Week Two - A New Normal...ish

So that's the end of week two (though you could tell me it's month two and I'm not sure I'd argue with you).

It's been another week of adjustments.  Like many people, I'm now running a school timetable five days a week and it's instantly made me realise how hard being a teacher must really be. 

I think we did a passable job of it this week.  We decided that even trying to replicate a school timetable (or have all the same stuff every day) was impossible.  It's anchored around some of the amazing online stuff that's cropped up (PE with Joe Wicks on YouTube and English Live! with Holly on Facebook) but there's a lot of flex around our diaries so we can 'teach' a bit and put some variety in alongside Maths, English and Reading.

It definitely felt like a long week at work - I was emotionally exhausted by 5pm on Friday.  It's hard to work out how best to pace yourself when working, sleeping and living all really take place in the same four walls, but I'll get there with time.

I've been out for my state-sanctioned walk every day (even fitting in some Plastic Detectives with Violet a couple of times - full back catalogue to be uploaded), and that feeling of fresh air (and even some sunshine) can't be over-estimated right now.  I even managed a 'run' on Sunday - now seems as good a time as any to try and get back into it, however slowly.

What's struck me is how quickly behaviours have changed when you go outside.  On the pavements everyone moves out to the edges, even stepping into the road to keep a safe distance.  Walking down the gennel near our house, people wait at the end or press themselves tightly up to the fence to let someone pass.  We're actively thanking people for keeping away from us which feels like a big behaviour change in a fortnight.

I've kept away from the news pretty well over the last week.  I've stopped watching the daily briefings live and just pick up the main points afterwards.  I've also decided it's no good to think about how this plays out in the long term and really just try and do a day at a time.  Estimates for how long some elements of our current lives could continue vary a lot and I don't see the point in trying to dwell on something so uncertain.  Last year's Stress Control has evidently been good for something!

Finally, it was good to see the nationwide reaction in support of the NHS this week.  I've got friends and family working there, all balancing the same challenges the rest of us are, but alongside the daily work to care for people.

Until next week.... stay safe, wash your hands

Week One - Listening Through The Noise

What a week eh?

I feel like I've watched enough disaster movies to know that the coming weeks and months are going to be less than ideal, but that we should all emerge blinking into the sunlight looking at a different world.

I'm encouraging Violet to keep a diary through all this because I think we'll all look back on these few months for years and years to come.  I thought I should try an do the same.

Like most people I know, I'm trying to be as sensible as I can be.  I don't have 2000 loo rolls, the only real stockpiles I have are half a dozen partially used bags of cous cous and quinoa (peak middle class eh?) and some Ryvita that ran out in 2016 but still tastes fine.

We've been outside every day but kept well away from anyone else.  I skipped visiting my mum for Mother's Day and I'm on day 8 of working from home.  Given I'm in a higher risk group, I'm only going to the shops when it's absolutely necessary as well.

Social media and the news, things I've always relied on for my own sanity and sense of connectedness are having the absolute opposite effect right now.  I've given up scrolling pretty much anything apart from Instagram and only posting elsewhere occasionally.

I get that people are angry.  Angry at those people ignoring advice.  Angry at those pushing three trollyfuls of shopping through crowded check outs.  Angry at people heading to the pub for 'one last night out'.  I'm angry too.

But I think people are scared.  Fight or flight has never felt stronger for me at times over the last few weeks.  That idea of 'doing what I've always done will mean I'll be OK' is completely out of the window now.  People resort to routine, comfort and self preservation when they're scared and I think that's what people are doing now.

Yes it's selfish, but I think it's understandable too.  People's anxieties manifest themselves differently, whether that's buying 10 bags of pasta, going to the pub or climbing to the top of the moral high ground.  It's all noise we're trying to process to do whatever the right thing is.

The advice means different things to each of us.  DON'T GO OUTSIDE.  SELF ISOLATE.  SOCIAL DISTANCING.  It's panic-inducing, that means people will panic.

I don't think any of us fully understand what this means right now and we're all doing what we can to get by.  I finally found a loaf of bread in the shops yesterday and it felt a little quieter.  Not normal, but not end-of-the-world either.

I don't know what the 'right' thing is.  But I know we need to be kind.  Buy what you need, stay a safe distance from people, don't berate those who perhaps genuinely don't understand, help a friend or neighbour, don't watch too much news or scroll Twitter all day.  Do what you can do and others will follow.

Stay safe, wash your hands

30 Songs

I mentioned on social media recently that finding my love for music had been a really positive step for me as part of Stress Control and CBT over the last 9 months or so.  The posts preceding this give you a sense of those courses were like.

