Reawakening

Spring helps me feel better. The warmer weather and increased hours of daylight encourage me to do things which benefit my mental health, like exercising and spending time outside. Sunlight also has an effect on your hormones, which helps you to sleep better and improves your mood — great for people like me, who struggle with depression and insomnia.

Many of the benefits are psychological.

Spring is a time of hope and reminds you that nature follows cycles. Just as trees and flowers burst back into life, there is a possibility of emerging from mental illness. This emergence may be a complete recovery or, as is more likely in my own experience, a period of relative wellness during which I still battle mental health problems, but can work towards my goals.

For me, mental illness follows these unpredictable cycles. Sometimes I can anticipate shifts in the cycle — such as expecting to feel generally better in the summer months — but often, my symptoms change in ways which have little rhyme or reason.

Dealing with unpredictability is difficult, but learning to roll with it is easier and better in the long run than railing against it.

Mental illness is unfair. Part of the reason why stigma surrounding mental health is so prevalent is that people don’t like to admit that mental illness can be random. They prefer to think it affects only a certain type of person or is consciously caused by sufferers. If you are nentally well, it’s probably more pleasant to believe mental illness only happens to weak people and therefore can’t happen to you. The truth, that mental illness can affect anyone at any time, is difficult to accept.

In fact, the truth is difficult to accept even when you experience mental health problems. I would LOVE to blame my mental illness on something specific I have done, because it would answer the persistent “why me?” question and means I could do something to fix it once and for all. The truth is trickier: I can adopt strategies to actively manage my mental illness, but I can’t control everything.

Sometimes you can do everything “right” and still experience a decline in mental health.

This happened to me at the end of last year. I was exercising regularly, eating healthily, socialising more and going to bed at a reasonable time every night. I was working and volunteering. I had goals. I was practically the poster child for self-managing mental illness, having stopped taking antidepressants in September. Yet my mental health got worse.

There was a clear catalyst, in the form of successive winter viruses which prevented me from doing a lot of my self-care tasks, but the sudden downward spiral in my mental health was unexpected and couldn’t be sufficiently explained by my physical illness. As I’m emerging from this episode, I’m learning to accept it as part of the cycle of my mental illness. I didn’t do anything wrong. I didn’t deserve to get worse — just as I didn’t deserve to get mentally ill in the first place. But it happened.

My instinct is to bemoan the fact that it happened, but it’s unhelpful. It means I focus too much on the negative aspects of my life and prevents me from making progress. Instead, I need to look forward.

 

 

Looking forward means acknowledging the past, working through it while focusing on the future.

One of the reasons I love history is how much it teaches us about the present. We can learn from both the similarities and the differences between the past and present. I have been doing this in counselling over the past couple of months, learning to recognise the patterns I have followed (often without realising) so I can break them. Finding the causes of certain patterns can be helpful, but it’s not necessary — the pattern can be broken without a full understanding of how it developed — simply noticing the pattern is the important part.

So I’m striving to create new, healthy patterns which promote good mental health. Yet I must acknowledge that it might not be enough. I could experience another episode of worse mental health despite developing these patterns.

Because there are no guarantees with mental health, it is vital to do whatever you can, when you can. Work with the cycles of your mental illness, striving towards your goals when you feel relatively well and allowing yourself respite during worse episodes.

Spring is a reawakening for me and heralds, I hope, a period of better mental health. However, if my health declines in future, I hope I can apply what I have learnt. I wish I didn’t suffer from mental illness, but I don’t want to waste time wishing things were different — I want to learn from my experiences and use them to help others. I want to look forward.

 

Stepping Up and Stepping Back

Mental illness can make things hard to plan.

You can never be sure whether a certain date will be a good day or a bad day. You don’t know whether this week will be difficult or relatively easy. Given this unpredictability, learning to be flexible is a key skill.

