BPD Stigma

I was recently upset and appalled by an article in the August 2018 issue of Psychologies magazine, which I previously respected and have found useful in the past, referring to people who have borderline personality disorder as “energy vampires”. I have written to the editor, explaining how the article perpetuates stigma and thought other people might be interested in what I have to say. The article refers to a book by Christiane Northrup which I have not read (and have no intention of reading if it has been accurately represented), but my main concern is with what Psychologies actually approved and published.

 

Psychologies magazine

Dear Suzy,

I am writing in response to the “How to avoid the energy vampires” article featured in the August 2018 issue of Psychologies magazine. The opening paragraph states: “When I use the term ‘energy vampire’, I’m talking about a subgroup of people — about one in five of us — who, in psychiatry, are called Cluster B personalities, with narcissistic, borderline, histrionic and antisocial personality disorders., and there’s a spectrum; you can certainly live with someone who’s a little self-centred and has narcissistic traits and then, at the other end, there are full-blown psychopaths.”

This email shall discuss borderline personality disorder (BPD), simply because I don’t feel qualified to comment on the other conditions mentioned. I have personal experience of BPD, having been diagnosed in November 2010, at the age of 26.

Labelling people with a mental illness — which includes BPD — is always harmful and increases stigma. To label us “energy vampires” is offensive. While the article mentions a spectrum, it uses the term “energy vampire” to refer to all people in that spectrum, including all people who have BPD. I can’t imagine that this paragraph would be accepted if, instead of referring to personality disorders, it had referred to depression, anxiety (both of which I also have been diagnosed with) or a physical illness.

Unfortunately, some mental illnesses continue to receive a disproportionate amount of stigma, stereotyping and discrimination compared to other mental illnesses. BPD is a key example and part of the problem is that it’s misunderstood, rarely being mentioned in mainstream media. On the rare occasions it is mentioned, such as in this article, it’s usually in negative terms.

The extent of this stigma can be seen across the internet and social media. Whenever Mind or Time to Change publish a blog post written by someone who has BPD, there are inevitably Facebook comments which perpetuate the negative stereotypes and stigma. These comments usually say that people with BPD are a nightmare to live with, difficult to interact with and generally not worthy of good relationships. Because BPD has not received the same amount of positive publicity as other mental health issues, people cling to the old stereotype as portrayed in Fatal Attraction. Yes, the most common impression people have of BPD is garnered from a 30 year old, misogynistic film!

Given this background, it should be obvious that labelling people with BPD as “energy vampires” feeds into the existing stigma.

I appreciate the apology you gave on Twitter and welcome any efforts to educate the general public abot BPD. There is a lot of ignorance and lack of understanding surrounding BPD, so positive representations would go a long way in addressing the damage caused by negative depictions and references. Many of us make positive contributions to our friends, families, communities and societies, but this is rarely mentioned in mainstream publications such as Psychologies.

If people with BPD are difficult to deal with, it’s because they are not receiving adequate treatment, help and support. This article makes no mention of this, simply terming all sufferers “energy vampires” who have a negative effect on the people around them.

Ironically, I had bought the magazine because I was interested in the “restore your energy” dossier and as BPD makes me incredibly sensitive to other people’s moods, I identify more as an “empath” than an “energy vampire”.

I would like to see Psychologies increase understanding of BPD. The negative stereotype is ridiculous considering the range of symptoms which can be experienced: individuals who have BPD may seem complete opposites. For example, both promiscuity and withdrawing from romantic relationships can be symptoms. Of course, the name itself is difficult for the general public to understand, with its connotations of character defects — many people assume BPD means “bad personality”. A lot of people I encounter don’t even realise BPD is a mental illness.

Please show that people with BPD are worthy of love and respect. We are capable of maintaining good relationships and contributing to other people’s lives in positive ways.

For example, I volunteer with a local youth mental health organisation. Last year, I ran a crowdfunding campaign which secured £15,000 to save our peer support groups in one particular town, which had been threatened with closure. In May last year, I completed a four day trek to Machu Picchu and raised over £1000 for Amnesty International, despite having panic attacks throughout the final morning of the trek. I blog about my mental health in an attempt to inspire other people with mental health issues to achieve their goals.

However, my own contributions are very small compared to a lot of people who have BPD. On Twitter, I see amazing examples of activism and personal achievements. People who are amazing parents, partners and professionals. Yet I never see them mentioned elsewhere.

I hope this email has explained why many of us with BPD find the article offensive and worry about its potentially damaging effects.

Kind Regards,
Hayley

 

Update: Psychologies magazine’s editor, Suzy Walker, has emailed me to take full responsibility and says that she is taking steps to ensure this doesn’t happen again and to promote understanding of BPD. She also invited me to blog about BPD on the magazine’s Life Labs website: click here.

I am impressed with Suzy’s response and optimistic that this mistake will lead to positive outcomes which will reduce the stigma surrounding BPD.

.

Rushing and Waiting

Progress in anything is often slow and nonlinear, but these qualities are exacerbated when you have mental health problems. In particular, anxiety and depression can create conflicting symptoms: it feels like I’m progressing too slowly and have the urge to rush into everything, yet it’s difficult to find the energy and feel motivated, plus many activities are too challenging. It feels like being torn in different directions.

Dog waiting

I have been feeling this way a lot over the past few months. So much of my time has been lost to mental illness that I feel frustrated when it steals more time from me. I’m glad and grateful that nowadays these increments of time can be (usually) measured in hours, days and weeks — in the past, they were most commonly measured in months and years — but it’s still stolen time. Time I can never get back.

My frustration might be due to my experience of losing so much time during my teens and twenties, when most of my peers were achieving amazing things, changing their lives and having fun. I may never reach the milestones of adulthood which the majority of people consider “normal”, like living independently and supporting myself without relying on state benefits, so it feels like everyone has overtaken me. I feel a deep need to prove myself, to demonstrate that my goals are worthwhile and I can make a valuable contribution to the world.

I constantly worry I am failing at life. I tend to dismiss my achievements, because it feels ridiculous to be proud of them when I struggle with tasks that most people find easy. I pressure myself to reach high standards because I hope it can atone for my failures, which include relying on my parents and finding driving a huge challenge nearly 9 years after I passed my test. If I could choose to exchange my achievements for being able to do everyday tasks, like shopping on my own and holding down a full time job, I think I would. Other people, I suspect, would find me more acceptable.

 

Waiting times.

