We all get stressed out sometimes, or even a lot of the time. Stress, by itself, is not a problem – it’s the same inbuilt human reaction that made our ancient ancestors run away from things that wanted to eat them, or to fight when they had to.
Life is full of stuff that stresses us out: work, family life, money… But how do we know when stress is reaching a point that could make us ill? Here are some tell-tale signs that stress could be leading to depression or anxiety:
- You’re not sleeping, and/or you always feel tired.
- You’re constantly lurching from one thing to the next.
- You’re always tense, worried or anxious.
- You’re getting headaches every day.
- You’ve stopped looking after yourself, and you’re not allowing any time to relax or recover.
- You’re run down and getting a string of illnesses.
- You feel overwhelmed.
- You can’t switch off or wind down.
- You’re not looking forward to anything any more.
- You feel irritable.
- You snap at people or get more emotional than usual.
- You feel vague, forgetful or indecisive.
If you’ve been experiencing stress for a prolonged period, there’s more danger of it leading to a mental health problem. That’s what happened to me towards the end of 2009 – I’d never experienced depression until then, but it has since proved a persistent thorn in my side. I’ve experienced all of the above symptoms. I still experience some of them, but now I recognise them and have some ways of managing them. I’m better at some things than others, and keep learning new ways of coping and looking after myself.
We need to stop stress before it stops us.
There are three important things I need to remember, and maybe these will help you too:
- You’re not alone. Mental health problems are very common, and there are people you can talk to, and who can support you.
- It won’t always be like this. You can get better, and you can manage the symptoms.
- There’s no shame in getting help. It’s not weak – it’s stronger to do something about a problem than to let it keep beating you. See your GP, see a counsellor, take the medication – different things work for different people. The important thing is to do something. Ignoring it is not dealing with it.
Stress, depression and anxiety are very convincing liars, and will tell you that you’re fine and should keep soldiering on. But be honest with yourself about how you’re feeling. If you don’t make changes, and if you carry on doing the same things that have got you to this point, how can you expect to get any better? It’s like breaking your arm and then repeatedly smacking it against hard objects, expecting it to magically cure itself.
Here are some other small tips:
- Plan some time for yourself. Think about things you enjoy doing, and allow yourself a chance to do them. It’s not selfish to put yourself first sometimes – sacrificing your health to please other people isn’t really helping anyone.
- Tell someone. It’s the first step towards getting better. Don’t let your problems silently stalk you from the shadows like a bully – expose them.
- Take care over how you speak to yourself. Don’t put yourself down or apologise for things that aren’t your fault. If you’re beating yourself up or always criticising yourself, that adds to a feeling that you’re not good enough and that you have to keep striving and ‘going the extra mile’. Learn to accept that ‘good enough’ is perfectly fine the vast majority of the time.
- Getting out into nature helps me – it gives me a positive distraction, some exercise and fresh air, and some perspective.
There are more things I’ve learned in this blog post.
What doesn’t help?
Here are some things that people might say to someone who’s experiencing a mental health problem:
- Be strong.
- Keep a stiff upper lip.
- Grit your teeth and get on with it.
- We never used to complain.
- Don’t make such a fuss.
- Just have a drink or two.
- Cheer up.
- Just relax.
- Man up.
People might mean well when they say things like this, but guess what? None of these things will reduce anyone’s stress. None of these things makes a mental health problem go away.
In fact, these sayings, attitudes and beliefs cause harm – people bury how they feel and avoid talking or getting the help they need because they don’t want to seem weak. They don’t want to be judged or pitied. By not getting help, we might suffer worse and longer – and that can have tragic consequences.
It shouldn’t be considered brave to talk openly about mental health problems, but it still is. The fear is real. The stigma persists. That’s why we still need to raise awareness through things like Mental Health Awareness Week.
So, you take your pills, have your therapy, learn some lessons, write a few blog posts, and your mental health problems go away and leave you in peace, right?
