Lost in Translation.

You walk out of the pharmacy onto the dirty, rubbish-laden pavement and realise that it’s late afternoon; somehow, already the end of another school day.

Children are everywhere, or so it seems. Jackets hanging haphazardly off shoulders, book bags trailing through autumn leaves. Learning long-forgotten in favour of pre-teatime treats clutched tightly with both hands.

Rosy-cheeked and full of chatter, their joy ought to be contagious; giggles and anticipation the currency of a Friday afternoon.

At the traffic lights, you wait for green and make your way back home, wanting nothing more than to be away from everything. And not in the ten minutes it will take to get there, but right now. In this moment, the immediacy, the need, is almost painful.

You move, one foot in front of the other, not fast but with the effort and purpose of someone who does not want to be. For a few seconds (that feel like hours) you are caught up in a throng of little ones, crowded outside a bookshop, clinging onto grown up hands, and find yourself wanting to scream. If it weren’t for the mask, and the strangeness of it, perhaps you would.

Something about their happiness jars with you, but not as much as everything else does. You hate yourself for it.

Looking up, the harsh light of the October sky hurts your eyes: dull and yet somehow far too bright. Passing a low-rent version of Kentucky Fried Chicken, you wince involuntarily, just as someone behind you squeezes by, clinking shopping bags bulging with wine, pizzas and beer.

Never one to be a kill-joy, it’s not the celebration itself that bothers you, but rather the sheer ordinariness of it. The glaring sign above it all saying – no, shouting – “THIS IS JUST WHAT WE DO,” that speaks so palpably, so violently of the life you know you are not living, even though you want to.

In recovery and in life, people talk a lot about bravery, about what it means and what it doesn’t. “Recovery is brave,” “Doing the next right thing is brave”, “Asking for, and accepting help is brave” are words you’ve heard countless times before.

You understand all of this. Of course you do. And in your heart of hearts, you know it’s absolutely true. But lately, there’s something missing. A disconnect of sorts, somewhere in the deepest corners of your brain.

“Bravery” and “Living” have got lost in translation; two words as hollow and fragile as empty promises, or as loved ones telling you to just eat.

It’s not new, this feeling of being out of sync, cut off from the rhythm and vibrancy of life. In fact, you know it all too well, often welcoming it in like a long lost friend.

Except lately, the familiar numbness has not come alone, having travelled arm-in-arm with sadness, yearning and regret.

Now, more than ever, your past and future selves catch glimpses of something that your current being simply can’t. Banging on the window of your mind with all their might, they are begging to be heard, singing the praises of possibility and hoping against hope that one day, you will see it too.

Something that has been so clear to them all along: a version of you bathed and dancing in golden light, living off a joy that is not fleeting or borrowed, but permanent, and absolutely, completely your own.

Eating disorders and early intervention.

Lately, I’ve been thinking a lot about early intervention in eating disorder treatment. As someone whose had anorexia for over a decade, this might seem like an odd thing to do, but there’s a reason behind it.

If you’ve ever looked into eating disorder statistics – particularly in relation to the effectiveness of treatment – you will probably know that early intervention is seen as vital.

In ‘A Critical Analysis of the Utility of an Early Intervention Approach in Eating Disorders,’ Laura Currin and Ulrike Schmidt discuss the significance of early intervention in the treatment of Anorexia Nervosa (AN) and Bulimia Nervosa (BN), giving particular attention to the role of schools and primary care providers.

In the paper, Currin and Schmidt identify “mid-adolescence into emerging adulthood (ages 15-25)” as the most common onset age for both presentation types, and consider the potential positive impact that early intervention can have on sufferers, particularly as they enter and progress through puberty.

In the Royal College of Psychiatrists’ Position Document (2019), early intervention for eating disorders (AN and BN) is described as “essential”, since supporting evidence suggests that it “may help to prevent illness onset or lead to an improved course of illness, e.g. through enabling earlier recovery, reducing or averting risk of chronicity and complications, preventing / lowering distress and avoiding disruption in people’s development and associated secondary disabilities.”

With regard to the nature and success of early intervention, the document acknowledges the impact of different illness stages, identifying the significance of different brain responses at each stage. Overall, in the early stages of developing an eating disorder, sufferers’ brain responses are likely to be more malleable (Treasure et al, 2015) and flexible, whereas in the later stages of illness, responses may become increasingly compulsive, habitual and entrenched, and the illness itself much more persistent.

