MAINTAINING WELL BEING A SELF HELP GUIDE A Preventative Approach for Managing Stress and Maintaining Well Being A Personal Workbook 1
Introduction Most people will find it hard to cope with the demands of every day living at sometime in their life. Just everyday living involves all kinds of pressures. These may include managing household chores, balancing finances, dealing with unexpected events or significant life changes and finding time for enjoyment and leisure activities. If the pressures and demands placed on us continue to build and our perceived ability to cope with pressures diminishes, this can lead to feelings of stress and a sense of being overwhelmed. When prolonged, stress can act to trigger unhelpful patterns of coping or lead to the development of common mental health experiences such as depression or anxiety. Just staying well on a daily basis can be a challenge. However, over the years we get a sense of what works and does not work for us. Our ways of keeping ourselves well are totally individual and unique to ourselves. We may learn form others, but nobody has all the answers. Life is a journey of discovery and learning. This Personal Workbook is a self help booklet designed to help you to think through, recognise and develop ideas and strategies to manage and maintain your mental health and well being. When under pressure it is all too easy to forget the simple things that you know are helpful in keeping you well. This booklet works on the premise that prevention is better than cure. All of us can benefit from actively thinking about the things that keep us well and help us to cope with everyday challenges that life presents. This booklet does this by reminding you of the things that you need to do to help you to stay well. Completing the work book will take time; but once complete it will be an important document to refer back to on a daily basis and at times of difficulty. You can complete it with the help of somebody you know and trust or you may wish to work on it on your own. You can do it in whichever way you find most helpful. It is designed as an aid for learning about yourself, what helps you and what doesn t, and how to get progressively more in control of your life and your experience. This can be an opportunity for learning more about yourself, improving your wellbeing and putting some contingencies in place when you have more challenging times. 2
Contents This Workbook comprises the following sections A Daily Plan pages 6-9 Understanding triggers & what I can do about them pages 10-12 Identifying warning signs pages 13-14 Supporters page 15 Reviewing the Situation page 16 Reminders page 17 3
Acknowledgements Maintaining mental well being is based on the Wellness Recovery Action Plan (WRAP) originally developed by Mary Ellen Copeland and a group of mental health service users who wanted to work on their own recovery this is what they found worked for them. This workbook is an abbreviated version of WRAP and is adapted from Feeling Stressed: Keeping Well, developed by Richard Frost at Workways and Maintaining Mental Well Being a Self Help Guide developed by Helen Fee, Mental Health Adviser, University of Exeter. The full version of WRAP also includes instructions on developing a crisis plan, as a means of guiding others on how best to make decisions and to take care of the person affected by mental ill health, for those times when problems and symptoms have made it very difficult for them to do so by themselves. The full version can be found at www.recoverydevon.co.uk. For more information on WRAP, look at:- Wellness Recovery Action Plan by Mary Ellen Copeland Edited by Piers Allott Published by Sefton Recovery Group 2005 Available from: Sefton Recovery Group MIND office Maple Unit Stoddart House University Hospital Aintree Longmoor Lane Liverpool L9 7AL ISBN 0-9549295-0-0 4
Using the Workbook Under each heading we have given some examples to help you think through the topics covered in the Workbook and they are simply that: just examples. Apart from how they affect you as an individual, there are no right or wrong answers. We ve allowed a whole page per topic but it s up to you how much you write. You may like to put it all in a ring binder so you can add pages at some point. The Workbook belongs to you and you decide how to use it. No one else can write it for you. You decide who to show it to and you decide whether you want someone to work with you on it or not. You decide how much time to spend on it and when to do it. It becomes your guide to support your own wellness and recovery. Keep it near you keep yourself well. 5
A DAILY PLAN Many people vary in how they feel from day to day. The weather, diet, sleep (or lack of it), our health and many other factors can govern whether we have a good or a bad day. This first section helps you to consider the good things about you, what makes you, you. 1. Setting up my Daily Maintenance Plan A) What am I like when I am well, when I am feeling alright? Examples: When I feel well I am active, I get up early, I feel calm, I smile a lot, I spend time painting and being creative, I socialise with friends, I go to the gym etc.. When I feel well and alright, I am 6
