Winterproofing

I tend to think of the clocks going back as a negative event: winter has always been a difficult time for me, bringing both physical illnesses and a decline in mental health. The past two winters have been particularly awful. Last winter, I was ill for nearly four months solid, with the flu, throat/chest infections and other viruses wreaking havoc. I couldn’t use the coping strategies I had put in place, as even the easiest took too much effort. My depression and anxiety got worse.

Sunrise

This year, I hope things will be different — but last winter has taught me that you can do almost everything “right” and still succumb to illness. 

There has been one benefit to the clocks going back that I haven’t appreciated/experienced in past years: the lighter mornings. Since I get up at 5am nowadays and take the dogs out around 6:10am, the change is obvious. We could walk up the lane again this morning, after being forced to take a different route (with streetlights) for the past few weeks. As you can see in the photo, the sunrise was glorious.

Prioritising Self-Care

While I can’t control everything, I am making sure I stick to my coping strategies and self-care activities. In particular, I am being strict about using my SAD lamp and exercising. I know it probably seems ridiculous to people who don’t understand how important these activities are in managing my mental health, but it’s necessary.

Sure, I feel like I’m being awkward when I tell my friends I can’t go out on the evenings I have gym classes, but I don’t want to risk damaging my mental health. My routine, combined with the physical exercise, helps me stay healthy. When I feel guilty for being so selfish, I remind myself that when I got ill last winter, I couldn’t socialise for weeks — being unavailable a few evenings a week is preferable to being unavailable throughout the winter months.

I’m also being stricter with strategies which I should implement more regularly/frequently than I do at present. Wanting to avoid a repeat of last winter is a great motivator! I’m trying to eat healthy meals, even if I eat junk as well, and making an effort to meditate. I know I could do better, but stressing out about not doing better is counterproductive…

Finding Pleasure in Winter

I have being trying to focus on my strengths and the positive aspects of my life recently, so I’m trying to take the same approach to winter. It can be difficult to appreciate the pleasurable side of the cold, wet and dark months, but it’s not impossible.

Winter creates the perfect atmosphere for reading ghost stories, which I enjoy. It’s also a good backdrop for hot chocolate, warm puddings and spicy curries. Brussels sprouts are in season, which I adore (seriously) and I can watch films or read without feeling I should be outside, enjoying the sunshine.

I like a lot of things about Christmas, too — though it can bring its own challenges. Seeing Christmas lights when walking the dogs, buying presents and listening to cheesy Christmas songs are all fun. It marks the winter solstice, so brings hope that spring will come. The days will get longer again and it feels like I’m progressing with the changing seasons — in theory, anyway! In the meantime, it’s back to ghost stories and hot chocolate.

Facing Down the Fear

I’m terrified of getting ill again. I dread feeling like I did last winter. However, worrying and getting stressed will only increase the likelihood of getting ill.

Instead, I’m attempting a more pragmatic approach. I will do everything I reasonably can to avoid getting ill (hence I got a flu shot last week, for the first time!), but I can’t beat myself up if I get ill. Whatever will be, will be.

It’s the same old story, really: there is no point in worrying about stuff which might or might not happen. Of course, knowledge and practice are different things — especially when you have anxiety…

I refuse to fixate on whether or not I will get ill. In fact, I accept that I probably will get a few viruses and colds. I accept that my depression will become more difficult to manage. But I can focus on what I’m able to do and put contingency plans in place.

Coping with winter is difficult, but I’m not completely powerless. I can choose to accept the possibility of illness while doing my best to keep it at bay. It’s my best chance of staying mentally and physically healthy.

Accumulating Expertise

Living with long term mental health problems involves a lot of trial and error. While some treatments and strategies have a high success rate in general, the only way to find out what works for you is experimentation – repeated experimentation. Strategies can vary in their effectiveness, both across time and in different situations. Some treatments are more difficult to access than others, such as talking therapies, which can be all but impossible to secure over long periods of time unless you can afford to pay for a private therapist or counsellor. Sometimes life gets in the way of your ability to implement strategies. During particularly bad episodes, nothing seems to work.

 

Capturing Information

One of the most challenging aspects of mental health is its pervasiveness. It affects every area of your life: career, finance, relationships, fitness, etc. – all of which also affect your mental health. Combined with fluctuations in symptoms, these factors make it difficult to assess the effectiveness of the various treatments and strategies you use to manage your mental health. Pinpointing correlations is difficult, let alone determining potential causes and effects.

