Why Boundaries Are Important When Living With Mental Health Problems

A few weeks ago when I was talking about the fact that I am getting discharged from an inpatient setting on the 20th of February/tomorrow if you are reading this on the day of upload, (handy link to that blog post here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems), I mentioned that there were going to be a lot of rules and boundaries in place regarding my mental illness that I would have to follow back home.
Seeing as these boundaries were set by my parents you might think I live in a particularly strict household with rules and regulations more often seen in a school rather than a home setting, but actually, I am starting to think that when you are living with mental health problems, it is vital for everyone to set some boundaries.

Thing is, when you have a mental illness bobbing along with you through life, you can guarantee that it is going to do all it can to interfere with any plans you had prepared. Thought you were going out for a night with friends? Surprise! Depression has crossed that out of the calendar and scheduled you in for a good old evening of crying into a pillow and thinking about what a terrible person you are. Decided to spend several hours working on that novel and actually being productive with your life? Nope! Instead OCD would like you to waste those hours antibacterialising various objects in the house that were already clean to begin with. No matter what illness you have, it is obviously going to impact your daily routine, and if left with total freedom, it is likely that it will impact your daily routine more and more as time goes on until you find yourself looking back and wondering how on earth things managed to get so out of control. Now when you are in an inpatient setting this aspect of mental health problems is managed somewhat by the rigid structure of your day to day life on the ward, but on the outside it is a hell of a lot easier to get carried away with your own rigid routines.

The reason for this is that I have started to realise that mental illnesses are much like dinosaurs, and living with them is analogous to being that professor that Richard Attenborough plays in Jurassic Park and it is that analogy (to be fair it has been a while since we settled in for a good old traditional Born without Marbles analogy) that I want to talk about today.

Maybe some of you out there haven’t actually seen Jurassic Park (and if you haven’t you really should, it is fabulous), but basically in Jurassic Park there is this guy called Professor Hammond (that’s the person with mental health problems in this analogy), and he owns this safari park of dinosaurs he created out of some blood that has been hiding inside of a mosquito for several thousand years (in the analogy the park is your brain and the dinosaurs are your mental illnesses, except obviously in the mental health version you did not create your dinosaurs/illnesses, rather they appeared one day and as a result you found yourself as keeper of this prehistoric zoo of insanity).

Having the dinosaurs there is obviously dangerous, so Professor Hammond does all he can to keep that danger to a minimum. In order to keep the visitors safe, he has a whole team of keepers helping him to keep an eye on his dinosaurs (aka psychologists and other mental health professionals), and there are physical boundaries/electrified fences set up all over the island around the dinosaurs to keep them in check. They are still dangerous dinosaurs, but when confined by their boundaries, their level of threat is somewhat controlled.

However in the film, before long, this idiotic man with absolutely no common sense turns off all the electric fences and cages that were housing the dinosaurs, and utter chaos ensues.
Without the fences, the dinosaurs do not remain in their neat little pens, they run amok and cause a hell of a lot of destruction and noise when doing so. That image (aka that of dinosaurs running madly all over the place eating people and crashing into everything), pretty much illustrates the importance of boundaries when living with mental health problems and why I have so many regulations in coming home.

For example, whilst I have been in hospital at my local eating disorder unit, there have been very definite rules set out to govern my behaviour. These rules are numerous and I cannot list them all for fear of boring you all to floods of uncontrollable tears, but as an example they have been things like the fact that if I do not eat my meal, there will be a replacement issued which if not completed will lead to consequences in ward round, or the rule that meal times take place at set points throughout the day with no option to delay that peanut butter sandwich for another five minutes. Meal times are meal times, you eat your meals in meal times, end of discussion.

Similarly there are rules to govern my OCD such as time limits for showers because without this kind of rule, my OCD tends to grab hold of all control over how long I take to shower and run with it a lot faster than I can chase after it (I was never one for athletics in school.)
When I have a time limit however, I have something to aim for, and though my OCD will still be present in my behaviours for the duration of the shower, it is my attempt at controlling it as best I can. If in hospital I weren’t to shower within the allocated time, I would be removed from the shower, so I sort of had to reason with my little OCD dinosaur to get through it. My dinosaur wanted to spend the next three years washing yet the rules meant this was impossible, so we had to work together and compromise. I would shower and do all the rituals I was told to, but only for a certain length of time. Having a time limit obviously didn’t always work and there are times where I still couldn’t stick to it, but like I said, it gave something to aim for and consequently I will still have that shower time limit now that I am heading back home again. Again it is unlikely that I will always be able to keep myself in check, but I know that without any rules in the shower things would be a lot worse than they often are and if I didn’t have a boundary set in place, then I doubt I would ever be able to get out of the shower at all.
I can of course tell my OCD that I have finished washing but OCD will always come back with “just another five minutes”, a request that, when given into, will be repeated every five minutes leaving me stuck in a ritual with no way out. With my rule, I at least have an argument against that. In the shower the OCD still dictates behaviours, but when it is time to leave the shower, I at least have the statement of “time is up and we must leave now to avoid consequences” to come back at any “five more minute” suggestions that should arise.

