Strategies for everyday coping

People discovered different ways to cope with their mental health problems in their everyday lives. Other sections describe how they tried to recover from mental health problems (see ‘Recovery‘), as well as manage their finances and accommodation (see ‘Finances, housing and benefits’). Here we focus only on how people try to cope day-day.
People talk about trying to deal with voices, passing the time, stressful situations, and completing everyday tasks like going to the shops. They mentioned different techniques, such as avoiding busy or noisy environments, or managing their voices using techniques by reasoning with them or listening to them for only a short period each day (see also ‘Hearing voices, seeing things and unusual beliefs’). Many ‘looked after themselves better’, or did ‘self-healing things’ (e.g. meditation), others had changed their occupation or lifestyle (see ‘Work and education’).

Coping with Voices

Over time people had found better ways of dealing with their voices. Whilst a few people no longer heard voices, others still had to deal with them every day. A few people had adapted to them and didn’t want to be rid of them (see below). However most found the voices stressful or even traumatic, and had learnt ways of dealing with them better. For instance, many people tried to improve their overall well-being, which they found lessened their voices or improved the nature of them. People aimed at improvement by decreasing their stress levels (e.g. getting enough exercise, swimming, yoga, meditation) instead of concentrating on one particular experience such as voice-hearing.

Reducing stress levels helps Dolly with her voices.

Age at interview 39

Gender Female

Age at diagnosis 22

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I mean it hasn’t gone away. I still have, have the voices. And I still see things, but it’s, to me it has just lost it’s power basically, it’s just an annoyance rather than something that, well it did used to take over my life and nearly killed me actually, but now it’s just, it’s just an annoyance. it’s, you know, a bit like having kind of bunion [laughs]. Yes, a mental bunion that’s it. Rather than you know, feeling like it was it as a cancer. it’s, that’s the difference really.

That’s a good metaphor for it actually.

[laughs] Yes, it’s a mental bunion. I mean uncomfortable, yes, but it ain’t going to kill me.

So how do you cope with this bunion on an everyday basis?

Well I like to keep my mind active. So I like to kind of kind of, do a lot of creative stuff. I love to paint, and I love to write. And I love to make music. And also you know, having a bit of a structure to my life has really helped. So actually my going to university really helped. And to kind of be close to nature, which is one of the reasons I moved down to [name of town] because I love the sea. And if there is a time I feel a bit like anxious or stressed or like a kind of you know, not mentally comfortable. I just have to walk across the sea and I just put things into perspective really.

Just, I think the biggest thing just is to be kind of myself and realise you know, negative, negativity is… is a kind of thing, this kind of… well the negativity will turn the bunion into a cancer, you know, I mean it’s, it’s… it’s protecting the, you know, I don’t know how I got onto bunions but [laughs] but it’s just realising certain parts of yourself need protecting and looking after and just to realise I have to reduce stress. Because when my stress levels are really high then the psychosis is more troublesome, you know. For example last, last year there was a… quite a lot of stress stressful things happening, and it did bring up the, the kind of, the voices were more constant, for example.

So I’m just saying I have to bring down stress levels. And just, well kind of going back to the, the bunion kind of metaphor, it’s the choice that we’re in, you know, comfortable shoes, or the stilettos of negativity really.

That’s a pretty weird metaphor for it, but I think you guess what I mean. Yes. So it’s just.. kind of just having self-belief. Doing positive things with your life, kind of… keeping occupied is, you know, is really helpful. Kind of learning to develop your emotions, you know, your emotional life.

And you know, I guess there’s lots and lots of things that are helpful. There’s not one thing I can really pinpoint. Laughing is you know, really helpful.

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Janey has found that she can concentrate on a particular conversation, or on her voices.

Age at interview 52

Gender Female

Age at diagnosis 29

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If things, yes, I get voices all time. This is… When I do police training and things like that, they kind of say well how can you do that? And it’s a matter of practise, and you say to them if I wasn’t well enough I wouldn’t be here. So I’m only going to turn up, you’re only going to see me when I’m well enough to cope with what I’m doing.

So how do you, when you’re well, how do you cope? How do you manage the voices?

