Mental Health

I paid people to shoot lasers at my face over a year ago now.  ...which is a much more fun way to say that I got Lasik eye surgery.  Prior to that, I had had glasses since second grade.  Steadily, my eyesight was beyond bad, that I genuinely could not function without them, let alone read anything that wasn't two inches from my nose.  

Y'all:  I couldn't even read the big E.  

Every morning I would wake up and simply not be able to see my room clearly.  The first few moments whenever my alarm went off were usually spent groping for my glasses, knocking them down more times than I could count, leading to that oh-so-fun moment of "I need my glasses to find my glasses" to start of my day.  I couldn't wear a mask at Halloween without some creativity or contacts, they would fog up in cold weather or getting something out of the oven (NOT a good time to be half blind, holding something piping hot), they needed to be cleaned and fixed/replaced from time to time, and giving them to the nurse before surgery was the final, true moment of vulnerability.  It was a fact of life, an extra component that required specific care and maintenance.  

Then, once all the dust had settled from my surgery, I didn't have to worry about it anymore.  I could wear whatever sunglasses I wanted.  I didn't have to clean them in order to see the TV clearly.  I could walk in and out of the house without rain spots on my glasses or having them fog up.  

And it was nice.  

I had thought about it more than once, how odd it was to me that people could wake up and just be able to see everything immediately.  I think the same principle applies for a great number of things.  Specifically, as I start my mental health and psychiatric nursing class, I think about it in terms of depression and anxiety.  There are people who feel down from time to time or situationally, and there are people who have depression.  There are people who feel situational anxiety, and there are people that feel anxious even when it's not "appropriate."  There are people who wake up each morning and grumble that they have to get out of bed; and there are people who wake up each morning and struggle to find the will to survive.  One may exaggerate; one may feel that particular, impossible weight in their bones.  It doesn't mean that grumbler's feelings are invalid, but it's also not the same as the consistent depth of those in a spiral of chronic depression.  Both sides know their own world thoroughly.  The "normal" folks cannot fully understand; the "abnormal" folks cannot imagine a world where it isn't a key part of their life anymore, but doesn't it sound like a beautiful relief, even if it only feels like a dream?  

I've hit upon this before in the vein of chronic illness--and certainly my own experiences--but I feel that I've been remiss to not hammer home the mental health components all the more thoroughly, because of the stigma attached and the very real impediments it creates toward appropriate healing and treatment for those that need it.  Mental health and physical health are so interconnected, we cannot separate them from one another.  

If we want to split hairs, there are different degrees of weights and weights on top of weights and other ways that pieces and burdens pile on top of one another, creating a mess of infinite possibilities, temperaments, and confusion that it's a wonder we even can relate to each other at all.  And yet, that lack of understanding is oddly enough a very human place to be, a uniting bond of understanding of what it is to be human.  We all understand suffering; but that doesn't mean that we understand how that person is specifically experiencing their suffering.  

I've been thinking about this a lot, especially as we get into our mental health clinicals.  I want my script to be helpful, to not add to the individual's pain but acknowledge it and attempt to empathize without being a condescending ass.  I want to be genuine without taking over the conversation.  I want to be better.  

Example from the week:  it's not uncommon for patients to apologize, to say variants of "I'm sorry for being a burden."  What I had been doing to this point was immediately jumping in to reassure them that they weren't, that I was happy to help them (regardless of how unpleasant the task was or any of my other personal feelings in the moment).  It occurred to me that this can be dismissive.  So, I'm testing out a new script, had the chance to use it recently, actually:  "You feel what you need to feel, but know that I don't think of you that way."  

It's hard to go from being at least somewhat independent to being hospitalized--partially immobilized by IVs/sutures/dressings, to be away from all you know, to be faced with your own mortality, to feel the weight of the uncertainty, etc.  These feelings are valid and quite possibly a part of the apology, an expression of their helplessness and/or uncertainty.  My previous tactic was blowing them off--gently, yes, but still blowing them off.  This change acknowledges what they're feeling without telling them that they're "wrong."  It's a small change and I will refine the wording as I go, but I want to see what it does.  

Instant Coffee

I remember my gateway into liking coffee.  Pop and I would go to Coffee Hound in town and get a caramel latte, sit and talk about everything and nothing.  Those moments were vastly important for connection and as a byproduct I grew to understand that there was a difference between the coffee available during fellowship time at church and something more...artisanal.  Coffee was a lifeblood for a lot of folks I knew, but I hadn't understood that it could be good.  

Forever and a year ago, Andy bought me an espresso maker.  It might have been for our anniversary or my birthday--Andy does not tend to give things on the "right" day because he's so genuinely excited to give things--but in typical Andy-magic fashion, he found an incredible deal on Craig's List or some such.  At first, I remember thinking that this was just going to take up our limited counter space.  And yet, after we got past the learning curve, I loved having it in our home.  I made a lot of cappuccino, and we wore that machine into the ground, having tried a few outlets for repair and finding that fixing it was going to cost as much as a new one.  

