Tag Archives: Mental health issues

Seeking Perspective

To echo pretty much everyone, these are strange times. On the one hand, social distancing measures necessitated by the COVID-19 pandemic make relatively little difference to my lifestyle, because having chronic mental health problems means I work from home most of the time and avoid socialising because my anxiety (and finances) make it difficult. On the other hand, I’m not used to everyone else being anxious and one of the symptoms of borderline personality disorder is a tendency to absorb other people’s moods, especially negative moods. I’m veering between feeling ‘normal’ because my mental health problems have become more normalised and sinking into pits of depression/anxiety/stress. Part of me wants to wail ‘I had so little in my life and now it’s been taken away’ but I read something on social media which resonated with me: now most people are experiencing a lot of anxiety, it’s time for those of us who have anxiety disorders to teach them how to manage it.

A mini disclaimer here: these are things which help me and may be inappropriate and/or inaccessible for some people. I’m not a mental health professional and this blog is based on my personal experiences, combined with things I have read or heard about helping others. It’s also worth bearing in mind that because there has never been a situation like this in living memory, there is a lot of uncertainty about what might help individuals manage their mental health and wellbeing. As this blog testifies, mental health management involves a lot of trial and error to discover what works for you. If you are in crisis and need help, please contact Samaritans or another appropriate source of help.

Here are some ways to try and find some perspective when you are anxious during a pandemic…

Find positives

I have a theory that difficult circumstances amplify people’s true natures. It’s not very scientific, but I keep seeing evidence of kind and generous people making efforts to be more kind and generous, whilst selfish bastards behave in increasingly selfish ways. Perhaps the people who display selfish behaviour have their reasons and I know I should try not to judge, but as someone who has spent time in hospital as a day patient and a visitor to an inpatient over the past 18 months, I have seen how under-resourced and pressured the NHS is at the best of times and I don’t understand why anyone would refuse to follow guidelines designed to minimise the COVID-19 pandemic’s impact on the NHS. (Side note: If this is you, please change your behaviour and follow the guidelines because you are harming other people). However, I have also been heartened by people offering to help and support others. NHS and retail staff risking their health to do their jobs, often facing abuse from the people they are helping. People stepping up to help their communities, forming emergency groups to help those in need. Friends reassuring each other through social media. Professionals providing online resources and live-streaming everything from exercise sessions to church services.

Finding positives is hard enough in itself, so I won’t tell you to focus on the positives (although, obviously, do focus on them if you can!), but please look for some positive things in each day. I’m making an effort to practice gratitude, because I’m lucky to have a home to self-isolate in and to have the NHS. Practicing gratitude in hard times can be difficult, especially when it’s difficult to accept our current circumstances, but it can help. My personal positives include: having a sunny bedroom (thanks to my brother moving out last year!), my dog (and my mum’s dog and cat), the masses of books I have available to read, my treadmill (which I bought 9 years ago because I was incredibly unfit and too scared to leave the house alone), chatting to friends via social media, gorgeous scented candles given to me by good friends, studying Psychology with the Open University and having my brother and his girlfriend drop off a few groceries yesterday, since my parents and I are self-isolating after getting coughs last Tuesday (we’re all fine and recovering). 

Keep moving

I attended a workshop a few weeks ago which highlighted movement as an antidote to anxiety and depression. As someone who manages my mental health through exercise, among other strategies, this is a familiar concept but something clicked when the workshop leader talked about figurative forms of movement alongside physical activities. The more I thought about it, the more I realised that many of the most effective ways of managing my mental health involve movement. Since exercise is an obvious option, I will focus on the more metaphorical types of movement.

Goal-setting is the most obvious example –– I tend to cope better when I am working towards a goal and making tangible progress. It helps me feel as though I’m moving in the right direction, even if I get frustrated about how slow my progress seems. Having goals is also important to me because during my worst episodes of depression, I don’t have any goals. I lose all desire and motivation. Compared to those times, it’s better to have some goals; often they are goals which seem ridiculously small and/or impossible, but they are goals. If self-isolation and/or social distancing is causing you to feel stuck, think about goals you could put in place and work towards right now, in your own home. These might be ambitious, but smaller goals are often most effective at navigating your way through a tough time. I have used such goals many times: cooking an actual meal instead of grabbing crisps, taking a shower, simply listening to music for 10 minutes, texting a friend, etc. Your goals need to fit your current situation to be helpful.

