Self-Care : Stress Management

 Continuing our section on Self Care is Stress Management.

No one is surprised to hear that stress can be bad for you. The kind of chronic stress that many people with mental illness and trauma live with is especially hard on the body. Symptoms can include pains, insomnia, sleepiness, low energy, being unfocused, nightmares, changes in appetite, increased alcohol or drug usage, emotional withdraw and more. It can have long lasting effects on your cardiovascular and mental health.

The most common advice you will see about managing stress are the same things we included in the post on Self Care: Maintaining Physical Health. Occasionally you will see suggestions for therapy or medication tossed in along with lots of recommendation to meditate. Those are excellent ways to support your overall health.

There are some additional healthy techniques and strategies you can use to manage stress in your day to day life.

• Set Realistic and Maintainable Boundaries
• Learn to say "no"
• Set aside time for yourself to decompress
• Learn to walk away 
• Seriously- GO FOR A WALK. It helps.
• Minimize your to-do list
• Its okay to have a "Good Day" list and a "Bare Minimum" list
• Consider how many of your to-dos are necessary, wanted, or just an obligation or expectation from someone else
• Take a break if you need it
• Build a reliable support network AND use it
• Being able to have honest compassionate conversations with those around you will give you the freedom to ask for support or for space depending on what you need
• Give yourself multiple ways to ask for support if you need them
• Talk out complicated feelings with a trusted friend
• Avoid unnecessary stressors 
• Don't get into emotional charged topics if you don't have the energy for it
• Delegate work if you need to
• Rationalize
• Your emotions are valid and your feelings are very real but sometimes they are not rational, take a moment to breath through it
• Don't try to control what is uncontrollable 
• Be Silly
• Will a dance party fix a fight with your boss? Probably not but the movement and some silliness might help you breath
• Sometimes all you can do is laugh, so embrace those moments as best you can
• Breathing and Stretching
• Stress can make you tense which is only going to make you sore later- be nice to future you and stretch. 
• Unwind
• Take time to disconnect from work and people. Give yourself a few minutes to just BE
• Consider setting a rule in your house that when someone walks in the door they get 10 minutes before being asked to do anything for anyone

There are also some unhealthy coping mechanisms that can create long term issues such as self medicating with alcohol or drugs, excessive sleeping, various forms of escapism, and unhealthy relationships with food or sex.

You can read more about healthy stress management here: Managing Stress (CDC)*

Stress management has been one of the biggest forms of self-care I partake in because the build up of stress brings out the worst in me. It makes me less than I am capable of - less kind, less compassionate, less whimsical, less myself. It takes a toll on my work, my family, my relationships.

Part of me is always thinking... but you've endured worse. You have survived worse. This should be nothing. 

Its not nothing though. We are not meant to live a life of constant unrelenting stress and because of trauma my whole nervous system goes into hyperdrive. I don't want to live like I did when everything was bad. I want to be able to enjoy the good in my life and I desperately envy those who live without the anxiety and spiraling.

But HOW do I manage stress?

It depends on the stressor. 

Work Stress - I ask my boss for help and I give myself grace to be less productive for an hour, an afternoon, or a day. I take PTO if I need to. If I am angry, I walk around the building a few times. If I am anxious about something irrational I take a few minutes to talk to my work bestie until the anxiety eases up.

Relationship Stress - I talk to my spouse. We have built a healthy marriage with strong communication and I rely on that foundation. I won't say the conversations are always pleasant or easy but I do typically feel better after a talk, and maybe a good cry with cuddles. We work to remember its us against the problem and that we are a team. He is my partner.

*This is similar to how I handle friendship issues. I try to only cultivate friendships where I can have serious conversations and address issues directly. It is not always successful and I am not perfect at it. I have come to accept that some friendships are not meant to be forever.

Family Stress - I reach out to those that can relate. I have built strong meaningful adult relationships with the women in my family so that I can reach out to my mom or my grandma or my aunt depending on the particular drama of the moment. I will discuss major issues with my husband. If I am really expecting something crazy, I may schedule a therapy appointment.

In-Law Stress - This is a particular subtype of family stress. I talk to my husband about how he wants to handle the situation and then I step back to let him handle his family directly if necessary. Occasionally a therapy appointment is helpful if I am really dwelling on something.

