The Impact of Isolation on My Mental Health Recovery Plan
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The COVID-19 pandemic has brought disruption to everyone’s lives. For those of us with mental health difficulties, the change to our everyday routines has had the potential to cause a flare-up of symptoms, and this has certainly happened for me. However, as time has gone on, I have settled into the new routine, whilst still being a bit unsettled by the changes that have occurred.
But one of the biggest effects the pandemic has had on my life is the alteration to my mental health recovery plan. Before lockdown, I had been attending a group therapy program for people with personality disorders for just over a year. In October I moved from the first stage of the group, the two-hour “emotional skills group,” into the next stage, the “therapeutic community” (TC). As a member of the TC, I attended the group for five hours every Monday and worked the remaining four days of the week.
When lockdown began, the TC was no longer able to meet. Some video sessions were suggested, but not everyone in the group has access to the technology needed for this, although the staff are looking at ways around this in the future. So instead, for the past two months, each of us have had a 20-minute phone call every Monday afternoon with one of the four therapists who run the group (rotating on a weekly basis). We’ve had a couple of worksheets sent to us to fill out to discuss in the phone calls, but the individual phone calls have been a big change from the group dynamic we are used to.
The idea of the group is that people with personality disorders often struggle with relationships, and in the group, we can practice those relationships. There are interactive sessions involving the whole group and even in the intensive personal sessions we are divided into two groups to discuss issues affecting us, so that the other group members, with the help of the therapists, can advise us and draw on their own experiences.
We’ve been encouraged, as we also were before lockdown, to call each other if we are struggling, to talk through how we are feeling and think about what we can do to help ourselves. We were also asked, when discussing the possibility of sessions halting before it actually happened, to check in with each other regularly, just to see how everyone was doing. I made a commitment to ring someone every week even if I wasn’t struggling, and I have now spoken to everyone in the group at least once.
Some people in the group are finding the current circumstances really difficult, and others are taking it well and seem to be feeling pretty good. But what I have heard from many of the group is that they will find it hard to go back to the TC. Many people with personality disorders are not used to reaching out for help and talking about their problems. Being in the TC has helped them with these issues, but as more time goes on without the sessions, the more out of practice we all become and the harder it will be to go back to the group dynamic.
My problem has never really been not reaching out, it’s been the opposite — relying on people too much and talking about my problems too much. Yet I have made progress with this through my work in the TC. Now I find myself keeping things to myself more, with the limited time I am getting for therapy now. There is never really enough time in 20 minutes a week to cover how I am feeling and what has been happening, as well as who I have spoken to and any worksheets I have been through. In particular, I have put on a bit of weight due to not walking as much as I used to, and as someone with a history of an eating disorder, I am struggling with this. I know I can call people in the group, but as time goes on I am getting less used to talking about how I am feeling, and more inclined to keep my feelings to myself.
We attend TC for 18 months. My leaving date was set for April 2021. Until then, I would attend TC every Monday. When it became clear that TC would have to stop, we were reassured that the leaving dates for everyone would be shifted to account for the time we weren’t able to attend. This means a delay in my recovery. It’s not realistic to expect that I’ll be “cured” when I finish in TC, but I’ve already started to make progress. With my leaving date shifted later, it naturally means more time in therapy and longer before I get back to “normal” life, including full-time work.
With lockdown imposed, many plans I had considered putting in place to help with my recovery have also been put on hold. My OCD and traits of obsessive-compulsive personality disorder mean that my whole life is planned, measured or counted and I find any unplanned deviations from my routine extremely anxiety-provoking. In my three-month review in the TC, I spoke about my problems with spontaneity and how I could start to try and overcome them. One of the main things I was thinking about doing was emailing a few friends at work and asking them to invite me to lunch with them at the last minute from time to time. When I am at work, my lunchtimes are as carefully controlled as anything else in my life. I have my writing group on Friday lunchtime, and with the remaining three days I go for a walk for one, write for another and usually have lunch with a friend with the remaining one.
Sometimes, a friend does ask me at last minute if I’d like to join them for lunch, and most of the time I say no, as I already have my lunchtime plans in my head, and find it very hard to change them. But I was going to practice this. Obviously now when working from home this isn’t possible. I can’t go to lunch with friends. Instead, I go for a walk with my wife and the neighbor’s dog (the neighbor is in a high risk group and is self-isolating). As the walk at lunchtime is the only walk I’m now doing every day, it makes it even harder for my brain to change my plans. The stakes are higher.
However, this brings with it opportunities. A few weeks ago, it poured with rain most days. The neighbor was in touch to say her dog wouldn’t want to go out in the rain. One day I went out anyway and walked on my own as my wife wasn’t keen. Another day she came with me. But there was one day where the rain was relentless. It had been coming down all day and even I didn’t want to go out. I kept looking out of the window and thinking “maybe it will stop soon.” But it didn’t. I really didn’t want to go out in the rain, but my brain was screaming at me that I needed to go for a walk and I would get fat if I didn’t go. It was really hard, but I challenged myself. Instead of going out, I rang someone else from the TC and talked about how I was feeling. By the evening it had stopped raining and I could have gone for a walk after work, but I didn’t. I took the opportunity to challenge myself and skip that day’s walking.
With the therapists from the TC, I have also thought about other ways to assist my recovery under the current guidelines. I took a half day off work and scheduled in some spontaneity. The very idea of this sounds counter-productive, but the therapist explained the idea was to do whatever I felt like that afternoon, when it got to it, rather than planning it out. I usually plan out all my days off, too. It was only half-successful — my brain just automatically plans and it’s hard to stop it. But even though I already had an idea of what I wanted to do with the time, I hadn’t planned an order and I didn’t set time limits on the activities I was doing (writing, Lego, playing on the PS4, reading). I had to put my phone face down and stick a blob of blu tack over the time on the laptop when I was writing, but it was a start.
With the current situation, everyone has more restrictions than usual. This naturally means that opportunities for recovery are reduced. But I think it’s important to think of creative ways to challenge ourselves and to actively work on our recovery.
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