Hello! In this post I’m sharing some personal stuff. I’d like to preface this by saying yes, thank you, I’m fine, I’m actually doing really well. I hope you are, too! There are some resources here that include actual expert advice and helplines.

For the last 15-20 years I’ve had pretty terrible mental health. I am doing well, because I have spent a lot of time discovering how to manage my health, and I’ve been fortunate enough to be able to adjust the rest of my life to accommodate this.

I think we don’t talk about mental health enough - at work, with friends, with family, and in general. Talking about it can be really helpful in dispelling stigma. I also think we need to acknowledge that mental health doesn’t start and end at “feeling a bit down”. It’s something we have a collective responsibility to understand, acknowledge, and make space for in society.

Each of us has a part to play in supporting others with their mental wellbeing; and companies specifically have a duty of care. We see a lot of burnout in startups and I think this is often dismissed as “not being able to hack it” rather than an acceptance of a really real health risk of working in these types of environments. As more of us are moving to intentional remote work, this risk increases and we need to mitigate it.

I’m sharing my own personal experiences & perspective with the hope that it either makes you feel less alone, or helps you understand what people with mental health conditions in your life might appreciate from you. I’m absolutely not a doctor or mental health professional - there are some resources here that include actual expert advice and helplines.

My messed-up brain

Content warnings: depression, anxiety, food.

I have clinical depression. When it hits, I cannot get out of bed. I physically cannot lift my limbs. My whole body is utterly drained and physically exhausted. If I’m lucky, on a bad depressive day, I manage to sit in front of TV or play a simple game on my phone or listen to music. Often reading, showering, making food and speaking in complete sentences are out of the question.

I have a panic disorder. This means that I have panic attacks from time to time - more often than I’d like. Once, while still hyperventilating in the office bathroom after the second panic attack that morning, I googled “how many panic attacks a day is normal”. Hint: the answer is not “several”.

I also have generalised anxiety. On a good day, I worry a lot and am generally uneasy and have a tendency to catastrophise. On a bad day this means that I don’t have the capacity to make any decisions. I don’t eat because I can’t decide what to eat, or where to take the first bite of a sandwich, and it’s all too stressful.

So it’s fair to say that my mental health is not good.

It was really only a couple of years ago that I first registered that maybe it was an actual health issue rather than just me having a bad personality and being a bit shit at life. In hindsight, there were lots of other opportunities to have done this:

in my second year of university and my then-girlfriend yelled at me for flaking on a date again because I wouldn’t get dressed or make any decisions about where to go (depression + anxiety)
during my masters’ degree, I spent ~2 months on a totally impractical schedule because I was too worried to go to sleep so would stay up till 4am, then be too tired to get out of bed the next day (anxiety + depression)
I cried a lot and had a couple of panic attacks in the first several months of my son’s life, because I was so terrible at being a parent (post-natal depression)
I quit two jobs because I couldn’t cope anymore (panic disorder + depression + burnout + stress)

With hindsight, I definitely could have identified this and started managing my mental health at least ten years before I did.

Managing my health

A handful of times I’ve spoken to a health professional or other well-meaning grown-up about my mental health and I’ve been told that I should exercise or cut caffeine out of my day or try meditation.

This is very sweet and well-meaning, but it is absolutely nothing like sufficient for many of us who have quite serious mental health conditions. So for me this feels like telling someone with a broken leg that they should exercise and eat more vegetables to get better. Like, sure it’s a great idea for maintaining good health, but it is absolutely not taking the specific problems seriously enough and will not solve them.

For me, managing my mental health is a multi-pronged approach. There are elements that I do, and elements others support me.

Medication: I take anti-anxiety medication every day. I’m really fortunate that this stabilises my brain chemistry. I’m also really lucky that the first one I tried has worked really well for me. I still feel joy and sadness and the ability to worry when it’s useful. My doctor had to talk me into trying this because I had treated it as a last-ditch resort, when actually it’s been genuinely life-changing for me for the last 3+ years.