In terms of statistics, this research found that as many as 60% of sufferers with a short duration of illness (3 years or less) achieve full recovery (referred to in the document as “remission”), compared with 20-30% of sufferers with a more sustained, longer period of illness.

The document states that primary care facilitators (such as schools, universities and GPs) play a key role in the identification, diagnosis and provision of early intervention treatment for eating disorders, and that things such as a lack of awareness, knowledge and specialist skills could result in underdiagnosis, misdiagnosis or delays in appropriate care.

Unsurprisingly, reading this document led me to think in more detail about my own eating disorder history. I’d never have thought to describe myself as a chronic case, nor as someone who might ever be referred to as a ‘revolving door patient’, but in terms of the duration of illness, I certainly fall into the more chronic category.

As a stand-alone realisation, this didn’t have too big an impact. That is until I began to think of it in relation to the aforementioned recovery – or remission – statistics. Having had anorexia for almost 12 years, there could be no doubt about the fact that, of the estimated 1.25 million people in the UK living with an eating disorder (BEAT, 2021), I am among the portion of long-term, enduring sufferers.

This struck me for a number of reasons, but particularly in the context of recovery. According to the statistics released by the Royal College of Psychiatrists, as someone with a sustained, longer period of illness, my chances of total remission from anorexia fall between 20 and 30%, as opposed to the 60% chance of those with a short-term history of being unwell.

Of course, I know that this research doesn’t represent everything (anyone who’s listened to the amazing Radio 4 podcast More or Less will be aware of the pitfalls of statistics). And I’m aware that just because I’ve read a bit of research, it doesn’t have to become a self-fulfilling prophecy. But I can’t pretend it didn’t have an impact.

Although eating disorders are not a choice, I very much believe that recovery is, and in this sense, it’s not in my interests – or my nature – to lay blame on anybody. But looking back at my own history, especially in relation to early intervention, I can’t help but feel I’ve been let down.

During my first year of university, when my eating disorder initially began to take hold, I remember reaching out to the GP on campus at the suggestion of my friends and housemates. I explained the difficulties I was having with eating, and the extent to which I felt that food, weight, shape and exercise were dominating my life. Although the doctor I saw seemed to understand my worries, he did nothing by way of investigation, referral or even basic monitoring. I was never weighed, no bloods were taken, and there was certainly no referral to the eating disorder service – nor even any mention of the prospect. He just warned me of the eventual chances of organ failure and death, prescribed me some antidepressants, and sent me on my way.

At the time, I thought little of any of this. It simply confirmed the – anorexic – idea in my head that the way I was living totally fine, and gave me the green light to carry on. For the rest of that academic year, things continued to worsten, until eventually, I was forced to take a leave of absense from my studies, on account of my mental and physical health. Once at home, under the care of my mother, I reached out again to my family GP. Although she was clearly startled by the obvious weight loss, this doctor did nothing in the way of offering any real support. Group treatment was mentioned in passing, and then waved away because of the likelihood that, despite being obviously underweight, I wasn’t really “thin enough”, and there would “probably be lots of people who were smaller and more unwell.”

Until my recent inpatient admission, more than a decade into my eating disorder, I haven’t thought too much about what happened during my first year at university. But, stuck in an EDU with nothing except time on my hands, it dawned on me just how negligent – and dangerous – the treatment I received really was.

Apart from the impact on my physical health, one of the biggest and most lasting effects has been on my mental wellbeing – particularly the extent to which anorexia has been allowed to dominate my life.

I am, and always have been, quite high-functioning. The perfecionist in me drove me to achieve First Class marks in my BA and MA, as well as numerous jobs in journalism, copywriting and teaching – all in spite of my eating disorder. I’ve travelled across Europe, America and Asia, formed life-long friendships, held down jobs and had lasting relationships, all with anorexia in tow.

By most people’s standards, I’ve lived a full and successful life so far, I don’t dispute that. But what I do know for sure, is how much better – and happier – things could have been if I’d receieved the help I so desperately needed as a young adult.

More than this, if I’d benefitted from early intervention, I’m about as certain as it’s possible to be that I wouldn’t be in the situation I am today: two months out of a (largely unsuccessful) inpatient admission, and struggling.