Connected to goal-setting is planning for the future. When you are able to plan, even if these plans are nebulous and unspecific, you create the sense of a future –– and there will be a future, no matter how improbable that feels, because that’s the nature of time. This too shall pass. Everything will pass. My plans range from huge, scary, life-changing possibilities to tiny, mundane ideas about what I would like to do. For example, I may plan to read a particular book when I finish my current reading material. Life feels extremely chaotic at present, so planning things to do in the immediate future can help create some structure. For instance, I plan to replace my gym classes with strength workouts at home. Planning events and activities for after the pandemic is over can give you a sense of perspective by acknowledging that this too will pass and when it does, perhaps you would like to live your life differently or achieve goals which you have put off.

Decluttering is something I have mentioned a lot in blog posts and for good reason: it creates a sense of movement by transforming your space and can sometimes change the way you live. I started making a conscious effort to declutter several years ago. Until that point, I had been a ‘more is more’ kind of person and since compulsive overspending was a massive issue at that point in my life, my home was crammed with lots of stuff. Eventually, I reached the point where I felt trapped by my stuff –– I could hardly move around my bedroom and I felt sick when I thought about how much it had cost. I started by getting rid of things I no longer used, including the desk at which I had studied throughout my Film Studies degree but never used for writing and box files of old magazines I rarely unboxed. Decluttering can be confronting, especially after several cycles, but it has left me with more physical space and headspace. I’m probably never going to be a minimalist, but most of my possessions are now things I use and/or like and I’m more mindful in my spending. It’s hard to describe, but decluttering helps me feel more free. 

Reassess your priorities

Extreme situations tend to make us reevaluate our lives, whether it’s a personal crisis, bereavement or a pandemic. A lesson I have learnt over and over again, especially in the past few years, is that health must be my top priority. Our health (physical and mental, which are inextricably combined anyway) affects everything else in our lives. After spending a week feeling crap because of pandemic anxieties and having a virus myself (no idea if it is COVID-19, but I had a new cough so I’m following the NHS/government guidelines), I’m trying to establish/reestablish some healthy habits –– especially eating more healthily and getting back into an exercise routine. I have also been trying to get into the habit of meditating for 12 minutes a day –– I started a few weeks ago and it seemed to help, but last week’s practice was sporadic –– and I’m aiming to do more journalling, to help my mental health. If this pandemic teaches us anything as a society, please let it be to take more responsibility for our health, individually and collectively, and support each other.

Being worried about family and friends has demonstrated that I’m not an antisocial misanthrope, despite sometimes feeling like one. I care about people. I suppose this is something I already knew, but it reaffirms the priority and when this is over, I would like to do more with my friends. I have often shied away from socialising because my only dependable income is £95 a week in benefits, thanks to my ability to work being impaired by mental illness, and I owe my parents a lot of money. However, now I’m thinking I should have taken more of those opportunities to go out and socialise. 

I have also been reminded of how important my Psychology degree is to me, because learning that my exam has been cancelled and not having been informed (yet) about the alternative assessment being put in place has caused a lot of stress. The exam is one of the requirements for the degree being BPS (British Psychological Society) accredited and while it has been pointed out that all universities are in the same position, nobody has actually stated that the BPS accreditation will not be affected. I don’t want to say too much, but I’m considering a career path which involves needing a BPS accredited degree to move on to the next step, so it’s hard not to catastrophise and imagine all my plans going down the drain. I know that’s unlikely to happen and there will be a way to figure out a solution, but anxiety isn’t logical. 

Similarly, despite having issues with my writing mojo over the past year, writing (particularly fiction) is still one of my priorities. Interwoven with this is my love of reading, which is providing some distraction and a little inspiration. If I were to die soon, I would regret not having completed a novel I’m truly proud of, regardless of whether it’s published. Other regrets which I hope to guide me in future include wasting too much time on people who take far more than they give back, not standing up for myself more, spending money on things which gave me relatively little pleasure and not travelling more. Think about what you are missing right now and what you are most worried about –– are these concerns reflected in the way you usually live your life?