Well, maybe they do and maybe they don’t. Perhaps they go away for a while, then pay a return visit at a later date. But it’s also entirely possible that your enemies will become like the horror movie franchise villains who stubbornly refuse to die, and come back for seemingly endless sequels.
The latest dip in my rollercoaster recovery began towards the end of last summer. These late-summer plunges have happened before in the last few years, but to avoid the pattern becoming too predictable, depression and anxiety – being two sides of the same coin, and being partners in crime – like to mix things up and take it in turns to lead. One weighs in first, usually triggered by some kind of prolonged stress or worry, then the other puts the boot in.
They seem to lie in wait for a time when I’m winding down and starting to relax, so holidays can be a prime opportunity. That’s when all the pent-up mental poison starts to ooze out and build up, like that nasty pink slime in Ghostbusters 2.
What does it feel like?
My thoughts turn dark and destructive, the despondency and lethargy set in, and other symptoms start to show:
- irritability and anger – finding people insufferably annoying, especially those who dare exhibit any energy or enthusiasm when I have none
- illnesses – I’ve had a different illness every month since last October, ranging from a standard cold to lingering laryngitis, suggesting a run-down immune system
- despair and fear – seeing the worst in everything, and finding it hard to see things getting better
- paranoia and over-sensitivity – I get wound up by any little comment aimed at me, even if meant in jest, to the point that I get embroiled in a series of long-running imaginary arguments
- over-thinking, indecision and forgetfulness – the din in my weary brain makes any kind of thinking difficult, and impossible at times
- mornings are hideous – I haven’t had problems sleeping with my latest episode, but getting myself up and out in the morning still feels like I’m having to physically drag my leaden body to wherever it needs to go.
“I’m fine, thanks.”
I wonder how many times a day we get asked how we are, or we ask how other people are. It’s how we greet each other; part of everyday conversation.
I’m generally a very honest person, but I have lied to people. I have lied a lot. Because many times when I don’t feel fine in the slightest, I don’t want to say so. It’s not that I mind being asked, I just want to pretend I’m fine until the reality catches up, and I don’t want sympathy, or to drag other people down.
The confusing thing about depression and anxiety is that we can also feel perfectly fine for much of the time. Once I’ve got through the first half of the morning and got suitably distracted, I might well have a perfectly decent day, unless something triggers a negative thought. Then I’m at the mercy of spiralling, toxic thoughts and feelings.
I am fine right now, and have been fine for the past few days, and that is good enough for me. If I wasn’t feeling fine, I wouldn’t be writing this and I certainly wouldn’t be sharing it.
So what am I doing about it?
As I always do with these episodes of mental ill-health, I try to face up to my problems and get help in various ways.
I went to see an excellent doctor, and – with some hesitation – decided to team up again with my old pal Citalopram, an antidepressant that I’ve just about managed without since autumn 2013. I always thought I wouldn’t want to go back on the meds, but it was a better option than struggling on without them.
I’ve been on a course, learning tips from cognitive behavioural therapy (CBT) and am on a waiting list for some further CBT to try and crack some persistent and recurring issues.
I’m trying to get out and enjoy nature as much as possible, so am grateful for the weather improving in the past week. The continuous rain and snow was, I think, getting me down more than I realised.
And I’ve finally found another kind of exercise that I’m enthusiastic about and committed to, having drifted terminally from running. I’ve joined a martial arts class after seeing how much my son loved it. The intense workouts leave me thinking I am either going to vomit or keel over, but it’s a good way to release tension and focus on something positive.
Perhaps my biggest lesson in these last few years has been that life does not have to be about doing, exceeding or producing stuff. There is great value in doing very little, or passing time in a not-obviously-productive kind of way – things like jigsaws, favourite TV programmes, games… and trying to rediscover hobbies like drawing birds.
I’ve also made a conscious decision not to set myself unnecessary challenges this year. Why add to the pressures of daily life?
