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.
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!
A few weeks ago, I reached the point where I was sick of feeling lethargic and unmotivated. I felt I was achieving nothing and realised I was missing the one thing which keeps me going, even when I’m struggling with my mental health: enthusiasm.
When I’m at my best, I am full of enthusiasm. It drives other attributes which define who I am at my best, including creativity, determination and curiosity. Unfortunately, a lot of those attributes seem to have slipped away this year.
I have debated over whether to blog about this, because I don’t want anyone to feel sorry for me or see it as a plea for attention. One of the risks of speaking up about your mental health problems, especially if you have borderline personality disorder, is getting stuck in a Catch 22 situation: you need to be honest and open about your experiences in order to help people understand, yet being open and honest exposes you to accusations of attention seeking and manipulation.
Part of me feels it’s “wrong” to discuss the negative aspects of my illnesses because I’m coping better than many other people. I’m coping better than I did in the past. However, “coping better” still involves numerous days of feeling suicidal. My self-harming and panic attacks have both increased this year. Often, it doesn’t feel like I’m coping at all.
There are a few obvious reasons for this decline in my mental health. I’m dealing with chronic pain from gallstones and sometimes it feels as if this alone has stolen huge chunks of my life. It stops me from fully enjoying fun activities and spending time with friends. I’m also reluctant to book tickets for events I would like to attend, because if my gallstones are playing up it will be a nightmare or if I have a bad episode, I would have to cancel anyway and lose money. In addition, gallstones symptoms interrupt my exercise routine, which is my main mental health management strategy. Missing a couple of workouts might not sound like a big deal to most people, but it’s akin to skipping antidepressants several days in a row – not advisable and potentially dangerous. My mental health gets worse when I’m less active, which means it’s harder to either get back to exercising or use other healthy coping strategies.
The surge in some of my symptoms is partly due to challenging myself in ways to which I’m not accustomed (understatement!). I completed an 8 month temporary job for a local youth mental health organisation which involved situations I find very difficult due to anxiety. While I’m proud to have stuck at it, there were many times when I thought they had made a mistake in hiring me and I felt I wasn’t good enough. I had hoped it would be a confidence-building challenge which could encourage me to seek more opportunities, but it led to a lot of self-doubt instead.
Finally, my Open University degree is going well, but while I’m pleased with my module results for the 2018/19 academic year, I wish I had been less stressed and more able to enjoy the process. Which is why, as my next modules are about to start, I want to recapture my enthusiasm.
Searching for motivation
Once I identified enthusiasm as something which would be beneficial, I turned to Google and typed “How to be more enthusiastic.” The search resulted in a lot of websites which churned out the same advice (this one is good but typical). As with a lot of wellbeing and self-improvement advice, some of it was very obvious but difficult to actually implement, especially if you have mental health problems. I know it’s important to sleep and eat well, for example, but depression and anxiety messes with both my sleeping and eating patterns.
However, one of the obvious options is exercise and I realised the importance of increasing my physical activity before my mood plummets further and makes it all but impossible. Exercise also helps me sleep better. Goal 1 of Project Enthusiasm was born: move more.
Moving more is easy in theory, but harder in practice. I was already sticking to my gym classes and walking the dogs at least 2 miles a day, but this isn’t enough to improve my mental health beyond the basic “get out of bed but zone out in from of the TV most of the day” level. To get the full benefits of exercise, I need to run at least 2/3 times a week. Running works for me in a way which other types of exercise simply don’t – I can slip into a kind of mindful meditation once I get into the rhythm of a run and focus on nothing but my current experience. Being free from the constant negative self-talk is a relief in itself, but then the serotonin increases after 15 minutes or so and I notice a shift in my mood.
So I have gotten back to running over the past couple of weeks and it’s working. No miracles have been wrought, but I’m a little less depressed and a little more motivated. Some of the runs have been very hard, but I force myself to start and each time I want to stop, I tell myself to try and run for 1 more minute. Often, this is every minute of the run. I have run slower than planned some sessions, but I have hit my mileage targets and these small achievements give me some confidence.
Note: I would never run through pain. When I tell myself to push through, it’s pushing through discomfort and while some of this discomfort is physical, it’s mostly mental. It’s a cliché to say people rarely regret a run (or different workout), but it’s true for me: I gain a sense of achievement from sticking to my plan and as someone who spent 20 years not being able to run far, I get a kick out of knowing I can keep going for a certain distance.