I came across this playlist challenge at probably just the right moment.  It's not something I'd normally ever entertain but I found it really helpful to focus on.  It was a way back into things I'd not listened to in a long time and some of the memories that went along with particular songs or albums. Getting down to 30 songs was tough, but I just kept reminding myself that these aren't my favourite 30 songs, or the 'best' - they're just things that speak to me when I look at each topic.

I put the list together as a whole over about four or five weeks and shuffled a few songs around a couple of categories before it was finished.  Weirdly I somehow decided that it was enough to have a list in a spreadsheet and didn't think to listen to it until yesterday (a good few months after I'd finished it).

What follows are my answers, a YouTube link and some explanation as to why I chose that song where I can give it.  Again, not the best 30 songs in the world, or even my 30 favourite - just ones that work well.  And listening to the list as a whole was, for me, a hugely positive experience.  If you have an Amazon Music subscription, you can listen to the whole lot in just 2 hours and 6 minutes here 

If you're inspired to have a go, drop me a line on twitter.com as I'm always on the look out for something new.

1.  A song with a colour in the title - Little Red Corvette by Prince
There's a few that sprung to mind here - ELO's Mr Blue Sky, Donovan's Mellow Yellow, Eiffel 65's Blue... but I remember hearing this, and more of Prince's music and it's always stuck with me.  Purple Rain was another contender but I went with pop to kick off

2.  A song with a number in the title - Four Out Of Five by Arctic Monkeys
I will basically fight anyone who says that Alex Turner isn't one of (if not the) greatest lyricists of this generation.  A song about a taco stand on the moon called The Information Action Ratio sounds ludicrous but I love it and it was the stand out track on Tranquility Base Hotel and Casino which I listened to non-stop for weeks

3.  A song that reminds you of summertime - Plage by Crystal Fighters
I've listened to hardly anything by this group, and I'd not heard this track in years but it immediately sprang to mind.  Light, airy and talking about going off down the beach.  Summer innit?

4.  A song that reminds you of someone you'd rather forget - Don't You Find by Jamie T

The entire song as about remembering people you shouldn't or would rather not and invariably I can't listen to it without mentally ticking off some of those names.  Jamie T's entire discography is excellent so would recommend if he's new to you

5.  A song that needs to be played loud - I Bet That You Look Good On The Dancefloor by Arctic Monkeys
Yes it's their second track in the first five.  Yes they'll appear again.  There's no rules and you're not the boss of me...  I remember hearing this on a demo CD before their first album came out and being blown away by it.  I think history shows that it was a focal point for British music as well.  I wore out the album CD I played it that much.  I've also seen this live and shouted along with thousands of others.  Spine tingling.

6.  A song that makes you want to dance - Dancing Queen by ABBA
Potentially a cop-out choice on the face of it, but for me Dancing Queen is associated with two very strong memories.  Firstly being the only album we listened to for a week on our A Level German exchange trip and secondly (and more recently) as the finale number for my daughter's ballet school summer performances.  It makes me want to dance because it's the only routine I ever know and I sometimes get the chance to embarrass her at class by dancing along.

7.  A song to drive to - Bright Lit Blue Skies by Ariel Pink's Haunted Graffiti
I'm not sure what to say about Ariel Pink other than he has a lot of interesting and varied music and you should give some of it a listen.  This is from his 2010 Before Today album and for me is perfect to have on for a summer evening drive.

8.  A song about drugs or alcohol - Blinded By The Lights by The Streets
As a tee-totaller it was hard to find something to personally relate to here.  I considered Blur's Coffee & TV as a compromise, but this from The Streets is almost certainly a more appropriate pills and clubs example

9.  A song that makes you happy - My Delirium by Ladyhawke
I can't remember how I first heard this, but it's always stuck with me as an upbeat pop number that I have to sing along to.  I saw her at the Leadmill in Sheffield too and getting to hear this live was pretty special

10.  A song that makes you sad - Five Bottles Of Shampoo by The King Blues
The message in this is a positive and affirming one, but I think as a husband and father, it's still appalling that 'don't be a prick to women' is a still a message that anyone should be talking about.  The King Blues are the only punk outfit I've seen live (Fibbers in York) and would urge you to listen to their whole 'Punk & Poetry' album if you're feeling even moderately rebellious

11.  A song you never get tired of - One Day Like This by Elbow
I could basically listen to this on repeat for a week.  It's beautiful and passionate and just generally perfect.  It was also used as the music for a video summary of my daughter's first ever dance show and a couple of years ago the senior girls did a ballet routine to it as well.  Lots of wonderful memories associated with a perfect song

12.  A song from your pre-teen years - The Sign by Ace of Base
My pre-teen years go up to the early 1990s so there's a wealth of stuff to choose from for this and narrowing it down was nigh on impossible.  That said, I can't listen to this without beaming and I think anyone would objectively say it's amazing.

