Stepping Up and Stepping Back

Mental illness can make things hard to plan.

You can never be sure whether a certain date will be a good day or a bad day. You don’t know whether this week will be difficult or relatively easy. Given this unpredictability, learning to be flexible is a key skill.

 

 

Being flexible requires some consideration…

The most obvious consideration is deciding your priorities: defining which aspects of your life are most important to you and keeping the order in mind. There might be times when you are too ill to tackle even your most important and basic needs, but much of mental illness isn’t so extreme — bad days may severely limit what you can do, but you can still do something. The trouble is, without clear priorities, it’s easy to waste the little energy you have on tasks which aren’t important.

When we complete trivial tasks but neglect our priorities, our tendency is often to blame ourselves — which can make mental health problems (and symptoms) worse.

I often fall into the trap of completing low priority tasks first. I tell myself that they will ease me into the important stuff, helping me avoid procrastination. This might work for some people, but when your mental health fluctuates, you can’t depend on being able to do the important tasks later.

You might feel drained later and simply won’t have the energy to do more. Or the depression could take over and you won’t  have the motivation or ability to do anything, let alone something important.  Or you could get lost in an anxiety whirlwind, stressing out and worrying so much that you can’t think straight. There are a million reasons, depending on the symptoms you personally experience, why “later” might not be an option.

 

Priorities need boundaries.

In order to prioritise effectively, you need to put boundaries in place. These can be flexible, but you need to be aware of them — and make other people aware, when relevant. Prioritising is pointless if you can be easily swayed by someone begging you to do an unimportant task. You need to make it clear that you have priorities and while everyone’s time is limited to 24 hours a day, mental illness steals time from you.

Setting and maintaining boundaries can be difficult, but it is necessary.

Boundaries help us to cultivate good mental health and to manage better during episodes of poor mental health. Given this, it’s a good idea to ensure you put boundaries in place at any time — the sooner, the better.

I recently had to set boundaries with someone for whom I do volunteer work. It was difficult for me to broach the subject, but I wanted to make it clear that I couldn’t prioritise them. I could commit to a few hours of work a week and would be willing to do more if/when I’m able, but my priorities are my mental health, writing work for which there’s a chance of earning money, blogging, training and preparing for my Machu Picchu trek and my other volunteer role, which is more closely related to my passions and career plans since it’s a mental health charity.

I felt awkward bringing it up, but this volunteer role has never been formal and I have never promised to do a certain number of hours. I still want to help, but not at the expense of my priorities. I feel better for having explained this, because I wanted to ensure that the expectations of those involved didn’t exceed what I could offer. I also didn’t want to feel pressured to put in more hours than I could commit to, because that would make my mental health problems worse. In fact, setting boundaries benefits everyone, because if my mental health declined a lot, I wouldn’t be able to do anything at all.

You might come across people who don’t respect your boundaries, but don’t be deterred by them: you set and maintain your own boundaries. They might try to push at them or knock them down, but you are in control. 

Your ultimate priority should be you.

You can’t help anyone or achieve your own goals unless you put yourself and your mental health first. Ensuring you are managing your mental health as best you can means that you will be able to do more than if you don’t prioritise it. In the list I made above of my own priorities, my mental health comes first. Why? Simply because I cannot do anything else on the list unless my mental health problems are under a certain level of control.

Knowing when to step up and when to step back can be complicated, but your main consideration should be how your actions will affect your mental health.

Again, this often requires flexibility. For example, sometimes I feel so anxious that going for a walk would make me feel worse. Going outside can make me feel panicky and I’m constantly on edge when my anxiety is bad, so I wouldn’t enjoy the walk. Most of the time, going for a walk makes me feel better, even if I’m experiencing some anxiety, because being outside and getting exercise improves my mood, plus I get a sense of achievement from doing it. The trick is to recognise when my anxiety levels make the activity shift from “helpful” to “detrimental”.

The same goes for any task or activity. Mental health problems can be complex and it’s all very well to make a list of what helps you feel better, but sometimes those things can make you feel worse. It depends on your symptoms and circumstances. Be aware of how you are affected by different activities at different times and adjust your boundaries and priorities accordingly.

 

It’s not just about mental health.

I refer to mental health because it’s the main focus of my blog, but everything I have said applies to physical health, too. In fact, my mental health and physical health are so intertwined that I tend to consider them together. For instance, prioritising my mental health means prioritising exercise — which improves my physical health.

The basics of cultivating good mental health and good physical health are the same: eating healthily, exercising, getting enough sleep, reducing stress, etc. Keep this in mind when deciding on your priorities and setting boundaries — a strong foundation of healthy habits helps you to do everything else more efficiently and effectively.

 

 

Types of Support People with Mental Health Problems Might Need

“How can I help when your mental health is bad?”

I have been asked this question a couple of times recently and didn’t really know how to answer, except to say that I always appreciate someone listening to me and checking in to ask how I am. It made me think about the different types of support I have received and/or wanted over the years I have experienced mental illness.

Here is a brief guide to the types of support you could provide to someone with mental health problems. Your ability to give different types of support will depend on your own circumstances and relationship with the person who has mental health issues. I’m not saying that everybody should aim to supply every type of support to everyone they know who is mentally ill — that would be impossible and inappropriate — but if you are wondering how you can help, here are some ideas.

 

Emotional support

I believe this is the most important type of support, because it enables people with mental health problems to help themselves. It’s easier to try to solve your problems when you feel supported. Emotional support also prevents isolation, which perpetuates mental health issues.

Defining emotional support is difficult, as it can include various elements and different people prefer different types of emotional support. At its core, emotional support is about kindness, compassion and empathy. It involves listening to the person with mental health problems and trying to understand how they are feeling.

