There are many reasons why people don’t accept a diagnosis of mental illness.

I received an email the other month from someone whose spouse had psychotic experiences and was later diagnosed with bipolar disorder. However, the spouse believes they had a powerful spiritual experience.

The spouse has agreed to see a psychiatrist, and continues to see their counsellor, but won’t take medication.

I’ve been in that very position, refusing both the diagnosis and medication. Understandably. The experiences I’ve had (two, quite recently) from a science approach typically are called psychosis. I like to call it non-shared reality. Regardless how you describe them, elements of these experiences are profound for me.

I’ve always had difficulty with the ‘either/or’ perspective. Either my experience is an illness as seen through the medical model OR it’s strictly a spiritual experience as seen through alternative perspectives such as the anti-psychiatry movement or transpersonal psychology.

What I experienced was more nuanced. To cavalierly categorize it as either only alienates me from potential help.

But what to do?

In my case, I encountered a brilliant psychiatrist who helped me understand what I experienced could be both. Or, more accurately, they could exist simultaneously.

I had undergone (and continue to undergo) spiritual experiences meaningful to me. While at the same time I have a mental illness that would benefit from some medical assistance.

I’ve come to understand the diagnosis of bipolar disorder, anxiety and psychosis does not diminish the importance of these personally transformative events. Mental illness and spiritual awakening are not mutually exclusive.

This was life-changing for me. It allowed me to embrace the spiritual path I held so dearly while also accepting much needed treatment for psychiatric disorders which were, in no uncertain terms, ravaging my life and relationships.

I am of the belief, for some people, we need to blend both approaches, spiritual and medical. If either one excludes or denigrates the other, it won’t be helpful. For me, the litmus test is this: does the person have the quality of life they want? Is the approach they are using causing them more suffering or less?

I wanted to be someone who didn’t need to take medications. But I’m not that kind of person. Some people don’t need to or can manage without. For me, I needed to be open to the possibility of needing meds and not needing them. I needed my support circle to be on board with that too. Or to be honest with me about any bias they had. That built trust. Trust in the end is the best bridge to help build a life worth living.

Allowing for ‘Both’ rather than forcing an ‘Either/Or’ stance made getting better, well…better. I am able to comfortably hold both my spiritual and medical model perspectives. It’s a fine line, but that’s fine with me.

The following are resources to help those of you grappling with the ‘either/or’ situation. Whether you are supporting someone who identifies only with the spiritual, even to their detriment, or for those of you given a psychiatric diagnosis and trying to reconcile it with your profound experiences, I hope these shed some light and offer insight.

1. Visions Magazine – This edition focuses on spirituality and how it related to mental illness. Visions is an award-winning magazine that brings together many views on mental health and substance use.

https://cmha.bc.ca/wp-content/uploads/2016/07/visions_sprirituality.pdf

The following I wrote or created in partnership with others. Each describe in different ways my journey integrating both a spiritual perspective and medical model approach to help my life come into balance so I could begin to flourish.

2. Bridging Science and Spirit – a 7-minute documentary https://www.youtube.com/watch?v=sXq9B9a3sOI

3. Does God* Have A Place In Psychiatric Treatment Plans? – blog

https://www.psychologytoday.com/ca/blog/crazy-life/200910/does-god-have-place-in-psychiatric-treatment-plans

Note: I use the word ‘God’ but don’t mean it in the strictly religious sense, per say. I use it interchangeably with Love, the Divine, Universe, Spirit, Goodness, what-have-you. Please replace it with what you are most comfortable with.

4. I Went Off my Meds to be More Spiritual: Spiritual Growth and Psychiatric Medication – an oxymoron?  http://victoriamaxwell.com/i-went-off-my-meds-to-be-more-spiritual/

5. Crazy for Life – My theatrical keynote (aka one-person stage show) focusing on my struggle to reconcile the mental illness diagnosis with profound spiritual experiences. In it, I describe how medication, for me at least, needs to be part of my wellness tool box. Not the only one, but one nonetheless. View a clip from the show here (watch at 1min 25sec): https://www.youtube.com/watch?v=z-CU5DaOl74&t=7s  Also available for download purchase. http://victoriamaxwell.com/product/crazy-for-life-a-story-about-accepting-help-for-mental-illness/

Have you had spiritual experiences within your mental illness? Do you think it is one or the other? I’d love to hear from you to learn about how you made sense of it.  

