Wednesday, August 31, 2011

Day 50: My Mood Disorder Action Plan

Tonight is my final MCBT class.  Our homework for this week was to come up with an action plan in the event that, in spite of our best meditative efforts, our depression recurs.  We were told to make a list of our usual depression symptoms (because they're usually the same in each person), write down three things we like about ourselves that we might forget when we become depressed, and create an action plan -- if we become more depressed, what will we do to care for ourselves?

As I've written before, the symptoms I'd long ago learned to identify have changed.

Here are the symptoms I used to have when my depression was getting worse:

  • Feeling the edge of The Pit
  • Feeling of “falling”
  • Feelings of excessive sadness
  • Excessive tearfulness
  • Irrational guilt
  • Catastrophizing thoughts
  • Taking things too personally
  • Anhedonia
  • Lassitude/lack of motivation
  • Insomnia
  • Overeating
  • Oversleeping

And here is what was going on with me last fall and winter:

  • Troughs or crashes in mood between the times of 4 and 8 pm become more frequent
  • Troughs or crashes in mood between the times of 4 and 8 pm become worse (tearfulness, paranoia about relationships, pessimism running to despair)
  • Troughs or crashes in mood lengthen beyond the 4 to 8 pm range
  • Tearfulness, sadness, or anxiety due to trivial or nonexistent things (such as cheezy songs, movies, tv)
  • Excessively bizarre thoughts or anxieties (such as worrying about the balance or destruction of photons in the universe)
  • Feeling the need to act on excessively bizarre thoughts, or take action on the basis of bizarre anxieties (needing to turn all the lights in the house on to keep it "balanced")
  • Increased irritability
  • Sudden, frenzied activity, especially late at night (such as suddenly feeling the need to clean the house at 11 pm)
  • Dramatic upsurge in energy after 10 or 11 pm
Hmmm. Not only are those nothing like my previous symptoms, but they don't look much like depression at all, do they? Good thing I'm seeing my pdoc in two weeks. I will bring this to him and show him it.

For kicks, here's the rest of my Action Plan:

Three Things I Like About Myself (that I tend to forget when I get depressed):
  • My sense of humor
  • My curiosity
  • My creativity
My Action Plan for Mood Symptoms Consists of the Following Steps:
  • Breathing Space (use breathing space to check in: would meditation be helpful or harmful at this time?  What is the best self-care I can give myself right now? What steps do I need to take next?)
  • Make a choice of what practices are most helpful to me and start using them (be nice to know what these are …)
  • Take specific actions, including the following steps:
    1. Inform spouse
    2. Inform pdoc *** if spouse is traveling, this is Step 1 ***
    3. Determine what would be the best action toward self-care and do it immediately
As you can see, my "action plan" is not much of an action plan.  That last one is pretty non-specific, and might not be enough to go on in a crisis.  

Do you have an action plan?  Do you have comments about mine?  Please let me know in the comments!


  1. I think that's a good action plan. Probably your doctor will help you figure out that third step :) I can't think of much else you'd want to add to an action plan... My action plan is also to tell my spouse.. And to not make any big decisions until feeling well again. I don't have a pdoc right now, but if I did, I would be telling them!

  2. In the final class yesterday, we broke up into pairs to talk about our plans. I was able to put a few more steps on it. For instance, I was partnered with another visual artist who said that one of his actions was to sketch, but when he'd tried that the day before, the sketches had gone badly and it didn't work.

    I remembered reading something years ago about a ceramics class that was divided into two groups: a group that was told that their grade would depend on making one bowl (so it had better be a damn good bow, right?), and one that was told their grade would depend on *how many* bowls they made.

    Guess which group made better bowls?

    I've decided to add drawing to my action plan, but the specific plan is to make ten drawings that take two minutes each. This takes down the pressure -- they're only two minute drawings, so who cares if they're good or not?


What are your thoughts? Talk amongst yourselves!