If you are living with mental health problems then, it is important to have your own rules in place to try and keep track of the interference it causes. You can’t control whether or not you have a disorder, but there are some things you do have control of that can help lessen the impact. Say you have an eating disorder and, as I will be attempting when I get home, you are trying to give yourself enough nutrition.
If you say to your eating disorder “I am going to eat better today”, then it is unlikely that you will achieve much, as “better” is a negotiable, subjective term that you will find yourself debating. Instead, hard and fast rules like “I am going to eat three meals and three snacks today” are more likely to merit results. They won’t necessarily mean you achieve what you want, yet again, like the shower time limit, it gives you something to aim for rather than a wishy washy “I will eat something” or “I will shower quicker” which without specifics don’t really mean anything and give too much control to your illness. I know that especially with eating disorders, giving into little things are a sure fire way of letting them spiral completely.
Whenever I have a bowl of cereal for example, I weigh out exactly the same number of grams each day without question. This is disordered of course, and one day I would like to pour cereal with all the gay abandon of a cereal pouring professional, but I know that if I don’t have a weight from my dietician to stick to, aka a boundary, then my portions will just get smaller and smaller. My eating disorder won’t ask for anything dramatic at first, just little requests like “just one flake less today” or “one gram less”, which doesn’t sound much but if you keep listening to that you will end up a few weeks down the line staring at a solitary rice crispy in the bottom of a bowl wondering where all the others went (and possibly hearing a very quiet pitiful sobbing from the rice crispy as they are very social creatures who, when portioned out individually, often get rather lonely. Rice has feelings too kids.)

You don’t have to make loads of rules and they can be small rules to start off, but no matter what the size it is vital that the rules are there. If you have depression, that sucks and you cannot control the effect depression will have on your mood. What you can control however, is things like taking any medication you have been prescribed or attending any appointments to try and keep it in check. If you have an eating disorder and a meal plan you have been told to stick to, make that meal plan your rule, your boundary that cannot be negotiated. Ok the eating disorder will still be there screaming and it may interfere with your behaviours, but having that meal plan there is a non negotiable that is not up for debate. With OCD rituals put time limits on how long they can take so that a quick five minute tidy doesn’t descend into a five hour mass organisation mission or at least put a limit in place as to how many times you are allowed to do something simply to give you something to aim for.
Like I said, this is not going to cure you of any mental health problems nor is it going to stop them interfering/being dangerous beasts much like the dinosaurs in Jurassic Park. In or out of a cage, a T-rex is a T-rex (unless it is a bunny in disguise), and you cannot control the existence of that T-rex or its nature/behaviour as a stomping, roaring, chomping scaly thing. What you can do however, is put boundaries in place to try and limit the destruction that dinosaur can cause, to do the best you can to take control of something that otherwise will take lack of rules as a chance to run amok to see what it can get away with, and that is why, as I go home tomorrow, I go with a set of rules and boundaries in place.

Coincidentally, that is also why mental health problems are like dinosaurs and why it is vital to have boundaries when living with them in your head/prehistoric safari park. Rules may be broken, but having certain rules in place at home does often help me to manage typically unmanageable situations a little better. If you have been in hospital, take hospital rules back home when you are discharged so that the illness doesn’t have the total freedom to reinvade, and if you haven’t been in hospital then maybe come up with some rules with friends and family who are willing to support you in your battle for sanity. Remember, a dinosaur is always going to be a wild destructive interference, but with boundaries, that destruction can at least be controlled as much as possible…I hope…

Take care everyone x

BoundariesDinosaur

Mental Health New Year’s Resolutions

Quick everyone! Get your noses out…Do you smell that? Just there?
That whiff of hope, new goals, exciting plans and new calendar pages all waiting for you like fresh, crisp bed sheets from the washing machine with just a slight undertone of possible regret for your behaviour last night and the sharp tang of cheap gin? That my friend is the smell of New Year’s Day, aka a day that is only a few hours later in time than the previous one, but a day in which we are supposed to be reborn and regenerated like Doctor Who (yes I am also thrilled that the next Doctor Who is going to be a woman but I have to admit that I’m still disappointed that the BBC didn’t go with casting a penguin in the role…Admittedly it would be hard for a penguin to hold a sonic screwdriver or operate a Tardis with flippy flappy wings but the waddling away from Daleks chase scenes would have been unbeatable).

