Mini Self-Care Strategies

We all know the importance of “big” methods of managing mental health, such as medication and exercise, but it’s easy to overlook the impact of “small” coping strategies. Mini self-care strategies typically take little time and effort, but make a significant impact. But because they seem so small, their importance is easy to downplay — you figure skipping them won’t really matter, ignoring the cumulative effect.

Journal

Acknowledging the importance of mini strategies is the first step.

It took me ages to figure out that the gaps in my journal were not only a symptom of my mental health declining, but also a contributing factor. When I write in my journal regularly, I feel better. Even if it’s just a few lines.Now I recognise how journalling helps me manage my mental illness, I know I need to prioritise it.

Observing patterns in your mental health is an effective way of working out which mini strategies work best for you. You can also experiment, trying new strategies and noting changes in your symptoms. Consider the impact of all your activities — even if it seems unlikely they affect your mental health.

 

Find ways of fitting mini strategies into your life.

Some people respond well to putting tasks on their to-do list (or must-do list), or scheduling them in their planner/calendar. Writing it down reminds you that these mini strategies are important and you should make time for them. However, some people can feel pressured by doing this, which may negate the benefits of the strategies.

The best way of making time for mini self-care strategies is to build them into your routine and make them a habit. For example, I write in my journal when I go to bed — it has become part of my routine, just like brushing my teeth. Piggybacking tasks onto established habits is very effective and easy to implement.

 

What counts as a mini self-care strategy?

Anything which makes you feel better in the long term and which can be done in a short amount of time. Note that these tasks could take much longer, if you choose, but it’s possible for them to have an advantageous effect in 5-10 minutes per day. Obviously, this will vary from person to person, but here are some examples:

• Journalling

• Listening to music

• Meditation

• Sketching

• Yoga

• Reading

• Knitting/crocheting

• Texting/calling a friend

• Gardening

 

Remember to do what works for you.

Perhaps your mini self-care strategies seem a little strange — or completely crazy — but it doesn’t matter, as long as they work for you. The crucial issue is developing the self-awareness to observe what works over a number of days or weeks; sometimes it will feel like your mini strategies aren’t helping, especially if your mental health symptoms fluctuate a lot, but it doesn’t mean they aren’t working in the long term. Stick with it and make notes.

Also keep track of how you feel before, during and after activities which you wouldn’t necessarily associate with self-care. I find that spot of decluttering is beneficial, for instance, although I wouldn’t consider tidying an activity I enjoy — at least, not while I’m doing it!

Don’t underestimate the effect of returning to activities you haven’t done for several weeks or months. Many of my self-care tasks were neglected over winter, when physical illness took its toll and caused a deterioration in my mental health, and I was surprised at how effective simple, little activites were in helping me feel better.

As always, there will be some trial and error involved to find what works for you. But once you find effective strategies, they are vital components in your self-care toolkit.

 

9 Months After Antidepressants

It’s been about 9 months since I completely stopped taking antidepressants, so I thought I would write an update/ponder on the issue. What follows is a summary of my experience and the issues it has raised.

Pill packets

There has been no dramatic change.

Browsing the internet, you would be forgiven for thinking that people fall into two categories: those who are anti-medication for mental illness and those who advocate taking anything you can get. The impression you get from this divide is that coming off antidepressants after over a decade will have a drastic effect – either you will feel awesome all the time or you will crash back down to the worst manifestations of your mental illness. This did not happen for me.

In fact, not taking antidepressants feels the same as taking antidepressants. I still get bad days, but I also have many good days. Managing my mental illness is a learning curve, but I’m finding and implementing more coping strategies. My hope that I would drop a lot of weight instantly did not (alas!) come to fruition. It turns out my fat has more to do with comfort eating and (lack of) portion control than medication…

Please note that I did not suddenly stop taking antidepressants. I discussed it with my doctor and gradually reduced the dosage over approximately 4 months, regularly meeting with my GP throughout the transition

 

It’s a personal choice, not a political statement.

I don͛t fall into either of the categories mentioned above: I’m neither anti-medication nor fanatical about antidepressants. Like most people, I suspect, I regard antidepressants as a useful tool which should be used to treat mental illness when it is needed and effective. My definition of “need͛” is when mental illness is affecting your ability to function”normally” which will be different for everybody, because it depends on what “normal” means for you. I also advocate using antidepressants in combination with other treatments where possible and appropriate, especially talking therapies.

I have no agenda in choosing to stop taking antidepressants. I decided it was something I would like to try for myself, to see how I coped without them. I’m not urging other people to do the same; nor am I urging them to keep taking medication.

