Limboland

I haven’t posted an update on what’s happening in my life recently, for a simple reason: nothing much has been happening. I don’t want to bore everyone, but I also realise that if I want to talk about my mental health problems in an honest and open fashion, I have to include the times when I feel stuck in limbo.

My mental health has been pretty stable for over a month, which is good in many ways — but it also means I don’t feel it’s improving. It’s a frustrating situation, because I feel well enough that I want to change things but not well enough to make drastic changes. All I can do is take small steps and hope my mood improves when spring finally arrives.

It feels as though everyone else is surging forward in life and I’m stuck.

Don’t get me wrong — I’m grateful that my mental illness is better than it was before Christmas and know from experience that I could be feeling far worse, but my day-to-day life is 90% struggle and I’m sick of it. I feel like I’m working hard to improve my life, but not getting the results I want.

I’m trying to focus on the things I can work on right now: writing more, doing my OU course and improving my fitness. However, the usual worries about finding paid work and not having enough money replay in the back of my mind on a constant loop. It’s stressful and bloody boring.

I think I’m getting better at self-care though, which is something positive. In particular, forcing myself to be active helps a lot — I was too subdued to walk the dog on Saturday and it sent my mood into a downward spiral. When I make myself go for walks, I usually feel better for it. As well as having a neurochemical effect, doing exercise gives me a psychological boost: I feel like I have done something worthwhile. In my own small way, I have achieved something.

I think I just have to accept how I feel, though I wish things were different.

I can manage my mental health, but I can’t fully control it. All I can do is keep going and hope things improve.

Reconnecting with Goals

February is a great time to reconnect with your goals, because the “new year, new you” hype is subsiding and you can gauge which of your New Year Resolutions are actually important to you. You have over a month’s feedback on how you have approached your goals. You might have made huge progress on some, while others have fallen by the wayside — and now is the time to figure out why.

Stepping stones

How do your goals make you feel?

Are you excited by them? Scared of them? Frustrated that you haven’t made more progress? Feeling any emotion at all is a good sign, because it means you care about the goal. It’s not something you have chosen arbitrarily.

Examine these emotions. Ask yourself why you are feeling each particular emotion. Sometimes this will be straightforward: you might be excited by your goal to start a particular course because it’s something you have wanted to do for a long time and you are passionate about te subject. Sometimes you will have to pick apart the thoughts and beliefs you hold about a particular goal to figure out why you are feeling an emotion.

Here is an example of a more complex process of unpacking an emotion: you feel angry about your goal to lose weight. You want to lose weight to be healthier and aren’t feeling pressured by anyone else, so why are you angry? What does the goal say about you? It says you are carrying excess weight (in your opinion), so what beliefs do you hold about this excess weight? You might think it means you have been lazy or greedy. You used to be slim and fit, but you have let yourself down. You are angry because you gained weight and now you have to make an effort to lose it.

If you are experiencing negative emotions in relation to your goals, see if you can reframe your feelings. Anger, in the above example, could be channelled into determination if you make an effort to be more compassionate towards yourself and stop focusing on the weight gain. Fear is often mixed with excitement — they share a lot of symptoms, like an increased heartbeat and feeling jittery — so practice telling yourself you are excited when you feel scared. It’s a different way of interpreting the uncertainty of what will happen when you work towards your goal.

 

Why did you choose your goals?

It’s easy to set goals which don’t really matter to you. We all get influenced by the people in our lives and society in general. We convince ourselves that achieving a particular goal will make us happy, because that’s how it’s sold to us.

Think about why you selected your goals. Are you hoping it will have potential side effects, such as making you more confident or assertive? If so, why not choose a goal to work on these side effects? It would give you a greater chance of success. Focus on guaranteed results (or as close as you can get): losing weight might or might not improve your confidence, but it will make you healthier if you choose an appropriate target and methods. Finishing writing your novel probably won’t result in a fantasy publishing deal, but it will help you develop your craft and increase your chances of success.

Having a clear vision for why you chose each goal will help you to stay on track when your motivation slips. If it’s someone else’s vision or a vision you know is a lie, it ain’t going to work.

 

Recommit, adapt, sideline or drop.

Use the information you gathered from asking yourself the above questions to decide whether to keep pursuing your goals. There is no shame in dropping goals if they are not what you want. It’s fine to sideline goals which you would like to tackle in future, but can’t or don’t want to prioritise now. Adapting goals isn’t cheating; it’s about refining them so they resemble what you want and how you want to approach them.

Rewrite your goals, even if you haven’t changed them, and recommit to working towards them. Reconnect with your whys. Visualise both working towards and achieving your goals. Be motivated by them. Imagine how you will feel when you achieve your goals.

Don’t judge your goals. So what if they might seem too big or too small to other people? These are your goals and they should be all about you,.

