Wellness Plan – Wrapping It Up

I’ve now written several blogs about my Wellness Recovery Action Plan, or WRAP. And it’s time to finish off this series.

The next two sections of the WRAP plan are entitled “When Things are Breaking Down or Getting Much Worse,” and “Crisis Plan.” I’m lumping these together because both point to severe symptoms, and the potential imminence for a relapse of my depression.

According to Wellness Recovery Action Plan (Advocates for Human Potential, Inc., copyright 2018), “sometimes, even when you’ve been making your best efforts to stay well, things can get a lot worse. Some people call this a breakdown, a setback, or a relapse….often your behavior changes so much that other people can tell something is wrong…Taking immediate action can make a difference in the outcome.” In fact, I might be able to avoid the Crisis part of my plan if I can successfully turn this situation around.

Some of my key indicators that things are getting much worse include that I am staying in bed, isolating. I feel anxiety and a heaviness in my chest, an urge to drive fast and recklessly, a desire to smoke e-cigarettes (I’m a non-smoker). I may have increased trouble concentrating, which was also a red flag in my Early Warning Signs.  But in this case, it would be worse. I’d be feeling like a burden to everyone around me. I may have the desire to self-injure or have suicidal thoughts (called suicide ideation – thoughts, but not a plan), and I’d find myself unable to pray. I’d dread the future and ruminate on the past. I’d have flat affect – expressing very little emotion.

So what do I do if things get much worse? First thing – tell someone! My husband, sister, or close friend. Call my therapist and psych doc right away. Reduce caffeine – drink herbal tea instead of coffee – and sit in my glider, which I find very calming. I would try to Face Time my old therapist – he can often “talk me down.” I think I’d call in my second round of support – three other close friends who I know love me and would offer me encouragement and prayer. Perhaps, if these steps work, a relapse would not occur.

The Crisis Plan portion of the WRAP is designed to make it as easy as possible for people to help me, because if I am in a depression crisis, I might not be able to make my own decisions. It outlines who I want to help me – by name – and exactly what I want them to do for me. Things like get me to the hospital emergency room, sit with me, hold my hand. And what I don’t want done, like what medicines I can’t take. It even outlines my daytime and household responsibilities and who will do them, like care for the pets and pay my bills and contact and keep my prayer team updated.

After the crisis has passed, the Post-Crisis Plan is implemented. It’s a brief section of the WRAP where I identify things that worked in my WRAP Plan, and things that need to change. Perhaps there are people I need to thank for their help in my crisis; perhaps there are apologies or amends I need to make as a result of things I said or did during my crisis.  This final portion of the WRAP allows me to step back into the responsibilities of my daily life, slowly, as I begin to return to my normal level of wellness. This may take time – crisis recovery is not immediate, and I will need to be patient with myself. But this is a good time to evaluate and make changes to my WRAP, as I can see what worked and what didn’t. Because post-crisis can be very introspective, it’s a good time to modify my WRAP to include stressors or early warning signs that I may have missed before. I can add to the Crisis portion of my plan while it’s still fresh in my memory – what additions do I need to make so that, heaven forbid, things go more smoothly the next time?

Ultimately, the goal of the WRAP is to help me avoid a depression crisis – to identify those markers ahead of time to avert another hospitalization or emotional break down. Because this plan is so thorough, I may be able to stay in remission for the rest of my life.

Wellness Plan Toolbox

The first step in writing my wellness plan is determining the helpful steps I already have in my daily life. When I am healthy, what is it I’m doing to make me that way? What are my day-to-day activities that signify health and wellness for me? “What things do I already do to help myself be well, stay well, and live in the way I want to live?” (reference: WRAP Plan app)

This toolbox of activities is critical to my Wellness Plan, as I’ll draw from this list at different stages along my path from wellness to illness and back again. When I feel stressors, or triggers, that might signify a depressive episode is coming, what can I do to alleviate it? Are there any tools in my toolbox that I can pull out and implement to avert an episode?

If I’m further down the path toward depression, and an episode is imminent, which activities can I use to lessen the severity of the episode?

If I’m on my way out of a depression, which tools will I use first to help me post-crisis?

My initial list was 14 wellness tools:

  • time alone with God in Bible reading and prayer (TAWG)
  • taking my meds
  • journaling
  • eating well
  • good sleep hygiene
  • spending time with friends
  • sufficient down-time
  • seeing my therapist regularly
  • keeping my psych doc appointments
  • blogging or writing
  • taking naps
  • reading
  • watching movies
  • Fresh Hope Support Group

But as I thought about steps I can implement in a pre-crisis, I realized I have several more tools, even though I’m not currently using them. Things like savoring a cup of tea, or coloring, or taking a walk in nature. I certainly need to tell my support team that I’m struggling, so they can help me watch for warning signs.

One thing I’ve learned about depression is that it clouds my thinking. I can have this wellness toolbox, but in the midst of a crisis, I’m paralyzed and don’t know how to get out of it. That’s the reason for writing a wellness plan when I’m mentally healthy: so when I’m not thinking straight, I can look back and see what I recommend to myself.

I intend to share my wellness plan with my support folks (husband, sister, therapist, friend) so that they can help me remember to reach into my toolbox when I need to. As soon as I’m done writing the whole thing, I’ll pass it on to my care team.