Choosing whether or not to take medication – any medication – at any given time is a personal choice. I don͛t judge people for taking antidepressants, which is partly why I find it difficult to respond when people congratulate me for stopping my medication. A lot of people try to place a moral value on taking or not taking antidepressants, but this is unhelpful and damaging. You are not letting anyone down or doing anything wrong by taking medication. Neither are you letting anyone down or doing anything wrong by choosing not to take it.

You have to do what works for you. For me, that has involved a lot of trial and error in finding the right type of antidepressants and the right dosage at various times in my life. If you (and your doctor) think you might benefit from medication, give it a fair shot – and don’t expect it to work miracles. The media loves to call antidepressants “happy pills” but they rarely have the effect of increasing your mood to that extent, let alone giving you instant happiness in a deep, meaningful way.

You may experience side effects, but you may not. Some people claim that the possible side effects are a strong reason not to take antidepressants, but this disregards the fact that for many people,
side effects are mild and/or temporary – or may not manifest at all. You also need to weigh up the side effects against the benefits of medication, as with medication for physical conditions.

Personally, I believe the side effects I experienced were minimal compared to the improvement in my mental health. In fact, the only major problem I have had with antidepressants is certain types and/or doses not being effective. Seek advice from your doctor, be prepared to experiment and ensure your expectations are realistic.

Withdrawal symptoms also vary a lot from person to person. I didn͛t notice any, so can’t comment much on withdrawal symptoms in relation to my own experience, but it’s something you must
consider when deciding whether to stop taking antidepressants. I waited until I was sure I could cope with any withdrawal symptoms before coming off medication; I needed to know I was in the frame
of mind where I could recognise them as physiological or neurological effects, rather than personal affronts, and seek help if required. Again, it’s a case of experimenting to see what works for you – you may need to reduce your dosage more slowly in order to reduce and cope with withdrawal symptoms.

 

Antidepressants are an important part of my story.

I don’t think I would be alive without antidepressants. They took the edge off the worst points in my life and got me through. I still had really bad episodes of depression, including times when I was suicidal, but they would have been worse and longer without antidepressants – as I found out when I was in my late teens and came off medication too soon because I felt ashamed that I needed them. That͛s why nobody should try to shame someone for taking antidepressants: not taking them could put their life at risk.

Antidepressants provided me with a useful stepping stone, allowing me access to other ways of managing my mental health. Without them, I would not have been well enough or motivated enough to discover strategies which I now find useful, like exercise and meditation. I would not have been able to access treatments like drama therapy and counselling, which have had a massive impact on my wellbeing.

I have been able to achieve long term goals because I have taken antidepressants. I would not have gotten through university without them or learnt to drive. Even trekking to Machu Picchu last month would not have been possible if I hadn’t taken antidepressants; I could only go out walking alone to train because medication boosted my mood enough to make it a possibility in March last year. I will reap the benefits of antidepressants for the rest of my life, even if I never take them again.

 

Stopping antidepressants is an achievement.

I have recently been able to acknowledge that coming off medication is an achievement: not in itself, but because it͛s a sign that I’m managing my mental health well. This is a marked contrast to the attitude I had in my late teens, when I was first diagnosed with depression and thought I needed to stop taking antidepressants no matter what the cost. Back then, I was preoccupied with trying to convince everyone I was fine and terrified of the stigma surrounding mental illness. Nowadays, I battle that stigma and realise it͛s okay to admit that I need help.

This change of attitude is critical – it means that when my mental health dipped at the end of last year, I sought help. I had the confidence to ask for the type of help I wanted (counselling), without either returning to medication or ruling it out. I also recognised the importance of the strategies which had enabled me to stop taking antidepressants, returning to them as soon as I was able.

My initial response to being congratulated for stopping medication was to be defensive. I thought it meant people were judging me for needing antidepressants. I have come to realise that their congratulations are shorthand for “well done for managing your mental health on your own terms and working hard to get to this point.” It acknowledges my strength throughout my journey, rather than implying I used to be weak.

I was also wary about accepting congratulations because I was afraid I would relapse. I regarded coming off antidepressants as an experiment, rather than a milestone. However, I was believing a fallacy: that people would rescind their congratulations if I returned to medication. Again, I was placing the emphasis on the antidepressants rather than my own frame of mind and efforts to self- manage my mental health. People were congratulating me for reaching a point where I could experiment with not taking medication; even if I take antidepressants again in future, I have still attained the achievement for which I am being congratulated.

 

My experience doesn’t imply judgment of others’ experiences.