13.  A song from the 70s - You're So Vain by Carly Simon
Again - how do you pick one song from an entire decade without having some kind of remorse?  Loads of artists fell away here because I just love this song - no grander, but also no better reason

14.  A song you'd love to be played at your wedding - Nobody Does It Better by Carly Simon
It felt wrong (and dangerous) to pick anything other than the song we had for our first dance when we got married

15.  A song that's a cover by another artist - Hallelujah by Jeff Buckley 
I'm unashamedly a snob when it comes to cover versions and so this was a fairly small pool to choose from, with Valerie by Amy Winehouse being the other consideration.  Buckley's version of this is haunting and powerful and the definitive version for a lot of people

16.  A song that's a classic favourite - Don't Stop Me Now by Queen
I'm yet to meet anyone who won't try and sing this at the top of their voice and if that's not the definition of a classic favourite, I don't know what is

17.  A song you'd sing a duet with someone on karaoke - Where The Wild Roses Grow by Nick Cave and Kylie Minogue
There's a reasonable argument to be made here that I might find someone to do Kylie's part, but this is a wonderful duet and that in itself was a deciding factor in it making the list.  Nick Cave is another one of those people who's lyrics I could listen to forever and he'll pop up again shortly.

18.  A song from the year you were born - Start Me Up by The Rolling Stones
Another one where there were a number of contenders (sorry Duran Duran) but I think you can't argue with some classic pop rock that's a toe-tapper

19.  A song that makes you think about life - Europe is Lost by Kate Tempest
Obviously none of us can remember a time before Brexit and I think Kate Tempest encapsulated that feeling in this track.  Her work in general is clever and astounding.  It's hard to pull out individual songs from albums that are essentially complete pieces in themselves, but this is exceptional

20.  A song that has many meanings to you - Everything That You've Come To Expect by The Last Shadow Puppets
There's so much odd fantasy in this that I'd almost struggle to give you one thing it means to me.  It takes me back to seeing them at Sheffield City Hall, it's a song I play to calm my anxiety when I have bloods drawn and it partly makes me cast my mind back to different people from my past. The bilabial plosives of "dirtbag ballet by the bins down the alley" are also incredibly pleasing

21.  A song with a person's name in the title - Stagger Lee by Nick Cave and the Bad Seeds
Loads to choose from here, but this made the list for two reasons.  Firstly Nick Cave's ability to tell murderous stories like this is unparalleled and secondly Stagger Lee itself is such an interesting song.  A folk song first recorded in 1923 and then retold in different ways by different artists over the years.

22.  A song that moves you on - 99 Problems by Jay Z
Jay narrowly beat out Britney's 'Toxic' here which was the first song on my running playlist for years.  I'm a big fan of his early stuff on The Black Album as well as Magna Carter and 4:44.  I saw 99 Problems live as part of the Watch The Throne tour in Manchester and it was incredible.

23.  A song you think everyone should listen to - People's Faces by Kate Tempest

Again, Kate Tempest's ability to tell a story and really see people comes through on this one for me.  I think it sparks something different inside all of us and is underpinned by a hypnotic hook.  Don't read my words, listen instead

24.  A song by a band you wish were still together - Something by The Beatles

Picking a single Beatles track is hard enough but I've always loved Harrison's simple love song.  This was another one from our wedding and something I used to sing to Violet when she was born.

25.  A song by an artist no longer living - Love Will Tear Us Apart by Joy Division

Ian Curtis died before I was born so I think that qualifies Joy Division for this one.  The first 30 seconds of this song alone are enough.  

26.  A song that makes you want to fall in love - One Hundred and Thirteen by Middleman

Most of us have probably been head over heels in love at some point in our lives, but I don't think anyone has ever managed to put down in words the beauty that we see in someone else the way that this song does.  It's spoken-word over gorgeous music and if this doesn't make you want to fall in love then nothing will

27.  A song that breaks your heart - Sometime Around Midnight by The Airborne Toxic Event

This is just pure artistry.  A song built on layers, from orchestral music, to soft lyrics, to guitars to an impassioned plea for an unrequited love.  It builds to a crescendo and really evokes that feeling of unrequited love and wanting someone when it's never meant to be

28.  A song by an artist who's voice you love - Not Mine To Love by Slow Club

Rebecca Taylor's voice is almost certainly the most incredible I've ever heard live.  Powerful, emotional and haunting it's criminal that Slow Club weren't more widely successful before the broke up after the release of 2016's One Day All Of This Won't Matter Any More.  Rebecca's work as Self Esteem is equally superb in the pop genre but this song (taken from the album Complete Surrender which you should also listen to) feels like she's looking into my soul

