Recovering Your Mental Health: A Self Help Guide

The information in this booklet is from studies designed to find out how people who experience psychiatric symptoms deal with these symptoms and help themselves feel better. The researcher and the study participants are people who have been told that they have a psychiatric or mental illness. Not all of these ideas work for everyone--use the ones that feel right to you. If something doesn't sound right to you, skip over it. However, try not to dismiss anything before you have considered it.

The opinions expressed herein are those of the author and are not necessarily those of the Center for Mental Health Services.

Have you been told that you have a psychiatric or mental illness like depression, bipolar disorder or manic depression, schizophrenia, borderline personality disorder, obsessive-compulsive disorder, dissociative disorder, post traumatic stress disorder or an anxiety disorder?

___ yes ___ no

Or do feelings or experiences like those that follow make you feel miserable, unsafe and get in the way of doing the things you want to do?

• feeling like your life is hopeless and you are worthless
• wanting to end your life
• thinking you are so great that you are world famous, or that you can do supernatural things
• feeling anxious
• being afraid of common things like going outdoors or indoors, or being seen in certain places
• feeling like something bad is going to happen and being afraid of everything
• being very "shaky", nervous, continually upset and irritable
• having a hard time controlling your behavior
• being unable to sit still
• doing things over and over again--finding it very hard to stop doing things like washing your hands, counting everything or collecting things you don't need
• doing unusual things like wearing winter clothes in the summer and summer clothes in the winter
• believing things like the television or radio are talking to you or that the smoke alarms or digital clocks in public buildings are taking pictures of you
• saying things over and over that don't make any sense
• hearing voices in your head
• seeing things you know aren't really there
• feeling like everyone is against you or out to get you
• feeling out of touch with the world
• periods of time go by when you don't know what has happened or how the time has passed--you don't remember being there but others say you were
• feeling unconnected to your body
• having a hard time keeping your mind on what you are doing
• a sudden or gradual decrease or increase in your ability to think, focus, make decisions and understand things
• feeling like cutting or hurting your body
• feeling like you are a "fake"

___ yes ___ no

If you answered yes to either or both of these questions, this booklet is filled with helpful information and things you can do to feel better.

First, remember, you are not alone. Most people experience feelings or experiences like these at some time in their life. Some of them get help and treatment from health care providers. Other people try to get through it on their own. Some people don't tell anyone what they are experiencing because they are afraid others will not understand and will blame them or treat them badly. Other people share what they are experiencing with friends, family members or co-workers. Sometimes these feelings and experiences are so severe that others know you have are having them even though you have not told them. No matter what your situation is, these feelings and experiences are very hard to live with. They keep you from doing what you want to do with your life, doing things you have to do for yourself and others, and doing things that are rewarding and enjoyable.

As you begin to work on helping yourself to feel better, there are some important things to keep in mind.

1. You will feel better. You will feel happy again. The disturbing experiences and feelings you've had or are having are temporary. This may be hard to believe but it's true. No one knows how long these symptoms will last. But there are lots of things you can do to relieve them and make them go away. You will want help from others including health care providers, family members and friends in relieving your symptoms, and for on-going help in staying well.
2. The best time to address these feelings and experiences is now, before they get any worse.
3. These feelings and experiences are not your fault.
4. When you have these kinds of feelings and experiences, it is hard to think clearly and make good decisions. If possible, don't make any major decisions--like whether to get a job or change jobs, move, or leave a partner or friend--until you feel better.
5. These feelings and experiences do not mean that you are not smart or are less important or valuable than other people.
6. Sometimes people who have these kinds of feelings and experiences are treated badly by people who don't understand. If that happens to you, talk to your friends about it (if you don't have any friends, or only have a few, read the section of this booklet on making new friends. Try to stay away from people who treat you badly. Spend time with upbeat, positive people, people who are nice to you, and who like you just the way you are.
7. Listen to the concerns and feedback from your friends, family members and health care providers who are trying to be helpful.
8. These feelings and experiences do not take away your basic personal rights, like your right to:
   • ask for what you want, to say yes or no, and to change your mind.
   • make mistakes.
   • follow your own values, standards and spiritual beliefs.
   • express all of your feelings, both positive or negative, and to be afraid.
   • determine what is important to you and to make your own decisions based on what you want and need.
   • have the friends and interests of your choice.
   • be uniquely yourself and to allow yourself to change and grow.
   • your own need for personal space and time
   • be safe.
   • be playful and frivolous.
   • be treated with dignity, compassion and respect at all times.
   • know the side effects of recommended medications.
   • to refuse medications and treatments that are unacceptable to you for any reason.