Lately, I have been in a reflective mood. I think it’s because I had to wait several weeks for my results from my first Psychology module. In the event, I got an overall score of 95 and surpassed my expectations, but I was anxious about failing because it would effectively terminate my pursuit of the degree. I managed to almost convince myself I had messed up my final assignment so much that I had failed the module. As frustrating as it was to waste yet more time worrying for no reason, my anxiety  sometimes gives me insights: studying Psychology is very important to me.

While it should be obvious that I’m not choosing to accumulate more student loan debt for no reason, I think part of me worried about my reasons for pursuing a Psychology BSc. I have no career path mapped out. No way of knowing how my mental health will affect my life when I complete the qualification. However, I do feel a strong desire to improve my understanding of psychology and mental health so that I can help others. Perhaps I will do this through my writing; perhaps it will be via research or something else. I don’t know the route I will take, but I have clarified my first steps and am heading in the right direction.

The experience has highlighted a few truths:

1. There will always be waiting periods in my life, whether it’s waiting to hear about results or taking action in the face of excruciatingly slow progress

2. My mental health issues might mean I have more waiting periods than the average person

3. The only way to deal with waiting periods is to accept them

 

Acceptance is bloody hard.

Acceptance. It’s a simple concept, but difficult to practice. My instinct is to get upset: “why should I accept chronic mental illness when other people don’t experience it at all or for shorter periods?” And no, reminding myself that other people experience more severe mental illness for longer periods doesn’t help. Yet acceptance is the only way forward, because fighting against mental health problems doesn’t work — you have to take a collaborative approach, working within your constraints while pushing for progress.

Unfortunately, accepting my mental health issues can be difficult for other people. Many friends have dropped away because they couldn’t understand my symptoms, or why my symptoms differ from their own experiences of mental health problems. I know I’m better off without these “friends” but it’s still painful. Society in general doesn’t seem to accept mental illness. Even when people express understanding for “high functioning” people who have mental health issues, they are quick to judge those of us whose ability to work is affected. Stigma still prevails: people assume you are lazy if you need to rely on benefits, many express sympathy while acting in unsympathetic ways and judge you based on how you appear on your good days, without considering how they might be outweighed by bad days.

It’s difficult to accept your own situation when other people send negative messages. Even common assumptions can be hurtful for those of us who don’t fit the “norm” and these assumptions seem to increase as I get older. People assume a woman in her mid 30s should have her own home, be in a serious relationship, work full time, want or have children, socialise at least a few times a week, etc. I don’t fit the pattern and probably never will.

Yet everything boils down to the same old truth: improving my situation requires acceptance.

 

Learning to be patient.

I know comparing myself to others is ridiculous. Everyone’s situation, experiences and challenges are unique to themselves. All I can do is work on my own goals, try to improve my mental health and hope it all works out in the end. Oh, and I should probably try to enjoy my life along the way!

Maybe that’s the key to self-care, achieving goals, managing mental health and life in general: to aim for progress, not perfection, and have fun whenever you can.

Setting deadlines for myself isn’t always healthy, although they can sometimes help me to feel motivated. Sure, I would love to turn my life around in an instant, but that’s not realistic. I need to hold on to the positive aspects of my life, especially when they are overshadowed by the negatives, and see what happens.

 

Patience

I haven’t posted for a while because I have been going through a bad patch. The trouble with mental health problems is they can convince you that nothing you do will have an effect. There’s no point in writing a blog post, you think, because it will be crap, nobody will read it and it won’t help anyone. So you convince yourself it’s best not to do anything, which is easy since you don’t feel like doing anything. Nothing changes, of course, because you’re not taking action. You just feel worse and worse.

Rose

It’s frustrating when I feel this way, because downward spirals are hard to escape. I tell myself  I’m waiting until I feel better before I work towards my goals, but not working towards my goals usually makes me feel worse.

I’m finding things particularly difficult right now, because even when I have been working towards a goal on a regular basis, my progress seems very slow. Losing weight, for instance, is once of my priorities for this year. I have a lot to lose, so I hoped the first half would drop off quickly. It didn’t, but that was okay when I was losing weight at a steady pace. Then it stopped. For no apparent reason. I don’t think I’m a particularly stupid person, so I knew that plateaus are to be expected and I would lose more weight if I stuck to my plan, but it’s hard not to have an emotional reaction. While I knew I should lose weight again, because I was sticking to my diet and exercise plan, part of me was screaming “you are failing, you are useless, you are hopeless.”

http://globalarchaeology.ca/2016/07/caherconnell/ My plateau didn’t last for very long (about a month), but I realised it reflected my attitude towards many of my goals. I find it difficult to keep going when I don’t see results.

I recently read a book called Drive by Daniel H Pink, which highlights the importance of intrinsic motivation. I nodded along, recognising that focusing on external rewards is not conducive to motivation, but I also admit that I put too much emphasis on recognition. I feel insecure sometimes and need a gold star to boost my confidence. It feels pathetic to admit this, but tangible results keep me motivated and when they are absent, or not good enough (in my own opinion), I find it hard to stay the course. I start doubting myself.

I’m currently waiting for the final result of my first Psychology BSc module (I’m studying part time with the Open University) and it’s torture. My first 3 assignments got 95 apiece, so I would have to mess up in epic style to fail the module on the fourth assignment, which seems unlikely. But, again, while I realise this on a logical level, the part of me which is entangled with my mental health issues keeps shouting about how I’m stupid and must be an idiot to expect anything good to come of studying.

However, I was forced to take action in spite of these negative thoughts. I needed to enrol on my modules for the next academic year and apply for my student loan. I had to ignore the voice telling me I was jinxing myself, because the alternative would be to wait another year before continuing my studies. If I do that each year I complete a module, I would take 10 years to complete the degree, instead of the anticipated 5 years. Obviously, that would be ridiculous, so I did what I needed to do.

http://paperbookintensive.org/contact/img_1293/ Taking action is almost always an act of faith. You have to trust that your actions will make a difference.

Keeping faith is especially difficult when you are working towards a big goal. I do my best to split big goals into smaller ones, acknowledging and celebrating small successes, but some goals are so big that you have to wait ages (so it seems) for even tiny signs of progress. The answer isn’t easy, but it’s essential: you need to focus on the process, not results.

Focusing on the process requires faith and patience. It’s about building the habits which will determine long term success. In short, it’s a long, hard slog.

