I had a strange experience a few weeks ago: I was thinking about potential career plans and found myself dismissing many possibilities because “I’m not that type” or “I’m not a people person.” Then something clicked inside my head and I realised that I would have said the same about numerous aspects of my current life. If you had told me 10 or 15 years ago that I would be a vegan who enjoys running, I would have laughed. If you had told me the same thing 8 years ago, when walking for longer than a few minutes was a struggle, I would have thought you were making a cruel joke. Yet there I was, willing to limit my future based on assumptions I make about my current abilities.
The more I contemplated this, the more I realised how often I had made similar statements about:
Things I do now, on a regular basis
Things I have done in the past
Things I consider an integral part of my lifestyle
Things I consider an integral part of my identity
When I started to examine my bald claims about not being a certain type of person, I realised a lot of my assumptions are simply untrue. For example, when I say “I’m not a people person” I’m thinking about the label “people person” in a stereotyped way. To be specific, it conjured images of people who are super-confident in social situations, who are outspoken extroverts who never get intimidated by other people. I was chatting about this with my friend Kat and she said 10 words which made me pause:
“Perhaps your idea of a ‘people person’ needs to change.”
I’m not a complete misanthrope, so I realised I’m probably more of a “people person” than I believe. I started to think about what the term could mean for me, as an individual, in relation to my skills and qualities.
This is the result:
Caring about people’s mental health and helping them to improve it
Listening to people’s experiences and concerns, trying to understand their perspective
Empathising with people in a variety of situations
Communicating with people through writing and blogging
Sharing my own experiences with the hope of inspiring or reassuring people
Learning about other people, cultures, interests and experiences
Spending time with people in small groups or on a one-to-one basis
Expanding my definition is helping me to think about my options in a more complex (and helpful) way, instead of dismissing entire career sectors. I will probably have to work on reducing my social anxiety and learning better verbal communication skills if I choose a career which involves working closely with people, but considering the specific changes I might need to make is more productive than refusing to explore my options because I don’t like parties or crowds.
Looking beyond stereotypes and changing or adapting definitions to suit my own situation is something I have already done, to an extent: I’m a runner, because I run, but I certainly don’t fit the competitive stereotype who enters marathons all the time and sneers at people who don’t run. Entering races on a regular basis isn’t something which interests me at this point in my life (although I keep an open mind to the possibility of that changing) and the only person I compete with is myself. Similarly, people who write should call themselves writers –– regardless of whether they have been published or paid for writing –– because that’s what they do. What we do.
However, just as I find myself saying “I want to be a writer” from time to time, especially when my confidence is low, I suspect I will forget to check my new definitions. It’s difficult to start consciously thinking of myself in different ways, especially when challenging assumptions and labels which have shaped my identity for many years. I think the key is to stop myself when I notice I’m using phrases such as “I’m not the type to do X” or “I’m not an X person” as an excuse not to explore something which piques my interest. Even if I decide the option isn’t for me, I will have made that decision based on solid research, not false assumptions.
In future, I’m going to try not to limit myself –– just as there’s more than one way to be a runner or a writer, there are many ways to be a “people person.” Or anything else I might want to be.
When I created this blog and called it Resurfacing and Rewriting, I thought the name would represent a clear journey: my mental health was improving and I was learning to cope with being well enough to work towards some of my goals, but not well enough to function ‘normally’. I never expected this journey to be linear and was certainly prepared for setbacks, but I didn’t realise that managing my mental health and attempting to chase my dreams would take the form of numerous cycles. These cycles have varied in duration, how difficult they are to endure and their impact on my life.
I’m currently resurfacing after a particularly difficult cycle, which was caused by having very painful gallstones for 15 months. Living in pain takes its toll on your mental health, regardless of whether you have a pre-existing mental health condition. I’m lucky that my pain was temporary, since I had my gallbladder removed just over a month ago, but I struggled to explain the pervasive and unrelenting nature of my pain to other people. I would say ‘I’m in constant pain’ and some people would interpret this as meaning I had frequent episodes of pain, whereas my reality was significant baseline pain 24/7 and frequent episodes of worse pain. I could sometimes distract myself from the pain, but it was always present.
Living with pain is depressing in its truest sense: I lost hope that my situation would improve and lost motivation to try. My feelings of helplessness and suicidal thoughts increased. I socialised less than usual (which is very little), because I found it difficult to focus on other people or having fun when I had my arms clamped around my stomach, trying to ease the pain a little. The only things which seemed to ease my pain were heat pads and lavender oil, which are difficult to use when outside your own home. My anxiety increased, because I had constant nausea and during my worst episodes I would collapse with pain and/or vomit so I was terrified of this happening when I was in public, especially if my mum wasn’t around to help and explain what was happening. I pushed on with my basic exercise routine and Open University studies simply because I knew failure to do so would make my mental health significantly worse.
After my surgery, the nausea disappeared straightaway and within a few weeks, my pain levels were lower than the baseline pain I had experienced with gallstones. I haven’t experienced any post-op pain which was equivalent to my worst episodes. The general anaesthetic didn’t affect me as badly as it did when I had eye surgery––rather than feeling as if I had the flu, this time I just felt tired and found it difficult to concentrate on anything for very long. These problems have eased over the past two weeks, so I feel alert and focused enough to get back to studying and writing. In fact, I feel pretty good and sometimes forget my core muscles are still a little sore… until I try to lift something too heavy or twist/reach in a strange way!
In many ways, 2019 feels like a write-off year. I failed to make progress in many of my goals and when I did achieve something, such as passing my Psychology modules, I felt I wasn’t making the most of the opportunity. My mental health declined after two years of improvement (on balance). Each step forward I took seemed to come at a great cost and was quickly reversed. I ended the year feeling battered and beaten, although knowing I would be starting 2020 without a gallbladder was a great source of hope.
So 2020 is about resurfacing and getting back to my priorities.