29.  A song you remember from your childhood - Karma Chameleon by Culture Club

Six fairly emotionally hard hitting and powerful songs are brought to an end with the first song I ever remember.  It's easy to almost dismiss it as 'classic 80s' but there's a lot more to it than that

30.  A song that reminds you of yourself - Mardy Bum by Arctic Monkeys

Hearing someone being called mardy is one of those things that always reminds me of home.  Those things we take for granted about our city that others don't understand mean more to us as we get older.  I remember my mum and dad calling me mardy when I was a kid, and I'm still prone to being a mardy arse now.  This was my ringtone for years and I can't think of anything better to describe myself

And that's that.  Hopefully you're telling yourself you can do better because these are just those that mean something to me.  Your memories and attachments are different, but if you do make your own list, hopefully it's as enjoyable for you as it was for me.

Controlling Your Future

If you want to catch up you can find the pre-session, week one ("What is Stress?"), week two ("Controlling Your Body"), week three ("Controlling Your Mind"), week four ("Controlling Your Thoughts") and week five ("Panic and Sleeping Well") posts in the links

And so StressControl comes to an end.  The title is from one of the slides in this session, but there was an open understanding that it's something easier said than done.  We followed a broadly similar approach as previous weeks, this time looking at our personal wellbeing and then covering a quick summary of the previous five weeks.  I'm going to talk a bit about wellbeing here as well as covering some of the things I've noticed or that have changed since I started, as well as what some next steps might be.

Wellbeing

In week one, we covered the idea that stress is a continuum with high levels of stress at one end, and low levels at the other.  This is a distinction worth making because it's not the goal to eradicate stress entirely, but to try and put ourselves towards the lower end of this particular spectrum.  If we think about stress as this horizontal line, wellbeing can be thought of as a similar, vertical continuum with poor wellbeing at the bottom and good wellbeing at the top.

The World Health Organisation talks about these two extremes as 'languishing' and 'flourishing' and of course, the idea is to move ourselves towards the flourishing end more often than not, whilst also increasing our ability to manage our stress.  As with anything worth knowing, overlaying these two concepts gives you a handy 2x2 matrix:

Recreated on my phone so more simplistic than it should be, but you get the idea...

Obviously we want to be in the top left as often as possible and in the bottom right as scarcely as possible, and because we're people, we'll often move around all four of these.  Some high level stats suggest that for every 10 people, three are langishing, five are middling and two are flourising and the tools we have at our disposal are aimed at keeping us away from the languishing end of the spectrum as often as possible.

We talked about what sort of things you could do to try and improve your own wellbeing, and with my work hat on for the briefest of moments, I was pleased to see that volunteering your time was something that was encouraged.  Being able to contribute to the wider world around us increases our own personal wellbeing too.  Listening to music, being more physically active, getting more fresh air and practicing mindfulness were all suggested too.  Learning something new or picking up an old hobby came up too and the idea is that our brains value the sense of accomplishment that comes with learning or completing something.

Mindfulness is something we hear more and more of but it was interesting to hear the definition they gave, which was really about focusing on the moment we're in without letting ourselves worry about the future or brood about the past.  It sounds fairly simple when you hear it like that, but trying to let your mind focus purely on what our sense are experiencing right here and right now can be hard.  I think autumn is a good time to try more of that as the leaves change colour, the air gets a little cooler and the familiar scent of fireworks starts to fill the air.  It's definitely something that needs practice, but along with some of the breathing exercises we covered, I think it can be really helpful.

We also talked about the fact that we almost certainly talk to ourselves much more harshly than we would do to anyone else who may be going through something similar. We're often our own worst critic, telling ourselves that something should be easy to do, or that worrying or feeling down is something we can just snap out of, when we'd take a kinder and more gentle approach to friends or family or came to use with the same feelings.  I think we all probably recognise that, and it's useful to think about what our compassionate self would say to our stressed self.

The final thing we covered was something I've heard of before but am yet to try and it's the idea of finding three things to be grateful or thankful for each day.  I suppose the idea behind it is that we're allowing ourselves to think about the positive things we've experienced rather than having that feeling that there's nothing good going on.  I'll see where I get to...

We finished the course with a quick tour back through the other five sessions but I won't repeat those here - links at the top of this post if you want to check out anything particular

What's changed?

So what have the last six weeks meant practically?  Well six weeks isn't really a long time so some of the changes or differences are in their infancy and as they said, it's almost like the hard work starts now when putting these things into practice every day away from the course.

