I submitted my final assignments for the Open University modules I’m studying this year well before the deadlines and I’m going to explain why I don’t consider this a Good Thing. The last two assignments are End of Module Assessments (EMAs) which are supposed to be analogous to exams, so there are no deadline extensions. Since my mental health is unpredictable and my current physical health even more so, I had to make contingency plans in case my mental health plummeted or I had bad gallstone attacks in the weeks before the deadline. It’s a coping strategy I wish I didn’t have to implement, but I have learnt that this degree of flexibility is necessary for me.
Preparing to be thrown off course by my mental health is an integral part of goal setting. In this case, I had to get ahead when I felt well and finish the previous two assignments, with deadlines in April, as soon as possible so I could focus on the EMAs. It was pretty intense, but ensured I had several weeks to work on the EMAs. Do I really need several weeks’ leeway? Absolutely. My health can easily become a huge issue without warning. My mental health can go into freefall and the scariest aspect is, sometimes several weeks wouldn’t have been enough leeway.
I was lucky this time around. My mental health has taken a downturn recently, but I could work around it.
What does “working around” my mental health mean?
Put simply, it means doing whatever I can, whenever I can. It’s how I live my life. Some days I can function like any other person and be very productive; some days I am unable to do anything other than slump on the couch, my mind whirring but producing nothing. Most days are a mixture.
Living with mental health problems is difficult, so I have had to devise coping strategies which work for me and help me to be more productive. These include:
Identifying my priorities at any given time. When mental illness limits the number of hours I have available to work (or do anything else), I need to know the best way to spend those hours.
Being super-organised. Depression and anxiety affect my memory, so I write everything down. I need to know my goals and break them down into tasks. I put these tasks on my to-do list, which is divided into high, medium and low priority tasks for each week. I also have a future to-do list, for tasks I can’t or don’t want to complete at the moment.
Being flexible. Because my mental health is unpredictable, scheduling tasks on specific days doesn’t work very well for me, so I try to avoid it unless it’s absolutely necessary. I sometimes allocate tasks to certain days, but I don’t beat myself up if I can’t stick to this plan.
I wish I didn’t have to use these coping strategies. I would love to be able to plan to work on my EMAs for a few weeks before the deadline, like most other people, but no possibility of an extension means I need to prepare for ill health.
This also applies to all other aspects of my life.
I’m sure some ignorant people assume I can do non-work tasks without making contingency plans and these are probably the same people who think mental illness is just an excuse to avoid work, but my mental health affects all aspects of my life. I have had to cancel countless enjoyable activities. For every night out I’ve had with friends, there were five I had to cancel at the last minute and hundreds I never planned because I knew I couldn’t handle it. When my mental health dips, I struggle to do anything, including leisure activities I can do at home, alone. During these periods, I can’t even read or concentrate on watching a film.
I used to feel incredibly ashamed of being forced to live this way. Many friends slipped away because they didn’t understand why I couldn’t go out like a “normal” person and often struggled to leave the house at all. They got bored with hanging out at each other’s homes when anxiety prevented me from going to the cinema or a café. However, as I get older, I’m learning to accept that this is the way it has to be. For now, at least. If so-called friends can’t accept my mental health problems, they can thank their lucky stars they’re not in the same situation and fuck off.
I wouldn’t have chosen this life of constant contingency planning, but I’m learning to make the best of it.
I’m getting better at controlling the things I can and letting go of whatever I can’t control. Better, but nowhere near perfect! I still get frustrated with myself, the universe and life in general, but I keep working towards my goals. My aim is simple: improvement. My life probably won’t change completely anytime soon, but most days are bearable and I’m proud of the goals I’ve achieved.
I can’t celebrate submitting my EMAs early, because I wish I didn’t have to rely so heavily on contingency plans, but I’m proud that I submitted them. Two years of my part-time Psychology BSc down, three (hopefully) to go!
The clocks going forward is always welcome to me, because the improvement in my mood is almost immediate. Everything shifts. It doesn’t mean I don’t have bad days and my depression doesn’t get cured miraculously, but I’m a little less depressed and it’s a little easier to cope. I feel less overwhelmed.
The brighter evenings make it easier to use some coping strategies which I find helpful, including spending more time outside and exercising outside. I can organise my day so that I can make time to walk or run in the evening. The change to BST is a powerful reminder that spring is here and summer is coming: things will change and get better. When my days are (generally) brighter and warmer, focusing on the positive aspects of my life becomes more natural to me.
Summer will also bring the end of my second year studying for a Psychology BSc part time with the Open University. I have three assignments left to complete for my two modules. It has been a difficult academic year, because the first half coincided with my gallstones making themselves known. Before I got diagnosed, I found it incredibly hard to cope. Until the past month, I was constantly trying to catch up on the work I had neglected when I was ill, falling behind on one module as I struggled to meet an assignment deadline for the other. I wish I had managed to enjoy studying more, as I find the subject fascinating and a lot of the material resonated with me.
Thankfully, my gallstones are a lot quieter at the moment, although I dread another bad attack. I still have the baseline pain and nausea, but I have found ways to cope. A friend recommended rubbing lavender oil on my stomach, because it’s anti-spasmodic, and that has been more effective than anything else I have tried (thanks, Su!). I also rely heavily on heat pads and find that intermittent fasting (eating during an 8 hour window) helps a lot. I still get moderate attacks, but not severe ones like I was getting from October to January, which left me writhing on the floor in agony. I’m hoping this will continue until June, because my end-of-module assignments are due at the end of May…
I’m also coping better because I’m exercising more, although there is some circularity in that it’s easier for me to exercise more when I feel better! I have been running again, which is brilliant for both my mental health and the gallstones. Although it’s difficult to ignore the gallstones pain, especially as it likes to affect my back and the tops of my hips (the iliotibial band), the endorphins kick in after 10-15 minutes and are an effective painkiller. I get a psychological boost from exercising, as well, because it helps me feel fit and strong. Knowing I’m getting stronger physically helps me feel as if I’m getting stronger mentally.
