I’ve been thinking about loneliness the past few days because I’ve noticed a shift in my mood. It’s a bit lower than normal and when I think about why that might be, it comes back to feeling lonely. A year and a half ago I moved from a big city where I had spent 6 years making some wonderful friends, to a small town where I only had my brother in a town over. Then 6 or 7 months ago I moved to another big city, where I have my other brother, his wife, and a close friend I’ve known for many years and his partner. While I do see my brother and sister-in-law fairly often, I haven’t seen my friend much due to schedules, etc. I also don’t have any other friends here and it seems to be harder to make new friends at 37 than it was at 30. I also haven’t had a serious romantic relationship for several years.
Loneliness is also something commonly experienced by people with chronic pain and chronic illness. This can be due to not being able to engage in activities you once could. It could be a lack of understanding from friends and family, perhaps even lost contact with them because of it. It could be an inability to work. And so on. While some people are totally content being on their own (and for the most part I’m totally fine being on my own), most of us crave connection. It’s part of our evolutionary history. Humans have always lived in groups, supported each other. And yet we’re always alone…
One of the four “givens” of the human condition, according to existentialism Irvin Yalom, is isolation. It’s something we fear and dislike, and yet it exists for all of us. I think of it this way, who is the only person you spend 24/7, 365 for your entire life with? YOURSELF. No one else. And so, chronic pain or illness or not, loneliness is something we need to be able to deal with. But how do we do that?
Here are some suggested ways to deal with it:
join activities that you can do – this is something I’m personally looking into right now. Is there a sport you can play? An art class you can take? Some other activity you can engage in with other people, even with your pain? Sometimes this involves making room for your pain, which you can learn to do here.
reach out to friends and family – even if you can’t see them in person, connect via text or phone calls or video chats. I talk to one of my best friends every week via Skype. A couple of my other good friends I video chat with every few weeks and text with regularly. It’s not the same but it’s something.
join online support groups – well I have a love-hate relationship with these, they can be a great way to connect and remember that you’re not alone. Friendships can even develop online. Listen to this podcast about it.
Speaking of making friends online, tryonline dating – okay, if you’re in a relationship this may not be the best idea, but you could try Bumble BFF in which the sole purpose is to make friends. Otherwise, I have made plenty of friends in the past via online dating (though that was pre-pandemic and it does seem to be a little harder now).
Become your own best friend – while this doesn’t completely take away feelings of loneliness, it can help you in the in-between times of being with other people. I’m definitely my own best friend. And yes, I do still get bouts of loneliness but they are few and far between (I just happen to be in one of the few).
No one likes to feel lonely, especially when paired with other emotions like sadness and anxiety. While chronic pain and illness can make loneliness more common, there are definitely a few ways you can combat it so that you can keep making the most of it.
I’m going to be right upfront and say it, we do not treat ourselves as kindly as we treat other people. I’ll also admit that as much as I’ve worked on self-compassion over 4 years of going to therapy, and a 2.5 year master’s program to become a therapist, I still have moments where I don’t talk to myself kindly. But it has dramatically improved for me. People with chronic illness and/or chronic pain tend to be even less kind to themselves than other people, and those other people struggle a lot too. Think about your latest self-judgment or self-criticism. Just take a moment to get it. Now imagine you have this friend, Friend A, and he/she/they started to call you that judgment or criticism or label and said you’ll never change that’s just who you are. Now imagine Friend B, and this friend says to you, hey, I noticed you’re having a really hard time right now and going through all this difficult/painful stuff, and I just want to be here for you. Which friend would you rather have? I’m guessing you said Friend B, so think about whether or not you’re friend B to yourself.
If that brought up some emotion I’m not surprised. So let’s talk about self-compassion (or just kindness or friendliness if you don’t like the term self-compassion). According to Kristin Neff, the world’s leading researcher on it, self-compassion is made up of three parts.
Mindfulness, which includes being present with our thoughts and feelings.
