Self-help program helps British Columbians manage their moods
Reprinted from the "Mind-Body Connection" issue of Visions Journal, 2014, 10 (2), p. 18
Most of us have circumstances in our lives that are outside of our control and that limit what we can do. For some of us, these are physical health issues, which can feel overwhelming and result in anxiety and low mood. An unhealthy cycle can develop, where the less we do, the worse we feel, and the worse we feel, the less we do. This leads to a downward spiral in our moods and our health.
The Bounce Back: Reclaim Your Health program was introduced in 2008 by the Ministry of Health via the Canadian Mental Health Association. It was specifically designed to help patients address mental health impacts of physical health problems. However, the program was soon expanded to include any adults who were struggling with their moods due to stress and who doctors thought would benefit.
In Bounce Back people use resources that include a DVD (Living Life to the Full), workbooks and telephone support from coaches to help them make change. Tools from cognitive-behavioural therapy help them discover what they can control and what a difference small changes can make. People begin to understand how their thoughts about themselves, the world and others influence how they feel, and they experiment with new ways of thinking and behaving.
Sarah was struggling with arthritis, chronic obstructive pulmonary disease and weight gain when she was referred to the program. She found that she was staying home more and more. It got to the point where she rarely left the house except for medical appointments.
Sarah wasn’t sure the Bounce Back workbooks would help her, as she felt her problems were all caused by physical issues. However, a workbook called Understanding How We Respond to Physical Health Problems explained how feeling ill can lead to reduced activity and low mood. Sarah recognized herself in the words.
She realized that she had stopped doing things she enjoyed and her life had been reduced to a routine of basic chores, watching TV and going to medical appointments. Sarah avoided anything that wasn’t absolutely necessary because she worried about being exhausted and in pain afterwards.
Sarah started focusing on her own well-being. Her Bounce Back coach helped her plan a small and easy goal to start. She had avoided asking others for help, but decided to ask a friend to help her go on an outing downtown in her community, to window shop for a while. The outing went so well that Sarah wondered why she hadn’t done it earlier, and her friend enjoyed the outing as well. And, Sarah realized how much she had missed connecting with other people. She started making more of an effort to get out of the house, often for small, fun activities like going out for coffee. She did get tired after an outing, so she made sure that she only went out for a short time and that she had a few days to rest afterward.
Sarah has been much happier and said that everyone noticed she seemed more upbeat and positive. Her physical conditions didn’t go away, but her mood improved, which helped her to feel better about each day and to cope better with her pain.
The Bounce Back workbooks are written by Dr. Chris Williams of the University of Glasgow, UK. They are a part of the Bounce Back program, which is available to people throughout BC free of charge with a doctor’s referral. For further information phone 1-866-639-0522 or see www.bouncebackbc.ca.
Juan has a heart condition, osteoarthritis and back pain. He had been on a wait-list for surgery for over a year and was starting to feel that it was never going to happen. Through using this same Bounce Back workbook, Understanding How We Respond to Physical Health Problems, Juan realized that most of his thoughts were focused on his pain, his heart condition and his anger at not getting the surgery he needed. He didn’t want to talk to anyone or go anywhere when he was in a bad mood, and he was cranky and in a bad mood nearly all the time.
Juan learned that his negative thoughts were making him feel worse and stopping him from enjoying life at all. He used another Bounce Back book, Noticing and Changing Extreme and Unhelpful Thinking, to learn more about the power his thoughts had over his mood. He learned how to recognize certain habitual negative thoughts, such as a pattern of jumping quickly to extreme conclusions. When he noticed this happening, he was able to remind himself that the thought wasn’t realistic. Juan altered his thinking, which interrupted the pattern and helped stop his mood from spiralling downward.
He also started a walking regime, venturing out a few times a week. He used a mobility aid and brought a friend with him. They went very slowly and stopped to rest often. The mild exercise began to have some positive physical effects, including improving his heart condition. Juan was still in pain, but started to let go of the anger around waiting for surgery and to enjoy his outings.
A tip from Reclaim Your Life: From Illness, Disability, Pain or Fatigue by Dr. Chris Williams:
“Your life is more important than your illness . . . You can create a new relationship between your illness and yourself that separates who you are from what you’ve got.”
Nancy suffers from vertigo and other chronic issues such as joint pain arising from an accident she had a few years ago. Her issues had become worse recently. She was feeling totally helpless and dependent on her husband and her mother to get through each day. She couldn’t even shop, prepare meals, do her hair or garden on her own.
Nancy used the new Reclaim Your Life: From Illness, Disability, Pain or Fatigue workbook. She worked with an exercise that asked her to think of times when her illness became a little “smaller” for some reason and then to write down in a chart why she felt better during those times. She filled the chart right up and then started including some of those things, such as talking to an old friend on the phone or visiting a garden centre, in her daily routine. She started thinking more about what she “could” do as opposed to what she “couldn’t” do.
Nancy also started to break her goals down into small, manageable steps. She found that her mood improved significantly and her anxiety decreased as she began to meet those goals and slowly add new goals.
“Instead of just forging ahead one day and then being in pain and unable to do anything the next, the workbook taught me how to pace myself,” she says. “I found myself feeling so much more positive, and I kept a journal of my accomplishments. My physical health also improved, and I no longer feel anxious and frustrated all the time.”
Bounce Back participants are taking a step in the right direction by reaching out for help. Many of them find, like the people in these stories, that connecting with other people can be very important to their mental and physical well-being. They also learn that big change begins with one small step.