   You may be told that the following things are not normal. They are normal. These kinds of things happen to everyone and are part of being human.

   • getting angry when you are provoked
   • expressing emotion when you are happy, sad or excited
   • forgetting things
   • feeling tired and discouraged sometimes
   • wanting to make your own decisions about your treatment and life.
9. It's up to you to take responsibility for your behavior and for getting better. You are the only one who can help yourself feel better. However, you can reach out for help from others.

What to do if these feelings and experiences feel overwhelming

If any of the following apply to you, or your feelings and experiences feel overwhelming, do some things to help yourself right away.

• You feel absolutely hopeless and/or worthless.
• You feel like life is not worth living anymore.
• You think a lot about dying, have thoughts of suicide or have planned how you will kill yourself
• You are taking lots of risks that are endangering your life and/or the lives of others.
• You feel like hurting yourself, hurting others, destroying property or committing a crime .

Things you need to do:

• Arrange an appointment with your doctor, a health care worker or a mental health agency. If your symptoms make you a danger to yourself or someone else, insist on immediate care and treatment--a family member or friend may need to do this for you if your symptoms are too severe. If you are taking medicines and you think it would be helpful, ask for a medicine check.
• Ask a friend or family member to stay with you until you feel better -- talk, play cards, watch a funny video together, listen to music, etc..
• Call someone you really like and talk to them about how you are feeling.
• Do something simple that you really enjoy, like "getting lost" in a good book, staring at a beautiful picture, playing with your pet or brushing your hair.
• Write anything you want to in a notebook or on scraps of paper.

You will find other ideas in the next section, Things you can do right away to help yourself feel better. As you learn what helps you to feel better, and take action quickly, you will find that you will spend more and more time feeling well and less time feeling badly.

Sometimes when you feel this bad, you may feel like doing things that are dangerous, frightening to others, or things that will be embarrassing to you or others. Keep in mind that no matter how bad you feel, you are still responsible for your own behavior.

If you possibly can, see a physician or a health care worker you like and trust. These feelings and experiences can be caused or worsened by medical illnesses that you don't know you have--like thyroid problems or diabetes. The sooner you get help, the sooner you will feel better. Insist on help with figuring out what to do about any feelings or experiences that are making you uncomfortable or keeping you from doing the things you want or need to do. If you feel it is necessary, ask to be sent to someone else who knows more about treating these kinds of issues.

Doctors and health care workers can tell you about possible things they can do for you or you can do for yourself that will help you feel better. When you go to see them, take a complete listing of all medicines and anything else you may be using to help yourself feel better, and a list of unusual, uncomfortable or painful physical or emotional symptoms--even if they don't seem important to you. Also describe any difficult issues in your life--both things that are going on now and things that have happened in the past--that may be affecting the way you feel. This will help the doctor give you the best possible advice on what you can do to help yourself. It's always easier to go to the doctor if you take along a good friend. This person can help you remember what the doctor suggests, and could take notes if you want them to.

Your doctor or health care worker is providing you with a service, just like the person who installs your telephone or fixes your car. The only difference is they have experience and expertise in dealing with health issues. Your doctor or health care worker should:

• listen carefully to everything you say and answer your questions.
• be hopeful and encouraging.
• plan your treatment based on what you want and need.
• teach you how to help yourself.
• know about and be willing to try new or different ways of helping you feel better.
• be willing to talk with other health care professionals, your family members and friends about your problems and what can be done about them, if want them to.