As lovely as this whole “New year new me” idea is however, like I said in last year’s “new year” post (Oh my goodness, look a handy link to that very post:Why Baby Steps Are More Important Than New Year’s Resolutions In Mental Health Recovery), it does put rather a weight of pressure onto one’s back to make sudden drastic changes, which is why I said last year about the fact that I am very much in favour of setting smalls goals and making small gradual changes over a long period, especially when it comes to goals relating to recovery from mental health problems.
Indeed, last year I made a big point of talking about making small mental health New Year’s Resolutions, but this year I realised that as helpful as that is as a piece of advice, I did not provide any examples or suggestions to help figure out what these goals could be…Shame on you Born Without Marbles of 2017!
Thankfully though, it is, as of today, 2018 and therefore, now being a completely new and different person since midnight (please note the use of extreme sarcasm), I am here to solve that mistake from last year with this post where I am going to try and sprinkle a few ideas out there for you on the internet as to mental health New Year’s resolutions should you so wish to make any this January.

I think that coming up with mental health goals is often a tricky one because mental health is such a broad spectrum that cannot be pinned down or confined (much like a cloud, a wave upon the sand or a certain curtain sewing, puppet operating, singing nun called Maria) so to help make this whole thing a bit easier, I have divided my set of suggestions into four main categories of ways that you can make small and manageable changes over the course of 2018. Let’s go!

1. Goals about treatment – This is probably the easiest category to make mental health goals for because these are basically just goals relating to whatever mental health treatment plan you have going on. Say for example you take medication but struggle to do so, one idea could be to set yourself the goal of taking your medication every time a dose is required, with a calendar or chart to help you keep track and aid as an extra reminder or motivator. Maybe you have an eating disorder and have a meal plan set by a dietician or are working towards building a meal plan up, maybe make a goal to follow what that dietician has said or to gradually keep up with increases in your meal plan until you reach the amount that is right for you and is going to help you best in your recovery. Hate turning up to appointments with your therapist either because you find them awkward or because your local psychologist’s waiting room smells like cauliflower cheese? Make a resolution to attend all appointments or at least increase attendance over a period of time (and maybe invest in an air freshener for your nearby surgery…I recommend something with a hint of lemon if like me you are partial to a citrus tang).
If you already turn up to appointments regularly, then there are still loads of appointment related goals that are possible like doing any therapy homework on time (I think I might need to make that one of my resolutions for 2018…the ”my penguin ate my homework” excuse has not been going down well for some time now), making more use of therapy sessions by being more honest or maybe taking notes of important things that are said to take away so that they don’t get lost in the “post appointment mental blank abyss”.
Even if you have a mental health problem and are not in specific mental health treatment you can still make goals in this category especially if for example pursuing professional support is something you are interested in. Booking yourself an appointment at your local GP surgery to discuss possible treatment options, filling a form in to get your name down on one of those pesky waiting lists, making a phone call about a first appointment or setting up an assessment or perhaps doing some research into nearby therapy groups you could attend, are all awesome mental health treatment related New Year’s resolutions to get 2018 started off with a bang (and by bang I mean therapeutically supportive environment…ahem…Kapow!)

2. Goals about physical self care –  In any toothpaste or shower gel advert they always make acts of self care like brushing your teeth or showering, look like such an easy, pleasant task (to be honest some toothpaste adverts I have seen go way past pleasant to the point where someone will look so eager and thrilled about brushing their teeth in the morning that they have the deranged look of a serial killer in a horror film with minty fresh breath), but in real life those things aren’t as simple as they seem. Sometimes when you have mental health problems just getting out of bed is a task to be proud of, let alone things like brushing your hair, showering, cleaning your teeth, eating or putting something on that isn’t pyjamas…However, as hard as all of those things are to do, they are important and taking care of your physical health and physical needs, though exhausting, often helps take care of the mental side of things too. Trust me I know, I have the days where I stay under a duvet and refuse to move but as hard as it is to drag myself out of my cocoon and into the shower, I have to admit I always feel a bit better when it is done.