I'll start with the positives:

• I've definitely used my rational voice more when I'm approaching known stressful situations (e.g. travelling).  I now need to think about being able to have that midset when more unexpected areas of stress arise.
• I've cut out more caffeine later in the day.  This is pretty difficult sometimes as my work schedule can be a little unpredictable but overall it's an improvement.
• I've followed some of the progressive muscle relaxation and breathing techniques fairly regularly and I think the breathing in particular has been really helpful.
• I've started blogging again - admittedly only about this course, but it's got me back into something I enjoy when I feel like there's something worth writing down
• I've started listening to a bit more music and watching a little less Netflix.  Music has been a longstanding passion of mine but it had become a smaller part of my day and redressing that has been good
• I've done more to cut out eating/snacking to try and cope with feeling tired or stressed.  Early days but it's a step in the right direction
• I've gradually started doing a little more exercise.  It's not quite as regular or frequent as I'd like, but definitely feels like a positive step
• I've only had one tension headache in about two months - that's definitely worth celebrating!

And a couple of things that aren't as good:

• I'm a lot more conscious that sometimes I just find myself clenching my jaw and I'm not sure how often it's been going on, but it needs to be very deliberate recognition of it before I stop
• I'm a lot more conscious of a pain or ache in my neck.  I can't work out if it means my pillow isn't quite right, or whether it's just holding tension in that part of my body
• I'm equally more conscious of the pain I get in my hip/leg that came before, during and after the London Marathon in April so I think I need to dig out the foam roller again for that
• I still feel knackered all the time

So what next?

We did a wellbeing questionnaire in weeks one, four and six and whilst my score in the stress half of it decreased (10 to 9 to 8), the low mood half remained fairly static (14 to 13 to 14) and I guess that's something to think about.  A lot of the symptoms associated with stress also correlate to the idea of low mood and whilst that might make the stress part of the diagram more manageable, it means you end up being fairly static on the wellbeing axis.

One of the facilitators suggested I ring up the IAPT wellbeing number and book in for some one-to-one discussion about disentangling the stress and anxiety from the low mood.  That feels like a pretty big step.  Part of me thinks that it should be easier having done this course - remember it took six months for me to ring up to book onto this in the first place.  Having taken the first couple of steps it should be easier to take the next few.  But it also feels hard to put yourself in a vulnerable place to talk about something you probably don't really understand yourself.

I'm going to keep plugging away with the techniques we learned on the course, and keep reinforcing the positive things I've started as best I can.  Progress isn't perfectly linear in things like this and it's OK to have the occasional step backwards as long as you're taking a couple forward too.  And I'm probably going to make that call...

If you made it this far (both on this post and throughout the course) then I hope it's been helpful in some way.  Everyone's experiences and circumstances are different so use what you can and discard the rest.  Hopefully I'll keep coming back to the keyboard more often than not - the focus can be quite cathartic sometimes.

Diabetes UK are running a hugely important campaign about improving the provision of and access to a variety of emotional support services. People with diabetes are twice as likely to suffer from burnout or difficulties with their own mental health compared to those without the condition. Some estimates suggest that one in ten people with diabetes are clinically depressed. You can read more about the vital It's Missing campaign by following the link. My story is just my story. If you need to talk to someone about how diabetes is making you feel, you can ring the Diabetes UK Helpline on 0345 123 2399 or you can ring Samaritans 24 hours a day on 116 123

Panic and Sleep

If you want to catch up you can find the pre-session, week one, week two, week three and week four posts in the links

Welcome to week five - dealing with panic and getting a better night's sleep.  Instead of covering these with the usual 'theory/practice' approach, I'm going to talk about them as two separate topics as that's really how we went through them in the session.  We were down to 10 (plus three people observing) yesterday which is a far cry from our 20 we started with, and I was a little surprised as I'd expected sleep to be a big draw.  One of the facilitators actually said that many people book onto StressControl explicitly for the sleep info as it's something that a lot of people want to know more about.  But first - panic:

Panic

We talked about what panic is and how those extreme feelings linked to fight or flight can, in some circumstances make us feel like we're dying.  A lot of the symptoms of panic are (unsurpisingly) similar to those of stress or anxiety - sweating, dizziness, heart palpatations, clammy hands, shortness of breath etc... Some regular readers may also notice that these are also symptoms some people experience when having a hypo (happy Hypo Awareness Week by the way...) so understanding the cause is really important.

We also talked about panic can be a response to a particular situation (confined spaces and having bloods taken from my arm), or can also be 'out of the blue' panic.  If you've never had a panic attack, it's not something I'd recommend.

In terms of management, a lot of techniques we've covered over the last few weeks came in to play.  Focusing on breathing is key as it helps us regulate our internal biology. We talked quite a bit about hyperventilating and how this adds to feelings of panic as you're upsetting the oxygen/carbon dioxide balance whichcan fuel some of the symptoms.  It's not something I have a lot of personal experience with though.