My goals for this year are mostly the same as last year, since I didn’t achieve them: increase my fitness and strength, reach my goal weight (made more challenging by gaining 25lbs from my lowest recent weight), save more money and complete a novel draft I actually like. These goals are specific and measurable, but I won’t bore you with the details! However, I also have two more nebulous goals… Firstly, I want to enjoy writing again and be guided by what I love to read and write, rather than what I think I should write or what seems more marketable. I have lost my writing mojo and although I completed some short stories last year, writing often felt like a chore and I lost confidence in most before submitting them anywhere. Secondly, I want to have more fun and surprise myself. I have no idea what form this will take, so I’m trying to keep an open mind and find out.
Since I’m recovering from surgery and still struggling with my mental health, I have decided to follow a few strategies when working towards my goals.
1. Reminding myself of my whys.
My core values are creativity, curiosity and compassion, so I try to use them as a compass. I want to write in order to connect with other people and promote empathy towards other people, especially those who experience mental health problems. I want my writing to be entertaining, informative and thought-provoking. I also hope it inspires other people to chase their dreams, especially if they feel held back by mental illness. My Psychology degree feeds my curiosity, but I would also like to use it to help other people––although I’m not yet sure how I will do this––and I hope it informs my blogging.
2. Easing in.
My instinct whenever I feel well enough to work towards my goals is to jump in and try to make up for lost time. This doesn’t work. Partly because it takes its toll on my energy and mental health, so I get ill and have to stop. I’m trying to get better at pacing myself this year, so I’m trying to ease back into working towards my goals where possible (university deadlines aren’t very flexible!) and build up momentum as I get stronger.
3. Seeking joy and inspiration.
This means appreciating the ‘small things’ in my everyday life and reading about people who inspire or motivate me to keep going. I’m trying to focus on the process of working towards my goals, rather than just the results, so I want to place more emphasis on enjoying activities for their own sake.
I hope 2020 will be a year of recovery and growth. While I have always valued health, especially since my worst years of depression and anxiety, my experience of gallstones has highlighted its importance even more––which is why losing weight and living a healthier lifestyle continues to be my top priority, alongside improving my mental health. I’m sure the ‘rewriting’ stage will come at some point, helping me reframe my experiences and view 2019 in a more positive light, but for now I’m resurfacing and coming back to my life.
One of the hardest aspects of long term mental health problems is spending a significant proportion of your life struggling with stuff which comes easily when you are at your best. Some things I may never find easy: crowds, dealing with inconsiderate people and talking to strangers will probably remain nerve-shattering experiences for the rest of my life. I’m not talking about pushing at the boundaries of my anxiety––I’m talking about mundane tasks which aren’t a challenge on days when my mental health is adequate, but become next to impossible when my symptoms increase.
Studying is the most obvious example which comes to mind. Usually, I can tackle reading and note-taking with no issues. Even on days when leaving the house seems insurmountable, I can do a little studying and feel as if I have done something worthwhile. However, common symptoms of depression (which I experience) include loss of concentration, lethargy and lack of motivation. There are some days when I take out my textbook and struggle to take in any information.
Last week, I spent four hours trying to write notes on a chapter of my psychology textbook. I had already covered the material, highlighting key points and making margin notes, yet I struggled to get anything down. After producing a few measly pages of notes (and my style of note-taking is loosely based on mind mapping, so there aren’t many words to each page), I gave up.
Years of negative thinking patterns have programmed my response to giving up: I beat myself up for being useless, lazy, worthless, stupid, incapable of basic functioning… you name it! What was the effect of this negative self-talk? Did I become more productive and sail through my to-do list? Er, no. I spent a few days feeling even worse than usual––which, considering I have chronic depression, is pretty bad.
My mood has shifted this week and there has been a positive effect on my productivity. With relatively little effort (compared to last week), I have completed most of the tasks on my high-priority to-do list. To put this in perspective, my average for the past couple of months has been completing approximately one third of my highest priorities each week and accomplishing little else. I’m delighted to be having a good week and try to ignore the voice in my head which tells me I don’t deserve to feel productive or that I need to get ahead now because, before long, something is bound to go wrong and mess things up. However, it’s hard to accept that there can be such a difference in the space of a single week.
I can’t control my symptoms on any given day. I repeat this often, because it’s a concept which a lot of people find difficult to understand. “You were fine the other week” they say, when I’m having a panic attack in the supermarket, or “You can write thousands of words some days, so why not every day?” But despite understanding the concept, I myself struggle to accept the reality.
Planning to have a “good day” when a deadline is looming or I have something special organised doesn’t work. I tell myself it’s important to finish this task ASAP because it will make me less stressed in the long run, but piling on the pressure just makes things worse. If I could plan all my bad days, it would be very convenient––I could choose to have them all during the summer, when I’m not studying, or dot them throughout the year and be prepared each week. Unfortunately, mental illness––and life––doesn’t work that way.
I’m learning (and relearning) to accept my bad days, because trying to fight them makes everything worse. Instead, the best strategy is to let go of my plans for the day and give myself what I need, whether that’s a run to boost my mood, resting to improve my wellbeing or reading to seek inspiration. Last week, once I had wasted a few days feeling terrible, I stepped up the self-care by feeding myself more nutritious meals and countering the negative thoughts using CBT techniques. I still didn’t feel amazing, but it was better than nothing.
I also realised my initial reaction to my improved mood and productivity this week wasn’t helpful: feeling angry and frustrated about feeling so awful last week was pointless. Instead, I could frame this week as a reminder that good days will always come again. They might take their sweet time in coming––sometimes months––and be too few when they do arrive, but they will come.
I hope these intense, prolonged struggles won’t be part of my life forever, but if they never go away then I need to accept them. Fighting them doesn’t work––it’s like trying to wrestle water. Moreover, if I do spend the rest of my life shackled by my mental health problems, I need to dredge my struggles and find something positive amongst the dross. I guess that’s what I attempt to do with this blog––thanks for reading!