 

 

Being flexible requires some consideration…

The most obvious consideration is deciding your priorities: defining which aspects of your life are most important to you and keeping the order in mind. There might be times when you are too ill to tackle even your most important and basic needs, but much of mental illness isn’t so extreme — bad days may severely limit what you can do, but you can still do something. The trouble is, without clear priorities, it’s easy to waste the little energy you have on tasks which aren’t important.

When we complete trivial tasks but neglect our priorities, our tendency is often to blame ourselves — which can make mental health problems (and symptoms) worse.

I often fall into the trap of completing low priority tasks first. I tell myself that they will ease me into the important stuff, helping me avoid procrastination. This might work for some people, but when your mental health fluctuates, you can’t depend on being able to do the important tasks later.

You might feel drained later and simply won’t have the energy to do more. Or the depression could take over and you won’t  have the motivation or ability to do anything, let alone something important.  Or you could get lost in an anxiety whirlwind, stressing out and worrying so much that you can’t think straight. There are a million reasons, depending on the symptoms you personally experience, why “later” might not be an option.

 

Priorities need boundaries.

In order to prioritise effectively, you need to put boundaries in place. These can be flexible, but you need to be aware of them — and make other people aware, when relevant. Prioritising is pointless if you can be easily swayed by someone begging you to do an unimportant task. You need to make it clear that you have priorities and while everyone’s time is limited to 24 hours a day, mental illness steals time from you.

Setting and maintaining boundaries can be difficult, but it is necessary.

Boundaries help us to cultivate good mental health and to manage better during episodes of poor mental health. Given this, it’s a good idea to ensure you put boundaries in place at any time — the sooner, the better.

I recently had to set boundaries with someone for whom I do volunteer work. It was difficult for me to broach the subject, but I wanted to make it clear that I couldn’t prioritise them. I could commit to a few hours of work a week and would be willing to do more if/when I’m able, but my priorities are my mental health, writing work for which there’s a chance of earning money, blogging, training and preparing for my Machu Picchu trek and my other volunteer role, which is more closely related to my passions and career plans since it’s a mental health charity.

I felt awkward bringing it up, but this volunteer role has never been formal and I have never promised to do a certain number of hours. I still want to help, but not at the expense of my priorities. I feel better for having explained this, because I wanted to ensure that the expectations of those involved didn’t exceed what I could offer. I also didn’t want to feel pressured to put in more hours than I could commit to, because that would make my mental health problems worse. In fact, setting boundaries benefits everyone, because if my mental health declined a lot, I wouldn’t be able to do anything at all.

You might come across people who don’t respect your boundaries, but don’t be deterred by them: you set and maintain your own boundaries. They might try to push at them or knock them down, but you are in control. 

Your ultimate priority should be you.

You can’t help anyone or achieve your own goals unless you put yourself and your mental health first. Ensuring you are managing your mental health as best you can means that you will be able to do more than if you don’t prioritise it. In the list I made above of my own priorities, my mental health comes first. Why? Simply because I cannot do anything else on the list unless my mental health problems are under a certain level of control.

Knowing when to step up and when to step back can be complicated, but your main consideration should be how your actions will affect your mental health.

Again, this often requires flexibility. For example, sometimes I feel so anxious that going for a walk would make me feel worse. Going outside can make me feel panicky and I’m constantly on edge when my anxiety is bad, so I wouldn’t enjoy the walk. Most of the time, going for a walk makes me feel better, even if I’m experiencing some anxiety, because being outside and getting exercise improves my mood, plus I get a sense of achievement from doing it. The trick is to recognise when my anxiety levels make the activity shift from “helpful” to “detrimental”.

The same goes for any task or activity. Mental health problems can be complex and it’s all very well to make a list of what helps you feel better, but sometimes those things can make you feel worse. It depends on your symptoms and circumstances. Be aware of how you are affected by different activities at different times and adjust your boundaries and priorities accordingly.

 

It’s not just about mental health.