I think managing the voices really it’s like, if you’re sitting in a restaurant with someone, and there’s conversation on the next table. You can choose to go with that conversation or you can choose to stay with the conversation you’re in. You can actually say right I’m putting my attention here. For the most part I can do that, except sometimes it doesn’t work, and that’s when I start getting ill again. And I don’t know why that happens exactly.

And do you find it easier in quieter spaces and noisier spaces?

I’m really, really bad with noise. I really hate anything that’s, that got a lot of. Lot of background noise going on. In fact I find A & E extremely to deal with. And sometimes my Gps waiting room. There have been times when phones keep going, and in the end I’ve said to the receptionist, Look I’m going to sit outside. Tell him But again there’s a coping strategy. I’ve found a way of, of dealing with it. So, and I actually really, really don’t mind, say if my husband’s away, not talking to anyone for a week. I’m quite happy with that. And I wouldn’t have a radio on at home. I would just have silence. Because it isn’t silence to me anyway.

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Annie has found that even ‘good’ stress, such as going on holiday, can be too much.

Age at interview 34

Gender Female

Age at diagnosis 18

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So it’s, you know, it’s not, and it impacts on everything. Because everything you’ve got to think of, you’ve got to think can I do that? You know, and don’t stress yourself out too much but then don’t stretch yourself out too little, and you know, it’s getting that balancing act so that you don’t kind of stress and raise up a major, major precursor to it. To be much as you cannot deal with stress because it just, so that everything that you become really guarded and you think I can’t do that because, because that might happen. You know, even like, you know, even good stress, even like going on a holiday somewhere new, you know, I mean it’s not stressful. But then I think oh God, because I can’t take, like I can’t take too much information. That sounds stupid. I get like overloaded really quickly and kind of sometimes when I get overloaded that’s when I get thoughts that aren’t quite true. So it’s kind of thinking how much sort of stimulation I can take and even like a holiday, when you get like lots and lots of new information and lots of new surroundings and stuff. That’s like a good thing, but in some ways it’s a bit of a scary thing, because I’m not sure whether I could take it if I’m not feeling particularly well. If I’m feeling, you know, if I’m having like a good period, yes I can, but if I’m on like, not feeling totally great, then it’s a bit like hm
And have you worked out any sort of strategies for dealing with that kind of balance?

I think so. I think yes, I probably have. I’ve probably kind of my friends now, with my friends, I’m quite sort of consistent with my group, and yes, I’m kind of, yes, it’s, it’s learning to accept what you can do isn’t it? But I’m not very, yes, theoretically [laughs] I’ve worked it out, practically I probably haven’t. I could probably [laughs].

A bit like dieting? [laughs].

That’s how I think. I can tell you what I need to do, but whether I actually do it or not, another matter. I’d say that that’s yes, it is another matter [laughs]. But yes, I mean I’ve had like loads of help as far as kind of working out what you can and can’t do for a month or have services and stuff. So they always sort of say like learning to live within your limitations and stuff. And they’re right and they always sort of say that acceptance is something that I really personally, I really struggle with. And they’re right [laughs].

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Even when people were particularly unwell (e.g. in hospital) they said they could still find ways to help them cope, such as staying away from the television or even reading a trashy novel. Rachel had developed a ‘WRAP’ plan (wellness recovery action plan) in case she had a relapse: it involved her staying in a peaceful environment and ensuring that no one asked her what was going on, as she knew she couldn’t explain.
Other people found that focusing on their strengths – such as their powerful imagination or creativity – was a great way to manage unusual experiences (see below). Some techniques that people used were suggested to them by mental health professionals.

Kirsty used a technique called creative visualisation to relax and to protect herself from…

Age at interview 40

Gender Female

Age at diagnosis 24

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I was talking to a friend the other day. I was talking about one day when I went up down the shop, and I could hear, a barrage of abuse, every time, say, a heavy lorry went past or something like that. And there was lots of shouting and swearing at me, and that, and I was getting lots of abstract pains in my legs and that, so it was as if I was being beaten up, but, but you couldn’t see anyone, you know, you could just hear them and feel then, and you know, those sorts of experiences, you know, they can be quite traumatic and that, so.

It must have been very distressing
Yes.

for you?

