This blog post is a follow-up to this earlier post, which details my battle with mental illness. It is written to be a resource for those who also struggle with anxiety and depression, and a compilation of the advice I have given to such people when consulted.
The older I get, the more incredulous I am about my life before counselling, medication, and the internal acknowledgement that I need to carefully manage my mental health. I think about all the bizarre rituals and routines I practiced in high school to manage the underlying strain of existence, and my brittle determination to ignore the anxiety which looms vampire-like over most of my adolescent memories. Some nights, the thing I want most in the world is a five-minute conversation with my younger self, just to let him know that he’s right, something is wrong, and yes, he should get help, and medication won’t destroy his creativity or his theology.
But I can’t, and so he’ll never know those things (until I do), and those years will never be rewritten.
However, I can give advice to others who are walking similar journeys, especially in regards to surviving an anxious or depressive episode. Conversations around mental illness are far more prevalent than when I was in high school, so most people who need help now understand the supports available to them, and understand both the possibility and benefit of medication. Yet, that doesn’t help people fight the relentless internal war against paranoia and despair that characterizes the creation, climax, and recession of a mental health crisis.
To fill that gap, I present these six rules. All of them are the result of my battle against the long defeat, and are presented in the hope that they will aid you as well. They are not the only rules, and they are not absolute rules, but they are good rules to follow.
Dealing with mental illness is a marathon of self-analysis. Rejecting intrusive fears or suicidal urges takes time and energy and a deep reserve of discipline and self-esteem. Yet often the first symptoms of mental strain are behaviours that sap energy and undermine discipline – altered sleep schedules, skipping meals or over-eating, and avoiding physical activity.
Fighting mental illness begins with a series of small victories that, over time, provide the physiological resources to attempt larger battles. Eat three meals with basic nutritional value every day. Set a bedtime before midnight and stick to it. Find a physical activity you enjoy, and practice it 3-4 times a week. If possible, find an activity which also has a social component (like an exercise class or rec. league), and involves being outside (like a running club). If you have to choose, prioritize the social component.
A few of my father’s maxims come to mind: “Nothing good happens after midnight,” and “Never argue [with depression] on an empty stomach.” Fatigue, hunger, and a lack of exercise have profound effects on your mood and discipline, and, unlike mental illness, they are relatively easy to fix.
2. Structure Is Your Friend (and Friends are Part of Your Structure)
The descent into a mental health crisis is often paralleled by a descent into disfunction and isolation. Simplifying your schedule and reducing obligations are an important part of managing a crisis, and doing so is a sign of wisdom, not an admission of weakness. YET, never withdraw to the point that your schedule is completely open. Instead, pivot your scheduling priorities from obligations that are draining to those that are affirming.
This can be difficult to achieve because, in the hurricane of an anxious/depressive episode, it can seem that every activity, down to simply getting out of bed, is draining. In those moments, it takes significant discipline to keep scheduling events and to not indulge in avoidance behaviours by cancelling them at the last minute. Yes, going out is initially tedious, but staying in with your demons is worse. Structure provides distraction, a sense of accomplishment, community, and (as recommended above) physical activity.
Most importantly, make sure you have at least one event a day that involves social interaction. Mental illness shrinks your world into a small, dark box, and the more time you spend alone, the smaller and darker that box becomes. If possible, try to schedule time with people that know you and care for you, and who know/understand that you are going through a rough time.
When you meet with people, ask them questions and try to care about the answers (take notes if you have to). Perform the empathy and interest that you desperately desire people to show you; eventually that performance will become authentic.
3. Find a Fellow Traveller
Unless you have an amazing insurance policy, you aren’t going to counselling sessions more than once every couple weeks. This is not enough. You’re going to need someone else in your life to talk to honestly about your mental health – someone who understands the struggle intimately.
Friends and family are wonderful and essential to your recovery, but, unless they also have struggled with mental health issues, they can’t be your fellow traveller. You need someone who will nod appreciatively when you mention Cipralex or Zoloft, who has funny stories about their counsellor, who has fought down a panic attack in a high school bathroom.
When I moved to Waterloo, Ontario and quickly began spiralling into an anxiety crisis, I asked a fellow PhD student who had been open about her own mental health struggles if we could meet and discuss experiences. That meeting turned into a semi-weekly tradition during my first two years in the program, and quickly became an important part of my recovery. We talked about doctors, medications, counselling, coping mechanisms, and support strategies. More importantly, we celebrated each other’s small victories, sympathized after setbacks, and expressed unwavering support.
I recommend that anyone managing a mental illness find a fellow traveller to share pain, articulate goals, and celebrate joy. However, a successful fellow traveller relationship is delicate. It requires vulnerability from both parties, as well as deep mutual respect. Hopefully you already have someone in your circle that you can reach out to, or you can ask for a recommendation from someone you trust (a mentor, a pastor, a friend).
Remember two rules when choosing a fellow traveller. First, do not flirt with this person. Neither of you are in a healthy place to begin a relationship. Also, romance would only handicap your ability to be authentic and honest to your fellow traveller about your mental health. Second, don’t choose someone who is untrustworthy, actively suicidal, or dangerous.
