Posted in compassion, mental health, Planning and journaling, wellbeing, wellness

Monday Matters: Creating a WRAP Part 5 (final in the series)

Over the course of April, I’ve produced a series of posts about the process involved in creating a Wellness Recovery Action Plan. Today is the final installment in which I look at Crisis Planning. As I stated in my last Monday Matters post, I did not complete this section of the booklet myself as my illness has never reached crisis point but I intend to go over what this part of the plan would look like and suggest some ideas of what you might include.

What constitutes crisis?

Although there is no set definition for a crisis, it can be described loosely as being a state of emergency that poses an immediate threat to your physical or emotional wellbeing. Therefore, in spite of your best planning and actions to keep yourself well, you find yourself in a situation where others need to take over your care.

Crisis planning

This part of the W.R.A.P. has 9 sections and I will go over in in turn. Although the whole plan is very personal to the individual, I can offer suggestions on the kind of information you might record in each list.

Part 1: What I am like when I’m well

This can literally be copied from the second page of your plan and is simply placed in this part of the document for ease of access.

Part 2: Symptoms

This is a list of signs that tell others that they need to take over your care. Some examples include violent out of control behaviour, psychosis (loss of touch with reality), paranoia, abusive behaviour towards self or others, inability to perform basic tasks such as bathing, brushing teeth etc, showing signs of planning own suicide (Mind website information on this can be found here).

Part 3: Supporters

This is a list of people you want to care for you if the symptoms you listed in Part 2 occur. Include family members and health care professionals but make sure you seek their permission to me added to your list so that have advance warning in case something happens in the future. You can also include a list of people you do not want included in your supporters list too.

Part 4: Medication

In this section, you can write which medications are okay to be given and which are not. So, for example, you might have reacted in a bad way to a particular antipsychotic in the past and be worried that it might make you worse if administered again.

Part 5: Community Plan

In this section, you can list your preferences for your care so you can feel you have some say in what happens when you are unwell. So, for example, you might prefer to have the Crisis team visit you at home and come up with a plan for you in consultation with your partner or you might feel that you are best off being hospitalised.

Part 6: Treatment Facilities

Here, you would list where you would prefer to be treated or hospitalised if that becomes necessary. You can also add facilities that you would rather avoid if possible and why.

Part 7: Treatments

In this part, you can include treatments and therapies which you feel would be most beneficial and those which you wish to avoid and why. You may have tried alternative therapies that have worked in the past and wish them to be administered again.

Part 8: Help from others

Here, you can write down what you want from your supporters which will help make you feel most comfortable. Obviously, this list is very personal but might include the kind of things you would like people to say to you for encouragement or avoid saying as you know they will not help.

Part 9: When my supporters no longer need to use this plan

In this section, write a list of indicators that your supporters no longer need to take over your care. What are the signs that show you are once again in control of your life? This might include features of wellness that you display which show you are well on the path to recovery.

Looking forward

Remember that if you do reach crisis point, despite putting all of the elements of a W.R.A.P. in place, this is not the end of the world and it certainly does not mean that you won’t recover. After you have taken the time to get yourself feeling better and stronger, you might like to revisit your plan with one of your supporters and discuss any improvements you might be able to make to your plan and the action which goes with it. Maybe, on reflection, you didn’t do enough to keep yourself calm and relaxed in daily life and could benefit from putting more self soothing activities into place. Or perhaps a loved one recognised signs of deterioration but you chose to ignore it or go into a state of denial. Whatever happens, you can learn from the experience and try to make plans for the future.

And that, as they say in the filming industry, is a WRAP. I hope you have found my series helpful and can see the benefits of producing this kind of document to help with issues relating to mental health. If you would like support to write your WRAP, I suggest looking into if there is a Recovery College in your local area or if you are able to work with a mental health professional as part of therapy sessions to make one.

Wishing you a wonderful week,

Posted in compassion, mental health, Mindfulness, wellbeing, wellness

Monday Matters: Creating a W.R.A.P. Part 3

Over the past couple of weeks, I’ve been sharing my experiences of writing a Wellness Recovery Action Plan to support my mental health. In Part 1, I shared what a W.R.A.P. is and why it’s useful as well as how to create a wellness toolbox. In Part 2, I wrote about making a detailed list of adjectives to describe what you are like when you are feeling well and also how to make a maintenance plan of every day activities that help to keep you well. This week, the focus is on triggers and how to cope with them, plus creating a list of early warning signs of deteriorating mental health. Obviously, this is very personal to you as an individual but I hope by sharing some of my lists you get the idea so you can have a go at making your own.

