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.

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.

 

 

How to Set Goals on Your Terms

Everyone seems to be talking about New Year’s Resolutions at the beginning of the year, whether they are setting their own or mocking other people for making them. The same stuff gets churned out year after year, as if achieving goals can be addressed with a one-size-fits-all mentality – yet year after year, most people fail to achieve their goals.

I believe the most effective approach is a personal one. Instead of listening to whatever guru is currently on television, turn to the premier expert on you: yourself.

 

  1. Figure out what YOU want

A lot of noise gets created by the media, social media, advertising, your family and friends, etc. We are bombarded with a lot of messages about what we “should” want: a thin body, a romantic relationship, children, a big house, a fancy car, designer clothes, luxury holidays… These things are sold as solutions to our problems and all too often, we accept that at face value because it’s easy and seems to work for everyone else.

You need to step back and question these assumptions. Why do you want any of the above? How would it change your life? How would it make you feel? Might there be different effects to the ones shown in glossy magazine images?

Pinpoint what you ultimately want, rather than thinking a certain goal equates to happiness. If you would like a new relationship, for example, how would you like to feel in that relationship? Supported, cherished, secure? Consider whether other things could be more effective in helping you achieve those feelings. I’m not saying you shouldn’t want a relationship or anything else listed above; I’m saying you need to work out why you want it and keep an open mind as to how you might achieve that why.

If questioning yourself doesn’t change your mind, that’s great! It means you want to achieve your goal for the right reasons and have clarified the specifics. For instance, if companionship is a priority for you in a relationship, you may not want to pursue a relationship with someone who works away for months at a time. You have a clearer vision.

However, if you have changed your mind about what you want, that’s great too! Don’t be afraid to search away from the beaten track. Who cares if other people don’t understand why you are choosing a specific goal? As long as it makes you happy, it’s all that matters. Besides, quirkier goals are usually more fun!

 

  1. Do your research

Has anyone achieved your goal? For most goals, the answer is yes. Seek these people out, online and real life. Find out how they succeeded and what they wish had happened in a different way. Ask for advice. Gather all the information you can at first, then select what is most relevant to you and your situation.

If your goal has never been achieved by anyone (gold star for you!), research people who have achieved similar goals. In fact, a lot of information and inspiration can be gleaned from reading about successes which appear different to what you want to achieve. Whatever your goal, factors like determination and confidence are bound to be issues.

It can help to divide your research into practical aspects and mental/emotional considerations. While there may be overlapping, it is helpful to organise your material this way because practicalities and mental/emotional concerns require different approaches. Further subdivisions can also be useful, as tackling your goal in smaller chunks makes it more manageable.

 

  1. Play to your strengths

What works best for you? What are your skills? Which of your personality traits can be characterised as strengths? How have you achieved goals in the past?

All of these things can help you tailor how you approach your goal to your own needs and idiosyncrasies. For example, if you struggle to get up in the morning, perhaps early runs aren’t the best strategy for you to get fit – exercising later in the day would suit you better and make you more likely to stick with your goal. The idea is to incorporate your goal into your life as seamlessly as possible – it doesn’t mean achieving your goal will be easy, but it will make things a little easier and increase the chances of achieving your goal.

Refer to your research: have other people used strategies which might work well for you? How have people with similar lifestyles or personalities achieved their goals? Are there any deal-breakers which you will need to fulfil in order to avoid failure?

 

  1. Define what success means to you

How will you know when you have achieved your goal? The answer is obvious for some goals, like running a marathon, but can be open to interpretation with other goals. For example, if your goal is to lose weight, what indicates success? A certain number on the scales? A clothing size? Define what you want.

If your goal is more difficult to measure, you may need to create your own subjective scale. For instance, if you want to simply be happier, how will you know? Our moods fluctuate and memories of emotional states are unreliable. Perhaps you could measure your happiness by the number of times you have had fun over a week. Or you could use a scale of one to ten to rate your level of satisfaction with different areas of your life.

It’s up to you how you define and measure your goal – just choose a mechanism which works for you.

