Nosce te ipsum. — Know yourself.

The relationship between a psychiatrist and a patient is a very complex thing. I will probably never understand it fully. However as a patient I have come to a conclusion that in my opinion is very important. I believe it helps if we see ourselves as equally clever as our psychiatrists. It might seem too bold of me to say a thing like that, but let me explain. The psychiatrist has enormous theoretical knowledge and also broad knowledge of differences between individual patients. However I as a patient am the only one that is present 24 hours a day. In other words: I can observe myself all the time, whereas my doctor cannot. Thus in my opinion the winning combination is to join the general knowledge of the psychiatrist and my knowledge of what is going on in my mind 24 hours a day. In my opinion this way of thinking also eliminates the very common feeling of being subordinate to the psychiatrist, which usually evokes anger in the patient and is thus not constructive.

In order to be able to give the psychiatrist relevant information about us we should obtain the habit of observing ourselves. This is not easy. But we can try. A useful suggestion might be a diary with short notes like: “slept well” or “slept only for two hours”, “felt sad” or “felt too happy”. If we show such a diary to our doctors, they will be able to discern some patterns. For example my psychiatrist was able to find out that my symptoms worsen just before my period. This means that the premenstrual syndrome makes also my schizoaffective disorder worse. Subsequently this observation helps me, because I do not take myself very seriously the week before the period. I know it’s the hormones that disturb my brain and make me behave badly. It’s not me as a personality that is annoying and difficult.

By writing short notes of our activities, we can also find out what the triggers of our symptoms are. For example: “stayed out late” and “had trouble falling asleep” one after another in the diary could suggest we better go to bed early.
Let me give you an example of how I handle my sleeping. Sleeping disorders were always the first symptom of my schizoaffective episodes. Thus with years I became afraid of not being able to fall asleep in the evening. This fear made it even more difficult for me to fall asleep. Therefore I started observing myself and in a few years I have come to the following conclusions:
1. I should be in bed at 11 pm the latest.
2. I should not work or have an exciting conversation after 7 pm. Evening parties are to be avoided.
3. I should not work at weekends.
4. If the day is stressful, I need relaxation activities in the evening: massage, incense, chamomile tea, soft instrumental music.
5. After the relaxation techniques I just lie down and keep repeating silently in my head: “Just Exist.” or “It’s time for sleeping.”
6. When my thoughts get very annoying, I imagine they are clouds drifting away from me. I do not try to fight against them.

I am usually successful and fall asleep before midnight.

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