Work stress nearly cost me my life

As Mental Health Awareness Week comes to an end I thought I’d write a bit about my personal journey and (hopefully) warn against the dangers of work stress.

I struggled with my health all through uni. As an introvert, I found the social life expected was too much for me, it was so far out of my comfort zone, I had to pretend to be someone else and that cost me more energy than I had. Team this was a course (medicine) that I found very difficult; the high proportion of patient contact was great experience but, again, cost me energy I didn’t have.

With my commitments sapping me energy, my mood plummeted and my thoughts followed. I felt I wasn’t good enough, I couldn’t cope, I was completely useless and I had imposted syndrome – someone was going to find out, I was a fraud and discover I didn’t have what it takes to be a doctor.

I got through medical school thinking “I just need to get through, it will be better when I qualify, there will be fewer assessments and I can get on with doing what I want to do, be a doctor”.

Unfortunately, when I qualified, while the daunting exams were over and I felt relieved that I’d made it, the stress did not stop. It might sound silly but until I qualified, I don’t think I realised that people’s lives were literally in my hands!

Yes, as a junior doctor, you have the support of a team but when on call or, as I was, working in a hospital with few doctors, it was down to me. I felt completely overwhelmed with the responsibility and felt I didn’t know enough. Imposter syndrome was crushing my confidence, the anxiety was crippling. Every time I needed to think clearly and quickly, my brain froze. Literally, no thoughts would come through my mind and I struggled to take action.

I spent many moments crying in the toilet. But this just led to guilt, I couldn’t do my job hiding and crying, so I’d dry my eyes and put on a brave face.

I still thought, “if I just get through this stage…” but I couldn’t survive thinking that at every stage. I tried to confide in my colleagues and they reassured me and supported me as best they could but my health couldn’t hold up.

One day I was a doctor, the next I was a patient.

My depression was severe and I was experiencing psychotic symptoms with my anorexia. My life was at risk with self harm and suicidal behavior. Of course, there were many contributing factors but work stress was right up there!

If you’re feeling work stress, please talk to someone, don’t hope it will get better, it needs managing. Your health is more important than any job.

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Is social media causing more stress than it’s worth?

The idea behind social media is brilliant, it connects us. Initially it was that simple, maintaining connections between people who’re friends in real life or building virtual relationships between people who may never, otherwise, meet.

But it seems to have taken on a life of its own, making demands on us to present a specific “public friendly” version of ourselves, we get caught up in how many ‘likes’, ‘shares’ and ‘follows’ we’ve had and it makes 41%* of us feel lonely. That doesn’t sound right!

For Mental Health Awareness Week, PushON, an eCommerce agency, conducted a survey asking all about social media, how it makes us feel and how it impacts our mental health.

In 27 – 64%* of us, social media evokes feelings such as resentment, sadness, anxiety and jealousy and it makes 48% of us feel self-conscious.#

We’ve had to invent a word for that special photo that’s usually filtered – the infamous selfie!

We’re feeling awfully confused about social media, many feel concerned about being over monitored or ‘spied’ upon in the evolving technological world, yet we worry that no-one will pay attention to or ‘like’ what we post.

I’ve had a mixed relationship with social media. When I’ve been less inclined to leave the house (as a depressed introvert, it’s an easy place to end up!) it’s been a way of keeping in touch with the world and interacting with people at a comfortable distance.

Social media is great at connecting people with similar experiences, I wouldn’t have met these people without social media but I developed relationships that boosted my recovery as we were ‘in it together’!

28% of people say they feel motivated by social media and 43% feel happy while using it.*#

As I recovered from anorexia I had amazing support from the Berkshire Eating Disorders Service and their Support, Hope and Recovery Online Network (SHaRON!). I didn’t have to sit awkwardly in a room and do ‘group therapy’ – I just logged on whenever, wherever – not only getting the support (from therapists and fellow sufferers) when battling my way through a bowl of soup but also giving support – this 2 way process was important.

But at the same time, there are some negatives! How many of us can say our facebook statuses give an accurate picture of our life? At any given time, a Facebook wall could be covered in wedding, sonogram and baby pics – giving the impression everyone is either planning babies, having babies or caring for babies and all of this is shiny and happy. We all know this is no-where near the truth! Most people aren’t thinking about babies or children at all and those that are, are stressed out about it, rather than it all being smiles and laughter!