Aside from breathing, remembering to engage our rational voice helps - you might feel like you're going to faint, but if you never have, is that a likely outcome or is the fear fuelling the problem?  We didn't cover avoidance in relation to panic so based on my own experience, I can tell you I actively do avoid situations that involve confined spaces where I can.  I can't avoid blood taking though so it was reassuring that my own personal brand of coping (deep breaths, play some music, focus on something else) is largely in line with proper advice.  I think it's helpful to add in the rational thinking bit too though (although I very nearly did genuinely faint once...)

Sleep

It did feel like sleep was the thing with the biggest build up, so it may be disappointing to here how it was nearly all grounded in the most mundane, common sense approach imaginable.  As with most things throughout the course, it's reassuring that there's nothing too complicated to learn that's brand new, but also makes you wonder why you can't always see the easy common sense stuff for yourself.

We covered difficulty getting to sleep as well as difficulty staying asleep - I guess the difference between quantity and quality of sleep.  Very few silver bullets here, but some of the things worth remembering are:

1. Avoid caffeine before bed (and bear in mind it can stay in your system for up to eight hours)
2. Reduce hot drinks closer to bed time (although the benefits of an Ovaltine are the exception there)
3. Alcohol might help you get to sleep but it can affect the quality of your sleep and you shouldn't end up being dependent on it
4. Eating a big meal before bed means your body will be digesting if after you've gone to sleep which again can affect the quality of sleep you get
5. Cool (but not cold) temperature is best - around 18 degrees.  I felt particularly vindicated by this point as I'm a fan of sleeping with the window open
6. Reduce noise and light where you can (ear plugs, blackout blinds) but playing white noise can reduce the affects of environmental noise
7. Reduce screen time before bed (even where there are blue light filters)
8. Keep your bedroom for sleeping and not working, emails etc

We also covered how even small changes can have an impact so if you're struggling with sleep then some of these may be for you.

I think what I found frustrating here was the X factor that diabetes can chuck into the mix.  I didn't have a decaf coffee after about 5pm yesterday, cooled the spare room (early start means I get the spare room) and had ambient noise that I know helps me get to sleep.  And then I had a hypo at 2am and was up for about 40 mins before getting up at 4:40am...  

I guess you can only control what you can control, but the impact that diabetes can have on sleep is catastrophic sometimes.  I also know that weeks like this where I'll be sleeping in four different beds in seven days means I'll struggle.

So we're nearly at the end - next week is the final week of the course where we'll link all these bits together in an attempt to have a more concrete plan about improving our wellbeing and thinking about how we continue the work after the course has finished.  All the hard work is still to come I think as it's the ability to stay focused on these techniques away from a weekly structure.

Hopefully this has been helpful - see you next week.

Diabetes UK are running a hugely important campaign about improving the provision of and access to a variety of emotional support services. People with diabetes are twice as likely to suffer from burnout or difficulties with their own mental health compared to those without the condition. Some estimates suggest that one in ten people with diabetes are clinically depressed. You can read more about the vital It's Missing campaign by following the link. My story is just my story. If you need to talk to someone about how diabetes is making you feel, you can ring the Diabetes UK Helpline on 0345 123 2399 or you can ring Samaritans 24 hours a day on 116 123

Controlling your actions

If you want to catch up you can find the pre-session, week one, week two and week three posts in the links

Anakin Skywalker is out, Peep Show is back!  This week at StressControl was focused on being able to control our actions and understand how the things we'd covered in previous weeks (effects on our body and controlling our mind) link together.  

Before we started, we re-did the wellbeing questionnaire from week one.  I think I'd slightly improved more scores but only by one point each.  Interestingly I still scored higher for low mood than for stress/anxiety so there's something to think about in that!

We had the trusty Theory - Coffee - Practice triumvirate to guide us through the session.  I scribbled quite a lot down this time, rather than solely relying on the printed materials as my reference for afterwards.

Theory

As with last week, the most simplistic thing to understand is that if stress can affect our actions, then being able to exercise control over our actions gives us an element of control over stress.  This is true for our thoughts and for the physical effects of stress too.

Firstly, some of the common ways we act when we're stressed.  I suspect these are familiar to many of us at some point, but note this is by no means an exhaustive list:

• Argue
• Bite your mails
• Withdraw
• Anger outbursts
• Cry
• Take longer to do [certain] things
• Go quiet

The bold ones are certainly some that I identify with, although I'm not sure whether being a serial nail biter since I was about nine years old means I've got 30 years of stress to control... It also serves as a reminder that while we feel the physical and mental manifestations of stress ourselves, there can often be consequences for those closest to us.

One of the other key things we talked about was the idea of Avoidance and the short vs long-term trade offs that can have for us.  It's fairly logical and sensible once you hear it, but I definitely needed it spelling out to be conscious of it.