The other strategy for mustering enthusiasm which resonated with me is to explore whatever you find interesting. To cultivate a sense of curiosity. For me, studying psychology and writing fiction are important, yet I have been feeling disconnected from both of them. Finishing last year’s psychology modules was so stressful that I lost touch with my love of learning the subject; completing the assignments was a bigger priority than exploring topics. Writing got pushed aside as my health problems ate up bigger chunks of my time, although perhaps I’m also experiencing a lingering disappointment or grief over my last novel attempt not working out as I had hoped.
Reading is the most accessible inroad (for me) to reconnecting with both fiction and psychology, so I made it more of a priority. I cut down on watching TV and forced myself to pick up a book, despite my mental health affecting my concentration. As with exercising, I felt a sense of “use it or lose it” because while I love reading and learning, I was unable to read when my mental illness was at its worst. I feel guilty for saying this, since I’m a writer, but when you’re depressed and anxious, it’s far easier to switch on the TV or play games than to read – even while you are able to do so. However, once I started reading more (in both frequency of reading sessions and duration), it became easier to concentrate.
I chose to focus on reading because I didn’t want to pressure myself to write a certain number of words, but I’m easing back into writing mote. Again, nothing miraculous has occurred and I haven’t completed a novel in two weeks, but I’m a little more productive. Immersing myself in stories has brought some inspiration.
Similarly, getting a head start on my OU module materials has reminded me of why I decided to do a Psychology BSc. The subject is fascinating and I want to apply my knowledge to my own life, as well as (hopefully) using it to help others in the future. My career plans are still fuzzy, but I would like to improve people’s understanding of mental health and empower people who have mental health problems to achieve their own goals. I guess I’m reconnecting with my sense of purpose.
I’m two and a half weeks into Project Enthusiasm and I say this tentatively, but…there have been definite improvements. While I will probably never be the type of person who bounces out of bed excited to see what the day brings, I’m trying to act in more enthusiastic ways. For the most part, this means forcing myself to start a run or a book chapter – once I get going, momentum (or stubbornness!) usually gets me through. My mood isn’t fantastic, but I feel less wretched and excited to get stuck into the new academic year. I even found the motivation to blog!
I’m also trying to emphasise the positive aspects of my life, because it hasn’t been all doom and gloom this year. The best change is the fact that I’m typing this while sitting on my new bed, in my new, bigger bedroom – one of many advantages caused by my brother moving out! I feel very lucky to be studying psychology and despite the ridiculous bloating (thanks to my gallstones), I’m maintaining a weight which is the closest I’ve been to a healthy BMI for many years. Sure, I wish things were better, but at least I feel like I’m heading in the right direction.
I’m currently recovering from a terrible episode of gallstones pain — well, it was a few of my worst episodes strung together over a few days and the first really bad episodes I have had since February, so a shock to the system. To clarify what I mean by “bad”, it involves me writhing on the floor in agony. The day after the last bad episode, my pain was still intense enough that I couldn’t bear to move unless it was absolutely essential. However, the most frustrating part of the experience was that it’s my own fault.
Okay, I didn’t ask to have gallstones and it’s not my fault that the current NHS waiting lists are ridiculous, thanks to the government penalising consultants for working overtime, so I haven’t had my gallbladder out. Maybe I wouldn’t have developed gallstones if I had stayed a healthy weight all my life, but overeating was how I dealt with my mental illnesses and one of the few coping strategies which was accessible to me during the years when I was scared of leaving the house alone. However, my recent painful episode could have been avoided if I had paid more attention to what was happening.
Since mid-May, I have relaxed my diet. I still want to lose another 20-30lbs, but a few other things took priority and stress took over during the final 2 months of my temporary job. I wasn’t eating a huge amount, but I was eating crap: more refined sugar and processed foods, fewer vegetables. I should have listened to my body as my gallstones became “noisier” but I pushed on, focusing on work and eating junk to deal with the stress (old habits die hard).
Fast forward to a couple of weeks ago and I realised that not only was I experiencing the worst episodes of gallstones pain I’ve had in a while, but my mood had plummeted. I needed to take control of my health.
I also had a minor epiphany: when my gallstones pain and mental health were better than they had been in ages, in March and April, I had been following a diet which limited processed foods and cut out sugar. I was also eating a lot less wheat. Feeling desperate, I decided to go back to basics and cut out junk food, processed food, wheat and refined sugar as much as I could. The worst that could happen, I figured, was that it would make no difference to the pain and I would get better nutrition.
