Day 15 - What do I tell myself (and do) to calm myself down in the event of a triggering stimulus?
It depends on what was triggering me!
There are a few things I know are likely to precipitate a significant flare-up of symptoms.
For example, getting into a “go go go” mode of achievements (nonstop participation for 12 hours at a state fair, cleaning four rooms in one day, taking on a HUGE project and insisting on finishing it all at once) is hugely risky for me. It turns out (I just read about this today) that people with bipolar disorder are more sensitive to and focused on rewards than not-bipolar people; for me, “achieving something” and especially “achieving something big” is a HUGE hypomania trigger. The classic thing is “Demeter cleans the bathroom and vacuums all her carpets and takes out all the trash in the house and THEN DRIVES TO CANADA BECAUSE WHY NOT.” (This has totally happened, pretty much in exactly that way.) The solution here is to avoid triggers (never plan to clean the bathroom PLUS two other rooms on the same day,) or let my family/friends know that I’m at risk and to watch out for hypomanic symptoms (that means I need to be in their physical presence.) The thing about triggering hypomania is that once you’re on the train, you don’t stop for a good long time. So you have to do everything you can to avoid the trigger, or at least get in a safe place where people can watch out for you. I’ve spent whole days sitting in my mom’s house giggling at every little thing, suggesting stuff for my sisters and me to do, and getting gently redirected - that didn’t stop the hypomania, but it kept me from escalating my behavior or doing something stupid.
Another example is when I’m heading into a situation where I know I might have a panic attack or gross anxious reaction of some sort. There are a LOT of situations (thank you so very much, AvPD, OCD, and agoraphobia) that cause moderate to extreme anxiety for me, and I have lots and lots of coping mechanisms to avoid the triggers. Like, I don’t go to movies on Saturdays after about 1pm. I don’t go to Cracker Barrel on a Saturday morning. I don’t go to Wal-Mart on Saturdays at all. Lately I’ve been taking Ativan before doing something I know will be stressful/anxiety provoking, and that helps a lot. I haven’t had to run out of a store sweating and about to faint in probably… two months? Some of that is because I haven’t been going out a lot, but some of it is because I’ve been smart about not doing stuff that’s risky.
And then of course sometimes I experience symptoms and it’s just - I have to deal with them, right? My first focus is on the core physical/emotional needs. Make sure the A/C or heater is on and that I’m in the shade. Drink some water. Eat some food, preferably carbs or carbs plus protein. If I’m in any pain, take some Advil; if my stomach is upset take some Pepto Bismol (I keep both on me at all times.) Make sure I’m breathing slow and deep. Close my eyes if there are lots of people or objects moving around; focus on trees and stuff if it’s a quiet place with nature nearby. Stretch my arms and stuff. I actually have a big list of things that help, printed out in my wellness book. When I’m stressed out while camping I know that I feel LOADS better (even if what’s stressing me out is some interpersonal conflict) if I brush my teeth, wash my face, pull up my hair, and change my socks. Not kidding. I’m not really clear on why changing my socks helps, but I’ve always been super sensitive to clothing sensations (I am still a tag cutter-offer) and that plus the OCD “clean is happy” thing are probably the big reasons.
And I rely on the wellness book for other ideas. It’s full of inspiration quotes and scriptures, the lyrics to songs I like, a list of the websites and search terms I find soothing or funny or whatever. Basically it’s an outsourcing of my emotional regulation system. Instead of trying to come up with ways of cheering myself up or getting a grip or whatever, I can turn to the book. Problem solved!
But all of that is short-term. Longer term, I write it all out in my journal or here on Tumblr (which all gets copied into my journal.) I might make a note of it for my next therapy or psychiatric appointment, or bring it up to talk to my sister with. Journaling and bringing things up in future appointments has been a BIG part of why I’ve been able to deal with stuff a little bit better lately than I had been. I truly believe that talking about my agoraphobia and fear of groups at the partial program and here on the Tumblr blog is a big part of why I was able to survive the support group I went to yesterday evening. And I KNOW that the thing they said at the hospital about it being OK to feel bad, and that trying for 5 minutes was good enough, and that as long as you choose to spend the day in pajamas (instead of laying on the guilt about accidentally staying there) you’re okay - all of that has made it less stressful, and less triggering, to have some of the symptoms I have.