I was very unwell with bulimia nervosa as a teenager. I felt insignificant next to my friends. I received comments on the size of my legs from horrible boys and I’d hate getting changed in the same room as my mates because I’d constantly compare myself to them. It was a feeling that had followed me my whole life, receiving comments on my weight from as early as four years old. I was always the bigger sister, in age and in size, and for me, the way my body looked had always stood out. I started experiencing bingeing and purging when I was around fifteen. I’d always loved food, but bingeing, to me, was a way to cope with how I was feeling. I would eat late at night when the house was asleep, feeling completely out of control as I ate until I was uncomfortably full and felt sick. I would dissociate during binges, it was almost like I had no idea what I was actually doing. I would eat foods that would normally make me feel anxious as I would try to eat little during the day as a way to ‘manage’ my binges. But my binges weren’t managed, at all — and I would cope with the guilt and shame I felt afterwards by purging. When I was finally done, I would sit in the bathroom and cry. It was a vicious cycle that I so desperately wanted to end, but I was so deeply absorbed by it. Over time, I stopped purging. This isn’t because I wanted to — but because I became very unwell from doing so and was hospitalized after vomit got stuck in my chest cavity and caused my right lung to collapse. It was an incredibly scary time and I was left with even larger feelings of guilt and shame — not just because of what I’d done, but because of what it could have meant for my family. I swore to them afterwards, that I would stop purging. But the bingeing never stopped. I couldn’t. And I still can’t. Eleven years on, I still binge most evenings. It is like it is so deeply ingrained within me that I can’t stop. No matter how hard I try. Photo by Naomi August on Unsplash Binge eating disorder is a serious mental illness where people eat very large quantities of food without feeling like they’re in control of what they’re doing. It’s a large amount of food in a short period of time, and unlike bulimia, purging usually isn’t involved. Beat Charity describes BED as being far from enjoyable. It’s not ‘overindulging’. Binges are distressing. And it can be impossible to stop even if you want to. Some people, including me, even forget what they’ve eaten afterwards. Beat says: “Characteristics of a binge eating episode can include eating much faster than normal, eating until feeling uncomfortably full, eating large amounts of food when not physically hungry, eating alone through embarrassment at the amount being eaten, and feelings of disgust, shame or guilt during or after the binge. Someone who experiences at least one of these distressing binge eating episode a week for at least three months is likely to be diagnosed with binge eating disorder. “Binges may be planned like a ritual and can involve the person buying “special” binge foods, or they may be more spontaneous. People may go to extreme lengths to access food — for example, eating food that has been thrown away or that doesn’t belong to them. Binge eating usually takes place in private, though the person may eat regular meals outside their binges. People with binge eating disorder may also restrict their diet or put in certain rules around food — this can also lead to them binge eating due to hunger and feelings of deprivation. People often have feelings of guilt and disgust at their lack of control during and after binge eating, which can reinforce that cycle of negative emotions, restriction and binge eating again.” Photo by Yuris Alhumaydy on Unsplash I know that I’m most at risk of bingeing when I’m feeling low or overwhelmed by my feelings. It’s a coping mechanism. Food is my comfort. But it can also happen when I’m feeling happy or in an average mood. Even though binge eating disorder is a recognised eating disorder, there is still a lot of shame and stigma attached to it. But I hope to make even the smallest mark in changing this — which is why I’m writing about it for the first time, for a publication that I am most comfortable with; that feels like a safe space. I know that for me, I often don’t believe I have a “problem”, because society tells us that. We’re so used to hearing about eating disorders such as anorexia or bulimia nervosa, that opening up leaves us vulnerable to being called “greedy”. And sometimes I tell myself that I’m just that because it’s easier than opening up to the world about what’s actually going on. It’s something I don’t talk about very often because to tell you the truth, I have long felt scared to speak out about it for fear of not being taken seriously. Even though I experience the same distress, guilt and shame that came with purging, not purging makes me feel like a failure. Like all of the awful comments, we hear in regards to greed are true. But they’re not. Every single time after a binge, I want to cry. It makes me feel really distressed and as though I have a complete lack of control. A lack of willpower. And that’s why it’s so difficult to open up — because I don’t want someone to confirm these thoughts. I haven’t gone into too much detail about my binge eating disorder, because it’s something that is still very personal to me, and because I want to follow Beat’s guidelines on what is appropriate within articles. It’s also something I still find hard to talk about. But I want people to know that it’s not something to laugh at, to make jokes about, or to dismiss. Binge eating disorder is a serious mental illness — it’s not being greedy or having a lack of willpower — it can be life-destroying. It’s time to acknowledge that.

