Overinvesting Spoons

I recently wrote about spoon theory, which is one of those concepts which everyone on the internet seems to be talking about when I arrive late to the party. Like bullet journaling and WhatsApp. Last week, I briefly chatted about spoon theory with a friend who blogs about her experience of MS, and she pointed out that you can overinvest spoons. You think you are setting yourself up for success by investing more spoons in activities which should lead to long-term gains in spoons, but the returns diminish and you don’t get your stainless steel dividends.

Spoons

This got me thinking and led to some interesting questions…

 

How many spoons should you invest?

If you get 12 spoons on an average day, what should be your investment strategy? It’s probably impossible to invest all of your spoons, but if you tried to do so, you would neglect your current needs. You need to do things which are necessary for your health and wellbeing today, which includes taking care of basics like eating proper meals and activities which bring immediate pleasure, like reading or chatting with a friend. If you don’t address your current needs, your spoons will deplete at a faster rate than you receive any dividends.

So imagine you can take care of your basic needs with 6 spoons. Should you invest the remaining 6? It seems sensible, since it could lead to a lot more spoons in the future. However, it also means you aren’t making the most of the spoons you have today by enjoying what you can spend them on. Imagine you have £150 of disposable income after paying your bills for a given month. Would you put it all into a savings account? No, because it would make you utterly miserable. It’s the same with spoons: you need to find a balance between saving and investing.

Personally, if I had 6 spoons left over, I would try to invest half and spend half on activities that make me happy. Spending 2 and investing 4 could work, but would be pushing it. Spending 4 and investing 2 is also a good option. I would keep a similar balance if I had more spoons, for example, if I had a really good day and there were 12 spoons left over, I would try to invest 6 and spend 6.

While this seems like a simple strategy, as with many issues concerning long-term illness, it raises some complicated questions…

 

Which activities count as investments?

You may enjoy many of the activities which give you more spoons in the long-term. Walking, for example, is something I find pleasurable and which improves my energy and mental health in the long-term. Activities like this are a mixture of spending and investment. It’s a bit like buying something you intend to use and enjoy in the short-term, but will sell for profit at a later date – like a classic car or limited edition fashion item. You have to decide what percentage of the spoons you spend on these activities count as investment.

This can vary on a daily basis. Some days, walking feels like more of a chore (usually when it’s raining), so instead of being 50% investment, it’s more like 75%. Other days (often in late spring sunshine), walking feels like more of a leisure activity and only 25% investment. As I keep saying in blog posts, finding what works for you will be down to trial and error.

Assessing the investment value of various activities requires being honest with yourself. Don’t kid yourself that specific activities are investments if you haven’t experienced any returns. You can still enjoy these activities, but as pleasurable pastimes. Conversely, some activities seem like they should bring more short-term enjoyment than they do and are actually more of an investment. For me, this includes social activities – I feel like I should enjoy them more than I do, because “normal” people seem to, but anxiety prevents me. Some social activities are more of an investment in my support network and confidence than pleasurable experiences – even if I have fun while participating in them.

If this all seems complicated, it’s because it is! Living with long-term mental illness can make even the simplest things complicated. In terms of spending spoons, it’s like investing in a wildly fluctuating market every day.

 

Are bigger investments better than smaller ones?

Different activities, including investment activities, require different numbers of spoons. This is a basic tenet of spoon theory. But when it comes to investing, is it better to choose a single activity which uses all the spoons you have available for investment, or should you spread your spoons over a few different activities?

Financial advisers would tell you that it’s generally better to have a diverse portfolio, which seems to favour spreading your spoons over more activities, but some high-spoon activities offer very high returns. I try to balance variety with investment in a couple of high-spoon activities. The variety may not be apparent on any given day, but I try to include several different activities over any given week.

My go-to high-spoon investment is exercise. It helps me feel better than anything else I’ve discovered so far and improves my mood in the short-term, as well as increasing my fitness and energy in the long-term. I invest in exercise most days, so I try to invest my remaining spoons in low-spoon activities like meditation and using my SAD lamp. Other low-spoon activities include listening to music, texting friends, reading and drawing.

High-spoon investment activities are useful tools, but carry a higher risk when you spend more spoons on them. Over-exercising, for example, can lead to exhaustion and injury – which means you get no dividends and will have fewer spoons each day for several weeks afterwards. Finding a balance is vital.

 

What can you do if you overinvest?