A few weeks ago, I reached the point where I was sick of feeling lethargic and unmotivated. I felt I was achieving nothing and realised I was missing the one thing which keeps me going, even when I’m struggling with my mental health: enthusiasm.
When I’m at my best, I am full of enthusiasm. It drives other attributes which define who I am at my best, including creativity, determination and curiosity. Unfortunately, a lot of those attributes seem to have slipped away this year.
I have debated over whether to blog about this, because I don’t want anyone to feel sorry for me or see it as a plea for attention. One of the risks of speaking up about your mental health problems, especially if you have borderline personality disorder, is getting stuck in a Catch 22 situation: you need to be honest and open about your experiences in order to help people understand, yet being open and honest exposes you to accusations of attention seeking and manipulation.
Part of me feels it’s “wrong” to discuss the negative aspects of my illnesses because I’m coping better than many other people. I’m coping better than I did in the past. However, “coping better” still involves numerous days of feeling suicidal. My self-harming and panic attacks have both increased this year. Often, it doesn’t feel like I’m coping at all.
There are a few obvious reasons for this decline in my mental health. I’m dealing with chronic pain from gallstones and sometimes it feels as if this alone has stolen huge chunks of my life. It stops me from fully enjoying fun activities and spending time with friends. I’m also reluctant to book tickets for events I would like to attend, because if my gallstones are playing up it will be a nightmare or if I have a bad episode, I would have to cancel anyway and lose money. In addition, gallstones symptoms interrupt my exercise routine, which is my main mental health management strategy. Missing a couple of workouts might not sound like a big deal to most people, but it’s akin to skipping antidepressants several days in a row – not advisable and potentially dangerous. My mental health gets worse when I’m less active, which means it’s harder to either get back to exercising or use other healthy coping strategies.
The surge in some of my symptoms is partly due to challenging myself in ways to which I’m not accustomed (understatement!). I completed an 8 month temporary job for a local youth mental health organisation which involved situations I find very difficult due to anxiety. While I’m proud to have stuck at it, there were many times when I thought they had made a mistake in hiring me and I felt I wasn’t good enough. I had hoped it would be a confidence-building challenge which could encourage me to seek more opportunities, but it led to a lot of self-doubt instead.
Finally, my Open University degree is going well, but while I’m pleased with my module results for the 2018/19 academic year, I wish I had been less stressed and more able to enjoy the process. Which is why, as my next modules are about to start, I want to recapture my enthusiasm.
Searching for motivation
Once I identified enthusiasm as something which would be beneficial, I turned to Google and typed “How to be more enthusiastic.” The search resulted in a lot of websites which churned out the same advice (this one is good but typical). As with a lot of wellbeing and self-improvement advice, some of it was very obvious but difficult to actually implement, especially if you have mental health problems. I know it’s important to sleep and eat well, for example, but depression and anxiety messes with both my sleeping and eating patterns.
However, one of the obvious options is exercise and I realised the importance of increasing my physical activity before my mood plummets further and makes it all but impossible. Exercise also helps me sleep better. Goal 1 of Project Enthusiasm was born: move more.
Moving more is easy in theory, but harder in practice. I was already sticking to my gym classes and walking the dogs at least 2 miles a day, but this isn’t enough to improve my mental health beyond the basic “get out of bed but zone out in from of the TV most of the day” level. To get the full benefits of exercise, I need to run at least 2/3 times a week. Running works for me in a way which other types of exercise simply don’t – I can slip into a kind of mindful meditation once I get into the rhythm of a run and focus on nothing but my current experience. Being free from the constant negative self-talk is a relief in itself, but then the serotonin increases after 15 minutes or so and I notice a shift in my mood.
So I have gotten back to running over the past couple of weeks and it’s working. No miracles have been wrought, but I’m a little less depressed and a little more motivated. Some of the runs have been very hard, but I force myself to start and each time I want to stop, I tell myself to try and run for 1 more minute. Often, this is every minute of the run. I have run slower than planned some sessions, but I have hit my mileage targets and these small achievements give me some confidence.
Note: I would never run through pain. When I tell myself to push through, it’s pushing through discomfort and while some of this discomfort is physical, it’s mostly mental. It’s a cliché to say people rarely regret a run (or different workout), but it’s true for me: I gain a sense of achievement from sticking to my plan and as someone who spent 20 years not being able to run far, I get a kick out of knowing I can keep going for a certain distance.
The other strategy for mustering enthusiasm which resonated with me is to explore whatever you find interesting. To cultivate a sense of curiosity. For me, studying psychology and writing fiction are important, yet I have been feeling disconnected from both of them. Finishing last year’s psychology modules was so stressful that I lost touch with my love of learning the subject; completing the assignments was a bigger priority than exploring topics. Writing got pushed aside as my health problems ate up bigger chunks of my time, although perhaps I’m also experiencing a lingering disappointment or grief over my last novel attempt not working out as I had hoped.
Reading is the most accessible inroad (for me) to reconnecting with both fiction and psychology, so I made it more of a priority. I cut down on watching TV and forced myself to pick up a book, despite my mental health affecting my concentration. As with exercising, I felt a sense of “use it or lose it” because while I love reading and learning, I was unable to read when my mental illness was at its worst. I feel guilty for saying this, since I’m a writer, but when you’re depressed and anxious, it’s far easier to switch on the TV or play games than to read – even while you are able to do so. However, once I started reading more (in both frequency of reading sessions and duration), it became easier to concentrate.
I chose to focus on reading because I didn’t want to pressure myself to write a certain number of words, but I’m easing back into writing mote. Again, nothing miraculous has occurred and I haven’t completed a novel in two weeks, but I’m a little more productive. Immersing myself in stories has brought some inspiration.
