Mental Health Series: June – Lack of Motivation

This is the sixth in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


Lack of Motivation

Indianola Beach Dock, Washington, USA (the image is mine but feel free to use it)

Lack of motivation might not be one of the first things that comes to mind when you think about mental health. Procrastination and the occasional bout of laziness are a normal part of life and we all have days when we simply can’t be bothered to do something, especially if the task is one we don’t enjoy (I’ll take reading a good book over cleaning the bathroom any day). Usually, this behaviour doesn’t cause us too many problems. At some point we convince ourselves to get on with the tasks we’re putting off and are able to move on with our lives.

For those of us who struggle with mental health problems, it’s not as simple as that. Lack of motivation that goes beyond idle procrastination is often a by-product of mental illnesses like depression and anxiety. It is a sign that our own minds are sabotaging our efforts and draining us of the mental energy we need to perform even the simplest of tasks.

When this happens, we can find ourselves locked in a self-defeating cycle. We have tasks to get on with that keep increasing in number, which can cause us to feel overwhelmed and anxious about not being able to get everything done. We can feel useless and angry with ourselves for our inability to manage our lives and for letting things get out of control. These feelings increase in severity along with the number of tasks until we reach the point that we don’t know where to begin and have no motivation to try.

Making lists of outstanding tasks can help, but even they can make things worse as they can become a visual representation of our failures if we are unable to achieve the goals we have set for ourselves. They taunt us in their incompleteness and are used by our mental illnesses as manufactured evidence of our weaknesses and lack of will power.

Lack of motivation can also apply to the things we actually want to do. Ironically, I had trouble motivating myself to write this post. I have a lot of competing priorities and big changes happening in my life right now that are quite overwhelming, and some days I feel like I’ll never have time to do everything, so finding the will to sit down and write a coherent post has been quite difficult. The only reason I pushed myself to finish it was because it’s getting very close to the end of June and I want to make sure that I keep my commitment to myself to publish a post every month. As tempting as it was to use my day off to lie down or try to tackle other things on my to-do list, I knew how angry and disappointed with myself I would be if I didn’t get this done.

It can be difficult for people who have not experienced significant issues with motivation to understand why we can’t simply prioritise our tasks and complete them one by one (in other words, “just get on with it”). Of course, we understand that doing this would make us feel better, but knowing that and actually being able to accomplish it are two different things.

To explore this idea further, I want to look at an example of when lack of motivation can have a debilitating impact on our ability to take positive steps forward in our lives – being unable to complete job or university applications. This is a really common problem for people who suffer from mental health issues and is about so much more than procrastination.

Imagine yourself sitting in front of your computer trying to work on a job application. Now imagine there is someone sitting next to you who does nothing but spout a relentless barrage of criticism. They bring up every mistake, every insecurity, every perceived weakness you have, and every reason they think you’re not good enough to get this job. To make matters worse, you can’t escape this person. They follow you wherever you go and refuse to leave your side. You try to ignore them and focus on what you’re doing, but they only get louder and louder until they’re screaming insults in your ear and you can’t focus on anything else.

Could you fill out a job application under those circumstances? Could you even summon the will to try when you know this person will always show up to sabotage you? Could you convince someone to hire you when you feel like you’re not even worth their consideration?

Probably not, and therein lies the problem.

Having a mental illness like depression or anxiety can cause us to feel exactly like this, only it is our own minds providing the constant stream of criticism and self-doubt rather than another person. We are not lazy. We are not putting it off because it’s boring. We are struggling with the very minds we need to carry out this task in the first place, which can make it feel impossible to make any real progress.

So, how can we deal with this?

Getting some help for any underlying mental health conditions is really important, but there are other, smaller things we can do to help become more motivated in the meantime.

I mentioned before that making lists can be counterproductive as they can make us feel like we’ve failed if we don’t manage to accomplish everything we planned to, but that can often be a result of making the lists too long or wide ranging. For lists to be effective at managing everything we need to do, they have to be achievable and suited to how we’re feeling at the time.

There will be some days when even small, seemingly insignificant tasks will require a Herculean effort, and we need to make allowances for that to avoid trying to do too much and feeling like we’ve let ourselves down if we don’t achieve everything we set out to do. If we’re tired or having a particularly challenging day with our mental health, then it makes sense that we’ll find it more difficult to get motivated.

On days like those, it’s important that we try to adjust our expectations of ourselves. For you, maybe doing the laundry is an achievement. If it’s something that you normally don’t manage to do, or do with great difficulty, and you’re able to do it, then that’s an achievement and you should view it as such. Accomplishing a task, no matter how small, gives your self-esteem something to work with in its battle against feelings of worthlessness, so it’s important to acknowledge it.

When I know I have a lot on my plate and I’m beginning to feel overwhelmed, I write a list of absolutely everything I can think of that needs doing, even if it’s not urgent. Then, I break it down into smaller, more manageable lists, making sure to include things that I actually want to do. It’s amazing how trying to catch up on a TV show that I’ve fallen behind on can actually feel overwhelming and turn into a task itself. Sure, it’s not vital to my day-to-day life that I stay well-informed about the lives of fictional characters, but the fact that I don’t feel like I have the time to do that can be very frustrating, so things like that go on my to-do lists as well.

To help combat the part of my mind that tries to make me feel lazy and useless, before I go to bed I make a mental list of everything I’ve achieved that day, down to the smallest task. If I haven’t had a particularly productive day, I try to remind myself that quiet days where I just sleep or watch TV are also important for my wellbeing, as they help me summon the energy to do more the following day.