We switched to using a French press after that, since Andy had been given a swanky R2D2 one for Christmas one year.  We ground beans each time, and eventually managed to break this one, too.  

THEN, I learned how to make drip coffee.  It was all completely backwards, but that was the way of it.  And, yes, we did run that machine into the ground as well.

...and literally as I write this, I'm drinking instant coffee from Aldi.  

That was the flavor I wanted today.  Our normal French press has cleanup involved:  pulling out the bag of beans and the grinder, grinding the beans, getting the kettle going, transferring the grounds to the French press, waiting, and disposing of the grounds after.  It is a richer cup and normally worth the steps, to be certain, but just not what I wanted in the moment while cranking through my class readings (and taking a break for writing).  Instant is fast--just microwaving some water and throw in a spoonful--and the only cleanup is putting the jar back in the cupboard afterwards.  Moreover, I wanted the comfort of something that tasted artificial.  

It's in a similar vein, I think, of craving a particular dessert, finding that delight and emotional connection toward a particular indulgence and flavor.  There is something reassuring in the occasional artificial.  Homemade macaroni and cheese is fantastic; yet, there are days where the blue box is exactly the flavor I'm looking for.  Maybe it harkens back to something about childhood, where it was such a treat to get a Happy Meal for supper.  We had homecooked meals made with love and fresh ingredients, still there is comfort in the immediacy and that particular flavor that is probably mostly preservatives.  Or salt.  Or both.  Or maybe it's an existential break, to not have to question whether something is "real" for a moment.  

Or maybe it's just coffee.

Managing Uncertainty

I was having a conversation with a friend the other day, discussing 2020 and all that implies.  Naturally, in this conversation living through a pandemic and naming the different changes and feelings associated with it took center stage.  Some parts of this conversation were very familiar, that I had had conversations with other persons that followed a similar theme.  

Here are the main points and commonalities I want to highlight:  everything was changing so quickly from day to day, which included new limitations, new data, new insights, and overall an unpredictability into their lives that they were not used to.  Things that they had taken for granted--such as being able to go to a coffee shop or pop over to a grocery store for something they needed for a recipe--now had extra steps or were impossible or a number of other complications.  

In short, their lives now had a significant level of uncertainty to them.  The security of their worldview, all of the pieces that they may have taken for granted were now put into question.  Right now, we can't plan a vacation because we don't know if travel will be an option.  Our favorite restaurant might not be open today or have limited hours.  For those with school-age children, it's in the air whether classes will happen in person or online or some mix of both.  Hell, my first day of classes for the new semester has already been canceled.  How can anyone plan for all these different possibilities?  We've lost the certainty and the security of tomorrow.

*Insert Rueful Laughter Here*

Folks, that's what it's like to live with a chronic illness.  I'm so sorry that you understand now, but I'm also glad for the forced empathy.  It's one of those places where I need empathy but it takes a lot of energy to explain.  That doom sense?  I'm used to it which means I'm oddly poised to be successful in navigating it in this context, too.  It doesn't make it easy, necessarily, just...familiar.  I don't trust tomorrow to be there.  I struggle planning out long-term in the future--I can dream, but I can't plan.  I'm accustomed to that loss, and as a result I function more flexibly with "normalcy" and "autonomy" upended.  I honor the feeling, but I don't tend to linger in it quite so long as I once did.  Even the feelings of isolation, that we cannot meet in person, that feeling was a huge part of my experience while I was convalescing.  

To be put in some examples:

• I have no idea what my body is going to do tomorrow.  I could be trying to go to the grocery story and blow an ostomy bag, need to turn around and change my clothes, and then feel miserable for the rest of the day, regardless of what other plans I might have had for the day.
• Similarly, when I wake up to a low spoon count, the day has to adapt to that, regardless of the goals I had for the day or the people that I let down by changing plans.  It's an emotional minefield.  Consider the emotions in telling family members that you cannot visit them and the complicated feelings that can invoke but take away the pandemic as a clear reason why, where well-intentioned folks ask "are you sure?" and dig that knife just a bit deeper. 
• I cannot plan long-term because I don't trust tomorrow to be there.  I could have another flare up next month that knocks me out of nursing school.  I'm stable in a lot of good ways so I don't find this likely but the world can change in a moment--unlikely is not the same as impossible.  
• Feeling isolated because I cannot meet people where they are, and I did not always have the chutzpah to ask them to meet me.  I had a few dedicated persons that reached out to me, but I lost contact with a lot of people that year.  At least with the pandemic there are enough other people feeling isolated that I would say folks are on-the-whole more responsive to online options and there are more opportunities, even as folks are still sorting out when/how to ask.  

