Category: mental health

Self-Care: Filling Your Cup

Last week’s blog entry that I entitled Self-Care drew some interesting comments that got me thinking. Gary, my husband, who is also a doctor, pointed out that taking care of oneself was a good investment of time and energy. A number of the things that I identified as self-care were doctor recommendations. I can see his perspective. Rather than resenting the time it takes to do the physical therapy or whatever it is that has been prescribed, one could look at it positively. Time spent making yourself healthier, perhaps pain-free, or with improved mental health, is a good use of one’s time and better than a lot of alternatives. Once again, reframing something has its benefits.

I also received useful feedback from Leah, my daughter. She argued that activities I was including in self-care didn’t necessarily belong there. She suggested that self-care can be thought of as activities that ‘fill your cup;’ things that restore your spirit. I like that notion. While I didn’t specifically list brushing my teeth as part of my self-care routine, it was included as part of what I do to get ready in the morning. I don’t think that should really count as self-care, except in the broadest sense. It is necessary to preserve my dental health but doesn’t do much to restore my spirit. Although, replacing morning breath with minty-fresh breath is a big improvement – I think I’m getting too far into the weeds here. It is safe to say I am over-analyzing this.

Back to the main point: Even if I take a broader view of self-care than the one Leah offered, I like the exercise of thinking about what is restorative. It is helpful to be mindful of the activities that energize us because when we do have a bit of time to spare, we can make a good choice as to how to spend it. Sometimes I take the path of least resistance – turn on the television and vegetate. There is a role for that, occasionally. But, more often than not, spending time on the couch watching something mindless is enervating. I feel worse, not better, afterwards.

What does make me feel better or more full? First and foremost, spending time with my children and grandchildren. Sometimes that isn’t possible so making a plan, having something on the calendar, so that I know when I will see them is wonderful. It doesn’t have to be complicated – we don’t need to be doing anything special – actually the less hectic the day, the better. A couple of weeks ago, our son’s family visited, and we went to the playground, came back and hung out. Our granddaughter set up an obstacle course on the living room floor (it involved navigating a path through pretend lava – paper – and hopping over pretend rocks – crayons) and we took turns. She is four years old and she delighted in first showing us what to do, then telling us if we were successful. I loved it. What better way to spend time?

Another thing I find energizing is travel. While it is fabulous to take trips overseas or to cities or landmarks in the United States, again, it doesn’t have to be that elaborate. I’m happy to explore the hilltowns a few miles away, or take a ride in the Catskills. Anything new is interesting to me and if we can find some natural beauty, a lake, some mountain views, all the better. I am happy just to take in the scenery. Of course, I wouldn’t turn down a trip to Paris or the Canadian Rockies, but clearly those are rare. The trip we took last fall to the national parks in Utah and Santa Fe was sustaining. I look at the pictures every so often and it brings back the exhilaration of seeing those beautiful places. Being in nature is the best way to restore my equilibrium. When my dad was in the hospital in Florida, and he was terminally ill, I either went to sit by the ocean for a few minutes or walked in the bird sanctuary most days and just breathed. If I hadn’t done that, I don’t know how I would have coped.

Reading, particularly a good novel, makes the cut as self-care, too. Not all my reading experiences, though, fall into this category. I have read stories that annoyed me. Why I stayed with the book is a reasonable question, but sometimes even when the main character is exasperating, I still want to find out what happens. Also, if I am reading non-fiction, it can be challenging to find the right balance between what is stimulating to learn about and what is so disturbing that I have to close the book for a while before continuing. Reading anything about the Trump administration would not fill my cup! I guess reading can be a bit complicated.

I can’t leave this topic without also mentioning art museums – I love them! They can be small, like the Fenimore in Cooperstown or Albany’s own Museum of History and Art, or huge like the Metropolitan in NYC, I find looking at the art in relatively calm, quiet spaces to be relaxing and energizing at the same time. Add an outdoor sculpture garden and I am in my element. I don’t even have to love the art itself, though if I can find a few pieces that speak to me that’s all the better. Walking through rooms where the focus is on what people have created and taking it in, is delightful. I think some people may get hung up on thinking they are missing something if they don’t ‘get it.’ I try not to worry about that – I just like looking and generally will find something that is either just interesting or moving.