Yesterday, I shared a tweet talking about how I add things to my to-do list having already done them, just for the satisfaction of being able to cross it off. And it seems I’m not alone in doing this, as more than 3,000 people liked the tweet, and many commented to say they do exactly the same thing — with some branding it a form of self-care. me: *writes to-do list* also me: *adds something i’ve already done just for the satisfaction of crossing it off* — hattie gladwell (@hatttiegladwell) April 5, 2021 And it made me realise: To-do lists really are a great form of self-care. Every morning, after a coffee and some breakfast (which in itself is another form of self-care), I sit down and write my to-do list for the day. It helps me to feel organised and in control of the day. It makes me feel ready for the day. It makes me feel like I’m going to accomplish something that day. In fact, writing a list on its own is enough to make me feel even the tiniest bit accomplished. And feeling accomplished makes me feel proud of myself. Today, my to-do list looks like this: Make sure you eat something for breakfast Send out at least one article idea to an editor Write this blog for InSpire the Mind Do some invoicing (must!) Take my baby for a walk to the park Check-in with one friend Although my tweet was meant to be more of a joke, it’s true — I do add things I have already done to my list. Because seeing them down on paper shows me what I have already achieved. To-do lists are a great form of self-care because it shows that you are taking the time to think about yourself, to think about how you can organise yourself. It shows that you have goals for that day, and that you’re intent on completing them. Photo by NeONBRAND on Unsplash And the thing is, it doesn’t matter if you don’t — because having the list there will help you to feel more prepared for the following day. What I like to do is to list things in the levels of importance. I get everything that I desperately need to do out of the way, and then I let the little things wait. This is something that was always difficult for me before because I’m an over-thinker and I’d think that if I didn’t get everything on the list done, I was failing. But this is not the case at all — and letting these little things go shows me that I am looking after myself. It shows that I am prioritising my time, energy, and mental health — which many of us don’t do enough. Looking after yourself in this way helps to prevent burnout It might seem like everything is urgent, but this often isn’t true. And realising this helps to eliminate the feelings of irritability and anxiousness that comes with the stress levels of burnout. A to-do list doesn’t have to be work-orientated, either. It can be anything. That’s the joy of it. If you decide to have a day off, you can still create a list — even if that involves picking your favourite movie and heading to the shops for your favourite sweets. And no task is too small; I feel accomplished just knowing that I’ve brushed my teeth and had a shower. And yes, this goes onto the list, because this in itself is a huge achievement — it shows that that day, I have done something to improve my personal hygiene, which can be very difficult when you are struggling with depression. Your to-do list doesn’t need to be full of daunting activities. And it’s okay and valid not to do something you’ve told yourself you would. In fact, a to-do list can be whatever you want it to be. Whether that’s getting your morning emails out and having a work meeting, or managing to make your bed and open your curtains. Photo by Sixteen Miles Out on Unsplash There’s a little rush of joy that I feel every time I tick something off, and that joy can improve my mornings — or even my days — dramatically. And it’s something I’d recommend to anyone: Get up in the morning and write a list of everything you want to achieve that day. Write down all types of things, work and lifestyle. It helps you to stay organised and in control, which is a positive thing because feeling a lack of control is so prominent within mental illness. I’m not saying a simple to-do list is a cure or even the best form of self-care out there. For me, I also love running a bubble bath and brushing and washing my hair (which at the best of times can feel like the most impossible task in the world). But what I am saying is that it’s a helpful start, and a start to other forms of self-care. And isn’t that a positive and encouraging reason to start writing one?

Photo by Author Two Kashmirs live on the same valley’s soil: one in its streets, the other in the memory of those who fled. The land of mystical poets, now entangled in geopolitical debates, highlights how geography shapes mental states differently across generations and distances. The internal lives of Kashmiri residents now differ significantly from those of migrated Kashmiris. Neither experience is uniform nor reducible to a single story, yet patterns emerge. As a Kashmiri who grew up watching older family members quietly battle mental health issues, and who studies a Master’s in Psychology and Neuroscience of Mind-Body Interface at King’s College London, I came to understand that the most important wounds in this story are the ones that come from loss, migration, and buried memories that are constantly present, but rarely discussed. To understand Kashmir today, we must look beyond the politics and borders and examine the mental states of people who carry its story. Fragments of Home: The Mind in Exile The 1990's saw a boom in emigration from Kashmir during a period of violent conflict between insurgents and the Indian government. Killings and violence across the valley led to displacement of Kashmiri Pandits, Muslims, and Sikhs. Kashmiri families left behind homes, lands, businesses, temples, and an entire neighbourhood built over generations; ultimately disrupting their deeply rooted sense of identity. In the years that followed, many were compelled to adapt to new cultures, climates, food habits, and festivals, to the point that much of their own identity was lost. Yet, traditions like the Janthari (Kashmiri Hindu calendar) endured, often surprising others with the depth and richness of their heritage. Kashmiri migrants struggled with persistent hypervigilance, where safety is never entirely internalised. A silent but constant survivor's guilt is often carried by those who left while others stayed. What is often romanticised as nostalgia takes on a more burdensome form. Involuntary flashes that blur the lines between the past and present, functioning less as comfort than recurring psychological pressure. This pulls future generations of Kashmiri migrants into a continual loop of transgenerational trauma and identity crisis, where identity is shaped not through direct memory but through narratives of loss, silence, and longing. What emerges is a more subdued struggle. Many question whether they have the right to grieve for a homeland they never lived in yet feel a strong connection to. Chronic stress and social dislocation extend well beyond Kashmir, as research across displaced communities worldwide links forced migration in older adults to adverse mental health outcomes and cognitive decline. This sits outside conventional diagnoses of PTSD or depression yet is no less debilitating. Photo by Author - Picture of her dad visiting his old house for the first time after 34 years since the Kashmiri exodus Mental Health Within the Valley Today For Kashmiris who currently reside in the region, it is not a sudden rupture but an ongoing continuity under shifting circumstances that shapes the psychological landscape. Everyday existence takes place in a setting of long-term uncertainty, periodic instability, and political complexity. Dr Insha Rouf’s research into dementia found a higher rate of DNA variations associated with Alzheimer's Disease in the Kashmiri population; findings distinct from other Indian populations. In terms of psychiatric burden, formal mental health infrastructure has been historically limited across the valley, which helps explain why traditional and faith-based healing remains embedded in everyday life. Spiritual healers such as Pirs and Fakirs are frequently sought after by many Kashmiris experiencing psychological distress, with reports suggesting that a majority of psychiatric patients consult spiritual healers before or instead of clinical services. These practices reflect far more than a replacement for clinical care. They are deeply ingrained in how Kashmiris perceive suffering and community. Decades of political and economic volatility have led to a higher prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD). These experiences are shaped by a range of interrelated factors, including uncertainty about the future, the scarcity of job opportunities that drive young people to migrate to different states, and wider consequences of residing in an atmosphere of protracted conflict, such as constant riots and severe military surveillance. An important factor is economic instability. Since tourism contributes significantly to the local economy, changes brought on by security issues or local events may have an immediate effect on livelihoods. Reduced tourism can lead to financial hardships and unemployment, especially for younger individuals starting their careers. Young individuals with higher education have been occasionally seen taking on informal jobs, indicative of the sad reality and pressure of the job market. Coping, Culture, and Evolving Mental Health Care Adaptation for survival is common. Coping strategies vary in response to these demands. While some people rely on routine, community, or faith, others may turn to maladaptive tactics like substance abuse. A 2022 report found an increased rate of self-medication in the Kashmir Valley, with respondents citing stress, trauma, and limited access to formal mental health support as contributing factors. Alongside this, mental health difficulties remain stigmatised. Cultural misconceptions and fear of judgement, frequently mean the difference between intervention and prolonged, untreated suffering. Despite enduring stigma and mental health challenges, initiatives have been introduced to improve access to care. One example is Tele-MANAS, a 24/7 mental health helpline designed to help bridge gaps in mental health services. Its growing reach has been documented by journalists covering mental health in the region. Journalist Irfan Amin Malik reported on the positive impact of Tele-MANAS on Kashmiri women experiencing mental health issues. Integrating telepsychiatry initiatives with broader mental health education and community outreach can empower Kashmiri residents to seek professional care rather than turning towards substance use or spiritual healers. This combined approach helps improve help-seeking attitudes and build resilience in low-resource settings. Photo by Author - Downtown Kashmir Beyond Comparison It is not about comparing hardships but understanding how geography reshapes emotional landscapes. Losses of land, home, safety, and belonging can take many different shapes, yet they all carry a remarkably similar weight. These experiences are often overlooked within dominant political narratives, resulting in a silent burden of invisibility and unresolved grief that is neither generally acknowledged nor properly processed. As these emotional traces endure over time, they seep into memory, identity, and mental wellbeing. The impact of displacement and protracted uncertainty is not limited to a single instance but is subtly passed across generations. Living in uncertainty influences adaptation and coping over time, while displacement can reshape an individual’s susceptibility to psychological and neurological stress. The Kashmiri experience must be acknowledged without oversimplification, as they are greatly impacted by their respective circumstances. Indian-administered Kashmir valley, once remembered for its breathtaking location, physical beauty, and distinct culture, is now more often defined by politics, borders, and history, while far less focus is given to the mental state of Kashmiris. The 22nd of April 2026 marked the one-year anniversary of the tragic terror attack in Pahalgam, and in this piece, we would like to acknowledge the lives lost during this event.