To end on a positive note…
There is one consistently positive thing that recurrent depression and anxiety do for me. Each time they gang up on me, and I go through this gruelling experience, it makes me rethink and evaluate my life. What can I do differently? What’s harming me? What’s good for me? What have I tried that worked but I’ve forgotten or neglected? What haven’t I tried yet? Is there something I should give up? Something I want to find time for?
So I keep learning and arming myself against these attacks. I’m lucky in many ways – my depression and anxiety are fairly mild compared to what many people endure, and I have the support of great family and friends.
I’m sharing this not to alarm anyone, not to attract attention, or to elicit sympathy or pity, or to be considered brave, but just to be honest about my experiences in a society that still stigmatises people with mental health problems.
I was on BBC Breakfast recently talking about how getting outdoors and enjoying nature helps me with my mental health. But how exactly does it help?
I’m going to start with two quick disclaimers:
- I’m not a scientist, so I won’t try to give you any scientific evidence of how nature benefits mental health. This is all about my personal experience. But that evidence does exist, as Dr Andrea Mechelli explained alongside me on the BBC sofa (see pictures below). Find out more about the study from King’s College London.
- Nature alone does not cure depression, anxiety or any other mental health problem. It’s one part of a toolkit of coping strategies that can help us to manage our well-being.
My own personal mental health battles are with depression and anxiety, and I find that nature does help me in a number of ways.
Doing something I enjoy
When we’re worn down by stress, anxiety and depression, it’s easy to forget the things we used to enjoy doing – or how to enjoy doing anything for that matter.
A few years ago, when I was frazzled and going through an episode of depression, my counsellor encouraged me to find time to do something I enjoyed. I’d always enjoyed birdwatching and walking, and tried to get out more and rediscover the pleasure of my abandoned hobbies.
A positive focus and distraction
Absorbing ourselves in nature can turn a walk – or even just a nice sit down in a park or garden – into a mindful experience that focuses us on the present and takes us away from the churning thoughts that tumble round our heads and the anxiety that chews at our tummies.
Hear the breeze rustling the leaves in the treetops; listen to the birds singing; watch butterflies and bees flitting among your garden flowers… I find that even a few moments being completely distracted by wildlife usually has a calming effect on me and lifts my mood.
As well as the wildlife, experiencing different places – or just retreating to a favourite wild place – can be very therapeutic. I find being in woodland or by water especially soothing.
Being outdoors has other health benefits too – fresh air, sunlight and exercise are good for our physical health as well as our mental well-being.
Discovery, excitement and adventure
One thing I love about nature is that there is always something new to discover – new species to see, new places to visit, new behaviour to observe. I’ll never forget the wonder of watching badgers in a woodland clearing after years of waiting for even a passing glance of one. If I’m planning a birding trip, there’s that sense of anticipation and excitement at what I might see, and the thrill of seeing a rare bird for the first time.
But a new experience doesn’t have to mean a new species – it can mean finding something unexpected in a familiar place. While off work with depression, I took a short walk from home, and found yellow wagtails – glorious, sunny yellow birds – bobbing about in a field where I’d never seen them before.
Nature is everywhere
It’s an unfortunate truth of depression that the things that are best for us are often the hardest things to do. Even for someone like me, who loves being outdoors, the draining, soul-destroying experience of depression can completely kill off all energy or enthusiasm, making the prospect of going out for a walk feel like the last thing I want to do.
At those times, if we just can’t face going out, we can still enjoy nature without venturing out. If you can see the sky or a tree, lawn or plant from where you’re sitting, you can still look out for wildlife. It’s amazing how many different species you can see in a fairly short space of time.
I feed the birds in my garden and can lose myself watching them – the goldfinches jostling for position on a feeder, the blackbirds fending off rivals, the wren that always follows exactly the same route into our garden and disappears for a moment in a bush…
Accept that it’s not going to work every time
Sometimes nature will help you feel better, even if only for a short time. Other times, it will not – but that doesn’t mean we should give up.
