My Self-Care Plan (Crisis Plan Redux)

I apologize for the long pause between posts. There’s been a lot going on in my life including some public speaking, some advocacy and other personal matters. Also contributing to the pause was my review of the blog to see where it’s currently at and where I want to take it. I haven’t been completely silent though, having continued to tweet and having started a companion blog on tumblr. You can find it here.

Image by Fotomek

I’d like to begin by revisiting some old posts, My Crisis Plan and My Wellness Toolbox. I do this because both have evolved since the originals were published. I’ll then follow-up with posts expanding on elements of each.

Today we revisit “My Crisis Plan” or, as I now call it, “My Self-Care Plan”.

My Self-Care Plan

The first evolution is a change in name. I no longer call it a crisis plan. The word crisis to me implied an element of panic, of a situation beyond my control. The idea, though, is to negate the influence of panic, to impart control. The words “self-care” do this. They also reinforce the purpose of the plan: to maintain my mental health through proactive self-care. Finally, it’s only when we reach the latter steps that any real “crisis” might be said to exist.

In form, The Self-Care Plan remains a graduated step-by-step protocol that I use to better manage periods of distress. To reinforce it’s importance, I still make it available throughout my notebooks and also online via my Google Drive. Again, I do this because I don’t want a return of the circumstances that existed on September 2, 2014.

My plan was created with help from the CMHA (Durham). Recently, though, I’ve discovered two apps on the Play Store that help you to create your own self-care plan.

The first of these is the BeSafe app from Mind Your Mind. Developed by a collaboration of agencies, the app allows you to make a safety plan, a self-care plan. For those in Ontario, Canada this plan can include references for local resources which gives you options to get help.

The next is the MyPlan app. This app consists of a seven-item menu, the first six of which require input from the user (the seventh is an “about the app” page). The user fills in details on his or her own symptoms of crisis, coping strategies, contact persons aided by a simple template explaining how these sections should be filled in.

Since I live in Ontario, I find the BeSafe app to be very beneficial to me. However, if you live elsewhere, MyPlan may better suit your needs. Both apps should be used during a period of calm so that they are ready to be used when needed.

Please note that BeSafe is also available on the App Store.

What follows relates to the original Self-Care Plan. I’ll post a separate blog describing the Plan I’ve created using BeSafe in the near fuure.

My Self-Care Plan begins with a statement of purpose: What to do when I’m feeling distressed, depressed, anxious or overwhelmed.

The statement of purpose is deliberately phrased to remove doubt from the equation. The statement tells me that I’ve a say in how I respond to distressing circumstances. It says: if I feel distress do the following things to reduce/remove/end that distress. It imparts an element of control into what often seems to be beyond my control, my mental health.

The Self-Care Plan then directs me to take progressive action divided into six primary steps.

The first step is to relax. I acknowledge that this isn’t always easy (that’s why there are other steps!) but it’s a necessary beginning. It reminds me that whatever the distress is, I have the tools to deal with it. So I can take a moment, or as many moments as I need, to just gather myself.

Step two is to breathe. It acts in concert with step one. While I gather myself, I take a few deep breaths. There’re times when taking these two steps is enough. By pausing, taking a breath or two, gathering myself, what at first seemed imposing, often diminishes to something eminently more manageable.

To help regulate my breathing, I have an app on my phone called Breathe.

If needed, I move on to step three, which tells me to begin apply my coping skills/activities. Again, the step is phrased to remove doubt. It’s a reminder that I’ve acquired new skills for a reason, so now’s the time to put them to use.

Step three has sub-steps only in the sense that I’ve multiple tools to try. Of these, there’s one which is always applied first, namely, to review my lists of successes. Major Depressive Disorder likes to lie about your achievements so I keep lists of my successes, no matter how small they may seem. On some days, simply bathing can be a monumental achievement, while on others it can be writing a blog post. Both are equally as important if they were the best I could manage on that day. The list reminds me of this.

Within step three I’ve other coping skills/activities: visiting my CALMtainer; going for a walk; colouring; writing; or more passive distractions like reading, listening to music or watching television. Each of these activities will be discussed more fully in subsequent posts.

On most occasions, my distress ends at this step, primarily because I’m currently in a better emotional place, a place where I’m now maintaining the gains I’ve made. However, when the Plan was first conceived, I was less secure about my mental health so there are three more steps, each one of which is more difficult than its predecessor.

The primary difference between steps three and four is the intensity of the activity. Step four calls on me to implement my relaxation, or mindfulness, or MBCT and CBT skills. I have a variety of relaxation soundscapes I listen to as well as a variety of relaxation meditations. I also have a number of mindfulness exercises, meditations and books that I can turn to. Finally, I have various MBCT and CBT tools to fall back on. Like the tools within step three, those within step four will be explored in more detail in subsequent posts.

Steps one through four are actions I take on my own. In steps five and six, though, I accept my limitations and reach out for assistance. Keep in mind that by this time I’ve tried my various coping techniques and they’ve failed. I’ve reached a point where I’m uncertain and hopelessness is growing. There’s growing frustration, renewed self-doubt and the possible increased risk of self-harm.

In step five, I turn to a suicide prevention app from Durham Mental Health Services  or this and make use of the tools. If necessary, this may require me reach out to one or more crisis lines (I have the telephone numbers for five different services). Which I call depends on the time of day and the immediacy of my distress.

If I’m fearful of self-harming, I move on to step six, checking in at my local hospital or calling emergency services.

I hope this post may help you begin to create a Self-Care Plan of your own. When you do, Please share it with us.