“Rock bottom” looks different for everyone; get help before finding yours.

If you’ve been living with physical or emotional pain for a long time, you might feel like you’ve mastered the art of holding the line. Maybe you’re coping just well enough that other people don’t notice or become concerned. Maybe you’ve become adept at keeping “rock bottom” at arm’s length.

There are two catches to this strategy. One is that “rock bottom” is different for all of us and we don’t always know we’re on its doorstep until we arrive. We might feel that we are coping fine right up until the point that the switch is flipped. Like ignoring back pain for years until a fall that pulls you out of work permanently. Or, hiding your addiction for months until your spouse finds the bottles and threatens to leave. For some people, rock bottom is more subtle, like your kid remarking that you missed their school assembly, again.

The other catch is that waiting until rock bottom can cause unnecessary harm. Sure, it can kick us into gear when nothing else will. But waiting until the damage is done – the argument, the injury, the job dismissal – starts our help-seeking journey from a rocky place. Not to mention the suffering that comes from holding onto pain longer than we needed to.

Readiness to change

So, we want to intervene before rock bottom, but when? The hallmark of quality healthcare is prevention, first, and early intervention, second.

Sometimes we can’t prevent harm from occurring because “life” happens, and we all go through difficult times. Other times, it doesn’t make sense to strive towards full recovery, such as in cases of chronic pain or illness. When this happens, we need to ensure the right opportunities and support are in place to facilitate change early and build active tools for coping. Our team at Geneva Wellbeing help with this part of the equation by providing addiction and psychology services, alongside a wide range of physical rehabilitative support.

But, even when high-quality support exists, the next biggest challenge is getting people to a place of readiness to seek it out.

Early warning signs

In the addiction space, clinicians refer to the most impactful consequences of addiction as “The 5 L’s”: Liver, Lover, Livelihood, Legal, and Loss of Control. This framework encourages whānau, friends and colleagues to consider the early warning signs that they, or someone they know is struggling.

The most important thing about the 5 L’s framework is that it doesn’t matter how much you’re drinking or using, it only matters what impact it’s having on the different domains of your life: your relationships, your health, your job and your mental state. Whether it’s substance use, or something else you’re struggling with, we can use a framework like the 5 L’s to get us thinking across the different facets of life.

Know your signs

Being completely honest with yourself, work through the following statements and make a note of how many of them you agree with. Remember: “pain” includes any kind of emotional, physical or behavioural difficulty, including any associated coping behaviours (e.g., problematic substance use, or anger issues).

1. I have noticed changes in my energy levels, digestion, sleep or eating habits that could be linked to my pain or coping behaviours.
2. I have wondered whether my health issues are a result of my pain or coping behaviours.
3. My partner, family, colleagues or close friends have expressed concerns about my wellbeing.
4. My relationships have become strained because of my pain or coping behaviours.
5. I have been late, missed meetings, caused conflict or underperformed at work due to my pain or coping behaviours.
6. My productivity, creativity or decision-making ability has been negatively affected by my pain or my coping behaviours.
7. Since I started feeling this way, I’ve stopped doing helpful things I used to do (e.g., hobbies, exercising), or picked up new unhelpful behaviours (e.g., drug use).
8. I regularly feel regret, guilt or frustration about my pain or coping behaviours but find it difficult to change.
9. I find myself thinking poorly of myself and feeling less confident in myself because of my pain or coping behaviours.
10. I have noticed emotional changes in myself due to my pain or coping behaviours, either feeling more emotional than normal (e.g., anger, sadness) or less emotional than normal (e.g., numbness).