A goal is simply something you want. It can be exotic or mundane. Easy or difficult. Safe or adventurous. Try not to care about what other people think (I know, easier said than done…) and remember, you don’t need to share your goals with anyone who might be unsupportive. You are changing your life — you’re the person who gets the final say on what you want.

 

Sort out your steps.

You don’t need to plan every stage of working towards your goal, but it helps. If nothing else, have a broad idea of the route. There will be inevitable detours and obstacles, but mapping the terrain will help you stay on track.

The most important thing is to plan your first steps. Make them small and easy, so you can cut through your excuses. If you need money to achieve your goal, your first step could be arranging a few extra hours at work or cutting a couple of nonessentials from your budget. Once you complete the first few steps, figure out the next few.

Take action and keep taking action. It’s simple, but it’s not easy.

When you feel demotivated, remind yourself of your whys and keep taking action. Even if it feels pointless. Keep moving. You might not feel like you are making progress, but simply working towards your goal is an achievement in itself. There will be setbacks and times when you feel like you haven’t made progress for weeks or months. You will get angry, frustrated and disappointed from time to time. No matter — just keep breaking down your goal into tiny steps and don’t stop.

 

Cut through your own bullshit.

We are brilliant at lying to ourselves. We say we are working towards our goals when we haven’t made progress in ages. We tell ourselves we haven’t achieved our goals because we lack money, time or good mental health. We give up on goals because believing they are too hard is easier than giving them a fair shot.

Be aware of your favourite excuses and be ready to knock them down whenever they crop up. If your goals have fallen to the wayside, be honest with yourself as to why that is. Have your priorities changed? Are you scared of failure or success? Have you psyched yourself out because your goal seems too complicated?

Stop kidding yourself. If you think you need more time/money/better health to achieve your goal, incorporate those mini-goals into your ultimate goal. Or figure out a way to achieve your goal without getting those things. Seriously. There are millions of examples of people who have achieved goals without having access to resources we view as necessary. Why shouldn’t you do the same?

If you no longer want to pursue your goal — and you’re being honest with yourself about it — have the courage to admit it. Don’t keep saying you want it when you have generated more excuses than action steps. You are allowed to stop, even if you have invested a lot of time, money and energy. Even if other people have sacrificed a lot. Spending more time, money and energy on a goal you no longer want to achieve is pointless, more likely to lead to failure and soul-destroying.

Bullshitting yourself uses up a lot of energy, so save that energy for the stuff you really want to do.

 

Choose your own path.

Setting and working towards goals is a personal endeavour. That’s why it’s important to connect with your goals and stay connected. If your heart isn’t in it, don’t waste your time — choose to do something you will actually enjoy and find fulfilling.

If you are choosing to abandon your New Year Resolutions now it’s February, examine why. Have you honestly stopped wanting to achieve your goals in the past five weeks? Did you choose a goal based on what you thought you should want? Or are you trying to convince yourself you don’t really want to achieve your goals because they involve a lot of hard work and potential failure?

Everyone is scared of failure, even those of us who try to embrace it. I know it’s a cliché to say the only sure way to fail is to never try, but that doesn’t mean it’s not true. Another cliché that’s true: we tend to regret the stuff we never tried, not the stuff we tried and failed to do. I try to celebrate failure nowadays, because it’s a sign that I’m trying to change my life — after years of being resigned to misery and despair, it’s refreshing.

So set forth and follow your own path, because you can’t live your life in the constant maelstrom of paying more attention to other people’s opinions and judgements than your own goals and desires. And have you noticed that people who ridicule failure the most, tend to be those who are too scared to work towards significant goals?

Turning Points

I have been thinking about turning points a lot lately — blame the new year! Everyone seems to be talking about their goals or how they have already broken their resolutions. I like talking about goals and how to achieve them, but so much of the discussion is polarising: people tend to be either super-motivated, insisting we can all transform our lives in a millisecond, or pessimistic and resigned to never being able to change. It’s frustrating, because the healthiest attitude, especially for those of us with mental health issues, falls between these black and white views.

Signpost

Turning points are decisions.

Whether you are trying to change your life or your day, getting the desired outcome starts with making a decision. The decision doesn’t guarantee a certain consequence, but it does mean there is a chance of success. It’s more effective than waiting for things to change on their own.

For example, if you are having a bad day and feeling more depressed than usual, you have a choice. You can wait and see how the day plays out, whether something will happen to improve your mood. Or you can decide to do something which might improve your mood.

What you do will vary, depending on your current abilities and access to activities. You might feel better if you could jet off to somewhere sunny, but that isn’t an option for most people — even if you have the money, work and other commitments get in the way. Going for a walk is one of my go-to options, but sometimes anxiety prevents me from going out. Watching a favourite film or TV programme is a good option for accessibility — though others include reading, listening to music and baking.

