Posted on Leave a comment

10 Ways to Improve Your Mental Health

Mental Health is a hot topic these days. More and more people are recognizing that they suffering in some way with depression, anxiety, bipolar disorder or other mental health issues.

Today I’d like to share 10 things that can help to improve your mental health. I hope you find these helpful.

1. Recognize There’s A Problem

The very first step to improving your mental health is recognizing there’s a problem. You may be feeling a sense of the blues that you can’t shake, or a generalized anxiety that you can’t control.

Perhaps you’re feeling out of control and going through severe mood swings from mania to depression. All you know for sure is that something is “off” and you need to figure out what it is. Whatever the case may be, recognizing something is wrong is the first step to making things better.

2. Ask For Help

Perhaps one of the hardest things we face in life is asking for help. We like to think we’re capable of handling whatever life throws at us, but it’s not always that simple. You may find that at work, you’re more than capable of tackling whatever you face, but at home it’s a different story. Or, perhaps you’ve faced challenges at home that seem easy, but at work, you’re struggling to find your place.

When you’re dealing with your mental health, you may already feel like you’re a failure. Asking for help could prove to be a very difficult thing to do, but if you don’t ask, you tend to stay stuck in the situation you’re finding hard to manage. Talk to your doctor about what you’re going through, or find a counselor or trusted friend that you can share your concerns with. Sometimes just the very act of sharing with someone can help you feel better without further steps.

Success! You're on the list.

3. Accept Help

Once you’ve asked for help, the next step is to actually accept the help that’s offered. This might mean medication for depression or Bipolar Disorder if diagnosed, or your doctor could have other recommendations such as Cognitive Behavior Therapy, Meditation, Yoga for stress, etc.

Accepting help doesn’t mean you will end up with a mental illness diagnosis. However getting a diagnosis simply means that your body may not be producing the right chemicals to help you feel the best you can. There are hundreds of diagnoses, including Depression, Schizophrenia, Narcissism, Bipolar Disorder, and more.

Basically, your mental health can be simple or complex. A doctor or counselor can help to diagnose what’s going on and offer you treatment options. There is no shame in having problems with your mental health. Mental health issues are not your fault and are no different than having a medical condition. With changing times, terminology should no longer hold the stigma it used to. We live in an age where awareness is everything and more and more people are admitting to mental illness in the hopes that we can eliminate the stigmas all together.

4. Get Active

It’s time to get active with your mental health treatment plan. Exercise is a great place to start and many doctors will encourage you to get out and do something physical to help you feel better. Biking, walking, swimming, golf, tennis…whatever you like to do is the best fit. Even 30 minutes a day of exercise can help to balance hormones, improve mood, lessen anxiety and encourage better sleep. Especially if you can do it in the sunshine!

5. Explore Medication

Your doctor may recommend that you start on an anti-depressant or other medication for your symptoms. Please realize that taking medication is not a sign of weakness…it simply means your brain isn’t producing the right chemicals and needs a boost.

I liken it to other diseases…you wouldn’t refuse medication for heart disease or a kidney problem and you wouldn’t have an issue taking something for Diabetes, so why would this be any different? If your brain isn’t creating the right chemical mix, medication is an easy way to correct the problem and bring things back into balance.

Of course ultimately, it’s your choice. Psych meds can have a range of scary side effects and it can sometimes take years to find one that will work right for you. There are also alternatives to medication use. For a list of options, click here.

6. Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) focuses on challenging and changing unhelpful thoughts, beliefs, attitudes and behaviors, improving your emotional response and aiding in the development of personal coping strategies that target solving current problems.

CBT rests on the idea that thoughts and perceptions influence behavior. Feeling distressed, in some cases, may distort one’s perception of reality. CBT aims to identify harmful thoughts, assess whether they are an accurate depiction of reality, and, if they are not, employ strategies to challenge and overcome them.

CBT is appropriate for people of all ages, including children, teens, and adults. Evidence has mounted that CBT can benefit numerous conditions, such as major depressive disorder, anxiety disorders, post-traumatic stress disorder, eating disorders, obsessive-compulsive disorders, and many others. Research also indicates that CBT can be delivered effectively online, in addition to face-to-face therapy sessions.

This link gives you a quick overview of what CBT is and how it works. Ask your doctor for a referral to a certified CBT professional if you think this type of therapy could be helpful for you.

7. Yoga* and Tai Chi

As discussed, exercise is a good way of helping you feel better about yourself. Some people find Yoga and/or Tai Chi to be of great benefit when they are struggling with mental health issues.

