Nurses with Mental Illness: Share Your Self-Care Strategies

  1. As we are all undoubtedly aware, our nursing jobs can leave even the hardiest of us tired, burned out, anxious, and depressed. Most of us will experience it at least once during the course of our careers, and I think it's safe to say that almost everyone suffers the occasional bout of "nerves". Caring for others makes it difficult to care for ourselves, so we all too often get through our work days by drinking too much coffee, eating too much junk food, and neglecting our bodies' needs for proper hydration and elimination.

    This is a tough job for anyone. But for those of us who are compromised by emotional and/or mental illness, every day can be an uphill battle, and stability is a goal that sometimes seems impossible to achieve given the nature of nursing in the 21st Century.

    Here, then, is a thread for nurses with depression, anxiety, OCD, and other mental health diagnoses to share the wellness tips and tricks that help them stay in control of their illness---and manage stress---while working as a nurse in today's healthcare environment. I don't know about you, but I'm sure I'm not the only AN member who's interested in learning about the self-care strategies other members use to keep their sanity in a profession that often seems all too eager to separate us from it.

    Just a reminder: please do not ask for, or offer medical advice, as this is against the Terms of Service of this forum. It's also not a good idea to recommend a particular medication or treatment for the same reason; as always, your own healthcare provider is the person best suited to advise you on any concerns.

    So, how do you cope? For me, it's a combination of several medications, a low-stress job, and regular therapy sessions with my psychiatrist; however, these things are only the beginning. Exercise in the form of gardening, music, prayer, and journaling are also part of my healthier lifestyle these days.

    Now, it's YOUR turn. Enjoy!
  2. Visit VivaLasViejas profile page

    About VivaLasViejas, ASN, RN Guide

    Joined: Sep '02; Posts: 26,724; Likes: 43,467
    RN and blogger extraordinaire; from OR , US
    Specialty: 20 year(s) of experience in LTC, assisted living, geriatrics, psych


  3. by   poppycat
    This is a great topic, Viva!
    I have bipolar (but it doesn't have me!) and one thing I've found that's a necessity for me is to be extremely organized. I have a set routine for what days I do what housework so that I always know what still needs doing. I also keep all appointments for both myself & my husband in the calendar on my phone & written in a paper planner. I had phone crash several years ago with all of that in it & didn't have a paper backup! Lesson learned!

    For relaxation, I play with my kitties, read, or watch TV. If I'm really feeling crazed, I pop in a CD with guided imagery & let it take me away. Much better than Calgon!

    I also have a very low stress job & only work 36 hours a week. That leaves me lots of time to play with my 19 month old grandson!

    At the end of next month I'm having knee replacement & I'm already lining up thing s to occupy me while I'm stuck at home so I don't go crazy.
  4. by   Marshall1
    Suffer from depression and anxiety here...for me, I limit exposure to noise, news, anything negative. I can get the "gist" of what's going on in the world from a quick scan of the news pages but I don't submerge myself in CNN or the like - most of the time it's a lot of "chicken little syndrome" talking and is repetitive so once or twice a day I can catch up w/o getting caught up. I don't watch a lot of tv anyway and nothing like Jerry Springer or realty type shows anyway - just not my idea of how I want to spend an hour of my life. I take care of my animals, make a "to do list" for the day and am happy if I get some of it done. I no longer push myself to be perfect.
    I have accepted a PRN hospital position versus going into a full time deal at this point. For me, right now, having the flexibility is more important than a large salary. We live within our means so if I can get a shift or two a week then great - if not, I will adjust.
    I have tried various meds over the course of the last few months..unfortunately, the side effects have created some issues so I'm still in the process of finding "the" right combination for me. I do believe they help but I don't believe they are the only answer. This is another reason I opted for PRN - so I can keep up with my MD appointments, rest and not feel additional anxiety as to how I am going to get to an appt. working a M-F job.
    I have good support in my spouse and have also accepted that I do not need to feel guilty or bad or apologetic because I don't, at this time anyway, want to be in management or a high stress unit. I've done some time in both, life sent some punches my way that changed me and part of my problem has been wanting to be who I was "before" things happened that caused me to permanently change.
    I take my time now and am learning about self forgiveness and giving myself a break on not being perfect. It's been a long time coming. I'm anxious to read how others cope as well.
  5. by   VivaLasViejas
    That's the part I'm having the most trouble with---wanting to be who I was before all this "stuff" happened to change me into someone I barely even know. I hate to think that this is my new normal. How do you accept that the changes are forever, and how do you come to believe that it'll be OK?
  6. by   LadyFree28
    Quote from VivaLasViejas
    That's the part I'm having the most trouble with---wanting to be who I was before all this "stuff" happened to change me into someone I barely even know. I hate to think that this is my new normal. How do you accept that the changes are forever, and how do you come to believe that it'll be OK?
    Viva, I have been struggling and asking the same question for five years...I have just started to realize I am who who I "was," and I'm just evolving.

