Tag Archives: health

Thinking about mental illness

How we think about mental illness, collectively, informs how a person who is suffering is able to behave. If we treat mental distress as something to be got over by ‘pulling yourself together’ or as not a real illness, then people suffering have little choice but to slog on, right up until they can’t.

I’ve found from personal experience over the last year, that if I draw direct lines between what I’m experiencing and some kind of bodily ailment, that I can make better choices about how to deal with it. What I’m going to offer here is crude and limited, but I hope it will work as a place to start.

A mild dose is like having a cold. It will probably clear up on its own in a fairly short time frame and it is possible to keep going and do all the things, although I’ll feel shitty and demoralised. Some time off would speed recovery.

A more serious bout is like having the flu – I really am going to need some time off to recover, I won’t be able to keep going as usual. It could knock me about for a few weeks and I’ll need to take things gently.

At its most serious, it’s like having pneumonia. There’s no way to keep going as usual, serious interventions, including medication and hospitalisation can be a consideration. Like pneumonia, serious depression can and does kill people and needs treating with just as much caution.

One of the important things about relating depression and anxiety to physical ailments is that it moves us towards treating the whole process as a bodily condition. I find this incredibly helpful. It’s not a failing, or a lack of will, or insufficient effort, any more than getting the flu is those things. Care and attention are required for recovery, but recovery is possible. For those who are afflicted in the longer term, other bodily analogies may prove more helpful.

Fevers are a useful analogy because when feverish, we can think all kinds of odd things that we wouldn’t believe for a moment when well. We can see and hear things that are illusionary. A breakdown in mental health can have a person thinking and believing all kinds of unhelpful things. If you can hold onto the notion that what’s happening may be a lot like the flu, it’s possible to avoid believing that the fever dreams of anxiety are based in reality. If depression and anxiety are things that are happening to you, not things you are, then it’s a good deal easier to resist them.


Stories about fat

Trigger warnings: weight, diet, body shape. And I’m starting with a trigger warning because this is a subject that puts some people in a very bad place indeed. Like most people my age, I grew up ‘understanding’ that being fat was the simple consequence of eating too much fat. That’s not how it works, and while more information is out there all the time, it doesn’t always filter through. The default is to blame and shame fat, still, which is bloody unhelpful.

It looks increasingly like sugar and refined carbohydrate are a far bigger issue than fat in the diet, and that the sugar industry has led the demonising of fat.

Sleep deprivation encourages us to retain fat. We live in a sleep deprived culture. I don’t know whether it’s because lack of sleep denies us processes that would have helped, or because lack of sleep is a crisis, and in a crisis, some of us store fat. Which leads me to stress – which tells our bodies there’s an emergency going on. For some of us, routinely trying to starve yourself thin can create and emergency that the body responds to by frantically storing everything it can. This was me in my teens, often only eating one meal a day, retaining weight, malnourished and miserable. Stress, and most especially work induced stress, and poverty induced stress are recognised things, but under-explored. There is also a known correlation between poverty and obesity, but no public debate about whether the stress of poverty, contributes alongside poor nutrition, to weight gain. If there were, we’d have to look differently at workplace responsibilities and government policies.

Thyroid function, and water retention and probably a whole heap of other medical conditions I’m not up to speed on can go unnoticed if we obsess over fat in relation to diet. If ‘get more exercise and lose weight’ is the only diagnosis available for the more padded person, other medical conditions – conditions that might well be causing or adding to weight gain – go unnoticed and unchecked. It happens.

Yo-yo dieting is a thing, and a lot of people get trapped in it. Brief attempts at wonder diets that cause weight loss in the shorter term, and then don’t work. This is in part because diets don’t deal with lifestyle as a whole. Wonder diets are often faddy, under-researched and won’t work for everyone, our bodies are different. It’s not just about how we eat, but about what we do with our bodies, how much we move, sleep, rest, and stress is all part of the mix. A happier life may make weight loss very easy, dieting misery can move us towards weight gain. Unhappiness leads to comfort eating, it can make us less active, and adds stresses to life that can help convince our bodies there’s a crisis we need to stock up calories to get through.