The discipline involved with following regulated steps in a slow and deliberate fashion helps to calm the mind and put the focus on your overall well-being. Feeling your muscles working together can be very soothing and the slow movements are safe for just about everyone. Mastering the various forms gives you a sense of success which can be great incentive to keep going.

*Please note: Yoga is not recommended for people with hypermobility. Thank you.

8. Nutrition

Your body needs fuel to function and good nutrition is key to feeling well physically and mentally. By following a healthy eating plan and getting plenty of fresh fruit, vegetables, whole grains and protein, you are aiding your body in running in top condition.

Caffeine may or may not fit into your life – some people find it makes them jittery, others have no problems. Try adding more water to your daily intake – it helps lubricate your brain and joints and keeps you hydrated for optimal function. Avoid sugary beverages as much as possible – they don’t add any value to your health.

9. Spiritual Practices

Being spiritual doesn’t mean being religious, but both can have a place in your life. If you are religious, you may find prayer to be of comfort while you deal with your mental health. If religion is not your thing, spirituality can come from the sense of a Higher Power, Nature, Music or other practices.

Try to engage in your Spirituality/Religion on a daily basis – you may find a time of prayer, being in nature or listening to music to be of value when done at the same time every day. Some people like to do this in the morning, when the day is fresh in front of them. Others prefer to do this at night, so they can reflect on the day.

Whatever time you choose, it’s your time to be honest with your beliefs and to honor them in a way that feels authentic to you.

10. Journaling

Many people who live with mental health issues find journaling to be of value. Being able to honestly reflect on your life without fear of others reading your words can bring great comfort. The key is to write honestly about your feelings, not worrying about recriminations and criticism.

Choose a time to journal when it’s quiet and you won’t be interrupted. Set the stage with a cup of tea or other beverage, find a quiet writing nook and let yourself go. Don’t worry about impressing yourself with perfect grammar – just let yourself go and free flow with the writing. Unless you choose to share your journal with others, this is for your eyes only.

The freedom that comes with writing can bring clarity to your life and help you recognize areas that might need improvement, which then leads to greater understanding and happiness.

A Few Final Thoughts

I hope these 10 steps help you to realize that mental health issues are important and need to be taken seriously. You deserve to feel your best and when you’re not, everything else seems to get bogged down.

By attending to your mental health, you are actually doing your physical body a favor as well, since you’re bound to feel better in all ways when you’re feeling better mentally.

Recognize the problem, ask for help and try some of the steps above and see if things improve. Your doctor is always a great place to start and counseling is almost always worthwhile. You owe it to yourself to be your best version of you. Good luck!

Pamela Jessen lives in Langford, BC Canada. She is a blogger who writes about Chronic Pain, Chronic Fatigue and Invisible Illness at  She also writes for The Mighty, and various independent publications. Pamela is also a Patient Advocate with the Patient Voices Network in BC.  She sits on 4 committees and one Provincial working group and has also been involved in advocacy work at the Canadian National level as well. Pamela is married to her amazing husband Ray and they have one cat named Dorie. 

Posted on 9 Comments

Improving Your Mental Health despite Chronic Illness, Post 1

Please note this post contains affiliate links. Thank you.

It’s been a while since I’ve discussed any mental health topics on the Zebra Pit, so I’m glad Mental Health Awareness Month has come around to help get me motivated. As many of you know, I have a complex PTSD diagnosis and because of this and several of my other diagnoses, I also struggle intermittently with depression and anxiety. I spent a few months in therapy recently to try to get some help to better control these issues and have picked up several new tricks that seem to be working wonders. In this two part series, I wanted to share with you some of the things that have worked well to bring me to a more stable and positive place in my mental health journey.

While I’m sort of a lifer when it comes to therapy and DIY mental health improvement, I found myself struggling when my disability became severe enough to rob me of a life and career outside the home. Between the deep sense of loss I suffered and the onset of dysautonomia and MCAS, my old bag of mental health tricks were failing. As it turns out, I needed some help to get things back in order and the changes I had to make were both related to my physical and mental health.

You don’t have to have complex PTSD to benefit from the techniques I discuss. It probably doesn’t matter how the depression and anxiety got started, either. What’s important to understand is that these conditions are NEVER “all in your head” or “imaginary” and you can’t “just get over it” when you’re suffering from actual clinical depression and anxiety. Can it heal naturally on its own? Sometimes, but healing is much faster and more thorough with active intervention. Generally speaking, these conditions take hold when there’s an imbalance of key hormones in the body such as seratonin, glutamate, and GABA.