Mental Illness - Sometimes I just have to accept that I can't stop the physiological symptoms of my mental illness and I just try to breath through the worst of it. There are times where I just sit and rationalize and others where I just keep repeating "It isn't real." because that is all I can do. I also allow myself to take some time off work when necessary and sometimes I run away from everything for an afternoon or evening. If rage is the issue, sometimes I use free writing to get it all out. Exhaustion is always better than misery.

Physical Illness- Again, sometimes you cannot stop your body from doing what it is going to do. I have worked on giving myself the permission to take the time off to rest and to not be ashamed of what is out of my control. I breath through pain and try to meditate. Sometimes it works and sometimes swearing helps more. 

At the end of the day, sometimes there is no good solution so I either cry my face off or go for a walk/run. 

-D.M.

* I have included a link to the CDC's website in this post because at the time of writing it is still functional. The current changes happening in the USA may result in this no longer working, at which point we will begin looking for alternate sources to reference.

Self- Care - When Good Enough is Good Enough

 In addition to our posts about Self Care, I have recorded a Vlog about some real challenges and what it means when "Good enough is Good enough."

Self-Care : Managing Mental Health

 I am not a therapist or doctor. This section is about basic common sense wellbeing and my experiences of working to maintain mental health with a chronic mental illness.

This post goes hand in hand with the one on managing physical health. Your brain is an organ that needs proper nutrition, rest, and care. If you don't have the basic physical needs met, its going to be harder to address your mental health.

Managing mental health is going to look different for everyone. It will depend on your constellation of symptoms, your diagnosis, and your goals. There are many tools available but what works for you might now work for someone else.

There are some forms of managing mental health that are more common than others. Often these are done as a combination but may be done exclusively.

• Therapy
• There are MANY types of therapy such as DBT, CBT, EMDR, etc. The type that works best for you will depend on your particular diagnosis and goals.
• Meditation/Mindfulness
• This can be used in conjunction with therapy and medication or alone. 
• Medication
• Some people find medication to be extremely helpful while others do not. 
• Progress is often not linear with medication and working closely with a doctor is necessary.
• WARNING: Self medicating with alcohol and/or recreational drugs may create long term issues such as addiction. 

How you manage your mental health is entirely up to you, but it is your responsibility to be informed and advocate for yourself. Learning as much as you can about your diagnosis, the treatments available, and the possible outcomes will allow you to set obtainable goals and work toward them.

Some good places to start are below:

https://www.nami.org/about-mental-illness/mental-health-conditions/

https://www.psychiatry.org/patients-families/what-is-mental-illness

https://www.who.int/news-room/fact-sheets/detail/mental-disorders

https://www.nhs.uk/mental-health/conditions/

https://www.mentalhealth.org.uk/explore-mental-health

Ready to look for a therapist, but don't know how - Check out this article that explains how:

How to Find a Therapist

Recently there has been an explosion of therapy apps like Better Health or Grow Therapy, if you are using these please be sure to thoroughly vet the professional you are working with. Depending on where you live and your insurance, these services also may be more expensive than traditional therapy.

Many traditional therapists are now offering telemedicine as part of their practice so you may find you have more options available to you than you initially thought.

Can't afford therapy but want to work on some topics on your own? Try these websites with free therapy workbooks.

Free CBT workbook

Free Therapy Workbooks

*** My Experience ***

I have posted some vlogs on here already about my personal progress with therapy and meds. I will likely do another vlog soon as an update.

I currently manage my mental health using routines, medication, and diet. I work with a psychiatrist that specializes in the places mental health crosses over with women's health due to my PMDD.

I was seeing a therapist for several years but was released from therapy as I had acquired and proven I could use my "tools" to function well. My therapist did advise I would likely need to revisit therapy at points in my life where there was a lot of stress and change. I had appointments leading up to my wedding for instance.

I have tried to meet with a therapist since then that was focused on CBT but did not feel she was meeting me where I was at and am currently looking for a new therapist. I want to find a therapist that has a stronger focus on PTSD and that has a background in EMDR, which is proving a little difficult since I want to keep my medications through my current psychiatrist. 

That's the broad overview but what does day to day look like?