Thinking specifically of anorexia and any of the associated behaviours, I also know that for me, early intervention could have had a profound, life-altering impact. From the outset, restriction became the way I made sense of things, and learned to cope with finding my place in an increasingly chaotic, hard-faced and unfamiliar world, particularly as someone with a physical disability. Almost inevitably, with restriction comes weight loss, and an often noticable change in body shape.

As such, I have come to know and understand my adult body, only through anorexia’s distorted lense. It has controlled and manipulated my life in many ways, but most specifically – and noticably – in terms of my body’s weight and shape – ultimately, the space it takes up, and the way it moves through the world. Although there has been a slight shift in my presentation over time, the patterns, behaviours and compulsions I experience are very much ingrained, and the habits incredibly hard to break.

In the context of this, I know that there’s nothing I can do or say to change the outcome of things as they currently stand; hindsight is a wonderful, and at times, heartbreaking thing. But, if I could go back and say anything to my younger self, it would be this: don’t take ‘no’ for an answer.

And that, I suppose, is the point of this post. If there’s anyone out there in the position I was in more than a decade ago, I would urge you not to give up. If at first, seeking help gets you nowhere, keep trying until you get the support you so rightly deserve.

Lovely.

08/06/2021

“Good morning my dear” one of the staff says enthusiastically, standing half in the doorway, half out of it. “I’m just going down to get your porridge from the kitchen.”

I stare back at her, blankly, by now resigned to my fate, begrudgingly coming to terms with my new found identity as ‘a person who eats breakfast.’

“Thank you,” I say, briefly meeting her gaze before looking intently down at the carpet.

“You look lovely,” she says brightly, glancing from my head down to my boots and back again. The way she puts it, I can tell there’s no room for objection or debate. It is a statement of fact.

“Oh, thanks,” I mumble, caught slightly off guard. This does not go unnoticed.

“I don’t feel lovely. I feel like a whale,” I say before I can stop myself, bracing myself for her response.

“Yes but you know that’s your eating disorder talking, don’t you? And it’s utter nonsense. You’re a young woman. Young women are supposed to look like young women, not six year old boys.”

“We need to stand up to this ideal and show the world what real women look like. Real women have curves and bums and boobs and they eat their porridge. Come on, let’s go!”

The red chair.

I’ve often heard people say that having an eating disorder is like seeing a red chair in front of you. Every time you look at it, you can see that it’s red. You know it’s red. There’s simply no question about it. But to everyone else in your life, everyone without an eating disorder, the chair is undoubtedly, unequivocally green.

Friends, loved ones and healthcare professionals tell you time and time again that it’s green, but no matter what you do, and no matter how hard you try, you still can’t see it. To you, the chair is absolutely, completely and utterly, red.

But that’s ok, right? It’s just a red chair. A harmless lump of wood that’s been pinned, glued and screwed together and painted the colour of a post box, or a ripe, juicy tomato.

At first, you don’t give it too much thought. You just agree to disagree with the non-believers and go about your life as normal, with the chair in tow that is very-much-red-and-definitely-not-green. You go to work, you come home, you socialise and make plans and set goals without worrying too much about the chair. But every so often, when you’re feeling low or downtrodden by the state of the world, you start to question it again. ‘Surely all these people can’t be lying to me. ‘What if it really is green?’ you wonder.

In need of evidence, you start to think more deeply about your life, looking in detail at everything from your relationships, work ethic and spending habits, to the way you communicate and move through the world. To your surprise, you find that almost everything in your life – the entirety of your inner and outer worlds – is orchestrated around that red chair. It’s almost as though your entire existence depends on it, which is absurd really, because it’s just a bloody chair.

As a sort of experiment, you try to extricate yourself from it, erasing it’s colour from your mind and imagining what things might be like if everyone around you were right, but you can’t. It’s impossible. Changing the chair from red to green, even only for a moment, feels about as appealing – and as possible – as choosing which of your legs you’d like to saw off and feed to a Great White shark in the midst of a Tsunami.

So, after that, in your mind the chair stays red. Just as the sky remains blue, the grass green and everything else the colour of, well, everything else.

But after a while, this red chair starts to get in the way. It’s there all the time. At every life event, every celebration, every breakfast, lunch and dinner. It’s there when you close your eyes at night, when you wake up in the morning, and eventually, it even appears in your subconscious, as you find yourself dreaming about it. Except, the visions you experience aren’t really dreams at all. Distorted, fretful and contradictory, they’re more like nightmares, straight out of the script of a terrible, twisted horror film.

