Accumulating Expertise

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

 

Capturing Information

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

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

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

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

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

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

 

Research and Development

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

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

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

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

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

 

Expectations and Judgments

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

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

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

 

Achieving Balance

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

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

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

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

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

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

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

Refighting Battles

One of the most frustrating and exhausting aspects of having a long term mental illness is you have to fight the same battles again and again. It’s not like a video game, where you pass a level and never have to retake it. Just because you manage to do something one day doesn’t mean you can cope with it the next.


Winding lane

It’s like Groundhog Day without a clear learning curve.

Symptoms of mental illness can fluctuate a lot. I know I mention this a lot, but it’s one of the core truths that people who haven’t experienced mental health problems find difficult to grasp. Even on a “good” day, you have to battle symptoms. They may not be as intense as they are on “bad” days, but they are still present.

Today, for instance, I went for a walk on my own (well, with my dog) for the first time in a while. I haven’t been walking him in the daytime during the summer because it has been either far too hot or raining. People who aren’t familiar with mental health issues might think I found this easy: it has only been a couple of months since I last went for a walk alone, I walk the route with my parents all the time and my mental health has been gradually improving since spring. I should have no problems, right?

Actually, I felt anxious. It took me several hours to work up to doing it and my mind generated a plethora of excuses and unnecessary worries. I felt better when I started walking, but I was still nervous. I kept thinking something bad might happen, that I would get hit by a car or fall over. I worried about meeting other people and feeling incredibly awkward if they tried to make conversation. I ruminated on whether it was too hot for the dog to be out, because the sun started shining despite the low-ish temperature. I was bombarded by symptoms of anxiety.

I shall reiterate: today is a good day. I enjoyed my walk and managed to break out of my negative thought patterns several times. I felt better for tackling the challenge. The point is, I may always have to cope with my symptoms. There may be a day in the future when I can leave the house without planning in advance and feeling anxious, but I’m not counting on it. I have to refight the battle every time I go out alone.

 

And there are many battles to refight.

Many of the things I do on a daily basis take effort. By writing this blog post, I am battling against anxiety and depression: my mind is filled with thoughts like “Why bother writing? It’ll be terrible no matter how hard you try” and “nobody is going to read it anyway”. I battle through because a). I enjoy blogging and writing about mental health, and b). I know there is a chance that my experiences may help other people to understand mental health problems or, if they are experiencing mental health issues themselves, to feel less alone.

I have to accept that these battles need to be refought over and over. It’s annoying and frustrating. It makes me sad and angry. It’s a real bitch. But the alternative is doing nothing.

Refighting battles is hard, but necessary. Many of the battles seem ridiculous, like motivating myself to eat proper meals instead of crisps, but I have to keep fighting. I know each battle takes me closer to achieving my goals and leading a better life, but it doesn’t feel like that when you are out on the battlefield.

 

Yet every battle you win makes you a little stronger.

I certainly don’t feel stronger every time I get through a mundane challenge, but getting through each battle gives me a little confidence. There are times when I get so distressed that even if I win the battle it doesn’t seem worth it, but these comprise a small percentage of my battles. The learning curve might not be clear, but it’s there — hidden under all the fluctuating symptoms. Every battle won imparts a lesson.

Today’s lesson is this: sometimes it feels pointless to refight the same battles because there is no clear indication of progress, but like a character in a video game, you are gaining experience points. I just hope I level up soon!

Lessons from Machu Picchu

It’s just over 2 months since I completed my trek to Machu Picchu and I’ve only begun processing the experience. It still feels a little unreal, like a bizarre dream – only one which everyone knows about! I have been trying to make sense of it all and some lessons have emerged…

Machu Picchu view
  1. You get to decide what your goals are, but not how you achieve them.

If you had told me what I would have to battle in order to reach Machu Picchu, I doubt I would have tackled the challenge. I faced physical illness, a decline in my mental health and bereavement – and that was during the preparation. The trek itself brought the joys of constant rain, altitude sickness, a throat infection and panic attacks. It was worth it in the end, but I wouldn’t have chosen to go through any of those additional challenges.

I thought my toughest difficulties would be improving my physical fitness and social anxiety. These were factors in making the trek one of the biggest challenges of my life, but they were overshadowed by the ones mentioned above. Everyone knows that life is what happens when you’re busy making other plans (which is a phrase I always hear as John Lennon sings it, though I know he probably wasn’t the first to say it), but sometimes life throws so much crap at you that you think there must be a sadistic god somewhere, having a laugh as he hurls misfortunes your way.