Prevention is obviously better than cure, but if it’s too late, you can take steps to recover and ensure you don’t overinvest again. First, consider what went wrong. Did you overinvest in a single high-spoon activity? Did you invest too many of your spoons without spending enough? Did you neglect your daily needs in favour of investing spoons? Don’t beat yourself up; try to understand what happened and why.

Secondly, take care of your current needs. You may need to sleep more, cut back on work or rely on others for more support. Figure out how you can do whatever you need to feel better right now. Spend all of your spoons on basic needs or enjoyable activities – hold off investing for a while.

When you begin to feel better, learn from your mistake and start investing slowly – one or two spoons a day, maximum. Sometimes it can feel so good to recover from a bad episode that you want to rush into action, but that will lead to an all-or-nothing cycle, which is unhealthy at best and can be extremely damaging. Also focus on activities which are a mixture of investment and short-term gains, like gentle walks or eating healthy, delicious meals.

 

Avoiding overinvestment can be difficult.

When you have a long-term condition, especially if you are ambitious, it feels like everyone else is sprinting ahead and you’re stuck in the slow lane. It’s tempting to push yourself too hard, especially when your health improves and you feel better than during worse episodes. Even when you know holding back is sensible and necessary, it can feel like you are making excuses not to pursue your goals at full throttle.

Thinking about spoon theory has given me a useful framework which helps me manage my mental health better. It was created in order to explain the impact of chronic illness to people who don’t understand what it’s like to experience long-term health problems, but it can also clarify the way you think about your own health. Using spoon analogies enable me to treat myself with more compassion and less judgement.

I think it makes me appreciate the spoons I have more, too. I wish I didn’t have to think about how many spoons I have every day, but I’m grateful when I have more spoons than I had at my lowest points.

Spoon Theory

I recently read about a simple and effective way to explain the impact of chronic illness to people who have never experienced long-term health problems: spoon theory. Spoon theory was created by Christine Miserandino as she tried to make her friend understand the debilitating effects of lupus. Her friend struggled to appreciate how everyday activities left Miserandino exhausted. She tried to sympathise with her challenges, but couldn’t empathise – until Miserandino grabbed some spoons as they ate in a diner and developed her theory.

The Basics of Spoon Theory

The original article is well worth a read, but this is the concept: spoons are metaphors for units of energy/ability and people with various chronic conditions, illnesses and disabilities usually have a limited number of spoons each day. When your spoons are “spent”, you are unable to do more activities. Even activities which seem simple to healthy people, like getting dressed or cooking dinner, use up spoons.

This means every daily activity has a trade-off. If you start the day with 12 spoons and use 3 getting dressed, showering and eating breakfast, you have 9 left for the rest of the day. Cooking dinner will use another spoon, ditto getting ready for bed, so that leaves 7 spoons remaining for the middle of the day. If you meet a friend for lunch, that could use 3 spoons, maybe 4, If you want to do a couple of hours of work, that might take 4 spoons. So what do you do?

You want to do both, but if lunch uses 4 spoons, it leaves 3 spoons for work – which means you will have to cut corners. Maybe you will be lucky and lunch will take 3 spoons; but you also might be unlucky and have to negotiate bad traffic on the way to meet your friend, meaning lunch uses 5 spoons. 6 if the traffic is bad on the way back. What do you prioritise? Work or lunch with a friend?

People who haven’t experienced long-term illness will probably think it’s no big deal – surely you can somehow find another spoon so you can do your work? Or do your work tomorrow? But your spoons are always limited. You only have a certain number each day. The number may vary, depending on the intensity of your symptoms, but you can’t magic extra spoons out of thin air. You can decide to postpone activities until tomorrow, but you can’t guarantee how many spoons you will have tomorrow. You may have a good day and start out with 17 spoons. Or you may have a bad day and start with only 5 spoons. How do you plan around that uncertainty?

 

Spoon Theory and Mental Illness

Spoon theory is useful in explaining how mental health issues can limit your life. It’s reductive, but that’s the point – it’s a way of simplifying the complexities of long-term health problems so they are easier to understand. I think of my spoons in terms of both energy and ability because anxiety and depression affect these factors, which also merge in the form of mental/emotional energy.

To explain what I mean, it’s easiest to use the spoon analogy. When I cook and eat dinner alone, it uses 1 spoon. If I invite a friend to my house, it takes 2 spoons because of the added anxiety using more energy. If my friend takes me to a familiar pub for dinner, it will take 3 or 4 spoons – more if it’s busy. If we go to an unfamiliar location, it uses at least 6 spoons. If we are joined by someone I have only met a couple of times, it uses an extra spoon. If someone I have never met is invited, it takes 2 extra spoons. If we are in a small group, a couple of extra spoons are needed; a large group takes 4 or more extra spoons.