I refer to mental health because it’s the main focus of my blog, but everything I have said applies to physical health, too. In fact, my mental health and physical health are so intertwined that I tend to consider them together. For instance, prioritising my mental health means prioritising exercise — which improves my physical health.

The basics of cultivating good mental health and good physical health are the same: eating healthily, exercising, getting enough sleep, reducing stress, etc. Keep this in mind when deciding on your priorities and setting boundaries — a strong foundation of healthy habits helps you to do everything else more efficiently and effectively.

 

 

Self-Intervention is Part of Self-Care

Knowing when you need extra help is a crucial part of self-care, although it can be difficult.

Learning to recognise when a worsening of symptoms becomes a need for extra help and support is vital for long-term mental health management. However, it can also feel like admitting failure. When your symptoms have improved, a decline in your mental health can feel like it’s your fault — that you have done something wrong which has caused your symptoms to get worse.

Everything feels darker and you are trapped into the “old” pattern of mental illness you thought you had come through.

The logical part of your mind knows this is wrong and nobody is to blame for their mental health problems, but the messed-up parts of your mind constantly tell you the same old myths: it’s your fault, you fucked up, you are doomed to be miserable forever.

 

You may try to ignore the situation, but it’s important to get help sooner rather than later.

I speak from experience. Over the past 3/4 months, my mental health has declined. This came after a fantastic summer during which I did things that were previously impossible for me (going to jive classes, for example) and felt well enough to stop taking medication after over a decade.

I came up with excuses for not going to my GP: I was stressed out because major renovations had turned my home (and life) upside down. I felt more depressed because I had been hit with one virus after another. These excuses were true, but my assumption that things would go back to normal when the workmen left and I regained my physical health were not.

I wasn’t coping and by delaying getting help, I suffered more and my mental health got worse.

I finally went to my GP on Monday. He is referring me to an organisation which offers counselling, which I believe will be most beneficial for me right now. I told him I would prefer not to go back on antidepressants at the moment, but I would never rule them out as a possible treatment. He was brilliant and accepted my insight into my own mental health — I had been a little wary of feeling pressured to take medication again without trying counselling on its own first, but that turned out not to be an issue.

If you aren’t so lucky and your GP pressures you to try a course of treatment which you feel isn’t right for you, remember you are entitled to a second opinion. However, it’s also worth examining your reluctance to follow the suggested course of treatment — some people resist medication, for instance, because they believe myths perpetuated by the media. Do some research, always asking whether your sources have an agenda which is at odds to your wellbeing, and make an informed decision.

 

Self-intervention, like self-care, is different for everyone.

For me, self-intervention was about recognising that I needed professional help and would benefit from counselling, which I hope I will receive. For other people, it might mean enlisting the support of family or friends, altering their lifestyle or adopting more self-care strategies. It could mean something entirely different, which I might not consider.

It’s about recognising when your mental health has dipped enough that you need extra strategies in place to prevent it from getting worse.

Ideally, this will lead to an improvement of symptoms, but the initial reason for self-intervention is to stop the situation declining further. The signs that you have reached this point vary depending on your recent mental health history and self-knowledge. Symptoms which may not concern one person, may be very worrying to another.

For example, I wasn’t concerned by a slight increase in my depression, because I know it gets worse in winter. However, while my low mood was normal for me, the increase in anxiety to the point where I was having panic attacks more often is a red flag. For someone else, the increase in depression could be a red flag whereas if they were already regularly experiencing panic attacks (as I did in the past), an increase in their frequency might be considered a small change.

Knowing your red flags is important in managing your mental health.

If you don’t have a high level of self-knowledge and self-awareness, keeping a record of your symptoms is helpful. I try to do this when my mental health problems get worse because whereas I normally have a high degree of self-awareness, this gets skewed by anxiety and depression: I tend to think things are fine until they get so bad I can’t deny it any longer. By keeping notes on my mental health, I could have noticed the worsening of symptoms before things got so bad.