Photo by Freepik I’m Niamh, a Psychology and Neuroscience MSc student at King’s College London and a Senior Practitioner in a commissioned rehabilitative service within His Majesty’s Prison and Probation Service in London. I am passionate about mental health and challenging the systemic barriers that prevent marginalised groups from accessing support. I hope this brief article encourages you to rethink the narratives we hold about crime, rehabilitation and the people whose lives are shaped most profoundly by these systems. You are at home, winding down for the evening, when you hear a violent crack behind the plasterboard. A pipe bursts. Within seconds, water is pouring across the floor, soaking the carpet and creeping under the furniture. Instinct takes over. You start dragging things out of the way, grabbing bowls, calling for help and trying to contain the chaos as it spreads around you. Or you could walk downstairs and turn off the mains. If I am being honest, I would probably spend a few frantic moments doing the first option before even remembering the second. Most of us would. But we all know which one actually stops the flood. Photo by Piotr Łaskawski on Unsplash This is a simple illustration of the Smoke Detector Effect in psychology. Our minds are built to react quickly and loudly to signs of danger, even when the real solution lies in addressing the underlying cause rather than the noise it creates. We panic at the symptoms and overlook the structure that produced them. And this is exactly where we find ourselves in the UK today. Crime and personal safety feel like growing concerns, yet the policies shaping our justice system are moving in the opposite direction of what communities may actually need. We are pouring our energy into reacting to the alarms, the headlines, the fear, and the political rhetoric, instead of fixing the structural issues that drive harm in the first place. The media plays a significant role in shaping this sense of rising threat, with outlets such as the Daily Mail referring to “no‑go neighbourhoods” and a “crime wave” in London. Whether this framing reflects reality or leans into dramatisation is a debate in itself. Nonetheless, it is an influential topic and can be drawn into political debate to reinforce particular narratives. Yet, recent government policy does not reflect the level of concern portrayed in the media. England and Wales are set to cut education and rehabilitation services in prisons by up to 50%, despite ongoing issues around reoffending and community safety. These cuts reflect the way we view people in the criminal justice system and show a lack of understanding of the complex steps that lead someone to commit crime and the factors that contribute to their reoffending. I would argue that poor mental health plays a major role. Higher rates of mental health difficulties have been documented before entering the criminal justice system, during imprisonment and after release, compared with the general population. It is important to recognise that this discrepancy should never diminish accountability for harmful actions, but it may strengthen the case for a justice system built on rehabilitation rather than punishment alone. Mental Health in The Criminal Justice System People entering the criminal justice system have consistently been found to have poorer mental health profiles. It is difficult to find data that fully captures this before contact with the system, but it raises an important question about how unsupported mental health difficulties can lead people down a harmful path. Naturally, this path can become cyclical if there is no intervention. If someone is already predisposed to poor mental health and enters a system that works against them, their likelihood of rehabilitation is low. Recent estimates suggest that nine out of ten prisoners have at least one mental health or substance misuse problem. Yet only one in seven people in prison are receiving mental health support while incarcerated. These figures come from 2023, so with the recent cuts to rehabilitation and education services, this disparity is likely to worsen. Altogether, this highlights the importance of addressing the mental health needs of people in the criminal justice system, both during their sentence and as they return to the community. Photo by Ye Jinghan on Unsplash The Importance of Rehabilitation Rehabilitation is one of the five statutory purposes of sentencing, as set out in section 57 of the Sentencing Act 2020. Post‑sentence supervision and license conditions, which are the rules people must follow after release (such as attending appointments or engaging in support services) are designed to support rehabilitation and help people reintegrate safely into the community. A recent 2025 report found that access to health and wellbeing services in prison, and continued support in the community, is directly linked to better rehabilitation outcomes. A key point is that services do not need to explicitly target mental health to contribute meaningfully to rehabilitation. This includes interventions that focus on upskilling, education and providing a sense of purpose, all of which can support a person’s wellbeing. The report emphasises that bringing these different forms of support together is essential for reducing reoffending. The Good Lives Model (GLM) is a strengths‑based theory of rehabilitation which argues that people are more likely to desist from crime when they are supported to achieve personally meaningful and socially constructive goals. It proposes that people strive to achieve certain core values, or primary goods, which are essential for a fulfilling and prosocial life. The GLM helps us understand how unmet psychological needs, social exclusion and environmental pressures can drive offending. Poor mental health can impair decision making, emotional regulation and the ability to pursue these goods in healthy ways. From this perspective, crime is not simply a personal failing but often a reflection of unmet needs and structural disadvantage. Rehabilitation that addresses mental health concerns, whether directly through clinical support or indirectly through access to meaningful activities, relationships and stability, helps individuals meet these goods in prosocial ways and reduces the likelihood of reoffending. Photo by Curated Lifestyle on Unsplash Investing in Rehabilitation is Investing in a Better Society Countries with the lowest crime and reoffending rates share a common feature: they invest heavily in rehabilitation that focuses on reintegration, wellbeing and mental