“Sometimes it takes an overwhelming breakdown to have an undeniable breakthrough” Unknown
I think this quote reminds me of how mental health episodes can lead to important life changes and self-understanding. Perhaps my biggest breakthrough after my last episode was returning to lifestyle choices and a life balance that supported my own wellness. Right after an episode is a crucial time for wellness. For me, post-episode sleep, rest, and routine are incredibly important. As well, it is a time for developing a sense of internal and external safety while slowly challenging myself to re-enter community. Typically, in this time, I have experienced shame, internalized stigma, low self-esteem, and social anxiety as the mask hiding my mental illness crumbles, along with the things that I identify myself with (work, living independently, etc.)
My last episode in 2015, starting with the end of my psychosis, marked the beginning of recovery after my mental health stabilized. It was January 2016. I had returned after being in the hospital to Bamfield, BC where my mom was living. It was a relief to be somewhere rural, with the wild west coast ocean and the night sky filled with brilliant stars. I feel a great calm when I am close to the natural world.
I remember where I was when the voices had faded. They often end with a buzzing sounds like radio static (one of the many mysteries of mental illness). Finally, I was released from this constant chatter keeping me from being present in the world.
In general, the first thing that happens after I am out of psychosis is that I begin to sleep. Sometimes even 14 hours a night with some napping in the day. My brain needs a rest after months of being on high alert. Also, the sedation effects of the medications are increased as the body relaxes. It is crucial for this rest to happen in recovery. People struggle against rest because they want to get back to their life, including things like work, school, and regular waking hours. In my experience, catching up on deep rest, is what helps me heal.
In my last episode, I focused on eating well and exercising. I wanted to nourish my body after a period where I wasn’t eating enough. In psychosis my anxiety is so high I don’t want to eat (and sometimes I forget to eat). Healthy food is so important for the body to recover. Think of mania and psychosis as depleting the body (the body is stuck in an activated nervous system state for a prolonged period of time). Sleep and nourishing food help the body to recover after extreme stress.
Balanced exercise is also important. This means different things to different people. I think gentle and consistent exercise that is not depleting, such as walking and yoga, are great for recovery. We know that high intensity workouts, running, and other exertive exercise can cause stress on the body. This kind of exercise can also put someone back into mania so a person with bipolar needs to be cautious about intense exercise.
One psychological and emotional need after a psychotic episode is regaining a feeling of safety. It helped that I could recover at my mother’s place so that I wasn’t alone during this time. Nightmares and flashbacks occur so having a safe place to recover is important. In psychosis, I believed terrible things were happening. Because it feels real, the body responds as if I am experiencing all these things. After my episode, I experienced some PTSD symptoms, such as avoidance of situations that reminded me of psychosis, nightmares, and specific fears and phobias.
It is a vulnerable time because, like many people with mental illness, we feel like we have failed. We also feel like everyone is judging us because of our mental illness and it can be excruciating to socialize, especially if you already have social anxiety. It was hard for me to answer questions like “What brings you here?” or “What do you do?” I wasn’t ready to talk about my mental illness. Yet, I knew I had to keep pushing myself to interact with people so that my anxiety didn’t have the upper hand. In Bamfield, my mom had kind friends who were supportive of me. Mental illness touches the lives of many people, and many people want to help. It is important to remember this when we feel shame.
I continued this routine of sleep, eating well, and exercise for six months before I returned to my life in Victoria. It wasn’t easy to rebuild confidence. I had to face my anxieties. I also had to resume an independent life. My family, friends, and my lovely dogs were big resources for me. My daily walks continued, and I was mindful of keeping a life balance (at least for the first four years until the pandemic started and life presented many challenges).
My greatest hope is that people with lived experience of mental illness will see the value of this vulnerable time post-episode, and, instead of judging themselves, will take advantage of a slow rebuild to focuses on self-care.