It finally feels like I’m moving forward again, after a hard winter. I’m making progress towards my goals, even if it’s slower than I would like, and things are beginning to change.
I have spent four months in”maintenance mode” and I’m sick of it. While it was necessary to cope with the pain of my gallstones, especially for the three months when I didn’t know what was wrong, I felt as if my life was on hold and my mental health was suffering. The gallstones seem to have calmed down: I still have the baseline pain and constant nausea, but I’m learning to handle it and the really bad episodes have become less frequent. Combined with the frustration of feeling stuck, I decided it’s time to refocus on my goals.
Top of my list is getting back to losing weight. It feels strange to admit, because I struggled with an eating disorder for many years, but the past few months have taught me that health is valuable and shouldn’t be taken for granted. I already knew that, but life has a way of re-teaching the lessons we need to learn and in this instance, the lesson was about physical health. I want to lose weight primarily to reduce my risk of heart disease and diabetes. My dad has both of these conditions and recently had a heart attack and double bypass. I don’t want that to be in my future, so I’m trying to avoid it by taking control of the factors I can influence: being a healthy weight, staying fit and eating well.
Exercising is also a priority, mainly because it’s the most effective way of managing my mental health. My doctor has encouraged me to stay as active as I can, because it will help me recover faster when I have surgery to remove my gallbladder. Knowing I can exercise without causing damage is a huge relief, especially after exercising caution when I didn’t know what was wrong, and I feel better when I exercise more often. My anxiety is easier to control and I feel less depressed. I also feel better physically, in a way which is hard to describe: generally fitter and stronger. Like I can handle anything that comes my way.
I’m slowly beginning to piece my life back together and have begun challenging myself a little… One of my mini-goals for this year is to be more confident when driving and I recently drove on my own for the first time in approximately two years. It feels strange to admit, because I passed my test nearly nine and a half years ago, but driving became a source of anxiety for me and it was easier to avoid it than to suffer. And that’s okay. I may feel a bit ridiculous for being unable to drive for such a long period, but I think it’s something I needed to do.
The past four months have been a reminder to take care of myself and switch to “maintenance mode” when I need to, but they have also taught me not to let problems stand in my way. It might be a while before my gallstones get sorted out, so it’s another burden I have to carry, but I’m pretty damn strong. I can take the weight and keep pushing onwards and upwards.
I spend a lot of my time thinking about goals, which are both a key strategy in managing my mental health and a source of frustration, anxiety, disappointment and other feelings which contribute to my mental health problems. On balance, working towards my goals (and achieving some of them) has a positive influence on my life. They give me a sense of purpose and fulfilment. However, this year has been a little strange, because one of my goals is becoming very visible to other people: I want to lose a lot of weight and have lost almost 5 stone.
Announcing my goals is something I find very awkward, even when it’s necessary. For example, fundraising for charity was an integral part of my trek to Machu Picchu last year and telling people about my goal put a lot of pressure on me. On the other hand, being open also enabled people to give me a lot of support and encouragement, which helped me achieve my goal.
Odd as it sounds, one of the few advantages of severe mental illness is that nobody has any expectations of/for you. During my worst points, I felt my life was such a huge disappointment and burden to people that I couldn’t disappoint them any more than I was already disappointing them. Having a shower or cooking a meal was a massive achievement; I had no other goals.
So having goals is a positive sign. I am trying to live a better life and working towards my goals indicates that I have some degree of hope (if not confidence) of achieving them. However, there is a shadow side: I’m terrified of disappointment and every failure along the way is a reminder that I have let down my family, friends and myself.
But people don’t always see the failures.
People complimenting me on my weight loss is great, especially since I can’t see the difference as clearly myself, but it has made me think a lot about how my experiences differ from what people see. It has also made me realise there are parallels with other goals and aspects of my life, which are less obvious because I can’t measure them in the same way that I can track my weight and clothes size.
My weight loss has become more visible over the past few months, so people see I’m now a size 14 instead of 18. They didn’t notice the first few months of this year, when I started eating less/more healthily but couldn’t see the results. People don’t see the weeks when I lose no weight, despite following my eating and exercise plan. They don’t see me getting frustrated and discouraged because the effort doesn’t seem to be paying off.
Likewise, people view my mental health from the outside. They only see me on my good days, because I can’t leave home on my bad days. My anxiety may seem much better, particularly as I get used to specific situations (gym classes, writing group), yet I still get panic attacks. I’m still too scared to drive or into a shop alone. There are days when I spend hours worrying about everything from whether my dog seems a little “down” to if I will ever repay my debt or move out of my parents’ house.
The outside only shows part of the picture. Yes, I have lost weight and my mental health is generally better nowadays, but neither has been as straightforward as it seems. My progress hasn’t been linear — and my mental health can be very erratic — but it looks linear to other people, who don’t see the effort, frustration and frequent disappointments.
The changes started a long time ago and it has been a rocky road.
While I consciously choose to work towards my goals at particular times, my ability to do so is often rooted in changes I made long before setting them. At my highest weight, during the final year of my BA in 2010-11, I was a size 26 and have no idea what I weighed except it was definitely over 20 stone. Yet I had already begun to make the mental changes which are helping me to lose weight this year: when I decided to go to university, I decided I was worth the effort. I was worth the expense. I was worth the risk of failure, embarrassment and disappointment.
At 18, when I had a place at another university in a different subject, I made a different decision. My self-esteem was nonexistent and I didn’t think I was worth the cost. I wasn’t worth the hard work.
I went through a lot of pain and despair before I started to build a little self-esteem. I took antidepressants and had counselling. I tried to help myself, but I failed a lot of the time.
Along the way, I tried to cheat my way to self-esteem by losing weight, going from a size 18 to a 12 in a few months. (Sidenote: sacrificing muscle tissue for a lower number on the scale is a stupid thing to do and takes ages to repair). I half starved myself, binged because I was hungry and then punished myself by eating even less. Over and over. I thought I would like myself if I could fit into a size 12, but I was wrong.