My anxiety and depression stem from a combination of genetics and environment. I experienced long-term abuse and neglect as a child and can also experience wild hormonal fluctuations brought on by the central nervous system dysfunction. The most likely culprits are my suspected autism, POTS and MCAS, as these all can have a big impact on the erroneous release of chemical mediators in the body. While the triggers are slightly different, the results are always the same, big fluctuations in mood and even bigger guilt when those fluctuations drive me to behave badly.

What I needed to get my anxiety and depression under control was a way to control my misbehaving mast cells and POTS, some CBT techniques to get me out of negative self-talk cycles and some mindfulness training to help keep me firmly grounded in the present rather than wallowing in the pain of the past.

My Mental Health Journey

If you’ve watched my video on PTSD and Chronic Illness or my post The Toxic Shame of Being Disabled, you know that my mental health took a big hit when I became too disabled to work, after I had done years and years of hard work to improve my mental health.  You’ll also know that I already realized my original toxic shame (that heaped on me by my abusers) was somehow connected to my inability to accept my chronic illness and the recurrent PTSD cycles I was entering every time I had to face a doctor or any sort of disbelief when it came to my conditions. I was so close, but I couldn’t quite make everything fit.

It may have been in my first therapy session that my therapist simply handed me the key to the puzzle about why I was still occasionally fighting those rage demons and being so hard on myself. In essence, I was being constantly retriggered because I was being treated by doctors, family and friends the same way I was treated by my mother, my only caregiver. In some cases, even the same words or phrases were used. That’s all it took to unravel hundreds of hours of hard work.

My mother didn’t care enough to pay attention or spend time with me or learn about who I was or even ensure that she was ever home to supervise, prepare meals or anything else. I was largely abandoned at age 4 and left to care for myself the rest of my childhood, as my mother always ensured her jobs were 2nd shift so she didn’t have to be home with us. I wasn’t allowed to use the stove until I was 10 and was left hungry often. When she was there, she struck me constantly with her words and occasionally with her fists. She chose always to believe the worst of me. I was attention seeking when I was ill. I was stupid, worthless and lazy when I did poorly in school (never mind that I had no one to tutor me at home and was moved from one school district to another year after year). And when I had difficulty working under the weight of all the emotional baggage and untreated genetic conditions, I was just plain lazy and slovenly and would never amount to anything.

Having a doctor tell me they didn’t believe me or summarily discharge me or behave condescendingly, immediately transforms me into that helpless 5 year old. Without doctors, I was lost and I knew it. Abandoned, unloved and disbelieved, just as I had been as a child. After a while of dealing with this from doctor after doctor, the anxiety I began to experience before my appointments grew until I was having full blown panic attacks every time I even thought about scheduling an appointment; a very bad place for a person with chronic illness to be.

Techniques for Mental Health Improvement

It has helped a little to finally be diagnosed and connected with doctors with knowledge of my health conditions. Unfortunately, it didn’t help enough. Understanding that my reactions were shame based also helped and let me feel a little less guilty about it. However, it wasn’t until my therapist helped me clearly connect the dots that I could fully accept my behaviors and stop the self-defeating cycle of being triggered, sometimes behaving badly because of it and then beating myself up about it and only fueling that shame more.

I had really begun to feel bad about myself. Even if I could still list the positive attributes about myself, they were all in past tense. I couldn’t feel them or feel like they still existed. I participated in frequent negative self talk that wasn’t even true. In psychological terms, this is known as distorted thinking and many people fall prey to its trap. My therapist helped me with that, too. She assigned me exercises to help me identify when my thinking was distorted and reason out why. This has helped me significantly and I no longer need to pull out the worksheet to do it. If I need to utilize it now, it happens in my head. The true beauty however, is that I find I rarely ever need it anymore. I guess that’s why the workbook it came from is called Ten Days to Self- Esteem! It’s a great cognitive behavioral technique and I’ll probably post about it in more detail going forward, but here are some copies of the worksheets in case you want to try it.

On this sheet you describe the thought and then assign which types of distorted thinking you’re participating in. Often, there are several categories that fit.

While working with a therapist is probably my number 1 recommendation, there are a variety of ways you can work on these issues alone and buying workbooks like those these exercises came from is a great way to get started. I always learn things from these books. Here are a few that I’ve read or completed and recommend, including the two from above:

The other psychological tool that’s been invaluable to me is practicing mindfulness meditation.  Meditating can be tricky for people with chronic illness. Most of us utilize mental blocks to help regulate our pain whether we’re conscious of it or not. Because of this, when we open ourselves fully in a meditative state, we get flooded with pain.  There is a work around for this, however: practicing ACTIVE meditation of some kind. It sounds complex, but it really isn’t. You just have to choose an easy task—crafts, arts, coloring, a guided meditation, tapping, gentle exercise or simple movements—and discourage any distractions or outside thoughts. Anytime you feel your mind wandering, you just bring it back to the task at hand.