The key thing to remember is that providing emotional support can be very simple. A text saying “thinking of you” means a lot. Spending time with the person with mental health problems, whether doing an activity or just chatting, helps, too. Asking how they are feeling and listening without judging, criticising or telling them what they “should” be doing makes a huge difference.

At its heart, emotional support is connecting with another person and showing you care. 

 

Practical support

Mental illness makes it difficult to do things which other people find easy. You can provide practical support by either accompanying the person with mental health problems or doing things for them. Some people will argue that doing things for someone who is mentally ill means you are acting as an enabler, but this is utter nonsense. You wouldn’t hesitate to help someone who is physically ill and cannot do certain things; mental illness is no different.

People need different types of practical support at different points, as their mental health changes and fluctuates. For example, someone might be too ill to buy groceries one month, but well enough the next month to go shopping with a friend. Asking what practical help you can provide is useful, but people with mental health problems are often reluctant to ask for help because they feel like a burden, so try to empathise and anticipate what they might need.

Practical support can include going with people to medical appointments (with their permission, of course!), making phone calls on their behalf and preparing meals for them. Be observant and try to pinpoint areas in which they are struggling.

 

Financial support

Mental health problems and money problems often go hand in hand. Taking a lot of time off work or being unable to work and subsisting on benefits usually means your income is very low. In addition, many symptoms of mental illness make managing finances difficult. Sometimes, mental health problems can cause overspending as well. Given this, it’s no surprise that many people with mental health problems get into debt and/or need extra financial support.

The level of financial support you can give depends very much on your own situation and your relationship with the person with mental health problems. If you are able, helping to pay for things or lending money without charging interest can be very helpful and relieve huge burdens. However, helping someone manage their finances can also be very useful — especially as many people with mental health problems can’t face dealing with their financial situation, so tend to ignore the problem as it gets worse.

Money is a sensitive topic at the best of times, so be aware that your offers of help might be refused. While there should be no shame in facing financial difficulties, especially as a result of illness, many people feel ashamed of being poor and in debt. They might (incorrectly) see it as a reflection of their own value and believe they don’t deserve help.

Be sensitive and empathetic when offering financial support. Don’t attach conditions which could put the person with mental health problems under extra pressure. Also consider your own needs: don’t give or lend what you can’t afford to lose. 

 

Advocacy

You can offer support by advocating for someone, fighting on their behalf when mental illness prevents them from fighting for themselves. In my experience, this is particularly valuable when the person with mental health problems is claiming benefits, since the DWP and its associated organisations care more about their targets than the wellbeing of vulnerable people. It’s also helpful in situations where people are trying to secure their legal rights, such as facing discrimination at work.

Advocacy takes many forms and depends on the situation, but can involve contacting people/organisations, filling in forms and logging events. It may necessitate research or following procedures. All of these things are difficult to negotiate when you have mental health problems, so having someone to advocate on your behalf means a lot.

 

Provide support responsibly

Remember to take care of your own needs when providing support — you will be less able to help anybody if you let your health/finances/relationships/whatever suffer. We have probably all been in situations where we wish we could help more, but damaging your own life doesn’t help anyone in the long term. Also look to your own sources of support, especially emotional support, to help you in supporting someone else.

Even if you can provide nothing but kindness and compassion, it will make a massive difference.

The Truth About Borderline Personality Disorder

It is difficult to explain borderline personality disorder adequately in a sentence or two, which means it doesn’t get talked about enough. I am guilty of failing to mention I have BPD, despite being open about having anxiety and depression, because it exposes me to ignorant, incorrect comments — sometimes by people who mean well — and people tend not to listen when I try to explain about BPD. So here is a very basic guide to the facts about borderline personality disorder and some of the most common misconceptions.

What is BPD?

Borderline personality disorder, or BPD, is a mental illness. The NHS website describes it as “a disorder of mood and how a person interacts with others.”

There are a range of symptoms associated with BPD, which are often grouped into 4 main areas:

• Emotional instability

• Disturbed patterns of thinking or perception

• Impulsive behaviour

• Intense but unstable relationships with others

It’s important to remember that everyone with BPD is individual and their symptoms manifest in various ways. Some symptoms seem to be opposites, such as promiscuity and withdrawal from relationships, although they may have similar roots and effects — such as avoiding long-term relationships.. For this reason, stereotypes of people with borderline personality disorder are particularly inaccurate and offensive.

 

What are the criteria for diagnosing BPD?

There are broad symptoms of which at least 5 must be present over a long period of time and/or have had an impact on your life in order to receive a diagnosis of borderline personality disorder. These include:

• Intense emotions which can change quickly (and often for no apparent reason or reasons which seem trivial)

• Fear of abandonment

• A weak and/or changeable sense of identity

• Impulsive behaviours, such as binge eating, drug taking and mindless overspending

• Suicidal thoughts and/or self-harming

• Difficulty establishing and maintaining stable relationships

• Chronic feelings of emptiness and isolation

• Feeling angry and struggling to control anger

• When very stressed, feeling paranoid, experiencing psychosis and/or feeling dissociated

For a fuller explanation see Mind’s website. Diagnosis can be made only by a mental health professional — in my case, it was a psychiatrist. Diagnosing BPD requires assessment of a complex range of symptoms, so it often takes a long time to be recognised. I was diagnosed when I was 26, for example, despite having displayed the symptoms since my early teens.

 

Does having BPD mean there’s something wrong with your personality?

No. Borderline personality disorder doesn’t refer to character or traits which we think of as constituting someone’s personality. Neither is BPD a personality type, such as those indicated by the Myers-Briggs test (I’m an INFP on that, in case you were wondering!). The term “personality disorder” refers to a pattern of thinking, feeling and behaviour. The  connotations of “personality disorder” are unhelpful when people don’t realise what the term means, but this can be countered with education and information.