Thankfully, my change of diet was very effective. Within 4 days, I felt well enough to return to kettlebells class (taking it easy). Within a week, I was no longer taking painkillers. After 10 days, I no longer needed to constantly use heat pads and lavender oil to reduce the pain. In addition, my mood improved — which could be due to the psychological effects of feeling a little more in control, as well as the change in nutrition. Nothing miraculous has happened, but I’m back to baseline gallstone pain levels and my depression has eased enough for me to feel a little more human.
In addition to diet, I think my experience was impacted by other factors. When my temporary job ended in July and I found out I had passed my Open University modules, there was an easing of pressure. I was no longer pushing myself to keep going through pain, stress, anxiety and depression at any cost. I could stop. But when I stopped, I felt drained — especially emotionally. I’m pleased to have completed my work project and OU modules, but neither went according to plan and I’m disappointed that I wasn’t able to maximise my opportunities or enjoy them a little more. Now I could stop, I had to process all of these emotions.
Needing a lot of recovery time is something I have learnt to accept in theory, but it’s frustrating. It typically takes me a few days to recuperate from a day out, which most people find relaxing in itself, so I suppose I should have expected a period of lethargy when the challenges of studying and working drew to a close. Trouble is, I want to keep going! I feel as if I have wasted most of my life because mental illness has had such disabling effects over the years, so I think I should push on as much as possible when I feel able to do more. Perhaps the gallstones pain was a blessing, because it has reminded me to put my health (physical and mental) first and foremost.
So what does taking control mean for me?
Prioritising self-care is essential. I’m sticking with my dietary changes, since I feel so much better in such a short time, and I want to improve my fitness. Yesterday, I had a run on the treadmill for the first time in 3/4 weeks and realised how much I have missed its mood-boosting effects, so I want to work on running farther at my new, faster pace (I have been working on speed this year, after focusing on distance for last year’s half marathon). Taking the time to practice yoga and meditation is also a habit I want to establish over the summer.
The other side of self-care is about putting myself in a better position to achieve my goals. I’m not entirely sure what that will involve, because the first step is to reflect on my progress and decide what’s important to me right now. A summer reset, if you like, before I start my next OU modules in October.
Paradoxically, a huge part of taking control is accepting that I can’t control everything. As the mental health literature reiterates, you can’t control what happens to you — but you can control your response. I had hoped this year would propel me towards a better future, but instead of feeling confident about building on my knowledge, skills and experiences, I feel beaten up. I hope that taking plenty of time to rest and work on my health over the next month will help me feel stronger.
Whatever happens, I will try to remind myself I am making progress — even when it feels so slow that it might not count. I spent too long living life on pause when my mental health was at its worst, so I’m not going to let the gallstones do the same.
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
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
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
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.
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.
One of the most challenging aspects of my mental health struggles has been overcoming my belief that my life was meaningless and therefore had no value. It became a self-perpetuating cycle: mental illness made me believe my life had no meaning and prevented me from doing anything which would give it meaning, which became evidence that my life was destined to be meaningless. I never realised I had the ability to create meaning in my life as it was, even during the worst times.
Choose your own path.
The first realisation was an obvious one: people create meaningful lives in different ways. Sometimes they focus on one aspect, such as having children or a specific career path. Many people create meaning “on the side” through art or charity work. There is no standard method of creating meaning, although there are many well-trodden paths.
Think about what you want — if I could grant all your wishes right now, what would your life look like? Choose what works for you: the values you prioritise, activities you enjoy, the goals you most want to achieve.
Creating meaning is about the process, not results, so don’t worry about whether you will be able to accomplish everything. Be open to changing direction as you learn more about yourself. At this stage, you are just beginning to explore how you find and create meaning.
Create a meaningful narrative.
Storytelling is a fantastic way of creating meaning and making sense of your life. What narrative do you want to tell? What do you want to rewrite or edit? You get to decide. You can’t change your past, but you can choose the stories you tell about it.
Forming a clear narrative from the chaos of life is empowering. You can use your story to guide your decisions and create meaning. For example, I decided the story I want to tell is about using my suffering to connect with others through my writing, whether blogging or fiction. Along the way, I want to support, encourage and inspire other people who have mental health issues.
Think about the stories other people tell about their own lives, especially those who have overcome adversity and create positive outcomes. Do any of them resonate with you? Again, don’t stress about whether you can live up to the ending you want. Your story will change many times, even if the core narrative remains the same, often in amazing and unforeseen ways.