I take my AM meds right when I wake up and sit up. This ensures I don't forget to take them and that they are working by the time I need to leave. One of my meds helps with anxiety that sometimes manifests as agoraphobia.

I eat breakfast with a glass of water every morning. Some mornings I am really on top of it and I have something super nutritious like avocado toast with leeks and mushrooms or bagels and lox. Other days that goal is just to get something in my stomach and I chug a glass of water then grab McDonalds on the way to work. Occasionally I really beat myself up about this. There are obviously healthier choices but I remind myself that the goal is to eat consistently and while high in fat, my McDonalds order is also high in protein that I need for my meds to work the best.

I take breaks at work and use that time to nap, color, or scroll positive media (okay its Pinterest fanfiction... but its not the news)

I keep a drink on my desk. Usually I finish my dalgona coffee and then switch to water. Hydration is good.

I go pee when I have to pee. I worked food service for a decade so this was hard to get in the habit of and its easy to assume this has nothing to do with your mental health but I can tell you, I am much shorter and easier to annoy when I am physically uncomfortable. Physical comfort can be important too.

I eat lunch with my husband or bestie (depending on if I am in office or work from home that day). It is a proper break, away from my desk, where I eat a complete meal. Again, sometimes I am on top of it and we have fancy bentos with a variety of food, or left overs from the night before, and sometimes its fast food. These serves a double purpose of allowing me to disengage from work, to spend time with a loved one and to ensure my body and brain have the fuel for the rest of my day.

I disengage from work when I get home. I allow myself my car ride home to rant to either my grandma or my roommate, then I let it go. My family tries not to overwhelm each other with asks when we get home... time to decompress. Occasionally something "big" happens and we all talk over dinner, but its more to inform the family than to rant.

I eat dinner. One of my PM meds works best when taken after a meal of at least 350kcal. (I thought that was very specific but its in the fine print) This one can be difficult because sometimes the anxiety makes it hard to eat and 350kcals feels like an impossible goal. Usually the only way I reach it is using peanut butter which is very calorie dense.

Dinner in my house is a family affair where we all sit down together to eat and talk. It's honestly something I look forward to and find helps me feel like I have community. Its also a great way to check in with what everyone needs. Sometimes that's a home movie date with my husband after dinner and other times my bestie and I go sit in the hot tub in our complex.

I give myself "me time" each night. This can be to game, read, call my mom, have a bath, watch a show, whatever. Its a space to be "off" for the most part. My hair is a mess and I'm in ratty PJs. My make up may be smudged on my face. Its just a space for me to unwind. There are absolutely stressful days where this is right when I get home and climb under my weighted blanket to just stare at the ceiling for a bit. Its a space to let my nervous system reset.

Bedtime is hardest for me. I struggle with anxiety and sometimes if I have hit a trigger, I am scared to fall asleep because of the nightmares. I take my meds about an hour before I plan to sleep most nights and then get around to cleaning off my make up, maybe some skincare or a shower, comfy PJs and then setting up my bed the way I like. My husband will occasionally spend some time rubbing my back or feet if I am having trouble relaxing.

I'll discuss how I deal with more specific issues like flashbacks, hallucinations, and mental breaks in later sections.

- D.M.

Catching Up in 2025

 

Self-Care : Maintaining Physical Health

I am not a nutritionist or doctor. This section is about basic common sense wellbeing and my experiences of working to maintain physical health with a chronic mental illness.

Maintaining your physical health can be one of the most important parts of your healing journey. That's not to say that is an easy process or that it will come naturally. Often times it will take what can feel like an enormous amount of effort.

Physical health includes 

• Basic hygiene activities (i.e. showering, brushing teeth, brushing hair)
• Eating nutritious food regularly
• Exercising
• A good sleep routine
• Attending to medical needs (i.e. routine physicals, taking medication on time, dental work)

It can feel daunting to try and meet all the criteria, especially if you live in a society that places a lot of emphasis on looking or living a certain way. You may have to shift your view point from focusing on how you "look" to others to how you feel holistically. 

Attending to medical needs may be the most difficult because depending on where you are, there can be social and financial barriers to getting consistent and good care. It can be nearly impossible to overcome these barriers for some as in the US we are seeing social safety nets being ripped away. If you do not have access to medical care, attending to the basic hygiene and physical wellness you can do without those interventions is especially important.

