Tuesday, October 15, 2013

Depression & Transitions-part 2 for OT blog day festival

In honor of world OT blog day festival, I decided to write some more about transitions.
Previous blog post (see below) or go to: http://occupationaltherapistwithdepression.blogspot.com/2013/06/transitions-discontinuity-in-routines.html

Consumer: Depression can effect transitions. As a date gets closer to a major life changing time (such as starting a level 2 fieldwork or going to my friends wedding) sometimes my depression kicks in and all I want to do is sleep. I am a person with depression who uses an "avoidance" technique. I feel that as if I just ignore it, I will not have to think about the transition and when it comes, it comes. Other times, I get so focused on minimal meaningless aspects of the transition (ie: see my blog post below, when I was moving to a place I had never seen, will I actually be able to park close to my apartment... I didn't think about the moving part or how I would sleep when I was not bringing a bed, I was fixated on this strange aspect of parallel parking). I realized for me: transitions turn on an avoidance technique that I either (1) ignore by sleeping / not talking about it or (2) don't think about the big picture and look at little details. This is either due to the fact that (1) I do not want to be disappointed (2) I feel too overwhelmed and want others to make decisions for me.  Even when people try to talk to me about this, I push them away and just say "Whatever" and I let the passive side of me take over. This is something I have recognize and know I need to work on, however, I am not completely sure how to work on it myself. As you read below, you will read the general advice I give, but I cannot say whether or not it would work for me because no one has ever done this.

As an OT: If someone you are with does not want to talk about transitions, sometimes the best thing to do is just educate them and let them know about the choices. Moving to a new place or from community to home living can be very mentally taxing. Sometimes it is best, if the person is taking a passive role to really help to increase their independence and self esteem by empowering them and using therapeutic use of self to feel as though they are making decisions and learning new skills for the transitions. Even if you, as the therapist, are the one who is really suggesting and giving ideas, by helping clients to feel secure in how they are transitioning (even if it is discussing minor details at first such as parking) and then slowly working on bigger issues, this can help a client to not feel overwhelmed. As OTs we task analyse and break down ADLs/occupational tasks, but never forget the environmental factor of time and breaking down the anxiety/depression that comes with  transitions. By analyzing the transition and coping skills used to avoid the transition or be anxious by the transition, we can help the client to focus on individual aspects so they do not feel overwhelming. That's my two cents and I wish I had an OT to help me out with this ;)

That's all for now folks! Hope you enjoyed.

Previous blog post:
Transitions-discontinuity in routines
Transitions are hard for everyone. Transitions can be even harder for people with mental illness or disabilities.
OT perspective: Supporting clients through transitions are an important part of  OT. Transitions can be defined as a “discontinuity” or “interruption” in habits and everyday activities (Blair, 2000). Transitions can be as simple as having to  wrap a leg for lymph edema everyday to moving to a new city or starting a career. By understanding the environmental impact and time management of transitions we can fully help our clients.
Consumer: I have been anxious for the past few months about moving. So much so that depression has really kicked in. So many regrets & feeling alone & isolated. I am bad at saying goodbye. As my therapist tells me, everyone feels anxious about moving, it's big changes. However, as with depression, I continued to ruminate on how I am feeling & how I am scared of moving somewhere might trigger an episode of depression. These feelings felt so deteriorating that it was making me not functional. I couldn't pack, I couldn't do work. I reached put for social support & got help. I made lists, I used positive coping skills. Thank you family. 

What are your thoughts on transitions? How do you deal with client transitions? What coping skills do you use? 

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