Mental illness is great at making us feel isolated, alone and completely incapable of doing life, the biased Facebook wall can compound these feelings. Don’t get me wrong, I’m not saying people shouldn’t share photos of their exciting moments. When unwell, it’s important to hold onto the fact that people do not write “struggled to out of bed today” or “washed my hair then watched TV”. Like good news rarely makes the newspapers, bad or neutral news doesn’t hit the Facebook status!

What’s more, while most of us are posting the edited highlights, 36%* of people admit they’re somewhere between ‘jazzing up’ their online profile and it being a complete lie.

Although social media can have a negative impact at times, 63% believed taking social media away would have a negative impact on them (with 1% believing they would feel heartbroken!)

There’s no debate, it’s here to stay, perhaps we all need to be careful, be clear about how we use it and don’t let it become a source of unrest or unhappiness – this is our choice to make!

*All stats from a survey of 1000 adults in the UK carried out by PushON, an eCommerce agency. (# Participants could choose multiple feelings). Survey carried in conjunction with Mental Health Awareness Week.

Managing stress is not rocket science but we have to make it a priority

The theme of this year’s Mental Health Awareness Week (14th- 20th May) is Stress!

85% adults in the UK experience some form of stress, 39% describe themselves as “too stressed”. #

54% people say they’re worried about the impact of their stress on their health. This does not mean stress is not impacting the health of the other 46%, it might be that they are unaware of it! #

Stress is key contributing factor to mental ill-health.

Mental Health services are more stretched than ever, so just imagine, if we removed stress or managed it better, we’d reduce the rates of mental illness and those who need the mental health services would get quality support in a more timely manner and staff within these services would have lower stress levels – it’s win-win!!

Spotting signs of stress

Stress can impact us in all sorts of ways; here are just a few examples:

  • Feeling irritable, anxious, low or tearful
  • Loss of interest or apathy
  • Fatigue and sleeping problems
  • Difficulty concentrating
  • Muscle tension and headaches
  • Social withdrawal
  • Stomach problems
  • Loss of sex drive
  • Using alcohol or drugs to cope

If stress is impacting you’re health, it’s vital to consider whether any changes could be made.

Causes of stress

The thing most likely to cause stress changes as we age, while young adults are more likely to be worried about money, those ages over 55 are more stressed about their health (which is a vicious cycle!). Those aged between 25 and 55 feel stressed about work and money.

A number of factors impact our working life, these are the top causes of stress at work:

  • 44% caused by work load
  • 14% due to lack of support
  • 13% caused by violence, threats or bullying
  • 8% due to changes at work *

At work, some people work better under some degree of pressure, after all, “pressure makes diamonds!” But stress is strain or tension caused by adverse or demanding circumstances – this means it has gone beyond the helpful pressure that makes us work more efficiently, it is having the opposite effects and actually decreases productivity and causes people to get ill.

A lot of causes are beyond our control so it’s how we manage the stress that’s going to be important.

Managing stress

There are no magic answers, we all know how to avoid or reduce stress, it’s nothing complicated but we’re not very good at putting it into action, we are our own worst enemy when it comes to putting ourselves first and looking after ourselves!

For some reason, we put our job or other people above ourselves, we think that it is more important to look after other people; we see it as selfish if we want some ‘me time’ or if we need to ask for help or support.

But think of it this way, if you’re permanently stressed out (even just a little bit) this will have an adverse impact on your health which in turn means you cannot look after other people or be optimally productive in your job. If we all put ourselves first a little bit, it’s for the greater good!

Identify the triggers – ideally avoid them but if that’s not possible, think outside the box, is there any other way around it? We’re under constant pressure to do more work in fewer hours but there may be other ways to improve efficiency without piling on the load! If it isn’t possible to avoid the triggers, at least you’ll be on the lookout and can put other management technique into practice.

Learn to say ‘no’ – why do we find this so hard?! We’re afraid to let people down but those of us who say ‘yes’ all the time get lumbered with all the jobs no-one else wants to do. Trying saying ‘no’ in different ways and the results can be interesting, for example ‘I don’t have time this week but I may be able to do it next week’ communicates that you’re willing but not currently able and if it’s urgent, someone else will need to do it. Just this week someone tried to make their deadline more important than mine, they wanted me to do their job first even though their deadline was 4 hours after mine – I was assertive and simply explained why I was not going to change my priorities.