Yes. I think a lot of it, you know, I’ve pretty much come through the other side. And I’ve had to deal with it for quite a few years now. So I’ve got little mechanisms. Little things that I’ve invented for myself within my imagination to try and deal with them and that. And I had a sanctuary. And the one I use is a cloud and I call it Cloud Nine. And I can get to Cloud Nine but hardly anybody else can. And it’s a safe, you know, it’s a nice white fluffy cloud and you just rest yourself there for a while, if things become a little bit too much and that you know, so
And how did you come up with that strategy?

That was through the help of a, a counsellor and that. And I think they call it creative visualization. And basically because I’ve got an active imagination, she said, you know, Work with what you’ve got or whatever, and use it as a tool You know, so if you’ve got good imagination, which I think is what tends to feed the hallucinations and that, you know, turn it, you know, turn on its head and you know, put it round to your advantage. So yeah, she suggested something like that. But I had almost been doing that before she mentioned it. So yeah.

What had you been doing before she mentioned it?

Just going off in my head, trying to find somewhere safe to be, sort of thing, you know, because I don’t know, if a, a real person, flesh and blood is bothering you know, you can take yourself away from them, or you know, send them out the door or whatever you know, but if it’s things that you can’t physically remove and that, you know, if they’re just, not exactly in your head, but if they’re, they’re not, then it’s difficult to say they’re not real, because they are pretty much real when it’s happening sort of thing, you know, but I was, just, I thought, yes, you know, I can get myself out of this by pretending.

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Rachel said that being in public when she thought people were insulting her was incredibly…

Age at interview 47

Gender Female

Age at diagnosis 27

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And, I think, I mean there would be times when I found the most difficult I think was being in public and believing that people were calling you a slut or a whore or which is incredibly undermining and there just comes a point beyond which you cannot go out. And I think what I would say to people who are suffering in that way, [inhales] is to do something like mindfulness, is to do the relaxation, to do the anxiety management, to do the things that are going to help practically. And mindfulness for voice hearing is incredibly useful, particularly if you’re troubled when you’re in public, because it teaches you to concentrate only on what you are doing at the time, rather than having your antennae out and taking in all this information because you’re so scared. Yeah, and I think if you, if it does get you that way you can end up becoming incredibly hostile to everything because you just feel persecuted. You know, you do, you just don’t get any rest, and particularly if you do get the more bizarre beliefs, I think with psychosis, you know, that you are being targeted by God or aliens or you are such a bad person that you deserve everything you’re getting. I mean that just is so… sad that, that people go through that and are like that about themselves when with a little bit of help you can stop the process. And I mean one thing I always used to say whenever I was talking to anybody was if, if somebody was actually in front of you talking to you, and like calling you those things, you wouldn’t put up with it, so why put up with it when it’s in your head, or it’s a belief that you have. Just tell them to go away. And there’s something called a broken record technique, which is where you just repeat and repeat the same thing. Which could be That is your opinion. I do not share it. And you just repeat it and repeat and I found that that was really helpful. Yes.

And where were you getting these techniques from?

From, well mental health services, you know, they’re absolutely wonderful. I mean if they’ve got, those on offer take them, take them, I mean there used to be, they treat them, and a lot of that has gone now. Yes. What can I say. So that when you were capable of, of doing something therapeutic, exercises and groups, you would do them to help you manage. You know, something like anxiety management. You know, anxiety is a process. It can be controlled [sniffs]. Relaxation. Brilliant. Mindfulness, again, is another group that was at day treatment.

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Some people used their voices as a kind of helpful marker of how they were feeling. Peter said that when his voices got bad he knew to slow down at work. Ron managed to put his voices to good use. He said that he would be lonely without them as he had had them for a long time. He also consulted them when he was making decisions.

Creativity and different activities.

Many people found creative activities particularly therapeutic. For instance, poetry, drawing, writing a journal or playing music could greatly improve overall well-being. For instance, one man found that writing down the way he was feeling helped him to better understand himself and his experiences.

Gary is now working with the Highland User Group (HUG) to provide more activities in in-patient…

Age at interview 37

Gender Male

Age at diagnosis 23

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They have to spend so much time doing paperwork, where they’re in an office most of the time, so they don’t actually get out to talk to people etc. So HUG is actually working with them, to try and, how do you put it, get more activities nursing, like nurses who act more active etc because basically you go in there and you sit and watch television all day, or you sit in the smoking room and that’s it. You know, and it’s not good. So HUG are working with them and apparently we do have money for this now, for doing things like pottery, aromatherapy, you know, all that type of thing. Yes, so because you know like, an occupational therapist?