Some symptoms of BPD may be thought of as personality traits, such as impulsiveness, but it isn’t necessarily the case that people with BPD are naturally impulsive. You can be impulsive when your BPD symptoms are worse, but the opposite when your symptoms are under control. In this instance, impulsiveness is a behavioural symptom rather than an innate tendency.

Most aspects of people’s character or what we describe as personality are not affected by BPD, though symptoms may overshadow them. Even during my worst episodes of mental illness, my underlying personality remains the same.

 

Can BPD be treated?

Absolutely. Depending on the symptoms exhibited by an individual, there are a range of treatments which can be helpful in managing borderline personality disorder. These include medication, such as antidepressants, and talking therapies.

Dialectical behaviour therapy is noted for being particularly effective and was developed in order to treat BPD. Personally, I have found drama therapy and counselling very useful. I also use CBT (Cognitive Behavioural Therapy) techniques to cope with some of my symptoms.

There are many self-help strategies which can help. For example, I have found exercise and meditation very useful. I have learnt what works best for me over the years (and continue to learn). Lots of self-care strategies which are used for other mental illnesses are useful for people with BPD, so it’s worth doing some general research around mental health management to find ideas.

As with mental health problems in general, finding treatments which work for you is often a case of trial and error. Different treatments may work better at different times, depending on your symptoms and situation. This means it’s important not to dismiss possible solutions which didn’t work for you in the past.

 

Busting myths about BPD.

The amount of ignorance and misinformation concerning borderline personality disorder is a constant source of frustration. I have written previously about how annoying I find it when people call it a “terrible label” rather than a mental illness, which perpetuates these myths.

Here are some more common myths:

People with BPD are manipulative. Some symptoms of BPD may come across as manipulative, but that doesn’t mean they are intentionally manipulative behaviours. Even when someone’s behaviour is intentional, it’s still a symptom and they didn’t ask to have BPD — nobody would — so set boundaries and offer empathy rather than judgment.

People with BPD are a nightmare to live with. There is a degree of truth in this myth, because anyone can be a nightmare to live with sometimes — but this doesn’t mean all people with BPD are difficult to live with all of the time. Many people with BPD are good partners, parents, children and housemates. Lots of us have qualities which make us delightful to live with most of the time.

All of us have bad days, regardless of whether we have been diagnosed with a mental illness, yet people with BPD get accused of being “nightmares” with more vehemence and less compassion than is shown towards most people. It’s a stigma which doesn’t seem to be shifting as much as the stigma surrounding other mental health issues.

If someone with BPD is exhibiting severe symptoms, they need help and support, not condemnation. Other people’s failure to deal with symptoms effectively can also exacerbate the situation, creating a “nightmare” situation which is not the fault of the person with BPD. It’s especially concerning that this attitude seems to blame people with BPD for their own illness, as if we want to suffer from an often painful and debilitating condition.

People with BPD are bad people. Not at all: they have a mental illness. Being mentally ill doesn’t make you a bad person (though it may feel like you are during bad episodes, especially when you are exposed to unsympathetic attitudes). This is stating the obvious, yet it’s shocking how many people forget and prefer to characterise people with BPD as merely bad people who are being difficult on purpose. This is never the case.

 

How you can support someone with BPD.

Make an effort to understand. Don’t make assumptions about the behaviour of someone with BPD. Read about the condition and the experiences of people with borderline personality disorder. Ignore the damaging comments people without BPD write on social media, which tell you more about their authors’ ignorance and lack of compassion than BPD.

Listen. Be there for them. Let them express their feelings without cutting them off or making assumptions about how they feel. If it’s hard to listen, remember it’s even harder to experience. If you want clarification, ask questions. Let them know you care — it might be simple, but it means a lot.

Provide practical help. BPD can be debilitating, especially since anxiety and depression are common co-morbidities. People with BPD might need someone to collect their prescriptions or prepare proper meals. It varies from person to person and between different times. If you are unsure of how to help, just ask at regular intervals and make it clear they are not being a burden.

Never blame someone with BPD for their own problems. Many symptoms of BPD are self-sabotaging behaviours, but that doesn’t mean they are intentional or that the person exhibiting these behaviours can control them 100%. Pointing out that some problems have been caused or exacerbated by these behaviours is usually unhelpful — people with BPD can recognise their self-sabotage and often beat themselves up about it without external admonition.

I know it’s frustrating to see someone make their situation worse, but blame doesn’t help. If you want to help someone with BPD control their symptoms and take responsibility for their actions, offer emotional support instead.

Support, don’t push. Everyone learns to manage mental illness at their own pace and different treatments or strategies work for different people, and at different times. If you find out about something which could help someone with BPD, mention it to them and let them know you will help them access the treatment, but don’t pressure them into trying it out.

 

If you remember nothing else from this post, please remember this: borderline personality disorder is an illness and people with BPD deserve support and compassion, not judgement and stereotyping.

Self-Intervention is Part of Self-Care

Knowing when you need extra help is a crucial part of self-care, although it can be difficult.

Learning to recognise when a worsening of symptoms becomes a need for extra help and support is vital for long-term mental health management. However, it can also feel like admitting failure. When your symptoms have improved, a decline in your mental health can feel like it’s your fault — that you have done something wrong which has caused your symptoms to get worse.

Everything feels darker and you are trapped into the “old” pattern of mental illness you thought you had come through.

The logical part of your mind knows this is wrong and nobody is to blame for their mental health problems, but the messed-up parts of your mind constantly tell you the same old myths: it’s your fault, you fucked up, you are doomed to be miserable forever.

 

You may try to ignore the situation, but it’s important to get help sooner rather than later.