God’s Peace, and the Power of Prayer

I have so many things I’d like to write about, but I can’t, due to the incredibly personal nature of them. About health. Work. Family. Sickness. Siblings. Parenting.

All the normal things of life.

But I can write about peace, and God’s faithfulness to answer prayer.

With the many difficult things I’ve been going through lately, I can tell I’m being sustained by friends’ prayers for me and my family. Because of these prayers, I don’t have anxiety about the unknown future. I’m not experiencing stress or great sadness. I’m a little fatigued, but I know it could be so much worse.

There are literally friends all around the country praying for my family, for the various things I’m facing. And God hears each prayer. They come before Him as incense, the prayers of the saints (Revelation 5:8). They are forever before Him as He sits on His throne.

And I am welcomed – no, invited – to come into the throne room with my prayers and petitions. Scripture tells me that I can come boldly before His throne (Hebrews 4:16). In fact, He longs for me to do so. He tells me to bring every concern to Him (1Peter 5:7).

The other night, I awakened around 3am with a rush of anxiety. Yes, it hits occasionally. And my first thought was, “Oh, no! All my prayer warriors are sleeping!” Funny, eh?!

For those of you who are praying, thank you. My family and I are so grateful. Your prayers keep us going, knowing that we are being lifted to the King of kings.

We don’t know what the future holds. None of us do. But, as the song says, we “know who holds the future.” God has everything under control. He’s working all things for our good. He is trustworthy.

I am at peace.

“I am leaving you with a gift—peace of mind and heart. And the peace I give is a gift the world cannot give. So don’t be troubled or afraid.” John‬ ‭14:27‬ ‭NLT‬‬

Discipline

Discipline – not a word that I like; I suspect many people don’t. But I’m finding that I need more of it in my life. I need discipline if I’m going to stay mentally and physically healthy, and reach my personal goals. I need good habits.

I’ve become more consistent lately at having my time alone with God in the mornings. The Lectio Divina Journal has helped with that immensely, as do the daily devotional emails I receive and read each morning over my cup of coffee.

I’ve started Morning Pages (The Artist’s Way by Julie Cameron), which is three pages of stream-of-consciousness thinking put on paper.  It’s supposed to clear my mind to make way for creativity to shine through.  I’ve only been at it a few days – even for a writer, it’s harder than it sounds! But this is another discipline to my morning routine.

Now I need to schedule my writing – for my book as well as this blog. I’m hoping I can be consistent with writing each morning for at least an hour. We’ll see how this goes, since I tend to blog at night; that’s when my blogging thoughts come together. But even that seems a bit haphazard – as the mood strikes – so I want to plan for it with more intention.

I also need to set aside time for activity. I hate to say it – exercise. I need to put it on the calendar, and walk every day, at least around the block. Slip on my tennis shoes and put on my headphones and head out the door. How else am I going to get my 10,000 steps?! Besides, all research points to the many benefits of regular exercise, for both physical and mental well-being. Indeed, many studies have shown that regular exercise is as effective as a mild antidepressant medication. So why don’t I do it? Lack of discipline.

I want to be more thoughtful about eating, particularly in the evening. As I mentioned previously, I’m using Noom to help me with my calorie intake. Unfortunately, I’m consistently blowing it every night, with after-dinner munchies.  Now to replace that glass of wine with a cup of tea, and the crackers with low-cal popcorn. And one piece of dark chocolate – not four!

I want these areas in my life where I need discipline to become habits, not chores. That’s going to require consistency and effort on my part. But the benefits will be worth it.

“No discipline is enjoyable while it is happening—it’s painful! But afterward there will be a peaceful harvest of right living for those who are trained in this way.” Hebrews 12:11, NLT

Writing in the Glory

Assignment from Writing in the Glory workbook by Jennifer A. Miskov:

Depression is like a heavy, wet, gray wool blanket, carelessly thrown over my shoulders. It weighs me down, bends me to a hunched posture. And it stinks!

**********

Depression brings companions of anxiety, hopelessness, fear, apathy, and the desire to isolate. Nothing sounds good. Nothing tastes good. Nothing is all I want to do. To sit alone and stare into space with “nothing thoughts.” Or worse – spiraling thoughts, like a tornado swirling, repeating the condemning and negative self-talk: I’m a failure; I’m all alone; I’m miserable.

Medicine “un-muddles” my thoughts; it clears my foggy brain and reduces the accusing ruminations so that I can think more clearly. That’s when the work starts: to“take captive every thought to make it obedient to Christ.” (2 Corinthians 10:5 NIV), and to replace it with God’s truth of who I am and how He sees me. This puts perspective back in order, and puts God back on the throne of my life.

Some days, the work is relentless. Every thought is off-base, and must be replaced. At those times, it would be easier to just rest in the familiarity of depression. I know the comfort of sinking down in my miserable-ness. It’s hard to reach for health.

But I don’t have to stay down – God will pick me up. He lifted me out of the slimy pit, out of the mud and mire; he set my feet on a rock and gave me a firm place to stand.” (Psalm‬ ‭40:2‬ NIV‭)

Thank you, Lord, that you do not leave me in depression. You are faithful to me, and You are always with me. I am not a failure – I am Your child. I am not alone – You are always with me. I do not need to feel miserable – You love me. You are good, God. In Jesus’ name. Amen.