Photo provided by Roar News With misinformation spreading through the rise of fake news and pseudoscience, the public is often left confused about science and research. This makes it even more important for scientists to share their work with the public in an accessible way, so we can learn directly from the source. Now, when I refer to scientists, this should also include future scientists or those studying the sciences. And it starts early. As students, we are constantly writing reports and essays, but I think we should be practising our ability to write for lay audiences just as much. I’m Suvi, a BSc Psychology student at King’s College London, coming to the end of my degree. Terrifying, I must admit. I’m lucky to have been able to edit and write for Inspire the Mind, which gave me the chance to brush up on my communication skills. I only wish I’d known of Roar News earlier in my degree as a student. Here at King’s College London (KCL), we have our own student-run newspaper called ‘Roar News’. Founded in 1973 and formerly known as Casey L, the newspaper offers students the opportunity to write about news, culture, science, sports, and commentary. To gain better insight into the publication, I interviewed former Roar News Science and Research writer and editor, Jana Bazeed. As part of the ITM × Roar collaboration, Roar News also published an interview with Inspire the Mind's co-founder, Melisa Kose. What is Roar News? It’s a student-run newspaper where students can report on any topics relevant to the student body. This entails anything happening on or off campus and essentially, whatever is relevant to students. Importantly, it is entirely led by students, with the editorial team and writers being students only. What Was Your Personal Journey to Joining Roar? It started in high school. I ended up doing a physics and philosophy degree in a roundabout way because I knew I liked to write and read, and loved philosophy and maths. After deciding on the degree, I looked at the extracurricular life of the universities, which has always been very important for me, and since writing is something I have always been passionate about, this drew me to Roar News at King’s. So technically, I’ve been involved in Roar News since my very first day at King’s. Why is Practising Communication Important? Following university, it’s normal to completely jump ship and try something new, like marketing or finance. Communication is a skill that you’re going to always need, whether it’s writing emails, presentations, articles, or grant proposals. To do so, you must learn to present your information in an accessible manner, learning to adapt to whatever audience you’re talking to. This is a skill that needs practice because it doesn’t come immediately for everyone. I mean that certainly wasn’t the case for me. It can be scary to pitch your first idea or write your first article, but there is no better way to get started than to just start. It’s not going to get you on a list for a Pulitzer, but it is a start. Why Should Students Write? A lot of Science, Technology, Economics, and Mathematics (STEM) students have this false idea that “Oh, I do STEM, so I don’t write” - when this is not the case. Writing is a good practice for students to learn how to communicate their work to a general audience because, frankly, in some cases, your science is only as good as how you communicate it. Doing so at university provides you with the opportunity to develop your skills in a low-pressure environment. This meant I was given plenty of flexibility and freedom in covering whatever topics I wanted to. Additionally, writing gave me many opportunities to network and attend events for free, so it’s a lot of fun. You’ll have to write at some point in your career, so why not in an accessible, supportive, and low-pressure environment? Being a writer and editor at Roar gave me an excuse to go and talk to the staff. I’d call them up for an interview, and you’d be surprised how many scientists got back to me. If you ever feel nervous about approaching scientists for an interview or a quote, I will say that scientists truly do love talking about their work. For many, their research is their life’s work, and they are often very eager to share their work. The hard part can be trying to translate this for a general audience, but that’s where editors come in. Photo by freepik Why is Science Communication Important? Considering all the exciting research at King’s, you’ll often see that the science departments aren’t exactly well-connected to the wider student body. People simply aren’t talking about the research, either because they don’t really understand it or frankly weren’t informed about it happening. This created a need for us at Roar to communicate the research happening at King’s in an accessible and digestible manner. We want our peers to hear about what their departments are doing, and make sure these stories aren’t going unreported. Even if the research doesn’t seem of interest to us now, it will be relevant to us in the future. Aside from students, we want the public to be informed about what is happening in the world of science, especially since a lot of research is publicly funded. For example, during the pandemic, many people were scared because they were being fed all this misinformation and couldn’t understand what was going on. This time highlighted the importance of making science and research more accessible and understandable for the public. Ideally, this would help reduce the apprehension around trusting scientists and science. What Are The Popular Topics Students Like to Write About? Since I’m a physicist, my background is very much rooted in physics. But like many other students, we’re also writing on healthcare, biology and AI. AI is an especially popular topic; I mean, it’s everywhere, even Vogue. It’s all anyone is talking about. With AI, it’s difficult because there are many upsides and downsides, but it’s not something we fully understand yet. This causes a lot of fearmongering, which makes it appealing to write about. It’s very relevant to us as students because you can see that it’s completely changing our education experience, and for many students, this is like three or four years of our lives. How Can Academic Institutions Make Research More Accessible to Students? I don’t blame students for not reaching out first, because it isn't always obvious that this is something we should be doing. So, while we want to encourage students to start, universities should help support this. This can look like hosting more workshops in collaboration with student magazines or societies to encourage students to write. It could also involve creating more opportunities for students to learn about the research going on within their departments. ___ Speaking to Jana was a great opportunity to reflect on why science communication and writing are so important to practice. It may seem like something that isn’t meant for us as students or researchers, but getting into science communication matters because it’s the bridge between complex research and the people affected by it. We want science to feel less like an exclusive club and more like a shared field, open to anyone willing to learn.