© Victoria Maxwell

I do it. You do it. Even birds do it. No, not that. I’m talking about sleep.

Anyone with depression or bipolar disorder, including loved ones of those with the conditions, knows how important consistent good night sleeps are to staying well1. They cultivate equilibrium in mood, mind and heart. Sleep is important for everybody. But, doubly so for anyone with a mood disorder.

Lack of sleep (or irregular sleep patterns) can both trigger a mania or be a warning sign of one.2

With Spring, worm moons, new moons, time changes, and solar flares, along with everyday ups and downs, good nights rests have been hard to come by for me lately. Not a good thing.

When I’m hypomanic (I prefer my personal term: the “Spazzy-McGuinty”* phase) I sleep only five or six hours a night. and still I wake up all bright eyed and bushy tailed. But if that goes on for too many days (more than three) it’s a red flag. Luckily, Spazzy McGuinty usually calms down on her own accord within a couple days. *The exact origins of “Spazzy McGuinty” remains unknown. However, I do know it is a ‘special’ term of manic endearment created by my husband Gordon and I.

When dank depression hits me, I sleep too much. I easily log (not necessarily sawing logs) 10, 12 even, 13 hours of sleep each night but still awake leaden and lost. It’s awful. Sleeping too much is part of atypical depression, which ironically, isn’t atypical at all. It’s actually very common. For others, insomnia is the beast of burden when their depression descends.

So how can sleep become a balm, instead of a bomb in your life when you’re living with a mood disorder?

Commonly referred to as “sleep hygiene” (good sleep habits), below are some of my tricks for consistently getting a good nights’ rest. For the record, I never thought my sleep was all that dirty. Who knew? Okay, well maybe the occasional dream, but still…

 Tips to change your sleeping from a bomb to a balm:

 1) Go to bed and wake up approximately at the same time every night and morning. I usually turn out my lights at 9:00 or 9:30 P.M.(sometimes even 8:30 P.M.). Yes, I proudly embrace my inner grandma. I wake up around 5 or 6 A.M. 8 – 9 hours is ideal for me. I can manage on 7 hours but only for a few days. This may seem like a luxury to sleep that long. But, trust me, it’s a necessity. I also don’t have kids – so it’s actually realistic.

 2) Create a pre-sleep ritual. As is the nature of rituals, I do mine in much the same order every night. These cues tell the brain that sleep is coming and accordingly, the brain begins to wind down.

 This is my pre-sleep ritual. Around 8:00 P.M.:

I change into my jammies, take out my contacts, take off my make-up (on a good night), put on my glasses, floss then brush my teeth and take my medication (mood stabilizer and anti-depressant). Then I snuggle into bed with my hubby. I write tomorrow’s to do list, jotting down anything I need to remember or do the next day so I don’t have it in my head to prevent me from falling asleep. I read for about an hour. Then I turn out the lights around 9:30 P.M. If I’m lucky, and I usually am, Gord gently strokes my forehead or arm as I fall asleep. My hubby probably doesn’t know this but he’s the most important and best part of my sleep hygiene.

 3) Keep the room cooler than normal. We keep a window open, just a crack, even in winter.

 4) Block out as much light as possible. Even light from under a door or from a clock radio can make going to sleep more difficult.

5) Use ear plugs and/or an eye mask. Put them on before you turn out the lights or if you wake up in the early morning when you need to get back to sleep. In hotels when I travel, I turn the clock away from me so the glare doesn’t disturb me and unplug the bar fridge so it’s as quiet as possible.

 6) Make it a TV/cell phone/computer free bedroom. This is a hard one from some people. But believe me. It works wonders to not have any electronics in the room. Some say even reading in bed is a no-no. But I’ve found it relaxes me.

 7) Don’t drink caffeinated beverages (if you drink them at all) in the evening. This includes black tea, soda like Coke and energy drinks. I rarely drink soda but do drink decaf coffee, rooibus or peppermint tea. I usually have only one cup per day. If I have more, I don’t have it any later than 5:30 P.M.