Eventually, I got sick of my life. I was 23 and my mental health had improved a little, but I hated everything about my life apart from my dog. One of my best friends was working in Spain at this time and had invited me to stay with her for a low cost holiday. I hadn’t been away since a family holiday when I was 17 and I love sunshine, so I was tempted. I had enough money for flights, food and spending. I was running out of excuses — except the usual one of having crippling anxiety. But I was sick of that excuse, too. I booked my flights and knew I would have to go through with it, even if I failed.
Looking back, I think that was the start of believing I was worth anything. I was sick of staying inside the house and missed my friend, but I also wanted to be the type of person who could travel somewhere. Someone who wouldn’t be fazed by going on a plane alone (and for the first time, to boot!).
That holiday changed my life because I realised I could do more than I anticipated. I could travel by plane without having a panic attack. I could wander around Valencia alone. I could even speak a few phrases of Spanish, including “I miss my dog!” I loved the holiday and it was well worth the costs. It opened up the possibility that I could do more. By the time I got home, I had decided I would try to get a place at university the next year.
I hedged my bets a little, going to my local university to minimise expenses and ensure I had some support at home, but I was trying to achieve something I had once thought was impossible. I believed I had missed my chance of going to university, but I was proving myself wrong.
My graduation was one of the happiest days of my life. So many people point to photos of themselves at their highest weight and say how miserable they felt, but I was happier than I had ever been. I was still struggling a lot and my weight is an indication of that, because I have always had a tendency to comfort eat, but I had finally gotten a degree. I was disappointed to have missed out on a First after my grades dropped in the final year, thanks to the stress of being diagnosed with borderline personality disorder and an eye condition which can lead to blindness in a single month, but a 2:1 was better than no degree. Besides, I already had a place on the Creative Writing MA course and was focusing on the next goal!
I became concerned about my physical health, which had taken a backseat for a long time. My fitness was atrocious and my habit of buying crisps and chocolate bars at the university shop had to stop now I didn’t have a student loan to finance the habit. I was too scared to walk outside alone, so I bought a treadmill (which is how I know I was over 20 stone, because I had to take weight limits into account when choosing one) and started walking. By the end of summer, I had dropped to a size 22.
I can pinpoint my current attitude to that summer: I started focusing on fitness and weight loss as a path to better health. The journey since then has been up and down, but although my weight has fluctuated a little, I haven’t gained a dress size since that time. I was finally making lifestyle changes — and for the right reasons.
I know I have come a long way, but it doesn’t always feel like it.
Part of the reason why I set myself a lot of goals is because so much of my life seems to stagnate; working towards goals reminds me that I’m making progress. I think this is especially important because monitoring my mental health is difficult.
Many aspects of mental health are intangible and while some symptoms improve, others regress. For instance, my anxiety and depression are generally much better than in my final two years at university, yet I drove 50 mile round trips to lectures four times a week and the most I have driven this year is a few 7 mile trips with my mum beside me. Having goals stops me from fixating on what I can’t do, switching the focus to what I can and might be able to do.
I achieved one of my key goals for this year at the weekend: I ran a half marathon. It has been a useful goal because, in addition to improving my fitness, running teaches me a lot about life. My main goal was to complete the half marathon, which meant I had to learn to pace myself. However, I also wanted to finish within 3 hours if I could, which meant pushing myself. It was difficult to balance these approaches during the race, but my mum and I made it in 2:59:51. Yep, a whole nine seconds to spare!
Knowing when to pace myself and when to push myself is one of the most challenging aspects of any goal. Part of the challenge is to appreciate how far I have come while focusing on where I want to be. It’s difficult not to get frustrated about how far away the end goal is, especially when working on something which will take months or years ro achieve. I find myself comparing my experiences to other people’s achievements — which is a fallacy, because as I pointed out at the start of this marathon post (pun intended), the outside doesn’t reflect the true experience.
Playing the long game, you have two choices: keep going or give up.
As with running long distances, working towards long term goals involves a lot of different factors. You need to develop a strategy and assess your energy levels to know when to push and when to pace yourself. You need to train and learn from your mistakes.
Gradually, you learn what works best for you and realise there is no point comparing yourself to other people. No matter how fast the other runners are, the only person you are really competing with is yourself. I suspect this is true even for elite athletes, who want to break their personal bests as well as beating the competition, but it’s especially true for those of us who just want to do our best and finish the race.
An advantage of playing the long game is that there’s always another race, another chance to make strides towards your goal. You might not manage it in the same way or time frame as you planned, but every experience teaches you something which will help you (eventually) achieve your goal.
The alternative is to quit, which guarantees you will never achieve what you want.
Achieving my goals is never pretty or easy. I often feel the universe is testing me or taking the piss — especially when my glasses broke 40 minutes before the start of the half marathon, meaning I had to run half blind — yet these additional challenges are what make my experiences unique.
I know I can run 13.1 miles without being able to see anything more than colourful blurriness and the three feet of ground in front of me. I can complete a four day trek while contending with altitude sickness, multiple panic attacks and a throat infection. On a more mundane level, I can write and study around the symptoms of my mental health issues. I can force myself to do a gym class straight after having a panic attack. I can make healthy choices most of the time, even if part of me still wants to munch crisps and chocolate.
I don’t always feel like carrying on, but I keep going because it’s the only way I have a chance of getting what I want. Challenging myself is the only way of discovering my capabilities. The long game is a massive commitment, but the potential rewards outweigh the sacrifices.
I was recently upset and appalled by an article in the August 2018 issue of Psychologies magazine, which I previously respected and have found useful in the past, referring to people who have borderline personality disorder as “energy vampires”. I have written to the editor, explaining how the article perpetuates stigma and thought other people might be interested in what I have to say. The article refers to a book by Christiane Northrup which I have not read (and have no intention of reading if it has been accurately represented), but my main concern is with what Psychologies actually approved and published.
I am writing in response to the “How to avoid the energy vampires” article featured in the August 2018 issue of Psychologies magazine. The opening paragraph states: “When I use the term ‘energy vampire’, I’m talking about a subgroup of people — about one in five of us — who, in psychiatry, are called Cluster B personalities, with narcissistic, borderline, histrionic and antisocial personality disorders., and there’s a spectrum; you can certainly live with someone who’s a little self-centred and has narcissistic traits and then, at the other end, there are full-blown psychopaths.”