Alternately, you may have an aversion to doctors, hospitals, dentists, needles, etc. that make getting care an extremely stressful or frightening experience. Therapy may help with these issues but if you are in a place where you have the option to research and select your providers, you may find a practice that specializes in helping people overcome these issues. I personally use a dentist that specializes in people with a fear of dentists because I found they actually listen to my concerns and are really good about narrating what is happening. 

*** My Experiences ***

This is certainly an area I struggle with. I do want to be healthy and I understand what steps I need to take to be healthy. Knowing and being able to consistently maintain habits are not the same.

I struggle the most with basic hygiene tasks feeling like a chore even when I know I will feel better after I brush my teeth or shower. It varies depending on my level of depression and anxiety who much effort I have to put into these activities. I did briefly work with a therapist on this but became frustrated that most of her advice seemed to focus on people who do not maintain hygiene rather than someone who is able to maintain it but has feels about it. I do think that is you are at a place where you cannot maintain basic hygiene, that therapy may be a viable choice for you. It just was not working for me where I was at.

Other areas are easier because I made them a lifestyle change like eating nutritious foods. I love food and I love cooking so it was fun to find new interesting recipes that provided nutrient dense meals high in omegas (which are good for brain health). I bought cookbooks that are specifically for mental health and I have cultivated some simple meals I can eat when out or traveling. It does mean that my journey with eating for weight loss has been more complicated. There is no trying fad diets or cutting out entire food groups for me, the work has to be in healthy sustainable portion control and moving more. I did have a doctor recommend trying the F Factor which is a high fiber diet that works with my goals and I have seen modest success when I stick to it.

Like many people, I struggle to get enough exercise now that I have switched to a desk job. I am trying to work in more things I enjoy like dancing and hopefully getting to some yoga classes. When the inspiration strikes to walk or hike, I go with it. 

Sleep has been harder for me since I do have chronic nightmares. I am currently on medication that helps with that. It doesn't make the nightmares happen less, it just makes it where I can sleep again after them - like the nightmares don't fully wake me up anymore. I do get much better sleep than I used to but I also still need longer sleeping hours than my spouse who does not have nightmares. This means I have had to develop a sleeping toolkit if you will. I try to take my meds about an hours before I need to sleep. I have a weighted blanket and stuffed dinos that I sleep with. I have very specific youtube channels that I find calming and watch before bed while I unwind (Studies suggest that watching TV before bed isn't good sleep hygiene, but it helps me avoid anxiety spirals). If I wake up too much or cant sleep, I flip my pillow to the foot of the bed and sleep upside down. 

Last we have attending to medical needs. I am at a place in my life where I have health insurance and the funds to access medical care as needed. The routine aspects of this are ensuring that my medications are refilled in a timely manner and taking them on time. Making regular appointments for check ups and screenings (For those with a cervix, you may want to know that a PAP test is not recommended annually - read more here: https://www.acog.org/womens-health/faqs/cervical-cancer-screening). Seeing a doctor when I become sick rather than waiting until it progresses and getting routine vaccinations for illnesses I am at risk for.    - DMGreisl

Control: How Control factors into Abuse (Trigger Warning: CSA, Suicide, domestic violence)

     There is no doubt that control factors in to abuse. It can take different forms and result in different types of trauma but control is often one of the main tools abusers have at their hard. I know readers who are working through their own trauma probably feel this is incredibly obvious, so this section is more for loved ones than survivors.

    Control can be physical, emotional, financial, sexual, reproductive, or social. It can be exerted in many ways, some more obvious and other more subtle. Abusers will often use this control to ensure their victims behavior or silence. It can be as overt as holding a weapon to their body or as insidious as convincing the victim that they are always being watched. Its common for people who leave abusive situations to be asked why they didn't leave sooner. Control is why. Their abuser had assumed a level of control that is hard to explain to others who haven't lived through the experience.

How do you leave if you have no money? 

Where do you go if you have no support group? 

When do you run if you are never alone? 

How do you stop someone bigger or stronger than you? 

How do you escape your own mind when they have twisted your reality?

What do you do if no one believes you? Or worse, they think you deserve this?

What do you do when its your boss or parents?