I’ve spent much of my life hating and resenting my body shape. I’ve starved myself as a form of punishment for being so disgusting – this is how I’ve felt about myself. Followed by the inevitable binges and the self-loathing those create, leading to a cycle of misery and excess weight. It’s really tough to break out of that self-perpetuating loop. I’ve done so by keeping the focus on doing things that make me happy. I’ve paid attention to how my body responds to foods, and altered my eating to do what feels good. I eat with a view to powering my body for whatever activities I have in mind, not with reference to my stomach size. I feel better about myself. I’ve got out of the punishment cycles and into a process that is about wellbeing and feeling good, and that has made a lot of odds.

 


Life with a body

It’s only in the last year or so that I started questioning what my body is for. It’s taken me until now to realise that I was unconsciously holding a belief that the important things revolve being either use or ornament. I’ve spent my life to date treating my body as something that exists to please or appease other people, not as something that is mine.

There’s a lot of pressure on women to focus on looking the part. We’ve been taught that thin matters – not fit, not healthy, certainly not muscular because muscles are all too often deemed ugly on women. We should paint our faces, blocking our pores, we should wear shoes we can barely walk in that will ultimately deform our feet, we should alter ourselves with surgery, botox, pull out most of our hair and so on. None of this is about being well, feeling good or being happy, it’s about being held up to impossible and unnatural standards.

My body is here to serve – and that’s an idea that I’ve had to wrestle with considerably. Notions of wife and mother cast us as giving to the point of self sacrifice. Too many workplaces would use our bodies to the point of sickness and exhaustion. We’re poisoning ourselves with car fumes.

I can’t speak to the male experience, or any non-binary experiences. While I don’t emotionally identify with being female, I’ve realised that expectations around what happens with my apparently-female body have had a huge impact on me.

What if the point of a body isn’t to look good for other people? What if the point is to live, feel, do…? What if the person who should most benefit from my body is in fact me? What if I’m not here to be used, not obliged to give whenever asked? It opens up worlds of possibilities.

I spent a lot of years trying, and failing to be thin. I’ve always been odd looking, smearing makeup on this face doesn’t change me into something conventional. I’ve been used, and been complicit in being used because I never thought there was more than that. Years of living in a space where it’s not about use and ornament and I get to be a person, has really opened things up for me. I start to ask what this body needs, what would feel good, what I would enjoy… these are the keys to an as yet undiscovered country.


Illness and the magic thing

It’s important to talk about mental illness. Only by talking about it will we challenge the stigma, get rid of the inaccurate myths, challenge assumptions and improve things for everyone.

One of the big problems with mental health is that we treat it as an individual issue, with little or no reference to how context impacts on wellbeing. One very significant aspect of context is the way in which other people react. I’m conscious that many of the same things hold true for chronic illness. Certain kinds of responses silence people who are suffering, make it harder for us to ask for help, and can increase distress, anxiety and alienation. How people react to illness can make ill people more ill.

The big one (I think) is the idea that if we only tried harder and/or did ‘the magic thing’ we’d be fine. What ‘the magic thing’ is varies, but it will be something the person we’re dealing with is sure is a fabulous fix for everything. We’re told we should be on medication, or shouldn’t be on medication. We should make more effort, or get more rest. We should stop eating a thing, or start eating a thing, or do yoga, or practice mindfulness…

The person who says ‘I’m really struggling right now’ is not helped by being told they need the magic thing to fix them. Not least because we’ve all tried a whole array of alleged magic things already, and they mostly don’t save us. When you’re down, and beaten and exhausted and everything is hard about the least useful thing to hear is that you should be making more of an effort with something. Fear of dealing with this silences people, encountering it can kick those who are already down.

The motives for how we respond to illness in others stand questioning. If we make a suggestion to someone else, we may feel that’s us off the hook. We did our bit. We have no further responsibility. We may believe that because we are well, that something we are doing is the reason for this, and not that it might just be luck. Belief in ‘the magic thing’ protects us from having to be afraid that we could be unlucky and get sick. It may also allow us to feel superior, that our cleverly doing the right thing is keeping us well while others fall and suffer because they aren’t making as much effort as we are. Being blamed for illness adds to depression, despair, and a sense of alienation.