Your health care rights include the right to:

• decide for yourself treatments that are acceptable to you and those that are not.
• a second opinion without being penalized.
• change health care workers--this right may be limited by some health care plans.
• have the person or people of your choice be with you when you are seeing your doctor or other health care worker.

Your health care worker may suggest that one or several medicines would help you feel better. Find the answers to the following questions to help you decide whether or not you want to take this medicine, and so that you have important information about the medicine. You can get this information by asking your health care worker or pharmacist, looking it up in a book on medications in the library, or by searching for it on the internet.

• What is the common name, product name, product category and suggested dosage level of this medicine?
• How does the medicine work?
• What does the physician expect it to do? How long will it take to do that?
• How well has this medicine worked for other people?
• What are the possible dangers of taking this medicine?
• What are the possible long and short term side effects of taking this medicine? Is there any way to reduce the risk of experiencing these side effects?
• Are there any dietary or life restrictions (such as no driving) when using this medicine?
• How are medicine levels in my blood checked? What tests will be needed before taking this medicine and while taking the medicine? 
• How would I know if the dose should be changed or the medicine stopped?
• How much does it cost? Are there any programs that would help me cover some or all of the costs of this medications? Is there a less expensive medication that I could use instead?

If your symptoms are so bad that you can't understand this information, ask a family member or friend to learn about the medication and to discuss with you whether or not this is a good medicine for you to take.

If you decide to use psychiatric medicine or medicines, they must be managed very carefully to get the best possible results and to avoid serious problems. To do this:

• use these medicines exactly as the doctor and pharmacist has suggested.
• report any side effects to your doctor.
• tell your doctor about any times that you have not been able to take your medicine for any reason so the doctor can tell you what to do--do not double the next dose unless the doctor tells you to.
• avoid the use of alcohol or illegal drugs (if you are addicted to them, ask your doctor for help).
• pay close attention to lifestyle issues that cannot be corrected by medications, such as stress, chaos, poor diet (including excessive use of sugar, salt and caffeine), lack of exercise, light, rest, and smoking.

Things you can do right away to help yourself feel better

1. Tell a good friend or family member how you feel. Telling someone else who has had the same or similar experiences or feelings is very helpful because they can best understand how you are feeling. Ask them if they have some time to listen to you. Tell them not to interrupt with any advice, criticism or judgments. Tell them that after you get done talking you can discuss what to do about the situation, but that first, just talking with no interruptions will help you feel better.
2. If you have a counselor you feel comfortable with, tell her or him how you are feeling and ask for their advice and support. If you don't have a counselor and would like to see someone professionally, contact your local mental health agency (The phone number can be found in the yellow pages of your phone book under Mental Health Services.) Sliding scale fees and free services are often available.
3. In order to deal most effectively with the way you feel and to decide what you are going to do about it, learn about what you are experiencing. This will allow you to make good decisions about all parts of your life like: your treatment; how and where you are going to live; who you are going to live with; how you will get and spend money; your close relationships; and parenting issues. To do this, read pamphlets you may find in your doctor's office or health care facility; review related books, articles, video and audio tapes (the library is often a good source of these resources); talk to others who have had similar experiences and to health care professionals; search the Internet; and attend support groups, workshops or lectures. If you are having such a hard time that you cannot do this, ask a family member or friend to do it with you or for you.
4. Get some exercise. Any movement, even slow movement, will help you feel better--climb the stairs, take a walk, sweep the floor.
5. Spend at least one half hour outdoors every day, even if it is cloudy or rainy.
6. Let as much light into your home or work place as possible--roll up the shades, turn on the lights.
7. Eat healthy food. Avoid sugar, caffeine (coffee, tea, chocolate, soda), alcohol and heavily salted foods. If you don't feel like cooking, ask a family member or friend to cook for you, order take out, or have a healthy frozen dinner.
8. Every day, do something you really enjoy, something that makes you feel good--like working in your garden, watching a funny video, playing with a small child or your pet, buying yourself a treat like a new CD or a magazine, reading a good book or watching a ball game. It may be a creative activity like working on a knitting, crocheting, or woodworking project, painting a picture, or playing a musical instrument. Keep the things you need for these activities on hand so they will be available when you need them.
9. Relax! Sit down in a comfortable chair, loosen any tight clothing and take several deep breaths. Starting with your toes, focus your attention on each part of your body and let it relax. When you have relaxed your whole body, notice how it feels. Then focus your attention for a few minutes on a favorite scene, like a warm day in spring or a walk at the ocean, before returning to your other activities.

