03 May 2015

On Self-Care; or, How Can I Help You?

Though the concept of self-care is not new, it's become increasingly commonly discussed through social media and blogs. It originated in the medical field as a term for identifying things that a patient can do to help manage their own care (a fairly self-evident definition, I should think). For instance, taking your medication as prescribed would be a simple and probably obvious act of self-care. Learning to identify triggers and developing healthy coping mechanisms is a more complicated, but also fairly obvious component.

Attack of the Crohn's

Three weeks ago, I began yet another Crohn's flare. I began a Prednisone taper, which tends to do the trick if I start it quickly enough. It failed, and by Wednesday last week, I realized I needed to go in for IV treatment (hydrating fluids, steroids, antibiotics, supplemental vitamins, and a partridge in a pear tree).

This wasn't the first time I've had to do that since my marital separation, but it certainly wasn't any easier, either. It's still scary, despite living with this stupid disease for just under a full ten years. Facing it alone reminded me how vulnerable I really am. Yes, it was self-care to recognize the warning signs of the flare and to begin treatment in a timely manner and to seek more treatment when that failed, but this self-care left me more demoralized even though it seems to have worked to stave off greater physical calamity.

Self-Care Is What, Now?

Self-care is something that's sort of evolved outside its clinical scope, and can be generalized as a "Treat Yourself" philosophy. I'm not here to pass judgment on the debate that has arisen from this expanded interpretation of the concept; that's not my place. But it is something that's on my mind right now so here we are.

I used to write about my experiences with depression regularly. Initially, I received strong, encouraging - and truly humbling - feedback. But then it seemed each post found a smaller audience than the last, and I realized all I was doing was adding to the world's white noise. I felt my series on depression had outlived its usefulness, and I largely got away from not just sharing those experiences, but blogging at all.

What Does Writing Have to Do with Self-Care?

One of the key things to managing my chronic depression is to feel useful. Sharing my experiences gave me that feeling, at least in the beginning. It bolstered my sense of self and it was something proactive I could do. Whether that meets the more stringent, clinical definition of self-care, I don't know, but I like to think it's a bit more substantive than "treating" myself to something that may make me feel like a proper human being instead of the stigmatized fugitive that I sometimes perceive myself as being, trying to keep myself going without drawing too much unwanted attention. I've been very fortunate to have been overlooked by the vicious trolls that seem obsessed with attacking mentally ill people's writings online, but at the same time I've also failed to really build any kind of audience that would let me know that what I've written has any value or merit.

So far, 2015 has been the worst year of either of my two lives (you may recall I regard my time as a patient at Our Lady of Peace as delineating my "first" and "second" lives). The first four months were endlessly brutal, not just to me personally but to just about everyone close to me. My family has been harangued by exhausting internal matters, including the passing of my grandfather in February and other things I won't go into publicly. Friends have been bombarded with everything from breakups to severe health issues, from job loss to the deaths of their loved ones. It's felt like everyone I know has been under siege for months, with no sign of relief in sight for any of us. That's exhausting and exasperating.

It also reinforces my sense that I'm useless.

What's All This "Useless" Business?

I haven't felt that I've made any meaningful difference for ages now; nothing that couldn't have easily been done by someone else if they'd just had the kind of time on their hands that I do when I'm not bedridden or trapped in a bathroom (which has been most of the last three weeks, not that that really matters). Well-meaning friends have cited examples of me being helpful to others, and while I don't deny that I've done those things, I also don't feel they justify my existence.

I've come to realize that I feel driven to redeem myself, though for what I can't say. Maybe Doc Holliday would speculate, "Being born". I've certainly held deep-seeded resentment about even existing since my youth. I can remember lying on the couch in our living room, inwardly seething at even being alive. I never shared those thoughts, because somehow I instinctively knew that rather than being understood or helped, I would at best be written off as "odd" but more likely chastised for not being sufficiently grateful about my life. As I've said on numerous occasions, though, depression doesn't have a damn thing to do with gratitude.

So What Kind of Self-Care Have You Practiced About Any of This, Hoss?

Recently, as I've tried to make myself engage with some of those closest to me about all this, including my remarkably patient physician, they've all come back to my writing. I became disillusioned with writing more than two years ago, which I think is evidenced by the noticeable decline in content published in this blog during that time. I tried starting to write a second novel at least twice, failing to gain any traction either time. I've become little more than a bench player over at Flickchart, where I've written next to nothing for nearly two years now.

Still, I have to concede that there for awhile, writing was a part of my self-care. It was a way to break through the isolation that depression creates around its prey, for one thing. It was also a way to use whatever aptitude for writing that I may have in a constructive, proactive way. I hoped I was helpful to others every now and again with something that I shared, whether to give them a new insight into what their loved one was facing or just to know someone else knew the view from where they stood. In short, writing was central to my self-care plan, and I got away from it.

I don't even feel useful to my loved ones - certainly not through writing, or anything else that I've been able to do for them here and there - much less have I felt useful to the world at large, which I know full well wouldn't miss me if I didn't wake up from my next nap. And if I'm being entirely honest, right now, I wouldn't miss much from this world if I didn't wake up from my next nap, either. Some people (don't make me name names; if you think you're one of them, you are). The cats. Doughnuts. My bed cocoon. I think that's about it.

Why Did I Just Read (skim) All of This? What Do You Want?

Firstly, let me say that I'm not sharing it because I want to read any comments about how "valuable" I am. I don't believe I have any value or worth, and I never have. I appreciate the effort you may want to make to get through to me, but trust me; your energies are better spent elsewhere.

As with previous sharing, on some level I guess I'm hoping those who may identify with where I am take something positive from it. Maybe just knowing that this happens to more people than just you might make it somehow less maddening for you, and if so, then I'm glad you found this piece, and I hope you find the peace that has been eluding me of late.

I do have something of a request, though, Dear Reader. I'm not recommitting to writing, as I still don't believe that what I write really matters, but what might be helpful for me is if I had an idea what you might find helpful. I've asked this before without much feedback, but I'm asking it again: If you could have me address something in writing, what would it be? It doesn't have to be about Crohn's disease or mental health. All I ask is that it be a subject - the more specific, the better - about which you genuinely would like to read if I addressed it in writing.

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