 

  1. Don’t be afraid to experiment and re-evaluate

Finding what works for you is reliant on trial and error. Don’t waste time playing it safe – if a strategy intrigues you, try it out as an experiment for a certain period of time. You have nothing to lose by trying something different for a week or two, but you could gain a lot if the strategy works well.

A word of caution: the time period of your experimentations depends on your goal and the new strategy you are trying out. Changing your diet for 3 days, for example, is not helpful in finding out whether it can sustain long-term weight loss. On the other hand, it may be long enough to establish that a new sleep routine works for you. Don’t give up your experiments too early – unless they are having a significant detrimental effect.

Make notes on what you try and the results. It’s useful to be able to refer back to them weeks or months later, when you might be facing a plateau in reaching your goal and need to assess why previous strategies you have used did or didn’t work. Keeping a record of your experimentations also helps capture ideas on what you could try in future – sometimes strategies which didn’t work at the beginning of the year can be ideal later on.

 

  1. Track your progress

A major reason for defining your goal and how to measure your success is so that you can record your progress. This helps keep you motivated and accountable. It stops you from carrying on regardless of whether your efforts are producing results.

Decide how often you want to track your progress. Weekly check-ins work well, because they keep your goal at the forefront of you mind, but fortnightly or monthly records might be more appropriate – it depends on your goal. Use a timescale which suits you, as long as you track your progress regularly.

Use a method of recording your progress which suits you. A gorgeous notebook might motivate you to take the time to detail your success, or using a smartphone app might provide a hassle-free and convenient way to track progress. Whatever method you use, keeping it simple will probably help you stick at it.

 

  1. Keep going!

I know I’m pointing out the obvious, but people often overlook the fact that most success is due to consistency. Hard work and determination go a long way. There are no shortcuts to achieving any goal that’s worth achieving – otherwise everyone would be doing it easily.

Sure, factors like luck can play a part, but even if you get a lucky break, you need to be ready for it. You need to have done the grunt work behind the scenes so that when a record producer asks to hear your demo tape, you can place a professional quality showcase of your talents straight into his hands. Some people might get quite far on charm and no substance, but they are rare and would go much further if they backed it up with other skills.

If you quit, the only person you are hurting is you. The world doesn’t care that you could have been the next great scientific genius or whatever – they will only care if you stick with your goal and produce great work.

Everyone has potential – but realising that potential is rare.

Choose to be one of the few who reach their potential, or at least a good percentage of their potential. Strive towards your goals and when you get knocked back, keep going. You can do it.

 

 

 

 

 

Easing into Change

I have been feeling a bit coy every time I mention this, but… I have a job. The first job I’ve had for over a decade. In fact, it’s the ideal job for me at the moment: it’s a writing job (CVs and cover letters), it’s freelance, the hours are flexible and I work from home. If all continues to go well over the next few weeks, I will be able to stop claiming ESA — which is one of my main goals for this year.

Yet, despite all of these advantages, I have been struggling with the transition. I am stressing out a lot because I really want this job to work out; because it would be devastating to fail when I am so close to achieving my goal. Part of me can’t believe that I have been given this opportunity, so I’m expecting it to be taken away at any monent. Getting into a routine has been difficult, too. I tend to either procrastinate or work nonstop for hours on end, neither of which is very healthy.

The whole experience is reminding me of the importance of transitions. Sometimes diving in head first is the right choice, but most transitions — especially if you have mental health problems — require slow, gradual changes. I’m trying to pace myself and build up the number of hours I work with each week, so that by the time I stop claiming benefits I will be earning enough to comfortably cover my expenses. In fact, that is the whole point of doing permitted work — to slowly reintroduce people with long-term illnesses or disabilities to work.

Part of me fights against this idea — I want to dive in and work as hard as I can for as many hours as I can — but I know that doing so would put my health at risk. It’s equivalent to a non-runner trying to run 10 miles every day. Stupid and counterproductive.

Instead, I am learning to be (even more) compassionate towards myself. I will not beat myself up for working too slowly or not working full time hours. I am not being stupid or lazy — I am in training for my future.

