The Five Signs That My Mental Health Was Declining That I Ignored

Pain is your protective mechanism. Ignore it at your peril.

It was back in 2016 that I had my first experience of depression and anxiety. That time it was triggered from dealing with multiple family members being diagnosed with cancer in a short space of time, the demise of a long-term relationship and frustrations with my work life all coinciding. Additionally, my occupation being a physiotherapist — primarily helping people with musculoskeletal and sports injuries — carrying the weight of expectation from people looking to me to “fix” their problems at a time when I didn’t have enough energy to look after myself, which took its toll.

The main thing I remember from this period was waking up exhausted every day and by the time I had dragged myself out of bed, brushed my teeth and dressed my energy was spent even before I had got to work! Somehow, I crawled my way through the days, getting home and plonking myself in front of the TV as I tried to recharge enough to do the whole thing all over again the next day. However, with the passing of time, a job move, and the help of some counselling these feelings passed and I felt like the old me again. Then enter 2020…

In March of 2020 England went into a national lockdown and I was forced, like many others, to work from home with much quieter days than I was used to. This wasn’t all bad though; no more commuting on packed trains into London, able to get up at a more sociable hour, more freedom in my day and the chance to slow down. Initially it actually felt like a bit of a release to have this “time off”. However looking back, the warning signs that all was not well were there as the pressures that come along with living through a global pandemic were taking an effect.

In Lorimer Mosely’s excellent book Painful Yarns, a book explaining pain science, he tells a story entitled “Nigel’s Superskoda 110’. In this story Lorimer recounts the day he was offered a lift home by a colleague who drove a dilapidated Skoda which only started if the right-hand indicator was on and reportedly sounded like a kettle once it hit 51mph! The owner of the car had little time or interest in cars and only drove this one as it had been left to him by a family member. Lorimer continues to explain that the driver used to drive around with the car radio at full blast in order to drown out an irritating rattling sound. The story culminates with the driver taking an entry curb a little enthusiastically and with a crash and a bang the engine ended up in the front seats next to them! The rattling transpired to be screws coming loose that should have been holding the engine in place. Lorimer’s message here is pain is a critical protective device. Ignore it at your peril.

Warning Sign 1 — I Fell Behind on Work

Being a physiotherapist carries a surprisingly high amount of admin work, and running a business means that on top of notes, reports and clinic letters there are also accounts, invoices to submit and chase when they remain unpaid and a host of tasks to keep things running smoothly. Normally I am up for the challenge and I keep on top of this, but slowly I started to slip and before long I was in a significant admin debt. This had multiple effects: my daily workload was greater, there was more pressure to complete the new days’ work and avoid adding to the already outstanding workload and there was a nice hefty dose of feeling overwhelmed to keep me company whilst I was trying to cope with this! Looking back, it was the “I’ll do it tomorrow” philosophy that I was employing that was actually harming me when on the surface it appeared as though it was helpful and taking pressure off.

Warning Sign 2 — I Stopped Meditating

I started meditating regularly in the Autumn of 2019 and I’ll hold my hand up, I didn’t get what the big deal was prior to this. Despite advocating it to patients I was falling into the category of ‘do as I say but not as I do’ therapist. And shamefully, the thing that actually pushed me into doing it? I had been reading and listening to stories of “successful” people and they all seemed to make time for meditation, so I figured it was worth a shot to springboard my way to success.

After my experiences over the last year, I can wholeheartedly say that I now LOVE meditation! I think it is wonderful and incredibly helpful. And like a ninja in total stealth mode, it changes you from within without you even realising. For me it helped me take a step back in difficult situations and see the bigger picture before responding or making an action. It allowed serenity to enter my mornings and brought peace to my mind before bed. My two go to apps are Headspace and Calm.

I’m not entirely sure why I stopped meditating when clearly it had such a profound effect on my mental wellbeing, but I think it stems from two reasons. One, a perceived lack of energy to do it and two, when you are in a dark place being alone with your thoughts can often lead to you feeling worse. And sitting still to quietly be alone with my thoughts seemed to be an invitation to these negative thoughts a louder voice, which I didn’t much fancy, and so I stopped.