Many people are scared to speak up about their mental illness. Perhaps it’s because they haven’t processed the fact that they have a mental health issue — but often it’s because they’re scared of the reaction. I remember years ago, when I was first diagnosed with bipolar disorder, experiencing worries about telling people that I had been diagnosed. I was worried that I wouldn’t be believed, and I was worried that people would just tell me to “get over it”. I was also worried that if people didn’t believe me, it meant I was overreacting. That I wasn’t really mentally ill. That I must just be attention-seeking. I eventually did start speaking out a few months after my diagnosis. First, I told my close family and friends. Some were supportive, some didn’t understand, and some gave me mundane advice about going for walks, without recognising that bipolar disorder is a complex mood disorder that requires more than fresh air. Thanks to the support I did receive, I started to feel brave enough to write about my mental illness, firstly on Metro.co.uk as that’s where I was working at the time; and secondly on social media. Photo by Sasha Freemind on Unsplash As I spoke out more and more, more people came to me to talk about their own diagnoses, and how it had been affecting them. They told me I was ‘brave’ to be speaking out, because they didn’t feel they were able to do so. I tried to tell these people that it was okay to talk about mental illness. That it was okay to have a mental illness. That they didn’t need the validation of others to recognise that they have a mental health issue. And this is true — you don’t need the validation of others. No matter how scary it seems to talk about what’s going on, the validation of others doesn’t make a difference to your diagnosis. And the same goes for those who are yet to be diagnosed (which is a common issue today, especially with the pandemic having delayed waiting lists for mental health services even more so). No matter how hard it seems when people don’t understand, it doesn’t take away from how you’re feeling. Nobody can tell you how you should feel, or what you should be feeling. The truth is, that there will always be people who don’t understand. There will always be people who suggest going for a walk, or eating differently, or drinking more water. There will always be people who tell you that there are others worse off. And this is sad. But please don’t let it make you feel like your mental illness — diagnosis or no diagnosis — doesn’t matter. Please don’t think it’s a reflection on you, or how you should feel about yourself or what you’ve experienced. Photo by Zack Minor on Unsplash It’s always helpful to be believed because it means receiving support that is actually helpful. But the validation of others doesn’t change what you’re going through. It can make it easier to talk about what you’re going through, for sure — but don’t let the validation of others be a determining factor to seeking help. And maybe it’s time to look at whether you really want people who don’t even want to learn or understand are worthy of a place in your life. Whether they’re helpful. Whether they make you feel better or worse. I’m not saying cut the people you love off completely, but perhaps you should look at whether these are the right people to be talking to — especially if they’re going to invalidate your struggles. It’s okay not to speak out about what you’re going through; there’s absolutely no pressure. But I want you to know that there is a whole community of support out there. People who understand what you’re going through. People who are going through it themselves. You can find these people through support groups both in-person and online (for instance, there is a ton of support out there on Facebook groups — for certain illnesses and for mental health as a whole). And there’s a huge community of people with mental illness, speaking out about mental illness, or being allies to those with mental illness, on Twitter. Photo by Corinne Kutz on Unsplash If you don’t know where to turn (besides your GP, or mental health professional), these communities can be super helpful in making you feel more accepted, and in knowing it’s okay — both to live with a mental illness and to talk about mental health issues. Opening up can be very scary, and know that it takes a great strength. But when you have a community around you that understands, it becomes easier. So seek that out rather than frustrating yourself educating those who don’t want to be educated. When you’ve just been diagnosed with a mental illness — or even if you’ve been diagnosed for a long time, or aren’t diagnosed at all but know that you do have a mental illness — the number one thing you need is support. And communities who understand can give you that daily. Please, please remember that people who don’t understand, simply aren’t educated enough on the subject. Please don’t let it define you. Please don’t let it make you think that because somebody doesn’t believe you, or won’t listen, that your experiences are valid. With or without the validation of others, your feelings and experiences and illnesses are valid. You are valid. And you are worthy of love, respect, and understanding. Maybe it’s time to focus on the people who give you that — and not on the people who don’t.

I’m tired of people telling me to get therapy. There, I said it. This might sound odd. Surely, people are trying to help, right? They’re trying to be thoughtful. They’re noticing that something’s up and that you need support (as long as it isn’t said in a spiteful way, of course). But it’s not that simple. Because therapy isn’t accessible to everyone. Unfortunately, especially during the time of Covid-19, therapy is harder than ever to get. I’ve been on a waiting list for psychiatric help, after transitioning from my perinatal mental health team, for months now. And still, nothing, despite being considered an ‘urgent’ case. And I’m not alone. There are thousands of people waiting for therapeutic help right now. But they cannot access it, often because, like me, they cannot afford it. Instead, we find our way onto a waiting list that can seem never-ending (or quite literally, is never-ending), or we turn to the likes of Samaritans for anonymous help over the phone. This might seem like I’m putting a downer on people who are trying to help, but I promise you I’m not — I’m just trying to shed a different light on it. Photo by Priscilla Du Preez on Unsplash Private therapy is often a matter of class. And telling people to go and get private therapy, when they are struggling and looking for help, can be classist. Not everyone has access to private therapy, because not everyone can afford to pay for it, without being late on their rent (or having to use up their overdraft in hopes of getting the right help). For instance, I used my own overdraft to pay for some private cognitive behavioural therapy when I was at risk of being hospitalised in a mother and baby unit. Despite using my overdraft and having to cancel just a few sessions due to no longer being able to pay for it, this was a privilege. And I accept that. But in some ways it wasn’t a privilege — it added great stress onto my family, because the £70-per-hour sessions that I needed every week added up, and having a new baby meant finances were tighter than ever, and so this stress only added on to the mental health issues I was already experiencing (which, for reference, was maternal obsessive-compulsive disorder). There is a lot of evidence that says that there is a strong socioeconomic gradient in mental health, with people of lower socioeconomic status having a ‘higher likelihood of developing and experiencing mental health problems’, according to the Mental Health Foundation. Photo by Dustin Belt on Unsplash Studies show that children and adults living in households in the lowest 20% income bracket in Great Britain are two to three times more likely to develop mental health problems than those in the highest. Employment status is also linked to mental health outcomes, with the WHO citing that those who are unemployed or economically inactive have higher rates of common mental health problems than those who are employed. And people can be unemployed for a number of reasons (FYI, they’re not lazy). There are people who are chronically unwell, physically, and mentally, who cannot work. People who are unwell who, despite being unwell, cannot even get government support. So, you tell me how they are supposed to pay for therapy, instead of joining the thousands on the NHS waiting lists? I’ve seen many people from a higher class talking about therapy, which is great. But then they recommend it to people from a lower class (like myself), like we don’t know that therapy is a thing. We do. It’s just not accessible to us. We need to recognise that mental illness is a class issue. I’m not saying people who are wealthier don’t have mental health issues — what I am saying is that they have more privilege. They have the means to get private therapy and help sooner, while the rest of us rely on GPs telling us the waiting lists are too long, midnight phone calls to the Samaritans (been there multiple times), turning up at A&E because you don’t know where else to turn when you’re in crisis, and suffering in silence. And so, yes, I’m tired of people telling me — telling us — to go and get therapy. It’s not simple. It’s not easy. It’s complex and inaccessible and soul-destroying when you desperately need help when you can’t get it. I’m happy for anyone who can get frequent private therapy, who experiences the benefits, who doesn’t have to go to their GP and repeatedly ask for support. But what I’m saying is, please don’t make out like this is something that everyone can do, because it is hurtful and invalidating. Support others, of course. But try to do it mindfully, and appreciate that not everybody is as lucky as you.