health. In 2019, the BBC reported on Norway’s rehabilitative model, noting that a system once centred on punishment had been redesigned to minimise the sense of incarceration, reduce psychological stress and create an environment that supports personal growth. They reported that “Recidivism has fallen to 20 percent after two years… in the UK it’s almost 50 percent after one year.” This comparison illustrates the impact that a rehabilitative, humane system can have on long‑term outcomes. While Norway’s model cannot be transplanted directly into the UK without wider structural reform, it demonstrates the value of investing in approaches that prioritise mental health. Adopting elements of this philosophy could lead to significant benefits for individuals and for society as a whole. Evidence consistently shows that people who leave the criminal justice system with support, skills and improved wellbeing are far more likely to contribute positively to their communities. This is not only socially beneficial but also economically sensible. The most recent government data shows that it costs just under £51,108 per year to keep one person in prison in England and Wales, and the prison population is projected to reach a central estimate of 100,800 by March 2029. Norway, by comparison, has a prison population of around 3,000 people and is estimated to spend between £73,000 and £100,000 per prisoner each year. Although this investment is higher, it is associated with far lower reoffending rates and a much smaller prison system overall, meaning rehabilitation‑focused approaches become more economically advantageous in the long term and allow public funds to be redirected into other vital areas. Investing in People, Not Punishment I was taken aback by the sense of hopelessness many people in the criminal justice system feel when returning to the community. It often comes through in comments like, “I may as well go back to prison, there’s nothing for me out here.” This attitude could be understood as a reflection of a system that, in many cases, does not provide people with the tools to succeed, leaving them feeling unsupported. When we look past the sensationalist headlines, it becomes clear that the real issues lie not in fear‑driven narratives but in the structural barriers that prevent people from rebuilding their lives. If we want a safer and more compassionate society, we need to address those barriers directly. It is no different from responding to a smoke alarm: we can either panic, blame and fuel the chaos, or we can calmly identify the source of the problem and take meaningful action to prevent further harm. Choosing the latter means investing in people rather than punishment, so that no one feels trapped in cycles of crime or convinced that they have no place or opportunity within society.

When I was growing up, I was brought up to understand, and to be understanding of mental health issues. My mum has bipolar disorder, and so I was always taught about it by her. I watched her experience episodes of depression and mania, which helped me to learn more about it, and to be empathetic, compassionate and supportive. I have an amazing relationship with my mother. We are best friends (though we argue like worst enemies occasionally), and so when I was later diagnosed with bipolar disorder when I was 19, I knew how to handle things. I knew what to ask at my psychiatric appointments — letting them know that I was interested in different types of medications, asking whether they would have side effects, asking about which symptoms to watch out for to recognise hypomania or depression. Photo by Jonathan Borba on Unsplash I also had her support there. She came with me to the GP appointment to push for me to get help for my mental health, after several breakdowns. She came with me to that first psychiatric appointment — the one I felt so nervous for because I imagined scary doctors in white coats (which didn’t happen, FYI). She has always been my support system. The person I go to when I need to talk. The person I go to for help. I see so many people say that they have parents who ‘don’t understand’ mental health issues, and this makes me sad. I can’t imagine a world where mental health wasn’t a prominent conversation in my life. And I wish more people had the opportunities to learn that I was given . I will make sure that my son has these opportunities. He has just turned one year old. Knowing that he is going to be learning from me for years to come, I will bring him up to understand mental health issues. To be empathetic and compassionate. To know what to do when someone is struggling. To know what to do if he is struggling. And to know that he can always come to me for help. It’s important to me that he knows this, because I don’t ever want him to struggle in silence. And I want a son who looks out for other people, who is kind and caring, who can be a shoulder to cry on when someone can’t talk to their own parents. Photo by Omar Lopez on Unsplash I also think it’s important for my son to be educated on my own mental health issues. I will never be reliant on him, nor will he ever be put in a situation where he has to support me, but I want him to be aware, because I want him to know that mummy has a condition that she cannot help. Just like any other condition, it’s not one to hide. Plenty of parents talk to their children about physical conditions — and mental health conditions shouldn’t be ones to hide. But I think seeing how I get through life with a mental health condition will help him know to always be kind to people, because you never know what someone is going through. Though you can’t always spot the signs, I’d like him to know that there are signs to spot. Conversations around mental health are becoming more and more prevalent, but I worry we may have missed the boat just a little bit with this generation of children, because really, the true conversation and campaigns have only just started. Which is why we need to be teaching about mental health in schools and in other areas of education, not just as a one-off workshop, but on a regular basis. Mental illness is something that can affect anyone of any age — it is not just adult-centric. It would make me incredibly proud to have a child who looks out for others, and that’s something all parents should aim for. Of course, I want a happy child, and I know that I can give him that because he will always be safe and loved more than he will ever know. But I also want a child who is caring and kind — and I think increasing the conversation around mental health issues can do that.