    Every survivor will have a personal story and the control their abuser had will vary. Its never as easy as just walking away. The act of walking away can be the most dangerous time in some cases, abusers thrive on the silence of their victims.

    " There are too many examples I could give and so I am going to use my personal one.

What would you do to protect your family? To ensure you had a place to live and food on the table?

Those are the questions I had to grapple with as a child because of my abuser. Adult me can see the lies but as an eight year old I couldn't. I loved my family and I knew we struggled. I didn't want my siblings to go hungry and I didn't want to be homeless. I didnt understand what was happening really, because not all sexual abuse is intrinsically painful.

What would you do?

Or the first person I told who would then tell me I would be all alone if I left him. I was young and naive but I had already had the police dismiss me and I was actively suicidal. It was stay or struggle worse if I was alone. I stayed... until he hit me. I wasn't sure if I would kill myself but I was sure he would kill me if I stayed.

I didn't have control of my home life. I didn't have control of my support group (family) and I didn't feel like I had control of my own narrative." - D

Control: Maintaining a healthy level of control

    Its not enough to regain control, it has to be maintained to find security and safety. 

 How to regain control as a survivor can be just as varied as the initial source of trauma. There are healthy types of control such as:

• Taking ownership of the narrative, telling your story out loud
• Establishing boundaries in existing relationships
• Creating distance or going no contact with abusers
• Self actualizing and self work
• Starting over fresh
• Therapy (multiple types)
• Exposure Therapy
• EMDR

    Maintaining this level of control will take consistent, imperfect actions until a habit is formed and likely routine maintenance after that. Ultimately self actualization and working on boundaries is necessary.

    Self actualization is the process by which an individual reaches their full potential. There are multiple stages to this process based on Maslow's hierarchy of needs. It starts with physiological needs, moves up to safety needs, then loving and belong, then esteem, and finally self actualization.

    Some of the simple ones such as air, water, food, shelter, sleep, and clothing can present their own challenges depending on the availability of resources or a history of self neglect. Progress is not always linear because you can find love and belonging but struggle with material needs or safety needs. Everyone's journey will vary depending on what resources they have available at the start of the journey.

Ultimately though the journey is about prioritizing your own wellbeing and accepting responsibility for your own needs, accomplishments, and shortcomings.

    Boundaries will also be needed to protect a sense of safety and ensure needs are being met. This can be especially difficult for some and needs practice for most to be effective. It can be hard to speak out and demand the respect your boundary deserves. Additionally boundaries are about what you will tolerate not your control of others.

"I will not allow you to yell at me. I am leaving" versus " You are not allowed to yell at me."

Accepted that other people have free will and will behave badly at times is part of the process. Its not necessarily an enjoyable part of the process but coming to terms with the difference will help build stronger boundaries and a sense of self worth.

Okay, but how do I maintain a healthy level of control?

Start small and work your way up. It will take consistent imperfect practice to make habits and even then you will likely still need to work on some things more than others.

1. Base Needs - Have you gotten enough sleep? Eaten a proper meal? Drank enough water? Took a shower?

  > "At first, you may need to make a checklist to help yourself remember these things or even set timers on your phone. I still use my list when I am having a bad day. Being hungry can really wreck your day." - D.M.

2. Safety Needs - Do you feel safe? If not, how can you create a sense of safety in your daily life?

> "There has been points in my life where this was hiding in my closet for ten minutes to reset. Sometimes I cant sleep and I need to plan out our budget for six months to feel secure. Does it feel crazy sometimes... absolutely... but I am the person who has to live in my head and the peace is worth it." - D.M.

3. Love and Belonging- Have you put effort in to foster a healthy, loving relationship? Do you need to reach out to a support group to begin building community? When was the last time you texted or called that friend who cares about you?

 > " This one can be a struggle when all my energy is sapped. I have saved especially sweet texts from people I love on my phone to help me when I really need it. Its so much easier to reach out just to say I love you then." - D.M.

4. Self Esteem - What does your self talk look like? Have you taken time today to note the things you accomplished or are you only looking at the unending to do list?

    > "I keep a gratitude journal for this purpose. I note one of each- something that made me happy today, something that made me feel accomplished, something I did for self care." - D.M.

We will be covering this more in depth in the next section as well.