So if a friend invites me to dinner in an unfamiliar location and invites a big group of people, including a few who I don’t know very well, it would require at least 12 spoons.

Let’s say I have 12 spoons on an average day. Can I go out to this dinner? No. Because I don’t have enough spoons to get ready, let alone travel to the restaurant and carry out my normal everyday activities. On a good day, I probably have 20 spoons. I can go to the dinner and probably cope, but it will limit the rest of my daily activities.

The problem is, when a friend invites me to such an event, I don’t know how many spoons I will have on that particular day. I can accept the invitation and hope for a good day, but the odds are against me. If I accept the invitation and it turns out to be a bad day, with only 6 spoons, I will have to cancel.

 

Can You Ever Use Spoons You Don’t Have?

What if I get invited to a very special event, like a wedding? Can I still go, even if I don’t have enough spoons? Yes – at a huge cost. I have pressured myself to go through with plans when I haven’t had enough spoons and it always has dire consequences. The best case scenario is it leaves me with a very limited number of spoons for the next few weeks. However, it usually leads to my experiencing worse symptoms – panic attacks, self-harm, harmful thoughts – which affect my mental health for weeks, sometimes months, afterwards.

When you try to use spoons you don’t have, it’s like spending money you don’t have and can’t pay back straightaway: you get charged interest and the amount owed increases rapidly. It’s very stressful and seldom worth the price paid in the end.

For this reason, I avoid accepting invitations to events which would use a lot of spoons. I hate having to cancel plans, because it makes me feel like a crappy, unreliable friend. I know I’m ill and can’t completely control my symptoms, but it still feels awful. The exceptions are special events, like weddings and christenings, which I would try to attend at all costs.

People struggle to understand how “borrowing” spoons takes its toll. They see me push myself to undertake challenges, so they think I can always push myself without ill effects. They see me act (vaguely) normally at a party for a few hours, but they don’t see me burnt out and suffering for the following week.

Sometimes it’s worth the price to try to “borrow” spoons, but it risks a great deal. I have to weigh up how bad I’d feel about missing an event or not undertaking a challenge against the probable effects.

 

Can You “Buy” Extra Spoons?

While you can’t magic spoons out of thin air on any given day, you can prioritise activities which will (hopefully) give you more spoons in future. Exercise helps me gain extra spoons, for instance, but I can’t determine when I receive the extra spoons. Going for a walk today (2 spoons) may give me an extra 3 spoons tomorrow, or an extra 5 spoons next week. But it might not.

Mental health management involves a lot of trial and error, as does spoon management. Broadly speaking, activities which improve your health and give meaning to your life will give you extra spoons in the long-term. But prioritising these activities can be difficult, because they require spending spoons which might be better spent on activities which give you pleasure and have other beneficial effects in the short-term. Choosing to prioritise activities for long-term effects is like investing money: you know it’s the sensible option in most cases, but buying something you can have and use right now is more appealing!

 

Spoon Theory Going Forward

I have only started considering my mental health problems in terms of spoon theory, but I think it’s already helpful. It can help me explain the reality of my daily life to people who haven’t experienced long-term health problems. It also enables me to view my difficulties with more compassion. When I’m unable to do something – especially something which seems easy – it’s not my fault for being useless: it’s just because I don’t have enough spoons today.

Mini Self-Care Strategies

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

Journal

Acknowledging the importance of mini strategies is the first step.

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

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

 

Find ways of fitting mini strategies into your life.

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

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

 

What counts as a mini self-care strategy?

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

• Journalling

• Listening to music

• Meditation

• Sketching

• Yoga

• Reading

• Knitting/crocheting

• Texting/calling a friend

• Gardening

 

Remember to do what works for you.

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

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

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

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

 

9 Months After Antidepressants

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

Pill packets

There has been no dramatic change.

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

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

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

 

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

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

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

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

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

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

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

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

 

Antidepressants are an important part of my story.

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

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

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

 

Stopping antidepressants is an achievement.

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

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

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

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

 

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

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

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

 

It’s still early days.

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

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

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

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

The Must-Do List

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

Must-do list

How to use the must-do list.

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

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

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

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

 

The must-do list forces you to focus.

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

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

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

 

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

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

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

 

Must-do lists improve productivity.

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

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

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

 

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

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

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

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

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

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

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.