This email shall discuss borderline personality disorder (BPD), simply because I don’t feel qualified to comment on the other conditions mentioned. I have personal experience of BPD, having been diagnosed in November 2010, at the age of 26.
Labelling people with a mental illness — which includes BPD — is always harmful and increases stigma. To label us “energy vampires” is offensive. While the article mentions a spectrum, it uses the term “energy vampire” to refer to all people in that spectrum, including all people who have BPD. I can’t imagine that this paragraph would be accepted if, instead of referring to personality disorders, it had referred to depression, anxiety (both of which I also have been diagnosed with) or a physical illness.
Unfortunately, some mental illnesses continue to receive a disproportionate amount of stigma, stereotyping and discrimination compared to other mental illnesses. BPD is a key example and part of the problem is that it’s misunderstood, rarely being mentioned in mainstream media. On the rare occasions it is mentioned, such as in this article, it’s usually in negative terms.
The extent of this stigma can be seen across the internet and social media. Whenever Mind or Time to Change publish a blog post written by someone who has BPD, there are inevitably Facebook comments which perpetuate the negative stereotypes and stigma. These comments usually say that people with BPD are a nightmare to live with, difficult to interact with and generally not worthy of good relationships. Because BPD has not received the same amount of positive publicity as other mental health issues, people cling to the old stereotype as portrayed in Fatal Attraction. Yes, the most common impression people have of BPD is garnered from a 30 year old, misogynistic film!
Given this background, it should be obvious that labelling people with BPD as “energy vampires” feeds into the existing stigma.
I appreciate the apology you gave on Twitter and welcome any efforts to educate the general public abot BPD. There is a lot of ignorance and lack of understanding surrounding BPD, so positive representations would go a long way in addressing the damage caused by negative depictions and references. Many of us make positive contributions to our friends, families, communities and societies, but this is rarely mentioned in mainstream publications such as Psychologies.
If people with BPD are difficult to deal with, it’s because they are not receiving adequate treatment, help and support. This article makes no mention of this, simply terming all sufferers “energy vampires” who have a negative effect on the people around them.
Ironically, I had bought the magazine because I was interested in the “restore your energy” dossier and as BPD makes me incredibly sensitive to other people’s moods, I identify more as an “empath” than an “energy vampire”.
I would like to see Psychologies increase understanding of BPD. The negative stereotype is ridiculous considering the range of symptoms which can be experienced: individuals who have BPD may seem complete opposites. For example, both promiscuity and withdrawing from romantic relationships can be symptoms. Of course, the name itself is difficult for the general public to understand, with its connotations of character defects — many people assume BPD means “bad personality”. A lot of people I encounter don’t even realise BPD is a mental illness.
Please show that people with BPD are worthy of love and respect. We are capable of maintaining good relationships and contributing to other people’s lives in positive ways.
For example, I volunteer with a local youth mental health organisation. Last year, I ran a crowdfunding campaign which secured £15,000 to save our peer support groups in one particular town, which had been threatened with closure. In May last year, I completed a four day trek to Machu Picchu and raised over £1000 for Amnesty International, despite having panic attacks throughout the final morning of the trek. I blog about my mental health in an attempt to inspire other people with mental health issues to achieve their goals.
However, my own contributions are very small compared to a lot of people who have BPD. On Twitter, I see amazing examples of activism and personal achievements. People who are amazing parents, partners and professionals. Yet I never see them mentioned elsewhere.
I hope this email has explained why many of us with BPD find the article offensive and worry about its potentially damaging effects.
Update: Psychologies magazine’s editor, Suzy Walker, has emailed me to take full responsibility and says that she is taking steps to ensure this doesn’t happen again and to promote understanding of BPD. She also invited me to blog about BPD on the magazine’s Life Labs website: click here.
I am impressed with Suzy’s response and optimistic that this mistake will lead to positive outcomes which will reduce the stigma surrounding BPD.
Progress in anything is often slow and nonlinear, but these qualities are exacerbated when you have mental health problems. In particular, anxiety and depression can create conflicting symptoms: it feels like I’m progressing too slowly and have the urge to rush into everything, yet it’s difficult to find the energy and feel motivated, plus many activities are too challenging. It feels like being torn in different directions.
I have been feeling this way a lot over the past few months. So much of my time has been lost to mental illness that I feel frustrated when it steals more time from me. I’m glad and grateful that nowadays these increments of time can be (usually) measured in hours, days and weeks — in the past, they were most commonly measured in months and years — but it’s still stolen time. Time I can never get back.
My frustration might be due to my experience of losing so much time during my teens and twenties, when most of my peers were achieving amazing things, changing their lives and having fun. I may never reach the milestones of adulthood which the majority of people consider “normal”, like living independently and supporting myself without relying on state benefits, so it feels like everyone has overtaken me. I feel a deep need to prove myself, to demonstrate that my goals are worthwhile and I can make a valuable contribution to the world.
I constantly worry I am failing at life. I tend to dismiss my achievements, because it feels ridiculous to be proud of them when I struggle with tasks that most people find easy. I pressure myself to reach high standards because I hope it can atone for my failures, which include relying on my parents and finding driving a huge challenge nearly 9 years after I passed my test. If I could choose to exchange my achievements for being able to do everyday tasks, like shopping on my own and holding down a full time job, I think I would. Other people, I suspect, would find me more acceptable.
Lately, I have been in a reflective mood. I think it’s because I had to wait several weeks for my results from my first Psychology module. In the event, I got an overall score of 95 and surpassed my expectations, but I was anxious about failing because it would effectively terminate my pursuit of the degree. I managed to almost convince myself I had messed up my final assignment so much that I had failed the module. As frustrating as it was to waste yet more time worrying for no reason, my anxiety sometimes gives me insights: studying Psychology is very important to me.