Active meditation isn’t just for spoonies, either. It probably works better overall for people in the current age where we’re always busy and constantly bombarded with information.  You can find a wide variety of apps, programs and websites to help you learn how, but I will also write about this in more detail, later. Here are a few great books on mindfulness and active meditation to get you started,now.

Another technique which sounds really simple, but often isn’t for people with anxiety and/or dysautonomia, is deep breathing. Deep breathing exercises are only helpful if you know how to utilize the technique and your central nervous system and muscles aren’t so locked that it’s physically impossible to take a good, deep breath. The 90/90 balloon exercise below will help you learn how to breathe deeply and will actually help you to build your core and helps to address several musculoskelital concerns:

Once you’ve been practicing the 90/90 for a little while taking a good, slow deep breathing exercises should no longer be a problem. When you begin to feel anxious taking several slow and measured breaths helps to switch the autonomic system and park it in rest mode. Doing this several times a day can be very helpful in maintaining peace. Be sure when practicing breathing exercises that you’re engaging your diaphragm and most importantly, going very slow and steady so you don’t hyperventilate. You can ry the breathing exercise below first to see if you need to practice the 90/90 exercises.

Pinterest image with blue sky and clouds is overlain by text. The text reads: "Breathing Exercises: 1.	Sit or lie flat in a comfortable position. 
2.	Put one hand on your belly just below your ribs and the other hand on your chest. 
3.	Take a deep breath in through your nose, and let your belly push your hand out. Your chest should not move. 
4.	Breathe out through pursed lips as if you were whistling. Feel the hand on your belly go in, and use it to push all the air out. 
5.	Do this breathing 3 to 10 times. Take your time with each breath. 
6.	Notice how you feel at the end of the exercise. The Zebra Pit"

How Exercise Can Help:

Exercise has many powerful attributes which are beneficial to spoonies, when done gently and with healthy consideration given to avoiding post-extertional malaise (PEM) and joint injury. Spoonies should exercise regularly despite pain and other problems unless your doctors tell you otherwise (for example people with NMH need to be evaluated before they take on exercise). It is important that you go slowly, pace yourself and protect your joints. For more information, visit these guides specific to POTS and EDS (the EDS one is probably good practical advice for most connective tissue disorders, but I would consult with your medical team to be sure.

Participating in a regular exercise program can improve overall mood, help balance hormones and raise endorphin levels, providing an overall feeling of wellbeing and happiness. It can improve sleep, something else which is essential for positive mental and physical health.  Exercise can also help to loosen tight muscles and help us relax and feel less anxious. It can also help get things off of your mind, especially if you work to stay present and focused on the tasks at hand instead of letting your mind wander to less pleasant ideas.

The activity doesn’t necessarily have to be “exercise” in the traditional sense. Anything physical that gets your heart rate up a little, blood circulating through your body and good deep breaths into your lungs is a great way to combat anxiety and depression. If you prefer to take walks, hike, garden, bowl, canoe or rent paddle boats, go for it! So long as it’s safe for you to perform that activity (see the articles above for some tips).

Spending time doing anything you enjoy is always a great way to turn around poor mental health, at least temporarily. Whether you consider spending time with friends and family, reading a book, taking in the fresh air and flowers at a nature preserve or going shopping to be great fun doesn’t matter, so long as you choose the right activity for you.

There are some great techniques here and I hope you find them helpful, but for most spoonies with some form of dysautonomia and/or mast cell disorder, you’re going to need some help from mother nature’s pharmacy. In part two of this series, I cover a number of over-the-counter natural medications, vitamins and minerals you can take to help with both depression and anxiety. I also discuss how medications can impact mental health and what to do about it when you realize something you’re taking is causing a problem:

References and Further Reading:

Success! You're on the list.
Pinterest Image shows a blue sky with clouds. The overlay text says "Improving your mental health despite chroinic illness. The Zebra Pit"
Posted on 3 Comments

PACE Trial Data Released

Republished from QMUL Releases the PACE DATA

Queen Mary University of London (QMUL) has released the PACE data to a patient who requested it under the Freedom of Information Act, as ordered by a recent tribunal, on the last possible day to lodge an appeal against the court’s order.

The move follows the publication three days previously of an open letter from a group of scientists including Dr. Ron Davis, Vince Racaniello and Jonathan Edwards, urging QMUL’s principal, Professor Simon Gaskell, not to appeal the tribunal’s decision.