Trigger warning: The following column contains discussions on self-harm, which some readers may find distressing. I self-harmed for years. It started with my hips. I would wait until everyone in the house was asleep, to take out the tools I would use to harm myself. I was fifteen and I had an eating disorder. Bulimia. I was so poorly that my lung ended up collapsing as vomit got stuck in my chest cavity. I was so mentally unwell that the only way I felt like I could take control over my life — because bulimia made it feel like it was spiralling — was to self-harm. Even after my recovery, I continued to harm myself. When I was 20, it all made sense. I was diagnosed with borderline personality disorder, a disorder where lots of people with the diagnosis use self-harm as a coping mechanism. I’ve always felt things deeply. Things that hurt me really hurt. And when I love, I really love. My emotions can be hard to control when things are really difficult. I’ve used self-harm as a way of coping. It’s not that I wanted to hurt myself — more that the feeling of doing it when I was in the middle of a bad episode was a way to calm me down due to the dissociation associated with it. Photo by Naomi August on Unsplash I no longer self-harm. I channel my urges differently. I use mental health medication as a way of coping, and if I feel an urge, I try to distract myself. It isn’t always easy, but I’ve come a long way and have learned how to better cope when things are hard. That doesn’t mean I’m fully recovered or that I’ve mastered mental illness. Of course not. Sometimes, things are truly, honestly, awful. But I’ve found there are things that help me to vent in other ways — such as writing, and cuddling my baby. To be honest, the main reason I don’t self-harm anymore is because of him. I don’t ever want him to see mummy hurting. I’m discussing self-harm in this column because it’s being talked about on social media a lot right now, because it’s summer. And, because it’s a truly important subject. People are out in short tops and dresses and shorts, and therefore, people who have scars might not be hiding them anymore. And that includes me. I used to hide mine — I’d wear long sleeves even in blazing heat just to protect myself from questions. I’ve long felt ashamed of my scars and embarrassed. Going out in short sleeves was a no-go for me, because I didn’t want to have to explain my history — especially not to people I didn’t know very well. Photo by Willian Justen de Vasconcellos on Unsplash This is the conversation being had on Twitter right now. Mental health advocates are rightly urging people to stop and think before asking sensitive and inappropriate questions in regards to scars — whether that be from self-harm or otherwise. And rightly so. Asking someone about their scars, especially when it is obvious what they are from, is rude, insensitive and ignorant. While many might not see that way, I do. And this is because, by doing this, you are asking about someone’s personal life. Scars are personal. And it should be up to the person who has them to decide when they are ready to talk about it — and if they are ever ready (which is completely valid if not). Talking about the history of your scars can be painful. And when you’re feeling empowered enough to ditch the long sleeves, the last thing you want is to wish you hadn’t. People might stare. And if they do, that’s on them. The bottom line is that we know our scars are there — and staring at them won’t make them go away. When you ask someone about their scars, you are asking someone to open up and to be vulnerable with you, at a time when they might not want to do that — and at times that are often inappropriate. This is not okay. It can lead you right back to those feelings of shame that you’ve worked so hard to not let hold you back anymore. And so, I’m asking everyone who reads this, to not comment on people’s scars this summer — or ever. You have no idea the strength it can take a person to ditch the long sleeves and trousers and to wear something that they have *really* wanted to wear for ages, but hadn’t because they were ashamed of their scars. If you feel the urge to ask someone about their scars, take a step back and think about how you’d like it. Think about how you might make someone feel. Think about the steps it might have taken to have them on display. These three questions are vital. Please let us just enjoy this summer, these moments, and our bodies in the clothes we want to wear. And please, don’t put us in uncomfortable positions for the sake of being nosey.

They say that everything you ever wanted to know about yourself, you can learn in 42km. This may sound dramatic, however, as it turns out the road really is a brutal teacher, as well as a mirror. For most of my life, I would have rolled my eyes at this. If someone had told little me that I would go on to cross three marathon finish lines before the age of thirty-two, I would never have believed them, probably laughed, and definitely presumed they were talking about someone the polar opposite. I can also honestly say that even three medals later, the disbelief hasn’t really left. But I’m not here to sell running. I know it isn't for everyone, and it’s definitely not the only way to support your mental health. If movement does help, then any exercise, distance, or speed is exactly where you need to be. Any step forward is a step in the right direction, and whether it’s a marathon or a mile, the mirror still works the same way. I’m writing this because both running and mental health are things I feel passionate about. I work in the creative industries, which can often be demanding but rewarding and I’ve always had an interest in telling stories. I’m writing this now because writing and getting outside to run have been hugely beneficial to my own mental health. Additionally, there is currently a lot of noise around running, and with more people pushing themselves through gruelling long-distance challenges, I want to understand the psychology behind what happens between the start and finish line. The First Hour: The Noise It’s difficult to summarise the feeling when the gun goes off and you cross the start line. Those first few miles are rarely about the legs; they’re about the mind. Even if your pace feels unnaturally slow, and you feel physically strong, it is mentally impossible to switch off knowing you have such a long road ahead. Overthinking naturally occurs; is every ache an injury, was that second coffee a bad idea, what if you actually can’t do this? This is often the ‘high anxiety’ point - your brain is essentially running a diagnostic check to protect you from the effort it knows is ahead. Most runners struggle here as the brain tries to calculate if it has enough energy for the next four hours, which creates a lot of mental noise. For me, these early miles are about drowning out that noise. I have to consciously let go of any expectations I had for the day, try to trust the training and appreciate my surroundings. It’s a lesson in staying present and taking things one step at a time. As someone who struggles with uncertainty, this is an important lesson to reflect on. Image Source: Author's own image The Second Hour: Identity We spend much of our lives presenting an outward version of ourselves. Day to day, if we don’t like the reflection in the mirror, we can choose not to look. But the marathon is a different type of mirror you cannot avoid - an internal one. The outside world disappears until you are left with only your thoughts, and the people around you who are also lost in theirs. This leaves you with the rawest version of yourself. You are doing something that less than 1% of the population will do, that you’ve trained relentlessly for, and now it’s just you and the (long) road ahead. I recently asked a close friend what her own journey taught her, and her answer hit home: "I found a lot of respect for a body I haven't always loved." In a society that teaches us, especially women, to view our bodies as constant works in progress to be edited in often unachievable ways, the marathon mindset offers a new perspective: look at what our bodies can do. Seeing Rob Burrow and Kevin Sinfield at the inaugural Leeds Marathon also reminded me of the bigger picture; that our identities aren't only defined by our individual struggles, but by also going that "extra mile" for someone else. For those unfamiliar with their story, after professional Rugby League player Rob Burrow was diagnosed with Motor Neurone Disease, his teammate Kevin Sinfield completed a series of gruelling endurance feats to raise millions for the cause, gaining national attention and an army of support in the process. If we are all capable of being kind and supportive to others, we should also be able to be kind to ourselves, however tough that can sometimes be. Image Source: Author's own image The Third Hour: Choice Passing the halfway mark is a strange milestone. Mile 13 often brings a collective sigh of relief or mutual nods of approval between runners - a collaborative ‘hey, we’re halfway; maybe we can actually do this’. It’s a brief moment where you have a small boost of self-belief, but it’s also where you know it’s probably only going to get tougher from now on. There’s a specific choice we make in these middle miles; to keep going, despite the fear of what’s to come, or to give in to pain and anxiety and let it control what happens next. We spend our daily lives trying to control so much, but you can’t control how your body or mind is going to respond to pushing it further than it’s ever been. Having this