    It has been trying to "heal" from PTSD...and it works my bipolar trait overtime!!!

    I've tried to be that person "before" person, and I have started to realize that I must evolve with the "now" person in order to be ME, even if I don't know what THAT looks like.

    It took me to realize this after changing jobs. I had to get my hackles down from who I was to who I am NOW...and I realize I do have strong traits and talents from the past I can take with me, and look forward and in the now be the same person...I've decided to accept this about a month ago...I was in a real bad fog since last year; and really thought I was "ok" even though I wasn't...sometimes I think I could've been successful at my previous job if I really stepped back and let that first opportunity go HOWEVER lessons learned; whatever my setback was, it will certainly help me grow in leaps and bounds; and I believe that is possible for everyone, regardless of age and it exclusive to ALL walks of life.

    One of the things I've learned to do is relearn compartmentalism addressing issue that bother me and then making a decision on how I view a situation or subject, and learned to compartmentalize in the "let it go box" or an appropriate, healthy way to deal with people who can be soul draining, or chronically unhappy, or emotionally immature, and are content with being that way. I also tighten my circle to people who are not in these categories or exhibit traits that could possibly trigger anything to feel traumatized. I really rely on those nursing skills in communicating with different personalities from fundamentals and mental health rotation to help me make sense of things, lol; it's also help me not sweat the small stuff, sometimes. Hey, I'm still learning.

    Sometimes, a good old fashion rant of volcanic proportions used to work, but did nothing to ease my stress levels ...they are now more about soapboxes, and moving it into a compartment for a soapbox day, if I need it; usually I'm more about a solution or a philosophy quote for a gripe lets it go until an opportunity for a solution is presented...and if not, it is what it is...

    One huge factor, for me that I utilize to keep me quirky, yet realistically positive and peaceful is meditation, deep breathing, and yoga to help me relax, have clarity and feel refreshed. To release negative thoughts through taking 2-5 minutes of my busy life really helps. I will meditate when I wake up, if I need a quick bathroom break, during lunch (yes, as a nurse I am MORE than happy to take a lunch, and cover for someone
    else to take lunch...we deserve it! ) and before I go to bed. Some days I meditate more, some less; enough to check in on my thoughts and stress level.

    Now I have an app on my smartphone to help me "check in" when the "old me" habits rush forward and my stress levels get high. It has a stress measurement, plus great "sessions" with positive affirmations and guided imagery. They range from 2-5 minutes, just enough to take time out of a hectic day and keep me centered.

    I believe in also vacations...if it is not in the budget, I LOVE reading, especially books from different countries and time periods.

    And an oldie but goodie from the "old" me, painting.

    I have DECIDED that it will be OK...even if I have to crawl before I step at at time.
    Last edit by LadyFree28 on Sep 7, '13
  7. by   VivaLasViejas
    Wow......some amazing responses already!