Similarly, getting a head start on my OU module materials has reminded me of why I decided to do a Psychology BSc. The subject is fascinating and I want to apply my knowledge to my own life, as well as (hopefully) using it to help others in the future. My career plans are still fuzzy, but I would like to improve people’s understanding of mental health and empower people who have mental health problems to achieve their own goals. I guess I’m reconnecting with my sense of purpose.
I’m two and a half weeks into Project Enthusiasm and I say this tentatively, but…there have been definite improvements. While I will probably never be the type of person who bounces out of bed excited to see what the day brings, I’m trying to act in more enthusiastic ways. For the most part, this means forcing myself to start a run or a book chapter – once I get going, momentum (or stubbornness!) usually gets me through. My mood isn’t fantastic, but I feel less wretched and excited to get stuck into the new academic year. I even found the motivation to blog!
I’m also trying to emphasise the positive aspects of my life, because it hasn’t been all doom and gloom this year. The best change is the fact that I’m typing this while sitting on my new bed, in my new, bigger bedroom – one of many advantages caused by my brother moving out! I feel very lucky to be studying psychology and despite the ridiculous bloating (thanks to my gallstones), I’m maintaining a weight which is the closest I’ve been to a healthy BMI for many years. Sure, I wish things were better, but at least I feel like I’m heading in the right direction.
I’m currently recovering from a terrible episode of gallstones pain — well, it was a few of my worst episodes strung together over a few days and the first really bad episodes I have had since February, so a shock to the system. To clarify what I mean by “bad”, it involves me writhing on the floor in agony. The day after the last bad episode, my pain was still intense enough that I couldn’t bear to move unless it was absolutely essential. However, the most frustrating part of the experience was that it’s my own fault.
Okay, I didn’t ask to have gallstones and it’s not my fault that the current NHS waiting lists are ridiculous, thanks to the government penalising consultants for working overtime, so I haven’t had my gallbladder out. Maybe I wouldn’t have developed gallstones if I had stayed a healthy weight all my life, but overeating was how I dealt with my mental illnesses and one of the few coping strategies which was accessible to me during the years when I was scared of leaving the house alone. However, my recent painful episode could have been avoided if I had paid more attention to what was happening.
Since mid-May, I have relaxed my diet. I still want to lose another 20-30lbs, but a few other things took priority and stress took over during the final 2 months of my temporary job. I wasn’t eating a huge amount, but I was eating crap: more refined sugar and processed foods, fewer vegetables. I should have listened to my body as my gallstones became “noisier” but I pushed on, focusing on work and eating junk to deal with the stress (old habits die hard).
Fast forward to a couple of weeks ago and I realised that not only was I experiencing the worst episodes of gallstones pain I’ve had in a while, but my mood had plummeted. I needed to take control of my health.
I also had a minor epiphany: when my gallstones pain and mental health were better than they had been in ages, in March and April, I had been following a diet which limited processed foods and cut out sugar. I was also eating a lot less wheat. Feeling desperate, I decided to go back to basics and cut out junk food, processed food, wheat and refined sugar as much as I could. The worst that could happen, I figured, was that it would make no difference to the pain and I would get better nutrition.
Thankfully, my change of diet was very effective. Within 4 days, I felt well enough to return to kettlebells class (taking it easy). Within a week, I was no longer taking painkillers. After 10 days, I no longer needed to constantly use heat pads and lavender oil to reduce the pain. In addition, my mood improved — which could be due to the psychological effects of feeling a little more in control, as well as the change in nutrition. Nothing miraculous has happened, but I’m back to baseline gallstone pain levels and my depression has eased enough for me to feel a little more human.
In addition to diet, I think my experience was impacted by other factors. When my temporary job ended in July and I found out I had passed my Open University modules, there was an easing of pressure. I was no longer pushing myself to keep going through pain, stress, anxiety and depression at any cost. I could stop. But when I stopped, I felt drained — especially emotionally. I’m pleased to have completed my work project and OU modules, but neither went according to plan and I’m disappointed that I wasn’t able to maximise my opportunities or enjoy them a little more. Now I could stop, I had to process all of these emotions.
Needing a lot of recovery time is something I have learnt to accept in theory, but it’s frustrating. It typically takes me a few days to recuperate from a day out, which most people find relaxing in itself, so I suppose I should have expected a period of lethargy when the challenges of studying and working drew to a close. Trouble is, I want to keep going! I feel as if I have wasted most of my life because mental illness has had such disabling effects over the years, so I think I should push on as much as possible when I feel able to do more. Perhaps the gallstones pain was a blessing, because it has reminded me to put my health (physical and mental) first and foremost.
So what does taking control mean for me?
Prioritising self-care is essential. I’m sticking with my dietary changes, since I feel so much better in such a short time, and I want to improve my fitness. Yesterday, I had a run on the treadmill for the first time in 3/4 weeks and realised how much I have missed its mood-boosting effects, so I want to work on running farther at my new, faster pace (I have been working on speed this year, after focusing on distance for last year’s half marathon). Taking the time to practice yoga and meditation is also a habit I want to establish over the summer.
The other side of self-care is about putting myself in a better position to achieve my goals. I’m not entirely sure what that will involve, because the first step is to reflect on my progress and decide what’s important to me right now. A summer reset, if you like, before I start my next OU modules in October.
Paradoxically, a huge part of taking control is accepting that I can’t control everything. As the mental health literature reiterates, you can’t control what happens to you — but you can control your response. I had hoped this year would propel me towards a better future, but instead of feeling confident about building on my knowledge, skills and experiences, I feel beaten up. I hope that taking plenty of time to rest and work on my health over the next month will help me feel stronger.
Whatever happens, I will try to remind myself I am making progress — even when it feels so slow that it might not count. I spent too long living life on pause when my mental health was at its worst, so I’m not going to let the gallstones do the same.