1. If you are having trouble sleeping, try some of the following suggestions:
   • before going to bed:
     • avoid heavy meals, strenuous activity, caffeine and nicotine
     • read a calming book
     • take a warm bath
     • drink a glass of warm milk, eat some turkey and/or drink a cup of chamomile tea
   • listen to soothing music after you lie down
   • eat foods high in calcium like dairy products and leafy green vegetables
   • avoid alcohol--it will help you get to sleep but may cause you to awaken early
   • avoid sleeping late in the morning and long naps during the day

2. Ask a family member or friend to take over some or all of the things you need to do for several days--like taking care of children, household chores and work-related tasks--so you have time to do the things you need to take care of yourself.

3. Keep your life as simple as possible. If it doesn't really need to be done, don't do it. Learn that it is alright to say "no" if you can't or don't want to do something, but don't avoid responsibilities like taking good care of yourself and your children. Get help with these responsibilities if you need it.
4. Avoid nasty or negative people who make you feel bad or irritated. Do not allow yourself to be hurt physically or emotionally in any way. If you are being beaten, sexually abused, screamed at or suffering other forms of abuse, ask your health care provider or a crisis counselor to help you figure out how you can get away from whoever is abusing you or how you can make the other person or people stop abusing you.
5. Work on changing your negative thoughts to positive ones. Everyone has negative thoughts that they have learned, usually when they were young. When you are feeling badly, these negative thoughts can make you feel worse. For instance, if you find yourself thinking, "I will never feel better," try saying, "I feel fine," instead. Other common negative thoughts and positive responses:
   

   No one likes me.	Many people like me.
   I am worthless.	I am a valuable person.
   I'm a loser.	I'm a winner.
   I can't do anything right.	I do many things right.

   Repeat the positive responses over and over. Every time you have the negative thought, replace it with the positive one.

Things To Do When You Are Feeling Better

When you are feeling better, make plans using the ideas in the previous section.

Things you can do right away to help yourself feel better, that will help you keep yourself well. Include simple lists of:

• to remind yourself of things you need to do every day, like getting a half hour of exercise and eating three healthy meals;
• to remind yourself of things that may not need to be done every day, but if you miss them they will cause stress in your life, like bathing, buying food, paying bills or cleaning your home.
• of events or situations that, if they come up, may make you feel worse, like a fight with a family member, health care provider or social worker, or loss of your job;
  • and a list of things to do (relax, talk to a friend, play your guitar) if these things happen so you won't start feeling badly.
• of early warning signs that you are starting to feel worse, like always feeling tired, sleeping too much, overeating, dropping things and losing things;
  • and a list of things to do (get more rest, take some time off, arrange an appointment with your counselor) to help yourself feel better.
• of signs that things are getting much worse, like you are feeling very depressed, you can't get out of bed in the morning or you feel negative about everything;
  • and a list of things to do that will help you feel better quickly (get someone to stay with you, spend extra time doing things you enjoy, contact your doctor).
• of information that can be used by others if you become unable to take care of yourself or keep yourself safe such as :
  • signs that indicate you need their help
  • who you want to help you (give copies of this list to each of these people)
  • the names of your doctor, counselor and pharmacist
  • any medications you are taking
  • things that others can do that would help you feel better or keep you safe
  • things you do not want others to do or that might make you feel worse

Key to successful recovery: family members and close friends

One of the most effective ways to improve the way you feel is reaching out to a very good friend, family member, or health care professional, either telling them how you are feeling or sharing an activity with them. If you feel that there is no one you can turn to when you are having a hard time, you may need to work on finding some new friends.