Triggers (AKA Stressors)

Triggers in your life are external events or circumstances that make you feel uncomfortable. They can include situations in your work or personal life that you know tend to stress you out or upset you. Writing these triggers down won’t stop them from happening, but it can help us put coping methods and action plans in place for dealing with the emotions that are felt.

The following are some examples of my triggers so you can get the idea for making your own list:

spending too much time alone

criticism from others

being overly tired

family friction

making a mistake

not being listened to

change to routine

packing to go on holiday

mental health themes in TV dramas

feeling left out

being wrongly judged

My coping methods / action plan

Do everything on my daily maintenance plan – keep routines going

Pick out some activities from my wellness toolbox

Talk to a supportive person about what has happened

Turn negative self talk into positive

Use mindfulness techniques

Do some soothing rhythm breathing

Focus on tasks that are easy to do

Make lists e.g. a packing list for holidays

Early Warning Signs

For this part of the WRAP plan, you make a list of signs that tell you and others that you’re not feeling mentally well. This helps friends and family to look for signs of deterioration and is also good for sharing with medical professionals. For me personally, I have different signs depending on whether I’m starting to become depressed or anxious or developing hypermania.

Signs of depression and anxiety

loss of appetite / comfort eating

feeling tearful over things that wouldn’t usually affect me

lack of motivation

feeling tired even after lots of sleep

agitation

want to be alone

irritability

poor concentration

feeling worthless / helpless

Signs of hypomania

constant talking – unable to switch off

mind in overdrive

erratic driving

spending lots of money to fix things

hyperactivity

sleeplessness

agitation

irritability

flick from one task to another in a bid to get it all done

Coping methods / action plan

Do relaxation exercises – meditation, yoga etc.

Pick out some activities from my wellness tools

Tell someone I trust how I feel

Do everything on my daily maintenance list

Seek medical help

Get some exercise

Ask for support with household tasks

Challenge negative thoughts

Celebrate small achievements

Although I found these tasks difficult to do at the time as I was living with the depression and anxiety symptoms, I do think they are really useful lists to make. I also found it beneficial to talk with others about coping methods and get ideas from them too.

I hope you are finding these posts informative and useful. I really recommend creating your own WRAP either by yourself or with a loved one or therapist. Sitting down and really thinking about yourself and what you are like at different times can really help. Also if you can feel yourself becoming stressed or unwell, you can put things in place to help prevent you from becoming worse.

Of course, the current situation with the virus is a huge source of stress and worry so, now more than ever, we need to look after ourselves and ensure self care activities are high on our agenda. A lot of our routines and aspects of our daily lives have changed beyond our control and for many, this will be one of your main triggers so make sure you put things in place to help you cope.

Until next time, stay home and stay safe and well,

Posted in mental health, wellbeing, wellness

Monday Matters: Creating a W.R.A.P. Part 2

Last week, I introduced the idea of creating a Wellness Recovery Action Plan (W.R.A.P.) as a tool for monitoring your own mental health and keeping yourself as well as you can. I discussed what a W.R.A.P. is and went on to share the first step as the creation of a list of wellness tools i.e. things that you enjoy doing and that make you feel good. If you haven’t seen this initial post click here to read it before you learn what to do now. Today, I’m going on to the next step which focuses on what you are like when you are well and on listing daily maintenance tasks that you really need to do to keep yourself well.

Having drawn up your wellness tools, you’re invited to consider what you are like when you are feeling well. When I did this, I got really upset as it was a reminder of how I am when my mental health is good and I felt like I’d not seen the real Laura for such a long time. Now I’m back to feeling great, I can look at my list and celebrate who I am.

In as much detail as possible, you should make a list of how you feel when you are well. Here’s a few examples from my list so you can get the idea:

talkative

friendly

full of positivity

calm

productive

energetic

loving

decisive

assertive

good sense of humour

The idea behind doing this is so that you can spend some time really thinking about the kind of person you are when you’re feeling well and then you will be easily able to spot signs that you are starting to struggle and put steps in place to prevent decline in your mental health.

Having written your list, you should then go on to think about the things you need to do each day to keep yourself feeling well. What you note down here should be every day things that you must do to maintain a state of wellness. This is known as your ‘Daily Maintenance’ plan. Here are some of the things on my list but obviously yours may have different tasks and activities on depending on how you spend your time.