I speak from experience. Over the past 3/4 months, my mental health has declined. This came after a fantastic summer during which I did things that were previously impossible for me (going to jive classes, for example) and felt well enough to stop taking medication after over a decade.

I came up with excuses for not going to my GP: I was stressed out because major renovations had turned my home (and life) upside down. I felt more depressed because I had been hit with one virus after another. These excuses were true, but my assumption that things would go back to normal when the workmen left and I regained my physical health were not.

I wasn’t coping and by delaying getting help, I suffered more and my mental health got worse.

I finally went to my GP on Monday. He is referring me to an organisation which offers counselling, which I believe will be most beneficial for me right now. I told him I would prefer not to go back on antidepressants at the moment, but I would never rule them out as a possible treatment. He was brilliant and accepted my insight into my own mental health — I had been a little wary of feeling pressured to take medication again without trying counselling on its own first, but that turned out not to be an issue.

If you aren’t so lucky and your GP pressures you to try a course of treatment which you feel isn’t right for you, remember you are entitled to a second opinion. However, it’s also worth examining your reluctance to follow the suggested course of treatment — some people resist medication, for instance, because they believe myths perpetuated by the media. Do some research, always asking whether your sources have an agenda which is at odds to your wellbeing, and make an informed decision.

 

Self-intervention, like self-care, is different for everyone.

For me, self-intervention was about recognising that I needed professional help and would benefit from counselling, which I hope I will receive. For other people, it might mean enlisting the support of family or friends, altering their lifestyle or adopting more self-care strategies. It could mean something entirely different, which I might not consider.

It’s about recognising when your mental health has dipped enough that you need extra strategies in place to prevent it from getting worse.

Ideally, this will lead to an improvement of symptoms, but the initial reason for self-intervention is to stop the situation declining further. The signs that you have reached this point vary depending on your recent mental health history and self-knowledge. Symptoms which may not concern one person, may be very worrying to another.

For example, I wasn’t concerned by a slight increase in my depression, because I know it gets worse in winter. However, while my low mood was normal for me, the increase in anxiety to the point where I was having panic attacks more often is a red flag. For someone else, the increase in depression could be a red flag whereas if they were already regularly experiencing panic attacks (as I did in the past), an increase in their frequency might be considered a small change.

Knowing your red flags is important in managing your mental health.

If you don’t have a high level of self-knowledge and self-awareness, keeping a record of your symptoms is helpful. I try to do this when my mental health problems get worse because whereas I normally have a high degree of self-awareness, this gets skewed by anxiety and depression: I tend to think things are fine until they get so bad I can’t deny it any longer. By keeping notes on my mental health, I could have noticed the worsening of symptoms before things got so bad.

Like so many things related to mental health, this is easier said than done, but keeping even a rudimentary record of symptoms can be useful.

 

Self-intervention is needed because many mental health symptoms aren’t noticed by other people.

There are plenty of reasons why other people might not recognise your symptoms worsening:

A lot of symptoms are internal. Negative thinking, headaches, low mood, etc. aren’t always apparent on the outside, especially if they are not expressed.

It can be difficult to distinguish when an already-present symptom is getting worse. If someone knows you experience a specific symptom, such as feeling nervous around other people, they may think all signs of this are normal for you and can’t tell when it’s worse or better.

Nobody is with you 100% of the time. Many symptoms are most apparent when you are alone and many may not seem concerning when glimpsed by someone who doesn’t realise how frequent they are. Under-eating or over-eating, for example, are often secretive behaviours and might not worry people who only see you displaying the behaviour over a limited period of time, such as your working hours. They don’t know whether this continues when you get home, or whether these behaviours are balanced out by other ones.

People might not know if something is a symptom of mental illness. There is a lot of ignorance around mental health and some symptoms might seem unconcerning to people who consider them merely quirks. Some symptoms might be considered normal by some people, such as dismissing a persistently low mood as pessimism or chronic under-eating as a low appetite.

Even if other people do realise your mental health is deteriorating, they might not know how to tell you.

They may assume you already realise or that you would feel uncomfortable if they brought it up. They might tell themselves it’s none of their business or that you might get better without their intervention. These assumptions may or may not be correct — the point is that you cannot rely on someone else to recognise your red flags and tell you to get help.

This means you have to make an effort to recognise your own red flags early, so that you can take action and get the help you need.

 

It’s better to plan self-intervention before it’s needed.

When you are relatively well, it’s the best time to make decisions abot what to do if your mental health declines. Don’t wait until worsening symptoms cloud your judgement.

I wish I had a clear plan in place. It would have made things easier and enabled me to get help sooner.

I had some vague ideas about what it would take for me to go back to my GP, but nothing written down. There was no list I could refer to, which would probably have convinced me to see the doctor when my symptoms got worse, rather than a few months later. This is something I plan to change.

While so much of self-managing your mental health is about focusing on positive change, having contingency plans is essential. If you have close friends and family members you trust, you can ask them to help. For example, you may ask them to flag up when you are displaying certain symptoms, such as withdrawing from social events. You can also indicate the kinds of treatment you would prefer in various situations, so they can help you get the treatment which is best for you.

I wish my mental health had continued its upward trajectory, but it hasn’t and self-intervention was necessary to prevent my health from deteriorating further. It’s a potent reminder that mental illness is not linear and for many of us, self-care involves preparing for episodes of worse mental health — perhaps for the rest of our lives. 

Sick of Being Ill

Long term mental illness + exposure to cold/flu-type virus = 3 and a half weeks (and counting) of feeling crap

I have a newfound appreciation for how healthy I have been over the past couple of years. I caught the odd virus, but I didn’t have an episode of physical illness lasting longer than a week or two. This has changed.

My current ailment has zapped my energy and given me a very painful chest, which is exacerbated by a cough. For the first couple of weeks, I also had headaches and earache. I also have a sore throat which ranges from a little dry to completely raw.