The data was requested in March 2014 by Alem Matthees, in order to allow the calculation of the trial’s main outcomes and recovery rates according to the methods specified in the trial’s original protocol. The original analysis methods were abandoned once the trial was underway and replaced by others, including an analysis in which patients could become more disabled and yet be classed as having “recovered”.

Tom Kindlon, a patient whose criticism of PACE’s analyses has been published in medical journals, said, “This is a great day for patients. We’ve waited years for this. Finally, it’s going to be possible for independent parties to scrutinise the data and, in particular, find out what the results would have been without all the unjustified changes to the study protocol. Looking at how the objective data relate to the subjective outcomes will also be very interesting.”

“This was a publicly funded trial and cost £5 million in taxpayers’ money — the data should never have been kept secret.”

-Tom Kindlon

He added, “This was a publicly funded trial and cost £5 million in taxpayers’ money — the data should never have been kept secret. It is very disappointing that both the PACE Trial investigators and QMUL fought the case so hard, forcing Alem Matthees to have to put in so much work when he is not well himself, and dismissing some other requests for basic information.”

The day before the data was released, the PACE authors published online the main results for the trial using the original protocol-specified methods. The new results show that only a third as many patients improved according to the protocol-defined analysis, compared to the numbers reported in The Lancet in 2011.

The results confirm suspicions long-held by patients and scientists who have studied the trial critically that if the PACE investigators had stuck to their own original analysis protocol, PACE would have appeared to be a far less successful trial.


The new results show that only 21% of patients were classed as “improvers” in the graded exercise therapy group, compared to the 61% claimed in the Lancet paper using an analysis developed after the trial was under way. 10% of patients in the group that received no therapy were “improvers”, indicating that, even with the subjective measures used, only one patient in ten reported improvement from the addition of graded exercise therapy. Results for the CBT group were similar to those for the graded exercise group.

These re-interpreted results were released without fanfare on QMUL’s own website. Despite the dramatic fall in improvement rates, the study authors said that the outcomes were “very similar to those reported in the main PACE results paper” and supported their Lancet conclusion that CBT and graded exercise, added to standard medical care, “moderately improve” outcomes for CFS patients.

But journalist and public-health expert Dr. David Tuller, of the University of California, Berkeley, who has criticized the trial in detail, said, “Let’s be clear. These findings are really much worse than those presented in published, ‘peer-reviewed’ papers. If these were the best findings for $8 million, then PACE really will not survive legitimate scrutiny.”

But now, with the original, raw data going to Alem Matthees, a more independent review is sure to follow.

Over the past several months, following the first of Dr. Tuller’s critical articles, patients and scientists have joined together all over the world to put pressure on QMUL to release the data. A petition led by #MEAction with over 12,000 signatures was featured in the Wall Street Journal, and was presented at the tribunal as evidence of the level of public interest in data release; and 24 ME/CFS organisations in 14 countries, representing tens of thousands of patients, wrote open letters to the university.  L.A. Cooper, head of #MEAction Network UK said, “Our thanks go out to Alem Matthees, who worked incredibly hard to achieve the release of the PACE data at what was almost certainly enormous physical cost.  Thank you, Alem!”

Source: QMUL releases the PACE data

Posted on Leave a comment

Sign the Petition: Misleading PACE claims should be retracted

A new petition from our friends at demanding retraction of the falsified trials that name GET and CBT as effective therapies for CFS:


Given the weak and flawed methodologies of the PACE trial, which claims that CBT (cognitive behavioral therapy) and GET (graded exercise) led to the recovery of ME/CFS patients, we, the undersigned patients, doctors, scientists, parents, children, family, friends, caretakers and #MEAllies:

– call upon The Lancet to retract the claim made in its February 2011 editorial [1] that 30% of patients, or indeed any patients at all, were said to have recovered in the accompanying Lancet paper on the PACE trial [2]; and retract from that paper all analyses and statements in relation to the absurd “normal ranges” for fatigue and physical function;

– call upon Psychological Medicine to retract the claims in this paper [3] that 22% of patients in the CBT and GET groups recovered, based on recovery criteria that were weakened so far from their original form in the study protocol that they no longer represent recovery by any rational standard;

– call upon the study authors to publish the recovery outcomes according to the analyses specified in the trial’s protocol [4] and to give independent researchers full access to the raw data (anonymised by removing trial identifiers and all other data superfluous to the calculation, such as age, sex or location). #MEAction undertakes to meet any reasonable cost of analysis or data preparation;​

– call upon all parties to reject the view that being as disabled as patients with congestive heart failure is a good recovery of physical function in CFS.

To sign the petition go to: Misleading PACE claims should be retracted | #MEAction.