Like so many things related to mental health, this is easier said than done, but keeping even a rudimentary record of symptoms can be useful.

 

Self-intervention is needed because many mental health symptoms aren’t noticed by other people.

There are plenty of reasons why other people might not recognise your symptoms worsening:

A lot of symptoms are internal. Negative thinking, headaches, low mood, etc. aren’t always apparent on the outside, especially if they are not expressed.

It can be difficult to distinguish when an already-present symptom is getting worse. If someone knows you experience a specific symptom, such as feeling nervous around other people, they may think all signs of this are normal for you and can’t tell when it’s worse or better.

Nobody is with you 100% of the time. Many symptoms are most apparent when you are alone and many may not seem concerning when glimpsed by someone who doesn’t realise how frequent they are. Under-eating or over-eating, for example, are often secretive behaviours and might not worry people who only see you displaying the behaviour over a limited period of time, such as your working hours. They don’t know whether this continues when you get home, or whether these behaviours are balanced out by other ones.

People might not know if something is a symptom of mental illness. There is a lot of ignorance around mental health and some symptoms might seem unconcerning to people who consider them merely quirks. Some symptoms might be considered normal by some people, such as dismissing a persistently low mood as pessimism or chronic under-eating as a low appetite.

Even if other people do realise your mental health is deteriorating, they might not know how to tell you.

They may assume you already realise or that you would feel uncomfortable if they brought it up. They might tell themselves it’s none of their business or that you might get better without their intervention. These assumptions may or may not be correct — the point is that you cannot rely on someone else to recognise your red flags and tell you to get help.

This means you have to make an effort to recognise your own red flags early, so that you can take action and get the help you need.

 

It’s better to plan self-intervention before it’s needed.

When you are relatively well, it’s the best time to make decisions abot what to do if your mental health declines. Don’t wait until worsening symptoms cloud your judgement.

I wish I had a clear plan in place. It would have made things easier and enabled me to get help sooner.

I had some vague ideas about what it would take for me to go back to my GP, but nothing written down. There was no list I could refer to, which would probably have convinced me to see the doctor when my symptoms got worse, rather than a few months later. This is something I plan to change.

While so much of self-managing your mental health is about focusing on positive change, having contingency plans is essential. If you have close friends and family members you trust, you can ask them to help. For example, you may ask them to flag up when you are displaying certain symptoms, such as withdrawing from social events. You can also indicate the kinds of treatment you would prefer in various situations, so they can help you get the treatment which is best for you.

I wish my mental health had continued its upward trajectory, but it hasn’t and self-intervention was necessary to prevent my health from deteriorating further. It’s a potent reminder that mental illness is not linear and for many of us, self-care involves preparing for episodes of worse mental health — perhaps for the rest of our lives. 

Glimmers of Hope

The end of January is limboland: the year is no longer shiny and new, but spring feels far away.

My depression tends to get worse in winter and by the time February comes around, my mood has been low for weeks. I have to search hard for small signs of hope, like the gradually lightening evenings and these catkins I saw when I went for a walk today.


As trees, flowers and other plants emerge from winter, it shows the strength of nature’s faith.

Nature doesn’t doubt that spring will come. It knows there will be better times ahead, when flowers can blossom and leaves can flourish. I struggle to find that faith in the midst of depression, even a comparatively low level depression such as I’m experiencing now, but seeing glimmers of hope in nature helps. It reminds me there is a cycle to everything, including mental illness — even when the seasons seem unbearably long.

Nature is preparing for the spring and summer ahead: I need to figure out how to do the same.

I need to search for the glimmers of hope in my own life and use them to motivate me to prepare for better times. It’s too easy to focus on the negative aspects of my life and ignore the positives.

In fact, seeing those catkins today counts as a positive in my life, because I can walk my dog on my own — this time last year, my anxiety was so bad that I couldn’t go out alone. When I walked up the lane alone in March last year, it was the first time in over a decade. That’s another glimmer of hope.