I do feel somewhat better this week — which means my symptoms are less aggravating than my frustration at not being able to get much done.

As I get more annoyed at my immune system, I get more annoyed at myself. Negative thoughts creep in more often. I blame myself for not having energy, viewing it as a sign of my general ineptitude…

Mental health and physical health affect each other.

Everyone knows and accepts how physical diseases can take their toll on mental health. We all understand why someone with cancer might develop depression. Many people understand how chronic ailments which aren’t life threatening may cause mental health problems. However, few people consider how mental health affects physical health.

Many people don’t realise that mental illness can have a variety of physical symptoms, many of which are debilitating. They don’t know that mental illness affects the immune system, leaving sufferers more susceptible to contagious physical illnesses. Like viruses.

When I was a teenager, I got viruses constantly. Many of them were attributed to “stress” because my mental illnesses weren’t diagnosed until I was 18. I was stressed, for sure, but I also had depression and anxiety. I was rundown and exhausted because I had insomnia from the age of 13/14. No amount of rest gave me energy, because my mind was in a constant state of turmoil. Little wonder that I caught everything going!

Of course, this can create a vicious circle…

Physical illness can make it difficult to take care of your mental health, just as mental illness can make it hard to pay attention to physical health.

Over the last few weeks, I have found it very difficult to practice self-care. I haven’t had the energy to do simple things like switch on my SAD lamp, repeat affirmations and meditate. I certainly haven’t been able to exercise.

This is a strange parallel to the past — when my mental health was at its worst, I struggled to eat healthily, exercise, sleep or do anything else to help my physical health.

I have noticed my mental health getting worse over the course of my illness. It’s not terrible, but it’s worrying.

Illness may be temporary, but its effects on mental health can outlast it.

My biggest worry is that the impact on my mental health will last much longer than the virus itself. I don’t want to slip on a downward spiral triggered by an illness which most people manage to shrug off after a week, with no long term effects. Trouble is, that’s beyond my control.

Maybe I will bounce back from this virus and feel awesome next week. Or maybe I will still be reeling from its effects far into next year.

Illness is a reminder that you are not 100% in control.

Whether illness is mental or physical, it makes you realise that you don’t have complete power over your life. While that may be obvious, it’s easy to get caught up in other stuff and then — surprise! — your plans get interrupted by a bloody virus. Or a resurgence of mental health problems. Or both.

Which is why I am so annoyed. I have a lot to do — I have just started volunteering for a local mental health charity and reprised mt volunteer role with the Lyme Regis Fossil Festival. I’m also doing a photography course and have been unable to do any of the (unassessed) assignments, so will need to get my act together to produce something halfway decent for the final assignment. Not to mention my writing projects and preparing/fundraising for my trek to Machu Picchu

I’m supposed to be doing stuff, taking action, being proactive, workig towards my goals… Only I have next to zero energy. Plus the decline in my mental health is paradoxically robbing me of my motivation and making me anxious about everything I want to do.

It boils down to this: a common winter virus is another thing that is relatively easy for most people to deal with, but threatens to derail those of us with mental health problems. And that sucks.

 

Your Christmas Survival Guide (Part Three)

This is Part Three of Your Christmas Survival Guide. For Part One, click here and for Part Two, click here.

  1. Focus on the good stuff

I love lots of things about Christmas, but it’s easy to lose sight of them when I’m feeling bad. I find it helpful to think about what I can enjoy when my mental health prevents me from doing a lot of the stuff people associate with Christmas, like parties. I love making lists, so it’s my go-to tactic, but I think making a list of Christmas activities I love is very helpful. I like being able to refer to a list when my thoughts are all over the place and I’m liable to forget about the things I can enjoy.

Christmas stocking

It’s easy to think Christmas is all about the big things, but a lot of the things I love are small. Drinking champagne (or prosecco, or cava…), listening to Christmas songs, playing board games, watching my dog open his presents, making gingerbread (and eating it!), watching musicals and Christmas films, putting up the decorations, reading ghost stories, etc. They are also accessible, meaning I can do most of them when my symptoms of mental illness are bad (though not when they are at their worst) and I don’t need lots of money or anything to enjoy them.

When you make your own list of things you love to do during the festive season (which don’t have to be Christmassy, by the way), consider scheduling some of them. Scheduling activities can provide some structure, which you may be lacking since Christmas disrupts your usual routine. It gives you something to look forward to, especially if you space them out before and after Christmas Day itself.

Don’t let other people dictate what you enjoy or how you spend your time. Think about what pleases you – it could be choir concerts, shopping, pantomimes, drinking whisky, making wreaths… Anything which brings out the best of Christmas for you. It’s easy to get caught up in the negative aspects of Christmas when you have mental health problems, but there is also a lot to enjoy.

 

  1. Remember it’s temporary

“This too shall pass” is a powerful phrase and it’s true. Christmas will be over by early January. Even if the hullabaloo starts in November, that’s 2 months: it’s finite. Do what you need to get through it and keep telling yourself it will pass.

Look ahead to the New Year, if you can. What would you like to do? What goals would you like to achieve? I like to make lists (again!). Try focusing on your favourite time of year (I love late spring/early summer) and how you can enjoy it all the more. If you find Christmastime unbearable, use any distraction you can find (assuming it’s not harmful) to get you through.

Also remember that the way you currently feel will pass. It’s hard to believe, but repeating “this too shall pass” can bring great comfort.

 

Wrapped Gift
  1. Experiment

While some or all of these strategies may help, nobody can dictate what works for you and the only way you can find out is by trying different approaches.