Intrusive thoughts are a normal part of life. Unfortunately, everyone has them. Maybe you’ve been standing on a train platform and had a mental urge to jump onto the railway. The thing is with intrusive thoughts, that most people tend to shrug them off as just that — thoughts. However, people with obsessive compulsive disorder will likely ruminate on them. They’ll question what these thoughts mean and whether they have any purpose. The most likely answer is of course no — but that doesn’t stop the anxiety. And so this is an open letter to anyone who has OCD, and who suffers from intrusive thoughts. Firstly, I want you to know that you’re not alone. I also have OCD, and I’ve fallen victim to the rumination of these thoughts, over and over again. It’s a vicious cycle that’s hard to beat. But I hear you. Secondly, I want you to know that your feelings are valid. It is totally understandable to feel anxious and uneasy because of your thoughts. It is totally understandable to question whether they are a part of your character. But they are not. Your thoughts absolutely do not define you. Thirdly, I want you to know that your illness is valid, too. OCD is often shrugged off as a need for things to be clean — and maybe this is your form of OCD. But the thing is, with OCD, it’s different. It’s constant distress by your thoughts and your urges and your compulsions. It’s crippling anxiety. It is not looking at your kitchen counters and wondering whether you need to go over them again with some kitchen spray. In fact, OCD was once ranked as one of the most debilitating illnesses in the world, by the World Health Organization. That’s how bad it can impact your life. Photo by Caroline on Unsplash Your intrusive thoughts are meaningless — not in a way that they don’t affect you, but in a way that they are not reflective of your character, or of who you are. They are, of course, a huge part of your life, and so there is some meaning there — in terms of the fact that the illness can so easily have a grip on you. Sometimes it feels like you’re chained to someone and being pulled along with no end in sight. But I want you to know that it gets easier. With time. With help. With treatment. But it’s also not easy to get treatment; I’m one to know that — it’s taken years of fighting for help to finally get to a place where I can shrug the thoughts off, even though it probably takes longer than the average person without OCD, and although they still cause anxiety. I learned this through multiple sessions of cognitive behavioural therapy (CBT). I was experiencing incredibly distressing thoughts (thoughts I’m not ready to open up about yet), that were impacting my daily life, to the point I was experiencing panic attacks daily and barely left the house. CBT was amazing in helping me to learn that my thoughts are not an indicator of who I am as a person. It helped me to acknowledge that I have an illness — and that it needs to be treated as such. What I have in fact learned is that I am a good person — and that my thoughts are actually reflective of this. I am so conscious of being a good person and of having a positive impact on people’s lives, that my OCD tries to ruin that and to convince me of the opposite. It tells you that you are a risk and that you are a monster. It’s often the exact opposite reflection of your character. I wish that those of us who do suffer from obsessive compulsive disorder felt more inclined to talk about our intrusive thoughts. To be open and honest and to live without fear of someone confirming our worst fears and telling us we are bad people. That’s the thing — people who don’t understand OCD might think these thoughts are real, even though they’re not. And so many of us feel too scared to speak out just in case this is the case. Photo by Priscilla Du Preez on Unsplash If you have intrusive thoughts and they distress you, know that you are a wonderful human being and that your thoughts are meaningless and mean. Your OCD is a bully, and while your feelings towards it are totally valid, it’s okay to want help. You don’t need to be embarrassed or ashamed. Please, if you’re suffering from obsessive compulsive disorder, speak to somebody about it. But speak to somebody you trust, and try to help them gauge an understanding of what you’re going through. To make this easier, it could start with a letter, exclusively stating the symptoms of OCD right at the top so that they have an understanding before you pour out all of the feelings you have been feeling for so long. But please, do pour them out. Don’t let them continue to build and build until you get to the point where you experience suicidal ideation (which I wrote about for InSpire the Mind here). It’s your turn to receive some help and some love and some support and some understanding. It is your turn to feel like you matter and that your feelings and experiences are valid. It is your time to have someone to hold your hand, and to help you lead the way through these so suffocating thoughts. Your intrusive thoughts are not you, and they will not beat you. Instead, I promise that you have the strength to beat them — no matter how much you don’t believe it right now.

Before I had my child, I was a different person. Not just in the sense that well, I didn’t have a child, but in the sense that since, my whole personality, my goals, and who I am has completely changed. Before the birth of my son, I didn’t have anyone relying on me. Things were different. I really struggled with my mental health, and the thing is, I had no motivation to help myself or to stop things from getting out of control. In my head, the only person I had to save was myself and, in my mindset back then, I didn’t respect myself enough to do that. Things would shift from quiet to turbulent and everything in between, my relationships and friendships suffering. My outlook wasn’t the same as it is now — back then, I didn’t value myself enough to change things or to turn things around. I had help there but I didn’t take it seriously because I had nobody depending on me and therefore I could just brush it off and ‘seek it another day’. But when I got pregnant, everything changed. I was in a stage of suffering but suddenly I had this little person in my belly already depending on me despite the fact we hadn’t even yet met. Getting pregnant (by surprise!) was a huge wake up call for me. Suddenly, I knew I had to get things together, not just for myself but for my baby. I wanted to be the best mum I could possibly be and I knew I could be that, even with mental health issues, if I just sought help and kept to having care available to me. Throughout my pregnancy I was under the perinatal mental health services. I had a consultant who I would meet with, before we entered into the strange world of Covid, but it then turned to frequent phone calls. I had people checking in on me frequently to make sure I was doing okay, to review medication and plans, and suddenly seeking help didn’t seem like a chore anymore, because I wasn’t just doing it for myself — I was doing it for the person I wanted to be for my son. Photo by Kristina Paukshtite from Pexels Unfortunately, after my son was born I was diagnosed with postnatal depression and things were really, really tough. My main intrusive thoughts were around whether I was failing as a mother. Every little thing would make me feel like I wasn’t good enough and I would constantly compare myself to other new mothers and feel like I wasn’t keeping up to the same expectations. My partner says that during the first two weeks of being a mother I looked ‘dead behind the eyes’. I mean, who wouldn’t? I’d had a somewhat traumatic pregnancy due to having hypertension and gestational diabetes, reduced movements leading to an early C-Section which in itself is traumatic enough; coupled with healing and coming home with a newborn, all in the time of Covid when my partner could only visit for one hour a day. Things had changed and my life had completely changed all in the space of a few days, and I guess my mind just didn’t know how to cope. But the difference is that this time I was proactive, because I had to be — I had my little one depending on me to be the best version of myself that I could possibly be, and therefore I didn’t stall in seeking help. I told my health visitor and I told the mental health services how I was feeling and I got help. And it helped. During this time, I also sought CBT and went back to my old therapist, because I wanted to try to treat what was happening to me the best ways I knew how. I had a reason to seek help now, and although I should have realised it before, there has always been a reason to seek help — because we as people with mental health issues still deserve to feel happiness. In my eyes, my son has saved my life in so many ways. Not just by giving me a reason to want to live every day, to flourish and be the best version of myself, but because he has made me realise that I was always deserving of help. Photo by Flora Westbrook from Pexels Which leads me to this: You are always worthy of help, love and support. From experience, sometimes the motivation isn’t there because you feel like things are never going to get better, or because you feel like you don’t deserve help, and deserve to continue feeling the way you are. But you don’t. Seeking help is hard, mentally and physically and it can be a draining process. But stick at it. I’m not saying that your mental illness is going to be cured, but help might just make it that little bit easier. It might help you to learn technique to manage and to build up your self-esteem and to realise that you deserve a reason to smile and to appreciate yourself. I’m not cured, I still struggle with my anxiety and still have the support of a mental health team — and what I do have is the will to continue working with them, to see my therapist. And this is thanks to my son — not just because he is my son and my one reason to be the best person I can be, but because he made me realise that I was always deserving of being the best person I could be. But you don’t need to find a ‘reason’ to seek help. You are the reason. And I promise you that when you realise this, your whole life will change.