I was googling “how to stay motivated during weight loss” earlier today and was reminded of something I already knew: motivation follows action. If you wait to feel motivated before taking action, you could be waiting forever. Time is always passing, whether you take action or not. What will you regret not doing 6 months, a year or several years from today?

So that’s why I’m forcing myself to keep going. It’s hard to make short term sacrifices without getting results, but my future self will thank me. I would rather turn down cake today than get diabetes in a few years. I would rather get stuck into studying this year than regret not seizing my opportunity 10 years down the line. I want to create healthy habits which will lead to my ideal life, or at least a better life than the one I’m living.

There’s a comment which writers often hear that has become a bit of a joke: “I would like to write a novel” — or its variant “I wish I had time to write a novel” — often accompanied by a wistful expression. The implication is that writing a novel is something people only do if they are privileged enough to have time and few other concerns, but this simply isn’t true. Thousands of novels have been written in segments of time snatched from busy days. If writing a novel (or doing anything else) is a priority for you, you can find a way to achieve it. The difference between people who say “I want to write a novel” but never do it and people who write novels is not a lack of time.

enter We all have 24 hours a day, 7 days a week and you can choose how it’s spent. It always passes, whatever you do.

Remembering this is, for me, a work in progress. I waste a lot of time; mental illness wastes a lot of time. But when I am well enough to take action, I try to force myself to take action. Waiting for results is frustrating, but waiting for motivation is a massive waste of time.

I will keep slogging, trying to achieve my goals, because not doing anything guarantees failure. It won’t be easy and I doubt I will ever learn to become patient all the time, but it’s necessary if I want to improve my life. Right now, it’s challenging. Maybe next week, month or year I will feel more motivated and gain more results. Either way, I plan to keep going.

I just hope Future Hayley will be grateful!

Leaping Forward

A year ago today, I started a 4 day trek to Machu Picchu. It was the biggest and most difficult challenge I have voluntarily undertaken, but also one of the best. While it didn’t immediately transform my life, as I had hoped, it has changed me in ways I’m just beginning to realise. The greatest effect is cutting through my excuses. I completed a major life goal, despite struggling with my mental health. Why shouldn’t I achieve more goals?

Parachuting
Photo credit: my dad, Darryl Jones.

In this spirit. I set myself a lot of goals this year. Some are boring and mundane (adding to savings, submitting more short stories), but a few are more exciting. One of them was to complete a tandem skydive from 15,000 feet.

As you can probably guess from the photo, I did the skydive yesterday — which happened to be my birthday. 

Last year, I spent my birthday doing an acclimatisation trek in Peru and being serenaded in a restaurant with the world’s longest version of Happy Birthday. I was surrounded by a wonderful group of people who have become my friends, but I was thousands of miles from home and had woken up very early, sobbing because I was scared I was making a huge mistake. I was worried I wasn’t capable of achieving any of my dreams, including walking miles up very high mountains.

My birthday this year was very different: I was at home and spent the day with my parents. However, I also wanted it to be as memorable as last year, so I scheduled the skydive and hoped for good weather.

Although the skydive was on a much smaller scale than Machu Picchu, it involved a lot of preparation. My first task was to get under the 210lb weight limit (the website says you can jump if you are heavier, but you have to tell them in advance and pay a surplus, so I wanted to avoid that), which was a big commitment since I started the year at 244lbs. I weighed in at 201.5lb yesterday morning and a few pounds heavier in my clothes and trainers when I got to the airfield, which was a relief!

I also needed to have my doctor sign a medical form to state that I was allowed to jump, because I have received treatment for mental health problems within the past 2 years and have a history of self-harm. I had an appointment a couple of weeks ago and my GP declared that I was at no extra risk compared to any fit, healthy person.

I understand the reasons for needing my GP to sign the form, but it feels disempowering to be told that I can’t sign my own medical form. I know my own mind very well precisely because I have mental health issues. Managing my mental health effectively involves monitoring my mood and motivation for doing certain activities. Far from being a form of self-harm or method to boost fragile self-esteem, the skydive was my way of celebrating my achievements and rewarding myself for getting through the almost constant struggles.

Because I still struggle. Every small achievement, from walking the dog on my own to completing an assignment, involves facing my anxiety, depression and BPD and managing my current symptoms. 

My symptoms are less apparent to other people nowadays; partly because they have lessened in intensity, but mostly because I am much better at managing them. I was anxious yesterday, for example, but didn’t appear more nervous than anyone about to be hurled out of a plane for the first time. I was focusing on controlling my breathing and being mindful, rather than listening to my worries and letting them escalate — though, truth be told, my anxiety disorder is concentrated on the possibility of humiliation rather than harm or death, so I was more worried about doing the wrong thing or puking!

Tandem skydive
Photo credit: my instructor at Skydive Buzz

In addition to being a celebration and reward, skydiving was also a reminder that I need to take chances in order to experience fun and excitement. I need to leap forward, despite being anxious and having other obstacles in my way. I may never “recover” from my mental health problems, but I can manage them alongside achieving goals and chasing my dreams.

I think the main difference between my life now and the episodes during which I was trapped by my mental illness, is that my fears have shifted. I am more afraid of not trying to achieve my goals than the potential for humiliation. I’m more scared of spending the rest of my life confined to the house than chasing my dreams. I’m still fearful of failure and rejection, but my greatest fear is living without trying to create a better life for myself.

Which is another change: I believe I’m worth the effort.

I used to hate myself and thought I deserved nothing, but that has gradually changed over the past 10 years and the change has accelerated since I trekked to Machu Picchu. It started with asking for help when I needed it and investing in myself, going to university after thinking I had “missed out” on the opportunity. Then I realised I could contribute to the world, through volunteering and using my skills to help local charities/organisations. Most of all, I gave myself permission to dream again, to consider the possibility of a different life.

Along the way, I have met more people who believe in me. I have had small successes which confirm that I’m worthy of support and investment, contribute a lot and can achieve things I once considered impossible for me. 

Sure, my life looks very different to how I expected and what I would have chosen, but you work with what you’ve got. I still struggle, but the truly awesome days I enjoy make the weeks and months of struggles less important than the triumphs. When I look back on my Machu Picchu trek, I don’t dwell on the panic attacks, throat infection, rain and altitude sickness: I remember arriving at the Sun Gate with my fellow trekkers, achieving our goal.

Changing Set Points

I have been finding things difficult lately, which feels strange to admit because my life is, in general, better than it has been for years. While I still have bad days (and some really awful days), my typical daily mood has been turned up a few notches.