As I consider this, I realize that I don’t find spa treatments all that fulfilling. The idea of it is more appealing than the actual experience. I like the end result of a pedicure or manicure, but the process just doesn’t do it for me. On the rare occasion where I have gone with a friend or with Leah, I have enjoyed it much more, but otherwise I would rather take a nice walk.

What do you find restorative? Have you thought about it? We might be making certain assumptions about what fills our cup based on popular culture and it may not really work for us.  It would be great if readers would share.

From a local winter walk in the woods – Five Rivers
From a local walk in the woods this past Fall – Thacher Park

Self-Care

If I spent all my time taking care of myself, following all the doctors’ directions, therapists’ advice, self-help manuals, I wouldn’t have time to actually DO anything! And I am a retired person and my children are adults who are living on their own. If I had a full-time job and young children, it would be nearly impossible.

Since last May I have been dealing with chronic hoarseness. After a number of exams and scoping of my vocal cords, I was referred for speech therapy. Fortunately, that testing didn’t find any growths, but noted a combination of the effects of reflux and muscle compression. The speech therapist did a thorough evaluation and recommended vocal exercises. She also gave me papers with foods to avoid (two pages worth) and foods that are encouraged (a small list). I also received some stretches to focus on loosening the neck muscles. I am supposed to do the stretching and vocal exercises 3 to 5 times per day. The protocol takes about 5 to 7 minutes. So far, I have been managing to do it twice a day and feel pretty damn proud of myself.

Another part of the routine recommended by the ENT, to help with congestion, is to use a netti pot and saline spray. I do the nasal rinse once a day and the spray twice. These take another 5 minutes. I’m also supposed to use a humidifier. Setting that up and taking it apart each day is another 5 minutes.

All of the stuff to try and deal with these throat and ear difficulties add up to at about 45 minutes each day.

In theory, these are the other parts of my self-care routine:

  • Waking up – brush teeth, take daily pills, wash face, comb hair – 10 minutes
  • Make the bed – several advice gurus stress the importance of starting the day by making the bed – I subscribe to that idea – 3 minutes
  • Exercise (at least 20 minutes but I actually do 35 either walking outside or on the treadmill) – if it is vigorous enough, it requires showering after, so add another 20 minutes. I am quick in the shower, so 25 minutes allows for getting dressed, too. I also play tennis once or twice every other week, each time 90 minutes (add another hour for driving to and from the courts).
  • Meditation – 10 minutes
  • Shower or bath – if I haven’t exercised and showered, then I will do that and take more time with it – more like a half hour
  • Moisturizing – face, skin, nails – 10 minutes
  • Journaling/affirmations/gratitude journal – 15 minutes (at least)
  • Eating healthy meals (with preparation) – I don’t know how long, but way longer than grabbing fast food. For three meals, it has to be at least 2 hours each day, including the time to eat and clean up.
  • Getting enough sleep  – 8 hours

Some of the things on the list above are aspirational.

I can’t accurately add up the time for those activities because it is so variable, but it is a large chunk of the 24 hours. And, again, that is as a retired person who only takes 10 minutes to get ready in the morning! Most people take longer. I wear no make-up. I don’t do anything special with my hair. I spend next to no time picking out clothing. All of those things could be part of a person’s self-care regime, requiring more time and attention.

My exercise routine is minimalist – better than nothing, but not the amount of time a truly fit person devotes to working out. For someone like, let’s say Jennifer Aniston, it is a full-time job to look like she does. Not that I would choose her as a role model. I don’t make a living on my looks and never did. Unfortunately, though, we live in a world where we set up unreasonable expectations of what we should look like, but the vast majority of us can’t take that much time to nurture ourselves.

Many people face other types of health challenges that require more daily attention. I’m very lucky. Other than this annoying thing with my voice, and the usual minor aches and pains that come with age, I am healthy. In the past I have had occasion to go for physical therapy (for a frozen shoulder or a tweaked back) and there were stretching exercises prescribed. Those kinds of regimens can be hard to stay faithful to.