You begin to realise that you can’t go on like this anymore. The red chair is sucking the joy out of everything, demanding to be seen at all costs. It’s blighting your life, but still, you can’t ever imagine things being different. You simply can’t imagine it being green.

Eventually, you reach crisis point. You ask for help, leaning on others around you – the very people who’d known that the chair was green all along. Even now, you still can’t see it, not really. But with support, encouragement and compassion, you’re able to imagine it, to consider the possibility of life without that red chair. Friends, loved ones and professionals tell you that at first, this life will seem unfamiliar and wrong, a bit like walking around with your shoes on the opposite feet. But after a while, you’ll come to accept change and embrace the unknown. You’ll get used to this new way of thinking – and living – and once you do, you’ll never need to look back.

The bottom of the well.

Last summer, I remember spending the afternoon in the park watching a small group of people celebrating a family birthday. They had balloons, party food, cake, cards and presents spread out on a picnic blanket, and every so often, would all cheer with delight as they popped open another bottle of prosecco.

I, on the other hand, was in the depths of an eating disorder, I’d just split up with my long-term partner, lost my job for the third time in as many years, and Covid-19 was wreaking havoc across the world. Suffice to say, things were going great.

Sitting on the grass, surrounded by pigeons (which, I discovered, are actually quite beautiful if you take the time to notice them) I was on the phone to a psychologist from the Eating Disorder Service.

She asked me – as she did every week – how I was doing, and I replied – as I did every week – that I was fine: actually, honestly, in spite of it all, really, completely and utterly fine. A statement which, both of us knew, was really, completely and utterly bollocks.

Once the pleasantries – and bollocks – were out of the way, I said:

“I don’t know. I feel like I’m at the bottom of a well.”

“Okay…” she started, clearly not sure where this was going.

“I feel as though, without ever really knowing it, I’ve fallen down a well and I can’t get out. So, now I’m just here and it’s dark and cold and I keep trying to climb back out again, but…I dunno. I can’t. You keep asking me how I’m doing and what I’m eating and giving me suggestions and trying things, and I’ve just been going round in circles, slipping further and further, and I’m trying to get a grip on something but it’s like there’s nothing to hold on to. The sides of this well are all slimy and…I’m stuck.”

“Right, okay. That makes sense.”

“Does it? I ask.

“Yeah, it’s a good analogy. It makes total sense,” she says, a bit too enthusiastically.

“What can you see?” she asks again.

“What do you mean?” I say.

“From where you are. In the well. What can you see?”

“Er…nothing. I can’t see anything. It’s just black.”

“What about if you look up? Can you see anything then?” Now her questions seem to be gathering more momentum.

“No, I still can’t see anything. It’s all just really, really dark.”

“Okay, but you know there’s a top, don’t you? You know there’s light at the top of the well, even though it’s dark, because that’s how you got down there.”

“I guess so….?” I say, beginning to lose any concept of where this might be going.

“So, we just need to find a way to get you back out again. You said there’s nothing to hold on to, but there is. You just need someone to be at the top, holding out some rope for you to grab onto, to pull you out again.”

“Right,” I say, hating how sceptical I sound.

“Think of it like…do you remember that story about those miners in Chile? It was in the news a while ago. They were stuck underground for days and days and everyone had started to give up hope, but they were rescued in the end – all of them.”

“Yeah, I remember,” laughing in spite of myself. “Are you comparing me to a Chilean miner?”

“Well, no, all I’m saying is…I know you feel stuck, and that’s understandable – I get it. But you’re not going to stay stuck. You just need someone to be there at the top, lowering down a rope to help you out, and that’s what we’ll do. That’s what I’ll do. It’s what I’m here for.”

*

Months later, it is the middle of winter, and I am alone in my flat, wearing layer upon layer of clothing but still feeling frozen to the bone.

Outiside, the air is crisp, and the sun is streaming in through the windows, castting delicate shadows across the living room floor.

I open my laptop to start a Zoom call, already knowing exactly what I’m going to say.

The call begins, we both smile and wave, and she looks at me and asks – as she does every week – how I’m doing.

Instead of saying I’m fine – totally, completely and utterly fine, I say:

“Do you remember that time, in the summer, when I told you I felt like I was at the bottom of a well?” I ask.

“Yes, I do,” she says, her words slow and deliberate.