 

 

 

Sick of Being Ill

Long term mental illness + exposure to cold/flu-type virus = 3 and a half weeks (and counting) of feeling crap

I have a newfound appreciation for how healthy I have been over the past couple of years. I caught the odd virus, but I didn’t have an episode of physical illness lasting longer than a week or two. This has changed.

My current ailment has zapped my energy and given me a very painful chest, which is exacerbated by a cough. For the first couple of weeks, I also had headaches and earache. I also have a sore throat which ranges from a little dry to completely raw.

I do feel somewhat better this week — which means my symptoms are less aggravating than my frustration at not being able to get much done.

As I get more annoyed at my immune system, I get more annoyed at myself. Negative thoughts creep in more often. I blame myself for not having energy, viewing it as a sign of my general ineptitude…

Mental health and physical health affect each other.

Everyone knows and accepts how physical diseases can take their toll on mental health. We all understand why someone with cancer might develop depression. Many people understand how chronic ailments which aren’t life threatening may cause mental health problems. However, few people consider how mental health affects physical health.

Many people don’t realise that mental illness can have a variety of physical symptoms, many of which are debilitating. They don’t know that mental illness affects the immune system, leaving sufferers more susceptible to contagious physical illnesses. Like viruses.

When I was a teenager, I got viruses constantly. Many of them were attributed to “stress” because my mental illnesses weren’t diagnosed until I was 18. I was stressed, for sure, but I also had depression and anxiety. I was rundown and exhausted because I had insomnia from the age of 13/14. No amount of rest gave me energy, because my mind was in a constant state of turmoil. Little wonder that I caught everything going!

Of course, this can create a vicious circle…

Physical illness can make it difficult to take care of your mental health, just as mental illness can make it hard to pay attention to physical health.

Over the last few weeks, I have found it very difficult to practice self-care. I haven’t had the energy to do simple things like switch on my SAD lamp, repeat affirmations and meditate. I certainly haven’t been able to exercise.

This is a strange parallel to the past — when my mental health was at its worst, I struggled to eat healthily, exercise, sleep or do anything else to help my physical health.

I have noticed my mental health getting worse over the course of my illness. It’s not terrible, but it’s worrying.

Illness may be temporary, but its effects on mental health can outlast it.

My biggest worry is that the impact on my mental health will last much longer than the virus itself. I don’t want to slip on a downward spiral triggered by an illness which most people manage to shrug off after a week, with no long term effects. Trouble is, that’s beyond my control.

Maybe I will bounce back from this virus and feel awesome next week. Or maybe I will still be reeling from its effects far into next year.

Illness is a reminder that you are not 100% in control.

Whether illness is mental or physical, it makes you realise that you don’t have complete power over your life. While that may be obvious, it’s easy to get caught up in other stuff and then — surprise! — your plans get interrupted by a bloody virus. Or a resurgence of mental health problems. Or both.

Which is why I am so annoyed. I have a lot to do — I have just started volunteering for a local mental health charity and reprised mt volunteer role with the Lyme Regis Fossil Festival. I’m also doing a photography course and have been unable to do any of the (unassessed) assignments, so will need to get my act together to produce something halfway decent for the final assignment. Not to mention my writing projects and preparing/fundraising for my trek to Machu Picchu

I’m supposed to be doing stuff, taking action, being proactive, workig towards my goals… Only I have next to zero energy. Plus the decline in my mental health is paradoxically robbing me of my motivation and making me anxious about everything I want to do.

It boils down to this: a common winter virus is another thing that is relatively easy for most people to deal with, but threatens to derail those of us with mental health problems. And that sucks.

 

Getting my Mojo Back

The past month or so has been difficult. In addition to the stress of coming off antidepressants, which I didn’t expect to be so stressful, several minor events threw me off course. I couldn’t even turn to exercise, which I have been using to manage my mental health, because I injured my hip. My mood was affected and at times, it felt like the world was conspiring against me.