So what does this mean and what wisdom do I have to pass down?  Great questions.  Glad I pretended you asked.  We can acknowledge that this is tough, and yet there are freeing elements of this mindset.  As a specific example, by not expecting tomorrow to be in a particular format, I have developed the flexibility to move more in the moment.  This builds a resilience over time.  I also manage some of that anxiety by making contingency plans--without crossing into obsessing about contingency plans, mind you--which allows me to be prepared for at least some eventualities.  Over time and some specific intentionality, I've built confidence in my own ability to adapt.  I'm pleased to have the skills in the same breath I'm furious that I have to depend on them for the rest of my life--chronic means chronic.  

I've heard a number of folks talking about "returning to normal," where they don't have to worry about getting sick or spreading illness to their loved ones--there are some people that this absolutely IS their normal.  The weight of that is difficult to carry.  And if you feel an unmet need of empathy, that's par for the course, too.  We can get better at handling the baggage as time goes or we can make the stubborn single-trip-in-with-the-groceries-even-if-it-kills-us kind of white-knuckled striving through this event.  

What skills and what empathy we choose to take out of it, that's purely up to us.  And it may not start as something productive, maybe taking years to turn into a good something.  It's okay to feel bad and upset with the circumstances.  It's possible to accept that you feel upset/frustrated/displaced/uncertain AND accept those circumstances at the same time.  Both can exist in the same space, and those emotions need to be honored.  In these ways--what we take and how we grow and whom we've lost--it's never over for any of us.

What is Rest?

What is rest?  

I don't know.

Roll credits!  That was the shortest blog post ever.

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...Okay, so that is still an accurate summary, but I do have a talent for talking about nothing for a while, when I choose to do so.

I'm nearly to the end of my break, with classes starting up again in another week.  A month gone already.  I entered into it with both relief and trepidation.  Relief because nursing school and all else has been thrilling but also exhausting, particularly with a pandemic thrown in; there was a bit of manic laughter after submitting my last final.  Trepidation because historically having time off is brilliant for the first two days, and then after that I begin to feel uncomfortable, where being idle for too long reminds me too much of time spent convalescing post health debacles.  That does not bode well for my mental state in those moments, where trying to find rest is oddly counterproductive.  

So what to do about that?  Mostly, I have been intentionally observant in this time.  From previous experience, I find that scheduling a few pieces in gives enough structure to meet the threshold of not too idle, so I sprinkled in a something at least every three days, so there was at least a something.  These included two online Bob Ross Paint-a-Long parties, D&D, a handful of catch-up calls, a few household projects, writing time slated around Luna's schedule, Discord-enabled Civilization games, Skype Sequence games with my parents, joined Zumba Zooms, and fit in a few other things here and there.    

And then there was also binge-watching some TV, a couple of carefully chosen video games, browsing for new memes, and longish walks with Luna sprinkled in the gaps.  The greatest surprise was reading seven books and finding the sheer joy of reading for fun again.  Reading without feeling guilty about not spending my time on my studies or something else, that's a feeling I had definitely forgotten.  

I don't think I can put a fence around what "rest" looks like--it's a feeling as much as it is an action.  I can only attempt to describe the outward appearance of the right set of circumstances for my own experience of these particular feelings.  My rest looks like being the appropriate amount of busy, but the kinds of busy feel vastly different.  More importantly, I have the ability to set my own schedule--that's what seems to be the true marker of what is a quiet day verses a relaxing day.  Watching a movie and reading a book and going for a walk are common themes, though sometimes an intense workout, being in a group of friends (virtually or otherwise as the world allows), or meeting new people are a much stronger effect.  For me, the same activity on a different day is not as restful as it would be on another, which seems...odd.

However, I've also been trying to quantify how much of the day on my own schedule "counts" toward rest.  Sometimes, I think that it's more the absence of a major stressor.  But even with that in my case absence of multiple major stressors with the presences of some minor good ones seems to be the sweet spot.  

So long story short, I feel that what counts as rest might have trends for certain folks, but how much energy is regained or how much time is needed or what activity is best seems to all be a moving target.  And that's simply not how I've thought of rest before.  There are patterns of certain activities working for me better than others, and there are trends about timing.  Yet, I feel that relaxing requires either a specific kind of openness or a specific kind of self-awareness OR sufficient practice to have figured out patterns anyway.  

I have some pieces honed nicely, but I daresay there's always room for improvement. 

Meanderings condensed into a convenient list:

• What you need for relaxation can be a moving target, where certain things can work better on certain days with certain situations.
• It takes a level of practice/self-awareness to get good at relaxing.
• It's okay to give yourself the freedom to explore these things.