Apple blossom and sky

This means I can (usually) practice basic self-care without huge effort, such as going for a walk and cooking healthy meals instead of grabbing junk food. Other tasks are harder to accomplish, like finding the confidence to submit my short stories and attending appointments on my own. It seems my “set point” of mood and ability has increased.

An improved set point is, of course, a Good Thing. I have no idea whether I will ever recover completely from my mental illnesses, but this improvement is an encouraging sign. It gives me hope.

Life is also easier to bear, because my bad days are less intense than they were at the end of last year. Feeling lethargic, unmotivated and low in mood isn’t great, but it’s preferable to being suicidal and self-harming on a daily basis. It might take a huge effort to get out of bed, but I can do it. That’s progress.

But there is a darker side to an increased set point and the hope it brings: I feel more pressure to do better.

Acknowledging Progress

A conversation I had last week highlighted this issue. I was asked if I had had a good week and I replied that it was neither good nor bad. Nothing terrible had happened, but nothing particularly good had occurred. I felt as if I hadn’t achieved anything. I was then asked about my week in more detail. I can’t remember my precise response,but it was something along the lines of “oh yeah, I walked the dog and went to gym classes, did some writing, studied… the usual.”

“The usual.”

Not so long ago, these things were not “usual” for me. Even a year ago, I was not going to gym classes or studying. Longer ago, I couldn’t walk the dog (let alone on my own!) or sustain any kind of regular writing practice. I realised that I wasn’t giving myself credit for how far I have come and that I expect more of myself.

Expecting more of yourself can be empowering. It has motivated me to challenge myself. The possibility that I can manage my mental health well enough to prevent it from limiting my life encourages me to dream, to plan, to take action.

On the other hand, expecting more of yourself can bring disappointment. Failure is inevitable in life, but raising your hopes enough to expect the odd success can make constant failure harder to handle. In many ways, it was easier when I expected nothing good to happen to me.

Accepting The Positive

Perhaps the problem is a disconnect between accepting myself as I am and wanting more for myself. Maybe, on some level, I still consider those things a paradox. It’s a kind of superstition: if I accept myself as is, I might be jinxing the possibility of a better life.

Paradox or not, in my experience, acceptance is usually necessary before I can change things for the better. When you are fighting against your current situation, it’s difficult to achieve anything. Once you accept where you are, you can create a map and move forward.

I tend to think of acceptance as admitting and owning the negative aspects of my life. A lot of the work I did in counselling last year was about accepting my mental health issues, plus the problems that have been directly or indirectly caused by them (finances, work, relying on my parents, etc). I might not like having mental health problems, or the effects, but I need to accept them as part of my life.

However, thinking about my recent weeks has made me wonder whether I am making enough effort to accept the positive aspects of my life. I suppose my default is to think of my achievements and successes as anomalies; brief, glorious moments rising out of the dross of my everyday life. I rarely acknowledge them, especially if I consider them to be small and insignificant.

Yet the small things are important. Vital, in fact.

During my worst episodes, I couldn’t enjoy the very activities I now consider “small”. I didn’t read much, because I couldn’t concentrate. Ditto watching films. If someone did something nice for me, or even if the weather was good, I would get upset because I believed I didn’t deserve anything good. Back then, if you had told me that I would be where I am now, I would have scoffed because it seemed impossible.

I need to be more mindful about the good things in my life right now, as well as being hopeful that I can achieve things I currently think of as impossible. A few years ago, I would never have dismissed the past few weeks as “neither good nor bad” — I would have considered them to be fabulous, amazing, wonderful! Instead of letting my new set point skew my reality, making me dismissive of the positive aspects of my life, I should celebrate reaching this new version of “normal”.

Maybe this is how recovery will work for me, increasing my set point until mental illness is no longer a controlling shareholder in my life.

Taking It In Your Stride

“Just take it in your stride.” Good advice, right? Nobody wants to be derailed by obstacles and challenges. However, those of us who have mental health problems can find it difficult (often impossible) to take things in our stride.

Even small and/or anticipated problems can knock us off course. Setbacks seem to confirm the negative beliefs we hold or have held about ourselves:

“I am a failure and always will be.”

“I’m not good enough.”

“I can’t cope.”

We feel people are judging us for making mistakes or not being able to cope with our problems. Our thoughts can spiral out of control, so that a tiny setback leads us to think our entire lives are catastrophes.

 

So how can you help someone gain perspective?

First of all, please don’t contradict what they are saying. You may think you are showing the person concerned that they don’t need to worry, but minimising and dismissing other people’s problems is unhelpful and potentially harmful. They are already judging themselves for not being able to take the situation in their stride; suggesting their problems are unimportant and they are therefore overreacting piles on more judgment. It may not be your intention to belittle them, but that’s how your words can be perceived.

By not being sensitive to how the person in question feels, you imply that their emotional reaction is the problem. This can be easily translated as “I am the problem”, thus confirming their negative beliefs and leaving them feeling worse.

Instead, try a more compassionate and productive approach:

1. Acknowledge how they feel. They are entitled to their emotions and none of us can control our emotional reactions, though we can learn to control how we express our feelings, emotions and thoughts. Don’t start giving advice straightaway — listen.

2. Try to understand their perspective. Keep listening. Ask questions to clarify how they feel. Try to connect and empathise, so that you can learn why they believe the problem, challenge or setback is a disaster.

3. Support them. Let them know you will help in any way you can and reassure them that they can improve the situation. If they ask for advice, give it, but don’t dictate what you think they should do. Ask them questions which help them consider their options and plan their own course of action — if they feel able to take action.

 

Check your language.

An issue I have encountered a lot when talking about my problems is people dismissing my concerns, often implying that because my life has improved since my worst periods of depression and anxiety, my current situation shouldn’t bother me. I’m sure most people don’t intend to make me feel worse, but many phrases which are supposed to be reassuring can have darker implications.

For example, “look how far you’ve come” can be motivating if someone is in a positive frame of mind, but can also be interpreted as “you should be grateful for the improvements in your life and not expect more.” I find it especially patronising when spoken by people who have led relatively “normal” lives, usually when they try to tell me that my current situation is better than I think — as though I have no right to be frustrated about my mental health, financial situation and living with my parents.

Other phrases which people think are motivating or reassuring, but actually leave a lot of us feeling worse, include:

“There are plenty of people worse off than you.” True, but there are many people better off than me — including the people who like to “remind” me that things could be worse.