The mosaic approach.
If you are struggling to find a narrative thread, try thinking of your life as a mosaic: you can create meaning from discrete activities and relationships, without needing to tie it all together. For instance, you may enjoy running and create meaning by occasionally fundraising when you participate in longer races. Maybe you volunteer for your church and find meaning in helping meet others’ spiritual needs (as well as your own). Perhaps you are an infrequent traveller and find meaning in exploring new cultures when you are able to get away. You could do all of these or a combination of different things.
There doesn’t need to be a single, overarching meaning across all aspects of your life. Yes, some people seem to have it, but you don’t need to. In fact, there might already be a predominant meaning which you haven’t yet identified, or perhaps never will. Your life isn’t a business proposal: you don’t need to reduce it to an elevator pitch.
Make it personal.
Creating meaning is extremely individual. You don’t need to do anything “Important” or “Selfless”. If you don’t follow your own values and preferences, you will find it very difficult to create a life which is meaningful to you. Copying other people won’t work.
You don’t need to save the world to live a meaningful life. You can create meaning in small, precious ways: crafting a beautiful piece of furniture, growing roses, reading to your child.
Mine your past and present.
Where can you already find meaning in your life? Everyone can find meaning, so “nowhere” is not a valid answer. Do you create stuff? Cook for your family? Blog? Study? Spend time with people you love? Look after a pet? Read? Walk outside? You can find meaning in all of these activities.
Check your definition of “meaning” — remember, you don’t need to save the world — and think about how other people and yourself benefit from what you do/have done. Small acts of kindness, chatting with someone, hobbies you enjoy… these have a positive impact in themselves, but can also cause a ripple effect.
Simple tasks can have meaningful outcomes which emerge much later. For example, I started spending a lot of time watching films during the worst phases of depression (well, second worst — I did nothing during the very worst points), which reignited my love of film and eventually led to a Film Studies BA. Going to university helped my confidence a lot and I would be living a very different (worse) life without it. I stayed on to study for a Creative Writing MA and continue to pursue a career in writing fiction. I didn’t know any of this when I first started watching more films and 12 years later, I think I’m only beginning to recognise its impact.
Mining your life for meaning can be slow and you may have to chip away for ages before you find a vein of gold, but it’s invaluable. Time spent searching for meaning and experimenting with ways of creating meaning is never wasted.
Consider alternative perspectives.
Ask other people about what gives their life meaning. What makes them smile? What makes their lives a little easier? You might be surprised by their answers.
How can you look at your life in different ways? For example, if you work in a supermarket and don’t find the work interesting or enjoyable (I’ve been there!), there are several perspectives which demonstrate how it can be meaningful. Perhaps the money you earn supports your family or allows you to pursue your goals. You might be the only person some people talk to all week, therefore your work helps them feel less lonely. You are developing customer service skills which will serve you well in a future job or starting your own business. The hours might enable you to spend more time with your children or pets. Maybe you take pride in doing the best job you can, for its own sake, which increases your confidence and self-esteem.
There are advantages to most situations, even if they are outweighed by the negative aspects, and they can be used to create meaning. Experiencing mental health problems is horrible and I wouldn’t wish it on anyone, but I have learnt many lessons from the pain and challenges. I would never go as far as to say mental illness has made my life better, but it has led to positive outcomes.
Creating meaning is an ongoing process.
Life is ever-changing, so our ways of interpreting it need to continually adapt. We may discover something which we thought would be meaningful turns out not to be. Often, we can be surprised by where we find meaning. Sometimes meaning emerges only with hindsight. As I said, creating meaning is more about the process than results.
Keep experimenting. Ask other people how they create meaning. Google it. Read for inspiration — start with Man’s Search for Meaning by Viktor Frankl, which is impossible to recommend highly enough. Don’t judge yourself for finding meaning in stuff which other people deem superficial or unimportant. Avoid pressuring yourself to find all the answers straightaway. Don’t compare your path to other people’s, especially if their values differ from yours.
Start small. You are already doing many meaningful things every day, even if it’s just getting through the day.
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.
I haven’t posted for a while because I have been going through a bad patch. The trouble with mental health problems is they can convince you that nothing you do will have an effect. There’s no point in writing a blog post, you think, because it will be crap, nobody will read it and it won’t help anyone. So you convince yourself it’s best not to do anything, which is easy since you don’t feel like doing anything. Nothing changes, of course, because you’re not taking action. You just feel worse and worse.