What I’m aiming for is a balance of productivity and relaxation that allows me to keep on top of things that need to be done, like paying bills and housework, while also making time for things that I really want to do, like spending time with friends or finding out who the hell ‘A’ is on Pretty Little Liars.

This isn’t always easy, and even now I’m struggling with feelings of anger and disappointment with myself that my day off did not go as planned. That said, before I go to bed tonight, I will still be able to list some achievements for the day that will temporarily silence my internal critics, this blog post being one of them.

Fighting a daily battle with mental illness is a full time job. We won’t always get everything done. We won’t always feel up to fulfilling every commitment. We won’t always be able to get out of bed. The thing we have to try to do is accept that this is okay. These jobs don’t give us vacations or benefits, so it’s up to us to manage the workload and take time out when we need to.

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Mental Health Series: May – Guilt

This is the fifth in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


Guilt

Beach along the Oregon Coast, USA (the image is mine but feel free to use it)

Unlike other emotions like anger, guilt is usually triggered by our own actions, not those of other people. We all have certain ideas about the kind of people we are, or, at least, the kind of people we want to be. We expect certain things of ourselves, and we believe we know ourselves well enough to predict how we will behave in any given situation. Sometimes, we create idealised versions of ourselves in our minds, causing us to believe that we would never act in a manner that would be hurtful to someone else, because we believe we’re better than that.

We hear about someone doing something we perceive as wrong and think, “I would never do that.” In some cases, like serious criminal offences, that is probably true, but there are grey areas of morality that make it difficult to judge how we would behave in a particular situation unless we actually experience it ourselves.

Guilt is the emotion that plagues us when we fall short of our own expectations. When we make poor choices or behave in a manner that is at odds with the person we thought we were, or believe we should be, we can feel shame and a sense of failure. We admonish ourselves for not doing or saying something differently, and become frustrated with our inability to change the past and take a different path.

If this guilt is the result of a mistake we have made, then our only recourse is to try to make amends for any hurt we have caused and to resolve to learn from the experience and behave differently in the future. If, on the other hand, guilt is the result of a perceived failing on our part that only we believe to be true, it is much harder to expunge.

What do we do when we feel guilt over how we have behaved towards someone, even if that person does not believe that we have done anything wrong? In that situation, we cannot ask for forgiveness because the other person believes there is nothing to forgive. So where do we turn to deal with our self-imposed guilt? I’ve been struggling with that question a lot recently, and it’s what I want to talk about in this post.

As I have mentioned in earlier posts, my mother has terminal brain cancer. For better or worse she is currently the central focus of my life and I have been forced to confront many difficult emotions in the 2 months since her diagnosis. One of those emotions is guilt about the kind of daughter I believe myself to be.

My mum and I have always been very close, and I have supported her as much as she has supported me. When she was first diagnosed with breast cancer a year ago, I took her hand in the doctor’s office and promised myself I would be there for her no matter what happened. For the most part, I have kept that promise.

I sat with her through every chemo appointment, and stayed up with her all night when it made her sick. I managed her medication schedule and made sure she took care of herself. I gave her gifts as a reward after every chemo session, and surprise bouquets of her favourite flowers when I thought she needed cheering up.

I did anything and everything she asked of me, but there is one thing I couldn’t do, and still can’t.

I can’t look at her without her wig on.

I tried in the beginning. I forced myself to sit there and watch her get all her hair cut off when it started to fall out. She coped so well and even made a joke of it, but I could barely hold it together. Afterwards, mum chose to wear caps and headscarves in the house, and I tried to be okay with that, but I just couldn’t do it. I hated myself for not being strong enough to face such a stark reminder of her cancer and the threat it posed to her life. Now that she has been given a terminal diagnosis, it’s virtually impossible for me to even try.

I hate that there’s a barrier between us when I need to knock on the door to give her time to put her wig on before I enter a room she’s in. I hate that she feels guilty whenever she accidentally forgets to wear her wig around me, as if she’s let me down rather than the other way around. I’m angry with myself for not being able to push past my anxiety and sadness so that I can be around her no matter what she looks like. I feel guilty that I’m not stronger than this.

On the few occasions I’ve seen her without her wig, it has triggered a cascade of emotion that has sent me into a spiral of panic, pain and sadness. She has been given radiotherapy to her head in an effort to give her more time, so she has very little hair at all now, and when I look at her without her wig I can’t help but see the cancer that’s going to take her from me, and I can’t bear that.

If she had alopecia, or decided to shave her head for charity, this wouldn’t be an issue. I would accept those things. But this isn’t about her appearance. The hair loss itself is not the issue, but rather what it represents. I’ve had people say, “Hair or no hair, she’s still your mother.” Of course she is. That is not in question and never will be, but it doesn’t change the visceral response I have whenever I see her without her wig.

I know there will come a time when she’ll be too tired to want to bother with it. By then the reality of her prognosis will be inescapable and we will all have far greater concerns. Until then, I need her to look like my mum for as long as possible while we continue to make good memories and spend valuable time together.

One of the reasons we’re so close is because she understands me so well, and we have talked at length about this and how best to deal with it together. I was willing to try to learn how to cope with her hair loss, but she sat me down and told me that she knows this isn’t about her appearance and that my struggle to accept it runs far deeper than that.

She has stood beside me through the years as I’ve fought so hard to stabilise my mental health and fight my way back from clinical depression and the night I planned my suicide. Losing my mum will be an even bigger challenge than that, and she loves me enough to want to do everything possible to make that easier for me. When I told her that I was worried that other people would think I was being selfish, she told me, “The hell with other people. This is about you and me and what works for us. This is my choice and I want to do this for you, so who cares what other people think? ”I love her so much for that.