control literally stripped away teaches that sometimes things are unpredictable and may have to get worse before they get better, and to trust the process (and yourself). The Final Hour: Truth At 35km in my third marathon, I hit a wall so big it felt like I physically was not moving. With mental and physical energy depleted, this is the point where most people are forced into ‘digging deep’, or hit the dreaded ‘wall’. I’ve found my thoughts cycling from feeling lucky to have even made start lines to other difficult things I’ve overcome, and focusing on getting to each next landmark for a different person I am grateful for. The main thing I kept mentally repeating was to just take one more step (over and over again). I’d come too far to give up. A lot of emotions come out here; you learn your ‘why’, and exactly what you say to yourself when things get tough. You also realise that if you truly put your mind to something, you can actually do it. I recently listened to a podcast where someone mentioned there is "always a bit of blue sky", which, although it sounds cliché, I think is a great reminder that even the toughest moments are temporary. The Hours After The End: Transformation The finish line is more than physical relief; it is a mental one too. But if I’m being honest, the moment you cross it isn’t always the intense high that people expect. The immediate feeling is often a quiet, numb and exhausted sort of shock. Psychologically, this makes sense; your brain is essentially resetting after being in survival mode for hours, and does not know how to process that it is finally over. Of course, the marathon doesn’t end at the finish line. It can take a long time to fully process and appreciate the achievement. On reflection, once you have seen what you are capable of when every fibre of you is screaming at you to stop, you can’t ‘unsee’ it. You learn that the person who crossed the line is not the same person who started. The "pinch-me" disbelief eventually turns into a different way of looking at ourselves. It’s less about a burst of pride and more about the evidence; you’ve met a side of yourself that a younger you assumed belonged to someone else, and that a future you can hopefully reflect back on and realise that if this was possible, then any previous rules, about what you can and cannot do, no longer apply. Image Source: Author's own image

A Bidirectional Relationship Image Source: Designed by Freepik Are Our Bodies and Our Minds Truly Separate or Are They Deeply Intertwined? This question has been debated for centuries. Thanks to scientific advancements, research increasingly shows that our mental and physical health are intertwined, influencing each other in complex and often surprising ways. One such example is the relationship between chronic illnesses and mental health disorders, where conditions like metabolic disease and depression can shape and reinforce one another over time. This connection becomes particularly evident when examining specific conditions in which mental and physical health interact in measurable and impactful ways. As an MSc student in the Psychology and Neuroscience of Mind-Body Interface program, I am interested in the intersection between mental and physical health. To explore this connection in-depth, I also spoke with a young woman who experiences both depression and type 1 diabetes. Her story reveals just how intertwined these conditions can be, as well as how difficult they can be to navigate simultaneously. Diabetes Mellitus and Major Depressive Disorder Image Source: brgfx on Freepik One condition that clearly illustrates the connection between physical and mental health is diabetes mellitus. Diabetes is a metabolic disorder of the pancreas that affects how the body regulates blood glucose levels. In type 1 diabetes, the immune system mistakenly attacks insulin-producing cells, resulting in little to no insulin production and high blood glucose. In contrast, type 2 diabetes develops when the body either does not produce enough insulin or uses insulin ineffectively. Although diabetes is medically defined as a physical condition, there is a common misconception that its effects are limited to our physical state alone. In reality, managing diabetes can place a significant psychological burden on individuals. The daily demands of monitoring blood sugar, adhering to treatment plans, and managing potential complications, can contribute to stress, anxiety, and depressive symptoms. While physical illness can have a detrimental impact on mental well-being, psychiatric disorders, like Major Depressive Disorder, can also affect the management of physical comorbidities like diabetes. Depression is characterised by persistent feelings of sadness, low energy, fatigue, and a loss of interest in daily activities, which can interfere with an individual’s ability to maintain consistent self-care behaviours in the context of diabetes, such as medication adherence (taking them regularly), diet, and exercise. In fact, a meta-analytic study found that depression was significantly associated with diabetes treatment nonadherence. Together, these conditions highlight a bidirectional relationship, where physical illness can contribute to psychological distress, and mental health challenges can, in turn, worsen physical health outcomes. Why is it Important: Diabetes is one of the most common chronic illnesses worldwide, affecting approximately 11% of the global population. Understanding how diabetes and mental health conditions like depression are connected is important not just for doctors and researchers, but for the people living with these conditions. When we recognise that physical health and mental health are closely linked, it becomes easier to support an individual as a whole rather than focusing on just one aspect of their health. A Path to a Diagnosis for Type 1 Diabetes As mentioned at the beginning, for this piece I I spoke with a young woman who experiences both depression and type 1 diabetes. For anonymity, we will refer to her by the pseudonym Claire. Receiving a diabetes diagnosis can be a long and frustrating process. Claire explains, “I was experiencing all these symptoms, but I had no idea what was behind it, and despite communicating them clearly, it took me four doctors to get diagnosed.” Common symptoms of diabetes include excessive thirst, unexplained weight loss, and persistent fatigue. However, some of these, particularly chronic fatigue, are also closely associated with depression. Because Claire had previously been diagnosed with depression, doctors initially attributed her physical symptoms to her mental health. She shared, “the doctor directed the blame onto my psychiatric medication and said I should see a psychiatrist soon.” Unfortunately, this is not an isolated experience. When symptoms overlap across conditions, it can become difficult for healthcare providers to distinguish between physical and psychological causes, sometimes leading to delayed or missed diagnoses. These healthcare challenges extend beyond diagnosis and into treatment. People with diabetes are two to three times more likely to experience depression than those without the condition. Only a portion of individuals with comorbid diabetes and depression are formally diagnosed and receive treatment. If left untreated, suffering from these two conditions could lead to poorer health outcomes. Claire’s Day-to-Day Living with Comorbid Depression and Diabetes Stress and emotional states can have an impact on blood sugar levels, and chronic illness can make you feel like you have decreased energy levels. Claire expressed that her “physical and mental capacity has reduced. What used to be my 70% is now my 100%,” which can make it harder to maintain a schedule. Insulin injections are one of the most common ways diabetic patients receive insulin. For many like Claire, insulin injections need to be administered “4-6 times in a day.” Managing diabetes can be emotionally and physically demanding and depression can make it harder to maintain the routines required for effective diabetes care. “On particularly rough [mental health] days, I find myself to be less regular with taking my insulin shots and less mindful of the impact my food choices will have on my glucose levels”, Claire shares. Her experience helps illustrate the cyclic nature of living with these conditions. Ways to Manage Both Depression and Diabetes: Image Source: jemastock on Freepik Given this interplay, researchers and healthcare professionals are increasingly advocating for integrated treatment approaches. Claire has found a support system with both her endocrinologist and psychiatrist. Evidence shows that implementing both mental health care and diabetes care can improve mental and physical health. Having a holistic support system can simultaneously address both biological and psychological aspects of an illness. Lifestyle factors also play a crucial role. Maintaining a regular sleep schedule, engaging in physical activity, and following a balanced diet are commonly recommended strategies for managing both diabetes and depression. While these changes can be challenging to implement, they offer a valuable foundation for improving overall well-being. As research in the mind–body connection continues to evolve, it is becoming increasingly clear that effective healthcare must take a holistic approach. Recognising the links between conditions like diabetes and depression is not just a matter of scientific interest, it is essential for improving diagnosis, treatment, and quality of life for millions of individuals worldwide like Claire.