Develop good time management – this is one of the most important things since managing stress can take time, it’s important to fit it in! It may be about travelling more efficiently, (e.g. going to the gym on the way home rather than making it a separate trip) or making a list of priorities and how long each will take. Time management is a whole separate topic but it’s important when managing stress.

Get more sleep – work out when you need to get up, subtract 9 hours – this is the time you should start getting ready for bed, this gives you 1 hour to wind down fully and get ready for bed. Of course, this may not be possible every night but instead of picking an arbitrary 11pm (for example), we have a time in mind that will help us get the full sleep we need. Having a lie in at the weekend has been proven to be beneficial but only for an hour or 2, sleeping away the whole morning to make up for major sleep deprivation during the week just leads to lethargy.

Exercise 4-5 times per week – people often say they don’t have time but time will not materialize out of thin air – you have to make time! Instead of staying that extra hour at work, go home on time and go for a half hour walk – this will help you sleep, for one and work more efficiently tomorrow. Find an exercise you enjoy, some people love the variety a gym offers, other like the simplicity of walking or jogging, some people need to exercise alone, some with other people – there’s something out there for everyone. Lifting a beer to your lips while watching rugby doesn’t count!

Have some ‘me time’ – everyone enjoys different things; from acrobatics and art appreciation to yoga and zentangle. ‘Me time’ can also be a long soak in a hot bath or walking the dog. This is particular important for introverts in a world designed for extroverts, other people sap our energy and we need time on our own to recharge.

Practice deep breathing and relaxation – there are huge benefits to spending a couple of minutes relaxing and breathing deeply:

  • More oxygen to the brain keeps it healthy and enables clarity of thought and better concentration
  • Reduces muscle tension
  • Lowers blood pressure reduces risk of cardiovascular disease
  • Improves posture
  • Releases endorphins, improving mood and decreasing pain
  • Encourages dispersal of harmful toxins

Taking things a step further, mindfulness or meditation can also be helpful.

Take your annual leave – there is nothing heroic about working your annual leave, we have it written into our contracts for a reason – it is vital to have a change of scenery and do something different (even if you ‘just’ stay at home) in order to recharge the batteries – it benefits everyone when you come back refreshed.

Remember, putting yourself first a little bit is for the greater good!

# stats from Forth survey Jan 2018

* stats from HSE survey

Honesty over Silence

Mental illness thrives on silence; secrecy and deception feed the illness and keep it alive. The longer we keep quiet, the more ingrained the thoughts, feelings and behaviours become.

I recently went to a conference entitled ‘Honesty over Silence’; the challenge is that once we break the silence and start being honest about our experiences, we become vulnerable. Vulnerability is tricky, it is sometimes considered weak, risky or even dangerous. But we need to see vulnerability as a positive assent, to be respected; it is to be embraced rather than feared or expostulated.

How many times have you been asked “how are you?” And said a bright and cheered “fine thanks, how’re you?”. This is fine if it’s just a salutation but how about we take advantage of this question to be honest? “I’m not doing so well today” or “feeling a bit down/anxious today”. We struggle to do this because it can lead to more questions or awkwardness but it could lead to some honesty and sharing; when one person opens up, it gives the other person a chance too.

Bringing our illness, addiction or vulnerability out into the light diminishes it. Depression in the dark is huge, black and unbearable – shedding light on it, can make it seem more manageable.

I hid my mental illness for many years, scared about what it was, lacking the language to explain what was going on. My journey to recovery only started when I finally said “I’m struggling”.

On occasions, Christians with mental illness can be made to feel they’re failing in their faith; it can be suggested that you don’t pray enough, or you don’t truly believe that God can cure you.

I’ve learnt that healing takes many forms – healing for me has not been about medical cure, it’s about walking a journey of recovery, making numerous choices, meeting inspiring people along the way and a lot of learning!