Warning Sign 3 — I Stopped Being (Virtually) Social

This may sound trivial given that we were in the middle of a lockdown during a global pandemic and there wasn’t really anything to be social about, I was hardly missing out on gatherings and parties! But responding to messages, returning phone calls and declining invitations to zoom quizzes were all examples of me starting to step back from my social circles.

I was selling myself the narrative that I wasn’t engaging because there wasn’t anything to chat about, and after the 25th Zoom quiz I had maxed out my general knowledge so there wasn’t much point doing any more. In reality I did want to participate in these things, I just didn’t feel that I could. The funny thing about depression is that it convinces you that you don’t have the energy or desire to be sociable and if you do reply to messages or join in with Zoom calls you’ll use up the little available energy you have and feel worse. Then when you have opted out of the social event or decline to accept the phone call it convinces you that you that you’ve lost all your friends and you feel lonely. Total w***** really!

Warning Sign 4 — I Couldn’t Decide

Soup or sandwiches for lunch? I don’t know. Shall we walk to the park or go into town? I don’t know. What time shall we go food shopping? I don’t know! Everyday decisions that seemingly require no effort were beyond me. Now I might not be the most decisive individual you’ll ever come across, but even for me it was bad. It was probably the decision making struggles that started to make me think there was a problem.

It’s an incredibly frustrating thing to go through. It is difficult to explain too. I think you get to a point where you’re stuck somewhere between indifference to the outcome and fear of getting things wrong and ending up feeling worse.

Warning Sign 5 — I Stopped Exercising & My Diet Fell Apart

As someone who has an active job, spends a lot of time advocating exercise as well as participating in running, Olympic lifting and general gym work I have always found enjoyment and stress relief from exercise. So for me to completely stop exercising should have been a big warning sign to me. But it was easy to fall on the excuses of gyms being closed and that I needed new running shoes, but really I should have been looking at the fact that I had lost interest in exercising and the “I’ll do it tomorrow” voice was bleeding over from work life to my exercise too.

Along with this, almost naturally, went a decline in diet. No longer was I putting in the effort to make healthy nutritious lunches and instead I was relying on sweet sugary snacks to get me through the day. This put me into a vicious cycle of the inevitable sugar crash meaning I would head back to the sweet jar chasing my next sugar high. I found because I wasn’t eating anything of substantial volume, this led to me constantly snacking through the day as I never satisfied my hunger.

Acceptance

When I reached the point that I could acknowledge these warning signs, I was able to take a step back and realise I needed to start addressing them. Much the same way as a marathon runner with knee pain comes to see me for treatment and I might recommend that they reduce or even cease running for a period of time and prescribe exercises to help their muscles get stronger I needed to do the right things to help my mindset recover from injury.

I started getting up earlier and having a fruit-based breakfast smoothie. For the first few weeks the fatigue was pretty high, so I made a conscious effort to take the weight of expectation off myself for each day. I set myself little daily ‘To Do Lists’ and quietly and steadily worked my way through them each day to give myself a sense of achievement. I got back into exercising — just 3k runs a few times a week with no expectation of running the whole way if I didn’t feel able to. It was the act of putting on my trainers and taking dedicated time to exercise that I wanted to achieve. I started meditating again — just three-minute bursts, again no pressure on whether it was a “good” meditation or if my mind continued to be busy, I just wanted to start. And finally, I showed myself compassion. If I didn’t complete my ‘To Do List’ that day I didn’t tell myself I hadn’t worked hard enough, or I should have stayed up all night until I’d done it or berated myself for being lazy. I accepted that I had done what I felt I had the capacity to do and praised myself for completing the tasks that I had managed instead.

I let things get too far before I decided to listen to the “rattling”. If you too are keeping the radio turned up to ignore some uncomfortable truths, then I encourage you to tune into the rattling sooner rather than later and hopefully you can stop your engine flying into your front seat too!