Think about what has worked for you in the past, but also keep an open mind. Different things can work at different times, so try things which you have dismissed in the past. For example, exercise is now one of the main ways I manage my mental health, but I used to find it next to impossible to do and didn’t notice any good effects when I forced myself to exercise.

Experimenting can be a great way of coping in itself. It provides some distraction from your thoughts and feelings. You are being proactive and focusing on finding solutions, which cultivates optimism.

Do some research – look online and find out how other people cope with Christmas and/or their mental health problems in general. Read self-help and psychology books. Try to understand the biochemical and cognitive functions behind your symptoms. Challenge yourself to find as many options as you can. Have fun trying the craziest suggestions you can find.

Don’t beat yourself up if you feel unable to do something – or anything. Experimenting is as much about finding out what doesn’t work for you as it is about finding what works.

 

  1. Remind yourself you are not alone

One of the greatest advantages of the internet is that you can connect to other people without having to go outside or actually meet them. Read blogs about people in similar situations to yourself. Participate in mental health forums. Visit websites about mental health. Simply reminding yourself that other people find Christmas difficult can help you feel less isolated and more able to cope.

Talk to friends and family if you can, whether in person or via phone calls, text messages, email, Skype, etc. You don’t have to talk about your mental health, although it can be useful if you can – just chatting about trivial things helps you reconnect. Don’t forget that pets are great company, too. Spending time with animals is beneficial for your mental health and talking to a pet is often better than talking to a friend, since you have no fear of being judged.

Don’t forget that if you need someone to talk to, you can call the Samaritans on 116 123 (in the UK) or visit Samaritans.org

 

To read Your Christmas Survival Guide Part One, click here.

To read Your Christmas Survival Guide Part Two, click here.

Your Christmas Survival Guide (Part Two)

This is the second instalment of Your Christmas Survival Guide. Find Part One here and Part Three here.

  1. Maintain self-care

Your routine may be disrupted, but you can still make time to do the things which help you to feel as well as possible. Prioritise anything which makes a huge difference, such as exercise or meditation. Look for ways to practice self-care amongst all of the other stuff that’s going on. It could mean making an effort to eat healthy food alongside the less healthy Christmas fare, writing a gratitude list before you go to bed, ensuring your alcohol intake isn’t too high, etc.

Self-care can also mean removing yourself from stressful situations. Remember you have choices (see part one of this survival guide) and just because it’s Christmas, doesn’t mean you have to do things with which you are uncomfortable. If any traditions or activities cause you distress, opt out. I know it’s easier said than done, but you need to take care of your mental health first and foremost.

A simple (and revealing) question to ask is: would this be acceptable if it wasn’t Christmastime?

If the answer is no, don’t pressure yourself to do something. It isn’t acceptable to expect you to sacrifice your mental health for the sake of tradition or keeping the status quo.

Do everything and anything you need to keep as well as you can. For some people, that’s a few key activities. For others, it means keeping as much of your usual routine in place as possible. It can also vary from day to day – perhaps you can get through Christmas Eve and Day without actively practicing self-care, but you might need to put a lot more effort into self-care during the week between Christmas Day and New Year’s Day. Do what you need to do.

 

  1. Make contingency plans

What can you do if everything goes wrong? If your mental health problems get worse? How will you cope?

These are difficult questions and it’s impossible to answer them completely, but try to come up with some options. Make a list of helplines you could call, such as the Samaritans (116 123 in the UK, by the way, or visit Samaritans.org). Tell your partner/roommates/parents what they can do if you are in distress. Write down everything which might help and make copies – keep a version in your phone, too.

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Think about what has helped you in the past. Something as simple as listening to a certain playlist (I have a playlist of “happy music” which boosts my mood) or spending time with a pet can be very helpful. Even if you think something is obvious, like chatting to a friend, write it down – you might not consider it when your thoughts are consumed by stress and anxiety. Having a physical list also reminds you that you have options, which you can lose sight of when your mental illness takes a nosedive.

It could be helpful to make lists for different situations. For instance, different things help me when I feel anxious or depressed (though there can be an overlap), so it is useful to have separate lists. The lists could be for different situations, such as what can help when you feel like your family aren’t making an effort to understand how you feel or when you feel overwhelmed by everything. The act of thinking things through can help stave off the problems you anticipate, since you will feel more able to cope.

Depending on your relationships, it can be helpful to share your lists with family and friends. It enables them to give you extra support and helps them understand your mental health. Having other people know about the lists can also make them more accessible, which makes it easier to implement your contingency plans.

Having plans in place for when things go wrong may seem pessimistic, but it is actually reassuring. It provides a safety net.

 

  1. Get some space

If you feel suffocated by the Christmas spirit, get away from it! It can be as simple as putting on headphones to listen to (non-Christmas) music and shutting yourself in your bedroom. Or go for a walk in the countryside, miles from any lights and crowds. Or take a complete break and go on holiday over the festive season.

No matter what your situation, you have some options available. If you will be surrounded by family at Christmas, earmark a room to which you can escape if it all gets too much. Tell people you need space when you use that room and hopefully they will respect that, especially if you explain how it helps your mental health. Fill the room with items which will help you escape for a while – books, scented candles, puzzles, DVDs, knitting, computer games, pen and paper… Anything which can provide a distraction.

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You may find you need less space than you anticipated. Knowing you have the strategy in place might be all you need or a 15-30 minute break could be optimal. On the other hand, if you do need to get away for hours at a time, it’s possible.

Giving yourself space is about prioritising your mental health, so explain why it’s important to you if anyone objects. Forcing yourself to participate in activities when you need space will only make your symptoms worse. By getting some space, you are taking care of both yourself and your loved ones.

 

To read Part One of Your Christmas Survival Guide, click here.

For Part Three of Your Christmas Survival Guide, click here.

