Tag Archives: health

What if we took mental health seriously?

At the moment here in the UK we have badly funded mental health resources and long waiting lists for anyone in crisis trying to get help. It’s an appalling situation. But, what if we didn’t even start at the point of trying to fix people’s mental health? What if we took mental health so seriously that our laws, culture and ways of living actively supported us in getting to be well? What would need to change?

Stress, and particularly stress caused by poverty and insecurity undermines mental health. If we wanted as many people as possible to be as well as possible, we’d have to deal with those problems. The money and resources exist. Universal Basic Income would remove a lot of fear from people’s lives, which would have wide reaching mental health benefits. 4 day working weeks, and work policies that promote mental health would be great. Shorter shifts, better breaks, kinder and more humane working conditions would all help considerably.

We’d have to take the climate crisis seriously. Distress around the loss of species and habitats is affecting many people’s mental health – especially young people. The insecurity and uncertainty caused by climate change impacts mental health. Flooding, drought, hazardous heat waves, crop failures – we can’t afford this level of uncertainty and threat. We can’t protect our mental health without protecting the environment.

Everyone needs green space where they live and free and easy access to that space. The relationship between mental health and green space is known. We also have better mental health when we have time, energy and opportunity for exercise – being able to move about outside is the cheapest and most sustainable kind of exercise available. That should be on everyone’s doorsteps. To improve everyone’s mental health, we would have to fill our towns and cities with plants and set more space aside for walking and cycling.

We need healthy bodies – good food, clean water, prompt medical care. We need the time and resources to be able to take care of ourselves, which isn’t available if you work long hours for not much money. A great deal of depression and anxiety is caused by being ill and being in pain. Taking mental health seriously means we need a culture of physical wellness too – you can’t separate body and mind.

Good mental health also requires social engagement and feelings of belonging. It calls for dignity and a sense of self worth – much of which would be tackled by dealing with the points I’ve made above. We need laws that uphold dignity and treat people as valuable and not disposable. We need systems that do not punish people for the accident of their circumstances.

We have to stop seeing poor mental health as a sign of personal failing or weakness. It’s a symptom of sick systems, broken relationships and inhuman ways of treating humans. To change that, we have to start thinking that kindness is better than exploitation, that wellbeing should not be a privilege for the few and that consumption is not the answer to everything.


Resilience and Efficiency

Efficiency tends to make people think of saving money and doing the most for least. The trouble with supposedly ‘efficient’ systems is they don’t have any slack in them, so as soon as there’s a problem or a setback, there’s trouble.

In workplaces this can mean having to work overtime if something goes wrong with a project or someone is ill. In healthcare it means not having the beds or staff to deal with something out of the ordinary. Like a pandemic. In education it can mean things like teachers not having the time to comfortably adapt to changes – as we’ve seen in the last year. In the short term, this kind of efficiency can seem cost effective. As soon as circumstances change, it doesn’t work and the cost can be high.

Resilience means being able to adapt. It means being able to afford to take time off when you’re ill, and not having to work people to exhaustion to make up the gap. Resilient approaches are also kinder, gentler ways of working. It assumes you should have options and scope for flexibility and that maybe short term profit isn’t always the most important thing. Assuming you’ll need the option to cope is a good idea, rather than just demanding more from people in times of difficulty.

Efficiency can also result in the normalising of crisis. You set something up so that it is running at capacity. You know perfectly well that things never run smoothly all the time, so the whole approach assumes that the answer it to pile on more pressure in times of difficulty. Once things become difficult, crisis becomes normal because there’s really no room for recovery or getting back on top of things This leads to people always having to work overtime, feeling constantly pressured to skip breaks,  and other such toxic things. Quality of life is undermined by work systems that are designed in this way. What is put forward as efficient can often turn out to be exploitative.

Other kinds of efficient systems require people to work like machines, operating at rates that leave no time for being sociable, or thinking about anything, or anything else human. We shouldn’t be asking people to work like machines – and in the long run this also breaks people, which isn’t efficient for us as a society. It certainly isn’t resilient, either.

The idea of resilience may be a good way to counter toxic narratives around efficiency. Resilience suggests pragmatism. If people aren’t prepared to treat other people kindly, they might be prepared to consider that resilience is a better strategy than short term efficiency.


What if we worked less?

