Tag Archives: health

New Year, New You?

We’re at the time of year when the diet and fitness industries will be trying to get your money. They will lie to you about how they can change your life. They will encourage you to feel unattractive and inadequate. They are poison.

New years of course prompt us to reflect on what’s happened and think about how we want to move forward. This is good, but for most of us, some kind of radical re-creation of self really isn’t necessary. You’re fine as you are. You may want to make some lifestyle changes to be happier in yourself, and that’s great, but those are the only terms on which to change.

My weight has varied a fair bit over my lifetime. One of the things I’ve discovered is that the people who were ashamed of me and critical of me when I was at my fattest do not praise me or love me now I am thinner. I have not won them over. Apparently it was never about my body size, it was just an easy thing to hurt me with.

My fitness levels have varied a fair bit too – mostly that’s to do with how other health issues are impacting on me. Sometimes there is too much pain and weariness for physical activity to be any kind of pleasure. I am most at ease with myself when I am stronger and more able – and frustrated by my body limitations. I have found that the best thing to do is focus on wellness and enjoyment, and not on any kind of arbitrary fitness goals. Bodily activity is something to relish and find joy in, not something to punish yourself with to try and meet some imposed standard of appearance.

As my body and its capabilities have varied over time, it’s become obvious to me that these are not the most important things. My relationships are not transformed by my body shape. My confidence and self esteem aren’t that much affected by how thin or fat I am – but they are affected by how other people treat me. The key thing is avoiding people who go in for body shaming. If I spend time with people who like me for who I am and who are not obsessed with how I look, then my life is happier and richer. I prefer the company of people who are kind and affirming, who support and encourage me. All of the good things that the diet and fitness industries claim come from diet and fitness industries, mostly come from people being nice to each other.

And while we’re being nice to each other, and being supportive and affirming we can look for the things that make us well and give us joy. We can eat the food that nourishes us, supports our mental health and gives us the energy to move our bodies in happy ways. We can move happily, for the joy of it. If you’re in need of a ‘new you’ look for opportunities to be happier, not ways to punish yourself for already feeling ground down.

New to managing your energy?

There’s going to be a lot of this about – people who used to be fine but who now need to manage their energy carefully. Fatigue is a common symptom of long covid. The psychological and emotional impact of lockdown is leaving people depressed, burnt out and exhausted. How do you cope?

My husband Tom recently had a stroke and went from being someone who could safely assume they had plenty of energy, to someone whose energy is unreliable. It’s come as a shock to him. So, be ready for it to be a shock and give yourself time and space to process that.

Often when people talk about poor energy they talk about spoons, and waking up in the morning and having to decide how to deploy whatever energy is available.  Only in practice, you won’t know – especially not when you’re new to this – how far the available energy might go or how tiring any specific activity might be. Things that used to be easy will no longer be easy and you will, at first, have no idea how to budget for that. Learning how to assess the energy cost and to budget for it takes a while – try to be gentle with yourself while you figure this out, and know that you will get it wrong sometimes. It’s ok to get this wrong, this is a steep learning curve at a really unhelpful, under-resourced time.

You have to decide what’s most important. If you want any hope of getting out of your low energy state, you have to decide that your health is the most important thing, and the people around you need to support that choice. (This isn’t always an option, sadly.) You then have to start off in the morning with the things that will most help you with your health. That’s going to be personal and will also need figuring out. Budget in time to rest, move slowly, but try to keep moving because you will feel better if you’re able to get something done – that might be a shower, or an email, or a small walk – whatever works for you. Set your sights low, aim low, but try and manage something.

You’re going to need patience. You’re going to have to forgive yourself for what you can’t do and be ok with asking other people to cover for you. Give yourself time. Healing takes a while. Learning how to manage what you’ve got also takes a while.

How hard is it?

If you’re dealing with long term illness, pain or mental health difficulties, it can seem appropriate to try and figure out how hard things really are. How does your experience compare with other people’s? This will likely stem from a feeling that you are making too much fuss, and not being stoical enough. You may not feel confident that you are entitled to ask other people to take your suffering seriously.

