health Archives - Essy Knopf

7 creative self-care techniques for neurodivergents

Reading time: 6 minutes

Do you struggle with self-care as a neurodivergent (ND)? You may not be the only one.

Surviving in ableist societies can be taxing for many ND folks at the best of times. We may spend all our energy just trying to fit in—energy we may otherwise need for rest and recharging.

Added to this, many self-care techniques can feel like a chore, especially when we are pressed for time.

Trying to squeeze one more thing into an already overburdened schedule when we’re already feeling overloaded can be particularly anxiety-provoking.

I remember once upon a time, the very idea of pausing to do meditation or a yoga class was enough to send me into a tailspin.

“That’s 20-30 minutes I’ll be losing from my schedule,” I would think. “20-30 minutes I don’t have!”

Given much of my workload was self-generated as a result of ADHD workaholism, my sense of urgency around time in retrospect didn’t make a whole lot of sense.

No one after all was demanding I submit a script in time for three different competitions. The deadline I had set for finishing my feature documentary was of my own devising.

The pressure of being a multi-passionate autistic

The issue in my case had to do with my fixating on the gap between where I was and where I wanted to be. I was a multi-passionate autistic and ADHDer with an array of interests I knew I could excel at…if only I knocked on the right doors and made the wrong connections.

This unsurprisingly is where I struggled most. NDs face very real obstacles with social communication and interpersonal relationships. And yet I told myself that I could ignore these obstacles. Sooner or later, my labors would yield fruit.

And so I continued to work in isolation, in the service of various passions that I hope to turn into viable careers.

After years of this, I began to feel rather hopeless about it. What, after all, did I have to show for all my effort, save a few life experiences and college degrees?

My dissatisfaction drove me only further in my pursuit of achievement, which in turn made my self-worth dependent upon that pursuit.

The time pressure I thus experienced was not the result of external circumstances but toxic self-perceptions. I didn’t believe myself to be “good enough” or deserving of self-care until I had first “made it”. Yet failing to care for my own needs only increased my anxiety and this sense of time pressure.

For other NDs, external circumstances may indeed pose a very real obstacle to self-care. When we are strung out between the pressures of operating in a neurotypical (NT) world, alongside commitments such as work, school, family, and social lives, self-care activities certainly start to seem onerous, if not out of the question.

Yet no matter how strong the impulse might be to put downtime on the back burner, without adequate rest and rejuvenation, our ability to fulfill these commitments and pursue our passions will suffer.

Should self-care techniques such as getting a massage or drinking water fail to appeal to you, consider exploring the following seven simple and unorthodox methods.

1. Shower mindfully – an unexpected NT self-care activity

Don’t have time to recline in a bath? Not a fan of bubbles and scented soap? That’s okay.

If being pummeled by hot water is more your jam, follow this quick 5-minute guide to increasing your shower pressure.

Next, shake up your mindfulness routine by trying this exercise while standing under your showerhead.

2. Shop guilt-free

Retail therapy can indeed have therapeutic benefits, but in excess, it can create debt that negatively impacts our mental health. Know however that self-indulgence doesn’t have to hurt your pocketbook.

Visit a discount store with low-priced items. Hunt down little items you might not otherwise have budgeted for, but which you know will add some value or comfort to your life.

For example, a shower caddy, plastic storage tubs, or a new drink bottle.

Whatever you end up buying, know that it is the act of spending money that generates the “feel good” feelings typically associated with retail therapy.

This way you’ll get all the benefits with none of the financial strain—or buyer’s remorse.

3. Have a lie-in

Pick a morning when there are no pressing matters to attend to and simply stay in bed.

Alternatively, use your morning to complete errands and spend the remainder of your day under the covers.

Make whatever adjustments are necessary to maximize comfort. Turn on your air conditioner, close the blinds, put your phone into airplane mode, make a cup of tea, light a scented candle, or switch on an essential oil diffuser.

If relaxing still proves difficult, and you find yourself battling anxiety, consider donning a weighted blanket or a compression vest.

These use deep pressure to help ease anxiety and are available to purchase online.

4. Ritualize a mini-hobby

Many hobbies require time and energy we aren’t always able to spare. If this is your experience, consider expanding your definition of the word “hobby”.

For instance, I was never much one for comedy, save for watching the odd opening monologue from a late-night talk show, schedule allowing.

When I discovered that these shows made a perfect accompaniment to my breakfast routine, I understood that maybe time wasn’t an issue after all.