“Things will change soon.” Maybe, but often nothing significant seems to change for years on end.

.”You’re lucky to have X.” Again, braodly true, but when X is my dog or parents who haven’t chucked me out on the street, it feels like whoever says this is scraping the barrel.

Before you try to reassure someone, consider:

1. Are they in the right frame of mind to hear this without misinterpreting it? Often, people just want to be heard. They aren’t expecting you to solve their problems or give them a pep talk. They may want to vent or express their emotions without being told they should feel differently.

2. Would hearing this actually help them? In most cases, especially when emotions are high, the answer is no. When I’m depressed, the most inspiring stories can make me feel worse because I feel so pathetic and unable to change.

 

What can you do if you can’t take things in your stride?

Try to stay afloat. Practice self-care and do what you can to stop things getting worse.

If you can, that is. Sometimes problems and setbacks can make us feel as though we are drowning and we can’t stop struggling. Instead of letting go and hoping we rise to the surface, we try to cling to things in desperation — though clinging to them will keep us trapped underwater for longer. We cling to unhealthy relationships, harmful habits and negative beliefs. We can keep clinging, or we can let go and accept our current situation.

Acceptance is bloody hard, but it’s the only way we can stay afloat. And unless we learn to stay afloat first, our attempts to swim against the tide and change our lives will keep sucking us under. It’s a lesson I’m learning over and over.

Berating yourself (and the world in general) gets you nowhere, because you get sucked down into the same old negative thought patterns. Practicing self-care and self-love lead to acceptance. Unfortunately, as the word “practice” suggests, it’s difficult to learn to love and care for yourself, so you need to pay attention and take active steps on a regular basis.

If you feel unable to cope, please seek help and support. Your GP is a good first port of call, but there are also various helplines, therapists and counsellors. Talking to a trusted friend or family member and asking them to help you access appropriate sources of support is a good idea.

 

Long term strategy.

When you have chronic mental health issues, feeling blown off course by life events which others seem to take in their stride is a frequent occurrence. I think the trick is to recognise when you need to stop swimming and float for a while.

Doing this can feel like you are taking a step backwards, but it actually prevents you from losing progress.

Constantly swimming against the tide is exhausting, so we all need a break sometimes. If you are experiencing mental health problems, you may need more breaks than other people — perhaps more than you would like — but it’s essential to float when you need to float. In fact, it’s the best strategy for your long term success and fulfilment.

Self-care helps you to swim further in the long run 🙂

Making Yourself Happy

My favourite mug (pictured) tells me to “do more of what makes you happy.” I bought it because I thought it would serve as a positive daily reminder, but the more I think about the phrase, the more I believe it’s a good philosophy for life.

Lilac mug

Doing more of what makes me happy fits with a couple of simple concepts I keep coming across:

1. Self-love and compassion get you further than self-reproach and punishment.

2. It’s up to you to make yourself happy — nobody else.

Society tries to tell us otherwise. We are told that the only way to achieve goals is to embark upon a gruelling regime, denying ourselves all pleasure until we attain whatever we want. We are expected to believe that the perfect partner will magically solve all our problems and make us happy. Yet what society tells us doesn’t work very often — and when it does, it involves making things more difficult and less fun than they need to be.

 

Treating yourself with love and respect

Self-punishment is counterproductive. It’s a lesson I have learnt many, many times over the years, but it’s a hard habit to break. Admonishing myself for failing to do something is the best way to ensure I continue to procrastinate.

We tend to assume that when we don’t live up to our own expectations, the answer is to get tougher: demand we work harder, faster and longer. Sometimes it works and we complete tasks we have been putting off, but this progress comes at a cost to our mental (and often physical) health. Worse, we start believing that this type of intense work under the threat of punishment is the only way we can achieve anything.

The true antidote to procrastination, anxiety, depression and most other problems is self-care . All of the bad things in my life are not the result of a lack of self-discipline, although they may appear so, but the consequences of self-punishment.

Even when other people have abused and bullied me, I piled on the punishment by believing it must be my fault. I must somehow deserve to be treated badly. Instead of seeking support, I alternated between harming myself — physically and psychologically — and seeking comfort in unhealthy habits which caused me more harm in the long term, including overeating and getting into debt through impulsive spending.

This kind of behaviour creates a vicious cycle. You berate yourself all the more because you have created new problems, such as debt and obesity. Other people also see these problems as a reason to insult and criticise you, pointing out that you and your life are a mess. You punish yourself more, which makes the problems worse.

It’s vital to realise there is another option — one which empowers you to solve your problems. To love, respect and support yourself.

I resisted this for a long time. When we say people “love themselves” it’s usually meant as a criticism — we think they are arrogant, conceited and/or selfish. Yet these traits actually indicate insecurity, not self-love. People either hide behind a mask of arrogance or build their sense of self-esteem upon a shaky foundation, like their looks or career. They don’t love themselves — they love the idea of themselves they want to project.

You can tell when people truly love themselves because they have a quiet confidence. They have no desire to show off or to belittle other people. They know they are not perfect — and that’s okay. While their self-esteem doesn’t depend upon their work or social life, they enjoy success in these areas because loving, respecting and supporting themselves is key to achieving their goals.

I’m learning to treat myself this way; it’s a work in progress and I still get bad days when I succumb to the old self-punishment routine, but I have made small changes. I think I’m more productive and I certainly feel better most days.

 

Stop waiting for a panacea

It’s easy to fall into the trap of believing a single thing can be the solution to all of your problems. Meeting your soulmate, winning the lottery, losing weight, a lucky break… If only you could have this single thing, everything else would fall into place. But life doesn’t work like that. Even if you woke up tomorrow with all of the things I have mentioned, plus a bunch more, you will still have problems.

I’m not saying that those things wouldn’t help to some degree: lacking emotional support and money is tough. Being overweight and unemployed exacerbates problems. Problems also tend to proliferate,  especially if you have mental health issues. But if you focus on your problems, solving the major ones won’t help as much as changing your mindset.

Choosing not to focus on your problems is incredibly hard, but it’s possible.

Again, I’m a novice in changing my attitude, but I have already noticed positive effects. When you focus on your problems, it creates a tunnel vision which blinds you to potential solutions. It also blinds you to the good things in your life, so you believe your life is 100% negative. Because you are focused on your problems, they often get worse as you remain passive instead of taking action towards finding solutions.