I recently read a book called How to Come Alive Again by Beth McColl, which has led to me thinking a lot about a subject which doesn’t get discussed often enough: the work involved in managing chronic mental illness. One of the book’s strengths is its acknowledgement that readers will have varying levels of functionality and these may fluctuate a lot, even over short periods of time, yet everyone has to work hard to try and maintain or improve their mental health. Some days, this means challenging ourselves and flying through a list of tasks. Other days, it means forcing ourselves to do basic tasks like drinking some water or getting out of bed. It’s all work.
A lot of people take this work for
granted. If you haven’t spent years struggling with your mental health, it may
be difficult to believe that simple activities are hard work for some of us.
You may not understand how taking a shower can sometimes seem like a gargantuan
challenge. You might wonder why people who have mental illnesses can’t just “pull
themselves together” and carry on like a “normal” person (a viewpoint I have,
unfortunately, encountered many times). But doing these things can be hard
work. Mental health problems can drain us of energy, motivation, self-belief
and a thousand other things which would enable us to cope better. Things which
many people don’t need to consider when tackling mundane tasks.
Working on yourself
Managing one’s mental health also
involves extra work, such as addressing complex issues and engaging in
activities which have a positive neurological and/or psychological effect. Last
week, some counsellors of my acquaintance were talking about their work and
mentioned that many clients expect counsellors to fix their lives for them.
Instead of embarking on counselling to work on their issues, they seek a quick
fix. As one of the counsellors said, “I can’t fix their lives for them. I’m not
I was fascinated by this
conversation, because I have received counselling at different points in my
life and had never approached it as a quick fix. In fact, the NHS counselling I
have received in the past is often criticised for being too brief to be
effective in the long term: six sessions, the first of which is an introduction
rather than a proper session. I went through two or three rounds of this with
different counsellors and it was a sticking-plaster solution which helped me
feel slightly better for a few weeks, only to deteriorate when I encountered
more challenges. I had been given neither the support nor the skills to
negotiate life as someone who has mental health problems. This started to
change when I was given a year of drama therapy, which enabled me to work
through a lot of personal issues.
I have also received longer-term
counselling (around nine or ten months) from a local charity in more recent years
and I was grateful to be given the opportunity to learn coping skills,
including how to be more supportive of myself. The counselling itself was hard
work, but putting what I have learnt into practice is an ongoing slog. I need
to learn to be more accountable to myself now I don’t have anyone to check I’ve
done my “homework” each week. Learning not to judge and criticise myself is
also a constant challenge—I worry I’m not pushing myself enough and accuse
myself of being lazy, even when I know I’m doing my best.
Tailoring your work to fit you
The work I do to manage my mental
health is very personal—not so much private, but adapted to my own needs and
preferences—and probably looks different to what many other people do. It has
been a long process of trial and error which is still ongoing. I have also
changed my approach at different points in my life, depending on what is most
effective at any specific time.
The biggest difference in my
approach over the past eight years is the prominence of exercise in managing my
mental health. I started walking on a treadmill, because I was too scared to
walk outside alone. My intention was to get a little fitter, because I had been
very inactive for a couple of years and my lack of fitness was beginning to
scare me. I had no idea it would lead to the decision to replace medication
with exercise and if I had started getting fit with that intention, I probably
would have been disappointed because it took around four years to reach the
point where I could consider reducing my antidepressants.
Medication is another thing people
consider a “quick fix” yet, like counsellors, antidepressants are not magic.
They rarely work instantly—it can take several weeks to see an improvement,
which is normal—and it may take some experimentation to find a variety and dosage
which works for you. However, even when I found antidepressants which helped
me, I didn’t experience the complete turnaround in mood expected by some
people: they simply took the edge off my depression, which meant I could do
more basic self-care tasks and work on improving my mental health.
All of these things seem so ordered when I write about them: counselling, medication, exercise and other coping strategies all organised into discrete boxes, all tracking a linear progression from “worse” to “better”. The reality is very different. My symptoms fluctuate a lot and the treatments I have used have been both effective and ineffective at different times.
I emphasise this point because
reading about other people’s mental health can create false impressions,
especially since many of us can’t write about our experiences during the worst
times so write with the benefit of hindsight. These paltry lines of writing represent
over fifteen years of struggle following my diagnosis of anxiety and
depression; especially during the eight years before I was diagnosed with BPD
(borderline personality disorder) and could finally make sense of the symptoms
which didn’t fit with anxiety and depression. I don’t think I could ever fully convey
my experience and while I can make sense of chunks in retrospect, other aspects
I will never understand.
It might be tempting to take some
things out of context and to make assumptions about the decisions I have made about
managing my mental health. For example, many people assume I disagree with anyone
using medication because I have stopped using it myself, whereas I actually
credit antidepressants with keeping me alive. Without medication, I would not
have been able to access therapy and counselling. I would not have started
exercising. I would not have been able to do a large proportion of the work I
need to do on a regular basis in order to maintain and (hopefully) improve my
So, what does this work involve?
My current mental health management
plan prioritises exercise: strength-based gym classes and dog walking
constitute its core, but I add running and yoga when I feel able. Exercise has
a strong impact on my hormones and neurochemicals, which is why I have found it
effective as a direct replacement for antidepressants (though not without its
drawbacks). I also find it very powerful psychologically, as feeling strong and
fit helps me feel more prepared for life’s challenges and I gain a sense of
achievement from every workout. Focusing
on strength and fitness means I approach exercise with a healthy attitude—it’s
not merely a way to control my weight through burning calories and I know that over-exercising
would risk injury without providing extra benefits for my mental health. My
exercise plan also gives my life structure, but without forcing me into a
strict routine which I would be unable to follow when my symptoms fluctuate.