However, this week is a lot better. My hip has recovered enough for me to return to gym classes, so that has boosted my mood and put me back on track working towards my fitness goals. I think using the SAD lamp has helped a lot, too. It’s the kind of thing I don’t notice doing good until I do less of it and experience a corresponding drop in mood. My fiction writing is also going well and I’m doing some volunteer work again, both of which help me feel more purposeful.

I have realised that getting my mojo back isn’t about a dramatic change or a magical transformation. It is simply the accumulation of small actions.

Like Austin Powers, I had my mojo all along. I just need to access it through concentrating on self-care. I have to keep doing the things which help me manage my mental health, even when — no, especially when — I don’t feel like doing them. These actions may be small, but they still take a lot of effort when depression and anxiety set in. They may be small, but they are significant.

My self-care actions, in addition to the ones already mentioned, include:

• Getting outside, especially in woodland

• Spending time with my dog and cat

• Eating reguarly and as healthily as I can

• Reading novels and short stories

• Watching The Big Bang Theory

• Mindfulness meditation

• Scribbling down my feelings

• Watching tennis (and Andy Murray reaching number 1 helps!)

• Texting friends/seeing friends

The result of getting my mojo back is that I feel more motivated and have more energy. There is room for improvement, but compared to how I felt recently, it’s brilliant! 

Again, this experience demonstrates the power of small actions when they accumulate. I find that very encouraging — not just in terms of mental health, but also how the principle can be applied to other aspects of life. You might not feel like you can do much to change things, but you can do something small. Keep taking small actions and you could change the world.

Learning to Be Well

Here are the 5 most important lessons I have learnt in the 6 weeks since I stopped taking antidepressants. I hope they might help people in similar situations, or help their families and friends to understand what they are experiencing.

1. There is no sudden shift from “mentally ill” to “mentally well.”

It’s easy to assume that being well enough to come off medication means you should be able to make other changes quickly and effectively, but you will probably find that life doesn’t look very different when you stop taking antidepressants. There will still be struggles and changes take time.

You can continue to take steps in the right direction, but bear in mind that these need to be steps — not giant leaps. Managing your expectations and being realistic helps you move forward while being compassionate towards yourself. Placing yourself under pressure to transform your life in a short period is neither practical nor fair.

2. A change in mood is not a relapse.

Life is full of ups and downs: we all know this, yet there is a tendency when you have mental health problems to think that normal fluctuations in mood signify a relapse. I have discovered that this intensifies when you stop taking medication. You wonder whether a natural reaction to an event, such as disappointment, is actually a symptom of your mental health deteriorating.

Be prepared for this reaction. Find a more accurate way of monitoring your mental health than listening to the stream of your thoughts. Simply recording your mood and other symptoms at regular times can establish a more objective picture. If you genuinely feel your symptoms are getting worse, discuss it with your doctor and/or other mental health professionals.

3. Self-care is more important when you feel all right.

Self-care is about prevention as well as treatment; I am learning that the former is essential. It’s tricky to keep up self-care routines when you feel well. You start thinking your time might be better spent doing other things. Unfortunately, you might not realise that this is a fallacy until your mental health suffers.

You need to be strict with yourself and do what you need to do every day. This varies from person to person, but for me they include mindfulness meditation, some form of exercise and using a SAD lamp during darker months. Prioritise your mental health, even when it’s tempting to do something else.

4. Don’t let yourself get sidetracked by setbacks.

There will be very difficult times and you will face challenges you didn’t anticipate. For example, I have injured my hip and have been taking a break from exercise, which is difficult because being active is an integral part of my mental health management. The only option is to work around setbacks. In my case, I am focusing on using other strategies to boost my mood until I can return to exercise.

Setbacks are frustrating, for sure, but don’t let them become excuses for not looking after yourself. If you are struggling a lot, remember that there is no shame in taking medication again. Try to show yourself compassion and think of alternative solutions for your problems. Don’t let setbacks dictate your life — figure out how to deal with them and move on.