8) Exercise, even if only for 10 minutes a day. I do some form of movement every day. I practice yoga, go running or walk to the mailbox. Whatever I can muster depending on the day.

Experiment with these suggestions. See if any work for you. Put them into practice and do them consistently. When you do, your mood and energy levels will become more stable. If however, you’ve been struggling with insomnia or hypersomnia for some time without relief, please see your doctor. Remember: Poor sleep can wreak havoc in the life of someone who is trying to manage a mood disorder. More importantly though, is to remember that establishing regular sleep patterns can also be a heavenly balm.

© Victoria Maxwell

1. Kahn D., Printz, D., Ross, R., Sachs, G., Treatment of Bipolar Disorder: A Guide for Patients and Families; p. 6; Postgraduate Medicine Special Report, April 2000

2. Helmer, J. Slumber Solutions (add hyperlink: https://www.bphope.com/slumber-solutions/ ), bp Mag/ bpHope.com, Winter 2011

 

In a previous post, I described the O.A.R.S. framework (Observe, Ask + Actively Listen, Refer + Support).  A simple protocol outlining how to approach someone in the workplace who may be struggling with a mental health condition. The 4-step system along with the ‘do’s and don’ts’ helps make difficult conversations more comfortable and effective. For a copy of a handout click here .

Besides good communication strategies, employers and co-workers need resources – resources beyond your typical EAPs (Employee Assistance Programs). Mental illness, a multi-faceted issue, needs multi-faceted solutions.

These are some workplace resources I recommend. I’ve chosen not to list the well-known and well-respected Mental Health First Aid or the Mental Health Commission of Canada’s workplace webinars. Likely you’re already aware of them. If you’re not, please do check them out.

I’ve decided to highlight ones that may not be on your radar.

Please note: I am not affiliated with any of the following organizations or individuals. I know them as reputable resources offering services and information to effectively help employers and co-workers address difficult mental health issues.

Mind: A UK based non-profit providing advice and support to empower anyone experiencing a mental health problem.  Included is a free download about how to support staff experiencing mental health problems: www.mind.org.uk/media/550657/resource4.pdf  

Visit www.mind.org.uk  to find other good resources.

 

Job Accommodation Network (JAN) is a free on-line resource that offers expert and confidential guidance on workplace accommodations and disability employment issues.

Unique to JAN is their Searchable Online Accommodation Resource (SOAR) system and their A to Z listings by disability, topic, and limitation. The databases lets users search for a specific disability (IE: anxiety disorder, ADHD) and then offers disability-specific accommodations, case studies and questions to consider. https://askjan.org/a-to-z.cfm

 

Not Myself Today: A fee-based program developed by the Canadian Mental Health Association for employers to help create mentally healthy workplaces. It’s evidence-informed, with practical solutions, focused on building understanding, reducing stigma and fostering supportive work cultures. www.NotMyselfToday.ca Visit https://cmha.ca/programs-services for other programs.

 

Mary Ann Baynton & Associates: Mary Ann Baynton and her staff offers various services to improve or resolve workplace issues related to individual or organizational mental health issues. Well-respected across Canada and beyond, she has been a pioneer in workplace mental health consulting since 2008. https://maryannbaynton.com

 

Deborah Connors offers training to develop psychologically healthy workplaces and transform culture. https://deborahconnors.com/

 

 

Hayley Peek Consulting: In partnership with Kim Sunderland, Hayley Peek offers programs that teach people how to have a supportive conversation with someone who may be struggling with a mental health challenge or illness. www.hayleypeek.com

 

Provides various free resources such as tools, training, strategies, assessments for employers, staff, managers to improve workplace mental health. https://www.workplacestrategiesformentalhealth.com/

What workplace mental health resources do you recommend? Send me your go-to websites or resources and I’ll list them in a future blog post with your suggestions.

© Victoria Maxwell

Feeling powerless over symptoms often goes with the territory when you live with mental illness. At least it can for me, particularly with anxiety and depression. This isn’t just the case for those of us diagnosed but also those who love and support us. They can feel at the mercy of these debilitating conditions when they’re at their peak.