Distress is not really a thing that can be measured in relation to other people’s distress. However, the urge to do so comes from experiences like being told you shouldn’t make a fuss because other people are worse off. By this logic, only one person in the world at any given time is allowed to make a fuss!

In any sane and compassionate scenario, what will matter is that you are suffering. If you have to prove you are suffering enough to be taken seriously, there’s something wrong with the situation. If you’ve had extensive exposure to having to prove your discomfort, you may be in the habit of doing it to yourself even when there’s no longer anyone around to suggest that it probably isn’t as bad as you are making out.

Many people have terrible double standards around taking their own discomfort really seriously while being dismissive of everyone else. It is of course the people who know perfectly well that they make a fuss about little or nothing who tend to mistrust other people’s self-reporting. People who are used to being comfortable often treat minor setbacks like a bigger deal, people who are used to being uncomfortable often learn not to let it be the most important thing.

I’ve noticed around my issues that I feel obliged to be able to explain and demonstrate things. If I am upset, I have to make sure that I can reasonably explain why I am upset and I have to feel confident that any normal person would also be upset in the circumstances. It’s never felt like enough just to not like something or be uncomfortable. I’m trying to stop doing this, and to make space for how I feel regardless of whether I can demonstrate the reasonableness of the feeling. I often catch myself accounting what I’ve done against how I’m feeling, like this is an equation to balance, and if I haven’t done enough to feel tired, I don’t feel comfortable stopping.

All bodies are unique, all situations are unique, all minds are unique. What someone else might do is not that useful a measure. How hard it is for you is the most important consideration. But, if you’ve had knocks to your confidence, or don’t get taken seriously, it can be hard to hang on to that. No one else really knows what anyone else is feeling or going through. How hard is it? Really only you can say. Feeling you are entitled to say can be challenging. Trusting that your experience and needs are what matter can be hard if you’ve been taught not to do that.

If you know it’s important to keep a sense of proportion… if you care about not asking too much of other people… if you worry about whether things aren’t as hard as you think they are… trust yourself. You are paying attention, you aren’t being self-indulgent, your experiences and opinions are valid. It’s the people who never worry about these things who tend to make a lot of fuss over very little. Try and work out whose the voices are that tell you your experiences aren’t valid – the odds are there are specific people who have downplayed your distress and treated you like you were playing up the discomfort to get your own way, or get out of something. You don’t owe those people anything at all.

Living with exhaustion

I first started having serious, inexplicable problems with exhaustion when I was about 14. My doctor at the time told me that it was ‘psychosomatic’ and mostly because I didn’t want to do PE. That it was impacting on my ability to dance and that I really wanted to dance, didn’t seem to matter.

In recent years I’ve identified a number of things that contribute to me having no energy. I get bouts of insomnia. I’m very hypermobile, this means everything is harder for me than it is for many people. My digestive system malfunctions when I’m stressed (probably because of the hypermobility) and failing to digest food isn’t good for the energy levels. I bleed heavily, so lack of iron can be an issue. I don’t seem to handle salt well so if I sweat or cry or bleed a lot I need to be careful with putting salt in or I wilt. But there are still also days when I have little or no energy and I don’t know why.

One of the things I’ve not had the energy for is fighting for a diagnosis – being self employed I can generally get away with the dodgy energy levels. I don’t want to go onto welfare, and I know there’s not much support available. So, I live with it.

However, one of the consequences of covid seems to be long term fatigue. Lots of people are now suffering with this, and it seems that fatigue is being taken more seriously. The idea that for some people chronic fatigue may be a consequence of having been ill is getting some traction. It is my hope that this will lead to the better treatment of people who were already struggling with exhaustion and poor energy.

The thing is, that if you have no formal diagnosis it can be very hard getting help, or even sympathy. It is difficult to persuade people to take you seriously, sometimes, when you don’t have a diagnosis. Especially around fatigue, where how badly it affects you will vary from day to day, and people may assume you are just being lazy, or uncooperative, or making a fuss. When I was a child, no one was considering hypermobility as a serious condition in need of care. I was still hypermobile. No one ever gave my grandmother a fibromyalgia diagnosis because that didn’t exist when she was struggling with pain and restricted mobility.