Be kind

Kindness is vital during difficult times and we need to prioritise being kind to both ourselves and others. Do what you can –– don’t beat yourself up because so-and-so on social media is coping so well and you’re a hot mess. We all have different experiences and resources, so we cope in different ways. Anxiety tends to fluctuate, so most of us have both wobbly moments and moments when we excel at coping and can support and empower others. Try not to compare yourself to others (I’m a massive hypocrite on this point!), because it’s not a competition.

Help others if you can, but don’t feel bad if you are struggling to keep it together and it takes all your effort to keep going through the day. As wonderful as it is to see people doing grand things to support others, sometimes a small gesture can make a big difference. Text a friend to remind them they are awesome. Spend a few minutes dancing to your favourite happy song. Share a helpful website link on social media. Try to be a positive force in the world, but remember that when you are struggling there’s no shame in giving yourself a break.

The bottom line: if you can do nothing else, the essential thing you need to do to be kind to everyone, including yourself and your family, is to adhere to the current government guidelines on self-isolation and social distancing. Even if you do nothing more, that’s enough.

Cycles of Resurfacing

When I created this blog and called it Resurfacing and Rewriting, I thought the name would represent a clear journey: my mental health was improving and I was learning to cope with being well enough to work towards some of my goals, but not well enough to function ‘normally’. I never expected this journey to be linear and was certainly prepared for setbacks, but I didn’t realise that managing my mental health and attempting to chase my dreams would take the form of numerous cycles. These cycles have varied in duration, how difficult they are to endure and their impact on my life. 

I’m currently resurfacing after a particularly difficult cycle, which was caused by having very painful gallstones for 15 months. Living in pain takes its toll on your mental health, regardless of whether you have a pre-existing mental health condition. I’m lucky that my pain was temporary, since I had my gallbladder removed just over a month ago, but I struggled to explain the pervasive and unrelenting nature of my pain to other people. I would say ‘I’m in constant pain’ and some people would interpret this as meaning I had frequent episodes of pain, whereas my reality was significant baseline pain 24/7 and frequent episodes of worse pain. I could sometimes distract myself from the pain, but it was always present. 

Living with pain is depressing in its truest sense: I lost hope that my situation would improve and lost motivation to try. My feelings of helplessness and suicidal thoughts increased. I socialised less than usual (which is very little), because I found it difficult to focus on other people or having fun when I had my arms clamped around my stomach, trying to ease the pain a little. The only things which seemed to ease my pain were heat pads and lavender oil, which are difficult to use when outside your own home. My anxiety increased, because I had constant nausea and during my worst episodes I would collapse with pain and/or vomit so I was terrified of this happening when I was in public, especially if my mum wasn’t around to help and explain what was happening. I pushed on with my basic exercise routine and Open University studies simply because I knew failure to do so would make my mental health significantly worse.

After my surgery, the nausea disappeared straightaway and within a few weeks, my pain levels were lower than the baseline pain I had experienced with gallstones. I haven’t experienced any post-op pain which was equivalent to my worst episodes. The general anaesthetic didn’t affect me as badly as it did when I had eye surgery––rather than feeling as if I had the flu, this time I just felt tired and found it difficult to concentrate on anything for very long. These problems have eased over the past two weeks, so I feel alert and focused enough to get back to studying and writing. In fact, I feel pretty good and sometimes forget my core muscles are still a little sore… until I try to lift something too heavy or twist/reach in a strange way!

In many ways, 2019 feels like a write-off year. I failed to make progress in many of my goals and when I did achieve something, such as passing my Psychology modules, I felt I wasn’t making the most of the opportunity. My mental health declined after two years of improvement (on balance). Each step forward I took seemed to come at a great cost and was quickly reversed. I ended the year feeling battered and beaten, although knowing I would be starting 2020 without a gallbladder was a great source of hope.

So 2020 is about resurfacing and getting back to my priorities. 