So, what is my point? First, that doctors and therapists of all sorts need to be realistic and work with folks to figure out a program that can be followed. Second, we need to be honest with ourselves – what are we willing to do? What do we have time to do? Do we believe in the regime that is being prescribed? Lastly, let’s not expect perfection. There’s nothing good about beating ourselves up over falling short of our goals – that can lead us to spiraling into negativity and being more self-destructive.

I want to be able to sing to my grandchildren – that is my main motivation for working on my voice. That and I don’t want to annoy people with my constant rasp. My throat doesn’t hurt, my voice just sounds bad. In a more general way, I want to be proactive about my chronic congestion to help lessen the number of sinus/ear infections I get and preserve my hearing. I will try to stick to the program, but I will also try to follow my own advice. I beat myself up enough about all kinds of things. I don’t need to add this to the list.

Other aspects of self-care: relaxing, reading a book, drinking coffee and spending time with my kitties-now kitty 😦

‘Learn-how-to-meditate-January’

I think the whole country, the entire U.S. of A., should take up meditation. I had this epiphany the other day after I finished the 20th of a 30-day class – each session is only 10 minutes –  offered through an app called Calm. I realize this is an impossibility on so many levels, but I’d like to make the case.

Much of the divisions in our country are caused by people feeling aggrieved. Some folks believe they are unseen or unheard by our government or by the rich and powerful. Some are bitter because of sour relationships. Others are angry because they think many in this country have been swallowed by a cult causing us to drift (speedily swim?) toward authoritarianism. Whatever the source of the grievance, I think the practice of meditation can help because it requires that you become more neutral, you need to adopt a stance of equanimity to sit quietly for ten minutes. I don’t mean to simplify something that is quite complex. Both the problems that have led so many to feel alienated/angry and the practice of meditation are complicated. But, they are simple, too.

Sitting quietly and breathing slowly and deeply for ten minutes each day is both the easiest thing in the world and the hardest. Quieting your mind, allowing emotions to flow through you but not possess you, takes practice. I am a novice, but I see the benefit of having done it for about a month (and, full disclosure, I missed some days during the month). Some people did a ‘dry January,’ I did a ‘how to meditate January.’

I was motivated to try this because during these last couple of years during the pandemic, I have found myself easily riled. I go from zero to sixty emotionally in seconds. I felt agitated much of the time. I read a headline and feel my stomach churn. I can’t say that my meditation practice has changed all of that, but there is noticeable improvement. I still get anxious at the prospect of taking Mom to the doctor, and I still feel my blood pressure start to rise when I read about Donald Trump’s latest rally, but I feel more in control. If it can do this for me, I can imagine what it would do for all the people out there who are living on the edge.

The practice allows you to acknowledge feelings that you might prefer to push down. Generally, I am pretty self-aware. I think for others who are not so blessed to be in touch with their emotions, it might be uncomfortable at first, but it would be a step in the right direction. When you don’t acknowledge what you are feeling it comes out in unexpected and unpleasant ways.

Another positive is that there are no religious aspects to meditation, unless one wanted there to be. I think it is harmonious with all faith traditions.

We are fixated with solving societal problems from the outside in – we enact new laws, fund programs, do research, require others to take action, and talk issues to death. Many of those steps, other than talking things to death, are admirable, and necessary. But, maybe, we need another approach as well. One that starts from the inside of each individual. Maybe if more people took 10 minutes a day to sit quietly and breathe deeply, there would be less hostility and better mental health. Just an idea.

I plan to extend my practice beyond ‘learn-how-to-meditate’ January.

Words of Comfort

Once again, the Covid pandemic is on my mind. Aside from wearying of the limitations it has placed on my life, it feels like the virus is closing in on me. It feels unavoidable. It has hit close to home as family members and friends have been diagnosed in recent weeks. While omicron seems to be less deadly than prior variants and results in less serious illness, it is still no joke.  And, until we are over the peak and on the other side, we don’t really know its impact.

People continue to make different choices in how they cope with the pandemic. Some reasonable folks have concluded that, while wearing masks in public spaces, they are resuming activities and living their lives. My husband is not comfortable with that approach, perhaps as a physician who is in the office seeing patients every day, he thinks the risk is too high until we clearly pass the peak of this surge. He goes to work masked and goggled, washing and sterilizing his hands relentlessly, but then declines most social activities. He would like me to make the same choice. For the most part I have, refraining from most things except I continue to play tennis once every other week. Since I am not working and we are now in the depth of winter, my life is quite limited. It leaves too much time to think, too much time to worry.