Recording information about your symptoms, treatments and coping strategies presents more challenges. When you are experiencing a bad episode, symptoms saturate your everyday life and making notes is the last thing on your mind. When you feel relatively well, recording information seems like an unnecessary hassle. Achieving any level of consistency is improbable.

There are also benefits and disadvantages to different types of record keeping. Writing in a journal is my preferred method, because it helps me to process my thoughts and feelings. It captures a lot of rich, complex information and gives me insights into my mental health which would not otherwise be recorded. However, using a journal takes time to write and more time to review. Since the information is purely qualitative, it can be difficult to measure progress or decline.

Another popular method of tracking mental health is using a system which asks you to rate your mood and/or other symptoms at regular intervals. You can do this through using an app or one of the questionnaires used by mental health professionals, such as the Warwick-Edinburgh Mental Wellbeing Scale. Bear in mind that when an assessment tool is designed to be used by professionals, it may not be user-friendly or suitable for self-assessment. If you would like to try the Warwick-Edinburgh Mental Wellbeing Scale, the NHS has a handy guide for using it to assess yourself: http://www.nhs.uk/Tools/Documents/Wellbeing%20self-assessment.htm

The main drawback of using a quantitative rating or tracking system is that the information captured is reductive. It tells you nothing about the context of your symptoms, unless you make additional notes. These systems are best used in combination with qualitative information – at the very least, noting which treatments/strategies you are using and any major contextual factors, like whether you have been having family problems or have an important deadline looming. However, it provides measurements which you can evaluate over time to spot patterns and determine which treatments/strategies work for you.

Full disclosure: I think tracking your mental health with quantitative methods is a great idea in theory, but it hasn’t worked for me in practice. I used an app called Moodtrack for a while and it was useful – when I remembered and felt able to use it. It allows you to make notes when you assess your mood, so you can record other symptoms, any activities in which you are engaged, external influences, current preoccupations… anything which you think might have an impact on your mental health. The information is easy to review, but doesn’t give me the same insights as journaling. Neither does tracking my mood and symptoms improve my mood in the short term, whereas using a journal makes me immediately feel better.

 

Research and Development

Finding the strategies which work for you involves a vital first step: being aware of potential strategies. You can learn about what works for other people from a variety of sources, including books, forums, blogs, social media and chatting – just beware of people who portray a certain treatment or strategy as a miracle cure. Most people find they have to use a variety of treatments and strategies to manage their mental health, although one or two strategies may be at the core of their approach.

Try to keep an open mind when considering strategies; often, activities which seem insignificant or a little strange can have a big impact. For example, meditation is frequently dismissed as being too hippy-dippy or a waste of time, but scientific studies and anecdotal evidence testify to its efficacy. You may not realise the value of a strategy until you stop doing it, which is what happened when I failed to use my SAD lamp regularly last winter. It’s fine to give up on strategies if they are too time-consuming or otherwise impractical, but commit to giving them a fair shot first.

Choose one or two strategies at a time: trying to incorporate too many at once is tricky, puts you under too much pressure and makes it difficult to tell which strategies (if any) are having a positive effect. Start with the ones which you think might make the most difference to you, or which are easiest for you to implement. Activities which don’t need any special equipment, like walking and meditation, are good starting points. Strategies which can be done inside your home also tend to be more accessible, like mindfulness colouring and yoga.

Anything you can do to make it easier to try certain strategies is a great idea. This could mean exercising with a friend for support, joining a class to keep motivated or setting reminders on your phone for self-care activities. Think about what you need. What are your particular preferences and obstacles? Selecting strategies which you believe you will enjoy is a good way to ensure you keep doing them long enough to assess their effects. Think about how you can increase the enjoyment factor of specific strategies, such as listening to your favourite music when you run.

Keep reading about mental health, but remember that you can find strategies which can help you to manage your mental health in other fields. For example, I find that decluttering lifts my mood and helps reduce my anxiety. I also feel better when I watch films, read and study. You may discover that different strategies work at different time, so have another shot at strategies which previously haven’t worked for you to see if anything has changed. This was the case for me with running: I tried it in my late teens and hated it, but now use it (along with other types of exercise) as one of my core strategies.

 

Expectations and Judgments

Mental health problems can be unpredictable. Everything can be going well and then, without warning, your symptoms worsen and your mental health plummets. It isn’t fair and you think there must be a logical reason for the decline, so you blame yourself. Maybe you didn’t implement your strategies as well as you could have, or you think you should have done more. You expected your mental health to improve or remain constant, but it didn’t – so you judge yourself for failing to live up to your expectations.