5. Find other things to focus on.

Rather than obsessing about your health, focus on other things — your relationships, work, passions. Get back to an old interest or try out some new hobbies. Learn something new. Set some goals which aren’t directly related to your mental health.

Activities which induce a sense of flow are ideal — your mind is focused on what you are doing, so there is no opportunity for negative thoughts to arise. Different activities work for different people, but most involve using a skill which challenges you without being so challenging that it causes negative feelings. For me, writing and drawing are most likely to induce flow.

However, activities which don’t necessarily induce flow can also provide a healthy distraction. I love film and literature, for example, so I get lost inside the stories. I also enjoy modern jive, although my skill level is too poor to induce flow — even when I get frustrated at my lack of coordination, rhythm and balance, it’s a break from my usual anxieties. Walking the dog involves little skill, but provides me with a lot of pleasure. Seek pleasures in your life — as long as it’s not self-destructive or damaging to others, these pleasures can help you get more out of life.

I want to manage my mental health so that I can live a full, satisfying life and this can only happen through paying attention to the things with which I want to fill my life. Filling your life with small pleasures can help you through the challenging times. Finding and fuelling your passions can help you learn to be well.

Accentuating The Positive

I recently read a very interesting book, Positive Psychology for Overcoming Depression by Miriam Akhtar, which has helped me to manage my mental health. I was already a fan of positive psychology, but hadn’t read anything which applied the approach to mental illness. The standard line given in books on positive psychology is that whereas most psychology focuses on what’s wrong, positive psychology concentrates on what people can do to feel good — rather than fixing problems, it circumvents them to find solutions.

I personally believe that there are benefits to either approach when treating mental health problems: there is no need to choose one and no reason why they cannot be used simultaneously. While this book focuses on depression, the strategies it suggests can also be used to manage other mental health problems — in my case, I find them useful for anxiety and borderline personality disorder. Another advantage of using this book is that it explains the theory behind everything without being dry or too academic. It’s suitable for any level of knowledge regarding positive psychology; whether you have never heard of it or if you are familiar with the subject, the advice is pertinent and never patronising.

As always, I would never recommend altering your course of treatment without consulting your doctor or another mental health professional, but an advantage of these strategies is that the chance of them causing harm is minimal — the majority will be ineffective at worst. If you are unsure about whether a particular technique might have adverse effects, discuss it with a mental health professional first. I will also caution that there is a lot of trial and error involved in implementing the strategies effectively, although it is definitely worth persevering, so don’t be discouraged if some of them don’t seem to work for you straightaway.

So what are the strategies? They are divided into broad chapters which examine each topic in detail: savouring, gratitude, mindfulness meditation, learning optimism, developing resilience, connecting with others, vitality and focusing on your strengths. There are several techniques desrcibed for each strategy, as well as advice on how to apply them and details on how they can boost your mood. There are also recommendations on which other strategies to try if one resonates with you.

I love how practical Positive Psychology for Overcoming Depression is — the focus is on applying the theory to your life and counteracting the effects of depression. It demonstrates how small changes can spiral into big improvements and left me feeling empowered. I think it’s particularly helpful for people like myself, who are learning how to manage their mental health and need reminders of how we can help ourselves on the more challenging days. I also like the optimism of positive psychology; I have spent many years trying to fix my problems and the shift in focus to how I can feel better despite my problems is refreshing. Of course, that’s not to say that I won’t continue trying to solve my problems in addition to using these strategies, but sometimes it’s easier and more effective to look at what’s going right in life and how we can create more of those things.

Daily Battles

Coming off antidepressants may have been a watershed moment, but the past two weeks have reaffirmed something I already knew: coping with mental illness is a daily battle. Sometimes the battles are small and sometimes they are easily won (though, oddly, these are often the bigger ones), but the battles still have to be fought. You can’t opt out.