Sure, enjoying Jimmy Kimmel, Samantha Bee, John Oliver, Seth Meyer, and Stephen Colbert isn’t strictly a hobby. Yet it can impart many of the usual benefits, such as supporting mental health and relaxation—in this case, through laughter.

By incorporating a mini-hobby like this into your day, we will stand a better chance of making it a habit, ensuring it survives peak periods of busyness.

In order to create a habit, we not only have to do it regularly—we also have to follow the four laws of behavioral change, as described by Atomic Habits author James Clear:

#1 Make it obvious.
#2 Make it attractive.
#3 Make it easy.
#4 Make it satisfying.

In my case, the enjoyment provided by watching these videos fulfilled law #4 (“make it satisfying”).

In order to “make it obvious”, I subscribed to each comedian’s dedicated YouTube channels so that their most recent videos appeared on my homepage.

By keeping my YouTube homepage always open in a browser tab, I enhanced the attractiveness of these videos (“make it attractive”).

And by waking up early, I was able to eat and perform my new ritual at my own pace (“make it easy”).

5. Take a power nap

Napping isn’t just the favored activity of layabouts—it’s also a super effective way to give your flagging energy levels a boost!

If your workplace doesn’t look favorably about employees taking catnaps, a quick lie down after a taxing day can help restore you.

Naps of between 10-20 minutes are considered ideal, as anything longer than 30 minutes can leave us feeling groggy upon waking.

Napping not only decreases sleepiness but can improve learning and m e m ory while supporting the regu l ation of our emot ions.

6. Get some green therapy

The emerging discipline of green therapy—also known as ecopsychology—is concerned with using nature to help us recharge our internal batteries. Multiple studies have demonstrated that the presence of nature can have a plethora of health benefits.

Venturing into the wilds may not always be possible, but you can reap the same benefits from visiting your local park. Twenty minutes as it turns out can be enough to relieve stress.

You reap similar effects using simulated green spaces. For instance, by placing fake plants around your home or workspace.

Another method involves slipping on a pair of headphones and listening to natural sounds, such as wind through trees or running water.

7. Try audio bibliotherapy

The act of sitting down to read a book in today’s helter-skelter world is becoming increasingly uncommon. But if you lack the patience to read the conventional way, you can always try listening to an audiobook instead.

Having your books read aloud to you can be an effective way to consume content without having to add to your already overburdened schedule.

Furthermore, if you’re suffering work-related stress or battling anxiety and depression linked to your busy lifestyle, reading books about these challenges can go some way to lighten your load and help you apply self-care techniques.

Healing through reading is known as “bibliotherapy”, and it can serve as a wonderful resource for those among us struggling to access support networks or the sympathetic ear of a therapist.

Books that teach self-care techniques

There is no one-size-fits-all solution to the challenges mentioned above. But if you aren’t able to invest the time to seek out personally appropriate guidance, consider exploring the following recommendations:

For dealing with stress: Full Catastroph e Living – John Kabat-Zinn
For depression: Feeling Good – David D. Burns
For anxiety: When Panic Attacks – David D. Burns, The Places That Scare You – Pema Chödrön
For dealing with difficulties: When Things Fall Apart – Pema Chödrön
For making peace with your mind: The Happiness Trap – Russ Harris
For setting boundaries (including at work): Boundaries – Henry Cloud & John Townsend
For learning how to practice self-compassion: Self-Compassion – Kristin Neff

8. Start a self-compassion practice to round off your self-care

Build a deliberate self-compassion practice with the support of the many free, downloadable resources on the Self-Compassion website.

Author Kristin Neff has prepared brief guided practices, a list of exercises, and tips for those new to the concept.

Finally, if you have a habit of going too hard on yourself and zeroing in on your supposed deficits as an ND, try adopting a strengths-based perspective.

Instead of looking at yourself as somehow flawed, acknowledge the many strengths that come with being ND, which I explore in another blog post.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Yes, male privilege exists. But it carries a terrible cost—especially if you’re gay.

Essy Knopf Leave a comment

Reading time: 6 minutes

The dominance of the male gender is visible not only in male privilege,¹ but also their overrepresentation in high-income brackets and their managerial roles.

It would be easy to assume that the many advantages enjoyed by males serve as a buffer against poorer health outcomes, and yet this isn’t always the case.

Men are for example more likely than women to die early from a number of causes, including suicide.² This trend is not exclusive to the US but it is present globally as well.

And these early deaths aren’t so much the result of lifestyle choices, some argue, as they are the profound loneliness lingering just below the surface.

