Movement is Medicine

For me movement is a daily practice and it cannot be missed if I want to stay well or move towards wellness. It requires the same kind of discipline as taking daily medication when managing mental illness. Movement is an essential part of my healing and mental health maintenance plan.

Different types of movement and exercise seem to have different effects on the brain and body. For example, cardiovascular exercise like running, biking, swimming, hiking or cross country skiing unravels and calms the mind. I can be deeply concerned about something from work or in my personal life, and this long, rhythmic exercise allows me to calmly work through problems or simply put them aside. Without fail my mind is settled by the end of one of these activities. There is also a benefit that comes from being out in nature breathing fresh air and taking in beautiful views while moving.

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Playing ping pong has another effect all together. This game takes an immense amount of focus and I cannot think about any other aspect of life while playing. I practice at least once a week, as the benefits are immense. As I practice each stroke all my mind and body can do is return the ball. Other activities I’ve enjoyed that require a high degree of focus include waterskiing at 32 miles an hour and playing ultimate frisbee. I imagine climbing would have similar merit, as one has to concentrate on each move and upcoming move and can likely think of nothing else.

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Freer movement such as dancing in my living room also has great benefit. I connect with my breath and settle into my body. For me dancing is very freeing. My body moves differently than it does playing a sport or doing a cardiovascular exercise. The beat of the music and the energy in my body flow together. I practice dancing with all the blinds drawn so I am not concerned with how a passer by might view what I am doing. Muscles that are tight from cardio unwind and my being feels looser and centred afterwards. This is truly liberating movement.

I practice one or more of these movements every day and I believe my mental health benefits greatly from this discipline. If I ever feel unmotivated or tired I will at least go for a walk. Movement is one of the many medicines essential for my mental health.

Note: After an episode or a period of low exertion I have to build back my stamina. I find it helps to use a fitness app to track my progress. I set small attainable goals that might start with walking 2 km and build to walk/run 3 and then 5km. Eventually I am able to comfortably run 5km. I always celebrate the act of just getting outside and giving a run a go. I try to get out in all weather conditions so that this does not become a limiting factor. If getting out feels like too much, I might also put on a yoga video in the living room or turn on music and allow my body to begin moving. Any amount of movement is better than no movement.

Hospital at Home

It takes a village … A patient is different from a child; however, it takes a large number of people caring for a patient healing from a psychiatric episode, as it does to effectively raise a child, to sway the momentum of the patient’s illness back to health. This is often a multi-week process that requires a very dedicated support team.

For the past ten years my family has been working to develop a ‘hospital at home’ methodology for treating manic episodes. We have found that there are downfalls to hospital care that can be better supported in a home environment. It has been difficult with serious episodes to be able to enact this plan, but this past episode we were successful.

During the intensely ill weeks of my manic episode, my parents and my partner had to provide twenty four hour care. This is a difficult expectation and may not be realistic for many patients. My world has to close in quite tight, and only people in my inner circle who do not judge my behaviours and do not gossip about what is taking place are welcome. My care givers including my psychiatrist, my family physician, my psychologist, my chiropractor, my acupuncturist, and my massage therapist are also integral parts of my care team during this period and at all times.

Only low stimulation activities are allowed during this time.

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I go for daily walks, often a few times a day, always accompanied by a family member. During these walks I refrain from picking up objects of interest or talking to strangers we meet along the way. I try to have at least one focus activity a day to help my mind return to the ‘real world.’ This can be writing, editing, colouring, baking, caring for plants (as I do in my home – see photo above), or any other artistic and purposeful endeavours. I try to avoid deeply contemplative conversation or activities, as these can further provoke my delusions.

My medications are closely monitored by my psychiatrist on an almost daily basis. These are an essential part of the recovery from a psychotic episode and it is tricky to find the right balance. I am religious about following medication recommendations. When I was younger this was very difficult, but with experience it has become clear that medication is unavoidable and I have learned not to resist taking my medication. While using high doses of medication I cannot drive and rely heavily on those close to me for transport. I only return to driving when my psychiatrist recommends this.

As the symptoms begin to subside I reintegrate other aspects of my life. I begin having coffee out with friends and carefully socializing more broadly. I also expand my focus activities to include working with friends and family on school and work projects. In order to resume work responsibilities I try to focus for longer periods each week, working up to 50% capacity before returning to work.

I am deeply thankful for the many supportive people in my life who love me as I am and help me recover from this very challenging illness with much more ease.

Low Stimulation

Low stimulation is a term frequently used in psychiatry for the type of environment required by patients recovering from an episode of severe mental illness, such as bipolar 1 or schizophrenia.

After four weeks of prescribed rest, I sit at home contemplating what low stimulation is and what made me well again. My bird feeder comes to mind. A week into my hospital at home recovery period, my dad found an old bird feeder belonging to my grandmother. He filled it with seed and we found a perfect resting place on the eves trough of my garage. This can be viewed from inside my kitchen or from two seats on my upper deck. The feeder turned out to be the perfect low stimulation remedy.

Initially the birds wouldn’t feed if I was obviously watching them. Now they’ve grown to trust me and they flit in and out of the feeder with relative ease with me sitting a few feet away. There are three main types of visitors including chickadees, sparrows, and a small bird that hangs upside down to eat with chickadee-like colouring. He might be my favourite, or she? They are all uniquely wonderful in their own ways. The sparrows travel in much larger flocks and are very pervasive eaters all day long. The chickadees seem to be more modest and only take what they need. Occasionally other creatures visit to try to benefit from the good eats. One day a squirrel jumped onto the feeder and clung sideways desperately trying to get a few seeds. He or she eventually dropped off having little success. The feeder is designed for lighter creatures and the food gets blocked when a heavy squirrel tries to eat. Yesterday an absolutely magnificent large flicker visited. The large bird also clung, somewhat more elegantly than the squirrel, to the large part of the feeder. He turned sideways to get a nibble. I now sit religiously watching the feeder several times a day and find this deeply restful and healing.

I write all this to express my enjoyment of watching these animals and to explain what low stimulation actually means for me, and likely other psychiatric patients. It is not being shut in a white walled room with your thoughts, which is actually torture. Low stimulation is more like sitting by a babbling brook with a light breeze. There are many things tantalizing the senses, but softly. It is not aggravating, like a gail force wind, but instead enjoyable and peaceful. This type of stimulation lifts the mind from the thoughts to a gentler more relaxed place. When designing mental institutions or hospitals, this concept needs to be deeply considered for the benefit of the patients. Nature provides the ideal low stimulation setting.