Mental Health – Psychotic or Self-managing?

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Back in March 2021, Jonathan MacDonald, Kaur Lass and myself had a conversation about Mental Wellness Habits, and this series of articles is based those conversations.

Important: mental illness may require medical intervention.  Check out nhs.uk/mental-health/ for important information.

It’s hard to miss the increasing call for us to talk about our mental health.  The guilty secret of mental illness that has haunted individuals and families is giving way to increasing openness and recognition that mental health is an issue for us all.  If this was 25 years ago, I’d be very reluctant to share my experience of a very severe manic episode that I had in my late teens.  The stigma could impact both my career and my social circle.  When I look back on it, I was very ill. What initially presented as a young person behaving bizarrely in the streets of Oxford – presumed by the police as due to drugs – marked the start of a 4-year period of being in and out of hospital receiving treatment (medication and ECT) for manic depression.  Although there is a lot of bad press about ECT (electro convulsive treatment) this was the watershed for me.  A short course enabled me to start to recover and get to the point where I have been able to self-manage my mental health.

How did I  manage my mental health?

I fortunately don’t have deep bouts of depression and by carefully managing my mood I have avoided any subsequent breakdown. But I am very cautious. For example, if I have two bad night’s sleep, then I will usually do something, so I get a proper night’s sleep. I am very aware I need to actively manage my workstyle and my lifestyle so that I do not get myself into a state where I am completely out of control. However, I am not on any medication anymore and I no longer have the fear of an imminent breakdown.

There are diverse ways of self-managing and medication is often crucial.   I would never recommend that somebody goes against the advice of doctors to take psychiatric medication.  Too many of my friends have died because they stopped taking their prescriptions.  (Check out https://mind.org.uk/ for advice) For many of us, we can only make choices about our behaviour when medication brings us to a point where we can start to make those choices.  But without the medication and ECT that I had, I would not have been able to make any changes to my behaviour.   It allowed me to be in a position where I was able to reflect on what things improved my mental state and what things undermined my mental state. So, staying up all night working on an exciting idea, is not a good thing for me.  Not having regular mealtimes puts me at risk.  More than one coffee in the morning, can limit my ability to manage my emotions.  Too much stimulation from other people or not enough stimulation from other people can undermine the balance of my mood.

An on-going process

I have come to a place where I can recognise when I’m on an ‘up’ and then make choices to reduce that impact and bring myself into a more orderly place rather than just enjoying the highs. Anyone with manic depression will say that the highs are wonderful.  It’s really exciting and great fun.  Medication can dampen that feeling.  I have found a way to self-manage so I can have the best of both worlds whilst being conscious, reflective, and prepared to listen to those around me.  But I also accept that there may be a time when medication is necessary to restore the balance.

Responding to others

Kaur Lass notes from his experience of working with people that you always have to remember how to keep yourself well by respecting and self-managing our interactions with other people.  We can encounter anger, joy, frustration, annoyance, excitement and fear from our interactions with others.  Learning to be aware and then self-manage these emotions is crucial. It’s very easy to lose yourself to your thoughts and your feelings.  Being aware of what is going on inside you gives you the power to stay calm and let go of problematic feelings that you are experiencing.  You can choose whether to listen and focus on what others are saying or hear your inner voice.

Is this age-related wisdom?

I was in my early 20’s when I came out of this breakdown.  I became extremely intentional about actively managing my mood.  Over the years I’ve got better at doing it, and have learnt more about myself, but I think the crucial thing was my intent.  I committed to make choices around what I eat, or when I sleep, or how much exercise I have, who I hang out with, how much alcohol I do or don’t consume.  There have been times when I have been tempted to work all night and there have been times when I have been tempted to go on great flights of fancy and have even more inspirational ideas.  But I also notice that I can overdo it and then I step back and make sure I do all the things that I know help me (being around people constructive to my mental health rather than destructive, eating well, sticking to sleep patterns etc).

Do you have to hit rock bottom first?

Kaur believes that the idea you must hit rock bottom to come out of the other side with the skills to manage our mental well-being is one of the greatest misconceptions.  He blames the fact that, historically, we have had very little mental wellness education in schools which means we don’t have a tool set or a mind set for how to be mentally well.

Again, it’s about intent and your inner decision to focus on things that keep you well. For Kaur, he eats vegetarian food, tries to sleep well, takes long walks at the weekend, shorter walks every day, and doesn’t watch much TV, seldomly news.  If he watches movies or documentaries, he picks ones that are good for his mental health – but it must be something that gives him something.  He believes strongly in the need to expose ourselves to more activities that keep us well and sees it as a lack of education that we are not doing this consciously very often. We sometimes happen to be in the right company or happen to take a walk somewhere, but how often do we have our own action plan for staying well?

Mental Wellness Action Plan

For Kaur, a key is to have an action plan, unique to the individual, of things to do each day. Things that keep them well. For example, starting each day with a moment of silence. If you have planned actions to keep yourself well then you have the possibility to stay on the wellness side and if you don’t then it’s very probable that you end up with (positive) stress, which leads to burnout. You have to notice what is going on within your mind and be aware of the warning signs.

What is clear from this first part of the conversation between Jonathan, Kaur and myself is that we all intentionally make sure to keep ourselves in a stable position and how much we use food, sleep and being with nature as part our self-management.

 

Charles McLachlan is the founder of FuturePerfect and on a mission to transform the future of work and business. The Portfolio Executive programme is a new initiative to help executives build a sustainable and impactful second-half-career. Creating an alternative future takes imagination, design, organisation and many other thinking skills. Charles is happy to lend them to you.