I struggled to be proud of coming off medication because I was afraid it would be misconstrued as judgment of both myself and others for taking medication in the first place. That isn’t true. In fact, I believe people should be congratulated for deciding to take antidepressants, as well as deciding not to take them, because asking for and accepting help is difficult.

I’m glad I was able to stop taking antidepressants because it was the right decision for me. It͛s not the right decision for everyone. I’m not under the illusion that it makes me a better person or better at managing my mental health than someone who takes medication. Comparing people in this way is unhelpful and cruel, because mental illness varies from person to person – especially when many of us have been diagnosed with more than one condition. Even when symptoms appear similar, the causes and effective treatments can be vastly different.

 

It’s still early days.

9 months seems like a long time in some ways, but represents only 5% of the time since I was first diagnosed with a mental illness. It͛s less significant when you consider that I was experiencing symptoms for at least 5 years prior to my diagnosis. My mental health has improved over the past couple of months, but I don͛t know what the future will bring – I could deteriorate and need to take antidepressants again. If I do, it won͛t signify failure.

All I can do is wait and see what happens, managing my mental health as well as I can in the meantime.

These 9 months have been challenging, but they have also been revelatory. I have coped better than I thought I could, both with little things like walking on my own and big things like trekking to Machu Picchu. I discovered that I can survive a bad episode without medication. I realised how big an impact physical activity has on my mental health when illness prevented me from exercising. I learnt the importance of small acts of self-care, like eating proper meals and making sure I do things I enjoy.

Most of all, I found that not taking antidepressants is not much different to taking them – for me, at this point in my life. There have been no miracles and no disasters. Just me, living and coping as best I can on my own terms.

Sunshine and Optimism

I love summer — and the effect it has on my mood. The sun has a physiological impact, making your brain produce more serotonin and regulating melatonin levels. This means you feel better and your sleep patterns improve. In addition, sunlight boosts vitamin D levels and vitamin D deficiencies  are strongly associated with depression. Try this article if you would like more information on the benefits of sunshine (and enjoying them safely) — it’s long, but fascinating.

Sunset
I love it when 9:30pm looks like this.

Summer also has a psychological effect.

I have a theory that good weather encourages mindfulness; especially in the UK, where we have to make the most of the sunshine while it lasts! Warm weather and long hours of daylight also make it easier to get outside and participate in activities which improve my mood.

Instead of watching TV or aimlessly browsing the internet, I read or scribble in my writing journal. Or just hang out with my dog. I can enjoy walking either early in the day or late in the evening, rather than rushing to get out while it’s still light and not raining too much. I spend more time meditating and practicing mindfulness.

Perhaps it’s better because it’s fleeting.

Would I enjoy summer so much if it lasted longer? I’m not sure. Perhaps I embrace it so wholeheartedly because I know it will pass too quickly. If we had warm, dry weather for most of the year, would I make such an effort to take advantage of it and participate in activities which benefit my mental health?

Maybe it would be easier to keep doing those activities. To keep getting outside and exercising or reading. Or maybe I would stay inside, watching TV because I know the sun will still be shining in a week, a month, a few months.

But why overthink it, when you can enjoy it?

The bottom line is that summer improves my mental health and helps me feel better. I intend to use the benefits to make improvements to my life and mental health while I can.

The Must-Do List

I came across the idea of writing a must-do list in a fun and practical book I read recently, Get Your Shit Together by Sarah Knight. It’s simple: write your to-do list, featuring everything you need or want to do, then prioritise it and choose 2/3 top priority tasks each day to put on a separate must-do list.

Must-do list

How to use the must-do list.

Using the must-do list is simple in theory: you must get these tasks done today, no matter what, before tackling anything else on your to-do list. These are your top priorities.

If you have a clear demarcation between different areas of your life, such as work and home, you can make separate must-do lists for each one. However, be aware that having more than a couple of must-do lists will defeat the object and make the strategy less effective. It may also be a good idea to keep your work must-do (and to-do) list at work, to help maintain focus.

Personally, I combine work and everything else onto a single to-do list, from which I create a single must-do list each day. I work from home and my hours are variable, since I work around my mental health problems, so there is little distinction between my home and work life.

The tasks on the list should be small and specific — even if they are part of a larger project. Split large tasks into smaller ones until you have manageable chunks.

 

The must-do list forces you to focus.

You are faced with your top 2/3 priorities in small, manageable chunks and can ignore everything else on your to-do list. This is why it’s important to make a separate list, so you don’t get distracted by lower priority tasks as you consult your to-do list.