In two weeks, my baby goes to daycare for the first time. He’s already one, and in his little life so far he has only met one other baby — once. I remember the first time he laid eyes on another child his age. It was like he’d had a lightbulb moment, realising that he wasn’t the only baby in the world. He looked so happy; smiling away and even trying to stroke the other boy like he would our cats. But it was also heartbreaking. Though I was made up for my baby, I couldn’t help but realise just how much he’d missed out on due to the pandemic. I know, we are lucky to still be here, and there is no denying that — we are lucky. But it’s still been hard. As a mother with postnatal depression, things have been difficult for a number of reasons. But I’ve been hit with an insatiable amount of guilt knowing that my son hasn’t had the start to life that he should have due to the pandemic. It’s out of my control and can’t be helped, but it has made me worry about his development. I’ve decided to put my son in daycare not just so that I have time to work, but because I know it will be good for him. I know how his face will light up when he’s surrounded by children his own age. I know that he’ll be so excited that he won’t quite know what to do with himself. Photo by Kevin Gent on Unsplash He’ll be going three times a week, and at first, I know I’ll feel panicked and upset. He’s been completely by my side for over one year now — so I know it will be upsetting at first, but that’s because I’m so used to him being attached to my hip, and it will be strange not having him in the house while I try to get some work done. I also worry for him — I worry that he will be really anxious, and won’t like being left in the care of someone else. I worry that he will be too attached to get used to a room full of babies; despite any excitement. I’m worried that he will be a really anxious child, because he’s so used to it being me and him all of the time. I know I don’t completely have to worry. I recently spoke to Katie Reid, a child psychotherapist in the early attachment service within the NHS, who told me babies born during the pandemic will be fine. She said that not seeing other children during the pandemic, will be more of a disappointment more than anything else. She said: “If your baby was born this year, the chances are they have spent most of their life within a very small and contained circle of people. It makes total sense that, as you begin introducing them to the wider world, it takes them a little while to learn about and feel confident around other people (even close family), and to need a bit more reassurance and comfort from their parents at these times. Photo by Ellieelien on Unsplash “The current situation is a challenge for everyone, and there is clear emerging evidence that for some babies lockdown is having a detrimental impact. If parents can manage their own feelings of isolation and stress while maintaining a sense of stability and connectedness, their baby should thrive.” My son is already thriving — but things are changing. Places are starting to open up (much like daycare centres) as Covid-19 restrictions are lifting. It can be scary and overwhelming and make you feel vulnerable. And if I’m feeling that as an adult, how will my baby feel when I say goodbye to him after dropping him off at daycare? I know I’m probably overthinking it, but it does make me worry, and I’m filled with the dreaded mum guilt. But all I want is the best for my son, and him socialising with children his age will be what is best for him. I just need to take it step by step — and so he will have taster sessions with me there, to get him used to the environment first. But I know it will be hard and I’ll probably spend the first day worrying about whether he’s okay. Not just because he might miss me, but I worry that he won’t know what to do with himself because he’s never been in a situation before where there’s a room full of other babies. All I can do is wait and see how he reacts; and hopefully he will thrive in the busy environment. Hopefully he’ll make the most of the situation and play and interact with the other children. Hopefully he’ll have a lovely time — and will come home to me beaming, excited and ready to go again the next day.

When I first started writing about my experience with mental illness, the world of mental health in media felt quiet. Of course, there were people writing about mental health issues — but there was nothing I could quite relate to. Writing has always been therapeutic for me. I treat it like a diary. In some instances, this is great — it allows me to write authentically and realistically. In other cases, it’s not so great, because it means that I’m vulnerable. Not just to other people but to myself. Sometimes I can be sat in a dark room just typing away, not really knowing what I’m writing, until suddenly I’m finished and I read through nothing but words of distress and upset. Writing about your mental health can be a scary thing to do. It can be scary for you; reading back words you didn’t even know existed in your heads. Words that show your sadness and your desperation. Words that leave you feeling lonely. Photo by Milada Vigerova on Unsplash It’s even scarier to share these thoughts with the world. But in many cases, it feels necessary. Because writing about your mental health means opening up to the world and showing that it’s okay to have feelings. It’s okay to have thoughts. It’s okay to be vulnerable. I do write about other things, of course. I love to write about relationships and about chronic health conditions and features of unusual but wonderful things (like the time I asked a bunch of men about their sex lives for an anonymous article). But mental health has always been my niche. It is what is most comfortable for me, because what I’m writing is the truth. And sometimes, telling the truth is the easiest thing to do. When it comes to writing. Talking about my feelings in person is hard. I struggle to get the words out of my mouth without a horrible lump in my throat choking me up as I try my hardest not to cry. I struggle to sit down and say how I’m feeling without bursting into a snotty, teary, red-faced mess. I guess I worry about what I’m saying. Whether my feelings are too personal, too intense, too much. But writing, unedited, unfiltered, feels safe. Photo by Yannick Pulver on Unsplash I don’t just write about mental health to get my feelings and thoughts out. I write for everyone else who is too scared to open up. I write to spread awareness of mental health issues and how they can affect every aspect of your life. I write for those who feel like they don’t have a voice. I write for those who feel like they have to hide their pain. It’s important to talk about mental illness, but I understand that not everyone wants to, or feels they can. And that’s okay. It’s okay to process your symptoms and your pain in your own way. There is no right or wrong way to do it. Whatever you do to get through is valid. But I want to write about mental health because I want my words to be out there in years to come, with someone coming across them when they feel like they’re alone, up searching the internet late at night because they can’t sleep. I want my words to be a comfort to those who need it; for those who feel like they don’t have anyone to talk to; for those who need someone to relate to. And so, I write about mental health for a variety of reasons. For myself, for other people, and because it’s important in today’s world where, despite it being 2021, mental health issues are still deeply stigmatised. But by continuing the conversation in whatever way we can, we can work to change this.