While it should be obvious that I’m not choosing to accumulate more student loan debt for no reason, I think part of me worried about my reasons for pursuing a Psychology BSc. I have no career path mapped out. No way of knowing how my mental health will affect my life when I complete the qualification. However, I do feel a strong desire to improve my understanding of psychology and mental health so that I can help others. Perhaps I will do this through my writing; perhaps it will be via research or something else. I don’t know the route I will take, but I have clarified my first steps and am heading in the right direction.
The experience has highlighted a few truths:
1. There will always be waiting periods in my life, whether it’s waiting to hear about results or taking action in the face of excruciatingly slow progress
2. My mental health issues might mean I have more waiting periods than the average person
3. The only way to deal with waiting periods is to accept them
Acceptance is bloody hard.
Acceptance. It’s a simple concept, but difficult to practice. My instinct is to get upset: “why should I accept chronic mental illness when other people don’t experience it at all or for shorter periods?” And no, reminding myself that other people experience more severe mental illness for longer periods doesn’t help. Yet acceptance is the only way forward, because fighting against mental health problems doesn’t work — you have to take a collaborative approach, working within your constraints while pushing for progress.
Unfortunately, accepting my mental health issues can be difficult for other people. Many friends have dropped away because they couldn’t understand my symptoms, or why my symptoms differ from their own experiences of mental health problems. I know I’m better off without these “friends” but it’s still painful. Society in general doesn’t seem to accept mental illness. Even when people express understanding for “high functioning” people who have mental health issues, they are quick to judge those of us whose ability to work is affected. Stigma still prevails: people assume you are lazy if you need to rely on benefits, many express sympathy while acting in unsympathetic ways and judge you based on how you appear on your good days, without considering how they might be outweighed by bad days.
It’s difficult to accept your own situation when other people send negative messages. Even common assumptions can be hurtful for those of us who don’t fit the “norm” and these assumptions seem to increase as I get older. People assume a woman in her mid 30s should have her own home, be in a serious relationship, work full time, want or have children, socialise at least a few times a week, etc. I don’t fit the pattern and probably never will.
Yet everything boils down to the same old truth: improving my situation requires acceptance.
Learning to be patient.
I know comparing myself to others is ridiculous. Everyone’s situation, experiences and challenges are unique to themselves. All I can do is work on my own goals, try to improve my mental health and hope it all works out in the end. Oh, and I should probably try to enjoy my life along the way!
Maybe that’s the key to self-care, achieving goals, managing mental health and life in general: to aim for progress, not perfection, and have fun whenever you can.
Setting deadlines for myself isn’t always healthy, although they can sometimes help me to feel motivated. Sure, I would love to turn my life around in an instant, but that’s not realistic. I need to hold on to the positive aspects of my life, especially when they are overshadowed by the negatives, and see what happens.
A year ago today, I started a 4 day trek to Machu Picchu. It was the biggest and most difficult challenge I have voluntarily undertaken, but also one of the best. While it didn’t immediately transform my life, as I had hoped, it has changed me in ways I’m just beginning to realise. The greatest effect is cutting through my excuses. I completed a major life goal, despite struggling with my mental health. Why shouldn’t I achieve more goals?
In this spirit. I set myself a lot of goals this year. Some are boring and mundane (adding to savings, submitting more short stories), but a few are more exciting. One of them was to complete a tandem skydive from 15,000 feet.
As you can probably guess from the photo, I did the skydive yesterday — which happened to be my birthday.
Last year, I spent my birthday doing an acclimatisation trek in Peru and being serenaded in a restaurant with the world’s longest version of Happy Birthday. I was surrounded by a wonderful group of people who have become my friends, but I was thousands of miles from home and had woken up very early, sobbing because I was scared I was making a huge mistake. I was worried I wasn’t capable of achieving any of my dreams, including walking miles up very high mountains.
My birthday this year was very different: I was at home and spent the day with my parents. However, I also wanted it to be as memorable as last year, so I scheduled the skydive and hoped for good weather.
Although the skydive was on a much smaller scale than Machu Picchu, it involved a lot of preparation. My first task was to get under the 210lb weight limit (the website says you can jump if you are heavier, but you have to tell them in advance and pay a surplus, so I wanted to avoid that), which was a big commitment since I started the year at 244lbs. I weighed in at 201.5lb yesterday morning and a few pounds heavier in my clothes and trainers when I got to the airfield, which was a relief!
I also needed to have my doctor sign a medical form to state that I was allowed to jump, because I have received treatment for mental health problems within the past 2 years and have a history of self-harm. I had an appointment a couple of weeks ago and my GP declared that I was at no extra risk compared to any fit, healthy person.
I understand the reasons for needing my GP to sign the form, but it feels disempowering to be told that I can’t sign my own medical form. I know my own mind very well precisely because I have mental health issues. Managing my mental health effectively involves monitoring my mood and motivation for doing certain activities. Far from being a form of self-harm or method to boost fragile self-esteem, the skydive was my way of celebrating my achievements and rewarding myself for getting through the almost constant struggles.
Because I still struggle. Every small achievement, from walking the dog on my own to completing an assignment, involves facing my anxiety, depression and BPD and managing my current symptoms.
My symptoms are less apparent to other people nowadays; partly because they have lessened in intensity, but mostly because I am much better at managing them. I was anxious yesterday, for example, but didn’t appear more nervous than anyone about to be hurled out of a plane for the first time. I was focusing on controlling my breathing and being mindful, rather than listening to my worries and letting them escalate — though, truth be told, my anxiety disorder is concentrated on the possibility of humiliation rather than harm or death, so I was more worried about doing the wrong thing or puking!
In addition to being a celebration and reward, skydiving was also a reminder that I need to take chances in order to experience fun and excitement. I need to leap forward, despite being anxious and having other obstacles in my way. I may never “recover” from my mental health problems, but I can manage them alongside achieving goals and chasing my dreams.
I think the main difference between my life now and the episodes during which I was trapped by my mental illness, is that my fears have shifted. I am more afraid of not trying to achieve my goals than the potential for humiliation. I’m more scared of spending the rest of my life confined to the house than chasing my dreams. I’m still fearful of failure and rejection, but my greatest fear is living without trying to create a better life for myself.