My goals for this year are mostly the same as last year, since I didn’t achieve them: increase my fitness and strength, reach my goal weight (made more challenging by gaining 25lbs from my lowest recent weight), save more money and complete a novel draft I actually like. These goals are specific and measurable, but I won’t bore you with the details! However, I also have two more nebulous goals… Firstly, I want to enjoy writing again and be guided by what I love to read and write, rather than what I think I should write or what seems more marketable. I have lost my writing mojo and although I completed some short stories last year, writing often felt like a chore and I lost confidence in most before submitting them anywhere. Secondly, I want to have more fun and surprise myself. I have no idea what form this will take, so I’m trying to keep an open mind and find out. 

Since I’m recovering from surgery and still struggling with my mental health, I have decided to follow a few strategies when working towards my goals.

1. Reminding myself of my whys.

My core values are creativity, curiosity and compassion, so I try to use them as a compass. I want to write in order to connect with other people and promote empathy towards other people, especially those who experience mental health problems. I want my writing to be entertaining, informative and thought-provoking. I also hope it inspires other people to chase their dreams, especially if they feel held back by mental illness. My Psychology degree feeds my curiosity, but I would also like to use it to help other people––although I’m not yet sure how I will do this––and I hope it informs my blogging.

2. Easing in.

My instinct whenever I feel well enough to work towards my goals is to jump in and try to make up for lost time. This doesn’t work. Partly because it takes its toll on my energy and mental health, so I get ill and have to stop. I’m trying to get better at pacing myself this year, so I’m trying to ease back into working towards my goals where possible (university deadlines aren’t very flexible!) and build up momentum as I get stronger. 

3. Seeking joy and inspiration.

This means appreciating the ‘small things’ in my everyday life and reading about people who inspire or motivate me to keep going. I’m trying to focus on the process of working towards my goals, rather than just the results, so I want to place more emphasis on enjoying activities for their own sake. 

I hope 2020 will be a year of recovery and growth. While I have always valued health, especially since my worst years of depression and anxiety, my experience of gallstones has highlighted its importance even more––which is why losing weight and living a healthier lifestyle continues to be my top priority, alongside improving my mental health. I’m sure the ‘rewriting’ stage will come at some point, helping me reframe my experiences and view 2019 in a more positive light, but for now I’m resurfacing and coming back to my life.

Accepting Struggles

One of the hardest aspects of long term mental health problems is spending a significant proportion of your life struggling with stuff which comes easily when you are at your best. Some things I may never find easy: crowds, dealing with inconsiderate people and talking to strangers will probably remain nerve-shattering experiences for the rest of my life. I’m not talking about pushing at the boundaries of my anxiety––I’m talking about mundane tasks which aren’t a challenge on days when my mental health is adequate, but become next to impossible when my symptoms increase.

Studying is the most obvious example which comes to mind. Usually, I can tackle reading and note-taking with no issues. Even on days when leaving the house seems insurmountable, I can do a little studying and feel as if I have done something worthwhile. However, common symptoms of depression (which I experience) include loss of concentration, lethargy and lack of motivation. There are some days when I take out my textbook and struggle to take in any information.

Last week, I spent four hours trying to write notes on a chapter of my psychology textbook. I had already covered the material, highlighting key points and making margin notes, yet I struggled to get anything down. After producing a few measly pages of notes (and my style of note-taking is loosely based on mind mapping, so there aren’t many words to each page), I gave up.

Years of negative thinking patterns have programmed my response to giving up: I beat myself up for being useless, lazy, worthless, stupid, incapable of basic functioning… you name it! What was the effect of this negative self-talk? Did I become more productive and sail through my to-do list? Er, no. I spent a few days feeling even worse than usual––which, considering I have chronic depression, is pretty bad.

My mood has shifted this week and there has been a positive effect on my productivity. With relatively little effort (compared to last week), I have completed most of the tasks on my high-priority to-do list. To put this in perspective, my average for the past couple of months has been completing approximately one third of my highest priorities each week and accomplishing little else. I’m delighted to be having a good week and try to ignore the voice in my head which tells me I don’t deserve to feel productive or that I need to get ahead now because, before long, something is bound to go wrong and mess things up. However, it’s hard to accept that there can be such a difference in the space of a single week.

I can’t control my symptoms on any given day. I repeat this often, because it’s a concept which a lot of people find difficult to understand. “You were fine the other week” they say, when I’m having a panic attack in the supermarket, or “You can write thousands of words some days, so why not every day?” But despite understanding the concept, I myself struggle to accept the reality.

