Part of taking care of yourself is learning to recognize the signs that indicate you're heading into dangerous territory. When Sascha got let out of the last halfway house, he was sent into the world with a list of warning symptoms to watch out for and a list of "coping skills" to help deal with them. While we think this is a good idea, we don't think they did the best job identifying symptoms or suggesting creative ways to handle them. So we're going to share their list first, and then give you a list we brainstormed based on our observations of ourselves over the years. We encourage you to make your own and share it with the people in your life.

Their List:

Mild

  • Thoughts crowding head
  • Feeling a need to go faster
  • Calling in sick to work
  • Leaving town
  • Not following through daily routine; missing any component of daily routine
  • Sleeping through alarm clock
  • Feelings of euphoria
  • Feelings of depression

Moderate

  • Missing a dose of medication
  • Traveling without adequate plans for sleeping arrangements etc.
  • Impulsive behavior
  • Feeling an urgent need to do something
  • Sleeping all day
  • Not being able to sit still
  • Taking on too many projects
  • Difficulty concentrating

Severe

  • Not sleeping
  • Racing thoughts
  • Decreasing medications without consulting psychiatrist
  • Quitting job without significant planning
  • Delusions
  • Loose associations (!!?!!)
  • Suicidal ideation
  • Stopping medications
  • Leaving without planning

Below we've arranged a sample list of manic symptoms and depressive symptoms that we notice in ourselves. Obviously not all of these hold for everyone, and some don't always indicate a problem"”as Sascha has pointed out, some people are bad about remembering to pay their bills all the time, not just when they're "symptomatic," for example. Nonetheless, we hope you'll use it as an example to prompt you into figuring out what your own warning signs are.

"Loose Associations" and Forecasting Dreams: Our List

 

Early Manic Signs

  • Forecasting dreams and other ESP stuff (knowing who's on the phone, when things are going to happen, what someone's going to say etc.).
  • Start waking up earlier and earlier.
  • Increased desire to flee/travel/adventure!!!
  • Food"”think about eating less often, or eat voraciously but stay skinny.
  • Seems less and less important to take care of practical things like cleaning room/bills/dishes. Very easy to overlook completely"”not even see the bag of month-old food rotting on the floor or the dishes in the sink.
  • Driving more aggressively/scattered/miss exits/don't pay attention as much.
  • Recruit more people into my life, promise to hang out with everybody, much easier to make friends.
  • Promise to take lots of things on"”projects, jobs, classes, meetings.
  • Start scheduling almost every hour of my day full of plans.
  • It's hard to watch TV and pay lots of attention to the storylines, but TV is the most fascinating thing in the world from an anthropological point of view. Everything is so interesting to analyze.
  • Become convinced I'm falling in love with people or just develop intense, all-consuming crushes. Start getting much more interested in sex and it seems easier to come by, more reasonable to have casually.
  • Vision/Perception changes"”everything becomes more vivid, more clear, often more beautiful and meaningful, I start seeing patterns everywhere and notice everything.

Early Depression Signs

  • My intuition is off"” I misjudge people's intentions and have lots of bad hunches. Assume everyone's thinking about me and noticing how awful I am.
  • I start wanting to sleep around 4 in the afternoon.
  • It's getting harder to see anything good anywhere.
  • Start disliking how I look: feel fat, or ugly, or hate all my clothes.
  • Crave sugar constantly. If I'm getting especially ornery I start wanting to binge on tequila and whiskey.
  • Desire to flee/need to change my job/house/friends/location/haircut.
  • Seems like it requires so much energy to take care of practical things like cleaning room/bills/dishes.
  • Seems unreasonably hard to get out of bed or out of the house.
  • Can't concentrate.
  • Doing anything that involves multiple tasks seems so incredibly complicated"”requires way too much energy.
  • Spending too much time on internet.
  • Canceing all my appointments with people.
  • TV seems overwhelmingly awful and the newspaper is unbearably distressing. Advertisements are obviously the devil's work.
  • Start doubting my relationships. If I'm with someone I start thinking we don't fit and should probably just break up. If I'm interested in someone I'm sure they don't like me.
  • Everything seems flat and dull and I notice all the rats in the alleys instead of the birds in the sky.

Things still go wrong sometimes. Our brains accelerate onto their own tracks and we might find ourselves heading back to a place we hoped we'd never have to revisit.

 

Written Plans

Just in case you end up in trouble again, it's a good idea to make some written plans that will leave clues for others in your life who want to help you. Getting things down on paper can even help you understand what's going on with yourself, and remind you later when you're losing track of what's real.

It's a good idea when you're in a relatively clear head space to sit down with the important people in your life and explain to them what you're going through in your various moods"”and to clue them in, as much as you can, on what changes in your behavior they might notice that would help them recognize if you're starting to get manic or depressed and might need some help. It's an even better idea to write these things down.

"Before I moved back into my collective house in Oakland we all sat down as a group and read through my lists of warning signs and daily checklist. It was a little embarrassing at first, but it was also the first time I ever sat with a group of my friends and talked about mental health, mine or anyone else's, and it was such a powerful thing."-Sascha

Part of sharing this information about yourself is agreeing that if your friends and family notice your behavior changing, they'll tell you and you'll try to trust their judgment. Come up with a written plan of what should happen"”what you can do and what the people around you can do"”if it seems like you're heading for trouble. It will give everyone something to refer back to when things get confusing. And if you write it then you theoretically don't end up having all your decisions made for you.

When Sascha got out of the halfway house they suggested the following "coping skills:"

  1. Refer back to daily structure.
  2. Take medication PRN's.
  3. Call psychiatrist.
  4. Call psychotherapist.
  5. Go to emergency room.
  6. Call 911.

This list seems a little incomplete and drastic to us.

It doesn't suggest anything non-medical or intermediate, like talking to friends, doing yoga, cooking food, visiting old mentors, reading favorite books, immersing yourself in music, going for a swim, meditating, taking some herbs, going to church, whatever floats your boat"¦ Though some of their advice does become necessary when things are really serious, this version of "coping" seems to reflect the priorities of a reductionist system that can't seem to imagine a form of health that doesn't rely solely on drugs, doctors, and the police. We can do better than that"”but the first step is becoming very self-aware and getting to know your patterns intimately.

"What has worked best for me at the worst times is just to realize I am overstressed and I need at this time to slow down if I want to remain on track. I go against my own grain and force myself to connect to people, I walk, write, have a long hot shower"¦.most importantly I rest"¦ We have to realize our own limits and strengths"¦ this is a real illness.. we need to take better care of ourselves like we would with any other disease."¦ we can transcend the cage"¦" -Shine