In an ideal world, you would be full of self-compassion and never judge yourself, expecting nothing and accepting everything with gratitude. That obviously isn’t going to work in real life: it is normal and natural to feel frustrated, angry and disappointed when your mental health dips. We grow up with the myth that if we work hard, we will be rewarded. We don’t like to be reminded that this isn’t always true, especially when we are the ones disproving the myth. Mental illness sucks precisely because you can everything to the best of your ability, incorporating coping strategies and seeking treatment when needed, only to slide into another awful episode.

I haven’t found a solution which enables me to control my expectations and stop judging myself – but I’m better than I used to be. You have to keep reminding yourself that you are not to blame for your mental illness. You have to try to enjoy the relatively good episodes and appreciate them. Most of all, you have to keep hoping you will get the balance right.

 

Achieving Balance

Managing long term mental health conditions is a balancing act. There will be times when you wobble and times when you topple over; the trick is learning how to regain balance. Picking yourself up after a bad episode is horrible. It feels like all your hard work has been erased and you are back to square one. But this is never true.

Every time a bad episode knocks you off balance, you learn something. It can take a long time to realise what you have learnt, but it is true. Every time you dust yourself off and manage your mental health well enough to see infinitesimal improvements in your symptoms, you learn something. Maybe you learn that you are stronger and more resilient than you believe. Or perhaps you find support in unexpected places, from new friends or acquaintances who have always been at the periphery of your life but now step up to help. You might learn about which values contribute to your wellbeing, finding hope in creativity, generosity or nurturing.

I think experiencing long term mental health issues is a process of learning. You are accumulating expertise about yourself and your particular mental health problems. You learn about what feeling mentally well means for you and which strategies help you get there. You learn to notice when your symptoms worsen and you need to increase self-care activities. You learn when to ask for help and what help you need.

You learn a lot about other people, too. You learn that some people are insensitive bastards who spread negativity wherever they go. You learn that others are ignorant and have no idea what impact their words and behaviour have on vulnerable people. You learn that some people are spiteful and will use your mental illness as an excuse to bully and abuse you.

However, you also learn that a lot of people are kind and caring. There are people who dedicate huge amounts of their time to helping you, both in official capacities and through friendship. You learn that your true friends will listen without dismissing your problems or telling you about people who are worse off. You learn who you can rely on for support during the darkest times, when you can’t even trust yourself.

Most of all, you learn a great deal about yourself when you experience mental health problems. It forces you to examine your life and what you would like it to be. You learn that you can cope with more than you thought possible. You learn about true strength, courage and confidence, which are not about presenting yourself as imperturbable and indestructible, but are about following your own path even when you feel like giving up.

Accumulating expertise in your own life is hard work and difficult, but brings many rewards. It helps you deal with the bad times, but also helps you seize opportunities during the good times. It helps you to recognise your vulnerability as strength and develop empathy for others. It helps you to live your life.

Beware Easy Narratives

If you read about mental health, sooner or later you will come across the Mental Health Cinderella Story. This type of story has a simple narrative: person suffers from mental illness, then finds a magical treatment or coping strategy and recovers, living happily ever after. It masquerades as a positive story about mental health because it supposedly gives hope to people who are suffering, but it can actually make people experiencing mental health problems feel pretty shit.

Grey and pink clouds

The problem with the Mental Health Cinderella Story is its simplicity. We all need to simplify stories about our lives — it’s natural and necessary — but we need to be aware of the effects of simplification and the inherent biases involved.

 

Oversimplification is demotivating, rather than empowering.

Most Mental Health Cinderella Stories are intended to be inspiring, yet they fail. Why? Because they portray the experience as black and white, glossing over the struggles and hardships. They present a certain treatment or coping strategy, such as antidepressants, CBT or walking, as a miracle cure. As soon as the miracle cure is adopted, they make linear progress towards complete recovery.

These stories rarely acknowledge that the treatments or coping strategies used can be difficult for many people with mental health problems to access. They don’t mention that many people experience awful days, weeks and months while using the “miracle cure.” The focus is on the evangelistic promotion of the particular “miracle cure” they have adopted.

Imagine how it feels to read such stories when you are already using the “miracle cure”, plus several other treatments and coping strategies, yet you are still struggling to manage your mental health. 