The connection between male privilege and loneliness

In I Don’t Want to Talk About It, Terrence Real makes a compelling case for socialization’s role in contributing to the all-too-common experience of loneliness among older men.

He notes that boys compared to girls are typically less spoken to, comforted, and nurtured by their caregivers, leaving them prone to passive trauma, for example in the form of neglect.

Real notes they are also socialized to cut themselves off from their own feelings, their mothers, and from social support.

That is, socialization teaches boys and men that entry to the club of masculinity is dependent upon their continued spurning of “dependency, expressiveness, and affiliation”.

Males are asked to uphold an impossible gender norm closely tied to the notion of rugged individualism.

Real says the cost of passive trauma and disconnection from self and others is that males suffer an unstable sense of self-esteem—and even shame—over their own emotions.

Forbidden the right of vulnerability, males have no choice but to emotionally numb themselves, internalizing rather than externalizing their distress. The result is covert depression.

Having been trained to avoid others’ support, men inevitably turn to “defensive compensations” for this depression, such as drinking, gambling, or sex.

The difficulty, however, lies in the fact that the resulting “addictions do to shame what saltwater does to thirst”.

Similarly, men may also seek an escape through grandiosity, or what Real calls the “illusion of dominance”.

The terrible loneliness of being at the top

What Terrence Real calls grandiosity, Lonely at the Top author Thomas Joiner describes as a fixation on earning money and building status.

Men in their 20s and 30s, he argues, are usually more self-focused than women. They assume an “either/or attitude toward wealth and status on the one hand and social connection on the other hand”.

But as men age, this attitude wreaks a terrible price in loneliness, resulting in significant health disparities and higher mortality rates.

Joiner however diverges from Real’s thesis here by describing factors other than socialization as contributing to the male inability to form and maintain interpersonal connections later in life.

For example, he cites the “people versus things” gender dichotomy. Namely that from a very young age, boys are more interested in things, while girls are more interested in people.

Males are by nature more inclined towards an instrumentality mindset, grounded in “assertiveness, self-confidence, competitiveness, and aggression”.

This is opposed to the typically female, people-oriented mindset, which celebrates expressive traits such as “affection, cooperation, and flexibility”.

Joiner notes other differences, such as the fact that boys get less social coaching from each other and from men when compared to their female counterparts.

Girls also have more gender- and age-diverse friendship networks. This contributes to females as a group enjoying greater interpersonal hardiness.

Having been spoiled with the “institutionalized, ready-made friendships of childhood”, men may fail to develop an appreciation for the “worked-for friendships of adulthood”.

Joiner claims that an instrumentality mindset can also lead to males developing a “don’t tread on me” attitude, best described as a “dogged self-sufficiency in the absence of healthy interdependence”. The links again to rugged individualism are, again, clear.

Joiner adds that “don’t tread on me” carries the tacit message of “don’t connect with me”. As argued by Real, men believe this attitude is necessary to preserving their conferred status as males.

“Don’t tread on me” combined with the single-minded pursuit of money and status normalized by our materialist culture can result in a more passive approach towards relationships.

Men as a result may be less likely to undertake the work necessary to maintain them.

In failing to feed or renew relationships, or to seek out new ones as they age, men may be setting themselves up for significant loneliness down the road.

The fact that men’s internal’s sensors are not fully attuned to their own emotional or social loneliness, Joiner agrees, further compels them to pursue said compensations. And rather than resolving loneliness, they only have the effect of compounding.

The health impact of engaging in addictive behaviors aside, loneliness itself can contribute to poorer health outcomes in later life while corroding one’s resilience and ability to cope with failures, disappointments, and losses.

When compared to seeking professional mental health, compensations are a more likely outcome among males, given that doing the former can threaten the male image of self-sufficiency.

And let’s not forget the stigma associated with male loneliness and accessing such services, which serve as obstacles in their own right.

How intersectionality can deepen male loneliness

Intersectionality argues that it is possible to simultaneously enjoy power and/or privilege in one situation, arena, or aspect of life, and oppression and/or disadvantage in others.

So while being male broadly conveys power and privilege, being an older male in Western society can have serious implications for one’s health and wellbeing.

If one happens to be an older male and have a minority identity such as “homosexual”, the impact can be exacerbated, for example through minority stress caused by stigmatization, discrimination, and prejudice.

This impact grows when one is also a person of color, a trait which brings many disadvantages in a White-dominated culture such as North America.³ ⁴

The minority status of being gay male alone contributes to arguably higher levels of loneliness. And there is also the fact that gay men as a population have to work harder to gain entry to the “male club”.