Your Christmas Survival Guide (Part One)

Christmas can be a difficult time for people with mental health problems. Everyone seems to be happy and excited. Your routine is disrupted. You feel forced to participate in certain activities. It’s the perfect recipe for a turbulent time – even without the added complication of mental illness.

However, there are some strategies you can use to make the festive season run as smoothly as you can:

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  1. Remember you have choices

People tend to use the phrases “it’s a tradition” or “it’s Christmas” to force others into doing things they don’t want to do, but you don’t have to agree. It can be hard to take a stand, for sure, but you need to weigh up the advantages and disadvantages of all your options. If doing something will cause you more distress than standing your ground, don’t let yourself be swayed.

Of course, this doesn’t mean you can’t be tactful or make compromises.

Look for ways to make things easier for you and anyone who might be hurt by your decision. For example, if you don’t feel able to spend all of Christmas Day with your family, explain that it will be stressful for both you and your family if you forced yourself to participate. Remind them that the options you face when you are mentally ill are not between having a great time with your family or a miserable time alone; it’s more likely to be between a distressing time with family or a subdued but bearable time alone.

Point out that you are not rejecting anyone personally. You would love to spend a day of joy with your loved ones, but if poor mental health prevents this, it’s not your fault – or theirs. Tell them how they can support you and your decision.

Perhaps you can prioritise certain aspects of Christmas and celebrate them with your family while opting out of doing everything. For example, join your family for lunch and opening presents, but spend time alone in your room or go for a walk when everyone else is playing board games or watching Christmas films. Again, explain that you believe this course of action will make things easier for everyone.

You are not being selfish by prioritising your mental health.

In fact, safeguarding your mental health shows love and respect for your family and friends, as well as yourself. Some people might not understand, but you need to put yourself first so that you can be a better partner/parent/child/sibling/friend. You are allowed to make your own decisions.

If people are upset by the choices you make, it’s not your responsibility (provided you are not wilfully hurting anyone, of course) and they have to deal with their own disappointment or anger. Maybe some people will blame you for their reactions, but you need to recognise that it’s not your fault they feel this way. Remember that even if a person has never been diagnosed with a mental illness, it doesn’t mean they handle their emotions in the best way – and certainly not 100% of the time.

 

  1. Curb unrealistic expectations

The last thing you need is to put more pressure on yourself, yet many of us fall into the trap of believing that Christmas can be perfect. You can’t expect your mental health problems to magically disappear just because it’s Christmas. Mental illness doesn’t care what time of year it is – and symptoms can be exacerbated by the activities and attitudes associated with Christmas.

A lot of the pressure we place on ourselves is unnecessary because we prioritise things which simply don’t matter. Finding the perfect present doesn’t matter – it’s the act of giving which shows you love the recipient. Cooking or buying a magnificent feast is unnecessary – as long as the food is edible and you are eating it with people you love, no one will care if it’s not Michelin star standard. It doesn’t even matter if Christmas day goes smoothly – the best stories involve things going wrong.

Lowering your expectations doesn’t mean Christmas can’t be joyful and magical. In fact, the best Christmases are often the ones we think will be boring or difficult.

I’m not saying you can’t be optimistic; just be realistic and acknowledge that perfection doesn’t exist. Especially not when you are spending a lot of time with family! There will be arguments and problems. Hopefully they will be trivial, like running out of wrapping paper or accusing your loved ones of cheating at Monopoly, but they will crop up.

The trick is to handle the problems as they arise, which is easier when you aren’t expecting perfection. Arguments don’t have to ruin the whole festive season, so don’t let them.

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Don’t set yourself up for failure by trying to do too much in too little time. Your family and friends would rather you were less stressed than killing yourself trying to make individual place settings on Christmas Eve. Write a list of what you would like to do and prioritise the most important. Then whittle those down to the absolutely necessary.

Aim to do only what is absolutely necessary and do other stuff if you have time and find them enjoyable.

Your Christmas doesn’t have to look like an advertisement. Having all the tinsel and trimmings in place won’t guarantee happiness – in fact, the stress of doing so much will probably guarantee you will be miserable. Neither do you need to cram your festive season with parties and themed activities. Christmastime won’t automatically make you enjoy going out, especially if it’s not how you usually spend your time. If you would rather stay at home with a book, do it – I probably will!

 

  1. Communicate

Let your family and friends know how you feel. Being open might be difficult, but it reduces the risk of people making incorrect assumptions about you. For example, letting friends know you are turning down their invitations because you have anxiety prevents them from assuming you don’t want to spend time with them. They might not always understand, but there is more chance of them gaining understanding if you are honest and talk about what’s on your mind.

Being open and honest also means that other people might come up with solutions which you may not have considered. For instance, they might suggest you spend a quiet afternoon eating mince pies at their house, rather than going out on the town. Of course, it is also helpful if you can make alternative suggestions when declining invitations, even if it’s just saying you would like to see them when you feel better.

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Think about how you communicate and what you say. Some people appreciate warts-and-all honesty, whereas others prefer not to know the details. Be diplomatic – it probably won’t help to tell someone you find them very annoying and that’s why you don’t want to go to their party! Try to empathise with the other person and think about how they would like you to express how you feel. For example, you might need to preface your main points with extra explanations if someone tends to be particularly sensitive.

Pick the right moment, too. The best time to tell your mother you feel anxious and overwhelmed is not when she is in the middle of cooking Christmas dinner. Try to find a time when the person you want to talk to isn’t busy or flustered. A relaxed environment helps and a neutral one, such as a café or during a walk in the countryside, is often better.

If it’s easier, communicate via phone or text message.

I know many people prefer to have serious conversations face to face, but if the alternative is that you don’t tell anyone how you feel, it’s best to communicate however you can. Pay attention to tone when writing written messages, as it can be difficult to convey. Err on the side of caution and make it obvious when you are being serious, when you are being more flippant, etc. Sarcasm is best avoided, since it’s easy to misread.