Daily Maintenance:

get up by 8am

have cereal, dried fruit and coffee for breakfast (or an alternative as a treat!)

take a vitamin tablet

check my plan for the day in my bullet journal

brush my teeth

shower

dry my hair and get dressed

Do yoga, some stretches or go for a walk

Do my morning activities

Have a healthy lunch

Do my afternoon activities

Make dinner and eat with my husband

Do a relaxing activity from my wellness toolbox list

Do chores e.g. dishwasher etc.

Make a plan for tomorrow in my BuJo

Relax

Take my medication

Go to bed by 11pm and enjoy at least 7 hours sleep

Obviously my plan changes depending on whether I’m attending classes or going out for the day, but it does give you a basic structure to your time and would be really helpful to refer to in order to keep yourself on track and productive. It’s also good to look at when you aren’t feeling so good as you can add small tasks to your notebook or bullet journal and celebrate the little successes in your day e.g. keeping yourself hydrated or doing a short household chore.

We were given a handout from the Recovery College in which to write down our lists but when I started to feel better, I made my own all bright and colourful pages using a MS Word document and then printed them out and put them in a folder. If you’re feeling particularly arty or love drawing, you could even create a pictorial list.

I hope you’ve found today’s post useful and that it has given you some insight into the usefulness of creating a W.R.A.P. If you have any questions, I would be happy to answer them in the comments.

Until next time, stay home and stay well,

Posted in life hacks, mental health, wellbeing, wellness

Monday Matters: Creating a Wellness Recovery Action Plan (W.R.A.P.) to support good mental health. Part 1.

A few months ago, I did a six week course at my local recovery college that focused on creating a Wellness Recovery Action Plan (W.R.A.P.). The concept of a W.R.A.P. was originally developed in 1997 by Mary Ellen Copeland and a group of like-minded mental health recovery advocates as a way of monitoring wellness and periods of difficulty, keeping yourself well and recording how you would like to be supported and by whom in the event of future issues.

At the time of attending the course, I was in a really bad place and found the sessions quite overwhelming and would end up in tears on a regular basis. However, I could still see the benefits of making a W.R.A.P. and completed all of the tasks and homework each week. I was really proud of myself for continuing to attend the group and now I’m well again, I would like to share my learning with you and discuss how you can go about making your own plan.

The first session of the course involved an introduction to the W.R.A.P. and discussion about how we were going to be supported in the creation of the document. We were given a handout so we could record our ideas each week and tailor our plan to suit our individual needs. If you would like to find out more about the plan from its original creator, you can click here to be taken to her website.

WRAP is a tool that can aid an individual’s recovery and its underpinning principles support the recovery approach. WRAP is a way of monitoring wellness, times of being less well and times when experiences are uncomfortable and distressing. It also includes details of how an individual would like others to support them at these different times.”

There are 5 main principles to the W.R.A.P. and these are:

Hope – that you will get well, stay well and go on to meet your dreams and goals

Personal responsibility – it’s up to you to decide what will most likely help to keep you well and who you would like to support you in order to give you the very best chance at staying well

Education – learning everything you can to enable you to make good decisions about your mental health and how you would like it to be managed

Self advocacy – making sure you have everything you need, want and deserve to support your wellness and recovery

Support – although it is primarily your job to ensure you stay well, the plan encourages you to accept that at times, you may need help and support with managing your mental health and that you can give selected others the chance to work with you to improve your quality of life

After learning about what W.R.A.P. is all about, we were set of the task of brainstorming ideas for a wellness toolbox. This was basically a list of things you enjoy doing which make you feel good. Mine included colouring in, painting, drawing, meditating, meeting a friend for coffee, reading, walking in nature, gardening and volunteering for a good cause. The benefit of working with a group of people who also struggle to maintain good mental health was that you could listen to suggestions from them and maybe try out some of their ideas if they appealed too.

For homework each week, we were invited to collect an item to bring in which could be put in a physical wellness tool box either as reminders of activities or to actually use to support your recovery or to keep yourself well. Ideas from myself and others included colouring in books, jigsaws, a scented candle, a chocolate bar, some bubble bath, photographs of loved ones (including pets!), memorabilia from special times and favourite books. The possibilities are endless!

I wrote a long list of ideas into a MS Word document and printed it off to put in a folder but you could also create a visual board using pictures collected from magazines or the internet or even do a Pinterest board. I think it’s a good idea to have a hard copy of your ideas so you can share it with people who support you in the maintenance of good mental health such as family members, friends or even your mental health professional or doctor.

I hope this has made you think about what you would include in your wellness toolbox. Let me know in the comments below what you find really beneficial for helping you personally to maintain good mental health – you never know, it might just provide me or someone else with an idea to try in the future.

Much love,