There is a balance to find here, because information sharing is a good and often helpful thing, but unsolicited medical advice from strangers is often demoralising. The thing to watch for is the tone. Sharing in solidarity – here’s the thing I tried, this is what happened – can be really helpful. ‘You should do this’ has a very different tone. There’s a power imbalance in it, a disrespect for the person on the receiving end. An implied superiority on the part of the person dishing out advice.

Another way of silencing, dismissing and injuring people who are ill is to tell them off for it. People who are told that expressions of distress are basically attention seeking and not ok learn not to mention it. You’re just making a fuss. You just want to be the centre of attention. You’re playing the victim again. You’re such a martyr… Which begs the question of why a person who is suffering should not be able to say so? The answer is all about the discomfort of the listener being more important than the distress of the person who is distressed. When you are deep in depression or other illness, and the distress caused by saying so is deemed more important than what you’re going through – that really doesn’t help. It’s a massive blow to self-esteem.

Depression and anxiety are at epidemic levels right now. We won’t change that without changing the context in which people are experiencing things.


Working with an uncooperative body

I’ve been in pain for years, and had come to think of it as normal. I know that lack of sleep, insufficient  oil, stress, using regular air beds, and being cold all make it a lot worse, and I’ve managed it as best I can based on this. At the same time, I’ve had dire burnouts every six to eight weeks for something like a decade. Deep pits of depression, related to exhaustion. Every time I’ve dealt with it by getting back up and at it.

This July wasn’t especially dramatic as a crash – pain, emotional dysfunction, loss of energy and willpower, despair – all the usual. What changed was that I just couldn’t face the process of getting up and doing it all again and trying to hold out for as long as I could before the next crash. My best efforts of recent years have only widened the gap between crashes, not solved them.

I made a radical decision to start putting my body first. To start paying close attention to what hurts, and when I’m tired, and acting on that rather than pushing through it. This has meant things like going to bed when I’m tired, no matter what time it is, asking my family to cover for me, saying ‘no’ to things. I’ve put down some voluntary work that had become stressful. Alongside acting to reduce pain, I’m looking at ways to build strength, flexibility and resilience, ways to get more emotional outlets that help me stay resilient, and reducing stress. I need more things in my life that enable me to feel good, and fewer things that leave me feeling shitty and I’m reorganising accordingly.

I have no idea what the consequences of doing this will be. Fewer reasons for anxiety will certainly help, and more rest, reducing exhaustion should help counter the depression. At a deeper level, the decision to put care for my body much higher on my list is about changing my relationship with myself, and not practicing self-harm or self-hatred as part of normal life. There have been plenty of times when I’ve pushed my exhausted body to keep doing things by inwardly hurling abuse and criticism at myself. On the really bad days, it’s self hatred that has kept me moving, reminders of how useless and worthless I am and how I need to get my sorry arse in gear and justify my existence. This too, I am putting down.

The decision to be kinder to myself is a decision to treat myself as an acceptable human being with the same needs and rights as any other human being. I’m not expecting this to magically solve all my problems, but it might give me the means to better deal with the days when I really hurt, or really have no spoons, and I have come to the conclusion that I’d give anyone else the chance to heal if they can and manage things better, and I ought to extend that to me. This year I have started saying ‘I matter’ – which feels radical, and dangerous, but I’m saying it anyway. My body is something I’ve called uncooperative, but I think it is my mind that needs to change, accommodating my limitations and not adding to what’s already difficult.


Positive affirmations that could really make a difference

Positive affirmation has come to mean little mantras and memes we repeat to ourselves to help us feel better about things. I tend to find them hollow and unhelpful. It’s worth repeating a thought form when I am trying to change myself – it is ok to rest- for example. Too often what we ask positive affirmations to do is replace what isn’t otherwise coming to us. The universe loves me. I am valued. I am good and my life is worthwhile.

I think about the people (I’ve been one of them) who in times of stress apologise for existing. We’re sorry that we take up space and carbon, that we breathe and eat. To feel this way, I have realised, you have to be convinced that you are not entitled to exist. We don’t get there on our own and we don’t get out of it on our own either.