Hostile attitudes towards homosexuals are often grounded in perceptions of their abnormality, i.e. “Too feminine”.

According to author Simon LeVay, gay men as a population are indeed different, exhibiting a “patchwork of gendered traits—some indistinguishable from those of same-sex peers, some shifted part way [sic] toward the other sex, and others typical of the other sex”.

In Gay, Straight, and the Reason Why, he cites studies that indicate that where it comes to instrumentality and expressiveness—typically male-favoring and female-favoring traits, respectively—gay men tend to be shifted towards the opposite sex.

Having gender-shifted traits in a culture that defines masculinity by limited expressiveness can thus double the pressure felt by gay men to conform to the stereotype.

It also means they are more likely to experience the disapproval of, and rejection by, others who subscribe to the standard (toxic) definitions of masculinity.

Social hostility can generate internalized homophobia, feeding into higher-than-standard rates of depression and anxiety.

It also provides a rationale for the all-too-common flight by gay men into compensations. (Consider here the higher rates of substance use and abuse, out-of-control sexual behaviors, and other process addictions.)

The link between gay loneliness and the potential for harm for example has been demonstrated in a study linking riskier sexual behavior as an avoidance strategy.

Those who engage in this strategy are for example exposed to higher rates of HIV and other sexually transmitted diseases.

The solutions to male privilege disconnection

To summarize, masculinity is coded in Western society in ways that are emotionally oppressive to males, hence the term “toxic masculinity”.

This oppression is intensified especially the case if you also share minority identities, such as being gay and a person of color.

When combined with a biological inclination towards instrumentality and a cultural bias towards rugged individualism, this can wreak great harm to our mental wellbeing and our relational world.

From this comes disproportionately adverse health outcomes, which as mentioned run in the face of the perceived advantages of being a member of an empowered and privileged gender.

Unfortunately, gender coding and social conditioning have been in existence for thousands of years. The intricate tapestry of our gendered lives cannot be unpicked overnight.

All the same, there are actions we can take as males to address the hidden costs of our gendered identity.

Namely, we can choose to embrace “dependency, expressiveness, and affiliation”. We can strive for a greater connection with our inner selves, and others.

Such connections can be forged, Joiner says, by engaging in shared rituals that create a sense of belonging, togetherness, or harmony, such as sharing a meal with loved ones.

Here are some other suggestions:

Connecting to nature: As men, we stand to benefit by interacting more regularly with nature.

This experience can reduce loneliness, especially when it provides opportunities to interact with others. For example, through hiking or gardening groups.

Daily phone calls: However awkward as calling people up out of the blue may seem today, relying too heavily on text messages can have some serious downsides.

Instead, Joiner suggests calling one person daily, if only for a few minutes.

Whether you have something pressing to talk about is not important. The goal here is to create connection.

Reunions: Organize a reunion with best friends from one’s younger days can be a great way to renews existing connections.

Given the male tendency to lose touch with friendships as we advance towards middle age, this is essential.

A reunion can also bring many of the benefits associated with indulging nostalgia.

Sleep regularization: None of the above is possible if our sleep schedule is out of sync with those of others.

If this is the case, we should consider shifting our life patterns to promote social interactions.

We can this by maintaining a regular sleep schedule and seeking out opportunities to interact with others, such as through a shared physical activity like a sport.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Social work

Social workers, here’s the practical guide to self-care you’ve been looking for

Essy Knopf Leave a comment

Reading time: 5 minutes

Surviving the social work profession ultimately comes down to the self-care habits you establish in social work school.

The strongest habits reflect an understanding of priorities. Amid all the competing demands of school, you may ask yourself which to put first.

Is it school? Your placement? Your job? Your family? NOPE.

Your number #1 priority is—and always should be—you. Because without health and wellbeing, you can’t properly attend other all the other priorities.

Many folk regard self-care as a nice “add-on” to their daily routine, such as a kind act towards one’s self, like taking a bath or getting a massage.

Such acts certainly matter, but self-care most importantly is ensuring you are getting the necessary sustenance for your body, mind, and spirit.

I’m someone who considers myself to be fairly well-versed in self-care principles. But even so, I still struggle to practice it.

What doesn’t help is that I, like most, have certain gaps in my knowledge of self-care principles. For example, it was only in my late 20s that I found out about sleep hygiene, a practice essential to getting a good night’s rest.

For this reason, I’m going to start with a brief overview of the five fundamentals of good health (some of which I touched upon in my previous post on social work s elf-care).