    That bit about allowing yourself to be the "new" you was just what I needed tonight. I got home from work a little while ago, where I'd had a particularly positive discussion with the charge nurse. She told me she loves working with me, because I don't freak out when it's crazy around there and I'm able to solve most of my own problems, as opposed to pestering her like some of the other admissions nurses do. She further stated that she'd never have guessed that I'm bipolar by the way I do my job (yes, everybody at my workplace knows) and take care of everything so thoroughly that she doesn't have to worry.

    THAT was the confidence-booster I've needed so desperately for what seems like ages. Finally I'm doing something right for a change, woo-hoo!! And I realized that even though I'M confused about what and who I am nowadays, I'm sufficiently medicated that people think I'm doing a good job---they're not seeing me as this loose cannon running around like a chicken with its head cut off. To me, that counts as a victory.
  8. by   NurseDirtyBird
    I thrive on routine. I don't mean stagnation, or that I must have things a certain way at a certain time all the time. Stuff happens, bad things, good things that bring a huge change, that's life. But I feel like I can handle the changes better without becoming overwhelmingly symptomatic if I have some semblance of my normal routine. I have my morning routine, I have my bedtime routine, I have scheduled workouts, I get a massage once a month, I go to therapy, I periodically go to my PRN job and come right back home to my bedtime routine. These things continue to occur no matter what else is going on in my life.

    I try new things sometimes, sometimes against my will, but I do it. Sometimes it's a minor annoyance that integrates itself into my routine, like an injury requiring PT or something. Sometimes it's a good thing, like getting a new pet, that changes things up a bit, but eventually becomes routine.

    Sometimes there are huge changes in life that upset everything and it doesn't matter what I do. But I still derive some comfort by sticking to my small routines. My cup of tea in the morning, my hot bath before bed and my monthly massage can make all the difference between going completely bonkers with stress or grief (or what have you, depending on the circumstances) and maintaining my mood. This has actually kept me from hiding under the covers in my bed all day during a depressive episode - yeah, it still happens sometimes, but my bed-hiding is a pretty rare thing now.

    It took me a long time to figure out that I was not the free-spirited artist I wished I could be, who took change in stride and embraced the beauty and terror of life with nary a blink of an eye. Reality sank in and I realized that nope, change sucks and I must find a way to cope with it because it is the one constant in life. And that's how I maintain some semblance of sanity.

    I have said "change" and "routine" so many times those words have lost all meaning. I apologize for this repetitive novella.
  9. by   Jenny878
    I have bipolar disorder. Even though I have bipolar 1, I tend to be much more on the depressive side, at least for the past several years. I have found that I actually thrive in a busy stressful environment because it get's me out of me head. I have no time to ponder my troubles, I become at one with my task. And after a crazy day, I feel the buzz of the adrenalin lifting me up. But I have found, especially recently that when I'm not working is when I feel terrible and start to feel the depression engulfing me. What do I do? I post of forums like this. I don't judge myself and I don't think of myself as different than everyone else.

    In fact, I am motivated to overcome things by not thinking that I am different from others, for better or for worse. I think that is important. I think some people set the bar too low. I remember one terrible shrink I had while in the hospital say to me in a case conference "you will never be like us". And what she meant was that I would always be sick and dependent and there was no getting better. Well I thought that was a bunch of crap. So I went back to school and finished up and then went to nursing school (graduating at the top of my class) and now working as a nurse, I'm good at what I do. In a way her comment helped me get better, to prove I am not sick and weak.

    For me self care involves exercise, eating a good diet, and sleeping enough. I do this in a large part for my physical health too. Trying to talk to others and keep up my friendships helps me with my mental health. Recently, I've tried to have more gratitude for what I have in my life and that even though I have a psychiatric condition, I have a healthy body with all my faculties and I have financial stability and I am someone who people like. I am doing good for people.

    I still have dark moments though, but I am surviving.
  10. by   VivaLasViejas
    You have a great outlook! I too have BP 1 but with more manic than depressive episodes, so I have to keep noise and other noxious stimuli dialed back or I lose it. That's why my last job ended in disaster---over time, the pace got to be too fast, priorities were constantly shifting, and there were far too many interruptions. Too much stimulus = meltdown.