My mental health issues started when I was young. When I was four years old, I experienced seeing things that were not there, and hearing voices. At the time, for reasons unknown; and my teens were filled with mood swings. I was later diagnosed with bipolar disorder, borderline personality disorder, and obsessive-compulsive disorder. I also live with a chronic illness called ulcerative colitis; a form of inflammatory bowel disease that causes inflammation of the colon and rectum. Symptoms started when I was 17. I lost an excessive amount of weight very fast, experienced rectal bleeding and chronic constipation and stomach aches. I went to the doctor multiple times, and each time I wasn’t believed. I was told it was just periods, women’s troubles, there couldn’t be anything really wrong. They were wrong. In 2015, when I was 19, I deteriorated in a very short space of time, until the point where I ended up in the hospital. After a week in hospital, I underwent an emergency operation to have the entirety of my colon removed. It had perforated and was so heavily diseased that I was told had we waited any longer, I would be dead. I was given a stoma bag. As you can imagine, this was difficult and traumatising. I had never seen a stoma bag before, nor did I even know what one was. But there I was laying in a hospital bed with a stoma staring right at me every time I looked down. Photo by Jonathan Borba on Unsplash I went weeks unable to look at it. My mum would change the bag for me because I couldn’t bear to. But I knew I had to do it if I was to get on with my life. It was a big step, but I remember the first time I changed my bag being a huge relief. It wasn’t as bad as I’d thought, and it was easier to do than I’d imagined. My family were a huge support and helped me to get through the initial weeks. My mental health was a mess. I felt lost and confused and unfamiliar with my new body. It was a lot to get used to and to come to terms with. But with the support of my family, I got through it. And actually, having a stoma bag was a blessing. I no longer dealt with stomach aches or the pain of chronic constipation and bleeding. I felt fit and healthy and physically comfortable for the first time in years. It felt freeing. I was able to do whatever I wanted when I wanted. I could wear what I wanted without worrying about huge bloating and pain from tight clothes. I think there are a lot of scary stories on the internet, and that’s because generally, people only talk about the negative things online because they’re looking for help and support. The people whose stoma bags have been a blessing to them are out there living their best lives — and I was one of them. I decided though, to have the stoma bag reversed 10 months later — I had initially been told it would be reversed after four, but I didn’t want to have the surgery too soon. Life for me was good. I was scared for it to change. The reversal was the biggest mistake I’ve made. I went into the operation feeling nervous but ready, having been told things would be ‘normal’ again. But my life is far from normal. I may have a bagless stomach now, but the pain is there, and I am now mainly housebound because I need to use the toilet so often. It is isolating and lonely and I look back and wonder why I even went forward with the surgery — like I was to know. This, accompanied by my mental health issues, has been difficult to live with. It’s a vicious cycle and I feel they play off on one another. If it’s not one it’s the other — I can feel like I’m in remission with my chronic illness, but suddenly my mental illness will come into play; and vice versa. My mental health issues can also cause me to flare up. Photo by Anthony Tran on Unsplash Stress has a huge effect on the gut, and when I am dealing with a manic or depressive episode, I will experience huge side effects gut-wise. It can lead me to being in the hospital, due to the amount of fluid I lose and the amount I bleed. This, in turn, causes greater mental health issues, because going through this for an extended period of time leads me to feel even lower, more anxious and more stressed. It’s a never-ending battle and you never know which is going to win: mental illness or chronic illness. Living with a chronic illness can be debilitating, both physically and mentally. But so can mental illness. Sometimes I think they’re one and the same, just in different areas of the body. I wish people understood how badly chronic illness can affect your mental health. But I also wish people realise what a drastic effect mental illness can have on your physical health. Neither are things to minimise, they can both push you to the point where you simply do not want to be here any more. These are feelings I have experienced. I recently wrote about suicidal ideation in my last column for Inspire the Mind. I have experienced this when I have been flaring with my chronic illness. That’s how much it can hurt. If you have someone in your life with either a chronic or a mental illness, please try to be understanding and supportive. It can be a really lonely and isolating place mentally, and negative comments — such as “you’re just being lazy”, or, “you’re being selfish”, when we have to cancel plans due to pain or mental health issues — that place blame on ourselves do not help. Check in with your chronic illness friends, reach out to those who are struggling with mental illness. A simple text to say ‘I hope you’re feeling okay’, goes a really long way.

I was diagnosed with postnatal depression six months after having a baby. It took this long because I didn’t open up about it until this point; during a chance phone call with my health visitor when everything came spilling out all at once. I had been suffering in silence for every month before that point, feeling low, like a failure of a mother, and scared that if I told anyone, my baby would be taken away from me. A year on from giving birth, and six months on from first opening up about my PND, everything has changed for me. I still struggle, but a lot less. I have moved house, I have been getting help, and I have support around me. I’m very lucky to not be in that dark place that I was back then. But, back then, I didn’t think any of this was possible. I thought that emptiness, that hollow shell of a person that I was, was a forever-thing. But it wasn’t. And it doesn’t have to be for you, either. Here, for InSpire the Mind, I thought I’d write about PND and about how you can seek help and do things to change the scenery. I’m not saying these steps are going to cure you; but they can be important steps of recovery, things that I myself am still practicing today. So here goes. Admit what you’re going through This is the first but possibly the hardest step to take when you’re living with postnatal depression. Admitting what you’re going through. It can be incredibly scary and for many reasons — one that’s not unheard of (in fact, I’ve seen it said loads on my support groups), is because you think that postnatal depression means that your baby will be taken away from you. This is almost completely never the case. Admitting what you’re going through can be hard, but it is the first step to recovery, the first step to releasing what you’ve been holding in for so long. Make sure that you sit down with someone that you trust, who can hold your hand and be a shoulder to cry on. Make sure that you’re in a safe environment. If it helps, maybe even write a letter to yourself or someone else — to explain everything you’re feeling. It can help you with clarity and with putting all of your words together. Photo by Omar Lopez on Unsplash Make sure your health visitor is aware This is the next scary step. Telling your health visitor. Health visitors are trained to pick up on illnesses such as postnatal depression so it may be that what you tell them doesn’t come as such a surprise. If you don’t feel comfortable telling your health visitor on your own, have someone you trust to do it with you, who can help you express what you need to get across for the right help. Find something to help you to release your emotions For me, I use writing as a way to channel my emotions. I