You Have Today

Today is my dog’s second birthday. It’s bittersweet, because as I mentioned in this post my last dog died the day before her tenth birthday. Birthdays, like New Year’s Eve, also remind me that life is fleeting and none of us know how much time we will be given. We can plan for the future, but there are no guarantees. All we have is today.

With this in mind, there are two vital components to getting as much as you can out of this one day you have been given:

  1. Gain as much pleasure as you can from today
  2. Take action towards achieving your long-term goals

The specific tasks you undertake will depend on your current situation. When you are depressed, it’s hard to find any pleasure in life so you may only get 30 seconds of pleasure from stroking a pet or smelling a rose. That’s great — it’s pleasure you may not have otherwised gained. If you have anxiety, taking action towards your goals may involve simply finding out whether there is an online course available in the subject you wish to study. That’s an important step and it doesn’t matter if someone else would have applied for the course straight away whereas you feel too anxious to take such a step; you are basing your actions on your own specific situation.

These teo components, pleasure and action, sound simple but simple isn’t synonymous with easy. You may need to remind yourself of them every day, perhaps by keeping a note stuck next to your mirror or setting an alarm on your phone. Procrastinating does nobody any favours. If you defer all tasks until you are in a different situation or feel better, you may spend all your life waiting.

For me, the nature and scope of tasks relating to pleasure and action can vary on a day to day basis. On my good days, I might aim to draft a short story or submit a few pieces of writing; other days, my sole aim could be to just read a page pf a book. Obviously I want to progress over the long-term, but I have to adjust my intentions every day. Today is all I have: my current mood, my current situation, my current life. All you have is today, so make the most of it.

Knowing Your Limits

I have taken an unplanned but intentional break from this blog over the past two weeks, because I was focusing on reaching my CampNaNoWriMo target of 70,000 words. I wanted to keep posting throughout the month of CampNaNoWriMo and certainly the first week of August, but my plans went awry. The main problem was that writing like crazy in the last week and a half of CampNaNoWriMo, following a two week slump, left me exhausted. Mental illness often makes people prone to fatigue, but my energy levels had been a little better lately so I didn’t consider how exhausting it would be to strive towards an ambitious short-term goal.

I resisted at first, but soon realised that I couldn’t carry on as I had planned: something had to give. Since Resurfacing and Rewriting is a long-term project and I want to maintain a high quality, it was appropriate to put it on hold. It was a difficult decision, but I knew it was the right one — focusing on CampNaNoWriMo allowed me to reach my target of 70,000 words in one month, which was an important goal for me.

Reassessing your plans and goals is essential for optimal mental health. Circumstances change, actions have unforeseen effects and priorities fluctuate. Instead of struggling to stick to your original intentions, it makes sense to step back and decide what to change. The trouble is, this can often feel like failure; we tend to measure success against our original goals.

When you have mental health problems, this can bring up a multitude of issues — will I ever be able to achieve what I want? Am I just useless? — which can negatively affect your self-esteem and anxiety. I have struggled with this a lot, though I’m getting better at seeing the bigger picture and realising that setbacks are not failures. Part of managing your mentsl health (whether or not you have a mental illness) is knowing your limits and slowing down when you see signs that you are approaching your limits.

This is easier said than done, of course! I probably should have slowed down at least a week before I revised my goals. My sleep pattern had been disrupted (more than usual, I mean: I’m prone to insomnia) and I was eating erratically. I was worried about not living up to my own expectations. I felt more stressed than I had for several weeks. However, the important thing is I stepped back and reassessed my plans before I actually hit my limit.

People often don’t give themselves credit for developing the skill of reassessing their goals. While it can sometimes feel like a cop-out, revising your plans can, conversely, enable you to be more productive and successful. Relieving the pressure provides space to explore your options and seize opportunities you might otherwise have overlooked. Instead of stubbornly slogging on and failing to reach your goals and/or harming your health, you can adapt to your current situation.

Sometimes goals aren’t worth the price you have to pay. Striving towards goals which cause more harm than good is worse than not having any goals. Don’t be afraid to be flexible when working towards your goals. Life is never 100% predictable. Reassess your goals at regular intervals and decide whether they need to be put on hold, prioritised or dropped altogether. Changing your plans isn’t weak: knowing your limits is a strength.