Yet I still achieved my goal. I achieved it because I wanted it more than almost anything else in my life.

You get to define what you want out of life and the only way you will get what you want is by defining it; goals give you a target, something to drive towards. You don’t get to dictate exactly how you get what you want, because there will always be obstacles flung in your path, but you can try one way and change course when needed. As long as you keep trying, there is a chance you will get there in the end.

 

Peru mountain home
  1. Your limits are further away than you realise.

I felt like I was being pushed to my limit many times during both the trek itself and my preparations. On the last day of the trek, getting derailed every few minutes by panic attacks as I climbed the 3000 (apparently) steps to the Sun Gate, I thought I would never get there. I stumbled along, feeling utterly wretched. Yet I didn’t reach my limit – I wasn’t even as close as I’d felt at the time.

I was walking. Very slowly, but I was upright. If I had been close to my limit, I would have been crawling. And yes, I would have crawled before I quit.

I was stronger than I realised, though I felt weak. I think this is something I need to apply to the rest of my life, especially during worse episodes of mental illness. I think most people would be surprised at what they can achieve – if only they would set themselves bigger goals. Myself included.

 

  1. Most people want you to succeed.

Sure, there are some nasty, petty people in this world who take pleasure in other people’s failures and miseries, but the majority want others to do well. I have received a lot of support, encouragement and congratulations over the past year – some of it from unexpected sources. People like seeing others achieve their goals; especially when doing so helps others.

This makes a lot of sense: people are in a better position to help others when they are successful. By supporting others in achieving their goals, you might be helping yourself (and others) in the long run. Unfortunately, some people have a win-lose mentality, whereby they see someone else’s success as their own failure. This is nonsense in most circumstances, when people are not competing directly for a limited reward, but it’s an attitude to which some people cling. They view life as an individual race, not a team game.

Seeing others succeed can also inspire and motivate you. From the moment I signed up for the trek, I hoped that my experience would inspire other people – especially those with mental health problems – to follow their dreams. I have since found out that at least one person has done so as a result of seeing me achieve my goal, which makes every single moment of struggle and despair well worth the effort.

 

Winay Wayna ruins
  1. You can help yourself and others – there’s no need to choose.

Following on from my previous lesson, achieving your own goals can help others – even if the link isn’t apparent. I thought of my goal of trekking to Machu Picchu as inherently selfish, despite the fact that I was self-funding and raising money for Amnesty International, because I wanted first and foremost to do it for myself. I hoped to inspire others, but my main motivation was to prove to myself that I could realise a long-held dream.

I think this was symptomatic of my own version of the win-lose mentality. While my “winning” didn’t necessitate another person’s loss, I thought of the trek as an individual pursuit. In reality, it was a team game.

The obvious teammates were my fellow trekkers, guides and our group’s doctor, without whom I wouldn’t have reached my goal. We cheered each other on through the most miserable moments, when we were cold and soaked through, denied even a decent view by fog/low cloud.

Everyone’s support was incredible. There were so many kindnesses. My roommate lent me fresh socks and carried my bag and walking poles up the monkey steps near the end of the trek. Team B (who know who they are!), kept my spirits up when I wanted to collapse on the bloody mountain and stay there. My success is their success.

However, I also had a great support team at home. My parents lent me money, enabling the whole challenge. My dad drove me to Heathrow and back (partly as my birthday present, to be fair), so I wouldn’t have to deal with the added stress of coping with public transport. My mum walked miles – literally – up hills to help me train. My friends kept encouraging me through the darkest moments, when I didn’t know whether I could carry on living, let alone training. Again, my success is their success.

I also realised that everyone I just mentioned (and more besides) took pleasure in my success. Just as I am glad when my friends and family achieve their goals. There might not have been an obvious or direct link which benefits others, but that doesn’t mean others didn’t benefit in some small way.

In fact, assuming your goals don’t cause direct harm to others, I would go so far as to say that achieving your goals always benefits other people – if only because you are showing them it’s possible.

 

Machu Picchu view
  1. Every step is significant, though most of them feel insignificant.

As long as you are moving forward, you are getting closer to your goal. It might not feel like you are progressing fast enough, or like you are progressing at all, but taking any action is a vital step. Again, this is something I need to apply to my life in general – I often feel frustrated because I’m not achieving my goals as quickly as I’d like. Of course, if your goal involves walking to a destination, there is a clear path (or at least direction) which will lead you there. For less tangible goals, you need to keep faith that you will reach your destination as long as you keep taking action.

When I was trekking to Machu Picchu, the majority of my steps felt insignificant. Having a clear path and destination, not to mention guides, didn’t stop my mental battles from hindering my progress. Blind faith didn’t keep me going – stubbornness did.