4. Stay Away From Black Holes
One of my early warning signs for an anxious/depressive episode is a sudden obsession with video games and fantasy fiction. When I am anxious, I submerge myself into the artificial reality of a game or the book until it dominates my attention throughout the day. In other words, one of my hobbies becomes an obsession that I use to avoid my increasing pain; a way to numb myself to reality by escaping into a fantasy.
I call the object of these obsessions “black holes,” because they consume increasing amounts of my time and attention while becoming increasingly difficult to escape. Unfortunately, dealing with anxiety or depression by throwing myself into a black hole, while effective over the course of a week or two, neither addresses the real cause of my anxiety nor succeeds in numbing my symptoms over the long term.
In my second year of university, I played a Nintendo Wii game called Monster Hunter Tri for two to four hours a day.The game provided my only release from the crushing anxiety of university, and yet it also consumed the time and energy I needed to seek help, reconnect socially, and get enough sleep. I think the game gave me just enough functionality to prevent burnout, while turning my life into an anti-social fog centred on hunting monsters.
Black holes, which include drugs, pornography, and other addictions, are easy, comforting, and seductive ways to escape from mental illness; they also quickly become obsessions that hamper the pursuit of real solutions.
To be honest, I haven’t found a good way to control my vulnerability to black holes. Consequently, I don’t allow myself to purchase any video games more complicated than Super Mario Run, or go to the fantasy/sci-fi section at the library. Because I’m so susceptible to black holes, part of my journey has been admitting that weakness, and altering my behaviour to avoid temptation.
5. Interrogate Your Thinking
Counselling forces you to speak your emotions and prophecies of failure, robbing them of power. It also allows another person to speak reason to your fear, and compassion to your self-destruction. Yet, it’s important to learn to interrogate negative thoughts, even when a counsellor isn’t around.
One of the great strengths of anxiety and depression is that they rob you of your perspective. Just as one minor setback becomes more important than several major successes, fear and despair become far more tangible than other emotions.
I would recommend practicing some form of cognitive behavioural therapy (CBT, look it up) as a way to interrupt the spiral. Ask yourself “What is currently making me upset?” or “Is this terrible event that I fear really a probably outcome?” or “Why am I blaming myself for things that are not my fault?”
Try to remember and celebrate the good things that happened over the course of the day, as well as your own accomplishments. Many depressed and anxious people have incredible difficulty acknowledging anything positive in their lives, and immediately attempt to switch the channel back to their own failures. Don’t allow yourself to do this; try to follow this desire back to its source.
For example, I am chronically vulnerable to the fear that I am too stupid to be an academic. For a long time, I believed that my memory was too poor for me to be a successful grad student, and that eventually I would be forced to drop out once my colleagues and supervisor stopped tolerating my stupidity and acknowledged the obvious. It took a long time to realize that my anxiety was rooted in three factors: 1. I’d recently moved to a city thousands of kilometres away from my family and friends, 2. I’d recently begun a new academic program and a new job, 3. I was unfamiliar with both the academic conventions and the level of work required of me in this new program, and attributed my initial failures to personal inadequacy.
I will never be an all-star scholar, but fear was rooted in understandably difficult life events, not in an abnormal memory. Once I began interrogating my thinking, I was able to regain some perspective over my life, and begin my recovery.
6. Forgive Yourself
This rule is special, because it is the lens through which all other rules must be applied. A mental health crisis is not the result of a deep character flaw, or an emotional defect, or even (primarily) a chemical imbalance in your brain. Most of the time it results from legitimate pain, or legitimate grief, or legitimate stress. The key word (obviously) is legitimate.
Why is it then, that the common response to a mental health crisis is self-flagellation? In other words, why do we blame ourselves for not being harder, better, faster, or stronger, for not avoiding mental illness, especially when all the statistics show that more people than ever before are dealing with anxiety and depression? That sort of condemnation only aggravates our crisis, and delays our healing.
Interrogating negative thoughts (as per rule number five) is important, but don’t let that interrogation devolve into pointless self-criticism. Remember that, under the circumstances, simply showing up (whether to class, to the gym, or to work) is an act of bravery. Celebrate your small victories, and qualify your setbacks with the understanding that, as you recover, your ability and capacity will improve.
It is deeply important that you forgive yourself both for having a mental health crisis, and for not being as productive during your crisis as you were before it began. Remember that, just as running with a twisted ankle is more difficult than running without one, living with anxiety and/or depression will take a toll upon your productivity.
Consequently, when I can’t perfectly obey all five of my previous rules on a given day, I don’t beat myself up over it. I still try, I still show up, I still make plans that will place me in community – but I am also willing to extend myself grace when I know I’ve reached my limit.
Rule number six is about gentle negotiation with your own injured mind. It is about encouraging yourself to do the things that are necessary for recovery (the above rules), while allowing yourself to fail without condemnation. This helps prevent the binge/bust cycle in which people frantically ignore the symptoms of mental illness one day, yet can’t force themselves to leave the house the next.
Forgive yourself daily, but don’t forget the rules. Be brave. Be tenacious. Allow yourself to depend on your community and your fellow traveller, and find manageable but meaningful ways to give back to those people.
These are my six rules. Maybe they will work for you the way they worked for me.