Kindness, or acting with care and understanding opposed to judgment.
Common Humanity, or acknowledging that all human suffer.
Kristin Neff also talks about some common blocks to self-compassion. And that’s what I want to talk about here. Because asking you, why aren’t you kinder to yourself, probably brought up something from this list, or a general, “I don’t know.” So let’s just address these now, in the context of chronic pain/illness.
Block 1: “It’s a sign of being weak.” I can see how you got there, especially if you’re a male (because let’s faced it boys are socialized to believe emotions and compassion make them weak or girly). The research actually shows that people who are kind to themselves have more internal strength, better coping, and are more resilience. This includes if you have chronic illness or pain. This is so important for being able to live a good life when you have chronic illness/pain.
Block 2: “I’m being selfish.” I’ve actually had a client say this to me before as a reason not to engage in self-kindness. This is another thought that isn’t compatible with the research, because what the research shows is that people who are self-compassionate are more compassionate to other, are more supportive of others, engage in more forgiveness, and are better at taking the perspectives of others. This is especially important if you have a chronic illness/pain and are also a partner or parent or caregiver. I have to say that as a therapist, practicing self-compassion has made me so good at building rapport with my clients because they feel more compassion coming from me.
Block 3: “I’m being self-indulgent.” This implies that you’re using it as an excuse not to do hard things. And yet, what does the research show? People who are self-compassionate actually engage in more healthy behaviours. For chronic illness/pain this means they exercise more, have better nutrition, and regularly attend doctor’s appointments and follow doctor’s advice (podcast on that here). All of this has been shown time and time again to improve people’s lives when they have an illness.
Block 4: “I won’t be as motivated.” I think this goes hand-in-hand with the last one, where you think you’ll just sit back and chill if you’re kind to yourself. Notice I said kind and not easy, because there’s a difference. Regardless, what does the research show this time? It increases our motivation. Why? Because we have less fear of failure AND get less upset when we do fail, and we take more responsibility when it comes to repairing our mistakes. Which means if you’ve struggled with certain parts of your illness before, you will be more motivated to fix them/do better in the future.
Where do we start with self-compassion? I’m going to leave these three meditations: lovingkindness, kind hand, and compassion with equanimity here. But if you don’t like meditation, that’s okay it’s not necessary. My favourite way to easily engage it in is to just take one of my hand, imagine it’s filled with kindness, the same that I’d give a loved one, and place it on the part of my body (usually my chest) that needs it the most. And I just hold myself kindly (sometimes with a half smile). That’s it.
I hope you’re kinder to yourself and keep making the most of it.
I, like many of you, spend a lot of time on social media. Though the ironic thing is that I’m not a huge fan of social media. Sure, it’s easy to mindlessly scroll, but I wouldn’t call it having fun. That being said, if you follow any of my many social media accounts, you’ll know that I often use it to (a) promote my content, and (b) share relevant health/mental health information (that is strongly evidence-based) to help fellow chronic illness warriors. But this post isn’t about me, it’s about the collective we. Because when it comes down to it, there are positives and negatives of using social media, especially when it comes to health information sharing and mental health outcomes. I took a look at the research from 2013-now (most of it more recent) to see what the thoughts were, and here’s a summary of what I found.
Let’s start with the good. A lot of the research found that patient’s, including Spoonies, are using social media for positive purposes. We use it often as a method of social interaction so that we can interact with other Spoonies. Social connection is important, and it can be helpful to talk to other people who are going through similar things as ourselves. Some studies have even shown that psychosocial health improves for people who use social media – again, likely because of the social connection we are using it for. One study mentioned that we all universally trust professional health sites (I mean, come on, who doesn’t trust the Mayo Clinic site for example) to gather information. They did note a cultural difference, in that people from holistic cultures tend to trust blogs, online support groups, and social networking sites more often. I’m not sure that this is a good or a bad thing, I think it depends on your worldview, so I’m going to leave it in the good section for now. Finally, when it comes to mental health, social media has the potential, depending on how it is used, to promote mental health. My TikTok channel is an example of me trying to help promote mental health coping skills. And while some studies (which I’ll talk about below) mentioned that social media may not be good for anxiety and depression, they also found no within-person differences, meaning there is only a correlation between social media use and these mental health outcomes, not causation (more on that in a moment).