“Well, this morning, I…I went to brush my teeth and…I just couldn’t do it,” I mumble, trying as hard as I can to get out what I need to say.

“Okay,” she replies gently, her words half acknolwdgement, half question.

“I just couldn’t do it, because all I could think about was how many calories there were in toothpaste.” In that moment I laugh, just as tears begin streaming down my face.

“So,” I continue, “All those months ago, when we talked about those miners, I wasn’t at the bottom of the well then, was I?”

She pauses, and looks at me, her expression full of sadness and regret.

“No, you weren’t. But, we didn’t know that then – neither of us did – and I’m not going to let you get to the bottom. You are too precious. Even if you can’t see it, I can. You have too much to give, and too much to offer. I’m not going to let this take it all away from you.”

Breathe.

Amongst all the chaos, know that you are worthy.

Breathe deep and remember that it’s okay to pause and take time for you.

Be still and focus on the good.

Even on the darkest days, there is so much to live for.

Just keep going.

One more for the road.

If I could have chosen any way to end my final dinner on the ward, it probably wouldn’t have been with a Bakewell tart. But as I sat planning my meals for the coming week, my eye drifted across to Wednesday – my agreed discharge date – and there it was: Cherry Bakewell and vanilla ice cream. I circled it almost without hesitation, and as I did so, I felt my lips break into a wry smile. What better way to end my inpatient treatment than with the very dessert that had been my undoing all those months ago? The more I thought about it, the more fitting it seemed. Poetic even, as though it was meant to be.

Despite my initial feelings – trepidation, hesitation, resolve, decisiveness – what happened that night was not kismet. In reality, my last supper at the Priory was anything but poetic.

At six o’clock, I walked into the kitchen as I had done so many times before, but on this particular evening, I sat down at the table alone. There were no staff and no other patients egging me on or coaxing me through; this time, I had only my thoughts and my eating disorder for company.

The main meal passed without issue or complaint, which I do recognise as a sign of progress. Pudding, however, was another matter entirely.

I’ve often heard that struggle looks different on everyone, and can manifest in many different ways depending on the situation, circumstance or context, but I don’t think I’d ever understood this so potently or so profoundly until then.

On the outside, I was just a girl eating a piece of cake, in a room full of other girls eating cake. But unlike some of the others, I was doing this on my own, without being forced, encouraged or even prompted. On the outside, I was calm and collected. There were no tears and no protestations, no visible signs of distress. I probably even looked like I was enjoying it.

But on the inside, I was dying. I was so full of hate and disgust and downright dispair that I was surprised there was room left in my body for my vital organs, let alone cake. And yet there I was, sitting and eating, smiling if anyone ever made eye contact with me, looking as though I didn’t have a care in the world.

That night, instead of feeling a sense of accomplishment or triumph, I went to bed terrfied. Not because I was going home, or heading out into the unknown, or embarking on ‘real recovery’, but because I had experienced first-hand how frighteningly easy it can be to put on an act. I was terrified, not of the food, not of leaving hospital, but of how natural it felt to mask my pain.

The burning building.

Imagine for a moment that you are in a burning building. Looking around, you see that the room you are in is being torn apart by fire and each one of the exits is completely blocked, engulfed in flames.

With no way out, no means of asking for help and no way of putting the fire out yourself, you are trapped. You begin to give up hope, resigning yourself to what you know will be a slow, agonisingly painful death.

All of a sudden, something compels you to look up. Raising your eyes to the ceiling, you see a trap door with a ladder sticking out from inside it.

Although it is high up, you know that if you stand on tip toes and stretch your arm out as far as it’ll go, you’ll be able to take hold of one of the rungs and haul yourself to safety.

But there’s a catch. The ladder is made of metal. If you reach up and touch it – even for a moment – it will be scorching hot, and will no doubt cause you severe pain, possibly third-degree burns.

So, what do you do?

Do you choose to stay in the room, knowing that eventually, the flames will reach the point where you stand and reduce you to nothing but a pile of smouldering ash?

Or do you choose to suffer in the short-term, taking a leap of faith and grabbing hold of the scalding hot ladder to pul yourself out of the flames?

Of course, there’s also a third option, one that lies somewhere in between the other two.

You could choose to take hold of the ladder, only to let go after a few moments, deciding that the pain of holding on to the burning hot metal is too much to bear.