You might feel no better after trying to change things, but the point is you tried — you took action instead of passively waiting and reacting to anything which happens.

 

How to create a turning point.

1. Decide what you want. What are your current goals? This could be something you have always wanted to do in life or simply changing the course of this week. It doesn’t matter — as long as it’s something you want.

2. Brainstorm ways to achieve what you want. Include everything which comes to mind, even if it seems stupid. If you get stuck, research ways other people have achieved similar goals.

3. Evaluate your options. Are they healthy? Realistic? Accessible? What would you need to fulfil each course of action? Don’t dismiss something just because it will be difficult, especially if it’s something you really want, but be aware of potential pitfalls.

4. Pick a course of action. Decide what to do and consider the steps involved. Your course of action may be single, consisting of a single step, or it could be complex. Again, research any aspects of your plan which you don’t know how to go about — fill in the blanks.

5. Take the first step. This is your turning point. No matter how small it seems, it could make a difference to you. Whatever the outcome, be proud of yourself.

 

Keep creating new turning points.

Improving your situation in the long term involves consistency and persistence. Success is more likely if you stick to your course of action and keep going. However, there will be setbacks and pitfalls. You will mess up. You will stray from the path you have chosen.

If this happens, don’t beat yourself up; just create a new turning point. No matter how many times you fail or let yourself down, you can always decide to change. Point yourself in the right direction, take the first step and don’t turn back.

Self-Caring

I find winter very difficult, so I was fascinated to read an article by Hannah Davies in the February issue of Psychologies magazine in which she discusses her mission to learn to love January. She says that January has now overtaken May as her favourite month, I don’t think I will ever love January more than spring or summer, but I do think it’s a great idea to appreciate the good things about winter. And yes, they are there — if you look hard enough!

Winter tree

One of the things Davies mentions in her article is the intricacy of bare tree branches. That image stuck with me, so when I walked up the lane to my favourite tree yesterday, I took this photo. She’s right — there is a lot of beauty in the stark patterns created by the branches and I have never taken the time to appreciate it before now.

Finding beauty in each day is also a great way to practice mindfulness. It’s difficult to seek out the little details when your mind is full of chatter.

Thinking about finding the beauty in every day, even in winter, made me think about self-care. I recently read The Self-Care Project by Jayne Hardy, which is a very good book with loads of practical information and exercises to work through. Jayne Hardy created The Blurt Foundation and I received the book in December’s Buddybox (which is a great way to practice self-care and support The Blurt Foundation). One of its messages has stuck with me: what does self-care mean for me, right now?

So, what does self-care mean for me at this moment?

It means working towards my goals, but also finding pleasure in the here and now. Appreciating the fact that I walk my dog on my own most days, which I simply wasn’t able to do 2 years ago. Enjoying reading ghost stories when I’m snuggled up in bed. Managing my mental health through exercise. Choosing to eat soup and porridge instead of crisps and cake for meals. And yes, looking forward to the longer, lighter days of spring!

 

Upgrading, Not Transforming

Happy new year! I’m sorry I haven’t blogged for ages. My depression got worse before Christmas and once I was feeling better, I had a lot of work and studying with which I needed to catch up. It’s been difficult, but the worst is over and I feel better for the days getting (gradually) longer and lighter.

I find it interesting that everyone seems to be divided at the start of a new year: they either buy into the “new year, new you” thing or rail against it. Personally, I believe both approaches have their benefits and a moderate approach is best. You are perfectly good as you are and self-acceptance is important, but there is a lot of value in setting and working towards goals.

I have a list of things I would like to achieve this year, but I’m also trying to appreciate my life as it is.

I have a lot of things to be grateful for, not least of which is having the opportunity to achieve (what I considered to be) a major life goal last year. I also feel I belong in my own life more, which is hard to explain. I suppose it’s about feeling as though I am doing meaningful things and contributing to the world in my own small way.

 

My approach: upgrading

I have been frustrated in the past (the recent past, too) that achieving a big goal hasn’t totally transformed my life. I know it was unrealistic to have those expectations, but I’m human and I tend to think “I would be so much happier and more successful if only I could do X.” I *think* I have finally learnt that while certain accomplishments or experiences may change my life, this is most likely to happen gradually rather than overnight.

Take trekking to Machu Picchu, for instance. I didn’t quite believe I could do it, right up to the point that I arrived at the Sun Gate, but I had all these assumptions about what it would mean if I did reach my goal. I thought I would be fearless, confident, unstoppable. I thought I would be able to change my life within weeks of returning home. I thought it would change me.

And it has changed me, but not as much or as quickly as I had hoped. I am more confident, although I still struggle at certain and in certain situations. I know I’m capable of committing to a huge goal and achieving it. Even of 99% of what I attempt results in failure, I know success is possible.