Planning to have a “good day” when a deadline is looming or I have something special organised doesn’t work. I tell myself it’s important to finish this task ASAP because it will make me less stressed in the long run, but piling on the pressure just makes things worse. If I could plan all my bad days, it would be very convenient––I could choose to have them all during the summer, when I’m not studying, or dot them throughout the year and be prepared each week. Unfortunately, mental illness––and life––doesn’t work that way.

I’m learning (and relearning) to accept my bad days, because trying to fight them makes everything worse. Instead, the best strategy is to let go of my plans for the day and give myself what I need, whether that’s a run to boost my mood, resting to improve my wellbeing or reading to seek inspiration. Last week, once I had wasted a few days feeling terrible, I stepped up the self-care by feeding myself more nutritious meals and countering the negative thoughts using CBT techniques. I still didn’t feel amazing, but it was better than nothing.

I also realised my initial reaction to my improved mood and productivity this week wasn’t helpful: feeling angry and frustrated about feeling so awful last week was pointless. Instead, I could frame this week as a reminder that good days will always come again. They might take their sweet time in coming––sometimes months––and be too few when they do arrive, but they will come.

I hope these intense, prolonged struggles won’t be part of my life forever, but if they never go away then I need to accept them. Fighting them doesn’t work––it’s like trying to wrestle water. Moreover, if I do spend the rest of my life shackled by my mental health problems, I need to dredge my struggles and find something positive amongst the dross. I guess that’s what I attempt to do with this blog––thanks for reading!

The Work of Wellness

I recently read a book called How to Come Alive Again by Beth McColl, which has led to me thinking a lot about a subject which doesn’t get discussed often enough: the work involved in managing chronic mental illness. One of the book’s strengths is its acknowledgement that readers will have varying levels of functionality and these may fluctuate a lot, even over short periods of time, yet everyone has to work hard to try and maintain or improve their mental health. Some days, this means challenging ourselves and flying through a list of tasks. Other days, it means forcing ourselves to do basic tasks like drinking some water or getting out of bed. It’s all work.

A lot of people take this work for granted. If you haven’t spent years struggling with your mental health, it may be difficult to believe that simple activities are hard work for some of us. You may not understand how taking a shower can sometimes seem like a gargantuan challenge. You might wonder why people who have mental illnesses can’t just “pull themselves together” and carry on like a “normal” person (a viewpoint I have, unfortunately, encountered many times). But doing these things can be hard work. Mental health problems can drain us of energy, motivation, self-belief and a thousand other things which would enable us to cope better. Things which many people don’t need to consider when tackling mundane tasks.

Working on yourself

Managing one’s mental health also involves extra work, such as addressing complex issues and engaging in activities which have a positive neurological and/or psychological effect. Last week, some counsellors of my acquaintance were talking about their work and mentioned that many clients expect counsellors to fix their lives for them. Instead of embarking on counselling to work on their issues, they seek a quick fix. As one of the counsellors said, “I can’t fix their lives for them. I’m not magic.”

I was fascinated by this conversation, because I have received counselling at different points in my life and had never approached it as a quick fix. In fact, the NHS counselling I have received in the past is often criticised for being too brief to be effective in the long term: six sessions, the first of which is an introduction rather than a proper session. I went through two or three rounds of this with different counsellors and it was a sticking-plaster solution which helped me feel slightly better for a few weeks, only to deteriorate when I encountered more challenges. I had been given neither the support nor the skills to negotiate life as someone who has mental health problems. This started to change when I was given a year of drama therapy, which enabled me to work through a lot of personal issues.

I have also received longer-term counselling (around nine or ten months) from a local charity in more recent years and I was grateful to be given the opportunity to learn coping skills, including how to be more supportive of myself. The counselling itself was hard work, but putting what I have learnt into practice is an ongoing slog. I need to learn to be more accountable to myself now I don’t have anyone to check I’ve done my “homework” each week. Learning not to judge and criticise myself is also a constant challenge—I worry I’m not pushing myself enough and accuse myself of being lazy, even when I know I’m doing my best.

