Thursday, 2 January 2014

Recovering from Nervous Breakdown

It's a New Year. And with it renewed Hope. Hope that I can recover. Hope that I can lead a normal, productive life that allows me to contribute to those that I love and to society at large. Hope that I can finally walk permanently out of the darkness that swallowed me and into a life that is satisfying and contented.

So just for today, let's talk about recovering from nervous breakdown, and the hope that we must grasp tightly onto  in order to accelerate that recovery.

Based on what I have experienced, and what I continue to battle, recovering from nervous breakdown is no easy task. It requires a great deal of work. It is a search for wellness punctuated by slippery periods of darkness, emotional turmoil and hopelessness. But based on my experience, and despite the frequent reappearance of many symptoms, recovery is possible.

I write this because despite discussions with a number of therapists and mental health practitioners, no one has ever handed me a 'list' of do's and don'ts: of what I should do to help my recovery. Instead, I had to collect these steps in bits and pieces. Creating them as I have here helps me to formalize what I have learned to date. Mind you, it's all a work in progress, just as is my recovery. I hope the following is of some help.

Actions to Recover from Nervous Breakdown

1. Regaining Hope: I put this at the top of the list because in my experience it is the most critical part of recovery, and unfortunately - and at least for me - one of the most difficult to achieve. My breakdown left me as a shell of what I had been before. My confidence was replaced by fear, shame, and self-loathing. Trust in myself and others was replaced by uncertainty. My definition of self had been fundamentally altered. Before, I thought myself to be a reasonably good husband and father; a successful writer and business person; a person others could count on in times of trouble. But following the breakdown, I was only filled with feelings of failure. 'Hope' for a future - any future at all - had vanished completely.

Yet hope is what motivates me to get up in the morning. Without hope - for love, for family and friendship, for a modicum of financial security, for contentment with oneself, for a productive future - the world seems a a dark hole within which I have no place or sense of belonging.

When all hope is lost due to mental illness, regaining a sense of purpose seems at times almost impossible. But we can all take actions to nurture hope within us.

Here's what I did to do just that.

2. Therapy: ongoing professional therapy, with a highly qualified specialist in trauma counseling, is at the fulcrum of my recovery. I see this woman every two weeks (I would see her more often if I could afford it) and have done so for almost two years. She creates a safe space for me in which I can share anything that is on my mind. She is not judgmental. She is supportive and caring. She has taught me a variety of simple-to-learn tools to help me cope with periods of anxiety and depression, including breathing and visualization exercises. She offers me ongoing encouragement. She continues to help me to dig down into the causes of my breakdown (which for me are important to understand so that I can avoid another one) and to resolve those issues. She suggests a number of activities (see below) and motives me to action those. She pushes me when I need it, and lets me off the hook if I need a quiet time for reflection. Our sessions are a great deal of work - during and after our hour together - and often unsettling as I confront myself, my past, and my actions and behavior. However, I know that her continued counselling is vital for my very survival, and also know that I'll be relying on her for many months to come.

3. Socializing: during my breakdown and driven by fear, my only real desire was to isolate myself. Yet isolation from others - from the joy of simple companionship - leads to further distress. Loneliness is no cure for breakdown. Rather, it only makes things worse. My counselor encouraged me to take part in a social activity. In my case, she believed it was more important to do so because I live on my own. Following her advice, I joined a local choir. We sing together twice a week. Singing has always made me feel good about myself, and working with the choir members can fill me with joy. Recovery requires socialization. If you're suffering from nervous breakdown, make certain that you do not isolate yourself. Instead, get involved with others even if every fiber of your being tells you not to.

4. Alanon and Sharing: I also joined Alanon (the support organization that works with relatives and friends of alcoholics). I qualify because my mother, now passed on, was an alcoholic. I meet with a handful of other people once a week. During these sessions I can share how I am feeling and any emotional turmoil I am experiencing in complete confidentiality. I am not here to promote Alanon or any other Twelve Step program. All I can tell you is that for me it works, and is having a positive impact on my recovery. I also suspect that the process of 'group therapy through sharing' not only enables me to decompress, but also provides personal fulfillment because by sharing my experiences I am also helping others. While you may not quality for Alanon or a similar program, I do suggest some sort of 'group sharing' process. Google 'Mental Illness 12 Step Programs' for possible options.