Regular exercising makes it easier
to practice self-care, as it means I have to shower often. Basic hygiene may
seem simple and non-negotiable if you have never had depression, but showering
less often is one of the key signs I’m relapsing. Ditto with changing bedsheets
and wearing clean clothes. This might manifest in subtle ways—leaving it a few
days between showers but making the effort when you need to go out or be around
people—and may never progress beyond this point, but it can get worse. Sometimes
it can feel pointless to make the effort to shower, because your illness prevents
you from leaving the house. I have been in this position and yes, I might have
felt better if I had showered more often, but I was in a lot of emotional pain
and had no energy. Nowadays, self-care tasks piggyback on my exercise routine:
I shower more, so I change my sheets more and wear clean clothes more often. It
also helps me sleep better, which further improves my mental health.
A lot of the work I do to get/stay
well comes under the umbrella of “stress/anxiety management”, which is my way
of describing a variety of techniques I use to varying degrees. Goal-setting
and planning are key strategies for me, because they help me to focus and stay
vaguely motivated. I use breathing exercises when I feel particularly anxious,
including 7-11 breathing (inhale as you count to 7, exhale for 11) and box
breathing (in for a count of 4, hold for 4, exhale for 4, pause for 4 and
repeat as needed). Venting my current stresses on paper also helps me feel
better, especially if I can identify action points which could reduce or solve
the problem, and I sometimes use a few CBT (cognitive behavioural therapy)
techniques I have learnt over the years.
None of this work is easy,
especially when my symptoms worsen, but there are some areas with which I struggle
a lot. Nutrition is difficult because I’m prone to emotional eating and often
grab food which is convenient rather than healthy. My diet is generally
healthier than at any other point in my life, but I sometimes slip into
unhealthy habits—a situation which is not helped by my gallstones symptoms.
Perhaps I will be able to prioritise nutrition in future and do stuff like meal
prep and batch cooking every week, rather than intermittently, but it’s not
something I’m rocking at present and that’s okay—I try to do what I can and I
may fall short of my goals, but I’m doing my best.
Considering the macros along with the micros
Most of the work I have detailed is
done at the “micro” level: small tasks performed on a daily or weekly basis. This
type of work is what fills most of my days. When things are going well, it
helps me feel in control and gives me the ability to enjoy my life. Doing the “micro”
work also puts me in a better position to handle the “macro” work.
The “macro” work is the big
picture: what I want out of life, my long-term goals and mental health
management from a higher perspective. Again, this work is very personal. My
priorities are my writing career, inspiring other people with mental health
issues to chase their dreams, owning my own home (which seems impossible) and
having fun along the way. Your priorities may look very different. My current
priorities are different to the ones I have had in the past and will have in
the future—they are subject to change, but they emerged from my values and I
use them to guide me.
Keeping sight of the “macro” work can be extremely difficult when you have mental health problems. When you are struggling to get through each day, you can’t think about long-term goals. Yet, there’s a paradox: keeping my long-term goals in sight reminds me why it’s worth struggling through the days, why it’s important to keep working on self-care and the other “micro” work which helps me feel better. It gives my everyday life a sense of purpose.
I have learnt to revisit my “macro”
work on a regular basis (at least once a month) for this reason. It makes my
life meaningful and it makes the small steps I take each day meaningful. Do I
get frustrated when I seem no closer to achieving my long-term goals and pushing
through my daily wellness work feels like a massive challenge? Of course! I’m
human. I wish I didn’t have to deal with mental illness every single day of my
life, but it’s the material I’ve been given and I have to mould it as best I
can. Considering the “macro” work also reminds me to check for progress, no
matter how small, which I might overlook. For example, submitting a short story
or making an extra debt repayment. My progress may be slow and excruciating,
but it’s still progress.
You control your own work
Nobody can tell you what to
prioritise in order to manage your mental health—trial and error is the only
way to find out what works for you. It’s annoying when we would all prefer a
quick fix, but it’s the nature of mental illness. Just in case you need me to
point out the obvious, this also means you can’t dictate what other people
should be doing to improve their mental health. You don’t know their struggles.
It might be easy to judge from afar and when we find something which works for
us it’s tempting to evangelise, but we don’t know what will help other people. You
don’t get to decide what treatments and coping strategies someone else tries—they
You get to decide what you try and
how to determine whether it’s effective. For instance, you may find something
which helps you, but is too difficult to implement or access on a regular
basis. You need to consider the costs and benefits of different types of work. Some
of my current strategies would not have worked for me at other points in my
life. For example, I tried to exercise at many different times, but struggled
to create a routine—I could only establish some structure when I was well
enough to attend gym classes. I still get anxious when I go to gym classes, but
the benefits are worth this cost and if that changes, I would have to
reconsider my situation. Likewise, the CBT techniques I find helpful nowadays
were introduced to me in my NHS counselling sessions and didn’t help at the
time. It’s important to keep trying new—and old—things to find out what works
for you and your lifestyle right now.
I am not magic. I have to put a lot of work into managing my mental health and trying to get well. Sometimes I make progress, but other times I seem to regress and wonder why I bother making the effort. However, I’m learning that when I keep trying to do the work of wellness, moments of magic come into my life. Half an hour of feeling enthusiastic and joyous, rather than anxious, when I’m chatting with a friend. A moment of gratitude when a butterfly crosses my path. Three solid hours of working on a project which could turn into something. These fleeting moments might seem insignificant, but there have been times when I experienced nothing good or positive for weeks on end. Nowadays, if I remember to look, most days contain a little magic.
I submitted my final assignments for the Open University modules I’m studying this year well before the deadlines and I’m going to explain why I don’t consider this a Good Thing. The last two assignments are End of Module Assessments (EMAs) which are supposed to be analogous to exams, so there are no deadline extensions. Since my mental health is unpredictable and my current physical health even more so, I had to make contingency plans in case my mental health plummeted or I had bad gallstone attacks in the weeks before the deadline. It’s a coping strategy I wish I didn’t have to implement, but I have learnt that this degree of flexibility is necessary for me.