Tailoring your work to fit you

The work I do to manage my mental health is very personal—not so much private, but adapted to my own needs and preferences—and probably looks different to what many other people do. It has been a long process of trial and error which is still ongoing. I have also changed my approach at different points in my life, depending on what is most effective at any specific time.

The biggest difference in my approach over the past eight years is the prominence of exercise in managing my mental health. I started walking on a treadmill, because I was too scared to walk outside alone. My intention was to get a little fitter, because I had been very inactive for a couple of years and my lack of fitness was beginning to scare me. I had no idea it would lead to the decision to replace medication with exercise and if I had started getting fit with that intention, I probably would have been disappointed because it took around four years to reach the point where I could consider reducing my antidepressants.

Medication is another thing people consider a “quick fix” yet, like counsellors, antidepressants are not magic. They rarely work instantly—it can take several weeks to see an improvement, which is normal—and it may take some experimentation to find a variety and dosage which works for you. However, even when I found antidepressants which helped me, I didn’t experience the complete turnaround in mood expected by some people: they simply took the edge off my depression, which meant I could do more basic self-care tasks and work on improving my mental health.

All of these things seem so ordered when I write about them: counselling, medication, exercise and other coping strategies all organised into discrete boxes, all tracking a linear progression from “worse” to “better”. The reality is very different. My symptoms fluctuate a lot and the treatments I have used have been both effective and ineffective at different times.

I emphasise this point because reading about other people’s mental health can create false impressions, especially since many of us can’t write about our experiences during the worst times so write with the benefit of hindsight. These paltry lines of writing represent over fifteen years of struggle following my diagnosis of anxiety and depression; especially during the eight years before I was diagnosed with BPD (borderline personality disorder) and could finally make sense of the symptoms which didn’t fit with anxiety and depression. I don’t think I could ever fully convey my experience and while I can make sense of chunks in retrospect, other aspects I will never understand.

It might be tempting to take some things out of context and to make assumptions about the decisions I have made about managing my mental health. For example, many people assume I disagree with anyone using medication because I have stopped using it myself, whereas I actually credit antidepressants with keeping me alive. Without medication, I would not have been able to access therapy and counselling. I would not have started exercising. I would not have been able to do a large proportion of the work I need to do on a regular basis in order to maintain and (hopefully) improve my mental health.

So, what does this work involve?

My current mental health management plan prioritises exercise: strength-based gym classes and dog walking constitute its core, but I add running and yoga when I feel able. Exercise has a strong impact on my hormones and neurochemicals, which is why I have found it effective as a direct replacement for antidepressants (though not without its drawbacks). I also find it very powerful psychologically, as feeling strong and fit helps me feel more prepared for life’s challenges and I gain a sense of achievement from every workout.  Focusing on strength and fitness means I approach exercise with a healthy attitude—it’s not merely a way to control my weight through burning calories and I know that over-exercising would risk injury without providing extra benefits for my mental health. My exercise plan also gives my life structure, but without forcing me into a strict routine which I would be unable to follow when my symptoms fluctuate.

Regular exercising makes it easier to practice self-care, as it means I have to shower often. Basic hygiene may seem simple and non-negotiable if you have never had depression, but showering less often is one of the key signs I’m relapsing. Ditto with changing bedsheets and wearing clean clothes. This might manifest in subtle ways—leaving it a few days between showers but making the effort when you need to go out or be around people—and may never progress beyond this point, but it can get worse. Sometimes it can feel pointless to make the effort to shower, because your illness prevents you from leaving the house. I have been in this position and yes, I might have felt better if I had showered more often, but I was in a lot of emotional pain and had no energy. Nowadays, self-care tasks piggyback on my exercise routine: I shower more, so I change my sheets more and wear clean clothes more often. It also helps me sleep better, which further improves my mental health.

A lot of the work I do to get/stay well comes under the umbrella of “stress/anxiety management”, which is my way of describing a variety of techniques I use to varying degrees. Goal-setting and planning are key strategies for me, because they help me to focus and stay vaguely motivated. I use breathing exercises when I feel particularly anxious, including 7-11 breathing (inhale as you count to 7, exhale for 11) and box breathing (in for a count of 4, hold for 4, exhale for 4, pause for 4 and repeat as needed). Venting my current stresses on paper also helps me feel better, especially if I can identify action points which could reduce or solve the problem, and I sometimes use a few CBT (cognitive behavioural therapy) techniques I have learnt over the years.