It goes like this:

If there's a particular situation or task that you know will cause you anxiety, your natural reaction is to avoid it.  In the short term that's great because it's reduced your anxiety.  The issue is that in the long term, it'll undermine your self-confidence and mean dealing with the stress or anxiety is increasingly hard.

The first part of that might be pretty obvious, but avoidance is telling ourselves we can't cope with a situation and so we withdraw and identify threats we wouldn't otherwise have considered.  

Going back to session one and the key principle of facing our fears we see the opposite.  Facing up to something rather than avoiding it is likely to be worse for our anxiety in the short-term, but it's building up our confidence to deal with stress in the long-term, which will have a positive impact on both self-confidence and self-esteem.

Practice

"So how do we do that?!" I hear you cry?  It's grounded in the idea of 'testing reality' and then engaging our rational/conscious voice (from session three) to do some problem solving.

Reality testing is really asking ourselves to consider two outcomes:

1. What's the consequence if the thing we're worried about happens?
2. What's the consequence if something else happens?

Remember the Big 5 Challenges?  We can use those to help answer the first question by being more conscious of our rational voice instead of our stress voice.

So then we problem solve:

• What problem do we want to solve?
• Figure out something that's well defined that would make us feel less stressed or anxious
• What will happen when I face my fear?
• Use the skills from controlling our thoughts to make our rational voice the dominant one
• Brainstorm
• What are the different courses of action I could take here?
• Choose the best option(s)
• Simple pros and cons of our options, and some honesty about whether we think these will bring us immediate success/change or whether we may need to refine them
• Work out a plan
• When will we take these actions?  Will it be more than one our our options?  Do we need to use some other skills/techniques (such as relaxation, breathing?)
• Put it into action
• Do what we've decided to do
• Review
• Did it go how we expected?  Will we do this again?  Do we need a more gradual approach?  Do we need to try something different?

When you read most (if not all) of this, it seems to be fairly common sense, and I think that's really important.  It's not a set of complex behaviours or tools that anyone needs to learn, but it's about being able to take a step back, try and disentangle ourselves from the immediacy of our situation and approach things differently.

There are some helpful handouts in the workbook to go through some situations in detail.  As I said last week, I think the difficulty for me lies in isolating some of these things in the first place.  But it's also not designed to be a quick fix, and most of the work will come after the course finishes.

I feel like I've started to put some of this into practice, particularly around my weekly train travel, but I also know that last week I jumped straight to a set of stress-induced thoughts and behaviours in a different situation, so I've still got work to do.

Session Five is looking at panic and improving sleep.  I only really experience panic in very specific situations so hopefully that'll be some easily translated learning.  I do a lot already to try and improve my sleep, so hopefully there'll be some things I can finesse there too.

If you made it this far, thanks and I hope it was of some use.

Diabetes UK are running a hugely important campaign about improving the provision of and access to a variety of emotional support services. People with diabetes are twice as likely to suffer from burnout or difficulties with their own mental health compared to those without the condition. Some estimates suggest that one in ten people with diabetes are clinically depressed. You can read more about the vital It's Missing campaign by following the link. My story is just my story. If you need to talk to someone about how diabetes is making you feel, you can ring the Diabetes UK Helpline on 0345 123 2399 or you can ring Samaritans 24 hours a day on 116 123

The Mind

If you want to catch up you can find the pre-session, week one and week two posts in the links

No Peep Show quote this week, but hopefully you'll see how this one ties in as we go.

I'm writing this one on the train to London having popped a few pills to try and take the edge of the symptoms of a tension headache that somehow seems to have gotten worse overnight.  The symptoms for me are what I imagine it feels like having a kitchen knife stuck in your temple, with the added discomfort of that sensation coming right down your neck too.  Happy Wednesday!

Week three of StressControl is focused on the mind - specifically controlling your thoughts.  They'd mentioned last week that this session was one that many people find helpful, and I think that was generally the case for me, though it left me with a few unanswered questions I probably need to focus on.  Something I neglected to mention last week was the brief discussion of General Anxiety Disorder - a condition that causes people to feel anxious about a wide range of situations and issues rather than one specific thing.  I bring this up now as it may also be relevant later...

Theory

As ever, the afternoon was split into theory and practice, but with a greater focus on practice this week.  We talked about about worry and rumination and that worry is a preoccupation with the future ("what if...?") and rumination is a preoccupation with the past ("if only...").  I think the former is more like me generally speaking, but I know I've over-analysed every word I've said to people in certain situations in the past so definitely a lot for me this week.

My main takeaway from the theory was that stress can affect how we think, which in turn can cause more stress or anxiety creating a fairly viscious circle.  The flip side of this is that if you can identify some of those thoughts and control them, you can control or limit how stress impacts you.  I think that's a fairly common theme (and where this week's image comes into play) - it's not about eliminating stress or anxiety, but being able to reduce, manage and mitiage some the impacts it has.  Rather than dealing in the absolutes of being totally stressed or completely stress free, it's learning to find the comfortable zone in the middle of a fairly vast spectrum.