Photo by Etienne Girardet on Unsplash Back in 2023, we published a scientific article , along with a blog version, showing that the body’s immune response is linked to adolescent depression, and that these biological signals look different in boys and girls. We ended by asking whether bringing together what we know about adolescents’ backgrounds and their biology could help us identify who is at risk of developing depression. And here we are today, trying to answer that very question. If you find yourself wondering why it took us two years to get here, well, that’s because things in research take time (something I’m sure my fellow researchers can relate to). But patience does pay off, and I hope I can invite you, my dear reader, to be curious as to why. Let’s dive into the story. The Question We Couldn’t Yet Answer The article I mentioned was part of the IDEA project, which stands for Identifying Depression Early in Adolescence , and is supported by MQ Mental Health . The main aim of the project was to understand which adolescents are at increased risk of developing depression, with a particular focus on low- and middle-income countries (LMICs). I am a postdoctoral researcher at King’s College London, and I was very fortunate to be part of the IDEA project led by Professor Mondelli and Professor Kieling. As part of IDEA, we developed a composite risk score (IDEA-RS) based on 11 sociodemographic factors, such as early life stress, family relationships, and substance use, to help us see if we could predict who would develop depression at an early stage. Over the course of three years, we used this score to recruit and study 100 adolescents (known as the IDEA RiSCo cohort), of whom 50 were scoring very high and 50 scoring very low at the IDEA-RS. Our recent article showed that the IDEA-RS was successful in predicting which adolescents would develop depression within three years of assessment. Photo by Faustina Okeke on Unsplash Looking for the Answers With that in mind, we set out to answer this question: Can we improve this prediction even more by combining sociodemographic risk with neurobiological markers? And if yes, could we create a biological “risk score” that complements the existing one? We wanted to add neurobiological markers such as increased inflammation or changes in the activity of certain brain areas like the amygdala - a key threat-processing region - to our prediction score because we know from existing research that some biological changes are linked to depression. We also know that the kynurenine pathway is linked to depression. This is the process by which the body breaks down tryptophan (important in mood and sleep regulation) into chemicals such as kynurenic acid and quinolinic acid, which can either protect (kynurenic acid) or harm (quinolinic acid) the brain. Last year, we published an article (and a blog ) using the same IDEA RiSCo cohort to show that an imbalance in this pathway was already present in adolescents at risk for, or experiencing, depression, particularly in girls. Taking all that into account, in this study we set out to look at inflammation in the body – a part of the immune system’s natural response to stress, illness, or injury. We measured this using blood proteins called cytokines, which act as messengers in the immune system. Some cytokines, including interleukin (IL)-2, IL-6, IL-12p70, and tumour necrosis factor (TNF)-α, have been linked to depression in previous studies, particularly when their levels are persistently elevated. Next, we looked at brain function using a type of brain scan called functional MRI (fMRI). This allows us to see how active different parts of the brain are while someone is performing a task. We focused on a small brain region called the amygdala, which plays an important role in detecting and responding to emotional signals, especially fear and threat. We measured how strongly the amygdala reacted when adolescents viewed faces showing fear, sadness, or anger. Finally, we examined a biological process known as the kynurenine pathway. As before, we looked again at the kyneurine pathway - this time, at the balance between the protective kynurenic acid and the harmful quinolinic acid. The ratio between them (known as the KA/QA ratio) gives an indication of whether the system is more tilted toward protection or vulnerability. A lower ratio may suggest reduced neuroprotection. After all of these baseline assessments, we followed adolescents for three years to see if any of them developed depression.   What Did We Find? On its own, the IDEA-RS could discriminate who would later develop depression with moderate accuracy. That was helpful, but was it better when we added neurobiological markers? The short answer is yes. When we started adding biological information, step by step, prediction kept improving. The most important result came when we combined everything together: the sociodemographic risk score (IDEA-RS) plus all eight biological measures (the four cytokines, the KA/QA ratio, and the three amygdala reactivity measures). That combined model was able to discriminate adolescents who would develop depression with substantial accuracy - we shifted from moderate to excellent prediction. In other words, biology meaningfully sharpened the picture. Photo by Noble Mitchell on Unsplash A Biological Risk Score: Making it Rractical Statistics are useful, but if the long-term goal is a tool that can inform prevention, we also need something that is simple to apply and easy to replicate. So, we developed a biological risk score, called the IDEA-BIO-RS. We combined all the biological markers into one overall biological risk score, allowing us to group adolescents as biologically lower or higher risk for developing depression. Even with biology alone, the difference was striking: in the biological high-risk group, 36% developed depression over three years, while in the biological low-risk group only 3% did. But the most clinically meaningful results emerged when we combined biological and sociodemographic risk. When Two Kinds of Risk Agree, Risk Becomes Clearer We grouped adolescents into four categories: low risk on both scores, high risk on both, or high risk on one but not the other. Among adolescents who were low risk on both the sociodemographic score and the biological score, none developed depression during follow-up. At the other extreme, among adolescents who were high risk on both, 44% developed depression within three years. Those who were high on one score but not the other fell in between. This pattern matters because it suggests two things at once. First, the combination can help identify a group where risk is high enough that targeted prevention could be justified. Second, it may also help identify a group where risk is very low, which is equally important if we want screening tools to be more precise and avoid unnecessary anxiety. What This Does and Doesn’t Mean What this study shows is that integrating biology with sociodemographic context improves prediction in a meaningful way, and that a relatively simple biological risk score can complement an existing sociodemographic model. It’s equally important to say what this study is not. It’s not evidence for a single biomarker of depression. Depression is too complex and varied for that. Different people may reach similar symptoms through different pathways. That is precisely why composite scores are so appealing - they take into account the complexity of real life and its multidimensional nature.   Why I Find This Hopeful In mental health, prevention often feels like something we talk about more than something we do. Studies like this are one way to make it more concrete. If we can identify adolescents who are likely to develop depression within a few years – not perfectly, but better than chance and better than sociodemographic risk alone – then we can begin building prevention pathways that are timely, targeted, and fair. And I think that is why it was worthwhile to wait a couple of years. My hope is that, with a little patience, we can see this making real difference in people's lives.