None of this work is easy, especially when my symptoms worsen, but there are some areas with which I struggle a lot. Nutrition is difficult because I’m prone to emotional eating and often grab food which is convenient rather than healthy. My diet is generally healthier than at any other point in my life, but I sometimes slip into unhealthy habits—a situation which is not helped by my gallstones symptoms. Perhaps I will be able to prioritise nutrition in future and do stuff like meal prep and batch cooking every week, rather than intermittently, but it’s not something I’m rocking at present and that’s okay—I try to do what I can and I may fall short of my goals, but I’m doing my best.

Considering the macros along with the micros

Most of the work I have detailed is done at the “micro” level: small tasks performed on a daily or weekly basis. This type of work is what fills most of my days. When things are going well, it helps me feel in control and gives me the ability to enjoy my life. Doing the “micro” work also puts me in a better position to handle the “macro” work.

The “macro” work is the big picture: what I want out of life, my long-term goals and mental health management from a higher perspective. Again, this work is very personal. My priorities are my writing career, inspiring other people with mental health issues to chase their dreams, owning my own home (which seems impossible) and having fun along the way. Your priorities may look very different. My current priorities are different to the ones I have had in the past and will have in the future—they are subject to change, but they emerged from my values and I use them to guide me.

Keeping sight of the “macro” work can be extremely difficult when you have mental health problems. When you are struggling to get through each day, you can’t think about long-term goals. Yet, there’s a paradox: keeping my long-term goals in sight reminds me why it’s worth struggling through the days, why it’s important to keep working on self-care and the other “micro” work which helps me feel better. It gives my everyday life a sense of purpose.

I have learnt to revisit my “macro” work on a regular basis (at least once a month) for this reason. It makes my life meaningful and it makes the small steps I take each day meaningful. Do I get frustrated when I seem no closer to achieving my long-term goals and pushing through my daily wellness work feels like a massive challenge? Of course! I’m human. I wish I didn’t have to deal with mental illness every single day of my life, but it’s the material I’ve been given and I have to mould it as best I can. Considering the “macro” work also reminds me to check for progress, no matter how small, which I might overlook. For example, submitting a short story or making an extra debt repayment. My progress may be slow and excruciating, but it’s still progress.

You control your own work

Nobody can tell you what to prioritise in order to manage your mental health—trial and error is the only way to find out what works for you. It’s annoying when we would all prefer a quick fix, but it’s the nature of mental illness. Just in case you need me to point out the obvious, this also means you can’t dictate what other people should be doing to improve their mental health. You don’t know their struggles. It might be easy to judge from afar and when we find something which works for us it’s tempting to evangelise, but we don’t know what will help other people. You don’t get to decide what treatments and coping strategies someone else tries—they do.

You get to decide what you try and how to determine whether it’s effective. For instance, you may find something which helps you, but is too difficult to implement or access on a regular basis. You need to consider the costs and benefits of different types of work. Some of my current strategies would not have worked for me at other points in my life. For example, I tried to exercise at many different times, but struggled to create a routine—I could only establish some structure when I was well enough to attend gym classes. I still get anxious when I go to gym classes, but the benefits are worth this cost and if that changes, I would have to reconsider my situation. Likewise, the CBT techniques I find helpful nowadays were introduced to me in my NHS counselling sessions and didn’t help at the time. It’s important to keep trying new—and old—things to find out what works for you and your lifestyle right now.

I am not magic. I have to put a lot of work into managing my mental health and trying to get well. Sometimes I make progress, but other times I seem to regress and wonder why I bother making the effort. However, I’m learning that when I keep trying to do the work of wellness, moments of magic come into my life. Half an hour of feeling enthusiastic and joyous, rather than anxious, when I’m chatting with a friend. A moment of gratitude when a butterfly crosses my path. Three solid hours of working on a project which could turn into something. These fleeting moments might seem insignificant, but there have been times when I experienced nothing good or positive for weeks on end. Nowadays, if I remember to look, most days contain a little magic.

