This week is Mental Health Awareness Week. We know the COVID-19 pandemic is having profound and long-lasting effects on our mental health. For many people with severe mental illness, it has become even more difficult to access services and get support.
Here our Website Lead, Lauren Anderson, shares her coping strategies for living with anxiety, complex trauma and dissociation during lockdown.
Understand your triggers
When something triggers a worsening of your symptoms, write it down. This will help you plan how to look after yourself in the future. Common triggers include stress, not enough sleep, conflict, loud noises, too much information and feeling overwhelmed or ashamed.
Find your oasis
An oasis is an activity that gives a break from your feelings. It should be an activity that needs you to focus, like reading, board games, puzzles, baking, colouring, writing, drawing, knitting, making something or playing an instrument. Avoid watching TV as it can be easy to wander into your thoughts or dissociate. Once you find your oases, use them to help you feel calmer and quieter inside.
Move to another room
During a flashback or intrusive thoughts, getting up and moving to another room (or walking around indoors) can help you to feel safe. This is very important if you have nightmares or wake up feeling panicky or upset. When you wake up, try to get up within 60 seconds or as quickly as you can. If you experience freeze responses or dissociative paralysis, focus on moving your eyes or a single finger or toe and work up from there. Keep your phone in another room overnight if it distracts you in the morning.
Stay in your window of tolerance
Traumatised people often have a very small window of tolerance, which can mean that your emotions are overwhelming or you struggle to think clearly. People with PTSD often experience things as too much or too little. If you stay within your window of tolerance, your coping strategies should not make things worse. Your feelings might stay the same or get a little bit better. If you try breathing exercises, mindfulness or other strategies, be careful and stop if it's outside your window of tolerance.
For many people with complex trauma, relaxation exercises and meditation can provoke intense feelings and emotional distress. Guided meditation or music can be easier to tolerate. There are some meditation exercises suitable for people with complex trauma, including focusing on a spot between your eyes and breathing in your favourite colour.
Alternatives to meditation
Listen to whatever makes you feel better, whether it's Dua Lipa, calming piano or metalcore. Curl up in bed with headphones or dance around in your room. You might need to rest or move. If you're not sure, try doing both.
Yoga or stretching
Building or maintaining muscle tension can be safer than breathing exercises. Slow movements that tense and release your muscles can help with physical sensations of anxiety in your body. I use Glo and Yoga with Adriene, which is free on YouTube.
Create an imaginary container for yourself to put difficult feelings when you have intrusive thoughts or overwhelming emotions. You might think about a box, vault, locked room or spaceship. When I have a panic attack, I imagine exhaling distressing thoughts into my hands and then pretend to shut them in a drawer.
Visualise your safe space
Think of an imaginary safe space where you can visualise yourself feeling secure, calm and happy. Many people think about a lake, waterfall, tree or castle. My mind is always looking for potential threats, even imaginary ones, so I feel safe when I think about being alone on a deserted planet, hiding in caves or at the top of mountains.
There are lots of different techniques to reduce anxiety, dissociation or other negative emotions by grounding your awareness in the present. You might pick a colour and look for objects of that colour in your room, count the alphabet backwards, say the date and time out loud, stamp your feet, hold a cushion or jump up and down. Many people find fidget spinners, squeeze balls, stretchy bands or therapy putty helpful.
Grounding strategies that work best for me involve a change in sound, temperature, taste or touch. I listen to music, hold my wrists under the cold tap, have a bath, eat frozen grapes or hot spicy food, drink blackcurrant juice, wash my hands, brush my teeth or wrap myself in a blanket. If it's an emergency, I'll cut a lemon into wedges and bite into them. It's very difficult to be anything but present when you're eating a lemon.
Find anchors in your room
If you wake up from nightmares or feel stressed in the mornings, find an object or colour in your room to anchor yourself to the present and remind yourself that you're safe. You might sleep with a stuffed animal, keep photos of your friends nearby or stick post-it notes on a mirror reminding you that you're safe and doing your best.
Be careful with media
Some TV shows can make you feel worse. Avoid crime dramas and soaps if you are triggered by violence or arguing. Stick to shows like Bake Off, Glow Up, Drag Race or Planet Earth where the content is predictable. Take a break from the news or social media.
Embrace your childhood self
Rediscover what you enjoyed doing as a child. I've been enjoying playing new versions of Crash Bandicoot, Rayman Legends and Streets of Rage. TV shows like The Animals of Farthing Wood and DuckTales are on YouTube. iPlayer has Doctor Who and The Worst Witch. Many children's and young adult books are great to read as an adult too. I like Diana Wynne Jones, Philip Pullman, Jessica Townsend, Laini Taylor and VE Schwab, who all write stories that are almost impossible to put down.
Ask for help
If you feel comfortable talking to friends or family, explain how you're being affected. They may be able to check in on how you're feeling, help with chores, listen or encourage you when you need support. If you'd rather talk to someone else, the NHS has a list of mental health helplines and where to get urgent help during a crisis. If home is not a safe place for you, we can provide support or refer you to other organisations who can help.
If you'd like to access mental health services on the NHS, sometimes you can refer yourself and for other cases you'll need a referral from your GP. There are also charities like us who are here to support you during lockdown. Our mental health services include online, telephone and email support, counselling, advocacy, advice and emotional support. We can refer you to other organisations if you'd like support elsewhere.
Get medication delivered
You can get medication that's on your repeat prescription delivered to your home by Echo Pharmacy, which is a free service from Lloyds Pharmacy recommended by the NHS. You can use NHS exemptions and prepayment certificates. If you have a lot of medication, you can save money with an NHS prepayment certificate.
Track your symptoms
I use a bullet journal style spreadsheet to track my symptoms. In the first column, I copied my main symptoms from the NHS A-Z of conditions. In the top row, I write today's date. When I experience a symptom, I put an x in that cell. There's some conditional formatting so the cell gets a background colour if it's not empty. I fill it in on my phone and glance at it throughout the day. If I'm too unwell to do this, I add what I can remember later. My GP thinks it's brilliant. It helps a lot if you get referred to new services or apply for benefits.
Learn about your diagnosis
If you're on a waiting list for treatment or unable to access professional services, you might find it helpful to read about coping strategies. If you experience anxiety, trauma or dissociation, I recommend Coping with Trauma-related Dissociation, The Complex PTSD Workbook and The Body Keeps the Score. Stay within your window of tolerance, take it slow and use your coping strategies if you start to feel overwhelmed.
Be kind to yourself
If you're experiencing stress or heightened symptoms, you might not be able to do everything you wanted to do and that's okay. You're dealing with a lot right now. Try to make things easier on yourself. Give yourself more time to sleep, meal prep so you don't need to worry about cooking and make time for yourself where you can. Forgive yourself when you make mistakes. And try to be even kinder than you were yesterday.
Mental Health Awareness Week takes place from Monday 18 May to Sunday 24 May 2020. The theme for this year is kindness.