Always in the ‘back’ of my mind

“When I first started this blog, I thought it would focus on my experiences with injury, chronic pain and rehabilitation from surgery – I guess that’s what I originally meant in using the word “wellbeing” in the name of my blog. However, I’ve come to realise that this is only half of the meaning of wellbeing when it comes to my health…”

If you have been, or are being treated, for anxiety or depression, and are living in Australia, I edge you to register to participate in a major study on the genetics of depression. 

The Australian Genetics of Depression Study, which is the Australian arm of an international study created to understand the genetics of depression, is recruiting Australian adults – aged 18 and above who have been treated for clinical depression.

I recently joined the study and signed up to submit a DNA swab. The data alone could be enough to help change the way mental illness is diagnosed and treated, and by looking at this in conjunction with DNA who knows what scientists might find? 

Find out more and/or join the study here.

When I first started this blog, I thought it would focus on my experiences with injury, chronic pain and rehabilitation from surgery – I guess that’s what I originally meant in using the word “wellbeing” in the name. However, I’ve come to realise that this is only half of the meaning of wellbeing when it comes to my health. You see, after posting about anxiety and depression in my last post, I realised just how much my experiences with mental illness impact on my day-to-day capacity to navigate the challenges of rehab. It’s not that I didn’t know this cognitively before, but I guess I just didn’t give enough credit to how bloody tough just one of either rehab or mental illness can be at the best of times, let alone both at once.

To my surprise, it seems a lot of people around me read my previous post, and have since asked me how the process is going. Although I am happy to report that I am well shot of pain medications and only relying on the odd anti-inflammatory, I’ve found it very difficult to give a straight answer about how I’m going with my rehab generally. Being in my body and the experience of injury rehab day-to-day, hour-to-hour, minute-to-minute, and having that unhelpful tendency to set lofty goals, I guess I haven’t really had the right tools to take a step back and assess whether things are going well.

Usually I would measure my progress by determining whether I’d met any given goal, particularly when it came to work or fitness. However, goal setting has been a massive challenge for me of late. I’ve been finding it tough to set goals that are achievable or realistic, probably because I have unusually high expectations of myself. This pesky little characteristic of mine has become blatantly apparent to me throughout my rehab experience. I set what I think are reasonable goals, but my body will only heal in its own time, so I inevitably discover the far-reaching nature of my goals when my body doesn’t measure up to the task.

My perceived ability to reach (or not reach, as is the case of late) goals has a direct effect on my head space and levels of anxiety. In turn, my levels of anxiety have a direct effect on my approach to rehab. It’s an unfortunate Mexican stand-off that I find challenging day-in and day-out.

I’m rewinding it ‘back’ to talk about that dirty little word “depression”

I used to be someone who took the approach of “sucking it up and getting on with it” when it came to anxiety and depression – it’s one of the down-sides to having an alter ego like Eugine. I sucked it up because it meant that I didn’t have to acknowledge that I was unwell, and even better, that other people didn’t know. Regardless of initiatives like ‘Are You OK’ and others whose focus is to remove the taboo around anxiety and depressive illness, I think I was in denial for up to ten years until it all caught up with me a few years ago.

Depression and anxiety are a constant battle. To effectively manage these conditions takes a huge amount of commitment every single day. For example, making the conscious decision to simply get out of bed was a big one for me. There is nothing more terrifying than waking up in the morning and feeling your whole body burn at the thought of moving.

It hit me at a time in my life that I would’ve considered myself very happy. I had discovered a passion for cycling, I had a lot of friends around me, a great job and lived in a gorgeous house with a wonderful housemate. I had nothing to feel “depressed” about. But suddenly, for seemingly no reason at all, I began to suffer from a case of complete lethargy. I was training hard, eating well and sleeping like a log… but that was just it, all I wanted to do was sleep. I consulted with my doctor and had three separate blood tests to find the virus that I was sure I had, but it turned out that I was a picture of health physically.