Setbacks and Balancing Acts

I haven’t blogged for a long time and there are usually two reasons: either I’m ill or I’m very busy. Both apply to my recent absence. I have started a new job, which I’m very pleased, excited and anxious about! It’s only six hours a week and temporary, but I want to do my best and have a significant impact, as I will be working with young people on an art project exploring mental health. My studies with the Open University continue, which is a heavy workload because I’m taking two modules (60 and 30 credits) this year and it gets very intense when deadlines are close together. In case this wasn’t enough upheaval, The Universe decided to throw a spanner into the works…

Balancing wood

I have been experiencing a lot of abdominal and middle back pain since October, along with constant nausea and some other symptoms. At first, I thought I had gastritis because I’m prone to getting bad gastritis, but some of the symptoms didn’t fit and the pain didn’t subside like it normally does. Last week, an ultrasound scan confirmed I have gallstones.

While it’s good to have a diagnosis, after three months of not being sure what was wrong, knowing I have gallstones doesn’t stop them from disrupting my life. A lot of people reacted to my suspicions that I had gallstones by saying “ooh, that’s very painful.” Now I know I have them, I can confirm that yes, they are extremely painful! I’m seeing my doctor next week, but in the meantime I spend most of my day with heat pads clamped to my upper abdomen and middle back/shoulder blades.

The gallstones are disrupting my life in general, making it difficult to establish a routine — which is something with which I struggle most of the time anyway, having to work around my mental health problems. They also stop me from following my exercise routine, which I depend on to manage my mental health, meaning the depression and anxiety have been taking hold. It’s been a stressful few months, for various reasons, and my physical health is preventing me from using some of my main coping strategies.

It’s easy for people to say I shouldn’t worry and to take it easy, but regular exercise is crucial for my wellbeing. When I stopped taking antidepressants, I replaced them with physical activity. Exercise has loads of neurochemical and psychological benefits which are essential for me to cope. Being unable to go to classes or run because I’m curled up in a ball of pain and/or vomiting has huge implications for my mood over the following days and weeks.

So I have been struggling.

The sporadic exercise and odd eating patterns have taken their toll: I have gained weight and am around 10lbs more than I was in October, when I reached my lowest weight of 174.5lbs. I use the word “around” because I’m extremely bloated and my weight varies a lot. I can be anything between 180lb and 190lb on any given day. I feel fat and puffy. It’s difficult to keep things in perspective and not feel like I’m undoing all my hard work.

I’m also painfully aware that gallstones can be caused by weight loss, which feels like a punch in the gut. For the first time in my life, I have been losing weight with a healthy approach — a healthy mindset and a healthy eating plan. I haven’t lost weight quickly or followed a high protein diet, both of which are associated with gallstones. Health was one of my main motivations for losing weight, as I have a close family history of heart disease and type 2 diabetes, which I would like to avoid. I did everything “right” and perhaps it’s stupid and immature, but I feel as if I’m being punished.

Balancing everything is very difficult. I’m trying to practice self-care and focus on the positive aspects of my life, but it’s hard. I feel as though I’m being dragged backwards just as things were beginning to go well.

Logically, I know the improvements I have made cannot be undone, especially by gallstones and a dip in my mental health. I’m still managing to work and study, thanks to both having very flexible hours. I have made it to most of my gym classes, although it’s frustrating when I have to cancel one. Gaining 10lbs is hardly slipping back into my old ways when I’m 60lb lighter than I was at the beginning of last year and over 100lb under my heaviest. I know plenty of people struggle much more than me, but it’s frustrating to see my progress slow or halt when I want to rush forward.

I’m trying to think of this period as a sidestep off my path (to recovery, achieving my goals, leading a life worth living, etc) rather than slipping backwards. I need to take the time to recover and do what I can, instead of pressuring myself to chase down more goals. In fact, my goals for 2019 are all continuations of what I have been doing: losing weight/getting fitter, working on my writing and trying to improve my finances. Sure, I wish I could achieve them all at top speed, but slow progress will still get me where I want to be.

I love setting goals, chasing my dreams and challenging myself, but sometimes we need to step aside and take a break. To maintain our position instead of risking harm by pushing on, regardless of how much it hurts. Strip everything back to your priorities and do what you can, instead of stressing about what you wish you could do.