Debt is a vivid example of how problems can spiral out of control when you don’t take action. If you continue the behaviour which caused the debt, your debt will get bigger. If you struggle to pay the minimum payments, your debt will get bigger as you aren’t covering the interest. If you do nothing at all, you incur penalties and your debt not only gets bigger, but can lead to legal proceedings.

Many of us have struggled with debt and a common reaction is to ignore it — except you can’t really ignore it, so you worry incessantly as you continue to overspend and struggle to afford minimum payments. You avoid taking the most basic steps towards tackling your debt, such as seeing what help and support is available (I recommend www.moneysavingexpert.com, which has loads of advice and supportive forums you can use anonymously). You are convinced you cannot solve the problem, so you don’t even try to create a plan.

This is a typical reaction to a lot of problems, from relationship issues to changing careers. We hope for a panacea to arrive as we watch our problems get worse. Perhaps you buy a few lottery tickets and then feel dismayed when you don’t win the jackpot, which is a way of fooling yourself that you’re taking action when you’re not doing anything productive. Waiting achieves nothing and makes us feel powerless.

You have to make yourself happy. 

Check your reaction to the above statement. Did you scoff? Did you accept the truth of it, but feel sad because you don’t think you can make yourself happy? Were you angry, because you were hoping for a different solution?

For most of my adult life, I would have reacted to that statement with anger, frustration, sadness and disappointment. I didn’t believe I could make myself happy. If anything could make me happy, I expected it to be money. Or perhaps an intensive therapy programme which would cost a lot of money.

If my beliefs were true, there would be no unhappy people earning more than £20,000 a year. Everyone lucky enough to own their own home would be happy. People with zero debt would be deliriously happy. Yet that’s not true.

You can do the same for all of these so-called solutions, because I’m yet to find one which can’t be disproved. There are plenty of people in relationships who are unhappy, even when they and their partner love each other and want to stay together for life. People with incredible bodies can be unhappy. Ditto those who have their dream jobs, travel regularly and are gorgeous.

First and foremost, you have to change your mindset. The good news is  changing your thought patterns is free and accessible to all. The bad news? It’s bloody hard and easy to give up, returning to your old beliefs that a million pounds and film star partner are the only solutions to your problems.

 

Choose to see the amazing aspects

Yes, changing your mindset is difficult, but it’s also amazingly wonderful. Anyone can learn ro do it, for a start. You don’t need to spend any money (though a few books can keep you motivated) and you can start right now. There are loads of strategies for changing your mindset, including simply listing the things you are grateful to have in your life. Do some googling and see what speaks to you (after you finish reading this, obviously!).

I suspect some people would prefer a different solution. If I had told you that the key to solving your problems, or at least learning to live with them, is a magic gemstone you can only buy in the Himalayas at sunrise on the third full moon of the year and it costs half a million pounds, you would have lots of excuses for not doing anything. “I don’t have the money, I can’t get the time off work, I’m afraid of flying, I don’t know the language…” You could do nothing and feel justified.

The only excuse for not trying to change your mindset is the difficulty factor. But refusing to change your mindset is more difficult in the long term.

All of the improvements I have made in my life have been difficult. The first time I forced myself to go outside alone, after years of anxiety preventing me from doing so, I was extremely uncomfortable. I wanted to turn around and run back inside. So why didn’t I? Because I knew that staying inside for the rest of my life would be more difficult than forcing myself to go outside for the first time.

You face the same decision. Changing your mindset is hard, but not as hard as continuing to struggle.

 

Doing more of what makes you happy will change your mindset

You may resist this concept, too. You may believe it advocates a life of mindless hedonism, indulging in unhealthy habits which harm you and people around you. Except those things don’t make anyone truly happy.

Happiness is not a quick buzz from drugs, alcohol or junk food. It’s a long term effect of living a satisfying, meaningful life. 

The things which make you happy are meaningful experiences: spending time with loved ones, reconnecting with your passions, contributing to your community, working towards personal goals. You can regonise them by the afterglow they produce. For example, playing video games keeps me entertained for a while, but serves mostly as a distraction. In contrast, reading gives me pleasure while I’m doing it and afterwards, when I think about what I have read. A meal with friends makes you happier than scoffing junk food alone, even if you eat the same amount.

You may be surprised by what makes you happy — and what doesn’t. Tackling challenges makes me happy, even if I don’t appreciate it at the time. Exercise makes me happy, because it has strong neurochemical and psychological effects. Baking makes me happier than eating what I bake. Watching my favourite television programmes keeps me happy for an hour or two, but the effect wears off if I watch for longer.

I’m adopting this philosophy in the spirit of experimentation. So far, my mood has improved and I think I’m less anxious. I hope it will help me to be more productive and to find creative solutions to my problems in the long term. If nothing else, it has reminded me that my old regime of self-punishment resulted in mental illness and other problems. Self-care isn’t a luxury: it’s a necessity.

Try doing more of what makes you happy — and let me know what happens!

My 29 Gifts Challenge

In January, I came across a book called 29 Gifts by Cami Walker. It’s part memoir and part self-help book. At the beginning, Walker is bedbound by MS, in debt and has a strained relationship with her husband, who has become her carer. A renewed acquaintance, Mbali, makes a strange suggestion: she should give something away every day, for 29 days in a row.

Wrapped Gift

What I love about this book is that Cami Walker reacts in the same way most of us would in her situation – she thinks the idea is ridiculous, especially considering she can barely walk and has no money. She has no intention of carrying out her prescription. In fact, she is about to go into hospital and convinced she couldn’t start the challenge even if she wanted to. Being told it’s time to stop thinking about herself adds insult to injury.

Yet… She begins. She gives away her first gift and the rest follow.

The upshot is, Walker changes her life through completing the challenge. It changes her mindset and opens her to opportunities she hadn’t considered. The change isn’t miraculous in the definitive sense – she still has MS and debt – yet her attitude brings many positive things into her life, which help to counterbalance the negative and give it a different flavour.

After reading the book, I thought “that sounds like something I would like to do” but I wasn’t sure if I would follow through. After all, we all have a million excuses for not attempting such a challenge: lack of money, other things to focus on, it might be a waste of time, etc. But it lodged in my mind and stayed there.