Well there’s one there, but he’s not very good. Sorry there’s actually two there I tell a lie, who are not very good you know. I mean, and the time I got sectioned for three months, I was supposed to like see him, and he kept on saying oh yeah, yeah, yeah, yeah, we’ll some cooking, and we’ll do this or do that. And it never happened. You know, so nbsp;

And what type of activities would you enjoy, you’re obviously into aromatherapy?

I like exercise. Art. I like paint. I’ve got a very open mind. I’ll try anything, you know, even if it’s something I’ve not tried before like sewing, knitting. That’s not quite true, I learnt to sew in the Army actually. don’t ask why. So yes, anything.

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Music has always seen Devon through difficult times. Music relaxes and makes you feel good is…

Age at interview 52

Gender Male

Age at diagnosis 22

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Because the music’s given me hope for the future. And that’s what I hold on to. The music and the acting actually. Yes, you know, I enjoy both and both helps me a lot therapeutically. Yes, I’ve fought back to put my hope on. If anything comes, if the worst comes to the worst my music will see me through, because you know, as long as I’ve got the energy and the strength I always be playing music. Because that’s what, from the beginning I said, well let’s go, my headmaster said you can go the special needs school across the road, and entertain the people with special needs. I’m still doing it through disability up to this stage, using my music, yes. And it helps me as well. When I’m playing for people it helps me as well. Especially if I ask, if I ask people afterwards, How do you like that And its, It was cool It makes me feel good. It makes me feel like I’ve done something, you know, and then it makes me feel good, so then we all feel good. Yes. it’s amazing.

It is really yes.

it’s not music therapy. it’s just normal music. But it’s therapeutic. Sometimes we’ll come home from work, you know, you go home, you’ve had a bad day, put a CD on, relaxing but you just listen to it. It relaxes your mind. It relaxes you, yes. So that’s how I see it. Sound Minds. Because what we can offer you, the music, you listen to it, and it helps you relax your mind. Makes you calmer. And when you listen to reggae music, just the pulsating beat of the drum and the base, it’s like a hypnotic thing. So you listen to it, and you listen to the rhythm. It helps your mind. it’s like its helping your mind, healing you. That beat. That rhythm. You know. And making the voice come, the melody like. And you get the voice on top of you, oh sweet, it relaxes your mind and makes you feel physically, well it makes you want to dance to it. That’s what a lot of people phone up for the reggae band, because when we play the music it makes you dance. It makes you listen to it, and it makes you feel happy. Yes. it’s a good thing. And basically that’s what I said, I called myself the wounded healer because I use the music as a form of, of therapeutic form, through the music yes. Especially my drumming. When I’m drumming I think it’s a gift. When I’m drumming the drums just take over and they start to ride the music, and the people say, oh Devon. I love your drumming But I don’t think it’s just me. There’s a spirit within me, I think it’s a gift. Iwhich I never thought I had before, but it seems to be like it’s helping people and it’s helping myself. Yes. I think that’s how Sound Minds came around Yes. it’s amazing. it’s unique. It is yes, yes.

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People said that, whatever activities you did to ‘de-stress’, it was important not to allow them to become pressures in themselves.

Tom found that playing the piano, reading, painting and writing poetry gave him a sense of…

Age at interview 39

Gender Male

Age at diagnosis 21

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I was teaching myself to play the piano at the time as well so that did, that kept me going. That gave me a purpose and kept me going.And although I couldn’t, you know, I could just half and hour here, an hour there, you know, it wasn’t like I could sit down and practice for eight hours, you know.Or ten hours or whatever, which is what I wanted to be doing. So rather than get frustrated, which I did a bit, I just tried to accept that I was ill stoically and make the best of things.

And how did you sort of manage that balance? Did you get more frustrated or were you more stoic?

Well, there’s not a day went past when I didn’t really curse being ill, you know. I’d because I don’t like being ill andI don’t, you know, I don’t having the flu never mind having schizophrenia so I spent a lot of time, not so much feeling sorry for myself, but cursing my fate, as it were, and but realising the best the best, there was nothing I could do about it, and the best thing to do would be just to be stoical about it. Which I which I hope I have been and which I which is my ideal way of coping with it really, is trying to rise above it, trying to forget it if I can, and just get on with things as best I can.