The five fundamentals of self-care

1. Eating well. As social work students, we will often be so busy we end up relying on takeout.

We can avoid this by meal planning and cooking in batches. Aim to get plenty of fresh plant-based nutrition.

2. Getting sleep. While it’s not always possible, we should always strive to go to bed and get up at the same time each day.

This is one part of practicing good sleep hygiene. Here are some other suggestions. Note that experts recommend getting seven to nine hours of sleep each night.

3. Exercising daily. All of us should aim for 30 minutes of “sweat-breaking” exercise every…single…day. Yep, you heard right!

If you’re short on time, consider doing a YouTube aerobic class. Failing that, try for a 20-minute walk around the block.

4. Staying social. It’s crucial that we dedicate time every week to enjoying the company of friends, family, peers, and partners. It’s all too easy otherwise to find ourselves caught up in an endless cycle of study.

5. Limiting intake. Sure, caffeine can help us shake off tiredness. And alcohol may help ease stress. But taken in excess, they may do us more harm than good.

The same can be said of highly processed foods. When we’re strapped for time or low on funds, it’s all too easy to reach for a packet of potato chips or a can of soft drink.

Try to stock your pantry and bedroom with healthy snacks. The proximity of these snacks can help you with resisting the urge to splurge on junk food.

Enhancing mental resilience

Laying the foundations for good health has the added effect of supporting our mental health—a quality crucial to survival in this profession.

Given some of us come to social work with a history of our own, stress can have the effect of triggering existing anxiety, depression, and/or emotional reactivity.

The good news is that these challenges can be addressed with time and daily effort.

Here are some techniques that can help with maintaining your mental resilience.

1. Meditation. This can be either guided or self-guided.

2. Breathwork. One example of this is the 4, 7, 8 technique

3. Grounding exercises. For instance, body scans.

4. Yoga. These days, yoga can be practiced from the comfort of your home, thanks to the variety of free classes available on YouTube.

5. Gratitude. A gratitude practice can include keeping a daily journal. Consider also writing down five things you’re grateful for on a regular basis, and/or sharing them with an accountability partner.

6. Affirmations. If you’re stuck on how to practice affirmation, consider using prompt cards.

7. Prayer. If you are spiritual or religious, know that prayer can have benefits similar to those granted by meditation.

8. Psychoeducation. Those of us with personal challenges such as anxiety and depression may find some benefit in self-education via bibliotherapy.

9. Therapy. Know that for many social work students, therapy services can be accessed for free through their school’s health center.

Coping with anxiety

Experiencing anxiety while attending school is perfectly normal. Taken to the extreme, however, it can be crippling. Understanding the mechanics of anxiety may go a little way to helping.

Anxiety boils down to overestimating a threat and underestimating your safety and ability to cope. Of course, knowing this is one thing, but dealing with it is another matter altogether.

For this reason, I would recommend revisiting the five fundamentals of good health discussed above. Are you fulfilling all of them? And if not, could this be contributing to your current stress?

After you’ve done this, ask yourself if exploring one or more of the practices I’ve suggested might help.

Failing this, know that you don’t deserve to suffer in silence. Ensure you seek support, whether from family, friends, your school, or community mental health services.

Self-education as self-care

Above I suggested seeking psychoeducation about mental health challenges through bibliotherapy. Here are some books I have read and can personally vouch for.

1. The Anxiety & Worry Workbook by David A. Clark & Aaron T. Beck. This book contains worksheets that can help you with addressing your anxiety using Cognitive Behavioral Therapy (CBT).

2. The Happiness Trap by Russ Harris. This book offers exercises that draw upon some very useful Acceptance and Commitment Therapy (ACT) principles and skills.

3. Feeling Good and When Panic Attacks by David D. Burns. These books draw upon CBT to teach readers how to overcome depression and anxiety.

If you’re interested in exploring mindfulness and applying some of the principles to your life, there are three additional books you might want to investigate.

4. Full Catastrophe Living by Jon Kabat-Zinn.

5. The Places That Scare You by Pema Chödrön.

6. When Things Fall Apart by Pema Chödrön.

Self-care and overcoming social work imposter syndrome

It seems that social work imposter syndrome is a rite of passage—but also a positive sign that you’re on the way to becoming a competent social work professional.

Imposter syndrome after all indicates self-doubt. And self-doubt reflects self-reflection, which is the first step to self-improvement.

Still, when engulfed by these negative feelings, it’s helpful to remind yourself of the following advice by Judith S. Beck, from her book Cognitive Behavioral Therapy: Basics and Beyond:

My goal is not to cure this client today. No one expects me to. My goal is to establish a good relationship, to inspire hope, to identify what’s really important to the client, and perhaps to figure out a step the client can take this week toward achieving his or her goals.