It’s a no-brainer really, isn’t it? Either way, you’ll have to experience pain, but if you take a leap of faith and grab hold of the ladder, you just might be able to hold on for long enough to escape. Trapped inside that burning building, you’ve got nothing to lose and everything to gain.

I’m sure you’ve guessed by now that in this analogy, the burning building is your eating disorder, and the scalding hot ladder represents recovery. It won’t be easy. At first – and probably for a long time after – it’s going to hurt like hell. So much that you wish you never started. But if you keep on going, in spite of all the hurt and pain, it’ll be worth it in the end. And when it happens, when the time comes and you’re finally free, you’ll be so glad that you took that leap of faith and never gave up.

Remember your ‘why’.

During my teacher training course, we watched a presentation called ‘What’s your why?’

The lecturer showed a series of inspirational videos designed, I think, to help everyone feel more motivated, and impress upon even the most jaded of audience members, that they had done the right thing in choosing a teaching career. Amongst other things, we saw an elderly man set off to climb Kilimanjaro in memory of his wife, and an emotional, if very overused clip of footballer Ian Wright going back to thank his secondary school PE teacher for making him the man he is today. (I’m not crying, you’re crying).

The presentation itself was a bit of a cliché, but the premise has stayed with me years after turning my back on the classroom.

‘Everyone’s got a ‘why”, the lecturer said triumphantly, by way of summing up. ‘What’s yours?’

This, I think, can be applied to many aspects of life, and eating disorder recovery is no exception. Even when things feel impossible, and you don’t know where to turn, it often helps to take a step back and remember why you started.

Lately, I’ve been feeling very, very stuck. More than just ‘hard work’, recovery seems to have become a bit of a thankless task; an investment that will never pay off – or so it seems.

After five months in hospital, I have gained weight, but everything else feels just as it was before. I am still bound by the same rules and routines, the only difference being that my body is bigger. Food is still the enemy; that thing I am not allowed. I am not free. Every mouthful still involves a maths equation, but on the outside, I look…fine. It’s an uncomfortable place to be. It’s confusing. It’s precarious. It’s so much hard work. Not even to live, but simply just to keep myself afloat.

The chronic overthinker in me worries about this a lot. This endless, exhausting balancing act. ‘What now?’ I ask myself at least nineteen times an hour. ‘What happens now?’

In all honesty, the answer is that I really don’t know. For now, though, I don’t think that matters. Now, I’m just focussing my efforts into remembering my ‘why.’

Whenever I think about why I started this, all I know is that my whole story is pretty wobbly. There was no ‘Eureka’ moment, no one, definite act of asking for help or letting go. Just a string of distressing psychiatrist’s appointments and an eventual – almost accidental – referral to the eating disorders service, described as “a bit like kicking a tin can down a corridor.” Whatever that means.

Back then, hidden under a high functioning veil of depression and anxiety, anorexia was my dirty little secret.

Or so I thought.

My eating pattern was at best erratic and at worst, totally non existent. But that was fine, right? That was just how I did things. Until then, no one had ever really questioned it, let alone called me out. And yet, there I was, sitting in front of a man I didn’t know, with more qualifications than I’d had hot dinners (sorry), telling me that the way I was living was wrong. And more than just wrong. That it was a slow, deliberate form of suicide.

At the time, I remember being in a sort of half-dissociated state, answering questions and nodding along to things, but all the while, watching myself from above as if my whole life was just a bit of a game.

None of this is real, I told myself as I felt hot tears spill from my eyes and roll down my cheeks.

None of this is real, I told myself as my fingers touched the bottom of the cardboard box of tissues that had been full when I entered the room.

None of this is real, I told myself as I tried to recall the last time I’d eaten a proper meal.

None of this is real, I told myself as I tried to remember what a proper meal was.

None of this is real.

Except, it was real. All of it. Every single confusing, arbitrary thing. Every tiny interconnected moment in time that had led me from the past to the present to the absolute of the here and now. It was all very real. And it hurt. It hurt in ways it wasn’t supposed to.

As I sat there, crying in front of the man I didn’t know, I wondered. Surely, somewhere, somehow, there was – and is – another way? A better way. A way that is happier, softer, more gentle. A way that is filled with hope.

After more than two hours, the psychiatrist asked me one final question: “Do you want things to be different?”

I opened my mouth to answer, but I was crying so hard that I couldn’t speak.

“I think that answers my question,” he said. “Thank you.”