GOOD FRIENDS ARE PEOPLE WHO HELP YOU FEEL GOOD ABOUT YOURSELF.

Here are some ways you could meet people with whom you may become friends. You may not be able to do these things until you feel better.

• Attend a support group. Support groups are a great way to make new friends. It could be a group for people who have similar health issues. You can ask your doctor or other health care professional to help you find one, or check support group listings in the newspaper.
• Go to events in your community like fairs and concerts.
• Join a special interest club. They are often free. They are usually listed in the newspaper. You will meet people with whom you already share a common interest. It might be a group that is focused on hiking, bird watching, stamp collecting, cooking, music, literature, sports, etc..
• Take a course. Adult education programs, community colleges, universities and parks and recreation services offer a wide variety of courses that will help you meet people while learning something new or refreshing your skills. Another benefit is that you will learn something interesting that might open the doors to a new career, or a career change.
• Volunteer. Offer to assist a school, hospital or organization in your community.

Things To Do When You Are Feeling Better

When you are feeling better, make plans using the ideas in the previous section.

Things you can do right away to help yourself feel better, that will help you keep yourself well. Include simple lists of:

• to remind yourself of things you need to do every day, like getting a half hour of exercise and eating three healthy meals;
• to remind yourself of things that may not need to be done every day, but if you miss them they will cause stress in your life, like bathing, buying food, paying bills or cleaning your home.
• of events or situations that, if they come up, may make you feel worse, like a fight with a family member, health care provider or social worker, or loss of your job;
  • and a list of things to do (relax, talk to a friend, play your guitar) if these things happen so you won't start feeling badly.
• of early warning signs that you are starting to feel worse, like always feeling tired, sleeping too much, overeating, dropping things and losing things;
  • and a list of things to do (get more rest, take some time off, arrange an appointment with your counselor) to help yourself feel better.
• of signs that things are getting much worse, like you are feeling very depressed, you can't get out of bed in the morning or you feel negative about everything;
  • and a list of things to do that will help you feel better quickly (get someone to stay with you, spend extra time doing things you enjoy, contact your doctor).
• of information that can be used by others if you become unable to take care of yourself or keep yourself safe such as :
  • signs that indicate you need their help
  • who you want to help you (give copies of this list to each of these people)
  • the names of your doctor, counselor and pharmacist
  • any medications you are taking
  • things that others can do that would help you feel better or keep you safe
  • things you do not want others to do or that might make you feel worse

Key to successful recovery: family members and close friends

One of the most effective ways to improve the way you feel is reaching out to a very good friend, family member, or health care professional, either telling them how you are feeling or sharing an activity with them. If you feel that there is no one you can turn to when you are having a hard time, you may need to work on finding some new friends.

GOOD FRIENDS ARE PEOPLE WHO HELP YOU FEEL GOOD ABOUT YOURSELF.

Here are some ways you could meet people with whom you may become friends. You may not be able to do these things until you feel better.

• Attend a support group. Support groups are a great way to make new friends. It could be a group for people who have similar health issues. You can ask your doctor or other health care professional to help you find one, or check support group listings in the newspaper.
• Go to events in your community like fairs and concerts.
• Join a special interest club. They are often free. They are usually listed in the newspaper. You will meet people with whom you already share a common interest. It might be a group that is focused on hiking, bird watching, stamp collecting, cooking, music, literature, sports, etc..
• Take a course. Adult education programs, community colleges, universities and parks and recreation services offer a wide variety of courses that will help you meet people while learning something new or refreshing your skills. Another benefit is that you will learn something interesting that might open the doors to a new career, or a career change.
• Volunteer. Offer to assist a school, hospital or organization in your community.

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