What Beck is stressing here is that the only true measure of professional success in this profession boils down to a single factor. And this factor is our willingness and ability to meet our clients where they are at.

Wrap up

If you’ve found any of the self-care advice I’ve shared here useful, let me know in the comments.

And if there’s anything you’d like me to cover, reach out and I’ll do my best to address it in a future blog post and video.

Please note that all of these tips and more are available in my free guide to surviving and thriving social work school.

FREE PDF GUIDES FOR SOCIAL WORKERS

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Social work Wellbeing

When self-care feels impossible as a social worker, try these five easy tricks

Essy Knopf Leave a comment

Reading time: 4 minutes

Working in a demanding profession like social work, I’m often reminded that self-care is a commitment many of us struggle to make.

Certainly, there may be factors that interfere with our ability to perform this vital activity. We may for example experience a time crunch at work and miss a lunch break in order to help a client in crisis.

When such a situation becomes routine, we should be worried. Many however refuse to take action, claiming they simply don’t have control over the circumstances.

Addressing self-care, however, is less about external circumstances than it is about certain problematic beliefs we hold to be true.

Common mental barriers to self-care

Chronic overwork usually happens because we permit it to.

For example, boundary issues may convince us we are obligated—if not morally bound—to take on more than our own share.

This can stem from low self-esteem or distorted self-perception, which are in turn fed by negative self-talk.

If given too much latitude, our internal critics will demand we constantly prove our self-worth, leading to workaholism, perfectionism, and other forms of grandiosity.

This is not a sustainable way of life. We can’t ignore our feelings of overwhelm and exhaustion forever. But in the absence of self-compassion, we will likely dismiss self-care as “unnecessary”, “wasteful”, and “selfish”.

Another contributor to overwork is time anxiety, a phenomenon by which we come to believe there is simply never enough time in which to complete all of our assigned tasks.

Like other forms of anxiety, time anxiety follows a simple premise:

if you do or fail to do X, Y catastrophe will happen

If you’re struggling to overcome one or more of these obstacles, or if the suggestions in my previous guide to self-care as a social worker didn’t quite hit the spot, I would suggest the following approaches.

1. Snack on self-care

Incorporate brief, “snack-sized” activities into your daily routine. For example:

Watch a humorous segment from a late-night talk show host on YouTube while eating breakfast
Check your favorite news website during work breaks
Watch a fun TV show while cooking dinner
Listen to an enriching podcast while cleaning or exercising
Do school readings while enjoying a hot bath
Practice a grounding exercise during moments of peak stress. For example: box breathing, belly breathing, or body scans

While multitasking has been linked to higher levels of stress and fatigue, self-care snacking in this fashion is a start…and thus progress.

2. Try gratitude & affirmations

Studies have found that practicing gratitude can significantly boost our mental health.

One common example is gratitude journaling. This involves writing down five things you’re grateful for each day.

Alternatively, you can share this list with a designated “accountability partner” either daily or weekly, in-person, or over the phone.

Another fun way to practice gratitude is with a freewriting gratitude exercise. Set a timer for five minutes, suspend your critical thinking, and start writing down anything and everything you could be grateful for.

When the timer ends, set down your pen and review your work. Does what you write check out? Are you surprised by the number of things you were able to list?

Another proven way to nip stress in the bud is by practicing affirmations. Consider opening or closing your day with an affirmation that emphasizes a positive aspect of your life or celebrates your strengths or achievements.

Here are some examples of affirmations you can use as part of a daily practice.

Thankfully, practicing gratitude nor affirmations are not time-intensive activities and can be performed during natural lulls that occur throughout the day.

3. Lean into self-compassion

Self-compassion refers to the willingness and ability to comfort oneself in moments of distress. This is a vital skill we typically learn by internalizing the soothing offered to us as children by our primary caregivers.

When our attachment to these caregivers is disrupted, however, through misattunement, invalidation, neglect, abuse, loss, and trauma, we may develop insecure attachment styles.

This impedes future relationships and deprives us of the chance to learn self-compassion, which can bolster personal resiliency.

Thankfully, self-compassion can always be developed through practice. To get started, check out some of the brief guided meditations, videos, and exercises available on Self-Compassion author Kristin Neff’s website.

Again, these activities can be done almost anywhere and don’t require a lot of time.

4. Get your body moving

Exercise may maintain our general health—but it can also help protect us against anxiety and depression.