Like a ragdoll in a tug-o-war between two kids or one in the washing machine (the ragdoll, not the kids) I can feel like I’m at the whim of my symptoms: negative self-talk, extreme fatigue, racing heartbeat, racing thoughts, incessant worry, rumination, lack of focus, aches and pains, hopelessness, emptiness – and those are just the pleasant ones. Kidding.

I enjoy feeling in charge of my mental health. Most weeks I am. But not always. Not by a long shot.

So what do I do? What can you do if you feel like this?

This is a strategy I’ve set up with my husband. It’s not a miracle solution, but it can help lessen the blows of bipolar disorder, psychosis and anxiety that I live with. It can help my husband better weather them too.

Let your loved ones help you. Enlist them into your wellness journey:

My husband knows me well. He catches signs of things shifting up or down better than (and before) I can sometimes. We all have our blind spots.

He’ll see me filling the Britta jug over the top line, or I’m getting up earlier (much earlier) than usual. Or like today, he’ll catch me making a grocery list and doing laundry at 5:00 in the morning. We’ve created a code word so to speak to signal I might be hypomanic. With kindness and enthusiasm, he’ll say ‘Oh. Spazzy Maginty is visiting us today!’

Another day, I fidget a lot in my favorite chair when we eat breakfast together. Or I won’t look him in the eyes when we talk. He might gently ask me ‘How are you doing?’ or more specifically ‘How’s your anxiety?’.

A different instance, he mentions my complexion looks grey and I’m sleeping longer than usual. Or he might recognize I haven’t run in a couple weeks. He’ll smile, look at me and ask if everything’s ok, knowing that likely it’s not.

His comments aren’t criticism but instead observation. Facts that I’ve changed from my baseline of wellness. It’s meant lovingly and delivered that way. It’s information I can use to my advantage. If I take steps to care for myself, I may prevent the anxiety, depression or hypomania from blossoming further. It’s not guaranteed, but it can reduce the intensity.

I’m not to blame for my conditions, and he’s not saying I am. I am however responsible for my health and reaching out for help when I need to.

My next steps are to be on the alert. Revisit and perhaps double up on my wellness tools. I check to make sure I’ve taken my meds and taken them properly. I’ll review and adjust my sleep patterns. Ask myself if I’m putting too much on my plate and if I need to, take things off. I’ll look at my exercise and aim to do a bit more, or do any if it’s fallen off the radar. I’ll call a friend and spend some quality time with them – phone or in person, doesn’t matter to me. As the incomparable Julie Andrews sings (sort of) these are some of my favorite (‘wellness’) things.

Ideally this will result in the levelling off of my symptoms. This isn’t rocket science. But it’s amazing how if I don’t see my warning signs early enough, and make the needed adjustment, how off course I can really go. And I’ve gone off course. Really off course in recent months. Think psychosis (twice) and major anxiety. But with the help and delicate diplomacy of my husband and my own willingness to accept assistance, getting back on more stable ground is possible.

3 Step to Help Prevent Relapse of Mental Illness

Note: Do these steps with your loved ones while you’re well, not when you’re struggling with acute symptoms.

To set the stage ask yourself:

What are your cues? Be specific. Ask your friends and loved ones to chime in about the warning signs they see. Compare notes.

Who do you want to be your ‘cue companion’? How do you want your loved ones or friends to approach you? Decide who and what’s most comfortable for you. You don’t need a husband, or even someone who lives with you. Just someone who cares.

What will your next steps be when they mention something? Have a list of your most effective wellness tools that you’re willing to commit to. Then pick one and do it. Be honest and clear about what you’re willing to do when warning signs start to rear their heads. Set yourself up for success Think tiny adjustments.

Then:

  1. When warning signs arise, your ‘cue companion’ has permission to mention what they see.
  2. Review your wellness tool list (with your loved one if you like)
  3. Take action: add, adjust said tools as needed.

Sometimes I worry, even feel ashamed at times, how much focus it takes to ‘manage’ my mental illnesses; that I might be a burden with all my mental health problems. But Gord has told me when he’s asking me about them, he wants to know. It’s ok, more than ok to talk about my mental health. Go figure?!