The things I’ve had to do to recover have taken time – I’d been thinking I was a terrible person for many years, the new neural pathways were not going to be formed over night – even if they had been (because God can do anything), it would have taken me a long time to get used to thinking differently and going back to old ways would have been very easy.

Jesus spent time with the stigmatised and marginalised, he showed them compassion and love which led to healing (in various forms). No matter who you think Jesus was, there is enough evidence to show he existed and was a very influential person – so, if he allowed people to be vulnerable, and even valued it, his is a good example to follow.

Christian’s believe Jesus was the epitome of vulnerability, he was God made flesh; omnipotent God became a helpless human baby, fully reliant on a care giver to provide for his every need – if God can do that, surely, I can say “I’m struggling with some dark thoughts at the moment”?

I’ve opened myself up many times in this blog but I still find it hard to be honest, and in turn, vulnerable, face-to-face – this is strange isn’t it?! I’m happy to tell strangers my inner secrets about suicidal thoughts, self harm or disordered behaviours (in the hope I can help others or make people feel they are not alone) but when it comes to being honest with my nearest and dearest, I don’t want them to worry or be brought down by my troubles.

However, the benefits of honesty far outweigh the perceived drawbacks:

  1. It can deepen a relationship
  2. You give others permission to open up
  3. You’ll find shared fears and vulnerabilities leading to you both feeling less alone
  4. Solutions may come to light

To name, just a few. How about we all give it a try, you never know what you might discover.

Inspired by the Honesty over Silence conference run by Kintsugi Hope – discovering treasure in life’s scars. Kintsugi is the Japanese art of repairing broken pottery with lacquer mixed with precious metals to highlight the join; our scars are part of our history, are brokenness is what makes us beautiful.

Why we’re still struggling to talk about mental illness

We’re making a lot of progress as more people get involved in talking about mental illness but it’s still very difficult for individuals to put their hands up and say “I’m struggling”. I believe fear is at the centre of this and there’s no easy way to break this down but we can do with small steps. 

1. Lack of understand and confusion

When I was first suffering with symptoms, I had no idea what was going on and I had no way of describing my distress – I didn’t know that the tight bundle of thoughts in my head, increased heart rate and tension was anxiety, I had no idea my lack of appetite was caused by an illness, I had no idea that feeling low and having to fake smiles was a sign I was unwell. I was frightened but I had no idea what I was frightened of. I didn’t know anything about mental illness and I had no language to describe it.

We need to raise awareness of signs and symptoms and make talking about our feelings common place, just like we talk about physical problems. More knowledge will make everyone more likely to see if someone gets unwell, and if we’re already talking about, it’ll feel less strange and awkward.

2. Fear of stigma

In general mental illness still has a negative reputation; people perceive the individual as weak or lacking in something. There are many misconceptions, such as thinking that we’re dangerous, unpredictable or unreliable. Some people think it’s our fault we’re ill, that we’ve done something wrong.

The truth is, mental illness does not discriminate, it is not a sign of weakness and we have good and bad characteristics, just like everyone else.

The way I fight this one is to go about my life and when someone least expects it, I let them know a little bit about what I’ve been through – this helps people see me for who I am first, then they realise being mentally ill is just part of me, it does not define me.

3. Fear of discrimination

“What will I miss out on?” is the fear. People worry about all sorts of things if they divulge a mental illness, “will I be able to get a job?”, “Will I lose my job?”, “Will I be able to get the promotion I want/deserve?”, “Will I have fair access to healthcare?”. I have heard stories about people being discriminated against in both work and personal life simply because they happen to have a diagnosis.

Someone’s mental illness should not be used as a excuse to overlook them in anything – it’s important to look at an individual’s characteristics and skills rather than judging them and making assumptions about them based on their diagnostic label. This is not unique t mental illness, there are numerous reasons people will be overlooked or left at the back of the queue – fortunately, the law is on our side. I sometimes feel like I have to work extra hard to prove myself but with perseverance, I hope we can stop discrimination.

4. Normalisation

When I first started having problems, in my teens, I thought it was ‘normal teenage angst’, I thought everyone hated their changing bodies and so I coped with it as best I could. Turns out my intrusive thoughts and anxiety were pathological!