I alluded to the biggest change in my life in the openings paragraph of this post — my trek inspired me to embark on a Psychology BSc with the Open University. I have no idea what impact it will have on my life, but I know it’s a step in the right direction. I will probably be able to join the dots only in hindsight, several years or more down the line. All I know is that studying is the right thing for me to do for now and it will provide me with more opportunities.

I have decided to view changes like my Psychology course as upgrades. They haven’t transformed my life, but they have set me on a path which may lead to transformation.

I have also decided to view my goals for 2018 as upgrades. Achieving all of my goals may not change my life a great deal, certainly not on a daily basis, but my life will improve. I hope to end this year fitter, healthier and with better finances. I probably won’t be able to solve the major problems in my life (poor mental health, a lot of debt, living with my parents), but I can make improvements.

 

Focusing on the process

A major lesson which life has taught me over and over again is that I can’t control the results of anything — I can only control what I do. I find this easier to accept in some areas of my life more than others.

Submitting short stories, for example. I know I can’t control whether my story will win a prize or get published; all I can to is submit it to the competition or literary journal. However, I got very frustrated when obstacles threatened my Machu Picchu trek. It was annoying, being on a once-in-a-lifetime challenge and struggling with altitude sickness, panic attacks and a throat infection. It wasn’t fair. But every time I started thinking about the unfairness, I had a panic attack. This made my situation worse. The only way I could make progress was to focus on the process, putting one foot in front of the other without thinking about how hard it was or how much further I had to go.

So my goals for 2018 are all about focusing on the process. I won’t bore you by listing them, but suffice to say that they are all within my control and achieving them should be possible as long as I focus on execution and not results.

Getting caught up in results often harms execution. For instance, if your goal is to lose weight and you have a specific time frame in mind, it can be demotivating when you have a disappointing week. You convince yourself you’re off track, even if you have been following your eating and exercise plan. You might wonder why you bother and get sucked into a downward spiral, comfort eating so much that you jeopardise the next week’s weight loss. Chances are your disappointing weigh-in was down to normal weight fluctuation, but focusing on it and losing sight of the process can turn a blip into an abandoned goal.

Focusing on the process doesn’t mean you ignore the results: it’s about giving the process a fair shot before you change or abandon it. 

The type of results for which you are aiming also bear consideration. How much are they within your control? Weight loss, for example, is within the control of most of us. While you may have medical conditions which make it harder to lose weight, it’s possible for most people (with some exceptions; I’m not denying that). You may have to tackle psychological issues and/or physical problems along the way, but you can do it. Other results are almost completely outside your control: winning a Nobel Prize or getting married to a celebrity you fancy, for example. These are not good goals, because you will be setting yourself up for disappointment (again, with a few exceptions).

 

Prioritising a healthy attitude

The biggest problem for me is that working towards goals can trigger my mental health problems. Facing a setback can exacerbate my depression and/or anxiety. I can quickly convince myself that I’m doomed to failure and might as well give up.

Conversely, working towards goals also has a positive impact on my mental health. It gives my life meaning and purpose. It bolsters my self-esteem and helps me develop resilience. 

Bearing this in mind, I have to be careful about how I approach goals. I need to keep a sense of perspective and remind myself of the progress I have already made, both towards a particular goal and in other areas of my life. I know my red flags — becoming obsessed about a goal, letting a goal affect my mood — so when my attitude is becoming unhealthy, I can stop and remind myself of what is most important in my life, i.e. maintaining the optimal level of mental health I can at any time.

I like using charts to measure my progress, especially those that focus on the process. For example, ticking or colouring in a box every time I go for a run or put £5 in my savings account. Having a visual representation of my progress helps me to keep perspective. Plus there’s something really satisfying about ticking or colouring a box!

 

Will you join me?

I believe setting goals is a (note: not the) key to a healthy and fulfilling life. I get sick of all the “new year, new you” stuff, especially when I see adverts claiming that losing weight will have magical effects on your life (I lost a lot of weight in the past and it didn’t make me happier or more successful and though I was physically healthier, my mental health was worse). However, I also know that almost everything I like about my life has been created through setting goals. Even when I haven’t achieved a goal, I have learnt from the process and often made progress.

So I encourage you to set healthy, exciting goals which will lead you closer to your ideal life.You might want to change your life completely, but change starts with improving the areas of your life which matter most to you. These small improvements snowball over time and lead to you doing things you never believed possible.

Go for it. You can make your life a little better. You might transform your life this year, but you might not — and that’s okay. Good luck!

Write-Off Weeks

Last week was a struggle. Why? Because my anxiety and depression were worse than “usual” (which gets redefined regularly, depending on the variety and severity of symptoms I experience over a several weeks or so). That’s it. Nothing bad happened. I just felt worse.