If you do not quality - or simply don't want to take part in such a program, I only suggest that you find someone you trust to talk to. A friend or relative can offer you a release valve for your emotions. They might also provide insight into how you really are (and I find that I can be terrible at  really knowing how I'm doing until someone sees me - and tells me) and offer suggestions. But don't be discouraged if you are unable to find the 'right' person. Remember that most non-professionals simply don't understand mental illness and nervous breakdowns. If they are unable to appreciate your situation, or if they 'scoff' at your desire to find help, fire them and locate someone else who is more helpful and sympathetic.

5. Work and Routine: work has defined me for years. Yet I am currently not working a whole lot for two reasons a) I am emotionally unable to work as much as I had before the breakdown and b) there simply isn't a whole lot of work out there in this Recession-plagued economy. Nevertheless, I make sure that I work. I work a minimum of 4 hours a day either at paid-for business writing (when I have some to do), or on new creative projects, or on this blog. When I work I try to be as disciplined as I was in the past. When I finish something, and if I'm proud of what I've written, it makes me feel rather good about my day and myself.

I also try to plan my day. We all need something of a routine to make life work...simple mileage markers that set out our day. But due to the aftermath of the breakdown, some days are still horrible. I'll get depressed. I won't have the energy, the motivation, or the will to complete simple tasks like walking across the street for a quart of milk. Eating becomes difficult because I don't want to prepare anything. Cleaning the house, doing laundry, making the bed...all of it sometimes seems overwhelming. At times all I want to do is smoke a cigarette and stare out the window.

And yet. I know that if I get off my butt and complete a task - any task - I'll feel better for doing so. I've learned to congratulate myself when I do something. Did I make dinner? Good man! Did I take out the garbage or vacuum? Wonderful! Did I drive into town to buy groceries? That's super because I not only made the drive there and back in one piece, but also had to plan, buy, and put away groceries. Good for me!

Routines that I used to take for granted are now unpleasant activities that can sometimes seem well beyond my abilities. And yet I know that if I make myself do them - one thing at a time - I'll get through the day in one piece, and experience just a bit of normalcy. And 'normalcy', that wonderful but often elusive feeling of self-belief and fulfillment when accomplishing even the most simple of tasks - is what I am trying sometimes desperately to capture. 

6. Exercise: I try to get as much as I can because exercise stimulates endorphins and makes me feel better about myself. I try to walk a few miles every week. I practice Yoga every day (most of the time anyway). In good weather, I work in the backyard. Frankly, I hate doing this stuff. But the reward is pretty terrific. I might be having a bad day. I'll exercise and immediately feel better. So what the heck and why not? 

7. Eating / Drinking: the old axiom 'moderation in all things' works very well when I bother to put it into practice. If I eat well, I certainly feel better about myself. If I drink moderately, I also benefit. I never (okay, almost never) drink to excess. The couple of times I did so taught me a lesson: I became anxious and depressed. So while I do enjoy a drink, I've put a stiff limit on the amount I'll imbibe. 

8. Sleep and Naps: I try to get a good 8 hours a night. Some nights are still troubled by nightmares or days-long periods of sleeplessness. I've learned to nap and try to take a siesta most days. I've learned: if I'm having a bad day or feel hopeless or crazy, an hour's sleep lets me wake refreshed and not feeling quite as bad. In other words: if I feel like taking a nap I no longer beat myself up for being lazy.

