The 48 hours when I didn't think self-management worked...

I had about 48 hours mid-2016 when I honestly thought self-management didn’t work. Everything that I had based the last 5 or so years of my life (personally and professionally) was a lie. Those 48 hours painfully passed, and left me with a reaffirmed understanding of self-management and belief in the process.

That invisible way stress accumulates, that way you start to be aware of it and think that you can cling on until X or Y and then you can rest and sort it all out… and then very suddenly, you can’t and it all crashes down around you. I had what I can only describe as a the worst panic attack, but it was nothing to do with panic and more a depression attack, but with all the standard panic attack symptoms. Typical for me, with my history of major medical events, this happened whilst I was out sailing. Whisked away by my (utterly brilliant and unconditionally supportive) parents to my grandmothers house, a real safe haven for me, I was in shock and quite numb. Everything had just got a bit too much, and I had burnt out. 

The problem was I had created a life where ‘managing stress and symptoms’ was my ‘thing’ and I had spent hours talking about how self-management could really enable people with long term health conditions ‘live well’. Here I was with my long-term health conditions, far from happy and far from well, mentally. So that obviously meant self-management was a farce. It didn’t work. The shitty laws of the universe meant that I was unhappy and unwell nonetheless.

After many cups of tea and biscuits in the garden, tears, TLC from Mum and tough love from Granny, I recognized this as depression and burn out and realized I had to do something about it. I remembered the CBT exercises I had done years before and found them again online to go through, guided and supported by Mum (just a brilliant listening sounding board), and decided I needed a bit of counselling. I knew the NHS counselling locally was too closely linked with the self-management service I work for to go there, so I remembered the employee counselling I could access through the Trust, made the call to the 'Employment Assistance Programme' and got started with a second call booked in for within the week. I worked out the major source of stress and decided to take a break from that activity for a while, and look for manageable short term replacements (joining film society, booking evenings with friends, researching other classes or activities to join, joining the local library and reading their ‘mood boosting’ book list…). I made an action plan for each hour, then each day to get me through that week (which helpful coincided with annual leave). I made sure I had healthy food easily available, and Mum and I planned to do gentle exercise together.

In a less raw moment of reflection after the passage of some healing time, I was reminded of the phrase I say countless time each week ‘the knowledge, confidence and skills to manage life with a health condition’. I had the knowledge (of CBT, of the EAP) and the skills (goal setting and action planning) to manage what my health condition meant for my life at that moment. I had said this phrase before, but I have reminded of just how important it is:

Self-management doesn’t mean you’ll never have bad days again, but perhaps those bad days won’t be so frequent, so bad, or you’ll be able to work through them quicker to arrive at a good day again.

Those 48 hours of thinking self-management doesn't’ work passed, and the feelings that triggered it are too passing – thanks to all the people who have supported me to develop the knowledge, confidence and skills to self-manage -  most of all, my parents! Self-management does work. If I wasn't supported to self-manage, I'd still be all at sea, literally and metaphorically.