You have to apply the same determination to working towards your goals, regardless of how insignificant each step seems. The only other option is giving up, which is the one sure way to failure. I think individual steps will always tend to feel insignificant and it’s only in hindsight that you can see how fully they contribute to achieving your goals. It’s part of the challenge, to keep taking action when it feels pointless.

 

As I said, I’m still processing everything.

These are the initial lessons I have learnt, but I feel like the challenge has changed me in ways that I’m yet to notice or appreciate. The changes aren’t exactly what I expected either – sure, I have more confidence and am determined to achieve more goals, but I am still dealing with anxiety and depression so they get in the way. I wasn’t anticipating a dramatic transformation, but part of me is disappointed that I didn’t get one.

I guess the main change is that I trust my intuition more. My instinct told me that trekking to Machu Picchu would be one of the best decisions I have ever made (as much as I dreaded it might turn out to be the worst) and I believe that’s true. It was an incredible experience. Trusting my intuition more has also brought me closer to my core values, making me think more deeply about how I want to live my life.

I guess I have to wait and see what the long-term effects of my Machu Picchu challenge will be. Perhaps the dramatic transformation will manifest in the future…

Mental Health and the Cult of Busyness

People seem to like being busy nowadays. If work doesn’t take up enough of their time, they schedule leisure and side projects with alarming rigidity. Even children have their “free” time segmented into extracurricular classes, clubs, groups and playdates. They then complain that they never have enough time – except it’s not complaining, because they detail their many activities in such a way that it’s showing off. Claiming “I don’t have the time” has become shorthand for “Look how busy and important I am.”


The implication is that if you don’t fill your days with a list of tasks longer than all of your limbs combined, you don’t matter. You’re not important. So where does that leave those of us with mental health problems?

I can’t schedule every minute of my day because I don’t know how my mental health will affect me on any given day. The best I can do is work around my mental illness. I can spend hours “doing nothing” – not out of choice, but because anxiety and depression paralyse me. I get trapped in negative thinking patterns and it drains my energy.
I would prefer to be able to fill my day to the brim, but I don’t think that’s particularly healthy. It places a lot of pressure on people, especially when things don’t go according to plan (which is inevitable at some point). If I try to live like this (and I have, in the past), I go into meltdown. My mental illness gets worse and I lose sight of what is truly important. Unfortunately, many people live like this without questioning its effects, because busyness has become the norm.

Busyness seems to be embedded in our culture. Whereas in past centuries people worked long hours to put food on the table, many people nowadays work to get more – more gadgets, more exotic holidays, more expensive cars, bigger houses. The problem is that a lot of this stuff is meaningless. It doesn’t make people happier and has a negative impact on their mental health. Is it a coincidence that mental illness appears to have increased as society has amassed more money and consumer goods?

Perhaps the cult of busyness wouldn’t be such a problem if it didn’t involve so much judgment.

People constantly judge how others spend their time. I know someone who when asked by a colleague whether she was doing overtime on a particular day, said no because she had things to do and was told “well, we all have things to do.” Yes, but it happened to be this person’s birthday – and her father had died suddenly 10 days before. I suggested she should have pointed this out, since funeral arrangements are pretty big priorities, but why should she? Nobody should have to justify how they spend their time.

Yet everyone seems to be clamouring to justify how they decide to spend their own time. How many times have you heard someone rattle off a list of reasons when asked whether they are doing something or attending an event? We feel obliged to explain ourselves when all that’s needed is a simple “no”.

We might feel the need to explain ourselves because other people are so judgmental. I have lost count of the number of times people have told me “I don’t have time to read” when they actually meant “I don’t consider reading a priority”, suggesting that I spend my time frivolously because I have always made time to read. Because reading isn’t important to them, they judge me for reading; they assume I don’t do anything else important, because their fuzzy logic dictates that anyone doing important things doesn’t have time to read. Actually, reading is essential for me because I am a writer. I also consider it vital for cultivating and maintaining good mental health. I think that’s pretty damned important. But why should I have to explain that reading is not just a hobby for me, but an integral part of my career and mental healthcare?

 

A major problem with the cult of busyness is its assumption of uniformity. It assumes we are all alike and have similar priorities which we address in similar ways. Mental health issues are not considered.

Mental illness has forced me to carve out my own path. I can’t fit the mould created by the cult of busyness. And people’s proselytization of the cult of busyness makes me feel worse, implying that I’m inadequate or unimportant. That because I don’t schedule every moment of my life, I don’t matter.