Mum is the most genuine person I have ever met and she has never gotten a lie past me since I stopped believing in Santa Claus, so I know she’s telling me the truth and not just saying what she thinks I need to hear. So why, after all the times she has reassured me that the wig is comfortable to wear, that she understands why I feel this way and that I shouldn’t feel guilty about it, can I still not shake the feeling that I’m failing her?

The only answer is that the guilt is coming from inside me. I always believed I was a great daughter who would (and could) do anything for her mother, but my inability to see her without her wig has forced me to re-evaluate that belief – a painful and terribly confronting experience.

Just like the anger I discussed in last month’s post, I don’t want anything to taint the time I have left with my mum, so I’ve had to find a way to live with this guilt and accept the way I’m handling her hair loss and what it represents.

I have had to learn to accept that I can only take so much. That if I’m going to keep getting out of bed every morning, holding down a job, maintaining my friendships, supporting mum while managing my own health problems and living my life the way mum wants to see me do, then something has to give. I have to adjust my own perceptions of the kind of person I am, because expecting so much of myself all the time is just asking for anger, disappointment and even more guilt.

I am harder on myself than anyone else around me, and I know many of you facing similar challenges can say the same. When there is so much weighing us down already, the worst thing we can do is add to the load by constantly admonishing ourselves when we are not able to do everything we wish we could.

We are not perfect. We cannot be strong every second of the day. We all have our limits of tolerance that we cannot exceed. That is human nature, and something we have to learn to forgive ourselves for. It is only possible to absolve ourselves of our self-imposed guilt if we are willing to accept the parts of ourselves that make us less than perfect. But as long as we do the best we can and keep going, then we have nothing to feel guilty for. If we can do that, then our best will be more than good enough.

Mental Health Series: April –Anger

This is the fourth in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


Anger

The sun obscured by haze from forest fires, Montana, USA (the image is mine but feel free to use it)

Like most emotions, anger exists on a spectrum. It can range from mild annoyance to blinding rage. Sometimes, anger can be a useful emotion. It can motivate us to stand up for ourselves and others, fight for justice and equality, and even help us survive in situations when it provides the strength we need to stay alive.

Anger can also be incredibly destructive, and that’s when it becomes a problem.

It can deceive us into thinking it’s an ally. It can make us feel stronger and more able to withstand the pain and fear that has triggered it, while, in reality, it is making us weaker. Like a drug that makes the user feel indestructible while simultaneously wreaking havoc on their health, anger provides us with a shield against the world while at the same time it saps us of our energy and positivity.

Whether it’s becoming violent, losing our temper with friends and family, or turning to self-destructive coping mechanisms like alcohol or drugs, repressed anger has a way of breaking free from our mental restraints and leaving devastation in its wake.

In my experience, this kind of intense anger can be provoked by situations that fall into three categories: disappointment and frustration with ourselves for mistakes we’ve made; hurt and mistreatment caused by another person (particularly someone we trust); and pain caused by something beyond our (or anyone else’s) control.

The third category is arguably the most difficult to deal with. While we can learn from our own mistakes or confront someone who has wronged us, we have no recourse when life simply goes wrong and there is no one to blame.

When I started thinking about how I would approach this aspect of mental health, two significant periods of my life came to mind: one from when I was a child, and one that I’m currently experiencing.

As I’ve mentioned in previous posts in this series, I grew up with a severely autistic younger brother. Completely non-verbal and often violent, it was an incredible challenge for my parents to cope with him. As a result, they inadvertently placed a great deal of responsibility on me at a very young age. My brother’s violent outbursts often came without warning and I was very frightened of him, yet I was frequently left alone with him and expected to keep him amused while my dad was at work and my mum did housework or cooked us dinner.

One day, after so long living in fear, dealing with being bitten, pushed around and forced to follow my brother’s rigid routine at the cost of seeing my friends and having a normal childhood, I couldn’t take it anymore.

He was in the garden driving his toy car in circles around the swing set. It was big enough for him to sit in, and he had already worn a muddy path into the grass from weeks of this repetitive behaviour. I remember vividly standing there staring at him, feeling all my unexpressed anger and fear rising to the surface until I couldn’t focus on anything else. There was a long-handled wooden brush propped up against the side of the house. I grabbed it and waited until the car came closer to me, and then I swung the brush as hard as I could at my brother’s face.

I didn’t really understand why I’d done it, but it became clear to me later on. I wanted my parents to realise that their reliable, helpful and ostensibly strong daughter wasn’t coping the way they thought she was. I wanted them to ask me why I had done something so out of character and give me the opening I desperately needed to express all the fear and anger I was feeling. I wanted them to protect me.

Instead, they reprimanded me for what I’d done, cleaned up the blood from my brother’s nose (which thankfully wasn’t broken), and said no more about it. He went back to driving his car and I was left feeling worse than I had before.

Obviously, lashing out like that was the completely wrong way of trying to deal with my anger, and I still feel terrible that I hurt my brother, but I can forgive myself for that. I was a frightened child acting out of fear and desperation. That said, I wish I had felt able to tell my parents that I was struggling. I never doubted that they loved me and were doing the best they could, but at the time I genuinely believed that they wouldn’t have been able to cope if they knew how I really felt.

I know now that I was wrong and that their marriage actually grew stronger during those difficult years, but as a child I had no understanding of this. All I saw were the negative effects of my brother’s autism. Things like my dad holding his bedroom door closed to protect the rest of us from his uncontrollable violent outbursts. My mum being taken to hospital after he attacked her when she tried to get him to brush his teeth. My parents fighting to stop him from cutting his own ear off with a pair of scissors when he had an ear infection and couldn’t handle the pain.