In the midst of my angst, I read some helpful words in the form of a poem that came across my Facebook feed:

I am no longer waiting for the other shoe to drop; it already did, and I survived.

I am no longer waiting for the time to be right; the time is always now.

I am no longer waiting to do something great; being awake to carry my grain of sand is enough.

I am no longer waiting to be recognized; I know that I dance in a holy circle.

Author: Mary Anne Perrone

The above lines are part of a longer piece, but these were words I needed to read right now. I’m not so sure about that last phrase – I don’t dance in a holy circle (I’m not sure I even understand what she means by that), but the idea that I don’t need recognition to find value in what I create is a thought I need to be reminded of. The belief that I am enough is something I continue to work on.

The first lines of this piece speak to the major challenge posed by the pandemic – the fear that the other shoe will drop. What am I worried about? The health of the ones I love. I want to know that family members who have Covid or another a health scare are okay, that they will recover quickly and suffer no ill effect. Unfortunately, I can’t know that.

Worry can always be around the corner. If I allow it, it can rule my life. I find comfort in those lines above – the shoe has dropped – at times. It is true that the worst has not happened – I am still here, as are Gary and my children, thankfully – but bad things have occurred, and I have survived. I have managed.

The other day I had a long conversation with a friend who is battling colon cancer. Her husband took the diagnosis hard, understandably. It is scary, though her prognosis is good. Her husband was depressed and after a time she confronted him, saying that she needed him to stop being so down, she needed a more positive attitude. He confessed that he was terrified of losing her. She reminded him that she is here now. When something scary and unknown hangs over you it is hard to be in the present.

Though I am not faced with the same situation as my friend, I related to the challenge they faced. The meditation app I started using a few weeks ago offered helpful insight into the scenario where you might imagine the worst. During one of the exercises, the guide pointed out that thoughts are not reality – thinking something doesn’t make it so. Worrying about future health complications has little to do with the reality of the here and now. It is easy to go down the rabbit hole of ‘what if,’ but it leads nowhere and accomplishes nothing. We can’t put our head in the sand, we need to plan when we have real information about what the future holds, but we can’t live in anticipation of the worst. It is a choice we can make. I can control my thoughts. What a revolutionary idea! It doesn’t come easy to me, but it is empowering to realize that I can redirect my mental energy.

I don’t think I used to have to work so hard to quell the worry. I didn’t worry so much before. Why am I now?

Maybe being inundated with bad news – people losing their homes to fire, people dying of Covid, a friend losing her husband to pancreatic cancer – has made it harder to cope. Bad things were always happening and will always happen. I think social media heightens the sense of disaster all around us. Did they always report when a retired third string quarterback for an obscure NFL team died? My Twitter and Facebook feed is filled with those stories. When someone as famous as Betty White died in the past, of course it made the news. But now it is hard to know what to do with all this information, especially all the losses. How can we process these deaths (whether related to Covid or not)? It is hard not to be overwhelmed.

Some periods of time seem more perilous than others. This is one of those times. I want to put the people I love in a bubble. But I can’t, nor would they want to live there. I need instead to focus on the joys, the beauty and the love today.

Serenity now! View from a walk at Five Rivers – another coping-with-the-pandemic strategy

Is This the Right Time?

           I picked an interesting time to stop taking my antidepressant! About two months ago I started the process of weaning off Zoloft. Two weeks ago, I completed the process. I was on it for years – certainly more than a decade. I began to consider stopping about a year ago. I noticed that I felt ‘flat;’ I wasn’t experiencing pleasure in moments that I expected to, like being with my granddaughter or going on vacation. That isn’t to say I didn’t enjoy those things; I did but I wasn’t fully engaged. I wanted to feel more, even sadness. I understood that Zoloft was likely protecting me from real lows, but I wasn’t sure it was worth the tradeoff anymore.

            The reason I started taking medication in the first place was not because of depression, per se. I am fortunate in that I have never experienced the debilitating effects of clinical depression. My problem was that I would ruminate – I lived in my head, and I was tired of it. I remember telling my therapist that I felt stuck. I would ruminate about unsatisfying social interactions or relationship problems. Sometimes I would get stuck on fears, even silly ones. A low point was when I was on the teacup ride at Disney with Leah and instead of enjoying it – she was – I was imagining the headlines when it crashed. Anxiety was more of an issue for me than depression.