Must-do list

So here is my plea to everyone, whether or not you subscribe to the cult of busyness:

1. Please don’t ask other people to justify how they spend their time.

It’s none of your business. People are free to select their own priorities and organise their lives accordingly. They might be dealing with problems which make it difficult to live what you consider to be a conventional life. They might just have different goals and interests, which means they value activities which you consider worthless and vice versa. It doesn’t matter why they spend their time differently to how you spend yours – they don’t owe you an explanation.

2. Don’t judge how others spend their time.

What seems unimportant to you might be essential for them. You don’t know whether particular activities are coping strategies or simple pleasures in an otherwise difficult life. Many activities have varying purposes and levels of importance in different contexts. For example: cooking can be a decadent hobby for one person, a way to feed their family nutritious food for another and the means of earning a living for another person. Unless you fully understand someone’s situation (which might not be possible, even if you are close), you are in no position to judge how they live.

3. Stop using the phrase “I don’t have the time”.

It’s an excuse, not a reason, and implies judgement of people who choose to make time for whatever you claim not to have the time to do. Everyone has the same amount of time: 24 hours a day, 7 days a week. Be honest and say “that’s not a priority for me at the moment” or, better still, stop trying to explain your choices. If someone invites you somewhere and you don’t want to go or have a prior engagement, say so briefly: “no, thank you” or “I’m already booked, but perhaps another time”. If someone asks you if you do something, just say yes or no. If they don’t ask and are just talking about an activity they enjoy, say nothing.

4. Stop showing off about being busy – especially through pseudo-complaints.

Some of us would love to be able to maintain your packed schedule. A successful career and vibrant social life? Yes, please! What you consider chores, others might consider to be components of a dream life. Next time you complain about having to ferry your kids around and clean the house, think about the people who would love to have children and their own home but are prevented from having them by circumstance.

5. Don’t make unsolicited comments about how other people spend their time.

I have a neighbour who thinks it’s amusing to say “all right for some!” when he sees other people sitting in their gardens. Regardless of whether they are also looking after children or have been at work all day. His thought process appears to be “they are relaxing and I am not, therefore I need to point out that I am busy”. I’m sure there is no malicious intent, but the implication, once again, is that he is more important than anyone who is not working or running errands.

Purple scream

This follows on from not judging how other people spend their time; you don’t know whether they have been relaxing all day or are snatching a quick break between tasks. Either way, it doesn’t matter. How they spend their time doesn’t affect you. The “all right for some” comment seems innocuous, but it can be hurtful and harmful. Someone (cough, my mum, cough) says it when she sees me watching TV, which makes me feel annoyed if I have spent most of the day working and upset if my mental health has prevented me from working. As a rule of thumb, don’t comment on how someone spends their time unless it has a direct impact on you – and be sensitive, because you never know what problems they are hiding.

6. Stop creating more work for yourself.

Most people are constantly busy through choice, not necessity. The trouble is, many convince themselves that the opposite is true. Your house will not fall down or turn into a hovel if you vacuum once a week, instead of every other day. If your evening classes have become chores which don’t contribute to your wellbeing or other priorities, they are not worth the sacrifice. Make work emails wait until morning if they are not urgent, instead of frantically answering them at midnight. Busywork can be as much of a time-suck as watching TV for hours – it yields similar results, with none of the pleasure.

7. Consider opting out.

A lot of people who buy into the cult of busyness seem to be stressed and unhappy. If this is the case for you, why not stop? You might be surprised to learn that you can cope with working fewer hours, even if it means only having one holiday a year or going without the latest iPhone, and be happier for doing so. You could discover you have more fun if you just hang out with your partner, instead of scheduling daytrips and dates every weekend. If you are already stressed and unhappy, what have you got to lose?

8. Finally, think about your mental health – and other people’s.

It’s frustrating when people make assumptions about what I can/can’t do, based on their own experiences and/or perceptions of me on good days. There are days when I can out-busy anyone, when I feel motivated, productive and full of energy. But they are few and far between. My mental health problems don’t let me act like a fully paid up member of the cult of busyness.

And that might be a good thing. While some people thrive under pressure (myself included), nobody benefits from constant stress with no respite. Even if you are coping well, consider how your lifestyle might affect your health in future – especially your mental health.

 

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.

 

The Therapeutic Side of Writing Fiction

I’m always a little wary when someone asks me if I write as a form of therapy. They usually expect a yes or no, but the answer is complex…

First of all, I don’t want to give the impression that writing is a substitute for talking therapies or other kinds of mental health treatments. While using any kind of art as therapy can be helpful, I think it’s appropriate as a complementary strategy rather than a complete treatment for mental illness in itself. (Sidebar: in my experience, there is no such thing as a complete treatment, but medication and talking therapies come closest, in my opinion).