I’ve read two books by Brendan Myers in the last six months or so that have really got me thinking about these issues. (Check him out, he’s a brilliant author). He talks about how we affirm each other and how those acts of affirmation make life good. When we share food, we affirm each other’s basic right to live. Every time people do something life affirming together, they affirm life, and each other.

There are a lot of things we do as a culture that don’t affirm life. Pressure to diet and all forms of body shaming. Denying each other rest in order to work more. Favouring screens over direct human contact. Using sex as a weapon. Increasingly we treat the sick, the elderly, refugees, the vulnerable as figures and not humans. We have a culture of not affirming each other’s right to live and not affirming each other’s humanity and I think it’s getting worse.

No amount of saying ‘I am beautiful’ will counter the effects of living in a culture where that beauty is seen as a commodity for others to use.

The idea that emotional and mental health are personal issues is widespread and I think part of the problem. We are to create our own realities and be impervious to the realities around us – and what a cold, isolating world we would have if we managed it! And how crazy we would have to make ourselves to hang on to tiny bubbles of personal reality like that.

We can choose to go the other way. Not muttering to ourselves that life is good and we are loveable as we are, but saying those same things to other people. You are valued. You are loved. To hug each other as an expression of physical acceptance. To share food with those who are around us, with those who need it. To affirm the right of people to live by rejecting the politics of throwing the vulnerable to the wolves. Avoiding beating each other to death with deadlines. There are so many things we can do for each other, to be kinder, and to affirm each other’s humanity and right to exist.

It means collective responsibility. It means not seeing broken health as the fault of the person suffering. It means making an effort to care for each other, rather than jealously guarding what time and energy we have. It means it is not enough to be personally ok if people around you are suffering. It means having higher standards, and a bit of idealism.

More than this, if we start affirming each other, we affirm that life is worth living. It is a declaration that life is worth having, and that which is alive merits treating with care. As a Pagan, I hold life as sacred. I don’t think I’m alone in this. We can affirm that life itself is worth something. Sure, you can spend time gazing into a mirror telling your reflection that you are beautiful and the universe loves you (I’ve seen it recommended) or you can try telling people they are valued. One of these things will make far more difference than the other.


Fast Food Politics

Back when I started writing the novel version of Fast Food at the Centre of the World, food banks were not on most people’s minds. We were well underway with the current obesity epidemic, but at the same time, it wasn’t at the level it is now. Monsanto were busily trying to take control of the world’s seeds, but again, things have escalated over recent years. The increasing threat of climate change, and the shocking degree of both hunger and food waste in the world make food an intensely political subject.

Food is also about our connection with nature. Young people today are growing up indoors, factory farmed by an increasingly pressured educational system and then distracted with small electrical boxes. They don’t get out much, they don’t play, they eat edible food-like substances and too many of them bloat. How many modern children will eat berries from a hedge or pick apples? How many would have a clue as to what they could safely forage? How many would want to?

Increasingly, we are imagining and developing food as something separate from nature; a manufacturing process that delivers it shrink wrapped, by lorry, to a supermarket shelf near you. How many children will get to lift a potato from the soil for themselves? How many will see a potato with mud on, and have to wash it? Vegetables come pressure washed, partially skinned and eager to decay.

It doesn’t get much more basic than food. In terms of basic survival, food is key. In terms of health, the state of your immune system, and your long term prospects, food plays an important part. And yet, we seem happy to accept whatever comes in the packets, and have done for years. The additives, some of which it turned out made children hyperactive. The sweeteners in soft drinks that will dry your mouth out and leave you feeling more thirsty. The trans fats, the corn syrups, the rising use of palm oil and its catastrophic implications for rain forests. The welfare of animals raised in utter misery to feed us. Animals sustained by antibiotics that are, through their overuse, reducing the usefulness of this vital medicine for treating human ailments.

Food is a battleground in which the profits of big business do war upon your health and wellbeing. Food is a battleground on every piece of land where indigenous species are wiped out to make way for farming. Agriculture is not blameless in this process. Just because you aren’t eating animals doesn’t mean your diet isn’t implicated in killing them (I say this as a vegetarian). Nuts, soya, palm oil, exotic fruits… it is not a comfortable thing to consider what a cashew costs in terms of lost habitat. Food is a battleground between us and every other species, and yet we waste so much of what is produced, we kill and destroy for no good reason, all too often. Viewed from a distance, it might look a lot like an inter-species form of genocide in which we go forth to wipe out everything that isn’t us and doesn’t overtly serve us.