Now, what about the bad? The biggest problem with social media is that information is not always of good quality or reliable, especially if it’s coming from non-healthcare professionals. It’s hard to determine what is good information and what isn’t. I’ve mentioned that I always look at the research before writing a blog post or suggesting something online. And when I say I do the research, I mean I read scholarly journal articles, which are written in the most dry manner, but contain important information. For this post, I read 6 articles, which no, isn’t a lot, but definitely a start. However, most people online don’t do this, and this is where caution should come in. Another issue is self-diagnosis, which I see all the time online. The problem is that users (whether it’s us as patients or people administering self-diagnosis apps, etc) are not trained medical professionals and, therefore, lack the competency to make a diagnosis. I know we all want a proper diagnosis, and that doctors don’t always listen, but they do have the training needed to diagnose. There is also very little evidence that social media actually improve any health outcomes. You could be a regular reader of this blog, and apply none of the information to your life (which I do always caution that you should consult with your own healthcare team anyway) and then see no improvements… so I understand why the research says this. Furthermore, if we are using inaccurate information (especially if it contains biases) then we could see a negative impact on our health. Finally, when we talk about anxiety and depression, as mentioned early, there have been studies that show that time spent on social media is moderately related to levels of anxiety and depression – however, because we don’t know cause and effect this could also be that more depressed and anxious people spend more time on social media, but it’s worth noting anyway. A major problem among adolescents (and let’s face it, most adults) is that though social media is a quick and easy way to access information about health/mental health, we rarely scrutinize the quality of information (as mentioned earlier). Okay, I know I said finally already but one more thing, sharing information on social media can lead to a lack of privacy (I literally see people share screenshots of their test results on Facebook groups all the time). So, just remember that when you’re sharing information – it’s now accessible to everyone.
I know it seems like I wrote a lot more about the bad then the good, but that’s not a bad thing… the bad is the cautionary part but the part we can use to our advantage. For example, if we start to scrutinize information for quality, if we try to not self-diagnose, if we apply accurate information only, and we’re careful about what we share, suddenly we don’t have really any “bad” parts of using social media for health/mental health purposes. Check out next week’s podcast episode with Amy Sinha about making connections online where we talk more about the good and the bad, as well as different types of connections we can make (available on Monday)! Keep on making the most of it!
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When I was first diagnosed with a chronic illness, my mental health started to suffer. I actually tried to hide that, even from myself, but my anxiety increased over the first 7 or 8 months until I started seeing a therapist (and thus my journey to becoming a therapist began). The thing is, I’m not alone as far as my story with my chronic illness taking a toll on my mental health. Many, many chronic illness warriors have been through the same thing. So, if you’re reading this and you’re struggling, know that it is normal and it is okay to struggle. Also note that change is slow. I can give you these 10 ways to improve you mental health (as I did a few weeks ago with physical health) but you aren’t going to feel better overnight, or after the first time you do these. It takes repeated practice and effort on your part (I still practice all of these!). If you’re ready for that commitment then let’s get into it!
Support and Connection – this is pretty much the opposite of isolation, which is common with chronic illness, and mental health issues such as depression and anxiety. Support and connection can come in the form of joining formal support groups (which are likely still mostly online due to the pandemic, but may be in person depending on where you live), or informally by talking with your family and friends, or connecting with others in the Spoonie community via social media. As we’ve seen from the pandemic, isolation is not good for our mental health so do what you can to stay connected. Check out this podcast episode.
