Keeping a lid on it

If I stand still for just a minute and take stock of my situation, I am baffled as to how I keep it together sometimes. I don't know whether its because I am stubborn, courageous or just plain stupid, but I keep plugging away even when an episode of doom lurks over the horizon. I have a vision in my head, and it doesn't include not being able to work, going to hospital, needing additional help to look after myself or abandoning my current life as I know it. This may well be misjudged or unrealistic but it is how I am currently managing my life.

I think I see my illness as the enemy. If you make friends with it you keep it close and always have one eye on it. Its a constant power struggle, where I perpetually realign myself with what comes on any particular day. I have to give myself little milestones as markers to see if I am on top of the game. The hardest thing I think, is trying not to state out loud the whole time, "I am finding everything difficult. Please give me 5 minutes to chill out and catch up."  The irony in this is when I am hyper manic, I feel like shouting, "Catch up for goodness sake! You're all going to slow". Balance and mundanity are not something I am familiar with.

So my day goes a little bit like this:

• Get up and check mood - get out of bed regardless
• Eat breakfast and try not to become overwhelmed with toddler chaos
• Practice laughing at my intrusive thoughts whilst making breakfast and cups of coffee
• Deliver children to nursery whilst being assertive but loving
• Drive to work, ignoring  internal dialogue which usually revolves around "I'm not good at my job, my boss regrets employing me, I must try harder" etc. Actively sing along to the radio to quiet mind noise
• Get into work and choose to be upbeat and engage with people, ignoring negativity and focusing on the positives
• Plan work around times when I am productive and energy levels are good
• Take a proper lunch break even though the office culture tends to promote a lunchless day and try really hard not to spend money compulsively on a load of rubbish whilst out and about
• Attend meetings and work really hard at externalising i.e: Count the windows, recite words from the page, actively listen if zoning out, disregard nasty high level managers attitude and practice taking reality snap shot (getting stuck in my head ruminating is not good for me)
• Have a caffeine break at 2-3 as my energy and mood dip at this time
• Finish off tasks if possible, but leave work if necessary (This is difficult as I am a conscientious worker and a perfectionist). Accept any constructive criticism and focus on accomplishments of the day
• Drive home without rerunning the whole day over and over again in my mind, and picking on the things I think I have done wrong
• Collect children and ensure positive praise and physical affection, even though I feel like curling up under my quilt for 3 hours first
• Arrive home and do some housework, including chemicals, knives, hot water and the like (More exposure therapy) and force myself to be loving and gentle because really I want to have a rant - my mood does not dictate my behaviour
• Put kids to bed, eat a meal and finally sit down
• Go to bed at my regular time, taking medication and respecting the sleep hygiene rules

Exhauting, isn't it.

Now this is my day in a very basic format, but what I am trying to show is that I have to work throughout the day to ensure I stay on top of my depression and symptoms. I also have to listen to my mind and body if things start to go off kilter. Now that is the really hard bit because most people have bad days, mood dips, react badly, make mistakes and get narked if someone tells them off. But at least I am living and not existing. I am not letting the beast drag me down. Oh yes, and actually I find out from my colleagues that the individuals I struggle with, the ones who are really horrid to be around, are actually resented and disliked by everyone else. Well thank god for that. I am not alone.

So where were we with the self esteem group?

I'm wearing my guts on the outside

When you have to be blisteringly honest about yourself in a room full of people, it really brings home to you how fragile and vulnerable you feel. After our first session I experience the emotional hangover from hell, and want to cry the whole time. It's like I've been filled up with cement and can't think straight I am wearing a suit with my guts on the outside all raw and exposed. I think that everyone can see my crippled soul.  Immediately I feel resistant to the change, and I can sense my inner voice telling me to run away. I'm caught between a rock and a hard place. I have to go through the pain otherwise I will always have low self esteem and this will exacerbate my depression. I 've got to put myself through this for another 9 weeks. Its going to be grueling. If I don't do it I'll stay in that horrid place of feeling bad about myself the whole time. I've got to grin and bear it as I desperately want to be well. I tell you this now, ignorance is bliss.

Starting any sort of recovery is like taking the lid off of Pandora's box. Once its off you cannot put it back on, and although you know the gratification of wellness and inner peace is only a CBT course away, its like chewing razor blades. When the first session is over, no one can make eye contact and we almost crawl on our knees back to the car park.

I try to pull on my behavioural activation techniques to stop my mood being contaminated, and attempt to do some basic things that involve activity and concentration. It's a disaster and I go home to my bed and a family bag of revels. Next time I need to prepare myself and really dig in, armour up with my hard bitch outfit and begin anew. It dawns on me why they get you to do the CBT course "Over coming depression and learning behavioural activation" first. If you don't have those little strategies you would want to go home and possibly do something silly! I get a distinct feeling that a few people are going to drop out of this course.