Therapy: every Friday lunchtime for a year and a half, I met up with my therapist in a local park. We went for a long walk and talked. This was revelatory for me. It changed the expectations that I put on myself, gave me a lot of perspective, and shifted my mindset so that I no longer thought of my mental illnesses as a personal defect or what I deserved for just being a bit shit. I no longer see him weekly but I have his number in my phone for when I next need him, and I’ve used one-off therapy sessions from time to time.

People: I have a really great support network that I’ve hauled together. My family, friends and colleagues pretty much get that I have these mental health conditions and am not always at my best, and they are considerate and supportive and patient.

Exercise & diet & meditation are cool too, but doing all of those didn’t come close to moving the needle for me. I don’t dispute that they’re all bad - like, exercise and eating well are pretty important to staying alive - but proper treatment makes the real difference for my mental health.

A strong support network

My partner, child, family, friends & colleagues all play crucial roles in my support network. Even if they aren’t aware of it.

I haven’t ever talked to my parents about the actual state of my mental health but actually they have been super helpful even without us ever explicitly talking about it. We haven’t talked about it because, for some reason, for most of my teens and 20s I had concluded that my mum believed that if you had bad mental health you should just pull yourself together and get on with it? I don’t know why I came to that conclusion. Hi mum & dad 👋 sorry!!

They use health-oriented language. If I take a day off work because I cannot get out of bed, it is a sick day. I am unwell. My partner tells our child that I’m not well. My child knows that my brain’s not working properly so I need cuddles and space.

They don’t minimise. They take me seriously. They understand that this is not ‘just feeling down’ or ‘being a bit stressed’. My company doesn’t have a policy where ‘duvet days’ are for hangovers and mental health - sick days are explicitly for mental and physical health.

They don’t use ableist language. They don’t call stuff ‘crazy’ or ‘insane’ or ‘nuts’ around me because they know that using this kind of language is harmful and dehumanising.

They forgive when I can’t do something. They don’t get annoyed because I flake on plans. They don’t take it personally or judge me when I can’t reply to a WhatsApp message for a few days. When I reach out to chat after months of silence, we pick back up where we were before. When I don’t do any laundry for three months, they pick up the slack and don’t complain or criticise.

They listen and ask questions about how they can help. If I’m overwhelmed with anxiety, my boss knows that the useful thing to do is help me descope; my colleague knows that I can’t put on my super-cheerful face so she’ll be hosting our company all-hands; my team offer really specific help which makes it harder to say no to their help and less stressful to hand things off to them. My family know how to shape our time together to accommodate my health and to make me feel the best I can.

They take feedback from me on what is and is not helpful. My take is that nobody should ever send a slack message that says “do you have 10 mins today?” without any context, especially not to people with anxiety - and so we don’t.

We factor it in to our plans. Depressed? Instead of meeting up we’ll chat by phone - or we’ll hang out in the same space doing something separate. Too anxious to sit still? We’ll go for a walk. Struggling to focus? We’ll split work between us to accommodate that best. Really low executive function? They’ll make all the decisions and I’ll just show up.

Work accommodations: my company offers useful resources like Spill so I can just book a one-off therapy appointment when I want one; they’re explicit that sick days are for physical and mental health.

Special mention here for the friend who found long-drop earrings that say ANXIETY in crystals and immediately sent me a link 💗

And onwards

All of this stuff - managing my health and having a great support network - have made it so that I’ve been able to function basically how I want to. I have a career I like, I have some friends, I have a great family, and I have a brain that doesn’t work the way I want it to by itself. It takes work, from me and from others, and it’s a continual journey.

For my mentally ill readers, I hope this has given you some sense of solidarity, that you’re not alone in living life like me. For those of you who have really great mental health right now, I hope this has helped you build some degree of empathy and some ideas for how you can support the people in your life.

Linking again to these resources that include actual expert advice, helplines.

Go forth and take mental health as seriously as you should.