I was trying to explain what went on in my head when I was embroiled in anorexia to a colleague recently (they asked!). I explained about the fear of food, of fat, of calories and of putting on weight. The reaction I got was “don’t all women feel like that?” – this person may have been trying to make me feel better or they may have completely missed my point, that these fears paralysed me and stopped me functioning. No – these feelings are not normal and I had to undergo years of therapy to enable me to eat with strangers or in public.

Sometimes it helps to see symptoms as ‘on the normal spectrum’ but this can prevent people from seeking help if they do not realise what they are experiencing is illness.

It’s important that talking about symptoms is normal but we need to remember the symptoms themselves are part off an illness and need treatment.

5. Wanting to protect other people

When struggling with something, it’s a common human instinct not to want to burden other people with it.

When someone you love is mentally ill, it’s natural to worry about them and want to help, not being able to help/solve the situation can add to the worry! When I’m ill, I do not want people to worry about me, I don’t see the point in someone worrying when there’s not usually anything they can do. It can make a relationship awkward.

Keeping loved ones in the dark does not protect them; people are more likely to worry if they think something is going on but they don’t know what it is. It can help, when telling someone about your illness, to also let them know what they can do. This may be something practical like cooking a meal, to come to appointments or to listen to you, without judgement, criticism or advice, but whatever it is, if someone feels the can be helpful, they are less likely to worry.

6. Guilt and shame

Due to stigma, discrimination and lack of understanding, people feel guilty and shame about being ill. We feel guilty about being ‘a drain on public resources’, we feel ashamed that we’ve relapsed despite therapy, we feel we ‘should’ be better but would anyone say any of this to someone with chronic lung disease or someone or renal dialysis? Of course not!

There is nothing shameful about being mentally ill – it is what it is, an illness, none of us choose to be ill nor are we to blame. We need to have compassion for ourselves, we need to talk to ourselves as we would talk to a close friend who was ill. Once we’re making steps to diminish the (wrongly placed) guilt and shame, we will have more confidence to talk about it.

I know, it can be very difficult to speak out but the current situation with discrimination and stigma will never change if we do not bravely continue to talk about mental illness.

ECT should be a last resort

TW – contains content some people may find upsetting.

I had tried all sorts of medications, they were not working.

I had tried psychotherapy, I was too unwell to engage.

I was suffering with severe depression, I was not eating and was fixated on suicide, I was so unwell I was merely existing – I could still fake normality with most people but ultimately I was going to find a way to complete suicide – I consider that a certainty.

I was sectioned in hospital as it was deemed I no longer had a capacity to make decisions about my health.

As a last resort, I was given Electroconvulsive Therapy (ECT).

I was told about all the possible life changing side effects, but ultimately, I didn’t have a choice. My mental state was going to kill me. Whether I wanted it or not, ECT was the only option.

NICE (National Institute for Health and Clinical Excellence) guidelines state it should be a last resort, at that point, the benefits far outweigh the risks… at any point before that, it’s tough to justify using ECT as other treatment (with fewer side effects) should be tried first.

Recently, I, and another lady called Sue, were interviewed for a video feature on metro.co.uk

Sue and I had different experiences but we agree on the most important fundamental aspects.

ALL treatments should be given with informed consent and ECT should be a absolute last resort!

Please bear in mind I had a terrible virus and my voice sounds terrible but watch and read this video feature on Metro.co.uk – let me know what you think.

All treatments have side effects, but if you’re dying, you, or the doctor treating you has to weigh up the potential benefits with the possible side effects of any treatment.

I learnt about ECT at medical school, we were taught that the side effects could be severe but patients with severe mental illness could experience positive outcomes. This was reiterated to me when my psychiatrist suggested it could work for me.

I don’t know why doctors would use ECT before trying other treatments, only careful, non-biased investigation of all the facts in each case would uncover this.

Sue states that the hospital where she had her treatment is using it 12 times more than any other areas of the country. There is no way of knowing the reason for this without further investigation but it would interesting to see why other hospitals use ECT less. I don’t like to speculate, it could be any combination of medications, therapies (psychological and occupational) as well as more 1-1 support, for example.

It would also be interesting to compare suicide rates between hospitals – if other hospitals are not using ECT when it could save their life, that would also explain the isolated statistic.

Audits and reports tend to throw up differences without looking into the whys or the hows. There also tends to be a lack of reporting making the sample size very small – therefore the results, although relevant and interesting, may not be significant.