The idea of four day working weeks is something many people have considered, and some businesses have even tried. How different would our lives be if we could afford to only work four days a week? What would change for us? How would we be impacted by other people working less?

Larger businesses can undoubtedly afford to pay workers the same money for four day weeks, and take on more workers to fill the gap. This would improve employment rates. In any sizeable business, there are management people and shareholders making a profit out of the work being done. A bit less money for them and a bit more investment in the people doing the work would make this possible. What evidence there is from people trying four day weeks is that you get a more motivated, healthier and more productive workforce, so it’s not really much of a sacrifice for the would-be profit makers.

I’m self employed so there’s no company that could treat me better than it does. But, if more people had more time off, I would benefit. More books would be read and more people would have energy to invest in leisure, which would probably improve my situation in turn.

More time off means having the scope to do more than just rest, recover and sort out your domestic stuff. More time off means more opportunity to enrich your life. What would you do with that extra day? You might study, or volunteer. You might invest more time in your physical health, or develop hobbies and skills that enrich your life. You’d have more time to meditate, contemplate, get outside, maybe grow your own food. Perhaps some of the less sustainable things you have to do out of time poverty could be changed.

How much of your life is currently organised around being time poor and tired from work? How much time do you even get to think about how you are living day to day? What would change if the people around you had more spare time? What would become available, emotionally and socially that isn’t possible at the moment? Who would you spend more time with?

What would it do to the economy if there was far more employment available, and people also had far more time to enjoy themselves? How would our spending choices change? What would happen to our towns, our communal spaces, and our green spaces if we had more time to use and appreciate them?

Poverty is stressful. Open up more working options, and many people would be in a far better state psychologically. Overwork has long been identified as a source of mental health problems. Stress and exhaustion make us sick, and exacerbate any illnesses we have. How much more well would we all be with a four day working week?

How would education change if a four day week was normal? How much more flexible could we make it, how many more options might people of all ages have around opportunities to learn and develop?

Asking what if we worked less also means considering some fundamental questions about what our lives are for and who they should benefit. Having more time for ourselves would make our lives much more about our own happiness and wellbeing, and that would be a truly radical shift.


Contemplating resilience

I’m writing this on a Friday morning. This is part of a new cunning plan about how I organise my time, and it has paid off well. I’ve shuffled about so that I don’t have to be online at any specific time in the morning. Anything that needs to happen before lunchtime is set up the day before, or earlier. This has worked out well. It means if I have a sleepless night, or am otherwise ill, I can get to the computer whenever, and nothing is messed up.

This shift also means that if I’m having a bad day for concentration, I’m under no pressure. This is as well – this is a blog post brought about by being short of useful ideas, written on a day when I’m in a lot of body pain and don’t have much energy. It’s a slow process, having ideas and writing.

I’ve become much more possessive of my time and energy. I’ve had to, there just isn’t enough of it to go round. I’ve started asking ‘what’s in it for me?’ What do I want? What do I need? These are not questions I am good at answering, but I’m going to keep asking them.

Flexibility helps. Giving myself more wriggle room for the really bad days, helps. Slack in the system helps. We live in a society that prizes efficiency, but, what efficiency really means is nowhere to go if something goes wrong. Efficiency doesn’t give you enough hospital beds in a pandemic. It doesn’t give you resilience in face of sudden change. It doesn’t give you options. Working when ill isn’t as efficient as taking time off to recover, but an overly efficient system won’t let you have time off. Ironically, trying to be efficient isn’t efficient as soon as the situation changes. There’s a lot to be said for trying to be resilient in the first place.

For me, resilience looks like being able to afford to stop and rest whenever I am too tired to continue. Days off at need would be helpful, but I’m not quite up to that, yet. I can work very short days when I need to, and on the day of writing this post, I’m contemplating that choice. I could push on with an interesting piece of work I have on the go, but I’ll do a better job if I’m not so tired. I can’t remember the last time I wasn’t tired, but it was probably more than a year ago.

Working hard doesn’t save anyone. It just grinds you down and reduces your quality of life. If your financial situation is so bad that you have no choice but to work long hours for little pay – that’s truly awful. I’ve done some of that kind of work, and I know that we need radical political change. No one should have to break their physical or mental health to be able to afford to eat. No one should be worked to death so that the billionaires, the shareholders and the people who profit from other people’s labour can keep doing that.