Similarly getting fresh air is important for your physical health as is eating which, even if you don’t have an eating disorder, can be difficult when you can barely muster the motivation to blow your nose. That said, it is bad enough being mentally ill without your body becoming physically ill and deprived of care, which will only make you feel more hopeless, so goals around self care physically are also important. Again they don’t have to be big and can start out as small as you like from “get out of bed for at least X amount of time every day” or every other day if that is too big a step. Setting yourself a goal to shower a certain number of times a week, brush your teeth every day, spend five minutes outside for a short walk and fresh air, or maybe make goals regarding eating enough proper food meals to take care of yourself properly. Whatever it is, in this category just make goals that are about taking care of your outer physical needs and hopefully they will have some effect on making your internal mental health nonsense a little better too.

3. Goals about socialising scientific Studies show that humans are social animals and that we feel better when we aren’t lonely. My brain studies however, show that socialising with humans is nevertheless very difficult sometimes, often terrifying and mentally exhausting. Again though, like showering and all that fresh air our lungs crave, it is important so some New Year’s resolutions for your mental health could be to do with your social life and, dare I say it, talking to other people and actually going out to make friends and have “fun” (Oh God I shudder at the thought!). I know that a lot of years my goals in this category include things like “Text a friend at least once a day”, or “meet up with so and so (trusty friend so and so, she really is good to me), X times a month.” When you are getting ready to actually carry out the action part to those goals and are getting ready to see good old so and so, you might be so anxious that the meeting doesn’t feel like it will be of any benefit to your mental health, but at the same time, doing what I usually want to do and isolating myself doesn’t benefit much either. Of course alone time is important but a bit of conversation can be a nice distraction and it can be a great motivator to see and hang around with the people you care about and who care about you. Who knows, despite all the anxieties, maybe you will end up having a bit of a laugh by accident and what a happy accident that would be!

4. Goals about interests I think this category is the hardest category to make goals up for as in this one to help your mental health it is about investing time in things that are nothing to do with mental health. That may sound like trying to improve your swimming without going anywhere near water, but mental health problems tend to be all consuming and it is important to make goals to try and get a bit of space away. I know that for me, days when I have multiple therapy appointments and spend the entire time talking about all the madness in my brain are exhausting and as important as it is to pay attention to the mental health things, it is also important to take space away from them too. Again this is incredibly difficult because i know that for me it can feel like you can’t take space away from your mental health problems because they are not a separate thing to you, they simply are you, glued into your internal brain make up but the key thing to remember is that though you might have mental health problems, you are not entirely your mental health problems (even if they try to convince you that you are). Whether you see it or not, you are a person too and a person who deserves to be treated like one. You would never tell someone with a broken leg that they were their broken leg so don’t let anxiety convince you that you are just one bundle of neuroses either. The best way to make goals here is to think about your interests which once again is difficult because when you are consumed by mental health problems, you don’t really have interests and might not get pleasure or enjoyment from doing anything. In that case I set goals to do things like “try a new hobby” or “try something that I used to enjoy” to at least make an attempt at getting in contact with even the tiniest bit of you that isn’t broken. Like I said you may not feel it, but trust me it is there and making goals that pay that little part attention might make it stronger in the long run.

So there you have it! Four categories in which you can make possible mental health New Year’s resolutions and goals to try and improve your mental health and wellbeing in 2018! Maybe you will love this idea and pick several goals for each category, maybe you will just make one tiny goal in one category or maybe you just want me to shut up so that you can go and put the kettle on to make a coffee (if that third one is the case please make me a tea whilst you are at it). Either way I hope this post has been of some use or benefit to you on this fresh, January New Year’s day or has at least given you something to ponder over whilst you enjoy that coffee you are going to make now (AND A TEA DON’T FORGET THE TEA.)
Maybe if you do make mental health goals, write them down to serve as a daily reminder/keep yourself accountable but unless you know tick boxes are helpful for you to see progress, try to avoid them in the interests of the days when you don’t manage to tick any of the boxes and feel like you have failed. Mental health New Year’s resolutions are NOT something you can fail at, they are just casual things you are trying to do as best you can when you can and any progress is so flipping awesome that if you achieve so much as part of one of your goals once this year I highly encourage you to run to the nearest person and insist they reward you with a well earned pat on the back (unless that nearest person is that serial killer like actor in the toothpaste advert…avoid her at all costs).

Overall, do whatever you can to try and maybe end 2018 in a slightly better place than you were at the end of 2017, even if that slightly better place is only a little to the left or just around the corner from where you were. Any mental health progress is progress and whatever happens, I will be forever proud of you (yes even you person who isn’t making goals and just wants coffee. You just read a whole blog! That is very pride worthy…now go and make that tea!).

Take care everyone x

New Year Marbles