And if I can’t, you know, if I can’t work more than a couple of hours a day, you know, I’m an I’m an artist, a painter and if I can’t pay for more than two hours a day, which I, and I’d rather be painting for twelve hours a day, then I just have to, although, I it’s difficult to accept. I just have to accept it as best I can, you know.

You were saying that the piano at the time, it gave you a sort of purpose and so on. Are there other things which were helpful at that sort of time?

I suppose reading literature, reading therapy, you know, I also fancy myself as a bit of a poet but I mean I used to write a lot of poems. Things like that. So that helped as well and just artistic things generally did help.And helped very much at times. Sometimes it, you know, sometimes it didn’t and sometimes they, you know, they caused a lot of pain because I couldn’t. You know, I felt I couldn’t do it properly. I could only, you know, like I was just saying and that sometimes that causes a fair bit of chagrin.But generally, artistic things helped and also my mum was, all throughout this time, my mum was absolutely brilliant, you know. It was great. Looking after me and being understanding and helping me in various ways and she was and I don’t think I would have survived if it had not been for her, you know. So that and also my dad helped and friends.

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Practical help

Many people had managed to get more practical help with things like shopping, housework and managing their money. Getting practical things under control could in turn help people feel less stressed and so cope better with daily life. Some people needed no help at all with these things, but others felt they could become easily overwhelmed. Arwen said that her step-dad helped with the supermarket shopping each week (See also ‘Support from family, friends and partners‘).

Annie can find tasks like going to the supermarket overwhelming and can sometimes feel as though…

Age at interview 34

Gender Female

Age at diagnosis 18

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If I’ve got like, what I perceive that I’ve got too much to do in a day or if town’s really busy. Or the supermarket, I’m shit at food shopping. I just can’t kind of cope with too much choice. And too much new stuff. I get kind of a bit stressed, but a bit more than a bit stressed, a bit kind of I can view things as a test really quickly, I kind of think. Like the other day I was in the mental health services actually, ironically. And like the radio wasn’t tuned in totally properly. The radio was like, it was like shitty old radio and it wasn’t tuned in so there was like white, like zzzz you know, what I mean buzzing noise at the background and part of me thought that was a test if I’m honest. Part of me thought, psychiatric services set this up, to see whether I’m going to flip. But stuff like that I can sometimes sort of think, this is when I’m not particularly unwell, but these are sort of every day. I can sometimes think the supermarket’s a bit of a test, like too much decisions, and whether I can kind of cope with it. Yes. And that’s kind of ongoing really, you know, even when I’m not… even when I’m kind of like in a total episode. I think for me, when I am not in a total episode, I still think I’ve got vulnerabilities to thinking that things aren’t, you know, to thinking that that’s a test and stuff when it isn’t a bloody test. it’s just the radios not tuned in properly.

So is it more about sort of organisations being more malevolent or that kind of thing or
Is not as coherent as that, in a way? Who would be testing you?

I don’t know. I don’t know. I know it’s not that it’s more, no it’s more kind of, it’s more like, not voices, but I don’t whether it is voices. It probably is voices. it’s more kind of like you know, you’re not, that you just can’t cope, and that you’re not going to be able to cope and you’re not going to be able toor that you’re not going to be able to cope with this and then that’s going to escalate and it’s seems, it’s whether you’re going to be pushed. I don’t know whos going to push me and I don’t know, you know, I don’t have any sort of idea that you’re going to be pushed and someone’s x, y, z are going to push you it just feels that they’re, that’s like a test, you can’t cope with that, and then you’re going to cry. I’m like ten steps ahead of myself. All the time. Well not all the time, but when I’m like a little bit unwell. Which I had I went into mental health services last week, where I’m not particularly 100% well, then that’s when I kind of start thinking stupid thoughts like that. Really.

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Kirsty heard voices coming from household appliances such as vacuums and fridges, which made it harder to keep up with the housework; she occasionally got people to help.

Work and education with psychosis

Onset of psychosis disrupting work and education   Many people had their education or working lives disrupted by developing mental health problems. People described their...