I was a doctor too but it’s my illness that stopped me practicing, not ECT. I’m just glad my illness didn’t take my life as well as my career.

For more information about ECT please read here (Royal College of Psychiatrists), here (Mindful Survivor) or here (Metro.co.uk).

When we stop talking about our pain

The other day, I read something that really struck home:

“You don’t learn to live with pain, you just learn to stop talking about it”

When an injury first occurs or before a chronic illness is diagnosed, we talk about our symptoms, if they’re worrying us, we have no problem saying “I’ve got a splitting headache again” or “My tummy ache’s not going away” or “The cold really affects my joints” but once you’ve got a diagnosis and are managing (with medication or otherwise) as best as you can, there seems little point to keep going on about it…this is something that seems to happen naturally but it’s a tricky thing that isn’t always the best thing.

One of my husband’s friends was having terrible back trouble a while back, as fellow Christians we were praying for him as he made decisions about treatment including the possibility of invasive surgery. After a while, I asked my husband how his friend was, he said he didn’t know – we didn’t know if that was because his back was better (unlikely) or he’d just stopped talking about it.

I have chronic pain in my neck, back and shoulders and have done for many years. This is due to spondylosis in my spine and fibromyalgia affecting all joints and soft tissues. Spondylosis is diagnosed with MRI and is a degenerative bone condition causing pain, including periods of inflammation and osteophyte (bone spur) growth, which press on nerves etc. Fibromyalgia is a condition diagnosed by ruling out all other connective tissue disorders which causes tender/trigger points and generalised pain and fatigue. I also have arthritis in my ankles which causes pain with every step I take.

I used to complain quite a lot, the conditions I have are difficult to manage, especially in someone “so young”, as my orthopaedic surgeon told me! I take regular pain killers, do physio, do regular exercise, get regular sleep and do relaxation techniques.

The other day my husband asked how my pain was, commenting that I’d not said anything about it for a while. I said that it was ‘as usual’ – I hate complaining, and I hate lying so it just is what it is!

I have come to realise I may have a low pain threshold (ie I feel pain sooner than someone else) but I have an incredibly high pain tolerance – I can put up with a lot of pain and still go about my daily life, not that it doesn’t bother me, just that I don’t let it stop me. This, of course, take a lot of energy which contributes to the fatigue I get anyway!

I find it difficult to talk about my pain as most people, when they hear about it, want to help in some way, or at least say something useful, sympathetic or supportive. But there isn’t really anything anyone can say or do to help. If I do mention it, it generally feels quite awkward and I defer to lying, along the lines of “it’s fine, I’m managing ok” or “I have good days and bad days” – which is technically true but my good days are still about 5-6/10 on the pain scale…

Normal for me is pretty bad but who wants to hear that every time I see them?!

If I don’t talk about it, people don’t realise that I’m suffering, assume I’m fine and don’t understand when I need to leave events to go to bed, if I’m distracted or if I don’t offer to help (set up tables, move chairs etc). I worry that people won’t believe me because I ‘look normal’ or they will just think I’m lazy or a flake!

The thing is, I can act normal, as I did the other day in breakaway training at work, but I pay for it afterwards. That evening, I could hardly think, my head felt like it was completely split open, my shoulders and arms were stiff and I coulnd’t move them without excruciating pain. Hot pokers and crushing vices could probably reproduce the pain fairly accurately.

I have read some fabulous books by Paul Brand and Philip Yancy about how we’re meant to listen to our pain, not get angry about it or wish we didn’t have it – it tells us something is wrong, if we didn’t feel it we wouldn’t pull our hand away from the flame or take care of a brewing illness.

Unfortunately when it comes to fibro, the thing that’s wrong is the pain communication system – this means, I feel pain when I shouldn’t. Pain from spondylosis is due to physical degeneration or deformities – I listen to my pain and do not push my body beyond it’s limits too often but it’s incredibly frustrating when my brain is active and wants to be doing, but my body just can’t.

I’m not looking for people to feel sorry for me (that’s fairly pointless!) – I’m just saying it how it is.

So it’s a difficult balance, talking about the pain doesn’t solve anything and makes other people feel helpless or awkward, not talking about it means people don’t know the truth, may think I’m rude or acting strangely.