Children shouldn’t have to see those things and feel frightened in their own home. It’s no wonder that I was angry. Talking about it likely would have made all the difference, and I’ll always wish that I had spoken up.

As an adult who has spent more than her fair share of time with psychologists, I know that talking things through is the best way of dealing with anger, and it’s one of the ways I’m trying to deal with the anger I’m currently feeling. It’s a different kind of anger than I experienced as a child. Not only because I now have the maturity to express it in a healthy way, but because, this time, I have no one to blame. Instead, I have only yet another confirmation of a truth that we all must accept as the cost of living – life isn’t fair.

Last month, my mum was diagnosed with terminal brain cancer. We lost my granny to cancer last year and my grampa five years before that. They helped raise me and I loved them both so much, and my mum means the world to me, so this news was absolutely devastating. When the oncologist gave us mum’s diagnosis and we walked out of the hospital, it didn’t take long for my tears to dry and angry thoughts to take their place.

Why did this happen? How had the doctors missed it? Why did our family keep getting hit with one blow after another?

Not two months previously, we had been told that mum had beaten breast cancer and that she would likely continue to live a long and healthy life. We had started planning for the future again after months of chemo, surgery and radiotherapy, and I was so angry that the battle we thought we had won was only part of a bigger war that we are going to lose.

In order to be able to talk about it, I have to understand and acknowledge why I’m angry:

I’m angry because my family and I have been through enough hell in our lives already.

I’m angry because the physical pain I deal with every day due to my health problems is making it much harder to deal with the emotional pain.

I’m angry because I won’t have my mum there for me when I get married and have children.

I’m angry because I’m losing the person I love most in the world and there’s nothing I can do about it.

I could easily become consumed with my anger at cancer, at my mum’s doctors for not spotting it earlier, at the universe for this cruel twist of fate – but that won’t change anything. All it will do is taint the time I still have with my mum and rob me of the energy I need to help both of us get through this. I don’t want to let that happen, so I’ve had to figure out how to live with this anger in a way that doesn’t compromise my mental health.

Unsurprisingly, this has involved a lot of talking. My mum and I have always been very close and she believes in having an open and honest relationship, which means we’ve been able to talk frankly about everything from her funeral arrangements to how I’ll cope after she’s gone. That’s been very upsetting at times, but it’s also a huge relief to be able to discuss and work through such a difficult situation together.

One of the hardest aspects of grief can be regret and unanswered questions, so mum and I are ensuring that I’m left with as few of those as possible. We talk even more than we used to, and if a question comes to mind, no matter how trivial, I make sure I ask it – even if it’s just her opinion about the latest reality TV show!

I know there will be times to come when I’ll want to ask mum’s advice and I won’t be able to, so she’s writing me letters in response to questions I think I’ll have in the future. Questions like what advice she would give me if I were pregnant with my first child and what she would like me to tell her grandchildren about her. It’s wonderful to know that I’ll be able to carry those words with me as constant reminders of mum’s support and guidance, even when she’s not here to say them to me herself.

She’s also asked me to try to find something to laugh about every day, which hasn’t been too difficult since this family has always met adversity with laughter. It’s the antithesis of anger and the perfect antidote for the feelings of dread and helplessness that we’re all struggling with.

If I allowed my anger at what’s happening to consume me, I wouldn’t be able to face up to the future and make the most of this quality time with my mum and the rest of our family. It’s time I won’t get back and I know I’ll never forgive myself if I withdraw from the people who love me because I’m too angry to be around them, so I force myself to confront my anger and push through it.

I’ve made a big deal about the importance of talking in this post, so I have to acknowledge that doing so is something that many people, particularly those who struggle with mental health problems, can find incredibly difficult to do. That’s absolutely understandable. When we open ourselves up to others, we become more vulnerable and have to face the fear of being dismissed or ridiculed, but that shouldn’t stop us from reaching out.

Talking about intense and confusing emotions is a skill that can be learned and practised until it becomes easier over time. For years I only wrote about my feelings in private journals and poems, but once I started talking to psychologists and close friends and family, it became a lot easier to express them. As I talked about in last month’s post, I wouldn’t be here now if I hadn’t learned to do that, which is why I’m encouraging others to do the same.

Since lack of support as a child with a disabled sibling was such a challenge for me growing up, several years ago I set up my own online support group for the siblings of those with Autism, Asperger’s Syndrome and Down’s Syndrome. You can find it here: https://www.facebook.com/groups/110123842407656/

There is also a wider support community for siblings of those with disabilities available via SibNet: https://www.facebook.com/groups/SibNet/

Mental Health Series: March -Depression

This is the third in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


Depression

Cloudy skies in Melrose, Scottish Borders (the image is mine but feel free to use it)

Depression is a term that is often heard, but not often fully understood.

It is a normal part of the human experience to feel unhappiness, self-doubt and despondency. Feeling these things for short periods at infrequent intervals is not depression – it is life. Depression is so much more than that. It is an all-encompassing, suffocating and debilitating illness that is relentless in its campaign to rob sufferers of their happiness, self-confidence and hope for the future.

The stereotype of depression might involve the image of someone holed up in their house for weeks, sleeping away their days, not showering or eating properly, and generally cutting themselves off from the world. Sometimes, this can be the case, but, more often than not, you would never know someone was suffering from depression unless they told you. Outwardly, they might appear to be perfectly fine. They might turn up to work or school, spend time with friends and family, even continue to pursue hobbies and interests, while all the time their own minds are attempting to sabotage them at every turn.