There are a few considerations about creating wellness in the time after an episode that might be helpful to reflect on:
- Create a supportive wellness team
This would be a group of professionals and close supporters who offer different forms of help for your mental health. A psychiatrist can monitor your overall mental health and medications. A GP (or naturopath) can help you monitor other aspects of your health. A counsellor can help you with emotional and psychological aspects of your illness. Nonprofit mental health agencies offer counselling, peer support, and wellness groups either free of charge or an affordable sliding scale. If you have access to a holistic health provider, physiotherapist, or massage therapist you can get support with nutrition, pain or stress-related ailments, nutritional imbalances, supplementation and a whole host of other things. Unfortunately, these services can be expensive. There is a lot of information on health on YouTube but you have to do the research to know if a specific treatment will work for you.
- Monitor for medication side effects
Usually in an episode, especially when hospitalized, you are given high doses of medication. This may be necessary to get you stable and keep you stable for awhile. The caution is that over time you may experience difficult, even life-threatening side effects. I always think about working towards the lowest dose that is still effective. Stability is the first part of recovery from severe mental illness. When the illness is stable, adjusting medications can be an important part of keeping well. As I have talked about in previous posts, the last five years I have been dealing with side effects from high doses of medications. I am currently working with my psychiatric doctor to lower meds. It is a slow process to keep my mental health steady while my body adjusts and experiences withdrawal. That is why all the other components of recovery are so important. Just a reminder that it can be dangerous to go off your medications quickly and without supervision and can increase your chance of another episode. I have experienced this when I was younger and went off medications quickly to lose weight.
- Learn what a balanced life means to you
I can’t emphasize enough how important it is to create a life that doesn’t have chronic high stress for recovery of mental illness. This may mean that life looks differently for you than your peers who do not have a mental illness. Maybe you work less, to spend more time working on wellness. Drinking and using drugs are not recommended when you have a major mental illness because they can make mental illness more difficult to treat. It is important to reconcile your feelings about adjusting your life to living with a mental illness. Sleep and nutrition are so important as well that you may not be able to do things like shift work. I have gone down the path of living as if I didn’t have a mental illness. Looking back, I see how this created a hard road for me. I would suggest listening to your body and letting go of what is not good for your mental health. Of course, this takes trial and error and being gentle on yourself.
Other people with lived experience may disagree with me on this point. They might argue that recovery means doing everything a person without a mental illness can do. Some people believe they can recover so that they no longer have a mental illness. You must recovery find a path that works for you. Like previous posts, an examination of values can help direct what your treatment/healing look like.
- Some days will be harder than others
Recovery isn’t a straight line of wellness. There will be hard days. It is important to remember that this is normal. Be gentle on yourself. Give yourself some love after a hard day. Find healthy, nurturing activities that relax you. During that initial post-episode time, I journalled a lot. It was very grounding to connect with myself. Explore your creativity during the post-episode time and see how it can help you heal.
Okay, are you ready to dive into making art?🎨
Therapeutic Arts Activity
Create two collages that explore how you feel in an episode and in the first 6 months after an episode.
Instructions
In your first collage, find symbols, colours and words that represent how you feel in an episode. In your second collage, do the same but representing how you feel in the initial post-episode phase.
Materials Needed
- Mixed media or coloured construction paper
- Photos, printed images or drawings
- Cut out or printed words or phrases
- Glue
- Scissors
Once you’ve completed this activity, here are some questions as guidelines for your personal explorations:
1. Reflect on your last episode, what did recovery look like in the first six months? What images and colours represent this time?
2. What did you learn about what helps you get well?
3. What wellness practices do you still do? How have they changed?
4. Are there areas of your recovery that you still need to strengthen?
When I worked on this activity, I started with some images in mind. What I was startled by as I created my first collage was the hidden unintentional symbols and layers of meaning that I saw as I reflected on my image. I am going to sit with it awhile. A therapeutic art session will often reveal insights, and emotions that you don’t anticipate.
Leaning in to rest in the initial phase after an episode is so helpful for recovery. It is my hope that those with lived experience of mental illness will experience less crisis, earlier stabilization, and enjoy good mental health in their recovery journey.
❤️❤️❤️ With care and kindness, Meegan
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