Finally, remember to keep communicating. Your mood, emotions and symptoms will fluctuate over the festive period, so keep those close to you informed. It doesn’t have to be a constant dialogue – just mention when you are feeling more anxious/isolated/depressed/irritated so that your family and friends can adapt.

Communication helps your family and friends help you. It tells them what to expect and how they might support you. Even if the effects aren’t what you expected, at least you have been proactive and tried to make things run smoothly – that’s all anyone can ask.

 

To read Part Two of Your Christmas Survival Guide, click here.

For Part Three of Your Christmas Survival Guide, click here.

When Mental Illness Meets a Virus

Into my third week of a virus which is draining my energy, causing a painful chest and plaguing me with coughing fits at least every half an hour, I don’t feel great. The physical illness itself is bad enough, but my mental health is also taking a battering.

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Cold/flu type viruses can make people feel depressed even if they are otherwise healthy. Some symptoms are common to depression: lethargy, general achiness, lack of motivation. However, when you already have a mental illness, the effects are exacerbated.

In addition to being ill making you feel like crap, it is difficult to keep up self-care when you are ill.

Apart from having very little energy, I can’t exercise because my chest hurts. I have been walking the dog, but at a glacial pace. The cold air aggravates my chest and breathing heavily is even more painful. This means I have lost one of the key methods I use to manage my mental health.

As my motivation has waned, it has become harder to practice self-care. It seems to take an incredible effort to switch on my SAD lamp in the morning. Eating healthily is already a challenge thanks to the kitchen renovation, but the illness has made it harder to prepare healthy meals because of the effort involved. It’s easier to grab a cereal bar or a packet of crisps.

I have to turn to the self-care strategies I use when my mental health is worse than it currently is.

I’m focusing on self-care activities which take very little energy. These include listening to happy music (which includes Xmas music now it’s December!), soothing hot drinks (also good for my sore throat and general stuffiness) and trying to be mindful. I have also been reading a little more, which might not be classified as self-care, but is very enjoyable.

More than anything, I have to remind myself that this is a temporary setback. I will feel well again — hopefully soon! — and I will be able to think clearly again. I will be able to be more proactive, so hopefully will feel less overwhelmed.

In the meantime, I believe it’s my prerogative to feel a little sorry for myself and drink lots of hot Ribena…

7 Things Anxiety Doesn’t Give a Damn About

1. Whether the perceived danger is real, exaggerated or imagined

Anxiety is anxiety. It doesn’t care about the statistical probability of something happening. A lot of the things you are anxious about might not make sense, but that’s anxiety.

Examining the likelihood of your fears becoming reality might be a helpful technique for dealing with anxiety, but it might not. Sometimes it helps to reassure people with anxiety that their fears are unlikely to come to fruition; sometimes it makes things worse. Listen to the person who has anxiety (especially if it’s yourself) and don’t tell them their fears are unfounded if they tell you it doesn’t help.

 

2. How lucky/talented/beautiful/rich/successful you are

Anyone can have anxiety. I know that is a scary thought for anyone who doesn’t currently suffer from anxiety, but it’s quite reassuring for those of us who do have anxiety. You can come up with a million reasons why any given person should not be anxious, but there is one reason why they might have anxiety which trumps them all: ANYONE can be affected by anxiety.

 

3. How nice people are

I know most people are nice. I know that when I go to certain places, like gym classes, pretty much everyone is nice — well, comsidering my experiences so far! But being around people, especially people I don’t know well, exacerbates my anxiety. It doesn’t matter whether they are polite, kind and considerate (although it definitely helps me cope better if they are): I will still get anxious around people.

 

4. The logics of the situation 

Anxiety isn’t logical. You can be anxious about trivial things and unbothered by things which would scare most people. You can be terrified of a particular situation one day and deal with it relatively easily another day. You can carry out a task without anxiety when you are alone and struggle when you are with other people, or vice versa. Don’t bother trying to make sense of it — anxiety defies logic.

 

5. Convenience 

Anxiety gets in the way of life. It makes things awkward and time-consuming. You can spend hours worrying about something and dissecting it afterwards, even if the task or event itself only lasts five minutes. Yes, life would be easier if things were different, but anxiety is inconvenient. All those of us who have anxiety can do is deal with it as best we can.

 

6. Embarrassing you

Whether you are the person suffering from anxiety, a friend, a relative, a colleague or an innocent bystander, anxiety doesn’t care if you are embarrassed by the symptoms it causes. It doesn’t care if you are uncomfortable with crying in public — or if you are uncomfortable with other people crying in public. It doesn’t care if it makes you shake, shout, collapse or run away.

By the way, if you feel embarrassed by someone else’s anxiety, this is your problem — so please don’t try to make it their problem. Don’t complain or verbally abuse them. Don’t make passive-aggressive comments or give them dirty looks. If it makes you feel better, remind yourself that experiencing anxiety is always worse than witnessing it — and that anyone can experience anxiety, so next time you might be the one in need of compassion and understanding.

 

7. Being told to calm down

I know it’s intuitive, but telling someone with anxiety — especially if they are in the middle of a panic attack — to calm down is one of the worst things you can do. It’s equivalent to telling them that they have no right to be anxious and their behaviour is unacceptable. You might mean well, but the effect is the same.

Besides, if those of us who have anxiety could calm down, don’t you think we would? It’s no fun knowing that your anxiety is actually attracting the attention you hate when you are out and people telling you to calm down feels like a kick in the teeth. Instead, try acknowledging how people with anxiety are feeling and giving them the time and space they need to cope woth their anxiety.

 

What else does anxiety not give a damn about? Make your own list and share!