9. Quieting the Internal Voices: I don't know about you, but I'll often talk silently to myself. And that little voice inside my head will often be full of ill will. It will berate me and what I've gone through. It will beat me up for my past behavior and the consequences that I and my family have suffered due to the breakdown. It will make my life a misery. When that bad tempered voice fills my head as it does so often it can wreck my day and my life. Quieting it is very, very hard to do. I've learned to gently 'blow' those thoughts from my head. That is, I visualize a nasty self-loathing thought as a dark cloud.. I then blow- and keep on blowing until it disappears over the far horizon. As I say, it's hard to do and there are days - nay, weeks! - when I'm not successful. But I also know that if I am to recover fully, and have a renewed sense of hope, I have to rid myself of these internal critics who have nothing good to say about me.  Too, during Yoga I'll try a simple mantra. Rather than hearing that voice shrill "You're a bad man!", I'll instead replace it with "You're a good man."  In short, I do my best to stifle those voices in order to gain some inner peace.

10. Drugs: Yes, I took Lexipro for a few months to help me combat depression and did so on the advice of my therapist and GP. Frankly, I didn't like the drugs at all. They resulted in a number of physical side-effects that I found to be unpleasant, although not debilitating. For this reason, I've decided that I will never again take such drugs. I prefer to conduct the battle without the aid of medication. But that's me and my opinion. As my therapist says, drugs are a short-term bridge that help us to get from one side of the breakdown to the other. If you're asked to take them, consider it. But my only advice is to conduct some research first. Avoid protracted use. If you're concerned, contact another medical practitioner for other opinions.

11. Spirituality: I am NOT here to espouse a particular view on religion or spirituality. I'm no theologian or minister. Frankly, I find such bombast to be unhelpful if not downright damaging. Recently, for instance, I found a website on mental health. It's only suggestion on recovering from nervous breakdown was to find Jesus. The remark left me cold. What if I happen to be Jewish or Muslim or atheist? Then what?

I will say, however, that spirituality and a sense of the religious have formed another - at times wobbly - leg of my recovery. I like to think that someone, somewhere - someone who is much bigger and more powerful and more caring than me - knows what they're doing. I pray. I ask for help. I ask that those I love are also protected and helped. I don't expect a miracle. I don't anticipate my bedroom to be filled with rapturous light. But sharing in this way with a power larger and more loving than me gives me hope.

12. Toward a New Definition of Self and Self-Discipline: Though my breakdown occurred over three years ago, I know that my recovery is only starting, and will be a lifetime journey. I still suffer from nightmares, occasional sleeplessness, an inability to properly focus on tasks at hand at times, and prolonged periods of depression and anxiety that leave me in darkness. During those dark times I want my life to end. I see no hope for a future. I let the voices take over; the ones that tell me that I'm a failure; that I hurt people that I cared for; that I am useless to myself and those that I love. Those times are torture.

But slowly, ever so slowly, things are getting better. The nightmares and periods of sleeplessness don't occur as often. The tools that I've learned, when I remember to use them, can silence those voices. I am learning to be patient with myself, knowing that recovery takes its time and that I will slip now and again. And probably most importantly, I know that I have much more work to do.

I know that I must redefine who I am. What is important to me. What my future holds and what I want and need. I know that I must be honest with myself to do this, which is difficult for me to do. I know that during dark times or times when I can't work, I must avoid beating myself up but instead let my body - and mind - rest. I know that I must remember to put into action what I've written above - a sort of Program of Self-Help. I need to do that because recovery is also about self-responsibility. No one is going to make me recover. Instead, I must choose to recover. If I don't, I have a good chance of either re-experiencing another breakdown which could possibly be far worse than the first one, or be institutionalized. I'll pass on those two options, thank you very much.

It comes down, I think, to self-discipline. Of learning to control my mind and heart to some extent, in hopes of protecting and nurturing myself. But self-discipline is also about freedom: of letting myself recognize that I am free again to be what I want to be and that despite what I (and countless others) have endured, my life will be what I make of it. I may have experienced a profound illness, but now I am learning the tools that give me renewed hope for a fulfilling future.

At the end of the day it's a simple choice for me. I can either recover or I can die. I choose to recover. I hope you do too.

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