One of the first and immediate benefits of participating in the Partial Hospitalization Program (PHP) at OSU’s Harding Hospital was that I quickly established a routine. After months of literally laying in bed, I needed to adjust both physically and mentally.

Our program started at 8:45 each morning and after a break for lunch at noon and continued until 3pm. This meant that I was for the first time in recent memory I was getting up at the same time every morning and eating 3 meals a day. There was a kitchen at program that provided cereals, milk, bread, fruits, juice, coffee, and tea. This was perfect as eating first thing in the morning has never been comfortable for me. Many of us took advantage of the service and arrived several minutes early to get our breakfast eaten. We also were given a voucher for lunch at a near by campus eatery. This meant I did not have to stress every day about packing a lunch or having cash on hand. So these three things: having a reason to get out of bed in the morning and not having to worry about my two day time meals made such a difference on my attitude towards each day.

I started on a Tuesday and by Thursday I felt absolutely exhausted. My kindly husband explained to my case manager that I just couldn’t physically handle another full day of intense therapy. Bailey (my case manager), and I quickly came up with a schedule that would allow me to get the most out of therapy without taxing myself to the limits. I learned that in my current physical health I could not spend more than 2 days away from the apartment at a time. So I took Wednesdays off and had the weekend to rest as well. Not only did this set a schedule for my program, but it also helped in establishing routines and boundaries for when I was on my own again and making plans, appointments, and eventually when looking for employment.

At the end of each day, by which time we were all exhausted from sharing our emotions, discussing our struggles, and confronting our schemas, we each participated in a safety check. We laid out some goals for our evening, how would we keep busy, how would we deal with negative emotions if they occurred, what were some coping techniques we could employ and were we safe, did we have a desire to hurt ourselves or others. The staff was tough during program, we had to have real concrete plans, we couldn’t just say “rest” or “eat dinner.” Without the structure of having goals and plans we were more likely to struggle with the issues that had brought us to the program to begin with.

One thing that I have struggled with being someone with a chronic pain and depression is that I often isolated myself regardless of how I felt physically. My depression and anxiety would exacerbate my physical symptoms and even when I was feeling well I was staying in bed. With the help of the clinicians during program I was able to lay out some conditions for myself. Setting an alarm for morning is important, getting up, washing my face, brushing my teeth, and taking my meds are also mandatory. After these tasks have been complete I can evaluate how I feel and whether I need to cancel any plans and take a rest day. This helps me get out of bed, but also alleviates a lot of guilt that results from having to cancel something. When I know I’m trying my hardest taking a rest day is taking the best care of myself as opposed to isolating or giving up.

PHP was only 5 days long, but after that I continued for almost a month of Intensive Outpatient Program (IOP). Our mornings were the same, I’d get up, grab breakfast and participate in the same sessions I had been participating in, but then I went home at noon. This gave me a much larger window of time to fill on my own. I found that after a week of well structured days this task was not as hard as it had been previously. My depression and anxiety were still high, I was still physically exhausted, but I had a much better outlook on how I wanted things to be.

Lastly, one of the conditions of leaving IOP was having an appointment scheduled with a therapist as well as with a doctor if new medication was prescribed while in the program. I had already seen my primary care provider who had agreed to prescribe my as needed medication for my anxiety. Finding a therapist was a little harder as it involved making phone calls, but I happened to land a great therapist who I see weekly.

Overall, by the end of May I was spending much more time out of bed and out of the apartment. I had even caught up with a friend and neighbor having a nice low key knitting and movie night. All of this was the catalyst I needed to have a pretty decent summer.

Today I have a set schedule for my week with some additions and subtractions as needed. Through out the week I attend physical therapy, meet withy my physical therapist, and work out at the gym. I’m also occasionally teaching knitting, crochet, and spinning classes, and I love to go to the coffee shop to write and read. At the beginning of the semester it was also decided that I would cook dinner on Wednesday night as Ryan works in the afternoon and then has to be up incredibly early Thursday morning. So far I have cooked two delicious meals and have been working on making plans for future dinners.

If you or someone you know had been struggling with chronic illness and/or depression I highly recommend taking the time to establish a routine. Get help from a therapist if you think you can’t do it by yourself. It has worked for me, and I know it has worked for other people I know.

When has a daily routined worked for you? What would you like your routine to look like? Let me know in the comments, I’d love to hear from you.