October Blue's and Mental Health

 Dear Diary,

"This is the time of year when depression increases. The way in which you rest is important. I hope you take in lots of sunlight and walk as much as you can."

October for me, always seems to mark the start of low mood winter. I can feel myself slipping back into depressive moods and accessing anxious thoughts. Discussing Crohn's and mental health is a little hard because it requires me to discuss emotions that are uncomfortable to dwell on, especially when I am actively trying to stay out of them. So I decided to leave my home and come and write this in the library. On the outside I may seem a little more together than I feel. But there are days when I want to crawl back into bed, and try to be a person on another day.

Indeed, last week I kept having some reoccurring worries as I was leaving my home: do I need the toilet, I need to toilet, if I go now I won't be ready in time, if I don't go there are no clean toilets around, thinking about this is making me late, being late is unprofessional. Before I found myself in a spiral of self criticism I just walked out the front door. I'll be late but I will be there, better to be productive for 1 hour, than stay in this spiral for 1 hour and do nothing

It felt like walking out in the middle of a fight. Before I could agonise with myself about my need for the toilet, I just left. I reminded myself, I would be back home soon with the comfort of my own home and toilet. If I needed the toilet that I could go to some public bathrooms, not ideal but also not the end of the world. I don't have to pause my whole day on an off chance.

These anxieties have followed me for a long time. Throwback to the days I would get dressed for uni lectures then stand at my front door paralysed by the fear and anxiety around feeling well enough to spend the whole day out. I wish back then, that I could have faced my fears head on in the way I am learning to now. 

CBT therapy has been extremely useful for me to manage my low mood and anxiety. The journey to finding the right type of help has been arduous and at times I did wonder if I would ever find something that could help me understand how I was feeling.

It's one thing to know that therapy, self-help books and meditation can improve your mental health. But it can feel like a waste of time, reading the books or attending therapy when they don't necessarily fit your situation. For every useful line of advice you find, you'll need to spend several hours reading through things that don't apply.

Or you spend 40 minutes of a 45 minute therapy session repeating something you had spent the entire last session discussing. How do you not get annoyed when your therapists only words of advice are "you are strong" "you should be kinder to yourself"? Internally I was yelling I already went over my fatigue being caused by Crohn's, and that that was making me depressed, which was making me stressed, which was causing my Crohn's to feel worse, which caused more fatigue. This conversation felt like an endless loop at one point with no hope in sight until I changed therapists and type of therapy.

It is not surprising that rates of depression are higher among patient with Crohn's disease and UC as compared to other disease and the general population.* The self help books I've tried don't write in the context of a pre-existing health conditions. And the approach I have encountered for those that do, has been to "eat yourself healthy," which can feel unhelpful when food triggers vary so widely between Crohn's patients.

I have felt hopeless and invalidated at times. What's the point of trying when nothing seems to be working right? Eating "healthy" doesn't help when it causes extremely painful bloating.

And what does getting mentally well even look like? Even when I am fine, I feel like I am biding my time for the other foot to drop, for another flare to happen?

It was timely then, that this year as I was finding myself slipping into my negative patterns, I found some things things that not only put words to how I was feeling, but made those therapy sessions make sense. A drama I had started by dropped earlier in the year: My Liberation Notes, I revisited on a whim. And a book I had reserved in the library 2 months earlier, becoming available: I want to die, but I want to teobokki by Baek Sehee.

I have found that my mental wellness journey is ongoing and evolving. I have found advice and support in conventional and unconventional places. A instagram reel recommendation for tv drama about healing, a book on Living with the Long term effects of Cancer*, a comment by a celebrity talking about their movie process, a doctor advised course of Vitamin D supplements, even in my own blog posts. 

I have made a note of anything that stood out to me so I could remember and use when I was finding life hard. Things to recentre and recite myself.

My liberation note was: I wish to be liberated from myself, to not internalise hurts and to get out of unhelpful patterns and spiral. To say what I need honestly and be more frank about what I am going through.

This line in Baek Sehee book reflects best how I am working on these things.

Whenever I feel weighed down by anger, sadness, irritation, or fear, I think to myself: I have to turn my gaze.

Crohn's does affect my mental health so I am working to build up my mental fortitude and find better coping methods for when things get hard or my pain become a challenge to manage. This year I am treading water to keep myself from feeling too low or stressed, an improvement on last year.

I hope one day I can meet October with a more hopeful outlook. Until then I will eat teobokki and continue to take small steps towards my own liberation.

~J~

*I originally picked this up because of its full title: Living with the Long-Term Effects of Cancer: Acknowledging Trauma and other Emotional Challenges