Whether you have a mental health diagnosis or not, we all have a responsibility to take care of our mental health.
Our culture is not one of prevention, but rather wait, wait, wait until you’re really sick.
We are taught to push through, snap out of it, distract, get it together. We are taught that caring for our mental health is selfish, a luxury, and often times taboo.
I used to wait until I was so run down that my symptoms were unbearable. I did not press pause on life or work until I absolutely could not function or get out bed. There was no choice, I had reached the point that it was impossible to do the things I needed, wanted, or was expected to do.
After 5 years of therapy, including 1 year of intensive dialectical behavioral therapy, two diagnoses, finally agreeing to medication, embracing sobriety, and establishing a routine and self-care practice for my mental health, I am at a place where I prioritize ME.
I press pause on life and will take a sick day when I feel the symptoms bubbling. Could I drag myself to work? Probably. But I know that taking one day to course correct will prevent a spiral and keep me mentally well.
I’m always learning and taking note of my choices. I know back to back traveling in-between working 6 days a week, lack of sleep, unhealthy foods, interpersonal stressors, job interviews, dating, missing doses of medication, and the lack of typical stress relievers due to COVID-19 has lead me here. But I can’t blame myself. I’m not perfect. The first step is awareness.
Have I done this before? Yes. Have I overloaded my schedule and had it backfire? Yes. Have I learned from my mistakes? YES. Just because I did the same thing again doesn’t mean I failed, I didn’t learn, or I should give up. Change takes time, being perfect is impossible, and it’s important to celebrate the small wins.
I still type out the “sick day” text and delete it 7 times before sending it. I still feel immense guilt and shame and fear. I still worry what people will say. I still think that I’m being selfish and ridiculous and should just get it together and go to work, telling myself it’s not that bad.
But you know what’s different? Despite all that willfulness, I press send anyway. I press send because I know all too well what could happen if I don’t. I know that I can make it through the day. I know that I could use coping skills to hunker down and get the things done.
I also know that in doing that, there’s a price to pay. And I’m not willing to pay that price anymore. The price looks like a disaster of a home, mirroring the disaster in my mind. It looks like days in bed. It looks like sky rocketed anxiety. It looks like missing bill payments, fights with others, withdrawal and isolation, my brain running so fast I become immobilized. It looks like one day piled on top of the other, the spiral feels never-ending, and days blending together.
Although taking one “sick” day doesn’t solve all my problems, it definitely lets me press pause, gives me a kick-start, and serves as a re-set button to use ABC PLEASE skills and get my mental WELLness under control. I am in charge of my symptoms, they are not in charge of me.
The ABC PLEASE skill is a DBT skill meant to decrease vulnerability factors. What I mean by that, is when we take good care of ourselves, we decrease our vulnerability factors to disease and emotional crisis. It is also necessary to take good care of ourselves so we can take good care of others.
I take care of others, daily. I work on an inpatient child and adolescent psychiatric unit with other occupational therapists who understand mental health. This doesn’t change the intense fear and anxiety I get upon taking a “sick” day. This doesn’t change that I hide a part of me. I can’t imagine how some of you may feel working in a place where “mental health” isn’t uttered, let alone understood.
If you are struggling with getting back on track, vulnerable to emotional distress, feeling run down and overcome by intense feelings or battling against symptoms and stressors, please try the ABC PLEASE skill.
The ABC PLEASE skill comes from the emotional regulation module of DBT.
A: Accumulate positive emotions.
We need to lean into experiences and events that align with our values, ignite positive emotions, and
give us the dopamine we need. We need these to feel hopeful.
B: Build Mastery
Do ONE thing that counts as a win. This could be make your bed or cross out a simple thing on your to-
do list. Do it. Even if you don’t feel like it, DO IT. This will make you feel competent, effective, and
challenge the hopelessness.
C: Cope Ahead with emotional situations
Look, we all have some awareness that a situation is going to be challenging. Make a plan to help you
in that situation. If you don’t know how to make a plan, reach out to someone who can help you.
During emotional distress, our brains shut down and we don’t problem solve or think quickly and
effectively. Having a plan and rehearsing the plan takes out the thinking part.
PLEASE: Take care of your mind by taking care of your body.
This looks like:
PL: Treating Physical ILlness,
E: balanced Eating
A: avoiding mood Altering substances
S: balanced Sleep,
E: getting Exercise.
More to come on how I integrate this skill into my day-to-day, and if I don’t, how I pay the price.
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References
Linehan, M. (2015) DBT skills Training: Handouts and Worksheets (2nd edition). New York, NY: The Guildford Press
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