There is the misconception that depression must have a reason to manifest, like a trauma or personal tragedy, but it doesn’t always work like that. This concept can be very difficult to understand. How can a person just wake up one day and suddenly feel overwhelmed by self-doubt and dejection? Why can’t they just go back to the way they were and ‘snap out of it’?

Let’s look at it another way. Mental illness can be just as debilitating as physical illness, and one should not be taken any less seriously than the other, so imagine for a moment that we’re discussing cancer, and not depression. Sometimes, cancer has an obvious cause, like exposure to asbestos or radiation. Other times, it just appears with no reason or apparent cause. One day, a person is fine and living their life, the next day everything changes and the life they knew is irrevocably altered.

Depression can be exactly like that. Sometimes there is a discernible cause, and sometimes it just appears of its own volition, unwelcome and unexplained, sending a person spinning off their axis into a world that doesn’t make sense anymore.

Like cancer, depression is experienced differently by each individual who suffers from it, and what follows is only my personal experience.

It was 14 years ago that I found myself planning my suicide one night at the age of 15, and, although I am a completely different person now than I was back then, I will never forget what it felt like.

For months prior to that night, I had been suffering from anxiety, OCD and clinical depression, although I didn’t realise how bad things were at the time.

I grew up with a severely autistic brother whose inability to speak and frequent violent outbursts made for a very frightening and isolating environment in which to grow up. In their struggle to cope, my parents inadvertently placed a tremendous burden of responsibility on me that I was far too young to bear. I operated under the misguided belief that if I told them how terrified I was of my brother, how often he attacked me and how much I wished I could just go out and play with my friends, my family would fall apart and it would be my fault.

By the time my brother was moved to a residential care facility where he could have the quality of life he deserved, the damage to mine was already done. I had become terribly withdrawn, fearful and anxious and struggled to relate to my family and friends.

As I got older and had to deal with the onslaught of teenage hormones and the social and academic pressures of high school, I developed severe OCD (described in February’s post) and a deepening depression.

I had trouble forcing myself to get out of bed in the mornings, and I can remember just lying there staring at my alarm clock and wondering what the point of living was. During one of those mornings, my thoughts wove themselves into lines of a poem that described my despondency and disconnection from my sense of self:

Poem

That poem was dated 20th July 2003, just over a month before the night I planned my suicide.

That morning had been pretty normal. I had lain in bed for a while before forcing myself to get up for school, look at the X Files episode chart pinned to the side of my wardrobe (which I had made to determine which episodes I would watch each night that would help get me through the day), then drag myself downstairs for a breakfast I had no appetite for.

My lessons went by as usual, and I was packing up after the end of a double period of Computing Studies. I have no idea what triggered what happened next, but I remember it vividly. As I was pushing my plastic chair back under the desk, I was suddenly hit by a wave of such profound despair and isolation that I felt faint and couldn’t move. The voice of my teacher issuing our next homework assignment faded into white noise and all I was aware of was the absolute certainty that nothing would ever get better and I would always feel this bad.

I wandered through the rest of the day in a daze until I got home. Dispensing with my planned X Files episodes, I put on an episode of my favourite show, Star Trek: Voyager, and sat despondently in front of the screen, a pile of prescription medications on the bed next to me (thanks to my physical health problems, there were plenty of those available).

My mind started to wander.  What would happen if I took them all at once? Would I have time to sneak into my parents’ drinks cabinet and knock back a few bottles as well before they found me?

I took the first few pills. I don’t remember what they were, little pink, innocuous looking things, and just as I was about to reach for more, I heard a powerful and authoritative voice projecting from the television:

‘In command school, they taught us to always remember that manoeuvring a starship is a very delicate process, but over the years, I’ve learned that, sometimes, you just have to punch your way through.’

It was Kate Mulgrew speaking as Captain Kathryn Janeway, and in that moment of sheer hopelessness that line was like a bolt of lightning illuminating a very long and dark night. In this episode, Voyager is trapped in the event horizon of a quantum singularity. Their only escape route is closing fast and the situation looks hopeless. As I continued to watch the scene unfold, Voyager’s struggle suddenly became a metaphor for my own. My hand remained suspended over the pills as I watched Janeway urge her helmsman to ‘keep it together’ as the ship was rocked by turbulence and structural damage.

When Voyager burst triumphantly from the quantum singularity, a surge of hope rushed through me as I began to believe for the first time that maybe I could escape too. I spoke to my parents and within a week my doctor had diagnosed me with clinical depression and OCD, and I began treatment at a centre specialising in adolescent mental health.

During one of my early sessions, the psychologists gave me a questionnaire to fill out so they could better understand how I was feeling. While they were discussing it with me, they asked me which question had been the most difficult to answer. I tried to tell them, but found I couldn’t get the words out, so they laid the questionnaire down on the table in front of me and asked me to point to it instead.

I pointed to ‘Do you think about committing suicide?’ I had answered yes.

That was the first time that I fully realised how ill I was, and I became committed to my recovery. My psychologists helped me to realise that my love of writing was a means by which I could find my way back to myself, and over the months that followed I crafted a path made out of words and metaphors that personified my depression into a force I could fight.

I sent fictional, sword-wielding versions of myself on grand quests to save towns terrorised by monsters who kept them in constant fear. Every time the monsters fell and the towns were freed, I imagined myself freed from the monster of my depression. It took a long time, but that approach is what helped me through, and, eventually, I felled my own, real-life monster.

Over the years, I have felt that monster stir to life again, but I have never let him get to his feet and drag me back to the hell I experienced as a teenager. I use every weapon at my disposal to keep him at bay – writing, my friends and family, my work, my favourite Star Trek episodes – whatever it takes until I feel grounded in the present again.