Having a condition that is not considered to exist is an exhausting, miserable, stressful place to be. Think about the women who endured post natal depression before anyone decided that was a real thing. Or the countless soldiers with shell shock before PTSD was an available diagnosis. I hope what’s going on now around chronic fatigue will help more people be kinder around these issues, and help more people recognise that just because there’s not much insight into a body problem, it doesn’t mean there is no problem.

Capitalism and the virus

All the evidence at this point suggests that the environment in which you are most likely to catch the virus is as follows: It’s a crowded space with poor ventilation. In the UK we’ve seen hotspots around university accommodation. Amazon had a significant outbreak in their workforce. Obvious candidates include crowded trains, cramped workspaces, over-crowded schools, and of course busy social locations like pubs.

What these locations all have in common is that they are designed to extract the maximum profit for the minimum cost. Space is money. Businesses that can squeeze more people into less room can make more money because the overheads are reduced. And whether that’s cramming people into a bar or a warehouse, the implications are similar – there is a health risk.

To do anything safely at the moment, we need space between people and good ventilation. This doesn’t combine well with trying to get the maximum profits for the least space. Capitalism does not equip us well to deal with the virus, and it has given us workspaces and social spaces that, by their cramped nature, are problematic at the moment. And really speaking, always were.

Imagine a world in which we wanted nice things. Imagine a world in which workspaces were always comfortable, healthy and good to be in, and where living well was more important than shareholder profit. Imagine well ventilated workspaces. Imagine workspaces where the mental and physical wellbeing of employees mattered.

Capitalism teaches us that all of these things should be sacrificed for the good of the profit margin. But surely there is more to life than profit? If we are to survive this virus, there has to be more to life than profit.

Environment and health

‘What is wrong with her?’ They asked.

Not ‘what is wrong with her environment?’

It’s a vitally important question and one that we too often overlook. When it comes to mental health and physical health alike we’re too quick to focus on the individual who is suffering and far too unwilling to consider the context.

Poverty, work stress and insecurity make people ill. We know this. The evidence exists. Poverty equates to poor diets, lack of access to green spaces and other insufficiencies that undermine the health of the body and the mind. We know that it is lack of control over your situation that causes the most stress and the most damage. We know this is why people in insecure jobs, zero hour contracts, short term contracts and at high risk of debt suffer from stress and all the illness stress causes. We know, but when people break, we make it personal, individual, specific.

We also know that people are happier and healthier when they have access to green spaces. We’ve seen this around lockdowns. The evidence was there before 2020 from studies from all over the world. Without access to green spaces, our health suffers. And yet, if we get ill for lack of time outdoors, this won’t be part of the discussion we have with our doctors, or the welfare system.

When children can’t cope with sitting for long periods at school, we ask what is wrong with the child, not what is wrong with how we approach education. When people aren’t especially productive in the workplace, we ascribe it to things that are wrong with them, and not to the workplace. When people don’t engage with each other socially, we blame them, and their relationship with screens. We don’t ask what’s creating the pressure to behave that way in the first place.

The environments in which we exist, work and attempt to live are not inevitable. They are co-created. They are often dictated by those with the most power and forced upon those with the least. But even so, they can be changed. We need change. In the meantime, resist the temptation to blame individuals for things that are done to them. Look for the collective in both the problems and the solutions. Support other people where you can, share resources. Resist the culture that says any of this can be fixed through hard work – this is a lie. Resist the culture that says suffering is good, or necessary – this is a lie designed to keep the many placid as we work for the benefit of the few.

Health – for the body and the mind, are very basic needs and essential for human flourishing. We need to live in environments that support human health, not spaces that undermine it.

Lockdown and mental health

It has worried me from the start that politicians aren’t factoring mental health impacts into their choices. I thought today I’d talk about some of what I can see happening, in the hopes that if any of you are experiencing this, there will be some comfort in identifying the mechanics. This is UK based but may apply other places.