Which is another change: I believe I’m worth the effort.
I used to hate myself and thought I deserved nothing, but that has gradually changed over the past 10 years and the change has accelerated since I trekked to Machu Picchu. It started with asking for help when I needed it and investing in myself, going to university after thinking I had “missed out” on the opportunity. Then I realised I could contribute to the world, through volunteering and using my skills to help local charities/organisations. Most of all, I gave myself permission to dream again, to consider the possibility of a different life.
Along the way, I have met more people who believe in me. I have had small successes which confirm that I’m worthy of support and investment, contribute a lot and can achieve things I once considered impossible for me.
Sure, my life looks very different to how I expected and what I would have chosen, but you work with what you’ve got. I still struggle, but the truly awesome days I enjoy make the weeks and months of struggles less important than the triumphs. When I look back on my Machu Picchu trek, I don’t dwell on the panic attacks, throat infection, rain and altitude sickness: I remember arriving at the Sun Gate with my fellow trekkers, achieving our goal.
I have been finding things difficult lately, which feels strange to admit because my life is, in general, better than it has been for years. While I still have bad days (and some really awful days), my typical daily mood has been turned up a few notches.
This means I can (usually) practice basic self-care without huge effort, such as going for a walk and cooking healthy meals instead of grabbing junk food. Other tasks are harder to accomplish, like finding the confidence to submit my short stories and attending appointments on my own. It seems my “set point” of mood and ability has increased.
An improved set point is, of course, a Good Thing. I have no idea whether I will ever recover completely from my mental illnesses, but this improvement is an encouraging sign. It gives me hope.
Life is also easier to bear, because my bad days are less intense than they were at the end of last year. Feeling lethargic, unmotivated and low in mood isn’t great, but it’s preferable to being suicidal and self-harming on a daily basis. It might take a huge effort to get out of bed, but I can do it. That’s progress.
But there is a darker side to an increased set point and the hope it brings: I feel more pressure to do better.
A conversation I had last week highlighted this issue. I was asked if I had had a good week and I replied that it was neither good nor bad. Nothing terrible had happened, but nothing particularly good had occurred. I felt as if I hadn’t achieved anything. I was then asked about my week in more detail. I can’t remember my precise response,but it was something along the lines of “oh yeah, I walked the dog and went to gym classes, did some writing, studied… the usual.”
Not so long ago, these things were not “usual” for me. Even a year ago, I was not going to gym classes or studying. Longer ago, I couldn’t walk the dog (let alone on my own!) or sustain any kind of regular writing practice. I realised that I wasn’t giving myself credit for how far I have come and that I expect more of myself.
Expecting more of yourself can be empowering. It has motivated me to challenge myself. The possibility that I can manage my mental health well enough to prevent it from limiting my life encourages me to dream, to plan, to take action.
On the other hand, expecting more of yourself can bring disappointment. Failure is inevitable in life, but raising your hopes enough to expect the odd success can make constant failure harder to handle. In many ways, it was easier when I expected nothing good to happen to me.
Accepting The Positive
Perhaps the problem is a disconnect between accepting myself as I am and wanting more for myself. Maybe, on some level, I still consider those things a paradox. It’s a kind of superstition: if I accept myself as is, I might be jinxing the possibility of a better life.
Paradox or not, in my experience, acceptance is usually necessary before I can change things for the better. When you are fighting against your current situation, it’s difficult to achieve anything. Once you accept where you are, you can create a map and move forward.
I tend to think of acceptance as admitting and owning the negative aspects of my life. A lot of the work I did in counselling last year was about accepting my mental health issues, plus the problems that have been directly or indirectly caused by them (finances, work, relying on my parents, etc). I might not like having mental health problems, or the effects, but I need to accept them as part of my life.
However, thinking about my recent weeks has made me wonder whether I am making enough effort to accept the positive aspects of my life. I suppose my default is to think of my achievements and successes as anomalies; brief, glorious moments rising out of the dross of my everyday life. I rarely acknowledge them, especially if I consider them to be small and insignificant.
Yet the small things are important. Vital, in fact.
During my worst episodes, I couldn’t enjoy the very activities I now consider “small”. I didn’t read much, because I couldn’t concentrate. Ditto watching films. If someone did something nice for me, or even if the weather was good, I would get upset because I believed I didn’t deserve anything good. Back then, if you had told me that I would be where I am now, I would have scoffed because it seemed impossible.
I need to be more mindful about the good things in my life right now, as well as being hopeful that I can achieve things I currently think of as impossible. A few years ago, I would never have dismissed the past few weeks as “neither good nor bad” — I would have considered them to be fabulous, amazing, wonderful! Instead of letting my new set point skew my reality, making me dismissive of the positive aspects of my life, I should celebrate reaching this new version of “normal”.
Maybe this is how recovery will work for me, increasing my set point until mental illness is no longer a controlling shareholder in my life.
“Just take it in your stride.” Good advice, right? Nobody wants to be derailed by obstacles and challenges. However, those of us who have mental health problems can find it difficult (often impossible) to take things in our stride.
Even small and/or anticipated problems can knock us off course. Setbacks seem to confirm the negative beliefs we hold or have held about ourselves:
“I am a failure and always will be.”
“I’m not good enough.”
“I can’t cope.”
We feel people are judging us for making mistakes or not being able to cope with our problems. Our thoughts can spiral out of control, so that a tiny setback leads us to think our entire lives are catastrophes.
So how can you help someone gain perspective?
First of all, please don’t contradict what they are saying. You may think you are showing the person concerned that they don’t need to worry, but minimising and dismissing other people’s problems is unhelpful and potentially harmful. They are already judging themselves for not being able to take the situation in their stride; suggesting their problems are unimportant and they are therefore overreacting piles on more judgment. It may not be your intention to belittle them, but that’s how your words can be perceived.
By not being sensitive to how the person in question feels, you imply that their emotional reaction is the problem. This can be easily translated as “I am the problem”, thus confirming their negative beliefs and leaving them feeling worse.