As someone who has suffered chronic anxiety, I have found daily exercise goes a long way to helping me manage this condition.

While I don’t always achieve the 30 minutes of moderate activity daily recommended by scientists, I do make sure to take 20-minute walks around the neighborhood at the very least.

Slower exercise should ideally be supplemented by higher-intensity workouts. For instance, I try to cycle for an hour one day, hike for a few hours on another, and do an hour of weights and jogging on a third.

If your mind tells you that taking time out to exercise will eat into your productivity, consider listening to a podcast or audiobook at the same time.

Should venturing outdoors or going to the gym demand too much from your schedule, try exercising from home with free-to-view YouTube aerobics classes.

5. Sleep hygienically

How is sleep a self-care activity? Usually, when we are consumed by work, we may not get our seven-hour minimum.

If our sleep is too short or the quality of it is poor, we may quickly find ourselves running on empty.

Practicing sleep hygiene is how we create the ideal conditions for sleeping. Some examples of good sleep hygiene are:

Going to bed and getting up at a regular time
Ensuring our bedrooms are quiet, dark, relaxing, and comfortable
Using our bedroom exclusively for sleeping
Removing electronic devices from our sleeping spaces
Employing blue light-free bulbs and the wellness feature on our Apple or Android devices (sometimes referred to as “night light”)
Avoiding large meals, caffeine, and alcohol before rest

Wrap up

Whatever your career choice, overwork is a possibility that can always sneak up unexpectedly.

Boundary issues, fierce internal critics, and time anxiety are just a few forms of mental resistance that can leave us especially vulnerable in this regard.

Danger arises when this resistance persuades us that the rightful place of self-care is on the chopping block.

Over time, such beliefs can become hard to shake. But by making some of the adjustments proposed above, you can take small steps towards becoming a personal wellbeing champion.

FREE PDF GUIDES FOR SOCIAL WORKERS

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

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Social work Wellbeing

Surviving in the social work field boils down to this single habit

Essy Knopf Leave a comment

Reading time: 4 minutes

What is your number one priority as a social worker? If self-care is not the answer, we need to have a chat.

Most Master of Social Work (MSW) programs will emphasize the importance of self-care upfront. It doesn’t take long, however, for this call-to-arms to butt up against reality.

We as social workers must navigate many competing and conflicting priorities daily. This begins as early as school.

With so much to do during our relatively brief degree, our days are often dominated by assignments and course readings.

Setting aside an extra hour for “you” time can come to resemble an unnecessary luxury. You may find yourself asking, “How can I afford to stop and relax when I have so much work left to do?”

It’s a question I promise will continue to challenge you over the course of your career. For this reason, self-care is a habit you would be best served by building right now.

Here are some ways you can get started.

1. Make a commitment to self-care

If you can exercise enough discipline to study for multiple hours every day, you can certainly commit a minimum of one hour to self-care.

In strict cost-benefit analysis terms, your brain may try to argue with you about the necessity of relaxing.

It may feel good to have dedicated downtime. But time away from your desk may also put you behind in your work and feed your anxiety.

This can become a vicious circle: time anxiety persuades there is never enough, and while this might certainly feel like it’s the case, it’s not true.

The issue is not whether you have enough time to take care of your personal wellbeing. Rather, it’s your willingness to re-prioritize it.

Let’s suppose you do. If you have time anxiety, this may worsen. But rest assured that over time, its death-grip on your psyche will weaken.

2. Block out downtime

Personally, I’ve found there are usually three windows each day in which most people can block out self-care time:

First thing, straight after waking up
Midway during the day, such as during a lunch break
Before bed, when one typically unwinds

The morning window works best for me (that is, supposing I get to bed early).

This period seems to afford me enough time to do a self-care activity such as meditation before my brain jumps aboard the “work ‘til you drop” train.

Another option is to dedicate a single day of the week such as Sunday to “you” time.

3. Permit yourself a personal life

Work is a hungry beast, and if we continue to encourage it, it will inevitably consume our personal lives.

We may suspend social outings and quality time activities with our loved ones. Or we may sacrifice a hobby that previously enriched our lives.

Diligence and dedication in professional settings are admirable traits. But when taken to excess, they can lead to workaholism.

Having healthy boundaries quite simply means saying “yes” to all that is conducive to our welfare, and “no” to things that aren’t. And workaholism is definitely something that qualifies as the latter.

Don’t neglect your personal relationships for the sake of your calling. Refuse to become a martyr for your chosen social work cause.

Instead, strive for a work-life balance. Schedule at least one social meetup a week. Revive that cherished hobby.

