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