There are occasions where my mood has been too dark – my thoughts too destructive and intrusive – for me to be able to get lost in the sights and sounds around me. There have been other times where I’ve felt crushing disappointment because I’ve ‘failed’ to see what I went out to look for (I’m trying to learn to manage my own expectations), or I’ve felt defeated and demoralised by the weather spoiling a day out.
One such day that stands out in my mind is when I took a day off work to go to Flamborough Head, one of my favourite places on the Yorkshire coast, on a mission to see some particular birds. I can’t remember what birds they were, but I can remember that I didn’t see them, and that I couldn’t even enjoy the beautiful scenery because of thick fog. I genuinely considered giving up on birdwatching that day – not only had I not seen what I’d wanted to see, the weather was manky, there was barely a bird of any kind to be found all day, and I was sick of dragging my telescope and rucksack around.
The bird that saved the day was an unlikely one. At the point of my greatest frustration, the movement of a small bird in the hedge up ahead caught my eye. I followed it, hoping it would reveal its identity, and it did. It was a male chaffinch – a very common bird, but a colourful one – and for some reason that splash of colour and the chaffinch’s perky character were enough to bring me back out of my brain fog. The actual fog lifted soon after that too, and I remember sitting on a bench, and discovering that a cup of tea tastes even better by the sea.
If you enjoyed this blog post, you might also like these:
- Dippyman: Birdwatching, depression and the BBC sofa
- Dippyman: Why birdwatching is good for my mental health
- My BBC Radio 4 Tweet of the Day on my encounter with a Water Rail
- Blurt Foundation blog: How nature helps me
- Bird Therapy blog by Joe Harkness
- Anxious Birding blog by Ian Young
Dippyman has been rather neglected this year, and continues to stand at a crossroads as it creaks into its sixth year.
It’s partly been quiet on this blog because I’ve been working really hard this year and there hasn’t been much space left in my brain.
The force awakens
It’s also been quiet because – and I’ve kept this quiet up until now – I’ve been under attack from depression again for the last few months. It’s come in waves, with star turns from anxiety, paranoia, insomnia, forgetfulness, fear and random anger. I’ve been fine some days, and far from fine on others. It’s a reminder that, when recovering from depression, the force does awaken from time to time, and I have to be on my guard and look after myself.
I’ve taken my own advice at times. I’ve stuck with my diary of positive things, and made sure I plan things to look forward to – like my trip out to sea (pictures below), looking for seabirds, at the start of this month. I find the sea calming, and to be out there for nearly three hours was a great escape. Not only that, I saw two firsts – a fleeting view of a Black Tern (one of the bogey birds that’s eluded me for years) and a Sooty Shearwater, which obligingly whizzed round the boat in a circle so everyone could see it.
I’ve been a poster boy for functioning depressives.
At other times, I’ve forgotten everything I’ve ever learned about coping with depression, and have done the whole ‘soldiering on’ thing, not really telling anyone, trying to prove myself, and generally being stubborn. And – just to take my own advice for a moment and to be kind to myself – I’ve done a pretty good job of it. I’ve taken on a lot and achieved a lot. I’ve been a poster boy for functioning depressives.
Another thing I’ve been doing is writing some blog posts for the Blurt Foundation, an organisation I admire enormously. My latest one was a chance for me to do something different, using my own doodles to show what you don’t see about depression.
I also keep chipping away at my children’s story, Splot, which must be on its sixth draft by now, in the hope that one day I’ll be happy enough with it to try sending it to an agent or publisher.
And, to be honest, I’ve struggled a bit with writer’s block. I’ve started and abandoned three or four posts, which I simply couldn’t get inspired by and couldn’t be bothered to finish. Each seemed OK when the idea had come to me, but had become deeply tedious by the time I sat down to write it. Heck, if I can’t be bothered to read my own writing, I don’t see why anyone else would want to.