I’ve come to realize that this little 3-step system is as much of a sanity saver for him as it is for me.

Try this out with your loved ones and let me know how it goes. Or, if you have a similar system already in place, let me know how that works for you!

© Victoria Maxwell

There is a vast difference between information and wisdom. I’m learning how to spot the difference. One fills my head and fuels my fears, the other feeds my heart and soothes my spirit.

I’ve made some pretty dumb mistakes. Don’t get me started about the time I became a frosted blonde – think ‘90’s – VERY 90’s, for an acting role. That I AUDITIONED for. But didn’t GET. So, as you might imagine, I could use as much help as possible to let go of stubborn patterns and to make the most of the present.

The following are ‘bon mots’ that I think are divine. I mean that literally. I believe words and their authors are often supernaturally (in the good sense) inspired when they’re writing and creating. When the words have wisdom you can feel they come from a place larger than the rational mind.

I discovered these quotes as I’ve done research, watched videos and read books. Some inspire me, while others help me cope.

My wish for you is that these unique strings of words cast magic in your life for now and always.

Let the ‘onslaught’ of insight begin! Umm… let’s soften things up a bit. How about: let the ‘onslaught of insight gently begin…yeah, that’s better. 

1. “Perfectionism didn’t lead to results. It led to peanut butter.” – Brene Brown (from her book ‘The Gifts of Imperfection’) talking about how ‘perfectionism diets’ led her to emotional eating.

2. “Violence isn’t a symptom of mental illness.” – Amy Willans, CBC radio interview 

3. “Let the good stuff in.” – Krystin Clark (from her book ‘The Grateful Jar Project’).

4. “While the world figures this all out, I’m going to continue holding doors for strangers, letting people merge in front of me in traffic, saying “please” and “thank you”, saying “good morning”, being patient with children, the elderly, the waiter, the customer service rep at the other end of the line, and smiling at strangers. I will not stand idly by and let children live in a world where unconditional love is invisible….. Find your own way to swing the pendulum in the direction of love. “ – Molly Strongheart (saw this first on a friend’s Facebook page – can’t remember who, but thank you!)

5. “To be successful you need to have a wishbone, a backbone and a funny bone.” –  Reba McEntire

6. “I believe that all behaviour serves a purpose. It just may be that we don’t understand what that purpose is.” – Dr. Lloyd Sederer (TEDx talk ‘When Mental Illness Enters the Family’) reflecting on how unhealthy actions are an attempt to cope. His is a great video with very practical tips for loved ones that emphasizes working WITH, not AGAINST the person who is unwell. (watch at 8 minutes 30 seconds).

7. “If you’re frightened of dying and you’re holding on, you’ll see devils tearing your life away. If you’ve made your peace, than the devils are really angels freeing you from the earth.” – adaptation of Meister Eckhart teachings from the movie ‘Jacob’s Ladder’. Trigger warning: the movie is quite scary and intense (but also powerful). Viewer discretion is advised.

8. “Fall down 7 times, get up 8.” – Japanese proverb

9. “…have patience with everything unresolved in your heart and to try to love the questions themselves as if they were locked rooms or books written in a very foreign language. Don’t search for the answers, which could not be given to you now, because you would not be able to live them. And the point is to live everything. Live the questions now. Perhaps then, someday far in the future, you will gradually, without even noticing it, live your way into the answer.” – Rainer Maria Rilke, 1903 from his book ‘Letters to a Young Poet’.

10. “Even if you’re on the right track, you’ll still get hit if you just sit there.” – Will Rogers

Comment below with YOUR favourite quotes. If I get enough, with your permission, I’ll compile them into a post. The more ‘bon mots’ the better. Don’t ya think?

© Victoria Maxwell

Bird Nerd I am.

I’m a bird nerd. They make me happy. Just watching them hop around, flitting here and there, puts a goofy smile on my face. I really love watching the ones in those small wee groups, like juncos, sparrows and robins. Oh and chickadees! Who doesn’t like chickadees? They’re so plucky!

And how cool is that to be named after the sound you make! Chick-a-dee-dee-dee, chick-a-dee-dee-dee. Wait that wouldn’t be so good for us humans, would it? The sounds we mostly make are burps and farts. Yes we talk, but our ‘organic’ noises aren’t our voices.

