I mention frequently that I have “several mental illnesses” but until now haven’t gone into too much detail about them. In a nutshell, I suffer from post-traumatic stress disorder, bipolar disorder, and borderline personality disorder. There are some undiagnosed obsessive-compulsive tendencies in there as well, and eventually I’m going to discuss those with my medication manager, but for now, we’re working what we know.
In August 2013 I was “diagnosed” with diabetes. I put the term in quotations as the diagnosis came through a phone call the day after I was discharged from the hospital with a bout of severe hypertension. My A1C, the test that indicates roughly the previous three months of average blood sugar level, was “within the threshold” of a diabetes diagnosis, and so I “might want to talk to my primary care physician” about it. Having neither insurance nor money, I had no PCP at the time either, and so since the doctor on the other end of the phone didn’t seem alarmed, neither did I.
Fast forward to September 2014. My darling wife and I were on our way to dinner when I started having the classic symptoms of a heart attack. We detoured to the emergency room, got admitted, and the next morning my fasting blood sugar was an even 400. It should be between 70-130 for non-diabetics. They checked my A1C. It should have been under 6. I scored a 10.4 and a brand new medication order for insulin to try and get it under control.
Since that time my first priority has been my health, both physical and mental. But there are so many things to remember to do. Wake up. Check and record blood sugar. Check and record blood pressure and pulse. Check and record weight. Shower. Shave. Brush teeth. Dress. (I’m told this one is important if I want to leave the house.) Eat breakfast. Take morning medications. Set timer to check blood sugar in two hours. Drive the wife to work, if necessary. (We’re a one-car family.) Exercise. Check and record post-meal blood sugar. Eat lunch. Set timer to check blood sugar in two hours. Write. Accomplish to-do list. Check and record post-meal blood sugar. Take afternoon medications. Get the wife from work, if necessary. (We’re still a one-car family.) Eat dinner. Take evening medications. Set timer to check blood sugar in two hours. Yoga. Check and record post meal blood sugar. Brush teeth. Take bedtime medications. Record something good that happened during the day. Go to sleep.
For someone whose daily schedule used to consist of
- wake up
- get coffee
- uhhhhhhh …
- go to bed …
… the above paragraph is a huge lifestyle change. It’s a lot to remember, and I still have trouble doing so. (I couldn’t give you that above list from memory, for instance, over a month later.) So I incorporated my love of journals into a tool to be used for Good.
Benjamin Franklin used to measure the worth of his day by 13 virtues. At the end of the day, he’d check off in a little book whether he’d lived up to those virtues that day. He did this every day for the majority of his adult life. The idea of using a book to record progress in living one’s virtues is the concept that gave birth to the Franklin Planner, the main product of the FranklinCovey company.
I went in a different direction and made my own. Moleskine makes a soft-cover squared book – almost 200 pages of graph paper. I created a checklist chart for each of the items that I need to do, and a separate chart for recording values for the vitals that I need to track from day to day. I also have a separate lined Moleskine book that tracks a progressive to-do list and also helps me remember things to tell my wife when she comes home from work. (She works in a call center, where communication between us during the day is sporadic at best.)
So these are my little black books. They have already helped to structure my days in many ways, where before I had little to no structure at all. Structure is an important tool for someone with mental health issues. It gives them the next thing to look toward, the next task to do, and can often keep them going when they otherwise couldn’t. Speaking for myself, if I go “off book” for more than a day or two at a time, that’s a danger sign that my depression is starting to sneak back in.
And having that danger sign, recognizable to my own self in the midst of a downward spiral, might be the best feature of all.