We’re social creatures, so being asked to isolate is really hard. Doing it heroically to save lives is feasible, most of us can get behind that and sustain it. Doing it when economically based contact is allowed, but love is not, is brutal. We can go back to work, but we cannot go to family, friends and lovers who do not live in the same house as us. We are allowed our economic relationships, but not the ones that matter.

None of this ever made any sense. The biggest source of spreading is households. If one person gets it, everyone gets it because most of us don’t have room to isolate from our families. We should never have been asked to do this. Ill people should have been isolated in medical facilities, keeping their nearest and dearest safe. If you have vulnerable people in your household the advice has been to go to work and isolate from them at home. Technically difficult, and emotionally harrowing. We should be able to cling tight to the people we love, and be confident we can keep them safe.

Big events with hefty financial aspects were allowed to go ahead when they should have been cancelled. Plane loads of people from virus-afflicted areas were allowed in unchecked. We were put at risk, all of us, for the sake of money. This kind of treatment will impact on your mental health. We’ve been lied to and blamed, over and over. This is gaslighting, and it makes people mentally ill.

The whole thing has been organised the wrong way round from the beginning. We should have been protecting close relationships and getting people away from numbers of strangers. We’re safer when we can assess our risks together. The friend I can talk to about how we handle this is far less hazard to me than the stranger who coughs on me in a supermarket. Not being allowed to keep the people we live with safe has massive mental health implications for many people, as well as the hideous virus implications.

Usual mental health advice is all about staying connected with people who can support you. We know what people need to be well, but that knowledge has been ignored throughout this crisis. If we put mental health first, we give people resilience. If we had protected intimate relationships and sacrificed economic ones, we’d be better off. If we had done this the other way, people would have felt less need to push back against the rules.

Usual mental health advice also tells us to get fresh air and exercise. The mental health of people with no gardens, and people living in cramped conditions is not being talked about. It should always have been ok to sunbathe at a distance from others. It should never have been ok to force non-essential, usually low paid workers to keep working and commuting. One of these things runs the real risk of spreading disease and the other, simply does not.

Faced with political choices where you and your loved ones are at risk, and you can’t do the things that might sustain your mental health – little wonder if many of us are suffering. We should always have been putting life ahead of money, and mental health is a key part of life, not some kind of luxury extra for the better off.

Touch and Health

Physical contact has a large impact on people. Mammals are tactile. There are all kinds of benefits to touch, if you can do it comfortably. Not being touched can add a lot of stressors. How we are touched by other people affects our sense of self, and our self esteem. My own experience is that being touched by people I feel close to helps to ease pain and tension in my body.

One of my first responses to social distancing was the realisation that there are people who matter to me a lot who I will not be able to hug for some time. There’s the heartbreaking possibility that there may be people I never get to hug again. I cannot use my body to comfort people who are fearful or otherwise distressed. There are people I would very much like to be able to hug close right now, and reassure in the way that only a hug can. But, they are safer if I don’t see them.

I have a lot of issues around touch. I don’t do it lightly or casually. For me, any kind of physical contact represents a fair amount of considered trust.

I am dealing with this by doing small visualisations. In the visualisation, it is a gentle, sunny day and I am meeting a friend. It is safe to meet them, and safe to hug them. Both of us are well. I hug them. I’m finding that running these little visualisations is helping me deal with my own fear, and with the pre-emptive grief I’m feeling because of that fear.

Isolation and mental health

There are reasons we use prisons as punishment and solitary confinement is considered especially harsh. Most humans are social creatures and isolation is bad for us. However, we’re faced with a pandemic that requires us to at least do some social distancing, and that for some people means as much isolation as possible in the hopes of survival. Isolation is bad for mental health, and depression also kills so there is a lot to consider here.

I’ve had a lot of firsthand experience of isolation impacting on my mental health. Living with a few other people does not reliably offset it, and it puts a lot of pressure on those people to provide emotional support. They might not be well enough resourced to do that. Isolation can feed anxiety and depression because there’s not enough to counteract it. There’s not enough positive reinforcement, counter-narrative to the distress, or distraction from it. If you have mental health problems already, being isolated with your own thoughts is hell.