“Caitlin” my doctor said one day, “tiredness is a symptom of approximately one thousand seven hundred illnesses. You’re going to have to give me more than this if you want me to help you find what is wrong”. Thinking that this seemed fair enough, I gave myself a week to notice any other symptoms before going back to see him. It was during this time that I realised it wasn’t that I couldn’t get out of bed, it was simply that I didn’t want to. I didn’t want to get up and head out for training rides, I didn’t want to go to work, and when I really thought about it I didn’t want to socialise either. It wasn’t because I didn’t love those things, because I did – I was happy with my life. But for some reason I just didn’t want to get out of bed and be a part of it.

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After a few years of treatment, I now know that I had a lot of thoughts, memories and feelings buried underneath that needed to be brought to the surface and attended to. I will never know for sure why it all decided to show itself when it did, but I can’t help but wonder if it was precisely because I was happy, so there was room in my life for me to start dealing with things.

Depression and anxiety are a constant battle. To effectively manage these conditions takes a huge amount of commitment every single day. For example, making the conscious decision to simply get out of bed was a big one for me. There is nothing more terrifying than waking up in the morning and feeling your whole body burn at the thought of moving. Sometimes I would wake to my alarm at 5:30am for a bunch ride and find myself lying in bed staring at the wall until well after 10am, just searching for the will to move. My mind would play tricks on me. I feared the thought of moving, of rolling over, certainly of getting up and walking to the shower. It seemed like there was too much uncertainty in all of that. Too much to deal with. Too much could go wrong. I felt so much fear for no good reason. This, let alone getting dressed and figuring out how I would get to work… I couldn’t even conceive how I would get through a day of work in such a state. Every day was a monotonous process of battling fear. On days when I wasn’t riddled with fear I usually felt completely emotionless.

Andrew Solomon: Depression, the secret we share TED Talk

For those of us lucky enough to have never experienced anxiety and/or depression, let me explain to you this: a given person suffering from depressive symptoms will not necessarily be unhappy. For some, this may be the case, but for many it is like a cloud that settles over everything – including happy thoughts and feelings. They’re there, but they can be difficult to access and doing so takes energy. For me, I believe my condition to be a mix of both post traumatic stress (known as PTSD) and a natural propensity to suffer from anxiousness and depression. But a lot of the time that I am effected nowadays, it is layered on top of strong feelings of gratitude, optimism, and happiness about aspects of my daily life, and a lot of the time the people around me are none the wiser of my dark cloud.

So how does one manage to pull themselves together amidst all of this? Well, I was taught that the only way is by doing the exact opposite to what your body and your mind is telling you. So, if your mind is telling you not to get out of bed, and your whole body burns with pain at the thought of doing it… it’s time to feel the pain and get moving. If the thought of making breakfast makes your chest tight… hold on and take every step you can without air in your lungs until you make it to the kitchen. And continue thus, making every conscious decision to fight your completely unfounded and unreasonable sense of fear, until you make it outside, and on to work. Then continue so, fighting every fearful thought and every tight breath, until you get through the day. Go home. Eat. Sleep. Wake up. Repeat. Until those things become process and the sense of fear is all but humming in the background.

For me, the biggest challenge in facing my “fear” was to get out on the road and ride my bike. It was the strangest feeling – I loved my bike, I loved riding, I loved the early mornings, the quiet, the hurt, the friends and the coffee – and I was not one to fear the risks involved in being out there. But every morning at 5:00am when my alarm went off, all that went through my mind was complete and utter fear. Fear of falling, fear of being hit by a car, fear of missing the bunch, or being dropped, of hurting, of failing to meet the goals of my training session… fear of being at the coffee shop around people who might engage me in conversation. And the worst part of all of it is that these things were the best medicine for me to tackle the very symptoms that made me want to stay in bed in the first place.