            All these years later, when it dawned on me that I was kind of numb, I thought maybe it was time to try life without Zoloft.  Even with the craziness of Covid, which has introduced another layer of challenge for our mental health, I wanted to give it a try.

            In one sense it was a good time to consider the possibility of going off the pills. When things started getting harder managing Mom and Aunt Clair’s health care about six months ago, I returned to therapy. After a few sessions I posed the question: Could the medicine be stifling my emotions? Was the dullness I felt caused by the drug? I wondered if, by virtue of being on Zoloft for so long, my brain had rewired itself. Maybe the pathways that led me continue to re-live the same conversation a hundred times had been rerouted – not to stretch the metaphor too far. She said that the flatness I was describing was a known side effect of medication and it was possible that my brain changed such that I would be less susceptible to ruminating. We discussed the process of discontinuing the medicine and what I should be on the lookout for in terms of side effects as I went forward. I also checked in with my primary care physician since my therapist is not a psychiatrist – my primary care doc actually prescribes the medicine. Having consulted with the two of them, having a plan in place, I decided to do it.

            With all that continues to go on with my mom and aunt (not to mention the relentlessly negative news from the world at large), it might not have been the wisest time to do this experiment. I think, though, it is also important for me to feel the pain of this part of the journey. Though I am only a couple of weeks into this, instinct tells me that it was the right step to take. I may change my mind – I haven’t disposed of the remainder of my pills – I reserve the right to go back on them. But, I think this feels more natural. I should feel sad that Mom is not herself. I should get angry and frustrated at the failures of our health care system. I should feel joy when my granddaughter runs at me to hug my knees, turning her bright, beautiful face up to mine, flashing a huge smile that melts my heart. I want to feel those emotions.

            It has been a dramatic welcome back to the world of emotion. People sometimes talk about oscillating between one feeling and another. My experience is more like the hour hand of a clock sweeping across an array of them – fortunately it isn’t the minute or second hand! That would be unsustainable. Anger, confusion, frustration, love, hope, despair, powerlessness, appreciation, grateful are all part of most days.

            As expected, anger is prominent. There is a lot to be angry about, and I have a shorter fuse now. I’m not sure that is a great development. Since Gary is often the one igniting the fuse, I have checked in with him to see if I’m being unreasonable. So far, we’re managing, or should I say he is. Isn’t he lucky! Seriously, though, I am working on handling my temper. It hasn’t been a problem, but I do notice a difference.

            Another expected emotion – sadness. Each time I am faced with the fact of my mom’s new limitations, I feel it. I am still not a crier. I wish sometimes I could get that release. Oddly, I find it comforting to be sad. Being numb to what is happening isn’t living. If I don’t dwell there too much of the time, I think it is healthy.

            If the last two weekends are any indication, the joy has ramped up, too. I spent time with my children and granddaughter two weekends in a row! One of those weekends was my birthday and we managed to combine all my favorite things: family, nature and art. I was more fully present. So far, so good.

My Gallery of Joy:

  • late summer flowers
  • sculpture made with cello bow hair
  • Leah’s band
  • Gary looking into the abyss
  • Granddaughter imitating her Dad

            I do notice some increase in anxiety. Stray thoughts about unlikely accidents (like my teacup ride) creep in, but they aren’t taking up residence. They aren’t getting in my way. At least not yet. I am hoping they won’t.

            Some may wonder why I am sharing all of this. It does feel a little weird to put this out there. But I want to ‘walk the walk’; I believe we need to destigmatize mental health issues and how can we do that if we don’t bring it out into the open? Maybe we’ll get to the point where it becomes a nonissue, then I’ll stop. We aren’t there yet. This is part of my journey, and I am choosing to share it. Hopefully it will help others who may be experiencing some of the same challenges. And, if not, maybe it illuminates what it feels like for those who have not been down this road.

Note: If any reader is considering stopping medication, please do so under the direction of a doctor and/or therapist. There can be serious side effects, especially if it is done abruptly, that need to be monitored.