If you start out mentally well and are isolated, you may be ok at first. However, you can still end up feeling unable to leave the house after a while. Boredom can slide you into depression. Apathy can take over, with loss of motivation, loss of joy in life, you do less, you feel worse, you cycle into depression.

Our minds and bodies are not separate systems. Poor mental health is poor health. It can often lead to choices that further undermine health. The things we do for short term comfort may only make our situations worse. The process is likely to be slow and it may not be obvious what’s happening if you haven’t dealt with it before.

Here are some suggestions. Having a voice and a face to communicate with helps – use online tools, use your phone, get the emotional intimacy of talking directly. If you don’t feel able to ask for help with being isolated, contact someone else and ask how they are doing. Rescuing each other often works best.  If there’s no one you can talk to, I find the radio helpful – it’s immediate, and feels more personal than television.

Think about who might be unable to communicate. Consider older relatives who aren’t tech savy. Make sure you know who of your friends is vulnerable. Who is old enough to be at extra risk? Who has underlying health conditions and may need to totally isolate? Who already suffers from anxiety? Don’t wait for them to ask for help. The nature of a mental health crisis usually makes it very hard indeed to ask for help. After all, people are dying out there, how can you approach your friends and family – who no doubt have their own problems – and ask them to give you some time because you are overwhelmingly sad? Mental health conditions are good at persuading sufferers that they are making a fuss and/or don’t deserve help anyway. Make the first move.

The politics of illness

I’ve been struck by the massive and wide reaching political implications of the coronavirus. There’s a lot to think about here.

Governments that put people before profit are clearly going to take better care of their people. Leaders who believe experts and take science seriously are going to be an advantage to their populations. Societies that organise for mutual aid and protection will do better than anywhere dominated by rampant capitalism. This may change how we think about politics and politicians.

Good leadership will reduce panic and focus people on what they can usefully do. Good information will help us stay safer, slow infection rates and protect the most vulnerable. Governments that don’t do that will put their people at risk.

There are many things we’re now looking at that we could have had all along – working from home, conferencing and studying from a distance, cutting back on travel. These are things that would always have helped disabled people. There will be no excuse moving forward, for not being a good deal more inclusive – clearly we can do this. These measures also reduce the need for travel, which has huge environmental implications and again, we should have been taking this seriously already.

Western countries that have been so intolerant of people fleeing war, famine and climate crisis need to get some perspective. If we look at our own responses to this threat, we might see people in other kinds of crisis in a more compassionate light. Many people around the world suffer a lot more, with considerably more stoicism and sense than white and reasonably comfortable panic buyers around the world have been demonstrating recently.

If your healthcare is free at the point of delivery, sick people won’t be afraid to come forward. People who are identified and treated are less of a risk to others. State funded healthcare is in everyone’s interests.

If you have good laws around work and sickness, people don’t have to work when sick. All diseases, coronavirus included, won’t spread as much when ill people are allowed to take time off to recover and not infect others. Flu kills a lot of people every year – there’s a lot we could do to reduce misery and suffering if we had a better work-health culture in the first place.

If we had universal basic income it would be really easy to shut down all non-essential work for a few weeks to reduce transmission.

The more structures, networks, systems etc your country has in place for taking care of people, the easier it is to respond to an emergency. If we focus on profit and efficiency, we pay for it in terms of resilience.

Coronavirus at its worst affects breathing. It is known to hit smokers hard. Clearly, air pollution will also create increased vulnerability. Our polluted commons make us much more vulnerable to diseases. We need to recognise that human health and planet health are the same thing.

Perhaps some good can come out of all of this. Perhaps we can start recognising how much we depend on each other. Health needs to be a collective concern. It needs to be framed within the health of our world as a whole. The politics of profit and growth are killing us, and this is just another example of that playing out. We need to change how we think, and stop treating people as expendable, and economic growth as a master to be served in all possible ways.