Anyway, moving on… I found this scientific tidbit about watching birds (see below to geek out on the research). It confirmed something I was already experiencing.

Simon Science Says: Just Add Birds!

Watch birds – any kind – from a window, in a garden or around your neighbourhood. Doing so is associated with lower levels of depression, anxiety & stress, according to a study from the University of Exeter in England.1

Everyday I work at my desk in my home office. I’ve purposely positioned it near a window that overlooks our back porch and old growth trees. Each morning I dribble a little bird seed on the railing. The aforementioned juncos, and others, enthusiastically gobble it up. See photo. Each time they jostle, doing their version of bird sumo wrestling to get access to the best feeding point, I smile. I feel like they’re my feathered co-workers. I don’t have to do anything except watch. I get this happy, present-moment-kind-of-feeling seeing them. Life feels simple and that feels good.

Try it out and see if you get the same benefit.

What does Simon Science Really Say?

According to a University of Exeter study which involved hundreds of people from both urban and rural settings, being able to see birds from windows, and on a daily basis around their neighborhoods, was associated with reduced rates of depression, anxiety and stress.

Drawing from the ‘attention-restoration theory’ which posits that being in nature, and even simply watching nature, promotes healing and lessens stress, researchers explored the potential benefit of nature to improve mood.

The researchers found no correlation between the species of birds seen, but instead the number, indicating that seeing common birds such as robins, crows and blackbirds on a regular basis is a key factor.

Evidence shows it’s not about identifying bird types, but instead, interacting with birds.

The UK Health Spectator rightly cautioned that “while the correlation between mood and nature was highly significant….(doesn’t explain) the cause of the relationship. For example, do happier people actively seek nature more or does a lack of exposure to nature lead to higher rates of depression, or is there some other factor?”2

As a fairly low effort and no-cost tactic that potentially could reduce anxiety and depression and boost mental wellness, it’s worth a shot, I’d say.

Do you already do this? What’s your experience? If you haven’t, try it out and see if you get any benefit. Email me or comment below and tell me!

For more Mental Health resources, tips & tools, sign up for my newsletter.

© Victoria Maxwell

References

1 https://academic.oup.com/bioscience/article/67/2/147/2900179

2 https://health.spectator.co.uk/just-looking-at-birds-may-help-to-keep-you-happier/

For all the talking we’re doing, for all the well-meaning campaigns, I still believe we are woefully under-trained (or untrained for that matter) in how to effectively and comfortably talk to someone about their mental health, particularly in the workplace.

This was the focus of a workshop I facilitated at the recent, successful Working Stronger conference hosted by the Canadian Mental Health Association – Alberta provincial branch.

The heart of this annual event is to bring together leaders and staff from various sectors and companies to acquire skills and engage in dialogue to increase the psychological health of their workplaces.

I performed my “Funny, You Don’t Look Crazy” about my lived experience with mental illness and my eventual return to work. Then I led an enthusiastic group of individuals in an interactive breakout entitled: “Ready, Set, Recognize: Detecting Mental Illness and How to Help”.

To be quite frank, I was nervous. I had several years employed in the not-for-profit health sector. But my corporate experience has consisted of a two-year stint in a small company (really small – 6 people including me!). 20 years ago.

I was hired as a marketing-assistant-slash-receptionist. Heavy emphasis on the receptionist part. Well, actually, heavy emphasis on the slash part. It was my first job since getting my “sea legs” back after being in the psych ward several times over the previous 5 years. Handling conversations, let alone their phone system, was going to take courage.

I held jobs both when I was struggling and in denial of my mental illnesses and also after when I was learning to manage them. It wasn’t easy for me. I know it wasn’t easy for my bosses or co-workers either.

4 simple steps to make the conversation easy and effective.

Working with well-meaning but misguided managers, and exceptionally talented ones, I’ve learned some strategies about what works and what doesn’t when it comes to addressing mental illness in the workplace.

The result is the framework I created called: O.A.R.S. (Observe, Ask + Actively Listen, Refer and Support). A simple protocol to support an employee or co-worker who may be facing a mental health issue.