However, bits of each of those abandoned posts have somehow ended up in this one – further proof that, if you want to be a writer, you just need to start writing. My plan tonight was, having abandoned yet another post, just to share some photos of the Yorkshire coast, but somehow the words trickled out in the end.
Recovery and persistence
That’s how it goes with recovery too, sometimes. It’s not all about big eureka moments, where you leap up and say ‘Ta-daaaaa, I feel amazing!’ Often, recovery is about sticking with it and chipping away, even when it seems hopeless and never-ending. It’s about persisting in a rather unexciting, unremarkable way, until eventually the light grows brighter and you realise you’re in a better place.
There is a commentator who sits in my head and witters.
He commentates on everything I do and everything that’s happening to me and around me. He’s particularly keen on wittering about things that haven’t happened yet – things in the future that he thinks I could and should be worrying about; things that could cause me stress.
There is a thin line between good planning and excessive fretting. My commentator shows no regard for this. Does something need planning? Well, why not worry about it at times when you can’t actually do anything about it? How about in the middle of the night?
He has his advantages. Sometimes he’ll pipe up with great ideas or witty remarks. But a lot of the time, I wish he would just shut up, because his accelerating rambling feeds my anxiety and prevents me living in the moment and taking one day at a time – something I know I need to do but often find impossible.
Sometimes he prattles on at such speed and volume it’s just a noise – a wall of sound. I can’t bear any other noise and can’t take in what people are saying. The din can prevent me enjoying what I’m doing. His chuntering fills my head, which means anything new trying to get into my headspace feels like an intruder. Sometimes my brain is so full, it overflows and I get forgetful.
If he gets bored of commentating on the present and future, he likes to play action replays. His collection of clips seems to concentrate on moments of stress or injustice, or things I’ve done wrong. Depending on how recent the incidents are, they can lead to futile yet destructive imaginary arguments. If he’s feeling particularly destructive, he conjures up imaginary scenarios to have imaginary arguments about.
These unwelcome tricks are things I’ve been learning to deal with over the past five years, when I first started trying to get to grips with depression. We all worry about stuff sometimes and get nervous about things we have to do. It’s normal. But when it’s the kind of ever-present worrying that leads to anxiety and heightens my risk of a return to depression, as it threatened to do last summer, I know I have to do something about it. I’m getting better at recognising the danger signs, taking action and looking after myself.
I am always keen to try new ways of silencing the gibbering fool in my brain. I’ve been trying to retrain him so he says positive things and replays positive clips. One way I’ve been doing this is to keep a diary of positive things each day, and reading back through what I’ve written to remind myself of things I could easily have forgotten forever. It’s a bit like sending a calming co-commentator into the commentary box, like the classic Formula One commentary team of Murray Walker – breathless, excited, verging on hysterical – and James Hunt, complementing Walker with a more thoughtful, observant style.
And, as I said before, I’m trying to live more in the present, so I’ve started going to something called Mind Calm, which is teaching me some basics about meditation. The principles make great sense – it’s about not being ruled by your thoughts, and being aware of what is happening in the moment – but my biggest challenge is to find time to practise regularly enough to make a difference. I’ve tried a couple of apps and books on mindfulness, but haven’t made those work for me so far.
My commentator has worked hard over the years. I think he would welcome the chance to put his feet up and take it easy. This stage of my recovery is about helping him to do just that.
It is one year since I last took an antidepressant, and I am going to celebrate – not because I feel wonderful and am bursting with elation, but because I want to rub depression’s face in it.
I’m going to celebrate because I do not want this milestone to pass without pausing to reflect on it. And that’s the kind of celebration it will be – a quiet, reflective one. Armed with a posh hot chocolate, I have sat myself down to write my first blog post for a couple of months, mainly out of sheer stubbornness (I put this evening aside to write, so that is what I am doing) but also because I get the feeling Paul Brookes – the name I give my depression – doesn’t want me to. And I will not let him have his way any more.