Preparing to be thrown off course by my mental health is an integral part of goal setting. In this case, I had to get ahead when I felt well and finish the previous two assignments, with deadlines in April, as soon as possible so I could focus on the EMAs. It was pretty intense, but ensured I had several weeks to work on the EMAs. Do I really need several weeks’ leeway? Absolutely. My health can easily become a huge issue without warning. My mental health can go into freefall and the scariest aspect is, sometimes several weeks wouldn’t have been enough leeway.
I was lucky this time around. My mental health has taken a downturn recently, but I could work around it.
What does “working around” my mental health mean?
Put simply, it means doing whatever I can, whenever I can. It’s how I live my life. Some days I can function like any other person and be very productive; some days I am unable to do anything other than slump on the couch, my mind whirring but producing nothing. Most days are a mixture.
Living with mental health problems is difficult, so I have had to devise coping strategies which work for me and help me to be more productive. These include:
Identifying my priorities at any given time. When mental illness limits the number of hours I have available to work (or do anything else), I need to know the best way to spend those hours.
Being super-organised. Depression and anxiety affect my memory, so I write everything down. I need to know my goals and break them down into tasks. I put these tasks on my to-do list, which is divided into high, medium and low priority tasks for each week. I also have a future to-do list, for tasks I can’t or don’t want to complete at the moment.
Being flexible. Because my mental health is unpredictable, scheduling tasks on specific days doesn’t work very well for me, so I try to avoid it unless it’s absolutely necessary. I sometimes allocate tasks to certain days, but I don’t beat myself up if I can’t stick to this plan.
I wish I didn’t have to use these coping strategies. I would love to be able to plan to work on my EMAs for a few weeks before the deadline, like most other people, but no possibility of an extension means I need to prepare for ill health.
This also applies to all other aspects of my life.
I’m sure some ignorant people assume I can do non-work tasks without making contingency plans and these are probably the same people who think mental illness is just an excuse to avoid work, but my mental health affects all aspects of my life. I have had to cancel countless enjoyable activities. For every night out I’ve had with friends, there were five I had to cancel at the last minute and hundreds I never planned because I knew I couldn’t handle it. When my mental health dips, I struggle to do anything, including leisure activities I can do at home, alone. During these periods, I can’t even read or concentrate on watching a film.
I used to feel incredibly ashamed of being forced to live this way. Many friends slipped away because they didn’t understand why I couldn’t go out like a “normal” person and often struggled to leave the house at all. They got bored with hanging out at each other’s homes when anxiety prevented me from going to the cinema or a café. However, as I get older, I’m learning to accept that this is the way it has to be. For now, at least. If so-called friends can’t accept my mental health problems, they can thank their lucky stars they’re not in the same situation and fuck off.
I wouldn’t have chosen this life of constant contingency planning, but I’m learning to make the best of it.
I’m getting better at controlling the things I can and letting go of whatever I can’t control. Better, but nowhere near perfect! I still get frustrated with myself, the universe and life in general, but I keep working towards my goals. My aim is simple: improvement. My life probably won’t change completely anytime soon, but most days are bearable and I’m proud of the goals I’ve achieved.
I can’t celebrate submitting my EMAs early, because I wish I didn’t have to rely so heavily on contingency plans, but I’m proud that I submitted them. Two years of my part-time Psychology BSc down, three (hopefully) to go!
The clocks going forward is always welcome to me, because the improvement in my mood is almost immediate. Everything shifts. It doesn’t mean I don’t have bad days and my depression doesn’t get cured miraculously, but I’m a little less depressed and it’s a little easier to cope. I feel less overwhelmed.
The brighter evenings make it easier to use some coping strategies which I find helpful, including spending more time outside and exercising outside. I can organise my day so that I can make time to walk or run in the evening. The change to BST is a powerful reminder that spring is here and summer is coming: things will change and get better. When my days are (generally) brighter and warmer, focusing on the positive aspects of my life becomes more natural to me.
Summer will also bring the end of my second year studying for a Psychology BSc part time with the Open University. I have three assignments left to complete for my two modules. It has been a difficult academic year, because the first half coincided with my gallstones making themselves known. Before I got diagnosed, I found it incredibly hard to cope. Until the past month, I was constantly trying to catch up on the work I had neglected when I was ill, falling behind on one module as I struggled to meet an assignment deadline for the other. I wish I had managed to enjoy studying more, as I find the subject fascinating and a lot of the material resonated with me.
Thankfully, my gallstones are a lot quieter at the moment, although I dread another bad attack. I still have the baseline pain and nausea, but I have found ways to cope. A friend recommended rubbing lavender oil on my stomach, because it’s anti-spasmodic, and that has been more effective than anything else I have tried (thanks, Su!). I also rely heavily on heat pads and find that intermittent fasting (eating during an 8 hour window) helps a lot. I still get moderate attacks, but not severe ones like I was getting from October to January, which left me writhing on the floor in agony. I’m hoping this will continue until June, because my end-of-module assignments are due at the end of May…
I’m also coping better because I’m exercising more, although there is some circularity in that it’s easier for me to exercise more when I feel better! I have been running again, which is brilliant for both my mental health and the gallstones. Although it’s difficult to ignore the gallstones pain, especially as it likes to affect my back and the tops of my hips (the iliotibial band), the endorphins kick in after 10-15 minutes and are an effective painkiller. I get a psychological boost from exercising, as well, because it helps me feel fit and strong. Knowing I’m getting stronger physically helps me feel as if I’m getting stronger mentally.
It finally feels like I’m moving forward again, after a hard winter. I’m making progress towards my goals, even if it’s slower than I would like, and things are beginning to change.
I have spent four months in”maintenance mode” and I’m sick of it. While it was necessary to cope with the pain of my gallstones, especially for the three months when I didn’t know what was wrong, I felt as if my life was on hold and my mental health was suffering. The gallstones seem to have calmed down: I still have the baseline pain and constant nausea, but I’m learning to handle it and the really bad episodes have become less frequent. Combined with the frustration of feeling stuck, I decided it’s time to refocus on my goals.