So, perhaps we should try to remember, if someone has a chronic condition, no matter what it is, diabetes, arthritis, mental illness, bowel or kidney disorders, they are managing it every single day. They may not talk about it but that doesn’t mean they’re fine, it doesn’t mean they’re not suffering just as much as when they do talk about it, all it means is that today, they’re not talking about it.

Sometimes I wish my conditions were more visible but most of the time I’m glad I can choose who I tell. I guess, my health is my business and I maybe I shouldn’t worry about what other people think.

Think before we speak, taming the tongue

The tongue is an incredibly powerful muscle, it can discourage or encourage, praise or curse, gossip or spread rumour, express love, hate or anything in between. If you believe in creation as set out in Genesis, (God) speaking brought the world into existence!

As children, many of us were given the simple message “if you’ve not got anything nice to say, don’t say anything at all”, this helps us stop before we speak and evaluate whether our words are nasty or nice, mean or kind, cruel or compassionate.

I don’t think I’m alone when I say I’m guilty of letting my tongue get the better of me. When I’m feeling a bit rubbish, I’ll say a curt word, for some reason, want to bring down the people around me – I can be nice and polite in public but it’s my husband who gets the less than helpful comments and underhand criticism. I don’t mean to be harsh, sometimes things just come out.

We’ve all been around people who seem to just want to discourage, knock confidence and generally hinder, cause difficulty or seem to oppose everything. I’m going to be blunt and say it’s best to let people like that slip out of your life but of course, this isn’t always possible.

I was asked in some recent bible teaching (name drop alert), with Simon Ponsonby(!), “how do you respond to criticism” – my answer was that I used to take it really badly, take it to heart, I would even twist it to fit my belief that I was useless, pointless and couldn’t do anything right. More recently, I’ve noticed I’m more likely to defend myself or even shut out the criticism; this is because I’m aware my self esteem incredibly fragile so if I take the criticism as I used to, it would mean all the work I’ve done to build myself up would be wasted.

However, we discussed that criticism can help us develop and be better people. This, of course, has to be the magical ‘constructive criticism’ – to give this kind of advise is about finding the right balance.

So, when I hear criticism, it’s important to evaluate it immediately and decide if it’s going to cut me down or whether it has the possibility to help develop me. If the latter, it needs to be listened to, understood and taken on board.

In the bible teaching, Simon was looking the book of James, chapter 3, about taming the tongue.

It’s not about saying nice things or not saying the horrible things you really want to say. We all know passive aggressive people who communicate incredibly loudly with their silence or through their fake niceness…this makes for a toxic atmosphere.

It’s about wanting the best for those around us, it’s about considering what they need to hear (NOT what we think they need to hear) but making sure you communicate effectively and take time to ensure they’ve heard what you intended.

Thinking about taming my tongue I’ve looked up the definition; although many definitions of the verb to “tame” suggest, submission or lacking in something, I’ve come across one that I think is more helpful when thinking about taming the tongue:

“To harness or control; render useful, as a source of power.”

This recognises the capacity of the tongue and that it can be used to accomplish great things. I’ve been challenged to tame my tongue, to think before I speak and (not stay silent) but speak with love and compassion, and ensure what I say builds up those around me. If I feel critical or argumentative, I need to consider what is best for the other person – can I rephrase what I want to say so they benefit instead of feeling got at?

I will THINK before I speak and consider whether it is:

  • True
  • Helpful
  • Inspiring
  • Necessary
  • Kind

Anxiety is like a car alarm

If you have a posh enough car, it has an alarm. If someone tries to break in, it makes a loud sound to warn them off and alert others to the problem.

In the same way, anxiety can be a useful alert system – when there’s a threat that requires the fight or flight response, adrenaline surges through the body in order to make us run faster or fight if necessary.

However, if there’s a fault with our car alarm, it will also sound when the wind blows, when a cat runs under it, when someone walks past or for absolutely no reason what so-ever!

If anxiety works in overdrive, it is set off, for example, when you think about going outside, or when you’ve been invited to a party, or if a compulsion has not been carried out correctly, or…for no clear reason at all.