Lowering the bar.

Ever since I was old enough to know what a sense of humour was, I’ve always loved making jokes.

Wherever I am, and whatever I’m doing, I’ll do my best to have a laugh and make light of the situation. I do it when I’m happy, when I’m nervous, when I’m angry, when I’m sad, and at all the bits in between. Even when my mood starts spiralling out of control, and I find myself in a deep, dark pit of dispair – which happens more often than I like to admit – I just laugh my way through and hope for the best.

Since being in hospital, I’ve relied on my sense of humour more than ever before. ‘If you don’t laugh, you’ll cry’ as the saying goes, and over the past few months I’ve found that to be absolutely true. I’ve also found that even if you do laugh, you will probably still cry, and sometimes, when things are really, really shit, you’ll do both at the same time. If that’s not a skill, I don’t know what is.

Whenever things are tough, I’ll often joke that the bar is very low. I do this, partly to detract from the gravity of the situation, partly for some light relief, and partly, I think, to give myself a bit of warning for whatever might come next.

This sounds pessimistic – and I agree, it probably is – but I’m sure there’s some logic in there somewhere. Probability suggests that if you set the bar low, you’re much more likely to achieve whatever it is you set out to do – whether that’s getting out of bed and brushing your teeth, getting dressed or eating breakfast. And when you succeed, you’ll be in a better position to tackle the next hurdle than if you’d set your sights too high and placed unrealistic expectations on yourself. Surely?

Recently, I read an article in Happiful magazine called ‘101 Reasons to be Hopeful.’ In it, actor and comedian Joe Tracini talks about his experience of living with Borderline Personality Disorder (BPD) – or “pound shop bipolar” as he calls it, and offers some hope for anyone else going through something similar. He describes living with suicidal thoughts on a daily basis, which are “always there…some days…just louder than the day before,” and how he knows that he’s done more good things than bad ones in his life, but that try as he might, he often only remembers the bad ones.

Joe said: “Nowadays, when I wake up in the morning, the only goal I set myself is to finish that day the same way I started it – in a bed, knowing I’ll see tomorrow. Even if today isn’t what I needed or wanted or expected, if I can just get through today…I’ll have another chance at tomorrow.”

When I read those words, it felt as though someone had reached out a hand and taken hold of mine. I felt a sense of connection, and for once, things made a bit of sense.

I’ve always struggled to set goals, and until recently, never really understood why. When I’m in a bad place, I find the whole idea of goal setting totally impossible – a bit like trying to paddle through the ocean with one of those tiny ice cream scoops instead of an oar. But when I’m feeling better, it still doesn’t get much easier. I can set goals, but they’re rarely realistic. In an effort to make up for the time I lost feeling hopeless and miserable, I set my sights too high, only to end up pushing myself to breaking point for no reason at all. And then of course, the whole sorry cycle starts again.

Often, when I’m scrolling through Instagram, I’ll come across posts that say things like “baby steps” or “take things day by day, hour by hour, moment by moment” and I’ll find myself rolling my eyes. Of course, I understand that sentiment, but even so, the cynical, over-achieving side of me baulks at the idea of setting such low expectations.

“How will I ever get anywhere if I spend my life patting myself on the back for getting out of bed and brushing my teeth?” I’ve thought to myself on many occasions.

I suppose my cynical side does have a point. I probably won’t get anywhere if all I ever manage to do each day is perform basic personal care. But who’s to say what getting anywhere really means? The older I get, the more I understand that when you think about it in isolation, goal setting is pretty meaningless. You can set – and achieve – all the goals you like, but if you’re still feeling miserable and hopeless at the end of each day, in spite of an ever-growing to-do list or teetering pile of accomplishments, then really, what’s the point?

When I read Joe’s words, it was as if something had shifted in me. I realised – perhaps for the first time in my life – that lowering the bar doesn’t have to be such a terrible thing, and certainly not a source of ridicule.

Like many things in life, lowering the bar isn’t a singular act; something that can never be undone, or that defines who you are. It is flexible and adjustable, and can be lifted higher or lower depending on the situation and context. Some days will be better than others – that, I think is inevitable – and on good days, the bar will be slightly higher, and you will – probably – achieve slightly more. But on days when it’s all you can do to stop the world from swallowing you whole, and your only focus is getting to see another sunrise, the bar will be low. And that is absolutely okay.