I want everyone to be able to take time off when they need it. I want everyone who is ill to be able to afford to rest and recover. Financially vulnerable people working when ill have certainly been part of how covid is getting around and a kinder, fairer system would have protected us all from the consequences of that.


Managing the energy

For some months now, I’ve really been struggling with energy levels. It’s affected what work I can do, and how far I can walk. It’s also been depressing and worrying. I’ve been making a lot of changes in order to try and handle things better and in the hopes of being able to recover from this to some degree.

I notice that I tend to think of poor energy as a head issue. It’s one I’ve previously dealt with by applying willpower and pushing through. Like a lot of people dealing with fatigue, I have a history of not being taken very seriously and being encouraged to think of it as a personal failing, not a body issue. I find that when I treat low energy as something that is happening to my body – not as a failure to make enough effort – I can improve things. Mostly it’s about food and rest.

Increasing my food intake often helps. Even if it doesn’t solve the energy problem, it tends to ease the panic and depression that go with having run out of energy. Toast is my friend. Fruit is also good. Plant-milks are easy to digest and sometimes biscuits are the answer. I have to remind myself that comfort eating doesn’t make me a terrible person, and that I am allowed to do things that help me feel less horrible.

Rest makes a lot of odds, and as I’ve explored in previous posts (Doing Nothing) sometimes flopping in a heap is about the only option I have. I’ve established that how and when I rest makes a lot of odds. It is currently fair for me to assume that I’ll get three or four hours in a day with good concentration and scope to be active, and that I might get a few hours beyond that where I can do some things in a more limited way – reading or crafting perhaps. I can no longer just work flat out in the way I used to. To have four hours or so of good brain, I have to take breaks. Slow the pace and more becomes possible. I still have to be careful not to wipe myself out, but pacing is clearly key.

I have to prioritise. I have to say no to things. I have to make the time to stop and recover.  It’s a lot to learn and is requiring me to identify and rethink a lot of beliefs I have about myself. I need to feel that I am allowed to rest, and I need to deal with the voices I have internalised that tell me otherwise. If I keep on as I was, I will likely get worse. If I can change things, there’s some hope of turning this around.


Knowledge, hypervigilance and control

Knowledge is power. In some situations, knowledge can be the difference between safety and danger, life and death.  And so, like many people at the start of the pandemic, I scrolled frantically looking for any information that would help me navigate.

I’m fortunate in that I’m fairly bright and decently educated and I know how to pick out good information from dross. I know how to read scientific content – I can’t read papers but I can get through a synopsis at least. I’m not unsettled by talk of probabilities- science rarely deals in certainties. I was looking for things that would shift the odds in my favour, and I found those – masks, ventilation, meeting people outside.

However, by the time I’d found what I needed, the habit of hypervigilance was back in, and I was also struggling to sleep. Hypervigiliance is not a new issue for me.  It’s a problem common for people who have endured bullying or lived with abuse. You pay attention to all the details, looking for signs of threat. When the rules change all the time, the goalposts shift, the hazards are unpredictable, when anger and blame can result from the slightest mistake, you learn to be hypervigilant to survive. And with the covid rules changing all the time, and the science evolving, I fell back into that, and it got into other areas of my life.

I found out quite by accident that I had been running high levels of hypervigilance for months. It explains the levels of body pain and exhaustion I’ve been dealing with. Being on high alert all the time is expensive. Scrutinising every detail is hard on the brain. Never relaxing, never feeling safe… it takes a massive toll and I’ve been doing it for months. Having broken out of the space where I was doing that, I feel hopeful that I can make a recovery. I’ve done it before, but this part of the process is challenging because I feel alarmed by not sifting for data all the time.

If you’ve found the last year exhausting, it may be that you’re in a similar process – with pandemic information, work upheavals, financial pressures and home schooling all likely sources of incentives to be hypervigilant.  Not seeing friends and family may mean you’re trying to divine from facebook posts how they really are. If some of them are vulnerable, this may be really hard work. If stepping away from the information sources is also stressful and scary, that’s a strong indicator of hypervigilance. It takes time to get over it, but knowing that the initial stages of breaking away feel awful may make it easier to navigate that.

If you’re going through anything similar to me, I wish you peace and calm. If the first steps towards that are hard, don’t be daunted, this is the way out. If you feed your brain less data to obsess over, it will eventually start to calm down.


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.