Oh yes, and during this I'm tying to hold down a really grown up job and introduce the new more assertive, esteem filled me to my well balanced and unsuspecting colleagues, god bless them! What a nightmare!

Identifying my low self esteem

What is really hideous is the fact that my self esteem is massively better than it ever was. Over the past 12 years I have worked hard at improving how I feel about myself and where I fit in the world. I try to be kind to myself and work hard at not letting other people treat me badly. Most people see me as confident, assertive and friendly. What they don't realise is that it takes loads of practice and its not actually how I feel.If you could read the mantra of my heart, you would see a different me.

The people that I know who suffer with low self esteem don't want to be that way. Its not false pride or martyrdom, but a genuine sense of just not being good enough. Its horrible really and fills you with a distrust of people and constantly attacks your confidence. You question yourself  and your abilities unceasingly, and its exhausting and demoralising. Here are some typical thoughts I have had about myself :

I'm just not good enough
People don't really like me, they just say that to be polite
I'm a crap parent
I am ugly and truly unlovable
People don't really love me, they say that to placate me
Everyone else is better than me
If I try harder maybe I'll be average

Now I could go on, but its not the best, looking at yourself in type and seeing how shite you feel about yourself. The thing is with low self esteem is that you create little rules for living that you hope in your heart, will stop the dreaded feeling happening. I am a perfectionist. I avoid conflict. I will constantly put myself down with self deprecating humour, but what it hides is a genuine dislike or lack of acceptance of self and stops you getting in there first. I'm a sad little git really, but lay off the pity as I'm taking a big bus ride away from the dammed internal dialogue, sprinting joyfully to the fields of glee where imperfection, failure and doing things half arsed is acceptable .

If  I now take a snap shot of my disordered and colourful life, the way I am put together is a bit like a ragdoll. I'm a mish-mash of bits, but although I'm a bit duff, I'm interesting to look at, good to cuddle and play with and a bit more unique than a cabbage patch doll. Yes, that means you normal people with your autonomy and moulded joints and matching outfits! Actually, that is just my perception. You know the one in which I see all the women who drop their kids off at school  as alpha parents who do absolutely everything right and are perfect. I am soon to learn that this is something that I do - its called wrong thinking. I generalise about situations, I filter what I hear, I categorise everything as black or white and I am hideously self punishing. I would LOVE to take a day off from being me - I really would.

Welcome to the CBT course on self esteem.

CBT is over - you're on your own

So I've managed the 12 weeks and I've learnt  loads of things that are actually very useful.  At the last weekly session, all of my mental club chums turn up looking as nervous and concerned as me. It's been lovely having somewhere to come each week and share about the madness. Now we have to go out into the world alone and practice our techniques and survive the world alone. The general feeling is one of fear as we won't have the group to fall back on, and most people are terrified of a depression relapse. The worst thing in the world is feeling well, then having your joy snatched away from you, not knowing when it will return. We all dread it on some level. There are no guarantees of wellness.

The therapist uses the analogy of doing your driving test. You have your block of 12 lessons, pass your test and then you have to go out and drive all on your own. You know intellectually that you can, but you're going solo and its a little bit scary to say the least. Its exactly the same as CBT. You have to go and put it into practice. Some poelple will have a car crash, some will have a few scrapes and some will drive aorund, blissfully unaware of any trouble whatsoever. Its a case of suck it and see.

I've done my score sheets that compare to my first week session feelings to my final week session, and they show that although I'm still depressed, my social functioning and anxiety are much improved. For me, this is fabulous as I know depression won't just go away, but I have a deep need to be able to function and get on with my life. Giving up is not an option. And I have been getting on with it. I am managing to juggle 3 days at work and 1 at home, looking after the kids, having more fun and generally being more involved in my own life and relationships. Its good news.

However, I now have to face another recovery hurdle which is deeply rooted and not easy to shift. Friends, I introduce you to low self esteem. "Low self-esteem means that you think you are a lesser person than others. It can often be traced back to early childhood experiences, such as heavy criticism, being abandoned, feeling unloved, or being ridiculed or abused. It can also be a symptom of depression." (www.thesite.org) In short, whether or not I am depressed, happy or otherwise, generally I think of myself as the dirt, which is on the turd on your shoe. And I am going to do another course which will help me to overcome this. Its going to be uncomfortable (which really means excruciating) , last 10 weeks (A bloody lifetime), but it will help (yeah right, but not for me, which I'm told is a typical low self esteem remark!).

Welcome to hell.