Self-help – At work

Always try to avoid sitting at your desk for meal breaks and coffee. Go and mix with other people, or just get some fresh air and private space somewhere.

 

  • Let people know that you’re not 100% at the moment. Confide in someone; get someone on your side. Can any part of your work be eased, put on the back burner for the time being?
  • When you are feeling depressed, you may find that you can’t manage your usual amount of mental work, but you probably can do more physical activities instead (even if you don’t really want too much).
  • Try to put off the more challenging, intellectual work until you are feeling better.
  • Don’t tackle difficult tasks when you are down. Avoid major work or personal decisions.
  • Delegate, shelve, or pass on as much responsibility as you can, tries to concentrate on the routine – which can be surprisingly soothing and much more easily achievable.
  • Use time management tactics. Pace yourself, divide your work into smaller chunks, and work at a steady pace.
  • Don’t rush, take it piece by piece.
  • Prioritise your tasks, and be prepared to abandon some of your lower priorities – or shelve some of your more overwhelming tasks.
  • If you find that you are a procrastinator, start by getting one thing done at a time.

 

Make a list of things you need to do and divide them up into:

 

  • Do it now, i.e. today’s jobs (keep this list short)
  • Do it later, and put these in your diary
  • Get someone else to do it (if you can)
  • Bin it (and be ruthless).
  • Beware ‘displacement activity’, for example making yourself frightfully busy with something unimportant.
  • Cross the things that you’ve achieved off the list, but check through them occasionally.
  • Give yourself a pat on the back about the ones you’ve done. This works at home or at work.
  • If you have an Occupational Health Department, let them know if you are not well. They are an independent source of advice and may be able to help make adjustments to your workplace to reduce the pressure until things improve.
  • Look forward to a target to get through the week, e.g. going out to eat with friends on a Friday night.
  • Be realistic. Don’t demand too much from yourself or set yourself impossible tasks that you are not going to manage, as they will only increase feelings of failure and hopelessness.
  • Make time for yourself in your working day.
  • Don’t be a perfectionist. Settle for ‘good enough’ just for the time being. Setting too high a target is very annihilating!

 

With other people

 

  • Being with other people is better than being on your own.
  • Pay someone a compliment unexpectedly.
  • Phone friends for a chat.
  • Confront your fears. If you’re avoiding something, perhaps feeling guilty about it, ask a friend to help see you through it, or think of something else you want to do even less, and do the first thing instead! (You have to creep up on your fears sometimes.)
  • Do something for someone else. Find out about voluntary work. It can help you start to think more about other people and focus rather less about yourself. There’s always someone who is in a worse situation than you. Putting something back in for someone else always helps.
  • Ignore well-meaning advice to ‘pull yourself together’.
  • Depression is an illness, and recovery usually requires antidepressant therapy and/or psychotherapy. You cannot make yourself ‘snap out’ of depression any more than you can ignore appendicitis, but you can decide to tackle it, to deal with it, and to get help to sort it out.
  • Don’t neglect your social life. Keep in touch with friends, as they can recharge your batteries too. A brief postcard to tell someone that you are thinking of them can be a delight to receive, and may be easier to do. Speaking on the telephone can be difficult when you are depressed.

 

 At night

 

  • Sleep is vital and the best remedy.
  • Don’t wind yourself up at night with too much late TV.
  • Get off the computer. The light from the screen will alert you and may interfere with sleep.
  • Watch the sunset, the moon, the stars, or the sunrise.

 

Self-help

 