A lot of people find this hard to accept: how can someone feel significantly worse for no apparent reason? I find it hard to accept, though experience teaches me again and again that it happens.

I have given up trying to analyse every fluctuation in my mood, because often there is no reason for changes in my symptoms. Even when I can pinpoint potential reasons, I can’t be certain whether they are causes or correlations — sometimes “reasons” are present but don’t affect my mental health. Winter, of course, presents its own litany of potential reasons — cold, wet, dark… Yet my mood isn’t always constant throughout winter.

I’m trying to be more compassionate towards myself and practice self-care, so I didn’t pressure myself as much as I have in the past. I gave myself permission to do whatever I could, even if that meant I did nothing. I focused on my priorities, but didn’t have the energy to fulfil all of them. In fact, the week was pretty much a write-off.

I feel guilty for neglecting my work, studies and volunteering, but part of me realises I could have done nothing more. Actually, I managed to go to all of my gym classes and walk the dog on my own, despite the heightened anxiety, which means the week was more of a success than it felt at the time. I tend to be strict when it comes to exercise, because it’s one of the main ways I manage my mental health. Skipping a session leads to more depression and anxiety; it also makes the next session much harder to do, creating a downward spiral.

I’m focusing on combining self-compassion with being strict about completing activities which help me to manage my mental health in the run up to Christmas. Christmas is difficult for me, but I also love it. I like the sense of togetherness and celebrating the days getting (gradually) lighter again. I like making time to watch films and bake. I love Brussels sprouts, cinnamon and tinsel. I enjoy buying presents and seeing colourful lights everywhere.

Yet some aspects of Christmas aren’t easy to deal with. I get frustrated when I make an effort and other people can’t be bothered, despite being far more able than me. It’s not a fun time to be single either, though at least I don’t have to deal with someone else’s family as well as my own! I shall be referring to my Christmas Survival Guide (and Part Two and Part Three) to help me through.

I have been feeling better since Friday, so I wonder if getting November out of the way has helped. November is the worst month of the year, in my opinion, so it’s always hard to cope. My plan is to concentrate on the things I like about this time of year and look forward to 2018.

I’m also in a reflective mood, brough on by the combination of the end of the year and my final counselling session on Friday. I have achieved a lot this year, but it hasn’t made a great deal of difference to my daily life. I’m still earning next to nothing and relying on working tax credits. I still have an enormous amount of debt. I’m still stuck living with my parents. I still have mental health problems which convince me I’m worthless and better off dead.

Yet trekking to Machu Picchu and being an integral part of a crowdfunding campaign which raised £15,070 for The Project have given me touchstones. I have achieved significant things this year and nobody can take them away from me — not even my mental illness. 

I may not have transformed my life, but I have completed a long-held life goal and made a difference. I have inspired at least one other person to chase her dreams — despite also struggling with mental illness. I may not feel confident a lot of the time, but I think my self-esteem has improved and I’m more willing to take on challenges.

I need to remind myself that while some weeks, or even months, will be write-offs, it doesn’t mean my life as a whole is a write-off.

Losing Spoons

The past couple of weeks have been difficult for me, mainly because I have been losing spoons.

The Spoon Theory is an analogy which helps explain how long term illnesses or conditions can deplete one’s limited energy. It was created by Christine Miserandino, who explains it here. I have previously written about my interpretation of Spoon Theory here and here. The basic concept is that everyone has a limited number of spoons, or units of energy, and when your spoons are limited by an illness or condition, you need to be very selective about how you spend them.

Spoons aren’t guaranteed.

The number of spoons available to you on any given day can vary — sometimes a lot. For example, on a good day I might have 25 spoons whereas I might have only 10 on a bad day. Most days, I average 15-20. The problem is, I don’t know how many spoons I will get in the future. This make planning problematic…

It’s a bit like getting paid a daily wage and never knowing how much you will receive. The amount sometimes bears a resemblance to your actions, i.e. the “work” you do, but there often seems to be no correlation. All you can do is invest, save and spend your spoons wisely — or rather, in what you hope is a wise way!

My current issue is that the number of spoons available to me, on average, have dropped over the past couple of weeks.

I partly expected this, because I attended two very important but anxiety-inducing social events a couple of weeks ago. As I have explained before, even when social occasions have been pleasant and enjoyable, it takes me a few days to recover.

However, the effect has been more dramatic than I anticipated. I think I may be fighting off a cold-type virus, as I have been tired and achy recently and sometimes my throat is scratchy. My mood has dipped too, as it is wont to do at this time of year, so my depression is absorbing more of my energy and motivation.

Accepting low spoon levels.

Having fewer spoons sucks, especially as I had been getting into a good routine with my writing, Open University course and volunteer work. Unfortunately, getting upset about the situation just uses up more spoons! It’s frustrating, because I feel like there should be a reason for losing spoons — perhaps I did something wrong or neglected some of the activities which give me more energy — but I can’t find one. It’s part and parcel of experiencing long term mental health problems.