The steps of O.A.R.S. are simple, but not necessarily easy. We aren’t used to having these conversations. The only way we’ll get confident is by practice.

One solution for companies is to offer safe learning opportunities and ‘rehearsal’ time for these dialogues in low-stake/no-stake situations.  We can be as awkward and unsure as we need to be and gain experiences of success that we can take into real-world scenarios.

I call the framework the Wizard of O.A.R.S. because, well, who doesn’t like a nice play on words? (Actually, I do know several people who don’t. But that’s beside the point.) And because oars bring balance, stability and direction to a boat. Just like oars, people can give support and guidance to those around them who may be facing mental health issues.

This is not a quick fix. The steps don’t work instantaneously. They can in rare cases. But they will gradually, over time, make a difference.

Observe – Changes in behaviour, length present + document

Ask + Actively Listen – Discuss concerns in terms of behaviour, its impact + needs

 Ask open-ended questions

 Mirror + validate

 Be patient + wait

 Be curious

 Discuss impact of behavior

 Focus on collaborative problem solving + actions

Refer – To resources in the workplace and/or community

Visit my resource page to download a Mental Health Resource Guide for additional tools.

Support – Continue to communicate and encourage; find agreement + set healthy objectives

Click here to download the detailed step by step O.A.R.S. e-guide with links to a fun video of Everyone Loves Raymond using active listening!

Observe, Ask & Actively Listen, Refer and Support: the Do’s & Don’ts

Before you have a conversation with someone at work about their mental health, here are some do’s and don’ts to keep in mind.

DO…

  • Set the conversation up for success
  • Check in with yourself: is it a good day for YOU to speak to them?
  • Check in: is it a good day for THEM?
  • Play it out: where, why now, how, what will you say, what might they say, how will you respond?
  • Have the facts: make sure the facts you have are correct
  • Determine your objective
  • Focus on building trust, rapport, safety + open dialogue so they feel free to talk
  • Speak to them as early as possible
  • Document behavior changes + note impact
  • Be clear about what you need from them
  • Prepare for own internal emotional reactivity
  • Plan + prepare for resistance
  • Listen without judgement
  • Use an icebreaker

DON’T…

  • Avoid talking about impact of behavior
  • Make assumptions about the behavior or jump to conclusions
  • Interrupt
  • Minimize or dismiss feelings
  • Try to fix or offer advice
  • Enable

Please note: The O.A.R.S. framework is for non-urgent situations. If you feel the individual is at risk of harming themselves or others, immediate care should be sought at the nearest emergency ward. If the individual refuses help and is actively suicidal or at risk for harming others, the police should be called to assist. Please consult your company policies and guidelines.

Do you want to make a positive impact? Have that conversation NOW.

Effectively talking to someone who you think may be struggling with a mental health condition at work can be fiddly and unclear. As a result, managers and supervisors postpone or avoid these conversations, especially if we think the person is going to respond with resistance. Maybe we hope the issue will resolve itself. It almost invariably doesn’t though.

Sometimes individuals dealing with mental health issues aren’t ready to admit it to others or themselves. I certainly wasn’t. It’s not an easy thing to accept. The stigma of mental illness, especially in the workplace, has decreased but it still exists. This can lead people to refuse assistance or refuse to acknowledge the problems directly.

Unfortunately, if left unaddressed, behavior resulting from mental illness may cause difficulties at work and result in discipline, termination or other negative workplace consequences.

As a manager, co-worker or ally you can be proactive and discuss the behavior with the person before it escalates into discipline or termination. The earlier you speak with someone, however uneasy this may be, the higher the chance for optimal outcomes. Early conversations also offer the best opportunity to prevent a condition (if present) from escalating or becoming chronic.

Letting a person who you’re concerned about know you’re willing to listen without judgement, support them and problem solve can open the door for discussion.

This is what Liz, my boss at the marketing company did when I went to her for help. Even before that, she prepped the ground for positive interactions. From the start of my time there, she focused on building a personal rapport with me. One based on trust, respect and active listening. She was frank, firm, fair, kind and honest. When I had difficulties, I knew she was the person I could go to and receive wise counsel and fair treatment.