Top of my list is getting back to losing weight. It feels strange to admit, because I struggled with an eating disorder for many years, but the past few months have taught me that health is valuable and shouldn’t be taken for granted. I already knew that, but life has a way of re-teaching the lessons we need to learn and in this instance, the lesson was about physical health. I want to lose weight primarily to reduce my risk of heart disease and diabetes. My dad has both of these conditions and recently had a heart attack and double bypass. I don’t want that to be in my future, so I’m trying to avoid it by taking control of the factors I can influence: being a healthy weight, staying fit and eating well.
Exercising is also a priority, mainly because it’s the most effective way of managing my mental health. My doctor has encouraged me to stay as active as I can, because it will help me recover faster when I have surgery to remove my gallbladder. Knowing I can exercise without causing damage is a huge relief, especially after exercising caution when I didn’t know what was wrong, and I feel better when I exercise more often. My anxiety is easier to control and I feel less depressed. I also feel better physically, in a way which is hard to describe: generally fitter and stronger. Like I can handle anything that comes my way.
I’m slowly beginning to piece my life back together and have begun challenging myself a little… One of my mini-goals for this year is to be more confident when driving and I recently drove on my own for the first time in approximately two years. It feels strange to admit, because I passed my test nearly nine and a half years ago, but driving became a source of anxiety for me and it was easier to avoid it than to suffer. And that’s okay. I may feel a bit ridiculous for being unable to drive for such a long period, but I think it’s something I needed to do.
The past four months have been a reminder to take care of myself and switch to “maintenance mode” when I need to, but they have also taught me not to let problems stand in my way. It might be a while before my gallstones get sorted out, so it’s another burden I have to carry, but I’m pretty damn strong. I can take the weight and keep pushing onwards and upwards.
I haven’t blogged for a long time and there are usually two reasons: either I’m ill or I’m very busy. Both apply to my recent absence. I have started a new job, which I’m very pleased, excited and anxious about! It’s only six hours a week and temporary, but I want to do my best and have a significant impact, as I will be working with young people on an art project exploring mental health. My studies with the Open University continue, which is a heavy workload because I’m taking two modules (60 and 30 credits) this year and it gets very intense when deadlines are close together. In case this wasn’t enough upheaval, The Universe decided to throw a spanner into the works…
I have been experiencing a lot of abdominal and middle back pain since October, along with constant nausea and some other symptoms. At first, I thought I had gastritis because I’m prone to getting bad gastritis, but some of the symptoms didn’t fit and the pain didn’t subside like it normally does. Last week, an ultrasound scan confirmed I have gallstones.
While it’s good to have a diagnosis, after three months of not being sure what was wrong, knowing I have gallstones doesn’t stop them from disrupting my life. A lot of people reacted to my suspicions that I had gallstones by saying “ooh, that’s very painful.” Now I know I have them, I can confirm that yes, they are extremely painful! I’m seeing my doctor next week, but in the meantime I spend most of my day with heat pads clamped to my upper abdomen and middle back/shoulder blades.
The gallstones are disrupting my life in general, making it difficult to establish a routine — which is something with which I struggle most of the time anyway, having to work around my mental health problems. They also stop me from following my exercise routine, which I depend on to manage my mental health, meaning the depression and anxiety have been taking hold. It’s been a stressful few months, for various reasons, and my physical health is preventing me from using some of my main coping strategies.
It’s easy for people to say I shouldn’t worry and to take it easy, but regular exercise is crucial for my wellbeing. When I stopped taking antidepressants, I replaced them with physical activity. Exercise has loads of neurochemical and psychological benefits which are essential for me to cope. Being unable to go to classes or run because I’m curled up in a ball of pain and/or vomiting has huge implications for my mood over the following days and weeks.
So I have been struggling.
The sporadic exercise and odd eating patterns have taken their toll: I have gained weight and am around 10lbs more than I was in October, when I reached my lowest weight of 174.5lbs. I use the word “around” because I’m extremely bloated and my weight varies a lot. I can be anything between 180lb and 190lb on any given day. I feel fat and puffy. It’s difficult to keep things in perspective and not feel like I’m undoing all my hard work.
I’m also painfully aware that gallstones can be caused by weight loss, which feels like a punch in the gut. For the first time in my life, I have been losing weight with a healthy approach — a healthy mindset and a healthy eating plan. I haven’t lost weight quickly or followed a high protein diet, both of which are associated with gallstones. Health was one of my main motivations for losing weight, as I have a close family history of heart disease and type 2 diabetes, which I would like to avoid. I did everything “right” and perhaps it’s stupid and immature, but I feel as if I’m being punished.
Balancing everything is very difficult. I’m trying to practice self-care and focus on the positive aspects of my life, but it’s hard. I feel as though I’m being dragged backwards just as things were beginning to go well.
Logically, I know the improvements I have made cannot be undone, especially by gallstones and a dip in my mental health. I’m still managing to work and study, thanks to both having very flexible hours. I have made it to most of my gym classes, although it’s frustrating when I have to cancel one. Gaining 10lbs is hardly slipping back into my old ways when I’m 60lb lighter than I was at the beginning of last year and over 100lb under my heaviest. I know plenty of people struggle much more than me, but it’s frustrating to see my progress slow or halt when I want to rush forward.
I’m trying to think of this period as a sidestep off my path (to recovery, achieving my goals, leading a life worth living, etc) rather than slipping backwards. I need to take the time to recover and do what I can, instead of pressuring myself to chase down more goals. In fact, my goals for 2019 are all continuations of what I have been doing: losing weight/getting fitter, working on my writing and trying to improve my finances. Sure, I wish I could achieve them all at top speed, but slow progress will still get me where I want to be.
I love setting goals, chasing my dreams and challenging myself, but sometimes we need to step aside and take a break. To maintain our position instead of risking harm by pushing on, regardless of how much it hurts. Strip everything back to your priorities and do what you can, instead of stressing about what you wish you could do.