I don’t know what a nutritionist would say, but for me, sleeping, eating and exercise are the ultimate trifecta – my body needs all of them  to be in sync with each other to be at its best.  If I don’t sleep, I eat poorly and this affects my energy levels so I don’t exercise. If I eat poorly, I don’t sleep and it has the same effect on my energy…  I guess you could say that the trifecta is a delicate equilibrium. In my experience, paying close attention to these elements hugely reduces the symptoms. However, when one or all are knocked out of whack due to illness, stress or a busy lifestyle – things that all of us as humans inevitably go through – the symptoms of anxiety and depression come creeping in to take ahold. The humming becomes a loud and prominent voice that talks you above anything and everything, until you are literally paralysed by it.

The nature of the beast means that dealing with something even as common as a cold when you’re suffering from mental illness makes the cold much more difficult to deal with. If you lose sleep from a blocked nose, or have no appetite because your throat is sore, then the equilibrium keeping it at bay falls out of place, adding this whole other layer to your ill-health. Mental illness compounds on any health problem, and for me it is always right there at the front of everything, every time I have so much as a sniffle.

Before my second spine surgery, I had been in so much pain that I’d been taking pain-killer AND prescription sleeping pills on top of my regular anti-depressant medication. This meant that when I came off the opiate pain killer after surgery, it was the first time in almost eight months that I hadn’t taken anything to help me sleep. I was totally wired for weeks. I would toss and turn for hours before falling asleep and wake regularly throughout the night. Simultaneously, I wasn’t eating properly. I was distracted and spent most of the day consumed in tasks like drawing, sewing, napping or watching all the Netflix I could manage. Consequently, I would forget to eat. Being so consumed in mindless activities also meant I neglected my rehab routine. Normally if I felt like this I would force myself to get on my bike and go for a ride. Cycling was almost the regulator for my system, it would help me reset when I felt I was getting sucked into the symptoms of my anxiety. . While I was in training mode I would also eat and sleep well. I’m stretching myself to think of a time that the exercise strategy didn’t help to reduce my anxiety. For now though, and maybe forever, this isn’t an option for me. So, I had focusing on finding a strategy to achieve the same outcome.

At first, I set myself what I thought was a simple goal: get out of the house for some form of exercise at least once per day. A routine – something to keep me focused. I had to work my way up to it over a few weeks, but I got there. After one week of the ‘once per day’ approach I was elated at what I had achieved and excited about the prospect of keeping it up. But I’d neglected to consider that work, medical appointments, running errands and finding time for friends are all things that require my energy too. I couldn’t keep up.

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caityleidoscope After a few hairy weeks earlier in the year with very low moods, I have been working towards the goal of getting out once a day for some kind of exercise. As someone who was very accustomed to exercising at least once (sometimes twice) a day on the bike, my body has missed regular exercise a lot. But even more so has my mind. I’m one week in on hitting my daily target and so far, so good! Here’s hoping my body holds itself together “

I unloaded my frustrations to a dear friend of mine whom I met through cycling, and who has recently faced some personal challenges of her own. Her advice? Focus less on goals and set a benchmark. Look back at a point in the past, like the first week post-surgery for instance, and use it as a way of measuring how far I have come, instead of trying to measure how far I must go to reach a goal. I didn’t know it at the time, but this was hands-down the best advice anyone has given me so far.

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caityleidoscope “Lately I’ve been having trouble seeing the woods through the trees. Being someone who is goal-orientated in life, I’ve found it hard not to step back and let my body guide me, rather than pushing my body forward.
Amidst all of the aches and pains, mental challenges and exhaustion, I’ve been lost without goals. Achieving my goals has normally been my way of knowing I’m improving.  Yesterday I unloaded my thoughts to a very wise and wonderful friend of mine who advised me to keep sight of how far I’ve come – to benchmark myself. Instead of looking forward, look back and visualise where I started. It’s such amazing advice, and something many of us goal-setters overlook. So here is me benchmarking: It has been 13 weeks since my second #microdiscectomy, and @stravarun tells me I’ve gone from walking an average of 1km 3 x per week to an avg of 5km 5 x per week. On top of that I am now working two days per week and completing 2-3 swim and pool strength sessions. I am still sore and stiff and tired, but when I look at it this way I’m pretty damn happy with myself. Thanks @instapixfe 