It has, at times, and for some prolonged periods, been a tough year without Citalopram, which was, after all, my constant companion for three-and-a-half years, and there have been moments when I’ve been very close to reuniting with it.
Brookes has lined up his henchmen, stress and anxiety, and sent them round to rough me up on a number of occasions, thinking that when they’ve given me a beating he can sneak back in. And he has come very close to doing just that.
The difference between now and five years ago, when he crept up on me for the first time, or three years ago, when he reappeared with brute force, is that I am wise to his ways. I can hear his stealthy footsteps. I can see his shadow on the wall. I can sense his malicious presence.
The fear is still the same. He still scares me. The innate caveman instincts of fight and flight kick in – I want to run away from my troubles, and end up fighting those henchmen day after day.
But, to a certain extent, I know what to do about it. I have learned how to look after myself. That’s all very well, but the trick I have yet to master is how to remember and do those things when I’m feeling weary, worn down, battered and lethargic, or when my stress levels are threatening to make my eyes pop out.
In those times when Brookes attacks, I need more than my natural fight and flight instincts, so I am building up a virtual box of tricks – some emergency rations for my well-being, and some weapons against the dark one’s powers. To outfox my enemy, this box will need to be crammed full of quickly accessible wisdom and self-care. I will need ways of reminding myself what is in the box, and ways of remembering to look inside it.
The first thing to go in the box will be a bit of self-praise. Well done, Paul. You did it. You made it through a year without Citalopram, hard though it may have been at times. And you wrote this blog when you really couldn’t be bothered.
The second thing will be to look back on all the good things that have happened, which can be too easy to forget. Good job I keep a book of such things (note to self – remember to look at it).
Oh yeah, and Brookes? I may not be jumping for joy, but I’m not dancing to your tune either. And if that isn’t worth celebrating, I don’t know what is.
A little over two years ago, I was off work with depression.
One day or night, I sat and watched 8 Mile, the Eminem movie, and took some kind of small hope from the underdog rapper’s never-say-die determination and ultimate triumph over adversity. My own determination wasn’t putting in an appearance at the time, and triumphs seemed in short supply.
Here in the present, it’s more than a month since I took my last antidepressant and there’s a part of 8 Mile that now seems particularly significant.
The film’s climax is a rap battle between Eminem’s character, Rabbit, and his enemy, Papa Doc. Now, I am no battle rapper or gangsta MC – I’m more Yorkshire Tea than Ice T – but I do know that the basic gist of such battles is to brag about your own greatness and insult your opponent as wittily as possible.
Except in this contest, Rabbit catches his opponent off-guard by confessing to all his own flaws and secrets – all the things Doc was about to hurl at him. It leaves his nemesis impotently lacking ammunition. And then he exposes him for the coward and fraud that he is. You can read the full lyrics here.
So, what’s this got to do with me and depression?
- Depression is a cowardly bully that skulks in the shadows and messes up your head – and it thrives on the shame and stigma that comes with it. It knows everything about you – all your flaws and weaknesses – and uses them against you. By talking to someone about what you’re going through, you expose it and weaken its power.
- You can also get to know your enemy, through counselling, talking to others (either in person or online) or reading about it. This helps to arm you against its dirty tricks. Stopping my antidepressants has been like taking down my shield. At times in the last few weeks, members of depression’s gang have roughed me up – stress, anxiety and insomnia have all had a go – but I am better able to fend them off than I used to be, because I know what they’re up to.
I’m not naïve about this, and will have to keep a look-out for future attacks, but for now this underdog has triumphed. I celebrated my first medication-free month with a glass of bubbly that had been at the back of a cupboard since before I started taking Citalopram.
Recovery from depression is slow. Even when you feel well, coming off the medication is tough. For an impatient patient, it seems like a never-ending war. But liberation from depression is possible.