Life tends to present many problems and uncertainties, which are tricky to handle without the added complication of mental illness. I find myself questioning my reactions when things go wrong — if I get angry, does it mean my mental health is worsening or is it a natural reaction? If I feel sad and disappointed when my plans go awry, is it “normal” or is it mental illness?

Logically, I know that my symptoms will fluctuate and that everyone’s mood, regardless of their mental health, fluctuates. In fact, many symptoms of mental illness are “normal” in moderation — it’s when they take over your life that they become destructive. For example, feeling unmotivated and lethargic once in a while is par for the course, but when I feel like that most days, it’s due to depression. I have to accept that the boundaries between mental illness and good mental health will always be unclear for me: I can never blot out my experience of mental illness, so it will always affect how I interpret my emotions and behaviour.

There are advantages to this continual assessment of my mood: I can gauge my symptoms and intervene before they get too bad. When I feel anxious or depressed or whatever, I can use my strategies to help myself feel better. I can also examine the circumstances of my change in mood and work out whether I’m reacting to a particular situation, in which case I may be able to find practical solutions. Being self-aware can be incredibly useful, but it’s not easy — it is both a battle in itself and a tactic for winning battles.

I find myself in a strange situation, because some days I feel extremely well and other days I still feel ill. Thankfully, the former are edging out the latter, but even good days present battles I hadn’t anticipated. Good days make me wonder if I ought to be doing more, achieving more. I question whether I am using my mental health problems as an excuse or if I’m just lazy. Pacing myself is a struggle.

I think perhaps the trick to winning these daily battles is to assess how I feel each day and act accordingly. There will be days when I can go out, have fun and act carefree. There will also be days when I zone out in front of the television and overthink every single aspect of my life. Some battles will be won in glorious fashion; others will, inevitably, be lost. I just have to keep fighting.

 

Withdrawal Speculation

My last post was about my decision to stop taking antidepressants, after over a decade of depending on them in order to function semi-normally, and it emphasised that there is a lot of uncertainty involved. When you come off medication, you have no idea whether you will face withdrawal or if the symptoms of your illness will intensify. All you can do is play the odds by reducing your dosage gradually and under the guidance of your doctor. It’s been just over a week since I took my last antidepressant, so I thought I would post an update.

Trouble is, it’s hard to observe your own thoughts, emotions and behaviour when you are going through change. It’s also difficult to distinguish between withdrawal symptoms and bad days: anxiety is a withdrawal symptom for the antidepressant I was taking (also a side effect, interestingly), but I have had anxiety for years and its ebbs and flows often seem to be without logical cause and effect. With this in mind, the fact that I felt quite vulnerable and shaky last week cannot be attributed without doubt to withdrawal, but I suspect it was a factor.

Yet while I felt more anxious and overwhelmed than I have been lately, these symptoms were mild compared to the anxiety I have struggled with over the past 14+ years. I didn’t even come close to having a panic attack, for example, and I still went out on my own. That was unthinkable 9 months ago.

I’m also wary about arbitrarily separating anxiety as a physical withdrawal symptom from anxiety as a natural response to making such a big change in my life. Being on edge is understandable during any period of uncertainty. I have googled my medication: I know that a lot of people have bad experiences in coming off antidepressants and that my particular drug is associated with some extreme withdrawal symptoms — and although these are very rare, they were a distinct possibility. I had no idea whether deciding to stop my medication was a huge mistake which could undo all the changes I have made recently and cause my wellbeing to plummet.

Thankfully, my anxiety seems to have been unfounded. I have noticed no other withdrawal symptoms and feel better than ever. I am even more confident that coming off antidepressants was the right decision for me.

Regardless of whether last week’s anxiety was down to withdrawal, I know there will always be fluctuations in my mental health. Everyone experiences these fluctuations and while mine might be more extreme, since I will always be prone to mental health problems, they are manageable. I can cope, with or without medication as needed. I can cope.