Many of us are guilty of procrastinating through busyness. We convince ourselves we are being productive because we are crossing items off our to-do list, yet high priority tasks are left unfinished while less important ones are completed. You then have the perfect excuse to claim you have no time to complete high priority tasks, because the crossed-off items on your to-do list provide evidence. You can ignore the fact that you wasted hours doing busywork instead of working on a major project.

The must-do list cuts through this bullshit. It makes you hyper-aware of your priorities and splits your goals into small tasks, so you are less likely to feel overwhelmed or intimidated by the important stuff.

 

The must-do list helps you realise you have plenty of time and space to tackle your priorities.

You don’t need to panic about how you can fit in everything on your to-do list, because you are not trying to fit in everything. You only have to fit in your top priorities. This enables you to approach your most important tasks with a clear mind.

You can focus on what is most important to you and accomplish what you want.

 

Must-do lists improve productivity.

Once you complete your top priorities, you can tackle the next ones on your to-do list. By doing this, you are getting ahead and have the security of knowing the most important tasks are done.

Compare this approach to the conventional to-do list: you get distracted by minor tasks which you do because they take little time, not considering how those “insignificant” 10-20 minutes here and there soon add up to hours. This leaves you with inadequate time to tackle the most important tasks, so you fall behind and if you manage to work on your priorities, you are forced to rush. You figure it might be better to leave those tasks, which also tend to be the ones requiring the most energy and concentration, until tomorrow — when you add more items to your to-do list and start the whole process over again, playing catch up and racing without getting anywhere.

The ridiculous thing is, it’s easy to make time for lower priority tasks at the end of the day, whereas doing them first swamps your whole day. The must-do list approach also leaves you in a better frame of mind to tackle those lower priority tasks: you are less stressed and frazzled, because you know you have taken care of your priorities. You feel a sense of achievement and satisfaction, which motivates you to complete a few more tasks instead of slumping in front of the TV all evening.

 

Must-do lists may seem counterintuitive, but they work.

I decided to try the approach because my chronic procrastination often meant I did nothing important for days, using my time and energy to complete meaningless tasks which I told myself “needed” to be done. I figured it would be better to get a couple of high priority tasks done, rather than several low priority tasks.

I discovered that writing a must-do list was far more effective than I had anticipated. Not only am I completing high priority tasks, but I’m also getting through many medium and low priority tasks.

Must-do lists have a huge psychological effect, setting you up to succeed. To-do lists, while useful, offer too many pitfalls which could lead to failure. Even when you prioritise to-do lists, you are faced with the distraction of other tasks on the list — a separate must-do list avoids this, while still providing you with the security of a to-do list.

The to-do list is a crucial part of this system, because it collates everything you need to remember. Trying to make must-do lists without the foundation of a to-do list doesn’t work. You can’t prioritise effectively unless you consider everything you need/want to do and trying to remember non-priorities creates a distraction. When you put everything on a to-do list, you don’t need to think about anything but your must-do list.

It’s early days, but I’m very impressed with the must-do list system. I’m more productive than I have been for months and less stressed. Give it a try — you might surprise yourself!

Living Option B

It’s inevitable that our plans go awry sooner or later, but for some of us the changes are so dramatic they throw our life off course.

Machu Picchu
My Option B looks like this. Sometimes.

This week, I read a book called Option B, which is co-written by Sheryl Sandberg. Sheryl is one of the world’s most prominent businesswomen and COO of Facebook. In 2015, her life was turned upside down when her husband, Dave, died suddenly at the age of 47. Option B is about how Sheryl learned to cope. Her cowriter, Adam Grant, is an author and academic with a PhD in organisational psychology. The book combines personal experience with psychological research and suggestions for how social and political changes could support people in difficult situations.

While bereavement is the book’s focal point, it addresses a range of issues and its lessons can be applied to a range of traumatic experiences. I found a lot of ideas to help me manage my mental health and the issues surrounding long term mental illness, but the main message I got from the book is: how do I kick the shit out of Option B?

The concept is simple: Option A would have been wonderful, but it’s not what happened. You are stuck with Option B, so how do you make the best of it?

For me, my Option A would have been a life unaffected by mental illness. Unlike many people, I never really lived this option for any period of time because my mental health problems began when I was a teenager. I have never held a job which wasn’t affected by my mental health. I have never lived independently. I have never met my friends in a pub without fighting anxiety. Sometimes I feel sorry for myself; I know it’s neither attractive nor helpful, but I wish I had gotten to live Option A.

But I got stuck with Option B: long term anxiety, depression and borderline personality disorder.