It’s frustrating when I feel this way, because downward spirals are hard to escape. I tell myself I’m waiting until I feel better before I work towards my goals, but not working towards my goals usually makes me feel worse.
I’m finding things particularly difficult right now, because even when I have been working towards a goal on a regular basis, my progress seems very slow. Losing weight, for instance, is once of my priorities for this year. I have a lot to lose, so I hoped the first half would drop off quickly. It didn’t, but that was okay when I was losing weight at a steady pace. Then it stopped. For no apparent reason. I don’t think I’m a particularly stupid person, so I knew that plateaus are to be expected and I would lose more weight if I stuck to my plan, but it’s hard not to have an emotional reaction. While I knew I should lose weight again, because I was sticking to my diet and exercise plan, part of me was screaming “you are failing, you are useless, you are hopeless.”
My plateau didn’t last for very long (about a month), but I realised it reflected my attitude towards many of my goals. I find it difficult to keep going when I don’t see results.
I recently read a book called Drive by Daniel H Pink, which highlights the importance of intrinsic motivation. I nodded along, recognising that focusing on external rewards is not conducive to motivation, but I also admit that I put too much emphasis on recognition. I feel insecure sometimes and need a gold star to boost my confidence. It feels pathetic to admit this, but tangible results keep me motivated and when they are absent, or not good enough (in my own opinion), I find it hard to stay the course. I start doubting myself.
I’m currently waiting for the final result of my first Psychology BSc module (I’m studying part time with the Open University) and it’s torture. My first 3 assignments got 95 apiece, so I would have to mess up in epic style to fail the module on the fourth assignment, which seems unlikely. But, again, while I realise this on a logical level, the part of me which is entangled with my mental health issues keeps shouting about how I’m stupid and must be an idiot to expect anything good to come of studying.
However, I was forced to take action in spite of these negative thoughts. I needed to enrol on my modules for the next academic year and apply for my student loan. I had to ignore the voice telling me I was jinxing myself, because the alternative would be to wait another year before continuing my studies. If I do that each year I complete a module, I would take 10 years to complete the degree, instead of the anticipated 5 years. Obviously, that would be ridiculous, so I did what I needed to do.
Taking action is almost always an act of faith. You have to trust that your actions will make a difference.
Keeping faith is especially difficult when you are working towards a big goal. I do my best to split big goals into smaller ones, acknowledging and celebrating small successes, but some goals are so big that you have to wait ages (so it seems) for even tiny signs of progress. The answer isn’t easy, but it’s essential: you need to focus on the process, not results.
Focusing on the process requires faith and patience. It’s about building the habits which will determine long term success. In short, it’s a long, hard slog.
I was googling “how to stay motivated during weight loss” earlier today and was reminded of something I already knew: motivation follows action. If you wait to feel motivated before taking action, you could be waiting forever. Time is always passing, whether you take action or not. What will you regret not doing 6 months, a year or several years from today?
So that’s why I’m forcing myself to keep going. It’s hard to make short term sacrifices without getting results, but my future self will thank me. I would rather turn down cake today than get diabetes in a few years. I would rather get stuck into studying this year than regret not seizing my opportunity 10 years down the line. I want to create healthy habits which will lead to my ideal life, or at least a better life than the one I’m living.
There’s a comment which writers often hear that has become a bit of a joke: “I would like to write a novel” — or its variant “I wish I had time to write a novel” — often accompanied by a wistful expression. The implication is that writing a novel is something people only do if they are privileged enough to have time and few other concerns, but this simply isn’t true. Thousands of novels have been written in segments of time snatched from busy days. If writing a novel (or doing anything else) is a priority for you, you can find a way to achieve it. The difference between people who say “I want to write a novel” but never do it and people who write novels is not a lack of time.
We all have 24 hours a day, 7 days a week and you can choose how it’s spent. It always passes, whatever you do.
Remembering this is, for me, a work in progress. I waste a lot of time; mental illness wastes a lot of time. But when I am well enough to take action, I try to force myself to take action. Waiting for results is frustrating, but waiting for motivation is a massive waste of time.
I will keep slogging, trying to achieve my goals, because not doing anything guarantees failure. It won’t be easy and I doubt I will ever learn to become patient all the time, but it’s necessary if I want to improve my life. Right now, it’s challenging. Maybe next week, month or year I will feel more motivated and gain more results. Either way, I plan to keep going.