The most annoying aspect of having few spoons to spend is being forced to narrow my priorities further than usual.

Having little energy means I have had to neglect very important parts of my life, because I need to prioritise my mental health first and foremost, followed by my work. I have no other option. I hate having to do it, but I can’t spend spoons which aren’t available to me.

It’s hard not to feel anxious about this state of affairs. I feel guilty for havig to cut back on my volunteer work and not seeing my friends very often. However, anxiety costs more spoons so I’m trying to avoid stressing out about the situation, since I have very little control over it (though that’s easier said than done!).

Moving through the mist.

All I can do is keep moving, even when my way is obscured. Giving in to frustration is detrimental — it won’t help myself or the people I think I’m letting down. I also try to remind myself that I’m not as depressed and anxious as I have been in the past: I may have fewer spoons, but at least I have spoons.

I will make an effort to acknowledge and appreciate what I am managing to do, though I wish I could do more. I submitted my first Open University assignment today, after neglecting it for the past few weeks. I wish I had been able to prepare it over a longer period of time, instead of writing it over the few days before it was due, but I’m glad I got it done.

I hope to get more spoons again soon, but I’m coping with the number I’m getting — which I suppose is good.

Self-Care: Simple and Complex

Self-care is a popular topic — and for good reason — but it tends to be oversimplified. 90% of the posts about self-care I see on social media don’t mention any of the issues involved. Lists of “100 acts of self-care”  make good clickbait and seem fun to share, but for many of us with mental health issues, they are intimidating and patronising.

All too often, self-care is promoted as a simple solution to mental health problems. The tasks advocated seem easy — to people whose mental health is relatively good — so we are told there is no excuse for not doing them. It’s rarely acknowledged that these “simple” tasks are almost impossible during bad episodes of mental illness.

There are exceptions to this glib approach to self-care, usually in social media posts and other materials produced by mental health organisations. The Blurt Foundation is particularly good at promoting self-care whilst addressing how difficult it can be and has a good self-care section on its website. However, many people and organisations have a lot to learn about how to present self-care in ways which are relevant to everybody.

Since it’s self-care week, I thought I would take the opportunity to discuss why self-care is more complex than it appears — especially for people, like me, who experience long term mental health issues.

 

There are different types of self-care — which vary in accessibility.

A major problem with any list of self-care activities is that a proportion of them will be difficult for many people to access or complete. When you see “20 easy ways to practice self-care” as a heading, bear in mind that none of them is easy for people experiencing mental illness and many will be impossible for people whose symptoms are moderate to severe. The ability to perform these tasks may also vary over the course of time — even from one hour to the next.

During the worst episodes of my mental illnesses, I was unable to do many of the “simple” self-care activities which people recommend most frequently: preparing a healthy meal, writing in my journal, seeing friends, going for a walk… In fact, the only act of self-care I was able to complete most days was getting out of bed. Usually because I needed to let the dog out.

You can try to practice self-care during relatively bad episodes of mental illness, but it’s important to select tasks which are appropriate for your current symptoms and situation. Getting dressed, taking a shower and making yourself a cup of tea are all acts of self-care which can make a difference to how you feel. They may seem ridiculously easy to someone who hasn’t experienced severe mental illness,but are very difficult when you are at your lowest ebb.

Tailoring your self-care plans to your current symptoms means they won’t always make sense to other people. For example, when my anxiety is bad but my depression is relatively good, I can do “difficult” tasks at home (cooking complex recipes, introspective exercises, running on the treadmill) but struggle to do anything outside, even a task which I have done many times before (walking the dog, going to the supermarket). You don’t need to explain yourself, but make sure you don’t judge yourself when other people express the assumptions and judgments they make about you. Mental illness isn’t logical.

Some of the activities depicted as self-care are so fraught with issues for people with mental health problems that they can leave you feeling worse. Anything which involves unfamiliar situations/environments/people, for example, is incredibly stressful for me. Getting a massage is not an act of self-care for me; it’s a situation which provokes anxiety when I think about the possibility! Going out for afternoon tea is a treat, but I don’t consider it self-care — allowing myself to be quiet and inactive for a few days afterwards to recover, however, is self-care.

Varying definitions of self-care are inevitable, especially when people have different mental health issues and different symptoms. For this reason, it’s important to define what self-care means for you. It’s also helpful to have different self-care strategies in place for different times/situations, depending on your mental health.

 

Sometimes self-care means not doing something.

Giving yourself permission to opt out of events and activities which could cause you distress and/or make your symptoms worse is a form of self-care. It’s a way of protecting yourself. Putting your needs first is not selfish — it’s necessary. Some people may accuse you of causing problems, but taking care of yourself is your main responsibility.