Secondly, I write for readers. If I write something just for me, it stays in my journal or folder. If I submit stories, I want other people to read and enjoy them. Regardless of whether a particular story has been therapeutic for me to write, the audience is one of my top considerations. This consideration always affects the story and may prevent it from being as therapeutic as it would be were the readers not taken into account.

With those caveats in mind, my answer is yes. I do write as a form of therapy, but there are also many other reasons why I write.

 

Not all writing is equally therapeutic.

To make things a little less complicated, I’m solely talking about writing fiction and specifically short stories, since they constitute the main body of my work to date. However, the therapeutic value of any given story varies a lot: many of my stories have had no therapeutic value, whereas some have been very helpful as therapy.

Can you tell the difference? I have no idea. I like to think I write to a high standard regardless of whether a story has been therapeutic to write, but that might not be the case! Do the more therapeutic stories have more emotional impact? Again, I can’t tell. I hope all my stories have some emotional impact, though the emotional effects depend on the individual story.

 

The raw material, whether it is inspired by life or not, is transformed.

When people hear “therapeutic” in regards to writing, they automatically think of memoir or autobiographical fiction. They assume that in order to be therapeutic, the story needs to bear a strong resemblance to the writer’s lived experience. Often, the opposite is true.

Amanda Palmer, in her excellent book The Art of Asking, talks about the transformation of life experience into art in terms of putting raw material into a blender. She typically uses a low blender setting when songwriting, such as level 3 on a scale of 1-10. In contrast, her husband (the author Neil Gaiman) uses a very high blender setting — often level 10.

I love this analogy. It’s a simple but effective way of demonstrating how two pieces of art can be equally as personal, but very different in terms of recognising the raw material from the finished work.

For me, the more therapeutic the story, the higher my blender setting. I know what raw material has gone into the story, but other people (even those who know me best) would find it all but impossible to tell.

 

The transformation of raw material is the most cathartic aspect of writing.

While pouring out my emotions in my journal can help me feel a little better, it’s the process of transformation that I find most therapeutic. I suppose it correlates with talking therapy: if you recount your experience to a therapist it usually provides a sense of relief, but venting your feelings is just the first step. The most useful part of therapy is questioning and evaluating. There is more value in learning to reframe your experiences and think about them in different ways. Ditto writing.

Transformation is crucial for the story itself, too. In order to be most effective, you need to select and adapt material (whether from life or another source).

You need to choose a focus for the story, to tease out a plot and create characters (even if they are heavily inspired by life) who serve the story. It doesn’t matter if, as many new writers complain, “that’s not how it happened!” Your task is to find the emotional truth at the core of your story and make it shine.

 

Writing is a constructive way of using your experiences — which can help you value them.

Many experiences are awful. Writing is one way I can find value in them — it almost gives them a purpose. This provides another way of helping me to reframe those experiences, so the therapeutic effect continues.

As I said at the beginning of this post, the therapeutic effects of writing fiction complement the other ways ai manage my mental health. If you would like to try writing — or any other art — as therapy, go for it. However, my main reasons for writing have nothing to do with my mental health (except indirectly) and when I approach writing fiction, therapy is never foremost in my mind.

15 Ways to Feel More in Control of Your Life

1. List your worries. This is deceptively simple: unidentified worries tend to accumulate, creating stress and anxiety without being challenged. Knowing your specific concerns gives you focus. You might find that you can disregard many of your worries and some may have quick, easy solutions. When you write down your problems, instead of being deafened by them clamouring for your attention, you can separate the genuine ones from the trivial. You can then address them one by one, without worrying (more!) that you are forgetting something.

2. Change your perspective from uncertainty to curiosity. Ask yourself what might happen if you do something, rather than worrying about undesirable outcomes. Your mind will give you dozens of answers without you needing to consciously try to answer the questions – and many of them will be positive or neutral, not the negatives which feeling uncertain makes you focus on.

3. Write a to-do list and so something – not matter how small. While there is evidence that people who do the easiest tasks on their to-do list rarely get around to doing the difficult ones (see Real Focus, from Psychologies magazine), when you are so overwhelmed that you feel paralysed,  doing anything is proof that you have some level of control. You can choose to do something, even if it seems insignificant. It isn’t about getting through your to-do list when you feel out of control of your life: it’s about challenging the notion that you can’t do anything.