My 29 Days challenge started by accident: I paid for a half marathon entry for my mum and myself, then I wondered whether I could count it as the first of my 29 gifts. I decided to approach the challenge as more of an experiment, to see what happened. I would make a conscious effort to give gifts for the following 28 days, without expectation or even hope that it would produce anything other than a warm, fuzzy feeling.

 

How to start the challenge…

The book sets out many suggestions for how to tackle your own 29 Gifts challenge. I didn’t remember to repeat the recommended affirmations every day and although I wrote about my challenge in my journal, I didn’t write a dedicated journal focused on the gifts and my thoughts/feelings surrounding them. I’m sure it’s helpful to do everything the book suggests, but it’s not necessary.

More importantly, the book points out that gifts don’t need to be monetary. You can give people your time, make gifts for them, do them a service or give them something you already possess. This is the crux of the challenge: everyone can give something.

You can also choose to give a gift to yourself. It may seem contrary to the nature of the challenge, but few of us consciously give to ourselves. Instead, we deny ourselves and then “treat” ourselves by overeating, overspending or engaging in other destructive behaviours – which gives us brief pleasure but leaves us feeling worse.

 

My 29 Gifts.

My own gifts tended to be about making time to connect with people. I made more effort to send my friends text messages, instead of convincing myself they wouldn’t be interested and would consider replying to be a chore. I shared things more, including sweets and blog posts. I also tried to be more thoughtful and helped around the house more than usual.

I had fun sponsoring a few friends, too. I gave small amounts and wished I could afford more, but their appreciation was reassurance enough that a few pounds can make a difference. It reminded me of how encouraging it felt when someone donated money for my Machu Picchu trek – no matter how much I doubted myself and my ability to complete the challenge, I felt supported and motivated.

 

So, did my life change?

Yes and no. My mindset has certainly changed. I had a terrible episode of depression before Christmas and started the year feeling more depressed and anxious than I had been for months. I was stressed about everything and as usual, a lot of this stress was concentrated on my debt, low income and lack of work prospects. Completing my 29 Gifts experiment reminded me that while I might not have a lot of money, I have enough. It made me more grateful for everything I have and switched my focus.

I also realised I have a lot to give, apart from money. I started valuing my time more. I strengthened my connections with other people. I feel more positive about my life.

Yes, it would have been cool if my challenge had resulted in bigger changes, but it has definitely had an impact. I don’t spend every day feeling sunny and serene – it hasn’t cured my depression, for a start – but I feel better overall. I have more confidence in my ability to change my life, though it will probably happen slowly rather than in huge, dramatic leaps.

It really does feel like the negative and positive aspects of my life are more in balance.

 

Try giving and see what you have to gain!

There is something special about the 29 Gifts challenge. It connects with a lot of concepts which I believe in, such as karma, compassion and gratitude. As Cami Walker’s friend, Mbali, pointed out, it takes the focus away from yourself and your problems. When you are looking for opportunities to give, you can’t wallow in negativity.

The beauty of doing the challenge is there’s nothing to lose. At the very least, you do a bit of good in the world. Its effect on your own life is a bonus.

And that warm and fuzzy feeling you get from giving is pretty damned good.

Choosing Is Hard

If you read about mental health, wellbeing and/or self-improvement, you have probably read a lot about ‘choice’. A lot of the information is true and basic common sense: our choices do determine our lives, no matter what has happened to us. We can choose how to react to life events, including mental illness. However, what the rhetoric often misses out is that making these choices is bloody hard.

For a start, you might not realise you have a choice. Mental illness makes you believe you are powerless. Depression, anxiety and other conditions change your thought patterns. You think you are useless, worthless, hopeless. You think your life is pointless. These thoughts often spiral out of control so all you can see is the negative fog of your illness.

I have certainly felt like this – I still do, during bad days or weeks. In the past, this mindset has lasted for months on end – perhaps years – and I truly believed there was no way out. I didn’t know I had a choice, even when I made choices like going to the doctor and taking my medication. I did those things because my parents said I should, not because I thought I could be helped.

Any discussion of ‘choice’ should acknowledge the vital roles of opportunity and support.

If you have no support, making choices is more difficult. You have no reassurance that you are doing the right thing – assuming it’s possible to identity ‘the right thing’. There is always an element of risk in making different choices, because results are never guaranteed. Without support, this risk often feels too high and you are too afraid to change, because you don’t know whether anyone will have your back if you fail.

Professional support, from doctors, counsellors and/or therapists, is very valuable. Sometimes, it feels like they are the only ones who have a degree or understanding and want you to get better, as opposed to wishing you would keep the status quo even if it’s painful for you. However, professional support works best when it is complemented by support in your personal life, from family and friends. If you have little support from those who are closest to you, it is more challenging to make decisions which might have long term benefits but cause discomfort (or even pain) in the short term.

Having support in other aspects of your life makes a difference, too. At work, for instance, you have more options when you have a supportive employers, managers and colleagues. They have the scope to offer opportunities which unsupportive people will not, such as training and mentorship. It also helps if you know you can have time off when you need it, without worrying that you will face a formal warning when you return to work (which happened to me, when I was employed by a certain supermarket).

Other sources of support could be accessed through education, hobbies and groups. Unfortunately, mental illness tends to narrow your life and makes you withdraw from these potential sources of support, which means it can take a great deal of effort to continue pursuing an interest or attending a class. During my worst episodes, I feel unable to do the things which help me feel supported and purposeful.

All potential choices may seem undesirable.

How do you make choices when all of the options have massive drawbacks? Sure, at least one choice probably has the potential to lead you in the direction of long term success, fulfilment and/or happiness, but it may also have huge risks involved. For example, I used to be too scared to walk my dog on my own. I had walked the route thousands of times over the years, often on my own, yet the idea of walking out of the house alone terrified me. Why? Walking on my own had numerous potential benefits, including enjoying the countryside and improving my mood, but it also carried the risk that I would have (another) panic attack in public.

Every time I have had a panic attack in public, I have experienced humiliation on top of the dread and discomfort which every other panic attack brings. It had an impact on my mood and other symptoms for weeks afterwards (sometimes months) and led to more restrictions in my life, such as not going out at all when I had previously been fine with my friends or family members. It also affected my confidence, meaning I would avoid doing anything which might result in failure.

So my options were: go for a walk alone and risk a panic attack which would have a devastating impact on my mental health, or stay at home and risk nothing other than living the rest of my life feeling bad but not as bad as I might feel after a panic attack. Neither option was desirable. Especially during times when I was experiencing a lot of panic attacks, so the chance of having one in public was greatly increased.

