A work in progress…

I have started a longer post about relapses, flare-ups and setbacks. But due to the flare-up/set back I’ve been having I couldn’t make progress on it in the way I had intended. 

My idea was to write about flare-ups and setbacks as I worked through my own. I thought I’d go over the resources and information I’ve collected and I’d use my own experience as an example. If I did this I thought, I’d benefit twice. Firstly, revisiting the information would help me with my own recovery. Secondly, I could write a blog post to share the information and also have it handy for the next time. It was a really nice idea. 

But of course, it didn’t work out like that. 

I could have written the post perhaps if I wasn’t in the middle of a setback. It was obvious it wasn’t going to work after a couple of days. First of all, I didn’t start improving straight away. I’d imagined there would be a steady progression. First I’d start feeling a little better and doing a tiny bit more. Then I’d keep improving gradually until I was back to exactly how I’d been before the setbacks. In my mind, I could picture this happening smoothly over the course of a week. 

In reality, I got worse to start with. I caught a cold, my mood was low and I began to show signs of depression. Then the clocks went back and the weather turned really miserable. The fibromyalgia flare-up continued to get worse because I’d not been able to move about as much or do my exercises diligently. This has affected my sleep… which makes me feel worse… and it’s harder to do things… and so the spiral goes on.

The only part of my plan I’ve implemented is setting myself one thing to do each day, whether I felt like it or not. Each thing is something that I mattered to me and that seemed possible on that day. Then I’d treat the rest of the day as free time. 

Examples:

  • Clean my teeth
  • Make a phone call
  • Walk to the allotment
  • Send an urgent email
  • Wash my hair
  • Leave the house
  • Go to yoga

I’ve had some success with this and my mood has improved a bit. My daily routine and good habits have all slipped. I think what I need now is a bit more structure to help me have a better sense of progress. I’ve decided I’m going to use the CBT technique called behavioural activation. I first came across behavioural activation when I was seeing a counsellor. It’s a technique to help you start again with the things you have stopped doing. The worksheets I’ve used are designed to help with depression but I’ve found it useful with setbacks and flare-ups whether I am depressed or not. 

When someone is depressed it is not unusual for them to stop doing things they would normally do, and to stop taking pleasure in things. This can create a vicious circle. Because things aren’t being done it’s impossible to feel any sense of accomplishment and easy to feel stressed or guilty about the undone tasks. This makes depression worse. This is what I’m experiencing at the moment. I’ve decided to use a behaviour activation worksheet rather than setting goals in my head or making a to-do list because it is hard to keep ideas in my head at the moment. I am very apathetic from the low mood. Migraine and a cold have made me more tired and foggy than usual. If I use a worksheet or workbook I can follow the instructions and I’ll need less brain-power or motivation. 

My behavioural activation plan:

List some routine activities:

  • Tidying up 
  • Yoga in the evening 
  • Watering the houseplants 
  • Washing up

List some pleasurable activities:

  • Writing my blog 
  • Text friends 
  • Going to the allotment 

List some necessary activities

  • Arrange a new prescription 
  • Get a quote 

When I ranked my list (see below) it became obvious my list is really unbalanced. I’ll work on it again tomorrow and add some more activities to each category so I’ve got plenty to choose from. Then I’ll make a schedule, probably the following day. I’ll am prepared to be flexible. I might need to swap out activities depending on my symptoms at the time. This isn’t easy and I may ask friends for support. If my mood continues I’ll contact Self-Help Services or the NHS for professional support. 

Easy activities:

  • Routine: 
  • Tidying up
  • Pleasurable: 
  • Text friends

Medium activities:

  • Routine: 
  • Yoga in the evening
  • Watering the houseplants
  • Washing up

Hard activities:

  • Pleasurable:
  • Writing my blog
  • Going to my allotment
  • Necessary:
  • Arrange a new prescription
  • Get some quotes

Resources & Sources

Worksheets & workbooks

https://www.get.gg/docs/BehaviouralActivation.pdf

https://www.talkplus.org.uk/downloads_folder/Behavioural_Activation.pdf

Explanation of behavioural activation

https://www.verywellmind.com/increasing-the-effectiveness-of-behavioral-activation-2797597 (Media Bias Fact Check rate VeryWell as pro-science and its factual reporting is rated as very high.)

Explanations of CBT

https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/ (The National Health Service provides science and evidence-based information for patients)

https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/#.XcQz-Ff7SUk https://www.mind.org.uk/about-us/our-information/ (MIND is a mental health charity in the UK. Its information has been certified by the Information Standard)

2 thoughts on “A work in progress…

  1. Looks like a really good plan. I am glad you are able to use some techniques you learned in counselling to give you some structure. I can definitely relate to the depressive cycle of not getting things done, feeling like a slob, feeling bad about yourself, and then continuing not to do anything because your headspace is already so negative and down so why bother. Something that has been helping me lately has been to assign a why to each of my tasks, even if it’s only a label of an area of my life. For instance, I’ll tag “Relationships” on a task like “Reply to pen pal.” This has been something I frequently put off, but one of my goals is to build and strengthen my relationships so seeing that bright yellow tag helps me see the bigger picture behind this small step. Other tags are: health, mind, Colin, Leo, home, projects, etc. I also have been adding an estimated time to task which helps a lot. Something like “Call grandparents” is a task that will stick around on my list for a long time because I just think it will take forever and I will have to listen to them yak on and on and I would rather do other things. But really, I could just set a timer for 30 minutes and catch up, and then say I have to go when the timer rings. I know from pomming that I can do anything seemingly scary for just 30 minutes. I also heard a good tip is to estimate how long you think a task will take you, and then try to beat that time as a little light competition with yourself – with no penalty for losing of course. It’s a nice feeling if you beat the time, and you learn something in the process.

    I am sure you have heard these tips before, but they’ve been motivating me lately, so I thought I would share 😀

    Nice resources and sources section!

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