  • Don’t lie in bed all day. The more you feel like staying in bed, the more you should resist it. Your body needs to be physically active to keep your body clock and natural body rhythms running. The more you lie in bed the less you’ll get done. If you feel too tired to stand up, get out of bed and stagger into a warm bath straight away. This will gently get you going and help you get started on the day ahead. Depression reduces your drive, but bewares the vicious circle of staying in bed and then feeling guilty about being slothful. This just makes depression worse. Depression is often worse in the mornings – but it does not ease by staying in bed. You need to be up, and distracted from your thoughts.
  • Try to keep your body clock running at the right time-don’t turn night into day.
  • If you are going through a bad patch of early morning waking (perhaps at 3-4 am) and cannot get back to sleep, get up and let your mind occupy itself with something other than fretting over your worries. Don’t lie there worrying about not sleeping. Read, write a letter, have a warm drink (but no caffeine or alcohol), tidy up your desk. Putting things into place physically may help your mind wind down and stop it bothering the rest of you. Although losing some sleep temporarily is unpleasant, you won’t become ill because of it.
  • Do not accept negative thoughts. Identify them and resist them. They are a very insidious part of depression. These irrational, unpleasant thoughts will disappear when your treatment kicks in. Recognise these thoughts for what they are and think up some distractions from them. Everyone has horrid thoughts at some time and these get exaggerated when your defences are down. If negative thoughts start to include thinking that things would be better if you were dead and you start to think about self-harm or suicide a lot, tell your doctor.
  • Suicide is irreversible – don’t act on your unrealistically hopeless thoughts. Treatment makes these thoughts, ideas and impulses go away. Feeling that nothing helps and that things are hopeless is part of the illness. Try to separate the real you from these irrational thoughts. They will then bother you less.
  • Use earplugs if your bedroom is noisy.
  • Eat early, so that your digestion has settled down before you go to bed.
  • Avoid late caffeine or alcohol. Alcohol isn’t a good sleeping draught as you tend to wake up when it wears off at 2–3 in the morning, with a hangover and needing to spend a penny.
  • Hot milky drinks seem to help.
  • Make sure that your bedroom is quiet and comfortable, not too hot and stuffy, nor too cold.
  • Have a consistent routine of going to bed at the same time, not too late, and read or listen to the radio to settle you down.
  • Don’t get overtired. A bit of fresh air and an evening walk can relax your tired muscles.
  • Avoid daytime naps if you are not sleeping well at night. If you do need a nap, do this after lunch and put the alarm clock on for, say, 11⁄2 hours later.
  • Treat yourself to nice fresh pyjamas and sheets. Is your bed comfortable?
  • Music playing in the background can be a pleasant distraction from bothersome intrusive thoughts when you are settling down at night.
  • Try learning a simple relaxing exercise. Try to regularize your breathing to be slower and deeper while you think of a favourite place – visualise the scene and enjoy it. Yoga classes teach this method.

 

Self-help tactics for early signs of mania

 

  • Signs of going high or hypomanic may include the following:
  • Broken sleep
  • Early waking
  • Overactivity with lots of grandiose ideas and plans
  • Reduced concentration
  • Selfishness, loss of usual consideration for others
  • Impatience and irritability
  • Loads of energy
  • Increased spending
  • Unwise or indiscreet decisions
  • Rapid speech
  • Loss of usual inhibitions, with promiscuity or increase in alcohol use.

 

The excitement of mania feeds on itself and leads to an increasingly hectic mood spiral, progressively detaching you from life’s realities. So, to calm yourself down:

 

  • General
  • Switch off from any major decisions, life plans or big purchases. Try to wait until you are more settled.
  • Actively reduce your work commitments; leave the crucial stuff for another time.
  • Plan out your day to avoid rushing.
  • Aim to achieve the bare minimum.
  • Be particularly careful when driving, especially if you are on any medication.
  • Be particularly careful not to be tactless with friends and relatives – you will need them later.
  • Switch from caffeine-containing drinks to herbal teas.
  • Don’t use alcohol as a stimulant, and avoid street drugs totally.
  • Don’t stay up watching the late TV shows; they’ll wind you up more.
  • Switch off the computer in the evening; don’t get excited by surfing the net at night.
  • Discuss any medication that you are taking with your doctor; some can induce mania.
  • Discuss using a suitable tranquilliser with your doctor.
  • Drugs such as haloperidol or chlorpromazine are often helpful, and you may need only a small dose for some days, if you act quickly enough.
  • Avoid late parties, or exciting outings.
  • Get your feet back on the ground; remind yourself that you are at risk of getting yourself into trouble at the moment that you will later have to clear up.
  • Concentrate your thoughts, not on your latest exciting schemes but on boring matter of fact things. Sorting out bills and housework can be good ways of bringing yourself down to earth.
  • Slow down. Walk, talk, and think more slowly.
  • If you are getting grandiose fantasies about yourself, deflate these by repeatedly saying, ‘I’m just Joe Bloggs’ or ‘It’s only me really; I’m not Superman or Superwoman.’
  • Try and ask for help early. Mood can rapidly become less manageable – later on you may be too ill to recognise it.

 

Sort out your sleep

 

  • People with bipolar disorder are especially vulnerable when sleep-deprived.
  • Get plenty of exercise in the day to relax yourself.
  • Be prepared to use some night medication, herbal or prescribed, for short periods.
  • If you do wake early full of ideas, don’t get up but stay put, and plan how to reduce the pressure in the day ahead.

 

Apart from mood stabilising drugs how can I help myself stay level? Is there anything I can do to manage myself better?

Moods don’t usually go out of control overnight. You usually have some warning of a mood swing, but being aware of your current mood level is not always easy. Quite often you don’t realise you are irritable until after you’ve snapped at someone. Learning to recognise your own early warning signals of a downswing into depression or an upswing into hypomania can give you the chance to catch it early and prevent things going very wrong.

If you can easily recognise signs of trouble, one approach is to ask your doctor for a small supply of medication to use at the earliest sign of trouble. This can be both reassuring (you have the means to help yourself rapidly) and very effective.