The Science and the Reality of Living With PMDD Image Source: Owl Illustration Agency on Unsplash For some people, the days before a period bring mild irritability or low mood. For others, the emotional shift is so intense it can feel like becoming a different person entirely. Premenstrual Dysphoric Disorder (PMDD) is far more than the occasional premenstrual mood swing. It is a severe, cyclical mood disorder that can disrupt relationships, work, social life, and a person’s sense of self. PMDD was formally recognised as a mental health diagnosis in 2013, yet it remains significantly underdiagnosed and under-recognised. An estimated 3-8% of people assigned female at birth are affected worldwide, representing millions navigating monthly cycles of instability, often without adequate support, validation, or effective treatment. I’m Dr Ellen Lambert, a Clinical Research Fellow at King’s College London specialising in PMDD. You may have read my previous article for Inspire the Mind about my personal experience of premenstrual mood changes. This article brings together scientific evidence with lived experience accounts from an interview with Kim Cormack, Community Outreach Manager at The PMDD Project charity. Image Source: Author's own image of Kim Cormack What is PMDD? PMDD symptoms typically emerge in the one to two weeks before menstruation (the luteal, or premenstrual, phase of the cycle), and ease shortly after bleeding begins. While many people experience some premenstrual changes, PMDD is distinguished by the severity of symptoms and the extent to which they interfere with daily life. The core symptoms required for a diagnosis are emotional and psychological, such as intense irritability or depressed mood. For many, these are accompanied by difficulties with concentration, as well as physical symptoms like bloating or headaches. The average person experiences around 450 menstrual cycles in their lifetime. For someone with PMDD, even a few days of severe symptoms each cycle can add up to years spent in significant psychological distress. Kim’s experience reflects this reality. She describes suffering for “weeks out of every month…with the worst being in the luteal week”. She experiences “anger and irritability, paranoia and deep, overwhelming depression”, where suicidal thoughts became the “norm”. In the past, this led to multiple plans and attempts to end her life. PMDD is not simply “a bad week”. It can disrupt relationships, careers, and a person’s sense of stability and self-trust. As Kim puts it, “Being afraid of your own mind and unable to trust your choices is terrifying”.   When experiences like this go unrecognised or misunderstood, it deepens distress and highlights the urgent need for research that can bridge the gap between lived experience and clinical care. Why Understanding Emotions Matters in PMDD One of the most misunderstood aspects of PMDD is that it is not caused by “abnormal” hormone levels. Instead, it likely reflects a heightened sensitivity to normal hormonal changes, affecting brain systems involved in emotion regulation. In other words, the issue is not the hormones themselves, but how the brain responds to them.   Difficulties managing emotions are seen across many mental health conditions, including depression and anxiety. This led us to ask whether emotion regulation might be central to PMDD, particularly during the luteal phase. This does not mean PMDD is “just psychological”. Rather, it reflects an interaction between biology and psychology: hormonal changes may increase emotional intensity, while regulation processes shape how those emotions are experienced and managed. Kim’s experience brings this into sharp focus. She explains that while other factors, such as “comorbid conditions like CPTSD and ADHD”, may play a role, “the dysphoric element of PMDD is overwhelming on its own”. At her most unwell, Kim describes feeling “hijacked… like there is an intruder in my mind that looks and sounds like me”, convincing her that she is “worthless” and that “nothing will ever change”. In these moments, she feels unable to trust her own thoughts. Yet this state is not constant. “A few hours later, I could be ‘me’ again”, she explains, returning to a self that is “full of love and compassion and positivity”. This contrast highlights the cyclical nature of PMDD and the disruption it can cause to a person’s sense of identity and control. Our Systematic Review: Exploring Emotion Regulation in PMDD To better understand the emotional processes underlying PMDD, a team of researchers and I conducted a systematic review (a structured method to review literature) to look at findings from 22 studies involving over 1,500 participants. We used a simple framework that looks at how people recognise emotions, choose how to respond, and put those responses into action. Several clear patterns emerged. People with PMDD showed stronger emotional reactions, found it harder to understand their emotions, and had fewer effective coping strategies. Even when strategies were known, using them often felt much harder, particularly in the late-luteal phase. You can read our full published findings here . This difficulty resonated with Kim, who explains that although she is usually reflective, “when PMDD is involved, my grasp of reality is entirely warped… my ability to reflect on my emotions and read other people’s is almost impossible”. People with PMDD were also more likely to dwell on negative thoughts (rumination). Kim recalls feeling “convinced that I was just broken… convinced that I was cursed”, highlighting how overwhelming and confusing these experiences can be. Even with support, applying coping strategies can remain difficult. As Kim explains, “even with the coping strategies I have learned in therapy, it is so hard to implement them in a luteal crisis,” where “the hijacker can convince you that even things that have helped before will never help again”. At the same time, appropriate support can make a difference. With specialist therapy, Kim says she has become “more informed and less scared”, although many professionals “have rarely even heard of PMDD”, limiting access to care. Why This Research Matters This research has important practical implications. First, validation: people with PMDD are not “overreacting”. Their experiences are real and grounded in biological sensitivity to hormonal change. As Kim explains, being truly heard by a specialist was “healing” after years of dismissal. It also highlights the need for menstrual phase-sensitive care. Support should take menstrual cycle timing into account, with skills developed during lower-symptom phases and supported during more difficult periods. Expanding coping strategies is equally important. Approaches that target emotional intensity and rumination, such as Dialectical Behaviour Therapy (DBT) and Acceptance and Commitment Therapy (ACT), may be particularly helpful. For Kim, this offers a sense of hope. She explains that if this kind of tailored support were available, she would “do anything to have it”, describing the relief of gaining “skills that are specific to PMDD”. Ongoing Research: Where We’re Headed Building on this, we are launching a new study (SPARK-PMDD) examining psychological and biological changes across the menstrual cycle to better understand what drives emotional shifts and symptom severity. Recruitment begins soon and information can be found on our website . This research is deeply meaningful for people living with PMDD. For Kim, contributing to research is not only about her own experience, but also about future generations, including her young niece. She emphasises that “one informed medical practitioner or therapist… can literally save a life”, and that while such support exists, it remains rare. For many, knowing that research like this is happening brings something essential. As Kim puts it, that word is “hope.” Image Source: Author's own image Acknowledgements: The PMDD Project We are deeply grateful to The PMDD Project, the UK’s first PMDD-specific charity, for funding this research to be published open access. Making the findings freely available ensures that individuals with PMDD, clinicians, and researchers can all access the evidence without barriers.

I have been a journalist since I was 17 years old. I’m nearly 26. So, that’s a long time for someone who’s still young. It started with writing for free for a well-known music magazine, and after blogging about my experience with inflammatory bowel disease through my own platform, I landed a job at Metro.co.uk. Metro.co.uk was my home for five years, I worked with some wonderful editors and met many talented writers who have gone on to do incredible things. I am so lucky that I was given the opportunity and the chance when I had just turned 20. But now — and it’s not a decision I’ve taken lightly — I think it’s time to take a break from journalism to focus on other things. I can’t quite believe I’ve just written that down, because it is scary and new and daunting. But there it is. After writing a tweet a couple of months ago explaining that I had gotten into a lot of debt — some due to a toxic relationship, and some mounted up from then — I was inundated with people’s kindness, many telling me about the jobs they had going and some even offering me work themselves. It was a sigh of relief, and, though the burden was still there, it made me realise how much there is outside of journalism. When I was younger it was different. I craved for every byline, ones that would make me more and more ‘established’, and I squealed when I first got that little blue verified tick on Twitter. But I realise now that it was different because I was different back then. Journalism has always been a dream of mine. Maybe it comes from watching too much The Devil Wears Prada, or maybe it’s just because I really enjoy writing. I didn’t have the opportunity to go to university, and I come from a working-class background, so I guess I’ve just always wanted something more. I wanted to challenge myself and to create dreams for myself that were not handed to me. Photo by Andrew Neel on Unsplash But now that I’ve seen outside of journalism over the past two months, I’ve realised that for right now, it’s no longer for me. And that’s scary to admit because it makes me wonder whether people will think I’ve just given up, or that I couldn’t really have loved it that much. But I do. I love writing. I love writing these columns because I am given no briefs and I am therefore allowed for my words to be authentic. It feels like I am able to write like myself for the first time in a long time. I’m tired of the briefs and the edits and the to-and-from handing back of my words not being good enough. I’m tired of my best pieces of writing being from the perspective of trauma. I’m tired of traumatising myself over and over just for the sake of some money that is not even going to cover one of my bills. I love journalism. And I know I’ll still dabble and maybe even come back to it one day — who knows how soon or how late. But for now, I’ve realised that it wasn’t making me happy. And the opinions of other people can’t reflect the choices I make for myself, otherwise I’d still be stuck doing something that makes me miserable. It’s difficult to freelance write around my son, as it would be working a 9–6 day shift. It’s a constant hustle and you have to be on it all the time, whereas I just couldn’t be. I was finding myself slipping and getting behind on deadlines and filing late, which made me feel embarrassed and ashamed. But there are issues in the industry that need fixing, like basing worth off of clicks instead of off heartfelt journalism — even though I know that’s where the money is. I’d also like to remind editors to take care when asking writers to re-go through their own trauma when writing sensitive articles, and to be more approving of anonymity. Freelance journalists are people. We are human beings, and we deserve a duty of care. Journalism has been a bit like a fever dream in that you never know what’s going to happen next. You can go from no work at all to work in all of your favourite publications; and that’s an amazing feeling and one that I’ll miss. And I’m proud and happy for anyone else who gets to experience this feeling, either as a new or an established journalist. What I will still do is write. I have this column in InSPIre the Mind , of course, and The Breakdown, and that’s not going anywhere. But for me, career-wise, I’m taking a step back from journalism and focusing more on what makes me happy, what I can do around my son, and what is going to cover my rent.