I’m relatively well, compared to what I have experienced in the past, yet Mental Health Cinderella Stories make me feel like a failure. I find myself wondering what’s wrong with me, that I haven’t made a full recovery when I’m doing exactly what this person recommends? Why do I still experience terrible days, whereas this person doesn’t?

 

The storytelling bias.

The truth is that some people’s experiences of mental health problems do align to the Mental Health Cinderella Story. They struggle, then they find a way to cope which enables them to make a full recovery and, often, never experience mental illness again. Good for them — I certainly don’t want them to suffer for the rest of their lives! The problem is, these types of stories are reported far more frequently and visibly than the messy, complex stories which resemble a lot of people’s experience of mental health issues.

My theory is that many people, especially those who haven’t experienced mental health problems, like to read or hear these stories because they are reassuring. They think, whether consciously or subconsciously, “it’s okay if I become mentally ill, because I can do what this person did and recover quickly by running/eating healthily/having a certain type of therapy.” It’s frightening for them to consider experiences, like mine, in which mental health issues have  massive, long term effects on people’s lives.

Nobody likes to think that they could try their best to improve a situation and still fail. Yet it happens. 

It’s frightening. It terrifies me, having lived through times when I believed everyone around me was cruel for not helping me to die, because I was suffering so much and nothing I did seemed to make a difference. However, ignoring reality isn’t the answer — which is what happens when the media tell certain stories, but not others.

 

Look beyond the sensationalist headlines.

One of the most frustrating aspects of the Mental Health Cinderella Story is that they are not always as simple as they are depicted. When you look beyond the clickbait headlines, a more complex story often emerges. Unfortunately, this message gets lost behind the sensationalism and perpetuates the myth of the “miracle cure.”

The stories are edited to fit the Cinderella arc, forcing experiences into discrete shapes and overlooking inconvenient aspects like relapses and factors other than the “miracle cure.” Many of the stories feature people who have resources which put them in a better position to effectively manage their mental health: financial security, supportive partners, understanding employers, access to various leisure groups and support services, etc. They are predominantly white, heterosexual,  middle class, educated people with traditional families. Yet none of these privileges is acknowledged in the Mental Health Cinderella Story, because the emphasis is put on the “miracle cure.”

If you don’t fit the same profile, or don’t have access to similar resources, these stories are more likely to evoke despair than hope. You come to the conclusion that the miracle cure hasn’t worked for you because you aren’t the “right” type of person.

 

Look for the motive.

A lot of Mental Health Cinderella Stories are selling something. Literally. People tell unrealistic versions of their stories because they want you to buy a product or service they are offering.

The product or service varies — I have seen the Mental Health Cinderella Story used to sell cookbooks, therapy sessions, online courses and books — and may not be obvious. For example, people tell their story to urge you to visit their website and then offer goods/services via the website. They claim to provide you with the “miracle cure” that worked for them.

I don’t have a problem with people selling stuff — there’s nothing wrong with trying to earn money — but I do have a problem with the overwhelming predominance of the Mental Health Cinderella Story and its unrealistic, narrow portrayal of mental health problems.

When you read these stories, be aware of what the author is trying to sell. Bear in mind that the story rarely (if ever) represents reality.

 

Be responsible when you tell your story.

I encourage everyone who has experienced mental health issues to tell their stories — we need much wider representation of different types of stories, from a much wider range of people. However, when you choose how to present your story, think about the effects it may have on people who are struggling with their mental health. Show them the truth, in all its messy, inconvenient and terrifying glory. Show them that there is hope — but you don’t need a miracle cure to find it.

Realise that the obstacles you have faced, and continue to face, give meaning to your story. Tell people about your challenges: days when your mood plummets for no apparent reason, the pain and isolation you felt (or continue to feel) at various points in your life, panic striking during routine activities, the times when your coping strategies make no difference, people in your life not understanding why you can’t do certain things or why your mental health fluctuates, not being able to do the things you enjoy (or not enjoying the things you do), wasting hours trapped in negative thought patterns, being too scared to leave the house…

Also remember that the challenges make your achievements all the more poignant and inspiring, as much as you would prefer not to be forced to cope with them. Tell people why you are proud of being able to do activities others find easy, after not being able to do them during worse periods of mental illness. Walking the dog on your own is a big deal when you have been unable to do it for ages. You should celebrate these seemingly-small achievements, as well as the big ones.

Most of all, beware of any stories about mental health which have a simple, easy narrative. “Happily ever after” is for fairy tales. You may recover fully from mental illness and you may be happy for the rest of your life, but there will still be problems and challenges. Conversely, you may struggle with your mental health for the rest of your life, but there can still be joy and triumphs amongst the struggle.