I feel guilty for refusing invitations, but I know the consequences if I go along with something which causes me more stress and anxiety than it’s worth. The people who really care about you will try to understand. They will see that you’re not being difficult for the sake of it and while they may be disappointed by your decision, they won’t hold it against you.

Another aspect of self-care is not getting caught up in other people’s emotions and judgments. If you explain the situation clearly and they take offence or accuse you of being selfish and manipulative, it’s their problem — not yours. Set boundaries in place and refuse to be drawn in. Stand firm on what’s right for you — it won’t be easy, but it’s easier than dealing with the consequences of not protecting yourself.

A note to anyone reading this who doesn’t understand why someone with mental health problems would refuse an invitation: events and activities which seem pleasurable to you can provoke a lot of anxiety and negative emotions. You may believe a party means only a few hours of discomfort for someone with anxiety, for example, but this is not the case. Instead, it means days (sometimes weeks) of anxiety beforehand, which may cause unpleasant symptoms like indigestion, diarrhoea and tension headaches. The “few hours of discomfort” actually feel like torture to someone with anxiety. When the part is over for you, it’s not over for someone with anxiety — they are left exhausted for at least a week and often ruminate on every little detail, worrying that people thought they were rude because they were too nervous to speak or that they embarrassed themselves in a million different ways. When someone with mental health problems refuses an invitation, please don’t try to guilt trip them into changing their minds — accept that they know what’s best for them and try to empathise.

A paradox in self-care is that sometimes not performing an act of self-care is self-care. This means recognising when a certain activity won’t deliver the benefits you hope, for example, forcing yourself to do a vigorous workout when you are already tired. Give yourself permission to do what you most need right now, even if that’s lying on the couch for a while.

 

 

Self-care doesn’t negate the need for help and support from others.

Self-care is not a substitute for mental health treatments and services, though it can form an important element of mental health management. It complements treatments like medication and talking therapies, which in turn can make it easier to practice self-care. While self-care is about taking care of yourself, it doesn’t mean you should struggle alone instead of getting help from other people.

Self-care is often presented as taking responsibility for yourself, but it’s seldom acknowledged that being able to take responsibility for yourself is a privileged position. You need to be well enough to practice self-care. Most people who experience mental illness need support from other people, in both personal and professional capacities — which should not be a source of shame.

Unfortunately, the language used in many social media posts, blogs and articles about self-care is careless. It implies that people who are unable to practice self-care are unworthy of help from other sources. Some people write about self-care as if it is “the answer” to our mental health crisis, which is untrue and potentially harmful.

Self-care is not a substitute for treatment or support. It’s a habit which we should all try to develop, whether or not we have experienced mental illness, without judging those who are unable to practice self-care. It can help us to achieve and maintain good mental health, but is not the only way to manage mental health.

 

Self-care needs to be practiced with self-compassion.

It’s not about creating a to-do list of tasks you “should” be doing, which often makes you feel worse. Don’t berate yourself for not being able to do certain tasks. Don’t feel guilty if a day, a week or a month passes without you being able to practice self-care. Do what you can, when you can.

Self-care starts with self-compassion and vice versa. When you believe you deserve compassion, you are motivated to practice self-care. When you practice self-care, you realise you deserve compassion.

Self-care is effective because it engenders self-compassion, leading to a positive spiral which changes how you feel about yourself. I realised this a few years ago, when I started making the effort to apply body lotion every week. My main motivation was getting rid of the dry skin on my knees, shins and elbows, but after several weeks I noticed it was beginning to change how I felt about myself and my body. It forced me to connect with my body, which I had always regarded with disgust, and taking time to do something for myself was powerful — it raised the possibility that myself and my body were worthy of time and effort.  A simple task shifted my mindset.

 

Self-care is not part of a reward/punishment system.

Self-care is not something you need to earn the right to practice: everyone deserves it. It’s not a reward for acting or feeling a certain way, or for doing something specific.  Conversely, it’s not a way of punishing yourself for not doing, thinking or feeling something different.

It’s about accepting yourself as you are, right now, and doing something to improve your mood, health or wellbeing. You don’t need to earn self-care or ask permission. You don’t need to tell anyone about it or keep it hidden. 

Neither is self-care a way to cancel out unhealthy or self-sabotaging behaviours. It’s not a column on a balance sheet, giving you permission to punish yourself as long as you counterbalance it with self-care. It’s not an excuse for not tackling unhealthy and harmful habits. It’s separate from your mental health issues and symptoms, although it influences your mental health in positive ways.

 

Check your self-care expectations.

Self-care is important and can have a big impact on your mental health and wellbeing, but it’s not a miracle cure. The effect is gradual and accumulates over time, especially as practicing self-care becomes a habit. It might make you feel better immediately, but it might not.