It’s 2021, and finally, people are loving their bodies, exploring being body positive, and sharing that self-love advice with other people. I have to admit, as a plus-sized woman, it makes me feel better. It makes me feel like it’s okay to be totally and authentically me, and I love seeing other people showering themselves in self-love. But, is it okay not to feel positive about your body all of the time? Does that make me a fraud? Sometimes, I ask myself this question. I lived with bulimia for years, and it completely took over my life, in ways that I can’t even explain. It is a torturous mental health condition to live with, and completely consumes you. Before I gained weight, my life was consumed by calories and eating under the recommended limit. But then I’d sit up in the kitchen while the whole house was asleep, bingeing on foods that I wasn’t even really hungry for, to the point I’m close to throwing up. And then I do. Over and over again. This kind of illness affects you physically and mentally, and when you have grown up being obsessed with ‘fat’ being a dirty word, it can be hard to learn how to love yourself. Photo by Jassir Jonis on Unsplash And I think that’s okay. I think that for everyone, including myself, things take time. You can’t suddenly rewire yourself after feeling a certain way for much of your life. I’m always awed by people who share their gorgeous photos and their inspiring posts, telling the world that it’s okay to have confidence in yourself. And sometimes, I feel like that. Sometimes I wake up and I don’t hate my body. Some days I wake up and I’m so inspired by other people’s advocacy that I feel that confidence I have always chased. But there are some days where I absolutely hate my body. The way it looks and how it feels. Days where I look in the mirror and want to cry. And this makes me feel bad. It makes me wonder whether I am a fraud for experiencing both body positivity and self-hatred. Can you be both? And I think my answer is yes. Not to the self-hatred, of course — but to not feeling totally body confident all of the time. Whether or not you have lived with an eating disorder, if you have ever struggled with image issues or body dysmorphia, or have just felt insecure, it’s okay to have bad days. When you are still living with a mindset of the past — even just a fraction of it — these challenges can be hard to overcome. Don’t feel like not feeling confident all of the time means you can’t still be a part of the body confidence, self-love community. Don’t feel pressured to feel a certain way that you are not yet ready to feel. Cherish the good days. The days where you look in the mirror and like what you see. The days where you look down at your body and notice its beauty. The moments where you aren’t constantly comparing yourself to other people. The, even short-lived, moments where you simply like your body, in its entirety, just as it is. Even if you don’t have them every day, they are worth the memories. They are worth being your own inspiration for searching for self-love. But accept the bad. Don’t overthink it, don’t pressure yourself with negative thoughts; just accept your feelings, and know that there will be better days ahead (even if they don’t all come at once). Note from Editors: Body shaming should never be confused with the possible health implications of weight changes. A weight within the medically recommended range for age, sex and height can help to decrease health risks as part of the general lifestyle, and always as personal empowering decisions, and never as a consequence of societal or cultural shaming. We want to emphasise that these two conversations are not mutually exclusive; discussion of the harmful impacts of body shaming can exist besides discussions about the health implications of weight. Critique of one doesn't invalidate critiques of the other.

When I got pregnant, my whole life turned around. I was feeling as healthy as I’d ever been, despite a diagnosis of gestational diabetes halfway through my pregnancy. Mentally, I was feeling on top of the world — not euphoric or manic, but mentally healthy. I had suffered from mental illness since my teens, and had been diagnosed with bipolar disorder when I reached adulthood. It was for this reason that I was put under the perinatal mental health team, because I was told I was high-risk for postnatal depression. But at the time, I felt far from that. I’d always struggled the most with obsessive-compulsive disorder, to the point I had been admitted under the Crisis team three times over the space of six months at one point. But carrying my baby, the thoughts were almost non-existent. After doing some research, I found that this wasn’t uncommon — all of the new hormones can overshadow OCD. It was a relief, because the intrusive thoughts I had been experiencing before pregnancy had been taking over my life. But it all came back once I’d given birth. At first, I thought it was just the baby blues. It had been a traumatic experience giving birth during the Covid-19 pandemic. My baby didn’t cry for ten minutes after being delivered via c-section, and was born with medication withdrawals and intermittent grunting; meaning we had to stay on the ward for four days after his birth, while I recovered from my C-section. Due to having contracted MRSA before the birth, I was kept in a side room. Nurses barely came in due to having to put on fresh PPE every time they did, and my partner was only allowed to visit for one hour per day. It was a really lonely time and, in pain from the operation, it was hard to get around by myself, as well as taking care of a newborn baby alone. Photo by Julien Pouplard on Unsplash It wasn’t the birth I’d imagined, at all. I knew I’d need to stay in the hospital but, not for four days — four days that went on forever. And so it wasn’t a surprise when the baby blues hit pretty hard when I finally got home. I was crying over absolutely everything and anything — happy, sad, bored, you name it; I would cry. Sometimes it would take just one look at my new baby and I was blubbering. But I was told this was normal, and that things would only be a concern if it lasted longer than two weeks. It did. Six months after my son was born, I was diagnosed with postnatal depression. But it wasn’t just PND I had been living with — it was postpartum OCD, too. According to the charity Maternal OCD , until recently, OCD in pregnancy and after having a baby has received very little research attention. However, recent studies suggest that OCD is more common at this time than other times in life; with some people developing it for the first time either during pregnancy or afterwards, while others find that pre-existing symptoms worsen. All of the symptoms I hadn’t experienced for nine months came flooding back, as if they had never left. I was a constant ball of anxiety, with the intrusive thoughts affecting every part of becoming a new mother. According to Maternal OCD, the increase in the incidence of OCD is likely to be related to the fact that pregnancy and early parenthood is a time when mums are naturally focused on the safety of their developing child, and feel particularly responsible for them. The normal stress and uncertainties of becoming a parent can also play a role. While I don’t want to go into the details of my thoughts, postpartum OCD usually revolves around significant fear of harm coming to the infant, with worries focused on accidentally or deliberately harming the child or of the child becoming ill. The charity adds: “It is important to note that the occasional experience of all of these worries is absolutely normal and indeed very common in mums and mums to be. However, some people find themselves so distressed that they will take measures to manage their anxiety or prevent their fears from coming true. “Depending on the worries, this could involve compulsive behaviours such as cleaning, praying, rumination or avoidance of activities or even of spending time with the baby. In this way, the thoughts and behaviours can interfere significantly with their wellbeing and their experiences of pregnancy and parenting. It is the extent of and response to