Food is nature. Food is politics. It is health. Food is our relationship with the world, and with each other. Hunger and excess should be matters of shame and alarm. Some of our children are rotunned with bad food and limited lives. Some of our children are dying of hunger.

We really need to start caring about this. I know, when I write here that I am largely preaching to the converted, that you’re reading because you share my concerns and beliefs about a fair few things. The challenge, for me, is in reaching out to people who are wilfully oblivious, convinced it’s not their problem, or that there is no problem. Fast Food at the Centre of the World is a bit of a stealth project. It’s an audio serialisation of the novel, free to listen to, and raises food issues, but it does so with magic, zombies, plenty of comedy, a slightly deranged magician and a fast food restaurant like no other. If I can just get one or two people thinking about food in different ways, that would be awesome.


Days off

People I know who take health and fitness stuff very seriously make a point of time off. Rest days, and even rest weeks when there’s no running around. Fasting days to clear out the system. It’s something I think about more than I do. The rest days are tricky because walking is my primary mode of transport and one of my main leisure activities. What else do I do all the time that it would be a good idea to take a break from?

Caffeine is an obvious candidate. I use caffeine to push through tiredness, and I use it most days. On a practical level, that reduces efficacy and can’t be doing me much good, so, a day off from caffeine now and then, or a reduced intake day, is something I try to allow myself time for. Today is a no-caffeine day.

The caffeine habit goes with a work pattern that doesn’t give me whole days off very often. Aside from the handful of things people pay me reliably to do, I have three books in progress at the moment, and unplugging from thinking about that is hard. The political side of my job requires me to pay constant attention to local and national politics – days off there are risky and infrequent. I have to know what’s going on. Sometimes I really wish I could have a day off and the respite of ignorance.

Fasting is difficult if you aren’t in a position to rest your body and mind a bit. Fasting is not a viable option if you also have to run hard, it’s just another scary pressure to add to the mix.

I’ve set today up so that I can float round the flat, and I’m intending to crash out intermittently through the day. No caffeine. There will be fruit juice and nut milk, because this is as much about changing what I do as it is about getting into the whole ‘fasting’ thing, and I’m not especially hardcore. It’s an opportunity to reflect on how I construct the ‘normal’ of my days, and whether that’s actually a good idea.

It is not my personal belief that people should work seven day weeks – it’s just that Tom and I are in a situation that makes it difficult not to. He has some hefty deadlines and spends most of his time working, and while I could take more time off (which wasn’t previously the case for me) I feel guilty about stopping when he can’t. If hard work equated to wealth, we’d be rolling in it.

It’s half nine, and I learn that I blog a lot slower without the morning coffee. My concentration is not what it could be, and today I am going to let that be ok. I’m not going to push against tiredness, I’m going to let my energy levels be low, and not do much. My theory is that this should be good for me. Thoughts on how that works in practice, to follow.


The troubling implications of a healthy lifestyle

One of the big pushes at the moment is to get people active enough to be healthy. The recommendation is to try and do five bouts of exercise per week, half an hour a throw. It’s the implications of this that stand thinking about.

I write this blog post having just come back from shopping. I’ve spent the last two hours walking in and out of town, and around it, I took things in for charity shops, and I came back carrying stuff. I’ve clocked up a few miles there, all of it whilst carrying weight.  I clock up more than ten miles a week in walking for transport, plus some occasional cycling for transport. I also walk for fun.

How, if you are reasonably healthy and have the use of your legs, is it possible to have a lifestyle that doesn’t deliver half an hour a day of activity? The answer has everything to do with our general dependence on cars, and our growing habit of staying at home being amused by our various boxes. Even the stats on couples having sex are down, and yes, that does count as being active! We don’t walk to the pub, or to neighbours homes, or local events. We don’t live near where we work, or near where we shop all too often. Urban design and positioning of critical resources (schools, doctors etc) increasingly assumes you have access to a car, and thus requires you to have that access, and makes it ever harder to get around by other means.