4. Make a plan, any plan. You don’t have to carry out the plan right now – or even anytime soon. The important thing is to consider how you will do something, whether it’s taking the holiday of a lifetime or losing weight. Work out the practicalities. If there are things you don’t know, make a note of your questions. Think of where you can research your plan. Making plans shows you that there are possibilities; you don’t have to adhere to your plans, but you know you could.

5. Declutter and then organise your stuff. Regaining (or just gaining!) control of your possessions makes your environment more pleasant and reminds you that you can control some aspects of your life. It’s a tangible step. You have to physically throw out (or recycle, donate, etc.) and rearrange items. For a long time, I resisted the idea that being in tidy surroundings can help you to think more clearly, but then I tried it (the threat of being crushed by towers of books forced my hand somewhat) and found out that it works. Try it – the worst that can happen is that you have a tidier home for a while!

6. Do something for someone else. When we are feeling overwhelmed and out of control, we tend to be lost inside our own thoughts. This doesn’t mean you are being selfish; it’s just difficult to think about anything else when you are in such a state of mind. Doing something for another person (or animal) forces you outside of your head. You can do anything – donate to charity, perform a random act of kindness, give a friend an impromptu gift, make a special dinner for someone… Anything you like.

7. Face your fears. Disclaimer:  I’m NOT suggesting you do something which endangers yourself or others. I’m saying that if you are afraid of doing something which is relatively safe, doing it is often the only way to prove that you can act in the face of fear. Just do it without expecting a specific result – check your bank balance, ask for a pay rise, talk to a stranger at the bus stop. In most cases, you will be no worse off than if you never tried – only now you know you can feel the fear and do it anyway.

8. Acknowledge that you can’t control everything. Sounds obvious, right? Yet so many of us get stressed about not being able to control everything. Acknowledging that some things are beyond your control paradoxically reminds you that you can control other aspects of your life. Even if you can only control 10% of your life, that’s a lot more than 0% and can make a lot of difference.

9. Instigate an Action Week. Decide to spend a week doing as much as you can to make changes in your life. Other time periods may work well – I like an Action Day, personally – but a week gives you long enough to start seeing effects, without being so long that you burn out and are left exhausted. The idea is to power through what you want to do without overthinking everything. Try that new dance class, complete a project, start online dating… You will surprise yourself with how much you can do when you focus on action rather than second-guessing yourself.

10. Be creative – make something. You can make anything you like and it doesn’t matter how good or bad the result. Concentrate on the processes of creativity: gathering ideas, selecting materials, developing skills, experimenting. You may find you lose yourself in a state of flow, which is amazing. But even if you don’t, you have spent some time making something and turning your thoughts outwards.

11. Learn to work with your natural tendencies, not against them. This requires a certain level of self-awareness, so observe your behaviour for a while beforehand. Do you tend to get up early or go to bed late? Do you prefer to eat two or three large meals a day or lots of snacks? Do you work best alone or with others? When you are aware of your natural tendencies, think about how you can align your lifestyle with them. In many cases, the changes you can or can’t make will be determined by external factors and responsibilities, like needing to get the kids to school and work hours, but even a few small changes can make you feel less like you are constantly fighting against the current.

12. Try prayer and meditation. You don’t need to be religious or spiritual to try prayer and/or meditation – or for them to work. In fact, I believe they are more effective if you don’t have any expectations. Regardless of whether the universe or a deity is receiving your prayers, simply praying helps you to order your thoughts. It can remind you to be grateful for the good things in your life and give you strength during struggles. Meditation can persuade you to step outside your thoughts for a while, giving you fresh perspective on life. Wherever You Go, There You Are by Jon Kabat-Zinn has helped me a lot, but there are plenty of other approaches and guided meditations to explore online.

13. Change your scenery. You don’t have to go on an exotic holiday to find different surroundings – look for places close to home which you don’t visit as much as you would like. For me, this is the seaside. For you, it could be a park, forest, café, garden or even a room in your house. Being somewhere other than the places we visit or use regularly can help shift our thinking, allowing us to gain greater perspective and organise our priorities.

14. Talk to a friend. I’m lucky, because I have a few close friends who are absolutely awesome. They listen to me as I obsess over everything and help me to straighten my thoughts. However, you don’t necessarily need a great friend or relative (though if you have them, you should use them!), because an animal or inanimate object can also work well. Why? Because I have noticed that simply verbalising my thoughts helps me to organise them. Without my friends saying a word, I catch myself worrying over stupid, trivial things and undermining my own confidence. Try talking about how you feel – you might be surprised. And if anyone tells you that talking to yourself is crazy, they are wrong. Just maybe do it in private, rather than at the supermarket.