the worries, rather than just having them that becomes the problem.” Photo by Fé Ngô on Unsplash It’s impossible for me to open up about my postpartum OCD without having a panic attack. So I’ll just say this: mixed with postnatal depression, the journey of becoming a new mum, and the huge amount of responsibility that I now had, postpartum OCD made the first few months of motherhood incredibly hard for me. It was hell. And I didn’t feel like I could talk to or open up to anyone for fear of what they would think. While the statistics show it’s common, to me it didn’t feel like it; it felt like I was the only one, and that it made me a bad mother. But it didn’t. Postpartum OCD is a seriously stigmatised and lonely illness to live with. You’re in a place where you’re constantly weighed down by anxiety and fear of people thinking you are your thoughts. Fear that your thoughts are real or that they are going to come true. Fear that people are going to take your baby away from you. The last point is why many mothers don’t talk about their experiences with postpartum OCD. Because they’re worried people will think they are a risk and take their babies from them. But the truth is, that OCD attacks the things that are most precious to you. The things that you love the most. It attacks the things you want to protect the most and makes you think you are a monster. But you aren’t. If you’re living with postpartum OCD, know that you’re absolutely not alone. And that there are people out there to talk to who will understand and who will be able to help you. If you’re under your perinatal mental health team, talk to them; but ask to speak to someone who specialises in OCD. You can also seek help from a qualified cognitive behavioural therapist if you have the means to. What you shouldn’t do is carry on suffering in silence. OCD Action has a great helpline that is really helpful, and if you need to talk at any hour of the day, Samaritans is there, too. If you can, try to open up to someone you trust, who can support you. They may not be able to completely understand, but talking helps. Most importantly, know that you are not alone, and that your thoughts are in no way a reflection of your character. In fact, they go to show how much you love your baby and how much you want to keep them safe and protected. OCD is hell to live with, so know that just for doing so, you are so incredibly strong. But you don’t need to suffer alone anymore — reach out to someone you trust, and talk to your doctor about what is happening. You don’t need to go into the specifics, but it helps. If all you can do is talk about how badly your anxiety is affecting you, that’s okay, too. Take it one step at a time. Each step closer to recovery shows the strength and determination you have, and will continue to have as you fight this.

I was diagnosed with inflammatory bowel disease in 2015. Ulcerative colitis, to be precise, which is a form of IBD that causes severe inflammation in your colon and sometimes, rectum. When I was nineteen, my bowel perforated. I had been going to the doctors for a year before this happened; concerned that something was truly wrong. I had been losing an excessive amount of weight, had experienced horrendous stomach cramps, and eventually, chronic constipation, and rectal bleeding. I was called a “hypochondriac”, and told that it was just “women’s problems”. No matter how many times I pleaded with the doctor to run some tests, I wasn’t listened to. Image source: Photographee.eu on Shutterstock I was very outgoing when I was nineteen. I’d just moved into my first flat with my partner, something I had saved up for myself for months before by working non-stop at the local pub. It was something I was immensely proud of because I come from a working-class background with little money. My ex and I had little money, too — but we had ‘our place’; a little loft flat above a small family. We made it our own and felt like real adults as we were both working long hours to afford it. I would go out with my friends and catch up with people all the time — I was physically insecure, but hid it well, and found it easy to communicate with people. I had fun. Being nineteen was fun. Until everything changed. I suddenly became really unwell around New Year 2015. I was mostly delirious, in and out of consciousness, using the toilet around 40 times a day with acidic diarrhoea that made it painful to go. I was physically, emotionally, and mentally drained. I was turned away from A&E three times before I finally went to stay with my parents because I couldn’t cope at home. It wasn’t until my mum found me lying on the floor in pain that she decided to take me over to her own doctor, who pre-diagnosed me with appendicitis. As soon as we arrived at the hospital, I was taken down to theatre and had my appendix removed. But this wasn’t the problem. In a side room of the hospital, I deteriorated over the space of a week, all of my observations alarmingly high and pre-septic. I was in agony, and couldn’t stop going to the toilet. On the Saturday of that week, I was lying in my hospital bed crying in pain, with the nurses around me trying to up my pain relief. Suddenly I heard popping noises coming from my stomach. My bowel was perforating inside of me. My mum screamed for a doctor, with the nurses frantically continuing to up the pain relief. The next thing I know, I’m sent down to theatre and awoke with a stoma bag. The histology report showed that my bowel was severely distended and inflamed, and they removed the entire colon. They then diagnosed me with ulcerative colitis. Image Source: Marian Weyo on Shutterstock Six years on and I no longer have the stoma bag, as I had it reversed — in an operation that connects my small intestine straight to my rectum to allow me to go to the toilet ‘normally’. I now have chronic diarrhoea and frequent flare-ups with rectal bleeding, as I have active colitis in my rectum, still. The whole experience has left me scarred, and I honestly feel like a shell of the person I once was. I am no longer outgoing; instead, I am nervous and uncomfortable around people. My body has changed so much and no longer feels like ‘mine’. I am lucky in that I have had a child since — something my surgeons told me would likely never happen due to the amount of abdominal scarring I have — and he is my absolute world. My life is filled with being a working mum, and I wouldn’t change it for the world. But I can’t help but mourn my former self. I feel like I didn’t get to live out my early twenties, instead, I spent those years processing medical trauma, and losing myself in the process. Having inflammatory bowel disease is hard — it’s completely different to IBS and is life-threatening. Every time I have a flare-up I suffer from flashbacks to the operating table, to looking around the room telling everyone I loved them because I was sure I was going to die. In fact, I was twenty minutes away from it. But this experience isn’t what affects me most — it’s also the amount of time I struggled in pain for, delirious, out of it. The length of time from falling sick to being operated on and waking up in what felt like a different body with a bag attached to me and my bowel poking out of my stomach. I don’t want people to feel sorry for me. I just want to tell my story, because it’s a disease that more than 300,000 people in the UK live with. I am lucky in that I made some amazing friends through IBD support groups, like The Toilet Me & IBD , but it still wasn’t the same. I missed feeling confident enough to go out. I lost my job. I had to move back home and start all over again. It was all worth it to have what I have now — a loving family and a beautiful boy. But I wonder what my nineteen-year-old self would be doing if she was still here. If it hadn’t happened. If I’d carried on being ‘me’. I wonder if I’ll ever see her again. And who knows? Maybe I will. Maybe I will come out of my shell and reignite the light in who I used to be. There is no happy ending to this story; it is more of a vent. A realisation into how deeply inflammatory bowel disease can affect you; not just physically, but mentally and emotionally, too.