2. Mindfulness – I know this comes up a lot but there are many, many studies showing that this has powerful effects on both physical and mental health. It can be formal meditations, but it doesn’t have to be. Mindfulness can be fully engaging in an activity, such as mindful eating or mindful walking. If you’re present you’re unlikely to be ruminating about the past (depression) or worrying about the future (anxiety). Take a listen to this podcast.
3. Assemble your healthcare team – that includes someone to help you with your mental health. If you can’t afford to see someone in private practice, check out community settings. I’m currently doing my internship in a community setting, where our services are free. There is a bit of a longer wait time, and is usually brief/short-term service, but it is definitely a good option for many people. Check out this podcast on depression and this one on anxiety.
4. Use holistic approaches – what I’m talking about here are approaches that utilize the body-mind connection. If you’re lucky you can find several practitioners that do so. For me, my physiotherapist has a BA in psychology so she always takes a body-mind approach (podcast with her here), and I also saw a naturopath before I moved, which is all about the body-mind connection. They can give you more ideas for how to take care of your mental health and understand it interacts with your illness. This podcast is with my naturopath.
5. Get moving – movement, of any type, is helpful not just for your physical health but for your mental health to. There have been studies to show that exercise decreases depression. Even if you’re not super mobile, going for a walk, doing some yin yoga, or taking up Tai Chi (podcast here) are good options to increase those endorphins and other neurotransmitters in your brain.
6. Connect with your values – who and what is important to you? If you can figure that out, then try to brainstorm some ways you can continue to live by your values, even with chronic illness. I’ll give you an example from my life. It is important to me to have adventures. Obviously travel is harder with a chronic illness, but it’s not impossible. So my friend and I (pre-pandemic) went on an “adventure vacation” to Costa Rica and for every “adventure day” we did a “rest day.” Honestly, it worked out super well, and we both felt more mentally and physically healthy that trip then we had in a long time. Check out this podcast.
7. Do what matters – this ties into this above, connecting with your values. Once you have done the brainstorming, it’s important to do the things that matter to you. So for me, it was travel. It might also be spending more time with family and friends, or being creative. Doing the things (what therapists call behavioural activation) actually decreases depression (lots of evidence here). Check out this podcast for more.
8. Find an outlet – this might tie in to doing what matters for you. My main outlet is writing (probably no surprises here), but I have other ones too, such as playing the piano and colouring. I know a lot of people use art or photography or music or dance. It doesn’t necessarily have to be a creative outlet, but creativity can be useful, because a lot like exercise, it gets those helpful brain chemicals to increase.
9. Distance yourself from thoughts, feelings, sensations, etc. that are “hooking” you – what I mean by hooking, is the ones that pull you away from your values, the ones you can’t stop thinking about and make your anxiety/depression/etc worse. If you think of it like fishing, when you cast, and then hook a fish, you immediately start to reel it in, and the fish struggles, flopping around. This is what some thoughts, etc. can to do us – make us struggle and flop around, doing things that are unhelpful. By putting some distance between ourselves and them can help decrease their power (this includes physical sensations of chronic pain).
10. Acceptance – whoa I know this is a big one because no one really wants to accept that they have a chronic illness. And yet this might be the most powerful part of the list for Spoonies. Not just accepting that you have a chronic illness, but allowing your to sit in the physical sensations of pain (without getting “hooked” by them), and allowing yourself to sit in feelings of sadness and anxiousness, etc. These are all adaptive for us. They are part of our evolutionary history. They are here for a reason, and we can learn to allow them to be without it stopping us from doing what matters.
I’m sure I’ve given you a lot to think about, so that’s all from me for this week. Keep on making the most of it!
And don’t forget, the self-care challenge starts for premium members on April 24. If you haven’t signed up yet, it’s just $5 CDN for 4 weeks of posts and check-in around self-care!
I know most of us are probably familiar with the phrase, “the pen is mightier than the sword,” and I definitely think that is true. Not just because I’m a writer (I love to write everything – this blog, self-help books, fiction novels and short stories, poetry, screenplays/teleplays) but because there is research that shows that writing (and very specifically journaling) is good not only for our mental health, but our physical health as well. This is one reason Chronic Illness Warriors might want to jump on the journaling bandwagon.