Tell your stories and seek out real, complex mental health stories. Try different treatments and coping strategies to discover what works for you and don’t be surprised if their efficacy fluctuates. Don’t place all your hopes on a “miracle cure” which may or may not work. Find real hope — it’s out there, but not in an unrealistic Cinderella story.


 

Changing Routines

I have come to realise that daily habits and routines make the most difference to my mental health. Big events have an impact of course, for better or worse, but the accumulative effect of the hundreds of tasks and mini-tasks I perform every day is greater. Which is why a drastic change to my daily routine has led to a recent improvement in my anxiety and depression.

Autumn sunrise

I started getting up at 5am.

Typing that sentence feels weird. I am not a “morning person”. I don’t bounce out of bed full of energy and joy, ready to meet the world. In fact, most of the times I had seen 5am in the past were a result of insomnia and/or staying up late.

I always thought of myself as a night owl; working late at night was normal for me, especially when writing fiction. On a good day, I only hit snooze once or twice when my alarm went off at 8am. If I dragged myself out of bed before 9am, I was doing well.

However, I kept reading that getting up early was a Good Thing. Loads of very successful people credited an early start for making them more productive. I began to wonder if it would work for me.

Then, one Tuesday about 6 weeks ago, I accidentally woke up early. I think it was around 5:45am. I was thirsty, so I decided to get up and go downstairs to have a drink. My brother later said “why didn’t you do what I do and drink water in the bathroom, then go back to bed?” I’m not sure of the answer. I suppose reading about the benefits of an early start made me think “I’m awake now, it’s an opportunity to experiment,” but it was subconscious.

I liked being up early, so I set my alarm for 5:30am the next day, then at 5am a few days later. I have been getting up at 5am since — yes, even on weekends.

 

Getting up early means I start my day with an achievement.

I always felt a bit crap rolling out of bed somewhere between 8am and 9:30am. If I overslept for longer, I felt like more of a failure. I was wasting a large chunk of my day dozing — my sleep quality was generally poor, but hearing my parents and brother leave the house in the mornings disturbed my sleep patterns even more, so I never felt well-rested.

It wasn’t an ideal start to the day and I never felt properly awake until noon. Anxiety and/or depression often cause me to procrastinate, so I would often reach mid afternoon without having done anything constructive. This feels crap, too, so the anxiety and depression would worsen and I’d be lucky to get anything done.

Now, getting up early is an achievement. I feel like I’m embracing the day, instead of hiding away from it until I summon the motivation to get out of bed. My mum and I have recently begun walking the dogs early as well, so that’s another item ticked off the to-do list before 7am. It sets me up for a more productive day.

 

It initiates an upward spiral.

When you have a long term mental illness, a lot tends to depend on momentum. When you are having a good episode and feel better, it’s easier to do more things which can improve your mental health. On the flip side, it’s easy to get into a downward spiral where you feel progressively worse and therefore are less able to do anything, let alone adopt positive coping strategies.

Getting up early helps me to initiate an upward spiral at the start of every day. Achieving this one, tiny goal makes my other goals seem achievable. It means I’m more likely to put on my SAD lamp, meditate, so yoga, write, read… All of those self-care activities which seem simple when you feel well, but are easy to neglect when you feel crap.

It’s important to note that I still don’t bounce out of bed. I don’t press snooze anymore, but it takes some effort to get up. I find it relatively easy only because it’s worth the effort.

I feel awake by 7am nowadays, which means I take less time to wake up, but I’m certainly not energetic and focused at 5am. I try to use the time to plan my day and do those simple self-care activities I mentioned. I think this makes a big difference to my mood, because I used to switch the television on as soon as I got up — often in the hope that it would distract me from symptoms of anxiety and depression.

The first hour after I get up gives me the opportunity to “check in” on how I feel and decide what I want to achieve over the course of the day. If I feel more anxious or depressed, I know I need to cut myself some slack and prioritise self-care. If I feel pretty good, I can prioritise work tasks and medium to long term goals.

 

My routine is still a work in progress.

Getting up at 5am has shaken up my whole routine and helped me make improvements, but it’s very much an experiment and there are areas in which I need to make more effort to change. I’m gradually building better habits, partly motivated by considering who I want to be, but there are many habits I need to tweak, transform or drop altogether.

The biggest change has been my mindset: I feel more ready to face the world. Even if most of the world seems to be asleep when I wake up!