No one had to tell our ancestors to get exercise, because their daily lives had them up and about and doing for the greater part. No one worried about overweight children when my mother was a child. It didn’t really matter what children ate, they went out and ran around and most of them were not fat. Fear of cars and road safety makes us reluctant to let our kids out. Fear of cars means that most children do not walk to school. When I was a child, it was technically possible to play ball games in the road. These days, that same road is lined on both sides, with cars, and no mercy will be shown to any child who dares to risk damaging one with a ball.

Try walking and cycling, and you will run into issues around negotiating with cars – alarming junctions with rapidly moving traffic are terrifying. Try doing a roundabout on a main road when you can’t accelerate, and some of them are doing fifty… try walking and see how far you can get on the footpaths before you have to try and cross a stream of traffic. If you’re walking as transport, or cycling, you really appreciate the car fumes and the noise as well, insulated from neither, they do not improve the quality of your experience.

Most of us have bodies that were designed with movement in mind. We evolved to walk, to run, to swim even. Not to sit on our bottoms all day, every day, moving a few feet from bed to sofa, sofa to car, car to office.  Yet we want to force our children into ever longer hours at school and in other structured learning activities, we bundle them around in cars, feed them passive amusements and wonder why the little dears get rounder with each passing year.

That we need telling to try and be active for half an hour every day, really ought to alert us to exactly how much trouble we are in, collectively. The lifestyle we’ve been so carefully constructing does not actually serve us very well. And the answer? Drive to the gym, apparently.


Being difficult

In the last year or so I’ve found myself in all kinds of new situations, dealing with people who do not know me well. I wanted to be able to jump back into the world after my hermit period, bringing all the energy, enthusiasm and stamina I used to have. The trouble is, I do not reliably have all of those things all the time anymore. I have to be careful around getting enough sleep, or I get ill. I don’t handle conflict, aggression or controlling behaviour well, either.

Admitting that I am a flawed and fragile thing, and flagging up in advance where I am likely to struggle, has not been easy. At first I hated how useless it made me feel. Arty, bohemian types often keep late hours, and trying to say that really I can’t start working in a thinky way at nine at night, felt really difficult. Especially not if I was ill and tired to start with.

As I’ve explored this, I’ve found there tends to be one of two outcomes. Option one is that the people around me take this seriously and budget it in, they plan extra time for me to manage energy levels. I get afternoon meetings, and if I’m flagging, it is ok for me to go curl up somewhere. A lot of the time, being honest about what I can and can’t do, simply results in the people around me gently flexing to accommodate that. No judgement, no criticism, no pressure, no problem. It’s an incredibly liberating experience.

Now and then, the outcome is very different. I might get a lecture about how I should not ask anyone to walk on eggshells around me. I might find people blithely overrun with timings and expect me to still be viable starting much later. I might be treated as though I’m letting the side down, being selfish or making a fuss about nothing if I can’t keep up. The assumption that I’m being wilfully awkward has caused me a lot of hassle along the way.

What has made it hard for me, is the feeling that if I own up to having serious but intermittent restrictions on what I can do, people will judge and reject me, assume I’m faking it, or otherwise think ill of me. There are definitely people who do that, but realising this is neither acceptable, nor inevitable has changed a lot for me. I can choose, and I do not have to choose the people for whom I am simply too much trouble and not worth bothering with. Why should I bother with someone who cannot be bothered with accommodating me?

In the last week, I’ve faced major anxiety sources, and done so with easy-going support. I’ve had some outrageously late nights, and watched my body seize up by slow degrees. So I’m back to the sleeping a lot, ready for the next big thing I want to do (Tuesday). As I can pace myself, this is no problem. If the people around me take on trust what I can and cannot do, and feel no need to tell me it’s not good enough or I should try harder, its fine. If no one treats me like a failure because I can’t run flat out all the time, life is a lot easier.

It’s been a bit of a revelation for me, over the last year. I’ve watched how people around me treat me, and react to me. I’m voting with my feet. Any space that can’t flex to accommodate my fairly modest needs, is not a space I need to be in.