There are two broad options when you are living Option B. You can bemoan the fact that Option A is lost to you and waste your life wishing it were different. Or you can find ways to cope with Option B. Find moments of joy, even if lasting happiness seems impossible. Achieve goals, though simple tasks may seem impossible.

Strange as it sounds, I’m not sure I would have achieved many of my life goals if I weren’t stuck with Option B. I don’t think I would have done a Creative Writing MA or trekked to Machu Picchu. If life had been comfortable for me, I wouldn’t have found the motivation to stretch myself. If I had enjoyed the mundane success of a steady job and “normal” life, I doubt I would have found the courage to face failure in order to fulfil my biggest dreams.

Living Option B often means regarding things from a different perspective.

In the past, I have fallen into the habit of thinking “What can I do? I can’t even walk into a shop on my own.” I set myself up for failure and paralysed my progress by approaching the problem from a position of weakness. I answered my question with what seemed like the only choice: I can’t do anything. I struggle with normal things, let alone “proper” goals.

A more empowering perspective is to think “This is what I want to do – how could I do it?” This is how I try to approach my big goals, the dreams I really want to chase. It engages the part of your brain which wants to solve problems, because it presents a specific dilemma.

Disclaimer: being able to come up with options doesn’t mean any of them are easier. In fact, many are extremely difficult to follow – even when you know they are the best options. However, simply being aware of options is a huge step forward.

When you feel paralysed by anxiety (or any illness, situation or emotion), you are stuck in your current circumstances and can’t see a way out. Thinking about what you want and following potential paths to achieving your goals lets a little light in; it may not throw open a door straight in front of you, but it creates a chink of light which demarcates an exit. You can use that light to negotiate your way out, even if you have to overcome many obstacles to do so.

More Option Bs will keep cropping up.

Even when you are already living Option B, life can toss more shit your way. Problems can often cause other problems, such as long term illness resulting in debt because it limits your ability to earn. Sometimes your situation seems to be improving, then it takes a nosedive. None of this is inevitable, but it happens a lot.

Maintaining a positive attitude when living Option B is bloody difficult, but it makes your life a lot easier.

The book discusses ways to challenge thoughts which are personal, pervasive and permanent. This is based on the work of Martin Seligman, pioneer of positive psychology and a hero of mine. He discovered that people are less able to overcome adversity when they blame themselves (personal), believe everything in their lives will be negatively influenced (pervasive) and believe the results will last forever (permanent). It’s easy to get trapped into this way of thinking, even when you can acknowledge that it’s not helpful.

I’m guilty of being aware of these patterns of thinking, but not being consistent enough in challenging them. I know the theory, but struggle to apply it in practice. The problem with living Option B is that there is a huge source of adversity which does seem personal, pervasive and permanent. Mental illness, in particular, feels like it’s your fault/is punishing you personally, can affect all areas of your life and feels permanent when you have experienced it for many years. How can you challenge something so monolithic?

The answer appears to be: by chipping away at it. The obvious starting point is that nobody is to blame for their mental illness. Sure, maybe certain behaviours, thoughts and coping strategies contribute to the development and progression of mental illness, but nobody chooses it. We all do our best as we battle through and sometimes our ways of coping aren’t the best options, but seem to be the only or easiest options to which we have access at the time. Besides, sometimes people can do everything “right” and still become mentally ill.

We can chip away at pervasiveness and permanence by considering the fluctuations of mental illness. I have bad days, for sure, but I also have good days. My mental health also affects my life in different ways at different times: when my depression recedes, I often find more energy and motivation to exercise or work on my writing. When my anxiety improves, I can get out more, be more sociable and submit more of my work. Again, this chipping away might not seem like much progress, but it’s the chink of light which lets you know there is hope.

Acknowledging that you are living Option B can be refreshing.

It takes the pressure off. You realise comparing your Option B to other people’s Option A is futile. You aren’t constantly chasing after Option A, once you acknowledge that Option A is no longer available. Instead, you can focus on turning Option B into a happy, successful and fulfilling life.

I can’t turn back time and prevent my mental illness. I can’t magically transform myself into someone who managed to move out of her parents’ house in her early 20s and has held down a full time job for 10 years. But I can work on building a satisfying career which will hopefully enable me to earn a living one day. I can strive to achieve my goals and find moments of joy amongst the pain and despair of mental illness. I can learn coping strategies and manage my mental illness so that it causes me less pain and despair. I can chase my dreams and try to inspire other people to see the hope in their lives.

And that, my friends, is what I think the book means when it mentions kicking the shit out of Option B!