find it therapeutic and when I’m not doing it for work, I’m doing it for pleasure. Find something that makes you feel the same — whether that’s a walk or journaling or baking or pottery. Find something that encourages you to take a breather from being a mum, something else to fall in love with that is just for you. It can give you some normality back. Join a support group Whether this is in-person or online, support groups can be very beneficial for your mental health. Not just because you’re going somewhere that gets what you’re going through, but because you’ll meet lots of other mothers going through a similar thing. Making mum friends can be hard when you have PND, because often you just want to stay in the house. But meeting like-minded people can do wonders for your mental health — especially if they’re outside the house, as it gives you an opportunity for sunlight and fresh air. Photo by Kelly Sikkema on Unsplash Take each day step by step Don’t go in headfirst to try to ‘cure’ yourself. Recovery isn’t linear and that’s okay. If you don’t feel up to doing something one day, don’t push yourself too much — there’s always tomorrow. What you don’t want to do is fall into the guilt trap when you have nothing to feel guilty for. We do enough of that to ourselves already. So take things day by day and challenge yourself when you feel up to it. You could set yourself small daily tasks which will make things seem easier and more bearable — for instance, get up and change the bedsheets. Have a shower. Put a little bit of makeup on. Brush your hair. Go for a walk with your baby. Meet up with a friend. Have a phone call with a friend. The options are endless and there’s no rush to do them all at once — or at all on your bad days. Be kind to yourself Remember that you are a new mum. You are vulnerable enough as it is without the added illness of postnatal depression. And you’re doing a great job. Don’t fall into the trap of the mum guilt if you don’t do something you had planned to do — or if one day, all you want to do is watch movies under the covers with your baby. Be kind to yourself and remember that you are doing what you can for your baby and for yourself — and that is something that should be commended. Go with what your health professionals tell you — but stick to your gut After being diagnosed with postnatal depression, the medication I was already on for bipolar disorder changed, and more was added to the list. This was a conscious choice and one that I spoke through with both my perinatal psychiatrist (who I had been admitted to at the start of my pregnancy due to having bipolar), and my health visitor. I’m still awaiting any form of therapy or other treatment. But it’s something I’d like to do. But if medication isn’t for you, then keep talking with your doctor until you agree a plan of action you are happy with. Listen to the information provided, but do your research, and if something doesn’t feel right, remember that you are not being forced into doing anything. Ask about your options, talk them through, and let your health professionals guide you — but absolutely do not let them tell you. And do not ignore them either. Keep talking to them. Remember that postnatal depression does not make you a bad mother Postnatal depression doesn’t ever, and will never, make you a bad mother. We seem to forget that postnatal depression is an illness, and one that can be treated, and one that can be recovered from — just like a physical illness. We wouldn’t tell ourselves that a broken leg makes us bad mums, would we? So show yourself that same kindness and recovery time when it comes to postnatal depression. Remember that you are loved and that you deserve support as much as the next person. Make sure you’re open with your feelings, that you have someone you are able to talk to, and that you continuously check in with your health visitor. Nobody thinks you’re a bad mum. You’re a mum who’s struggling, and who needs support. Recognising that makes you a great one. If you need to talk privately and confidentially and don’t feel ready yet to talk to your GP or your health visitor, Samaritans are available 24/7 for free, on 116 123. Don’t suffer in silence.

“It doesn’t matter, we all know what we’re getting at”, I see strangers say online as they discuss the difference between mental health and mental ill health, and the way we speak about it on social media. I see people say that discussing mental health terms correctly isn’t an issue, because it’s all one and the same — but it’s not. Language around mental illness matters. It matters because mental health and mental ill health are not the same thing. We all have mental health, good and bad. We all experience different thoughts and feelings and emotions. But it’s different for people who are mentally ill. Who experience intrusive thoughts and anxiety and panic attacks and intense emotions and dissociation. Who experience dark thoughts and suicidal ideation and low mood. Who experience elated mood and mania and psychosis. It is different for people with mental illness. Photo by Yuris Alhumaydy on Unsplash Language around mental illness matters because it’s about respect and understanding. It’s 2021, but still we are not properly educated on mental ill health, and I think that is partly down to the way we talk about it. We need to individualise conditions because they are all different and all affect people who are mentally ill uniquely. I have bipolar disorder, obsessive compulsive disorder, postnatal depression, and borderline personality disorder. That’s a lot of labels and not ones that I define myself by — because for me (and this doesn’t go for anyone else who experiences it differently), my mental illnesses are a part of what makes me me — they are not all that I have to offer. But it still pains me when I see awareness days and hashtags (like the most recent one), talking about mental health issues as if they’re all the same thing. What does Mental Health Awareness Week really mean? Does it mean awareness for people with mental health issues, or does it mean awareness around general mental health? It is not clear, and therefore is difficult to want to fully participate when you’re not sure whether something is actually for you. Photo by Kristina Tripkovic on Unsplash Mental health does matter, of course it does — but it’s something we are all aware of. But when it comes to complex mental health conditions, I feel many are too scared to talk about them or even to open up out of fear of misunderstanding or negative responses. But we can’t be fully aware until we’re talking about all conditions. Language around mental health issues matters because mental illness matters. It matters as a separate conversation to mental wellbeing. It destroys lives and affects people not just emotionally or mentally, but physically and financially, too. Mental illness kills. That’s why it’s so important to distinguish it from mental wellness and self-care. The latter is important, but it’s okay to have two separate conversations without lumping it all into one hashtag. It’s a good thing to have two conversations because it educates people and raises awareness of what mental illness is really like. The conversation around mental health and mental illness cannot change until the dialogue opens up beyond self-care and wellness. We can make a start by separating mental health and mental illness, to encourage people to talk about lived experience rather than self-care and wellness. But we as a community can not make all change — change needs to come from the government, because the mental health services need more funding. This is something that we talk about every mental health awareness day, week, or month — people with lived experience discuss how they’ve been continuously let down or left in the dark. These are the experiences that we need to be sharing, to highlight how damaging being left without access to help is. I’m all for self-care and wellness, but I think that for the sake of people living with diagnosed or undiagnosed mental health conditions, the focus needs to be on making real, government-funded change — and conversations around why this matters.