So the whole reason I wanted to write about this is because I was re-reading a textbook for my practicum (basic counselling skills, etc) and one of the interesting things that I read was that a researcher named Pennebaker found that people who record “troubling experiences in diaries showed better immune system responses and significantly better health than those who did not.” Now, I’m not saying I think that any kind of writing is going to suddenly magically cure any of us and we’ll just feel 100% better by doing so. The research though is super interesting. I think that most people can acknowledge the mental health is helped by sharing our story – through therapy, support groups, and writing/journaling. I personally find it just good for my mental health to do any kind of writing, including creative writing, whether or not it directly has to do with my struggles (let’s face it, every writer has a character who is more like them). It can feel good to journal because it can allow you to process, be reflective, and just get something off your chest, and it’s particularly effective if you are struggling with your mental health on top of your physical health.
In terms of physical health, researchers have found journaling to help with viral infections such as Hepatitis (so yes, potentially even Covid-19 as well). There was also a study that looked at gratitude journaling by those with heart failure, and found that morbidity was decreased and inflammation was reduced in the majority of patients. Now obviously more research always needs to be done but it is an interesting and promising start. How exactly does it all work? Well, that’s not 100% clear but journaling can lessen overall stress (for those reasons I stated for mental health) and stress and immune functioning are related, so it kind of makes sense that like some other mindfulness activities, journaling (or perhaps other forms of writing) can be helpful. I’m all about the “even if I just feel better today” (or for a few hours) attitude. Why not help ourselves in the present moment? All we really have is this moment, because the next one doesn’t exist yet, and the last one has passed. In this moment, if journaling helps me feel better and potentially helps my body and mind function better, than maybe that’s a good reason to make today the day you start a journal.
Have a good week and keep on making the most of it!
This is my little early Merry Christmas/general Happy Holidays post for 2020. This year has been hard for many people, and the holidays are probably stressful or sad for many people this year, especially without being able to see family as normal. I don’t want to repeat my podcast topic for the week (you can find that here), so I’m not going to talk about stress, I’m going to talk about connecting during the holidays. I will state that I am with my parents. As a single person I’ve joined another household and this is my first Christmas not working in retail as well so I actually have time off (though according to my friends in retail this year is not like a regular holiday season there anyway). We’re also very careful, literally take our temperatures every morning and don’t leave the house to go anywhere. Safety first.
Now, for this connections thing. Yes, it’s important to be safe and try to avoid cross-household gatherings. But we’ve all heard this in the news for weeks already. What can we do to have connections? How can we still be social or have a normal Christmas (or whatever holiday you celebrate)? Here are some of my suggestions:
use Facetime/Zoom/Skype/whatever video chat service you like to connect with family on the holiday. This could mean eating dinner together while video chatting. Opening presents while video chatting. Playing games over video chat. Or all of the above. It can help make it feel a lot less lonely and a bit more normal.
use those video chat services to connect with your friends! Much of the same way listed above. This is how I’ve connected with most of my friends over the past 9 months anyway, so might as well continue!
Do some holiday baking and gift wrapping! Whatever you normally do (or maybe this year try it if you don’t normally) and leave it on the door steps of neighbours, friends, or family. Have a socially distanced conversation when you drop it off.
Spend time with your fur babies. They are a great way to feel less lonely and connect.
If you’re feeling desperate make sure you reach out to a hotline or textline for support. That’s what these lines are for. I signed up for a 2 hour shift on Christmas Day with Kids Help Phone. I have no idea if it will be busy or slow but I do know that this year more than ever, people need support. So use these programs if you need them.
Remember, you are loved. This year is not normal. It doesn’t have to be terrible. Try to remember the positive, and make as many connections as you can.
Happy Holidays. Make sure you make the most of it!