My experience with Liz gave me confidence that has influenced me to this day. THAT is the kind of impact you can make.

 

 

© Victoria Maxwell

Could your workplace benefit from learning how to comfortably address mental health issues? Contact Victoria to discuss the Workplace Mental Health Awareness package: a performance of ‘Funny, You Don’t Look Crazy’ followed by the ‘Ready, Set, Recognize’ workshop. You’ll learn the simple O.A.R.S. protocol to make those awkward conversations easy and effective. Contact me.

For the past month, I’ve been practicing a breathing meditation my Chi Kung teacher, Renate, gave me.

Each time, I’m amazed how calm, relaxed and alert I feel after about 5 minutes of this controlled deep breathing. Like really peaceful. And for someone who’s recently been as anxious as a hummingbird on cocaine, this is pretty cool.

Then just last week I went to see my GP, Dr. Yee, to get my medications renewed. While there, she also reminded me about Box Breathing (also called 4 square or tactical breathing).

“Tell me about it again.” I said.

“Pretty simple. Breathe in through your nose for 4, hold for 4, exhale through your nose for 4, hold for 4. And repeat it a few times. There’s good evidence it kicks your parasympathetic nervous system into gear and you’ll feel relaxed.”

Huh? A little light bulb went on for me. That’s almost identical to my 9 Breathings Tibetan Meditation.

I got home and went on ‘the google’ (as my husband and I like to call it).

Box Breathing, or controlled deep breathing, activates the parasympathetic nervous system (the ‘rest and digest’ system) and regulates the autonomic nervous system.

In other words, it helps get me out of the stress response when my anxiety is high, my trauma is triggered or I’m heading into a challenging work project even.

It’s called tactical breathing because, get this… Navy Seals are trained to use it. 1 Special forces, law enforcement and first responders use it when there’s a crisis or a threat is perceived. When their stress response is activated they need something that will bring them back to calm, and clear their head, so they can act effectively.

You’re probably quite familiar with the fight or flight response, yes? Or the lesser known “fight, flight or freeze” response. Heart rate increases, adrenaline and cortisol flood the body, eyes dilate, muscles tense and senses sharpen.

Military personnel, even athletes, learn box breathing to calm their system so they can think more clearly and operate effectively in high stress situations.

Who knew ancient yogis and Navy Seals shared a common practice to reduce anxiety?

The Mayo clinic has found deep breathing effectively helps with PTSD, generalized anxiety, depression, even insomnia and pain management.2, 3 It’s also been shown to decrease the release rate of cortisol, trigger the release of pleasure-inducing neurochemicals and eliminate toxins by bringing more oxygen into the bloodstream. 4

Box Breathing in a nutshell:

After some practice, it can be used anywhere, anytime if you’re feeling stressed, say before giving a presentation, about to have a difficult conversation, if you feel a panic attack coming on or feel yourself triggered.  Do this while seated comfortably.

  1. Close your eyes or soften your gaze. Inhale through the nose for a count of 4 until your lungs and belly are full.
  2. Hold for a count of 4. Try not to clench your jaw or muscles.
  3. Exhale through the nose for 4, emptying your lungs and belly.
  4. Hold for 4.
  5. Repeat at least 3 times or as much as you like.

Tip: If counting to 4 is too difficult, use a count of 3. If it’s too easy, increase to what feels right. As you get practiced, increase the length of the breath and hold.

My meditation includes additional elements: hand and finger postures (mudras) and visualization with colour, but the basic framework is the same. As are the results: clarity and calm.

I highly recommend using this practice when you feel generally stressed, or for more acute stress if a traumatic memory has triggered reactivity or panic.

Try it yourself or share it with your clients. Tell me if you found it effective. I’ll be practicing most mornings as part of my meditation and prayer practice (and if my computer crashes or I can’t find my cell phone! 😊).

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© Victoria Maxwell

References:

1. https://thepreppingguide.com/box-breathing/

2. https://www.medicalnewstoday.com/articles/321805.php

3. https://ritualize.com/box-breathing-military-secret/

4. https://unbeatablemind.com/7-tangible-benefits-of-breathing-exercises/

Watch Mark Divine, former Navy Seal, teach his version in this video here.