    I've learned to try to channel the tremendous energy of mania into my writing, or if I'm too over-amped to sit at the computer, I do some sort of physical activity---usually housecleaning or rearranging the furniture---with my iPod going. My thoughts tumble around like squirrels in a cage and race so fast that it's like having all the TV stations on in my head at the same time. The only way to slow that process down is to exhaust myself physically, and when I get to that point the only thing I can do is call my doctor and have him tweak my meds.

    Recently I tried doing that on my own, and naturally I had to experiment with the one that really glues me together. Bad idea. Suffice to say that I won't try it again......

    All this goes to show that even with similar diagnoses, everyone manifests different symptoms which respond to different ways of managing them. Let's keep those tips and tricks coming!
  11. by   Jenny878
    Wow ViviLasViejas! It sounds like you do a really good job of channeling your creative energy in a positive way. That's great and truly inspirational! It is pretty weird how bipolar disorder can manifest so differently for different people. For the first few years after my diagnosis, I was on the manic spectrum and my highs were as high as they get. As soon as I was stable for a few years though, that's when the depression settled in and stayed. I am glad my mania is gone though, because it was way to disruptive and dangerous. I've put my life in danger when I was manic.

    I think there is still so much that is not known about the condition and that it is probably not a homogenous illness. There's probably more than 2 types. Anyway, with further research, I think we will know much more.

    More tips and tricks. Meditation, yoga, and physical activity. Channeling creative energy, like VivaLasViejas mentioned above. I think anything that draws a person out of their thinking. The depressive mind and the manic mind are like traps. Any activity that quiets the mind and engages the thinker into an activity outside of the mind would be helpful. Sometimes another trick I have with depression and thought distortion (negative thinking) is to not believe my thoughts. I will tell myself that I can't trust these thoughts right now and not to believe them. And a lot of the time, over and over again I find this to be true, that my thoughts were lying to me when I am depressed.

    I think this has been mentioned before, but self soothing is important too. Doing good things for ourselves. A nice comforting bubble bath with soothing music. Hot coco or a favorite meal. Buying ourselves something special or going to a movie. Writing down good things about ourselves on note cards and putting them up so we can see them. Getting a massage or a haircut and things like that to show love for ourselves are important too.
  12. by   VivaLasViejas

    And a lot of the time, over and over again I find this to be true, that my thoughts were lying to me when I am depressed.

    That's a trick I've learned in cognitive-behavioral therapy. When I'm down, especially when I'm down on myself, I have to remind myself that my brain is actually lying to me. It's the nature of the illness (although I have trouble remembering when I'm manic and feeling great about myself that my brain is lying to me THEN, as well ).
  13. by   Swellz
    I am not coping. I just cried at work today on and off for 2 hours. I couldn't shut it off. I just came off 3 weeks of nights where I felt I did well (new grad here), and poof, first dayshift back, and I fell to pieces. I know I need to be doing things outside of work to take better care of myself, but any advice on how to handle it during the shift? I always struggle more moodwise in winter, so that is just compounding my issues right now.
  14. by   Marshall1
    I'm sorry to hear you are struggling...are you having to switch from days to nights on a rotating basis? If so, I would think that would make things more difficult. For me, personally, I have accepted that because of my basically lifelong (since age 7) struggle w/depression and anxiety, medication will be a part of my life - at least for periods of it. I have also realized that a M-F job, which I know sounds extremely appealing to some, is NOT for me and has caused my issues to exacerbate. I am in the process of returning to the hospital setting but in a PRN position and on a unit that is not high stress. It's a drive for me ( a little over an hour) but the balance it will afford me will be worth it. I have no advice other than to say no job is worth your health so if it's the job itself - start looking around - even new grad or fairly new grads who have their foot already in the door are in a better position to find something. Good luck