I’m almost 30 now and my outlook on life is completely different than it was then, but the fact that, at 15 years old with decades of my life in front of me, I genuinely believed things would never get better and I would always feel that kind of despair, is terribly sad and shows the power depression wields over its sufferers.

I was incredibly fortunate to have the support available to help me recover, but not everyone is able to work their way through depression and come out the other side. For some people, the only choice they have is to find a way to integrate their depression into their lives, accept it as part of who they are, and carry on. That takes incredible strength and courage. Ironic, considering that depression makes you feel as though as you are weak and worthless.

One notable example of this is author and mental health advocate Matt Haig. His book, ‘Reasons to Stay Alive’, is an illuminating insight into the mind of someone living with depression. There are also countless blogs, twitter accounts and books/magazines out there that are working towards making mental health a less intimidating and misunderstood subject, and ensuring sufferers know they are not alone.

It can be extremely difficult to relate to someone with depression if you’ve never experienced it yourself, and you may be at a loss as to how you can help them.

There are no easy answers to that, but never underestimate the power of simply listening. As someone who cares about them, you can provide a supportive and non-judgemental opportunity for them to express whatever difficult emotions and thoughts they are experiencing, without the fear that you will dismiss them or think they’re crazy. There is immense value in that, because it means they can contradict their depression when it tries to tell them that they’re a burden and no one cares about them.

Be an ally in their fight. Pick up a metaphorical sword and stand beside them. Tell them that they matter, that they are valued and that you are always there to listen. Encourage them to pursue any (safe and legal) avenue that makes them feel better, even if it seems strange or trivial.

Above all, remind them of this: where there is life, there is hope, and things can get better. I, and others like me, are proof of that.

 

Mental Health Series: February –OCD

This is the second in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


ocd

Up the Eildon Hills, Melrose, Scottish Borders (the image is mine but feel free to use it)

Most of you have probably heard of the term ‘OCD’. I hear it thrown around in casual conversation all the time. It’s often used to describe people who like to clean and keep things neat and tidy, who are very organised, or have a somewhat peculiar personality quirk like needing to keep their ornament collection arranged just so. I hear people remark, “oh, I’m so OCD about that”, when referring to their need to make their bed every morning or have their coffee at exactly 9 a.m. every day.

That’s not OCD. It’s not even close.

I’m certainly not suggesting that everyone who casually uses that phrase is being overtly insensitive or insulting. I’m sure it never even crosses their minds that it might be taken personally by those of us with actual experience of it. Unfortunately, whatever the intent behind it, that statement trivialises the severity of a condition that is so much more than just the desire to keep things neat and tidy.

If only OCD were that simple – or that benign.

Obsessive Compulsive Disorder is a mental illness that causes sufferers to experience unbreakable cycles of disturbing and negative thoughts that produce high levels of anxiety, usually accompanied by the compulsion to complete repetitive and sometimes bizarre rituals in order to cope. Often combined with other mental health conditions such as depression and suicidal thoughts, OCD traps sufferers into a pattern of behaviour that can cause them to believe that if they stop performing these rituals, or perform them incorrectly, something terrible will happen.

If you have OCD, it is genuinely possible for you to believe with absolute certainty that your family will die if you don’t check the soles of your shoes exactly 3 times as you walk down the street, and that it will all be your fault.

It can compel you to circle the perimeter of a room and touch objects in a specific sequence before you’re able to sit down.

It can force you to align objects at precisely right angles and get unreasonably angry if one gets knocked out of place.

It can leave you with chapped and dry hands because you feel the uncontrollable need to wash them over and over again to try and rid yourself of non-existent dirt and germs.

It can extend the length of your supermarket trips because you have to reshelve out of place products and straighten up the chewing gum displays.

It can mean that you feel so trapped in a room with closed doors and curtains that you have to repeatedly open and close them to prevent a panic attack.

In case you think these examples are exaggerated for effect, they’re not. Those rituals used to be mine. They are part of the rigid pattern of behaviour I was trapped in for over a year when I was 15 and severely mentally ill.

I recovered a long time ago, which is why I can now see them for what they really were and write about them objectively, but at the time, they formed the bars of a prison that meant I had to have home visits from two psychologists because I couldn’t manage the anxiety and all the rituals that would be required to get me from my living room couch to the treatment centre.

I can still remember how humiliating it was to have to walk around the house and show them all the bizarre and nonsensical rituals I was compelled to perform. They then had me sit on the couch with a piece of paper and a pen. When I felt the urge to perform one of the rituals, touching the mantelpiece with both hands at exactly right angles to the clock, for example, I had to draw a graph of my anxiety levels. When I wasn’t able to stand it any longer, I was allowed to perform the ritual, and then had to record how my anxiety levels dropped, and how quickly they began to rise again.

One of those graphs would have looked like this:

graph

You can see a pattern here. A disturbing thought would enter my mind, triggering my anxiety. That anxiety would continue to build, and, lacking the ability to rationalise my feelings and deal with them, I would be compelled by my OCD to perform a ritual to calm the anxiety. I would experience only a brief reprieve before the anxiety would start building again, like a wave about to break on the shore (or the mantelpiece, in this case).

Eventually, I was able to attend regular sessions at a treatment centre specialising in adolescent mental health, where I was diagnosed with clinical depression and suicidal thoughts alongside the OCD. A challenging triad, to say the least.

With the help of my psychologists, I learned to process my traumatic childhood and address the underlying reasons behind my anxiety. I found that writing came naturally to me, and I personified my OCD into a monster that could be fought by Buffy the Vampire Slayer-style heroines who were really just idealised versions of myself.