15, See a doctor. I hope this list helps you, but remember to see your GP if you are feeling out of control and overwhelmed. I have been helped by everything on this list, but medication and counselling have also helped immensely. Always get professional help and support whenever you need it.

 

 

 

 

The Myth of Independence

Everyone wants to be independent, right? We want to have the freedom to do what we want without relying on other people. We want to live according to our own goals and values. We tend to think that depending on other people will get in the way of living our lives as we wish. That’s all bullshit: nobody is truly independent.

I struggled with having to rely on my parents. I have had mental health problems throughout my adult life, so I’ve depended on them for practical and financial support for thirteen years. I had to leave three jobs because of mental illness; despite providing doctor’s notes explaining my absences, my employers seemed to regard the absences with suspicion and instead of supporting me, put me under more pressure so I ended up resigning. I have paid my parents “rent” to cover some of the grocery and utilities I use since I left college at eighteen, but my finances have been irregular for long periods so my parents have lent me a lot of money. I would not be able to live alone because the benefits I receive barely cover the living expenses I have now, which are minimal.

I also rely on my parents to pick up my antidepressant prescription. I could probably do this myself nowadays, but in the past I have been too scared to leave the house – let alone go into a pharmacy and talk to strangers. My mum also makes sure I eat a proper dinner most of the time, which sounds trivial but makes a big difference when I’m too depressed to cook for myself. My parents accompany me to appointments when needed and make phone calls on my behalf when I’m too anxious to do it myself.

As you can tell, my life is far from independent. I rely on state benefits and my parents just to survive. I rely on the NHS to provide me with treatment for my mental illness – treatment which has helped me to become a little more independent. I have learnt not to feel guilty about being a burden; at least, most of the time – it’s one of my major insecurities during periods of depression and/or anxiety. I have also observed something interesting: I have never met a wholly independent person.

All UK residents are entitled to NHS treatment which is free at the point of service. We rely on our employers to pay us on time and follow workplace laws which protect us. We depend on the police force to prevent crime and convict criminals. We expect supermarkets to sell us good quality food. Even if we consider ourselves to be someone who will never claim benefits (hey, I used to be one of you!), the welfare state still provides a safety net. Whether you like it or not, you are not self-sufficient.

On a personal level, most of us depend on family and/or friends for many things. Moreover, many of us like helping others and enjoy being asked to help out a friend or relative (within reason, of course!) – yet we balk at the idea of asking for help ourselves. I also find it fascinating how some forms of dependence are accepted, while others are criticised by many people. Apparently, living with my parents at 31 is shameful, but if I had kids and relied on them for free childcare nobody would bat an eyelid. Going to an appointment with your mother is viewed as a bit weird, whereas going with a partner is completely normal.

Being so dependent has opened my eyes to the hypocrisy surrounding the idea of “independence”. The major difference between those who think they are independent and the rest of us, is that we are aware of how we depend on others. A lot of people are simply unaware of their own privilege, like the middle class white male who gets a good job because he was recommended by a friend of a friend but is convinced he was the best candidate. Independence is an illusion. Once we give up this illusion, society will be more empathetic and compassionate towards those who need support – in particular, elderly people, people with disabilities and people with mental health problems. When we accept that nobody is wholly independent, we empower everybody to set and achieve their own goals in life, without worrying about how others may judge them.

After all, nobody is going to tell Stephen Hawking “yeah, you might be one of the most successful physicists of our time, but your achievements don’t count because you depend on other people to fulfil your basic physical needs” – so why do so many people think it’s acceptable to ignore some people’s achievements simply because we can’t be as independent as others?

You Are Not Normal!

This week, I read a charming book called What The **** Is Normal? by Francesca Martinez, who faces multiple challenges because she has a terrifying condition: she is a comedian. Oh, and she happens to have Cerebral Palsy but prefers to refer to herself as “wobbly”. Francesca points out that nobody is normal and having a disability — including mental illness — just means you do things differently. We all have different abilities, strengths and skills — so why do we define some people by what they can’t do and not others?

Francesca’s book is awesome and should be read by everyone (especially politicians, in my opinion), but I found it very interesting from the perspective of someone with mental health problems. Francesca and other people with physical disabilities spend their lives being told what they can’t do, often erroneously; myself and others with mental illness spend our lives being told, erroneously, that we can do things. We can “pull ourselves together” and “snap out of it”. My conclusion is that people should mind their own bloody business!