At first, I had to think hard about a point in which to set as my benchmark. I needed to really visualise how I felt at one week post-surgery: the pain, lack of movement, how daunting it felt to perform basic tasks like showering. And then where I was when I first started hydro sessions at the beginning of January – only able to complete a few strength exercises and a few laps walking up and down the pool. But once I had this firmly in my mind, suddenly things changed. My perspective became a whole lot more positive. It’s all about perception.

Everything I do now is one step forward from where I was two or even five months ago. Even when I’m having a terrible day and my anxiety is taking over, I can get into the pool and know that every little bit of work I do is money in the bank. I can feel good about my efforts, even if my effort is little because I have done the opposite of what my anxious mind has told me to do, which is nothing at all. Positivity and mindfulness are a fantastic way to combat anxiety, and with the physical benefits of doing even the slightest bit of exercise, my mind and body are both benefitting. This way of looking at things forces me to be in the moment when I’m engaging with rehab, and congratulate myself more often for improving as I have – both of which are so important.

I still think that setting healthy goals are an important way to guide improvement in any situation, however I’ve now learned that all this time I had been missing a key element in my methodology of setting and achieving goals: the benchmark. Things will rarely go the way we plan in life, which makes reaching our goals all the more joyous. However, when things don’t go to plan, having a benchmark can help us to cut our losses and be proud of what was achieved in the process. This lesson is not only one for injury and rehab but for anything and everything in life. At this point in my life, it’s also a bloody good tool to help me maintain the equilibrium and face the challenges of mental illness and injury recovery at once.

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caityleidoscope “I’ve been making a habit of late, heading to the swimming pool for a combined #hydro strength and laps session. When I first started going in January, I accidentally took up a lane reserved for a swim coach and his athletes. “I’ve got this lane booked at 5pm” he said at 4:15pm. “It’s ok”, I replied. “I’ll only be about 20 minutes” “I doubt that” he said, seemingly looking at my swimming costume. I got the feeling he thought I’d be jumping in and proceed to swim laps for the next few hours….
“I promise I will be gone before you need it”, I said respectfully, and went about my business.
At this point in my rehab, I could only manage a few exercises from the program at any one time – worried that my body would come away tied up in knots from overuse of muscles. As I walked up and down the lane very slowly, clearly not an Olympic effort, the man approached me and asked “what’s the matter, are you injured or something?” … a convo ensued in which it came out that I had just had my second spine surgery in as many years, due to a car accident when I was younger. “You should’ve told me!!” He said, in a raised but kind voice. “I would’ve let you have the lane to yourself!” I got the feeling he felt pity for me, and with that I think I was done for the day.
Now, every Thursday when I go back there my old mate is there with his athletes, and often asks how the recovery is coming along. It’s an excellent reminder of that first day we met, and how little I was capable of. I think of it often, whenever my body is tired and I wonder why I’m there. It’s a benchmark on how I’m improving. Two months on and yesterday I did my full strength program quite easily, followed by 700m of swimming. And as I walked out for the day the coach asked me how I was going, I found myself smiling and said “slowly, but I think very well.” Thinking to myself that I need to be in the present like this more often… not looking towards the future or thinking where I “should” be… but appreciating my strength and fitness in the now”

On a final note, as I write this I feel so incredibly lucky to have the support of intelligent friends who are tuned in to the challenges of life, who listen and can  reflect on my thoughts an experiences. Friends off whom I can learn invaluable life lessons that help me grow as a human. Thanks to my amazing friend Fe for listening to me and being there for me like it ain’t no thing. I love you ♥

 

 

 

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