This post deals with the subject of chronic pain & its effect on mental health. CW: depression, anxiety, self-harm, suicidal ideation.
Even in today’s seemingly enlightened society, with all this information at our fingertips, some people still think of mental illness as something to be feared and stigmatised: the crazy murmurers with the matted hair who spit curses in the street; women who talk in baby voices and have mastered the creepy head tilt; the psychos who always ‘dunnit’ in the ‘whodunnits’. We can be led to think that mental illness is a lifetime affliction that only affects the select few. It makes us feel comfortable to believe that it is something far removed from us. Of course, the reality is that mental illness (being offered as the opposite of ‘mental health’) is often not portrayed reliably. And, as is the case with physical disability, it is something that could become a significant part of any of our lives in the blink of an eye.
They say ‘wellness is a crown the healthy wear, but only the sick can see it.’ I first began to notice my mental health when it started to decline at age 16. Within a month of starting a new school, I began to experience what I see now was debilitating anxiety and depression. I began to experience visceral fear on trains and in school corridors, convinced that I stood out like a sore thumb and everyone hated me on sight. I became so fearful and anxious that I stammered when I was spoken to, and the frustration and panic morphed into a desire to self-harm.
When I tell this story, I sometimes mention my overbearing perfectionism, my evangelical Christian upbringing, and occasionally even the shape of my jeans (I was rocking bootcuts when everyone else was in skinnies: just one visual reminder of how completely out of place I felt). What I next to never point out is that, at the time, I was just setting out on the journey that culminated in my diagnosis of vulvodynia and vaginismus. I got the infection that triggered off these pain signals in February of my first year at sixth form; I had just turned 17. So whilst the depression and anxiety were not caused by the appearance of vulvodynia, it certainly didn’t help matters. How could it, when the tannoy in my brain (which anxiety and depression had hijacked) kept pumping out messages that I was disgusting, unloveable, a freak?
As a person with chronic invisible illness, depression, anxiety and their perverted menagerie of friends have become part of my day-to-day life, like some f***ed-up Sesame Street. I’ve had to develop my own vocabulary, my own way of understanding what’s going on in my mind. For example, I live with a reasonably consistent inner narrative of an alternative timeline, in which I take matters into my own hands and put an end to my suffering. My brain likes to remind me of this once or twice a week, and sometimes much more if I am in the grasp of a pain flare. I am not suicidal. However, I’ve come to recognise my brain thinks it’s helping by pointing out (sometimes with irksome persistence) that, in the face of a lifetime of pain for which medics currently offer no relief – a disabled lifestyle which has rendered me dependent on my family and makes physical intimacy with a partner a very particular kind of challenge – one could see a certain logic in sparing myself all that faff by exiting the mortal coil. I have come to treat these “helpful hints” as white noise, the flurried binary whirrings of a machine desperately trying to compute how a human lives meaningfully with chronic illness. I do not wish to act on them, but I do not chase them out with a broom either. I simply try to breathe, and let the thoughts be.
Let’s be real: living with chronic pain can be flipping depressing. For one thing, it’s exhausting, and when we’re exhausted, it can be harder to guard our mindspace against thoughts and feelings we’d rather not countenance. This is where practising mindfulness and meditation can be incredibly helpful, as our mind-guarding (and mind-accepting) muscles become stronger and more readily useable, even in times of weakness. I can happily spurt out that endorsement, as if I do it every day. But ultimately, I’m still bloody cynical when I’m depressed, and tend to forego these practices all together. I’m working on that.
The biggest thing I can do for myself and my mental health is to practise self-care. This can be making sure I take lots of Epsom Salt baths, or it might constitute lighting a scented candle. Some days it looks like carving out time to I take the dog for a walk (even if I have to make a special effort to get dressed in something other than pyjamas, as is often the case). If you’re new to the idea, I’d heartily recommend checking out #boringselfcare on Instagram, a wonderful series of drawings by @makedaisychains.
However, I can guarantee you that my self-care now always consists of positive self-talk and soothing self-touch. The former is particularly important when I’m struggling, especially when I’m walking more than a short distance in a flare. If you got close enough to me as I limp along, you would hear me whispering to myself: ‘Keep going, you brave warrior. You’re doing so well. Not far now. You’ll be so proud once you’re done, and then I’m going to make you a lovely cup of tea.’ People might think I “look crazy”, but that’s on them for having archaic notions of the reality of mental illness.
The second thing on that list, ‘soothing self-touch’ (quiet there in the back), is something I learned from the fantastic Alayna Fender, a YouTuber and qualified Mindfulness teacher. I like to think that most people know me as a kind and caring person. However, extending this care to myself has been a whole other issue. Soothing self-touch has really helped me in my journey towards greater self-compassion. Before you get all excited and giggly, we’re talking about a very platonic kind of self-touch. It’s a parental, non-judgemental way of ‘being there for yourself’ and offering yourself support as you would a friend or loved one. Again, I’m sure some people would find the concept of giving yourself a gentle arm rub, hand-hold, or full-body hug a laughably pathetic image. And again I say: sounds like they could use a hug to melt away some of that freely-given judgement #sorrynotsorry. Self-touch is particularly important for me to remind me that my body is not the enemy; that I am supposed to be working with my body to feel well, not against it. It’s a comforting way to externalise the resolution of extending kindness to yourself. If you think it might be something you’d benefit from, watching Alayna’s video would be a great place to start.
Famous psychiatrist and Holocaust survivor Viktor E. Frankl wrote that ‘an abnormal reaction to an abnormal situation is normal behaviour.’ I’ve recently found great comfort in these words (and his other thoughts as written in Man’s Search for Meaning). We’re complex beings, and our minds are naturally going to be affected by what goes on in our bodies and vice versa. If our temporal, lived experience is consistently crappy for long enough, we’re going to feel crappy too. So in my darker days, I always try to remind myself that I am not alone. I did not choose this suffering, and I do not have to always bear it with grace. My duty is to extend myself as much kindness and compassion as I can, and keep putting one foot in front of the other. Maybe tomorrow I’ll feel a little better. But for now, there is the patchwork blanket my Mum knitted, a huge pile of books I haven’t read yet, and cuddles with my dog.
Happy World Mental Health Day.