I was only able to make the choice to go for a walk on my own after receiving a lot of treatment and support, including medication, therapy and counselling. I also had people in my life who understood enough to help me, instead of forcing me to make certain choices before I was ready.

It’s hard to keep making choices without seeing results.

Many of the choices we make do not have instant effects. Some do not reveal their full effects for months or years. This makes it difficult to choose certain courses of action and to keep going after you have made the initial decision.

Often, I only realise the effects of my choices in hindsight. Something reminds me of how life used to be and when I compare it to my present, I can see which choices have led to the difference. Several years ago, I was extremely unfit. I was at university full time and prioritised my studies over everything, because I believed I had something to prove after assuming I would never have the opportunity to pursue a degree. I walked less, especially after I passed my driving test just before starting the second year, and did no other exercise. Walking to and from the car park was a challenge because I had become so unfit.

Nowadays, I am pretty fit: I walk every day, go to three gym classes a week and try to run at least twice a week. This did not happen overnight. The first choice I made was to buy a treadmill, so I could walk inside (as previously mentioned, I could not walk outside alone at this time). I started walking very slowly and for short periods of time. It felt pathetic, being challenged by an activity I used to find easy, but I gradually built up my speed and distance. Looking back, those first walks on the treadmill represented some of the best choices I have made. But at the time, they were painful and frustrating because my progress seemed slow. Choosing to keep walking was difficult and if I did not have the treadmill, I doubt I would have persevered.

I could only make the choice(s) to continue walking because I was in the right headspace and had the right opportunity (access to credit so I could buy the treadmill). When you don’t have the right mindset, support and opportunities, it is extremely difficult to keep going.

You may not see the full impact of your choices for a long time.

Related to the previous point is the fact that the consequences of your choices, good and bad, might not be apparent for years. Looking back, I realise that I made a lot of mistakes. Every time I stayed at home because I felt too anxious to go out, my world got a little smaller and darker. Each time I struggled on my own instead of asking for help, I became more anxious and depressed. Would I have made different decisions if I knew the full effects? Maybe, but I did the best I could in the circumstances.

It is important not to blame yourself or other people for past actions taken in good faith. While the choices made might have led to an undesirable situation, most of us believe we are doing the right thing when we take those decisions. Every time I stayed at home, I thought I was sparing my friends and family the embarrassment of my anxiety symptoms. Each time I refused to ask for help, I believed I was sparing people from my causing them trouble or inconvenience. We are all experts with hindsight, but we should never forget how it feels when you make poor decisions because you think they are for the best.

Your choices may have unexpected consequences.

Your choices may have unforeseen effects, whether positive or negative, which can be difficult to cope with or understand. When you are trying your best to make positive changes in life, it’s difficult to respond to one of your choices backfiring.

Sometimes, your choices create problems because other people don’t understand your perspective. They may think you are causing unnecessary stress for yourself by choosing to pursue a certain goal. They may accuse you of being selfish for spending your time and money on your own priorities, instead of the things they think should be prioritised. When considering people’s reactions, it is important to remember that they have their own issues and sets of beliefs. Their responses say more about them than you.

Dealing with the unexpected can be hard. When you make choices, you often assume they will have specific consequences and unforeseen effects can make you question everything. The fear of unexpected consequences may cause indecision for some people: it may seem illogical, if you believe they can improve their lives through making a certain choice, but they may feel more comfortable sticking with what they know, even if it is making them unhappy. Their behaviour might not make sense to you, but trying to understand rather than berating them is more likely to enable them to change. People in this situation need support, not judgement.

Making the ‘wrong’ choices doesn’t make you less worthy of love, support or respect.

Some people talk about others making a ‘choice’ to do something which has negative effects, without considering whether they had any support or opportunities to make a different choice. It’s easy to judge and, unfortunately, many people who judge have experienced difficulties themselves and believe others should be able to overcome their problems simply because they themselves did. Their attitude is ‘I managed to cope, so why can’t you?’

There are, of course, a number of potential answers to this question. Different people have different life skills, coping abilities, levels of self-esteem, supportive factors in their lives, etc. Often, these differences cannot be appreciated by those on the outside. Someone who seems to have everything going for them, such as a good job and family, may have very low self-esteem and believe they are unworthy of the positive changes they can make. Somebody who appears to have supportive parents may actually be undermined by them at home, when nobody is there to witness it.

If you have helped yourself by making good choices, please don’t judge those who are not ready (and might never be ready) to do the same. You are not superior to them.

If you have made and/or continue to make poor choices, try not to judge yourself. You deserve support. You deserve a better life.

The bottom line is, making choices can be difficult and many people feel unable to choose courses of action which will help them in the long term. Judging and punishing people in this situation helps nobody. It is unlikely to persuade them to change their behaviour; in my experience, it makes them feel more wretched and more likely to make poor decisions. We all have a choice, but we might not feel able to choose.

Limboland

I haven’t posted an update on what’s happening in my life recently, for a simple reason: nothing much has been happening. I don’t want to bore everyone, but I also realise that if I want to talk about my mental health problems in an honest and open fashion, I have to include the times when I feel stuck in limbo.

My mental health has been pretty stable for over a month, which is good in many ways — but it also means I don’t feel it’s improving. It’s a frustrating situation, because I feel well enough that I want to change things but not well enough to make drastic changes. All I can do is take small steps and hope my mood improves when spring finally arrives.

It feels as though everyone else is surging forward in life and I’m stuck.

Don’t get me wrong — I’m grateful that my mental illness is better than it was before Christmas and know from experience that I could be feeling far worse, but my day-to-day life is 90% struggle and I’m sick of it. I feel like I’m working hard to improve my life, but not getting the results I want.

I’m trying to focus on the things I can work on right now: writing more, doing my OU course and improving my fitness. However, the usual worries about finding paid work and not having enough money replay in the back of my mind on a constant loop. It’s stressful and bloody boring.

I think I’m getting better at self-care though, which is something positive. In particular, forcing myself to be active helps a lot — I was too subdued to walk the dog on Saturday and it sent my mood into a downward spiral. When I make myself go for walks, I usually feel better for it. As well as having a neurochemical effect, doing exercise gives me a psychological boost: I feel like I have done something worthwhile. In my own small way, I have achieved something.

I think I just have to accept how I feel, though I wish things were different.

I can manage my mental health, but I can’t fully control it. All I can do is keep going and hope things improve.