Instead, try a more compassionate and productive approach:
1. Acknowledge how they feel. They are entitled to their emotions and none of us can control our emotional reactions, though we can learn to control how we express our feelings, emotions and thoughts. Don’t start giving advice straightaway — listen.
2. Try to understand their perspective. Keep listening. Ask questions to clarify how they feel. Try to connect and empathise, so that you can learn why they believe the problem, challenge or setback is a disaster.
3. Support them. Let them know you will help in any way you can and reassure them that they can improve the situation. If they ask for advice, give it, but don’t dictate what you think they should do. Ask them questions which help them consider their options and plan their own course of action — if they feel able to take action.
Check your language.
An issue I have encountered a lot when talking about my problems is people dismissing my concerns, often implying that because my life has improved since my worst periods of depression and anxiety, my current situation shouldn’t bother me. I’m sure most people don’t intend to make me feel worse, but many phrases which are supposed to be reassuring can have darker implications.
For example, “look how far you’ve come” can be motivating if someone is in a positive frame of mind, but can also be interpreted as “you should be grateful for the improvements in your life and not expect more.” I find it especially patronising when spoken by people who have led relatively “normal” lives, usually when they try to tell me that my current situation is better than I think — as though I have no right to be frustrated about my mental health, financial situation and living with my parents.
Other phrases which people think are motivating or reassuring, but actually leave a lot of us feeling worse, include:
“There are plenty of people worse off than you.” True, but there are many people better off than me — including the people who like to “remind” me that things could be worse.
“Things will change soon.” Maybe, but often nothing significant seems to change for years on end.
.”You’re lucky to have X.” Again, braodly true, but when X is my dog or parents who haven’t chucked me out on the street, it feels like whoever says this is scraping the barrel.
Before you try to reassure someone, consider:
1. Are they in the right frame of mind to hear this without misinterpreting it? Often, people just want to be heard. They aren’t expecting you to solve their problems or give them a pep talk. They may want to vent or express their emotions without being told they should feel differently.
2. Would hearing this actually help them? In most cases, especially when emotions are high, the answer is no. When I’m depressed, the most inspiring stories can make me feel worse because I feel so pathetic and unable to change.
What can you do if you can’t take things in your stride?
Try to stay afloat. Practice self-care and do what you can to stop things getting worse.
If you can, that is. Sometimes problems and setbacks can make us feel as though we are drowning and we can’t stop struggling. Instead of letting go and hoping we rise to the surface, we try to cling to things in desperation — though clinging to them will keep us trapped underwater for longer. We cling to unhealthy relationships, harmful habits and negative beliefs. We can keep clinging, or we can let go and accept our current situation.
Acceptance is bloody hard, but it’s the only way we can stay afloat. And unless we learn to stay afloat first, our attempts to swim against the tide and change our lives will keep sucking us under. It’s a lesson I’m learning over and over.
Berating yourself (and the world in general) gets you nowhere, because you get sucked down into the same old negative thought patterns. Practicing self-care and self-love lead to acceptance. Unfortunately, as the word “practice” suggests, it’s difficult to learn to love and care for yourself, so you need to pay attention and take active steps on a regular basis.
If you feel unable to cope, please seek help and support. Your GP is a good first port of call, but there are also various helplines, therapists and counsellors. Talking to a trusted friend or family member and asking them to help you access appropriate sources of support is a good idea.
Long term strategy.
When you have chronic mental health issues, feeling blown off course by life events which others seem to take in their stride is a frequent occurrence. I think the trick is to recognise when you need to stop swimming and float for a while.
Doing this can feel like you are taking a step backwards, but it actually prevents you from losing progress.
Constantly swimming against the tide is exhausting, so we all need a break sometimes. If you are experiencing mental health problems, you may need more breaks than other people — perhaps more than you would like — but it’s essential to float when you need to float. In fact, it’s the best strategy for your long term success and fulfilment.
Self-care helps you to swim further in the long run 🙂
If you read about mental health, wellbeing and/or self-improvement, you have probably read a lot about ‘choice’. A lot of the information is true and basic common sense: our choices do determine our lives, no matter what has happened to us. We can choose how to react to life events, including mental illness. However, what the rhetoric often misses out is that making these choices is bloody hard.
For a start, you might not realise you have a choice. Mental illness makes you believe you are powerless. Depression, anxiety and other conditions change your thought patterns. You think you are useless, worthless, hopeless. You think your life is pointless. These thoughts often spiral out of control so all you can see is the negative fog of your illness.
I have certainly felt like this – I still do, during bad days or weeks. In the past, this mindset has lasted for months on end – perhaps years – and I truly believed there was no way out. I didn’t know I had a choice, even when I made choices like going to the doctor and taking my medication. I did those things because my parents said I should, not because I thought I could be helped.
Any discussion of ‘choice’ should acknowledge the vital roles of opportunity and support.
If you have no support, making choices is more difficult. You have no reassurance that you are doing the right thing – assuming it’s possible to identity ‘the right thing’. There is always an element of risk in making different choices, because results are never guaranteed. Without support, this risk often feels too high and you are too afraid to change, because you don’t know whether anyone will have your back if you fail.
Professional support, from doctors, counsellors and/or therapists, is very valuable. Sometimes, it feels like they are the only ones who have a degree or understanding and want you to get better, as opposed to wishing you would keep the status quo even if it’s painful for you. However, professional support works best when it is complemented by support in your personal life, from family and friends. If you have little support from those who are closest to you, it is more challenging to make decisions which might have long term benefits but cause discomfort (or even pain) in the short term.
Having support in other aspects of your life makes a difference, too. At work, for instance, you have more options when you have a supportive employers, managers and colleagues. They have the scope to offer opportunities which unsupportive people will not, such as training and mentorship. It also helps if you know you can have time off when you need it, without worrying that you will face a formal warning when you return to work (which happened to me, when I was employed by a certain supermarket).
Other sources of support could be accessed through education, hobbies and groups. Unfortunately, mental illness tends to narrow your life and makes you withdraw from these potential sources of support, which means it can take a great deal of effort to continue pursuing an interest or attending a class. During my worst episodes, I feel unable to do the things which help me feel supported and purposeful.