b) This is what I need to do for myself every day to keep myself feeling as well as possible What do I do each day to keep myself feeling well, feeling alright? Examples: have a shower, read a book, phone a friend, go for a walk, go to bed by 10, eat 3 proper meals, drink enough water etc 7
c). This is what I need to do, less often than every day, to keep my overall wellness and sense of wellbeing. What do I do less often than every day (weekly, monthly, yearly) to keep myself feeling well and feeling alright? Examples: go on holiday, see a relation, go home, go to the cinema, review life goals/ambitions, get an overview of all my work. 8
d.) These are the things that I know I need to do to sustain my wellness, but for some reason do not do them. What are the things I know I need to do to stay well but for some reason don t do them? Examples, take regular exercise, take regular breaks, make a study plan, go to bed early, keep a diary, eat well, tidy my room. 9
2. Understanding Triggers & What I Can Do About Them Triggers are things that happen to us that are likely to set off a chain reaction of uncomfortable or unhelpful behaviours, thoughts or feelings. A) Recognition: What triggers me? What are the things that cause me to feel stressed, irritable, unhappy or difficult to be with? Examples: problems at work, anniversary of loss or trauma, ways that others treat you, being over-tired, family conflict, illness 10
B) Action: Avoiding & Controlling Triggers What can I do to AVOID or LIMIT my exposure to things that trigger me? Examples: focusing on priorities, avoiding stressful situations, having a study timetable, talking, to a friend or counsellor, talking to a tutor, playing music 11
C) Coping With Triggers When They Occur What can I do when I am triggered to prevent things from getting worse? Examples, take time out from the situation, tell somebody my worries, go for a run, etc 12
3) Identifying warning signs Early warning signs are the subtle signs of changes in your thoughts or feelings or behaviour, which indicate that you may need to take action to avoid feeling more stressed or to prevent a worsening of your condition or situation. A) Recognition: What Are My Early Warning Signs, the subtle signs of changes within me? Examples: feeling told off, experiencing strong emotions, withdrawing, forgetfulness, being obsessed with thoughts, being mentally tired, feeling nobody likes me 13
B) Action: What can I do about them? What action can I take when I recognise the early warning signs? Examples: talking to a friend or counsellor, rationalising thoughts, being assertive, getting, organised, focussing exercises, making lists 14
4. Supporters List those people you could provide some additional support when things get difficult. They can be family members, work colleagues, friends or health care professionals. You may want to name some people for certain tasks. These are my supporters: Name Phone number Name Phone number Name Phone number Name Phone number Name Phone number Connection/role Connection/role Connection/role Connection/role Connection/role There may be health care professionals or family members that have made decisions that were not according to your wishes in the past. They could inadvertently get involved if you do not include the following: I do not want the following people involved in any way: Name Why you do not want them involved (optional) Name Why you do not want them involved (optional) 15
5. Reviewing the Situation This section is for completion at a later stage when necessary. If despite your best efforts at caring for yourself and working with others, you still go through a difficult patch this is not the end of the world, nor does it mean you cannot recover and the issues can be helped. Recovery is a process that you can get back to at any time and after any experience, no matter how bad. But in order to do so it will be very helpful to reflect on what has happened to you and learn from it. Some can do this alone, most of us are greatly helped by having someone we trust to turn to, and talk it over together but pick your time when you are ready and willing to make sense of it, and you have the energy to do so. Then talk and think through what has happened, and compare this with what you have written so far. What have you learned about yourself and others through this difficulty? Are there any of your Action Points that didn t work out as you had hoped? What changes can you make now to your workbook and the Action Points to make further difficulties less likely? (Print off new pages and date them if that helps) Keep it near you keep yourself well 16
Reminders For completion either now or later Think back through what you have written in the Workbook what conclusions can you draw that may be helpful? In my experience these are things that support my wellness this works for me: These are some things that I would like to try to see if they would support my wellness: 17