The need to perform my rituals fell away over time, until I stopped performing them almost completely. I can definitely still see elements of OCD in the way I behave, particularly in my need to organise and clean, but I can live with those traits and have accepted them as part of who I am.

As I discussed in the first post in this series, I still have an anxiety disorder and I’ve needed further counselling since my original treatment but, over time, I have learned how to channel my anxiety in productive rather than restrictive ways. The mantelpiece that used to attract my hands like a magnet is now, thankfully, just a mantelpiece.

I’ve written about my anxiety several times before, and I freely talk about it, but I never talk about my history with OCD. Maybe it’s because it’s still difficult to admit that I used to walk around performing those bizarre rituals in a desperate attempt to master feelings I couldn’t control. After all, nobody wants to admit things that might make them sound crazy.

The crux of it is, as a society, we don’t talk about mental illness in the same way that we talk about physical illness. If, instead of OCD and compulsive behaviours, I had suffered from debilitating migraines that caused me to throw up a lot, would I still be embarrassed to talk about them? No, because, generally speaking, physical illness doesn’t carry the same stigma as mental illness does. One tends to invite sympathy, while the other invites incredulity. It’s easier to accept that someone is nauseated with migraines than to accept that someone could genuinely believe they would die if they didn’t turn a light switch on and off exactly 7 times before leaving a room.

If you know someone who you suspect is suffering from OCD, the best thing you can do is show them understanding and patience. If you observe them doing something that seems strange or unusual, try not to stare or question them. Be patient, even if their need to check all the doors are locked for the third time in a row is making you late for something. Try to remember that there’s a war waging inside their mind between the knowledge that their rituals make them look crazy and the uncompromising power of the OCD that compels them to perform them anyway. They need to know that they can trust you and that you’ll be there to listen if they feel able to talk about it.

Tempting as it may be, the worst thing you can do is try to prevent them from performing their rituals. That will only serve to heighten their anxiety to unbearable levels and make the situation worse, possibly resulting in a panic attack or an angry outburst. The only way to successfully treat OCD is to address the root cause and develop alternative ways to cope, and that will most likely involve professional help, time, and a lot of patience. But it is possible.

If you’re suffering with OCD yourself, hold on to the fact that you’re not crazy. You just have a more unusual way of coping with your anxiety. OCD, anxiety and depression all feed off each other, and hiding what you’re going through won’t make them go away. Maybe you’re worried that people, even medical professionals, will think you’re crazy and dismiss you out of hand. That’s understandable, but all I can say is that not one of the many doctors and psychologists who have treated me over the years ever judged me for my behaviour or made me doubt my sanity. OCD is a real, diagnosable condition that can be successfully treated.

The combination of my OCD and depression led me to plan my suicide one night 14 years ago. I wouldn’t be here now if I hadn’t gotten help, nor would I be building a life I’m proud of. So can you. Just don’t try to do it alone.

 

Mental Health Series: January –Anxiety

When I started this blog 3 years ago, my intention was to post about books, writing and the publishing industry. I have done that, but, over time, I have found myself writing more about mental health. It has been cathartic for me, but also very rewarding. When someone tells me that my posts have helped them to better understand the feelings of someone they care about, or have enabled them to better express their own difficult emotions, it reaffirms my decision to openly discuss my own experiences, no matter how difficult it is.

Rather than continue with my sporadic posts, I’ve decided to channel my thoughts into a series. This will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


anxiety

Petrified Tree in Yellowstone National Park (the image is mine but feel free to use it)

Anxiety is an emotion we are all familiar with to some degree or another. Modern life is full of situations with the potential to provoke it. Job interviews, first dates, exams, election results – to name a few.

Anxiety on this level is normal, and will usually pass once the situation that triggered it is over. Having an anxiety disorder is different for two reasons:

1) Our anxiety can be triggered over the smallest, most innocuous situation.

2) It’s with us all the time.

It follows us through every area of our lives as an unwelcome companion that seeks to undermine our self-confidence and force us to question every decision we make, every word we say, and every thought we have. All the time, every day.

Here’s an example of an unremarkable, very common situation that we all experience from time to time: we send a text or an email, and the recipient doesn’t respond for a while.

There are a number of perfectly reasonable explanations for this. The other person could be busy, or have no phone signal or battery power. Maybe they just don’t feel like responding at that particular time. No big deal, right? This isn’t an issue. At least it isn’t if you don’t suffer from an anxiety disorder.

If you do, then the following is an example of how your treacherous mind can escalate this non-issue in less than 60 seconds.

Hmm, it’s been a while since I sent that message.

Checks time the message was sent.

Over 3 hours, actually. Why hasn’t she replied? Is she annoyed with me?

Rereads message for potential clues or accidental causes of offence.

I don’t think she could have misunderstood me. Wait, did I say something wrong the last time we spoke?

Mentally reviews previous conversations.

Well, everything seemed fine. We had a good time and she didn’t seem annoyed. What else could it be?

Checks phone and the time again.

Maybe she’s still at work, that’s why she hasn’t replied. But it’s after 6 p.m., she should be home by now.

Considers all the potential disasters that could have befallen her on the way home.

Oh my God. What if she’s been in an accident? Or been attacked?

Quickly checks her social media pages for evidence that she is, in fact, alive and well.

No new posts for the past 12 hours. Anxiety is turning to panic.

How would I even know if something happened? Would someone tell me? Do her parents have my number?

The phone beeps. She’s replied. “Sorry for the late reply! I got held up at work. Damn meeting ran over again.”

