got to the end of the day, feeling absolutely horrific, I still did get to the end of that day. (At this point I’d probably have buried my head in the duvet, into the pillow, having shut down the light in the room as much as I could, having cleaned all my makeup off, my mask, from my face, scrubbed my teeth so the mint taste distracts me, and having surrendered myself to bed and oblivion.)

Blurring into Oblivion

So here’s another end of the week. It was a great week for discussion on mental health. It was a terrible week for funding cuts. It was an alarming week for statistics on mental health and men’s suicide figures. It was a good week at work. It was an okay week for running. And it was a week. It was.

See you next week?

Exploring Accra

Oxford Street, Osu - quite quiet, for once, on a Sunday

Arriving back from Ethiopia, the temperature in Accra seemed even hotter than before, if that was even possible, and I spent most of the week in a jet-lagged haze. Waking up at 4.30 I would have about 2 hours' worth of buzzing energy...sadly not sustainable into work...and thus requiring a large quantity of caffeine, and then a larger quantity of sleep to get through each day.

This sleepiness and heat goes well with sitting around doing not very much, and this seems to be a favourite pastime. In the neighbourhood where we live, for example, there are security guards outside a few of the buildings. The walls around are high, with metal gates hiding the houses or offices for the most part, so it's hard to tell what's going on - if anything - behind. The guards, if they are indeed guards rather than men of ages ranging from between 20 to 60 just hanging out and playing cards, also seem engulfed in the sleepiness of the heat. It really is just too hot to move much. The greatest movements to be seen come from the occasional thrust of a playing card down in a winning move. Or the lizards, darting out from underneath a shrub and quickly skittering into hiding again across the grass.

A lizard out for a stroll

Only a few streets away the life of the city deafens every passer by. "The street is a roadway delineated on both sides by an open sewer. There are no sidewalks. Cars mingle with the crowds. Everything moves in concert - pedestrians, automobiles, bicycles, carts, cows and goats." So writes Kapuscinski describing Accra. In the late fifties and sixties. Apart from slightly fewer goats and cows to be seen, very little has changed as you walk down Oxford Street in Osu.

On Saturday afternoon Amanda and I venture out to explore Accra culture. We plan to visit the national museum and two galleries in the Asylum Down area of Accra, and take a taxi to the museum to get us over to that side of town. The museum is a two storey plastered building, where, if you wanted to perform Bikram yoga or take a free sauna, I can highly recommend as a place to spend some time. I have no photos of the inside of the museum, as it cost an extra two cedis for the privilege to take them, and apart from a few fragments of excavations and some samples of Ghanaian patterns there actually wasn't much to photograph. Oh, and my camera battery has run down, my 'universal charger' seems to be universally broken and my iphone isn't letting me download pictures to my PC. So no photos for this blog post - until I sort it out.

The most interesting part of the museum describes aspects of the slave trade, dating the history back to the first influx of travellers from Europe, and then more, Portuguese, Danes and English to name but three. Looking at the buildings where slaves were held, and also held before transportation out of Africa, I begin to understand that the castles and forts here in Accra, for example Osu castle, are remnants - and reminders - of this time.

Unfortunately the sleepiness of Accra appeared to have been infectious, and we missed out on both galleries as we were too late for one and the other was closed. We wandered through the main streets of Asylum Down towards the ringway road, instead looking at the exhibitions of local stallholders - very much awake and touting for business by the roadsides. You can buy anything by the road - eggs, bread, phone cards. We even spotted an enterprising young man selling massive, DJ-style headphones in among the plantain chip vendors. Everyone is out and about on Saturday travelling around in the tro-tro shared buses looking for a bargain or catching up.

We finished our walk at Champ's sports bar, evidently an ex-pat haven as we suddenly found ourselves watching Man U with a smattering of other white folks in this heavily air conditioned bar. The highlight of this day came following the match, though, when suddenly a silver haired woman approached our table, and asked, "Amanda and Jessica?". No, we're not wanted for any series of crimes here in Accra. Instead this turned out to be Brenda - better known in hash circles as Highland Fling - whom I had contacted by email the week before to figure out where the running (and beer) action was in Accra. "I thought, there are two white girls who look like they're new to town, so perhaps it could be Amanda and Jessica," Brenda tells us when she joins us for a drink. A retired teacher who has lived in Ghana for 38 years, Brenda is 'a character' alright.

Apparently Accra - which still has the open sewers mentioned above, by the way - is now 'too comfortable' as you can get everything. Plus the traffic is dreadful. Spending time with Brenda could be the best 'exhibition' of the day - we're learning about the culture, the people and the life with a beer to hand. Perfection.

We're off this weekend to join other hashers on a trip slightly up the coast to a beach-side hotel for more running, beer and talk with Brenda. I'm pretty sure she'll be featuring in posts to come!