I find the best policy (for me) is to approach self-care with hope, but not expectation. I know there are possible benefits to any given act of self-care, but I don’t take them for granted. Most of the time, there are immediate benefits — often the satisfaction of completing a task! — but these are bonuses.

The long-term impact of self-care is also unpredictable and not guaranteed. Some of my self-care activities have produced positive results after months (or more) of seeming to have no impact; others have been effective after a short time. Many activities appear to be pointless until I stop doing them, at which point I notice my mood drops and other symptoms worsen.

I always find myself repeating that managing mental health involves a lot of trial and error, but it’s especially true for self-care. What works for you is often surprising. Something frivolous, like painting your nails, can have a bigger impact than it seems to merit. Other activities, like eating healthily, take so long to have an impact that it’s easy to get demotivated and give up. I think approaching self-care with the spirit of curiosity and experimentation is helpful.

The most powerful aspect of self-care is the act itself: by performing self-care you are telling yourself that you matter, you are valuable, you are worth the effort. And you are right!

Winterproofing

I tend to think of the clocks going back as a negative event: winter has always been a difficult time for me, bringing both physical illnesses and a decline in mental health. The past two winters have been particularly awful. Last winter, I was ill for nearly four months solid, with the flu, throat/chest infections and other viruses wreaking havoc. I couldn’t use the coping strategies I had put in place, as even the easiest took too much effort. My depression and anxiety got worse.

Sunrise

This year, I hope things will be different — but last winter has taught me that you can do almost everything “right” and still succumb to illness. 

There has been one benefit to the clocks going back that I haven’t appreciated/experienced in past years: the lighter mornings. Since I get up at 5am nowadays and take the dogs out around 6:10am, the change is obvious. We could walk up the lane again this morning, after being forced to take a different route (with streetlights) for the past few weeks. As you can see in the photo, the sunrise was glorious.

Prioritising Self-Care

While I can’t control everything, I am making sure I stick to my coping strategies and self-care activities. In particular, I am being strict about using my SAD lamp and exercising. I know it probably seems ridiculous to people who don’t understand how important these activities are in managing my mental health, but it’s necessary.

Sure, I feel like I’m being awkward when I tell my friends I can’t go out on the evenings I have gym classes, but I don’t want to risk damaging my mental health. My routine, combined with the physical exercise, helps me stay healthy. When I feel guilty for being so selfish, I remind myself that when I got ill last winter, I couldn’t socialise for weeks — being unavailable a few evenings a week is preferable to being unavailable throughout the winter months.

I’m also being stricter with strategies which I should implement more regularly/frequently than I do at present. Wanting to avoid a repeat of last winter is a great motivator! I’m trying to eat healthy meals, even if I eat junk as well, and making an effort to meditate. I know I could do better, but stressing out about not doing better is counterproductive…

Finding Pleasure in Winter

I have being trying to focus on my strengths and the positive aspects of my life recently, so I’m trying to take the same approach to winter. It can be difficult to appreciate the pleasurable side of the cold, wet and dark months, but it’s not impossible.

Winter creates the perfect atmosphere for reading ghost stories, which I enjoy. It’s also a good backdrop for hot chocolate, warm puddings and spicy curries. Brussels sprouts are in season, which I adore (seriously) and I can watch films or read without feeling I should be outside, enjoying the sunshine.

I like a lot of things about Christmas, too — though it can bring its own challenges. Seeing Christmas lights when walking the dogs, buying presents and listening to cheesy Christmas songs are all fun. It marks the winter solstice, so brings hope that spring will come. The days will get longer again and it feels like I’m progressing with the changing seasons — in theory, anyway! In the meantime, it’s back to ghost stories and hot chocolate.

Facing Down the Fear

I’m terrified of getting ill again. I dread feeling like I did last winter. However, worrying and getting stressed will only increase the likelihood of getting ill.

Instead, I’m attempting a more pragmatic approach. I will do everything I reasonably can to avoid getting ill (hence I got a flu shot last week, for the first time!), but I can’t beat myself up if I get ill. Whatever will be, will be.

It’s the same old story, really: there is no point in worrying about stuff which might or might not happen. Of course, knowledge and practice are different things — especially when you have anxiety…

I refuse to fixate on whether or not I will get ill. In fact, I accept that I probably will get a few viruses and colds. I accept that my depression will become more difficult to manage. But I can focus on what I’m able to do and put contingency plans in place.

Coping with winter is difficult, but I’m not completely powerless. I can choose to accept the possibility of illness while doing my best to keep it at bay. It’s my best chance of staying mentally and physically healthy.

Accumulating Expertise

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

 

Capturing Information

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

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

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

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

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

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

 

Research and Development

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

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

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

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

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

 

Expectations and Judgments

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

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

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

 

Achieving Balance

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

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

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

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

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

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

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