Well, now I feel like an over-dramatic moron. What a waste of time and emotional energy that was.

This is only one example of countless self-sabotaging thought processes that an anxious person can experience on a day-to-day basis. It’s exhausting, debilitating, and a hindrance to our happiness and wellbeing.

So why can’t we just rationalise these thoughts until they disappear? If we know we are prone to over-analysing a situation, why are we not able to reassure ourselves that it’s not as dire as we fear?

Believe me, we’ve tried. We can come up with rational explanations for these situations just as well as you can. The problem is, those explanations get drowned out by the much louder voice of our anxiety. You can’t apply rationality to what is an inherently irrational and emotionally driven thought process. That’s why phrases like “don’t worry, it might never happen,” however accurate and well-intentioned they may be, mean nothing to us. A situation we have experienced could have had a positive outcome 99% of the time, but our anxiety forces us to focus on the 1% of times when it didn’t. A situation only has to go wrong once for us to worry that it will go wrong every single time.

When I first started considering how I was going to explain this concept, I came up with the following analogy. I’ve always used metaphors and analogies to explain and process how I feel, and I find them to be very effective.

Imagine chronic anxiety as a train, speeding along the tracks in the darkness. Imagine a person standing by the tracks (let’s call them ‘Rational Thoughts’). They see the train getting faster, out of control, heading for disaster. Wanting to intervene, Rational Thoughts starts running alongside the train, screaming for it to slow down. But the train is always faster. Always out of reach. Then, suddenly, before their helpless eyes, the train crashes.

That crash is a panic attack.

The kind where the world shrinks to nothing but the terrifying place inside your head. The kind where you find yourself on the floor, hunched over a toilet or a bucket, trying not to vomit, with no idea how you got there, because your adrenal glands are flooding your body with adrenaline, triggering your fight or flight response. But you can’t fight your anxious thoughts. They are intangible and impervious to your efforts to resist them. And you can’t run from them either, because they live where you live – inside your head.

Your heart is beating too fast. Your breaths are coming in short, sharp bursts, like your lungs have forgotten how to function, like they might give up on you any second. The panic escalates when you realise you can’t stop it, and you have no choice but to let the wave pull you under, tossing you around until it crashes on the shore and leaves you weak and gasping for breath.

And the worst thing? The trigger for such an extreme reaction could have been the smallest, seemingly insignificant thing. Like a text not being answered.  Maybe the cause isn’t even discernible. Maybe the train just crashed because it did. Because you have an anxiety disorder, and that’s just how it is.

For anyone reading this who does not suffer from this kind of crippling anxiety, but wants to support someone who does, I can imagine that it might sound like talking to us would be a minefield of potential triggers that could make us feel worse. You might be wondering how you could possibly help.

I’ve been incredibly lucky to have been surrounded by wonderfully supportive family, friends and colleagues since I began having mental health problems when I was a child. There have been many examples over the years of when someone has said or done exactly the right thing at the right time, one of which happened last year.

2016 was a really awful year for me and my family, and as a result my anxiety and stress levels were very high. I tried not to let my state of mind affect my work, which is very important to me, but there were days when it was obvious that I wasn’t doing well.

On one of those days, my manager asked me if I was okay. She’s well aware of both my physical and mental health issues, so this wasn’t an unusual question. When I said no, she asked me if I was in pain, or if it was my anxiety that was bothering me. This question simultaneously expressed concern and understanding while also acknowledging that my anxiety was a genuine issue for me. It made me feel supported and comfortable enough to admit if I needed to go home early or take a day off.

When you have any kind of health issue, physical or mental, that’s all you really want.

Acknowledgement, empathy and a willingness to listen.

In the case of anxiety disorders, we don’t expect others to understand the reasons behind our anxious thoughts (we often don’t even understand them ourselves). We’re not expecting others to fix things or come up with magical solutions. We just need some understanding and the security of knowing that if we need to withdraw from a situation because it makes us too anxious, that we won’t be judged or thought any less of. It’s a great injustice that so many sufferers of mental illness are told to just get over it and that it’s all in their heads. Imagine if that were the response to a broken leg or a cancer diagnosis? An illness is an illness no matter what form it takes.

From my perspective, I know my anxiety is my problem and I don’t expect other people to alter their behaviour to accommodate every anxious thought I have. It would be completely unreasonable, for example, for me to expect my friends to drop whatever they were doing to answer my messages immediately.

I know that 90% of the time my anxiety is lying to me. It’s taken a lot of work over many years, but I have gotten to the point where my anxious thoughts are mostly just background noise. They’re there all the time, but I have coping mechanisms to stop the train from crashing. They don’t always work, and sometimes my anxiety gets the better of me and can turn even positive situations into nerve-wracking ordeals, but I keep going. I’ve even found ways of using it to my advantage in my job (you can read about how in an earlier post here).

Every time something good happens and my anxiety is proven wrong, I add that memory to my arsenal of weapons to use against it in the future (writing these memories down is a good way of doing this). When a situation makes me anxious and threatens to overpower me, I mentally list all the times I’ve been in a similar situation in the past that had positive outcomes. This calms me down and gets me to the point where I can move forward and deal with the situation.

For those of you who suffer from anxiety; you are not alone. There are people in your life who care about you and want to help, but might not know how. If you can’t talk about your emotions directly, ask them to read this post, or a book with a character you identify with, or maybe even a quote from one of the many inspirational mental health writers out there, like Matt Haig.

Anxiety likes to make you think you’re weak and a burden to others. That’s another lie. It takes a great deal of strength to fight with your own mind on a daily basis and still get out of bed every day. Don’t ever forget that, and don’t ever stop fighting.