Anxiety is terrifying because adrenaline surges through our body as though we are experiencing a threat on our life.

We can take the analogy a bit further, the first few times your car alarm goes off, you dash out to check, thinking someone is stealing your car.

When we feel anxious, we assume it’s an accurate feeling for the threat posed so react appropriate, usually by running away or avoiding the situation. For example, if agoraphobic, we stop going outside, if we have social anxiety, we stop socialising, if we have obsessive compulsive thoughts about switching the light switch exactly 17 times, we have to switch is exactly 17 times.

Or, in my case, I developed a fear of fat and of putting on weight so felt anxious around food, this combination led to anorexia. So what started as a simple fight or flight response getting out of control, led to a complicated mental illness and years of difficulty.

Both, the car alarm and anxiety, can be distressing and negatively impact those around us no matter how hard we try to hide it.

Unfortunately, by the time we’ve realised the anxiety is not an appropriate response to the situation, the behaviour has become a habit.

If our car alarm goes off multiple times we turn it off – unfortunately, we cannot do this once anxiety has “gone off” too many times.

However, take it another step – when we take our car to the mechanic, they check out the wiring, maybe replace or re-set some of the workings.

Here’s the good news – we can re-wire our brains – how great is that?! We can re-train our neural pathways so that we react with an appropriate level of response. This may take a long time but it is possible with the right therapy and a lot of perseverance!

Recovery from mental illness isn’t about staying within your comfort zone

Regarding mental health recovery, I just saw someone on facebook advise one of my friends to “take baby steps”- totally agree with this, but then she said “go at a pace you’re comfortable with” – this, in my humble opinion, is dangerous ground… let me explain.

Recovery from mental illness is going to be painful, it’s like physio, it ain’t gonna work if it doesn’t hurt! No pain, no gain and all that jazz!

The one barrier to recovery, I’ve seen over and over again is being terrified of change and needing things to stay the same.

There’s the old adage – no-one likes change and it’s true.

Yes, being mental ill is horrendous, no-one actually wants to be ill but, wanting to get better and wanting change are two very different things – I don’t think anyone would be ill if getting better was easy, straight forward and didn’t involve making massive painful changes to the way we think, feel and behave.

Unfortunately, the longer someone has been ill, the more comfortable the illness is, which makes change even harder. BUT there’s also the opportunity to use the feelings of frustration to motivate the change.

When recovering from anorexia, comfort, for me included, feeling hungry, saying “no” to food and making decisions based on consuming few calories and burning many. If I’d been told to “go at my pace”, I wouldn’t have gone anywhere at all. I’m not saying I wanted to stay ill but changing even the tinniest thing caused distress I couldn’t manage.

As odd as it sounds, depression can also be comfortable. I had my routines, I had people care for me, my thinking patterns were familiar, I believed the running commentary in my head… I was useless and trying was pointless – it was easier to stay in these patterns.

How could someone not want to break free?! Of course, I wanted to break free but I also didn’t want anything to change.

There’s a fear of failure, and let’s be honest, taking huge leaps increases the chance of failure, then confidence in one’s ability is knocked! So, it’s essential to take baby steps but I always found the tinniest step was uncomfortable.

Once I’d decided I was going to tackle recovery and make it work, I had the right people around me, people who had faith in me, they presented me with challenges they believed I could achieve; every step was difficult, I had to fight my daemons and manage extraordinary levels of anxiety, but if I’d not gone through that, I’d still be at square 1 (or worse).

With all mental illnesses it’s important to make the changes stick, so, unfortunately, there’s no such thing as a day off! If you take your foot off the gas, chances are, steps backwards will occur.

Deciding to take a day off (as enticing as it is!) is dangerous territory!

So, baby steps – yes, even half baby steps, but as soon as you think it’s ok to stay comfortable, chances are, recovery will halt.

I DO NOT want anyone reading this to feel bad about taking steps back or not making progress, this is natural and (dear I say) ‘normal’! Recovery is exhausting – it’s seriously been the toughest thing I’ve even done, it’s so difficult to make the ‘right’ decisions days after day!

I’m simply pointing out, that in my experience (in myself and supporting people) recovery is about stepping out of your comfort zone, not staying within it.

I hope this will help supporters understand why linear recovery just isn’t possible!