The other part of the theory that I really identified with was this idea of a grasshopper as an illustration of how thoughts can escalate quickly (i.e. grasshoppers jump quickly from place to place, and we can do that in our own minds too).  An example is to consider someone who doesn't like public speaking.  Being in that situation gives them some of the physical symptoms (see session two), but also means that this impacts their thoughts.  Catching someone yawning while they're presenting could mean a thought pattern along the lines of:
- that person's bored
- everyone's bored
- I'm boring
- I'm no good at this
- I'm useless

Of course there could be a dozen reasons why someone is yawning, such as being tired or too warm, but the mental impact of the stress is to jump to that final conclusion of being useless really quickly.   Side note - I was yawning while they talked through this bit because the room was really warm and I felt very self conscious about it.

I definitely related to that a lot - it felt very real for some situations I find (or put myself) in.  I think what I still find amazing is that this genuinely isn't how everyone approaches things.  I was talking to my wife about how this kind of stuff manifests itself when I travel for work (train is delayed, I'll miss my connection, I won't get a seat, I'll be late, I'll look disorganised and unprofessional, people will think I don't care) and she shrugged and said "I just think I'll get the next train and it'll be fine".

Practice

So the practice was broken down into a three different aspects, but I'll focus on the first two here.  The first was basically a mini mantra - Stand back, remove the blinkers, wait a minute.  The premise is really to not immediately react and have your thoughts escalate, tell yourself to focus on the potential wider factors and take a moment before reacting.  So in the above example, just beause someone is yawning doesn't mean you're useless, peeling back the blinkers means you give yourself time to see the wider possibilities like somone being tired or being in a warm room.  This is 'laying the foundation' for some of the other tools.

Again, it's not about absolutes and removing the anxiety completely, but more focused on the idea of giving the conscious/rational voice the chance to dominate the stress voice in your head.

The other main tool we went through is called the Big 5 Challenges and is a set of questions or challenges to put to ourselves when we start to encounter stressful thoughts to try and give the conscious voice a chance to dominate the stress voice.  

The Big 5 Challenges (with a short example) are:

- What's the worst thing...?   If this thing I'm worrying about does happen - what's the actual worst outcome I could encounter, and is this the same as I'm actually worrying about right now?

- What are the chances...?   I might be worrying about something happening, but how likely is it?  Have I been in this situation before and my worry has been for nothing

- What is this worth....?   Am I spending time worrying about something that is fairly trivial?  Is life too short to be giving up time to this situation?

- Weighing the evidence (The Court Case)   I might be worrying about something, but am I missing some evidence?  I'm worried I look silly but everyone's just getting on with things around me so maybe I'm wrong

- The five year rule   If I look back on this moment in five years (or five months or five weeks) will it really matter?  Am I putting too much emphasis on this now when it doesn't matter?

It's not about using all of these for every situation, but about understanding that one or more of them will be appropriate for a particular situation.   This is definitely helpful for me, and looking at them, I know I've done a couple of these more recently, so it's good to know I'm on the right track.

What's clear is that all of this takes time and it's definitely a longer journey to carry on after the course finishes.  I think that'll be the challenge, because with diabetes it's always a physical thing to understand and treat, whereas with stress, worry and anxiety it's sometimes harder to pin down.

So let's try and tie this together with a rough kind of bow on top.  I talked about unanswered questions at the start, alongside the familiar sharp pain of a tension headache, and I think this is where the difficulty lies.  I understand that the headache is a physical symptom of something and so I can use some of the breathing/relaxation techniques (alongside codeine and paracetamol), but I'm not really sure what's driving that physical symptom - I can't pinpoint a specific thought or feeling that's making me feel particularly anxious, yet here we are.  I'm definitely not diagnosing myself with General Anxiety Disorder, but I think the hard work is going to be in trying to isolate some of these things that might be in my subconscious.

Next week is about controlling our actions.  It's been a long post this week, so give yourself a pat on the back if you made it this far - we should all be doing that for ourselves more often.

Diabetes UK are running a hugely important campaign about improving the provision of and access to a variety of emotional support services. People with diabetes are twice as likely to suffer from burnout or difficulties with their own mental health compared to those without the condition. Some estimates suggest that one in ten people with diabetes are clinically depressed. You can read more about the vital It's Missing campaign by following the link. My story is just my story. If you need to talk to someone about how diabetes is making you feel, you can ring the Diabetes UK Helpline on 0345 123 2399 or you can ring Samaritans 24 hours a day on 116 123