All potential choices may seem undesirable.
How do you make choices when all of the options have massive drawbacks? Sure, at least one choice probably has the potential to lead you in the direction of long term success, fulfilment and/or happiness, but it may also have huge risks involved. For example, I used to be too scared to walk my dog on my own. I had walked the route thousands of times over the years, often on my own, yet the idea of walking out of the house alone terrified me. Why? Walking on my own had numerous potential benefits, including enjoying the countryside and improving my mood, but it also carried the risk that I would have (another) panic attack in public.
Every time I have had a panic attack in public, I have experienced humiliation on top of the dread and discomfort which every other panic attack brings. It had an impact on my mood and other symptoms for weeks afterwards (sometimes months) and led to more restrictions in my life, such as not going out at all when I had previously been fine with my friends or family members. It also affected my confidence, meaning I would avoid doing anything which might result in failure.
So my options were: go for a walk alone and risk a panic attack which would have a devastating impact on my mental health, or stay at home and risk nothing other than living the rest of my life feeling bad but not as bad as I might feel after a panic attack. Neither option was desirable. Especially during times when I was experiencing a lot of panic attacks, so the chance of having one in public was greatly increased.
I was only able to make the choice to go for a walk on my own after receiving a lot of treatment and support, including medication, therapy and counselling. I also had people in my life who understood enough to help me, instead of forcing me to make certain choices before I was ready.
It’s hard to keep making choices without seeing results.
Many of the choices we make do not have instant effects. Some do not reveal their full effects for months or years. This makes it difficult to choose certain courses of action and to keep going after you have made the initial decision.
Often, I only realise the effects of my choices in hindsight. Something reminds me of how life used to be and when I compare it to my present, I can see which choices have led to the difference. Several years ago, I was extremely unfit. I was at university full time and prioritised my studies over everything, because I believed I had something to prove after assuming I would never have the opportunity to pursue a degree. I walked less, especially after I passed my driving test just before starting the second year, and did no other exercise. Walking to and from the car park was a challenge because I had become so unfit.
Nowadays, I am pretty fit: I walk every day, go to three gym classes a week and try to run at least twice a week. This did not happen overnight. The first choice I made was to buy a treadmill, so I could walk inside (as previously mentioned, I could not walk outside alone at this time). I started walking very slowly and for short periods of time. It felt pathetic, being challenged by an activity I used to find easy, but I gradually built up my speed and distance. Looking back, those first walks on the treadmill represented some of the best choices I have made. But at the time, they were painful and frustrating because my progress seemed slow. Choosing to keep walking was difficult and if I did not have the treadmill, I doubt I would have persevered.
I could only make the choice(s) to continue walking because I was in the right headspace and had the right opportunity (access to credit so I could buy the treadmill). When you don’t have the right mindset, support and opportunities, it is extremely difficult to keep going.
You may not see the full impact of your choices for a long time.
Related to the previous point is the fact that the consequences of your choices, good and bad, might not be apparent for years. Looking back, I realise that I made a lot of mistakes. Every time I stayed at home because I felt too anxious to go out, my world got a little smaller and darker. Each time I struggled on my own instead of asking for help, I became more anxious and depressed. Would I have made different decisions if I knew the full effects? Maybe, but I did the best I could in the circumstances.
It is important not to blame yourself or other people for past actions taken in good faith. While the choices made might have led to an undesirable situation, most of us believe we are doing the right thing when we take those decisions. Every time I stayed at home, I thought I was sparing my friends and family the embarrassment of my anxiety symptoms. Each time I refused to ask for help, I believed I was sparing people from my causing them trouble or inconvenience. We are all experts with hindsight, but we should never forget how it feels when you make poor decisions because you think they are for the best.
Your choices may have unexpected consequences.
Your choices may have unforeseen effects, whether positive or negative, which can be difficult to cope with or understand. When you are trying your best to make positive changes in life, it’s difficult to respond to one of your choices backfiring.
Sometimes, your choices create problems because other people don’t understand your perspective. They may think you are causing unnecessary stress for yourself by choosing to pursue a certain goal. They may accuse you of being selfish for spending your time and money on your own priorities, instead of the things they think should be prioritised. When considering people’s reactions, it is important to remember that they have their own issues and sets of beliefs. Their responses say more about them than you.
Dealing with the unexpected can be hard. When you make choices, you often assume they will have specific consequences and unforeseen effects can make you question everything. The fear of unexpected consequences may cause indecision for some people: it may seem illogical, if you believe they can improve their lives through making a certain choice, but they may feel more comfortable sticking with what they know, even if it is making them unhappy. Their behaviour might not make sense to you, but trying to understand rather than berating them is more likely to enable them to change. People in this situation need support, not judgement.
Making the ‘wrong’ choices doesn’t make you less worthy of love, support or respect.
Some people talk about others making a ‘choice’ to do something which has negative effects, without considering whether they had any support or opportunities to make a different choice. It’s easy to judge and, unfortunately, many people who judge have experienced difficulties themselves and believe others should be able to overcome their problems simply because they themselves did. Their attitude is ‘I managed to cope, so why can’t you?’
There are, of course, a number of potential answers to this question. Different people have different life skills, coping abilities, levels of self-esteem, supportive factors in their lives, etc. Often, these differences cannot be appreciated by those on the outside. Someone who seems to have everything going for them, such as a good job and family, may have very low self-esteem and believe they are unworthy of the positive changes they can make. Somebody who appears to have supportive parents may actually be undermined by them at home, when nobody is there to witness it.
If you have helped yourself by making good choices, please don’t judge those who are not ready (and might never be ready) to do the same. You are not superior to them.
If you have made and/or continue to make poor choices, try not to judge yourself. You deserve support. You deserve a better life.
The bottom line is, making choices can be difficult and many people feel unable to choose courses of action which will help them in the long term. Judging and punishing people in this situation helps nobody. It is unlikely to persuade them to change their behaviour; in my experience, it makes them feel more wretched and more likely to make poor decisions. We all have a choice, but we might not feel able to choose.