We should also stop labelling each other. You may have noticed that I don’t use terms like “depressives”, instead refering to “people with depression”. I do this because language is powerful and nobody should be indentified by a medical condition. Of course, medical conditions can be part of your identity — I have talked about the merits of mental illness — but it should never be the whole.

I think Francesca is fucking amazing and her message, delivered with the force of her hilarious humour, is vital: you are not normal. Nobody is. So why waste energy bewailing the fact? Whether you have a physical or mental condition that affects how you live, there are far more important things to worry about thatn how “normal” you are.

Don’t Dwell on Other People’s Negativity

Sometimes I’m convinced that some people exist only to make everyone else miserable. To bring us all down when we feel a little better than usual. To rip apart our dreams. Of course, the reality is that these people are unhappy and haven’t learnt to deal with their emotions in constructive ways. They criticise, insult, drain, deride and belittle other people in misguided attempts to express or assuage their own negative emotions. It’s useful to regard them with empathy – not so that you can steer them onto a different path (only they can do that for themselves), but so that you can decide how to handle these people and their negativity.

First, don’t expect them to change. Change is possible, but it’s not inevitable and you have to deal with certainties, i.e. their current behaviour.

Secondly, you must prioritise your own health – which includes your mental health. You do not have to be someone’s scapegoat or whipping boy. You do not have to accept another person’s bad behaviour.

With these points in mind, determine how big an impact certain negative people have on your own wellbeing. Decide whether or not you would like to change the situation – would you be content for things to continue as they are? If not, think about how you could change the situation.

In some cases, cutting all contact with someone is the best solution. If a so-called friend or family member continuously treats you like shit, they are not worth your love and attention. You deserve to be treated with respect, at the very least. It may take some planning to cut contact with certain people, for example, anyone you live or work with, but if you can’t cope with their behaviour it will be worth the additional short term hassle. It is also helpful to discuss your decision with other people, whether close friends and relatives or a mental health professional.

A less drastic alternative is to cut down on the amount of contact you have with the person in question. If they demand to know why you no longer phone them every week or spend hours listening to them whinge and moan, simply explain that spending a lot of time with them is having a negative impact on your own health. Don’t attack them and try to be specific, for example: “when you complain about your work, I feel drained and dejected because I can’t work at the moment and wish I had work problems. I know it’s not your fault, but it isn’t mine either and I don’t want to spend time with you when it leaves me feeling bad.” Keep the focus on the behaviours which impact you, not the person themselves. You can reassess your decision at regular intervals, so that if the person does change in the future, you can spend more time with them without it leaving you feeling worse.

Another option is to change the way you spend time with negative people. If meeting in a café usually involves your companion ranting about their relationship, try meeting up for a dance class or to go to the cinema. You can still chat beforehand and afterwards (and even during, if the activity allows), but because the time is broken up to make room for the activity there is little opportunity for a prolonged monologue. A change of scenery can change people’s behaviour even if you can still chat throughout – going for a walk, for example, may be more conducive to positive, two-sided conversations. Plus you can speed up if your companion starts moaning, so that they are too short of breath to rant!

You can also refuse to engage in someone’s negativity. This takes a little practice to build up your confidence in doing it, but it’s very effective. When the negative person starts complaining, say “I’m sorry, but I have a no-negativity policy. If you would like to find solutions to your problems, I’d be delighted to help but I can’t be a sounding board because it affects my mood and wellbeing.” If they criticise you, say “I disagree, because…” and give evidence for your opinion. For example, “You might think I’m lazy, but I disagree because I work hard in the office and I’m studying in my spare time.” If their criticism is true, acknowledge it and move on. If they continue to criticise you, say “I’m aware of your feelings. There’s no need to repeat them.” If they respond negatively, walk away.

Walking away is a great strategy because it removes you from the situation, which prevents you from feeling worse, and gives you space to clear your mind and assess the situation from a more objective perspective. If you have nowhere else to go, lock yourself in a toilet cubicle until you feel more equipped to deal with the situation. Negative people often criticise this strategy as “running away” but it’s actually a way of facing the reality of the situation. If you stay and let someone’s negativity bring you down, you are not in a position to determine the truth of what they are saying. Your viewpoint will be skewed by your now-negative thoughts and emotions. If you were in physical danger, you would have no qualms about walking away – why should it be any different when your mental health is endangered?

Finally, try not to give negative people your headspace. Their criticisms and insults are their opinions. Even if there’s some truth in their words, dwelling on them is unhelpful. Pick apart their words and look for evidence of whether there is any truth in them. If there is not, there is no value in dwelling on the words. If there is some truth and it bothers you, think of constructive solutions. Other people’s negativity is theirs – never let it become yours.