Rather than constantly drawing from your well, take time out to replenish it.

4. Don’t go at it alone

Further to the last point, healthy relationships are like armored vans that can carry us through a warzone of difficult times.

These relationships are thus crucial to our mental health and serve as an invaluable buffer during difficult times.

But they are only as helpful as we allow them to be. In times of need, don’t hesitate to reach out to coworkers, supervisors, partners, friends, and family members.

5. Self-care through the support of a therapist

None of us come to the social work field a clean slate. Each of us has a history, and the work we do can cause parts of it to resurface, both good and bad.

A therapist can help us with processing our experiences, as well as professional challenges like countertransference.

The insights of another professional can go a long way to supporting us in becoming better practitioners.

6. Start meditating

Mindfulness-based strategies are an effective way to support mental resilience and ward off overwhelm and anxiety.

The most commonly known strategy is meditation.

Guided meditations can be found in person or online. UCLA Health for example has many recordings on its website, and there are subscription-based meditation apps such as Calm and Headspace.

An example of a self-guided meditation I use daily is breath counting. This is very simple to practice.

First, get into a meditation posture. A common one is sitting upright, with your feet planted on the floor, your hands resting on your lap, and your eyes either open or closed.

Next, count one, inhale, two exhale, three inhale, four exhale… Go right up to 10, before resetting to one.

Every time your mind wanders or you become distracted, bring your attention back to the sensation of your breath and resume counting.

The breath counting meditation has the most beneficial effect for me when performed one to two times a day for 20 minutes at a time.

If you are new to this kind of meditation, I would recommend beginning with a three-minute meditation, slowly work your way up to a longer session.

Whatever method you choose, know that finding your meditation groove can, at least, initially, be a struggle—especially if you’ve had no prior experience with mindfulness.

For that reason, I would recommend starting with guided meditations or exploring free resources such as these five mindfulness-oriented phone apps.

7. Explore yoga or prayer as self-care

Another mindfulness-based strategy is yoga. If you can’t make it to a studio, try a virtual class. Many are available free to watch on YouTube.

Another mindfulness practice worth mentioning mention is prayer, which has been found to offer similar benefits to other forms of mindfulness.

For these reasons, if you are spiritual or practice a religion, it may be worth incorporating a prayer practice into your daily self-care regimen.

Wrap up

If you’ve ever caught yourself saying “There is no way I can humanly do all of this,” know that you by far are not the first social worker to feel this way.

Feeling overwhelmed as we so often do in these instances is an opportunity to pause and check in with ourselves.

Are you getting enough time to recharge your batteries each day? If not, maybe it is time you carved out a slot in your daily schedule for a self-care activity.

Sure, it may not always seem practical. But let me ask you this: how much more practical is the alternative…professional burnout?

FREE PDF GUIDES FOR SOCIAL WORKERS

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

LGBTQI+ Wellbeing

Enough with the toxic culture of COVID-19 shaming

Essy Knopf Leave a comment

Reading time: 6 minutes

After 10 months of trying to evade COVID-19, the virus finally caught me.

No—I had not been flagrantly breaking coronavirus restrictions. While others attended social gatherings, held parties, and failed to honor COVID-19 safety guidelines, I scrupulously stayed in my bedroom.

When I did emerge, it was only to exercise, shop for food, and spend time with my partner. But wearing my face mask the minute I walked out the front door and keeping my distance was not, as it turns out, enough.

COVID-19 numbers in Los Angeles hit new highs in December 2020, and as an extra precaution, I took to avoiding my roommates and wearing a face mask whenever I stepped foot in communal areas.

My immediate social circle shrank from two to one. Seeing just my partner seemed like a fair compromise to make, even if it flew in the face of rules not to mix with members of other households.

Two weeks later, my partner came down with COVID-19. By the time we received the positive diagnosis, it was too late: I too had been infected.

Until this point, I had steadily nursed anger towards those whose reckless actions were fueling case spike after case spike—the same people, undoubtedly, I saw walking the streets without a mask.

But catching COVID-19, I found myself suddenly wondering if I was no different from those I had so harshly judged.

Even as I succumbed to the tidal pull of illness, I was sliding down a spiral of another kind entirely: shame.

the thoughtful gay coronavirus toxic covid-19 shaming — Down and out with flu-like symptoms.

How ‘COVID fatigue’ is fueling a COVID boom

During the subsequent days spent in bed recovering, with only self-doubt for a companion, I began conducting a moral inventory of the (deeply questionable!) actions that had led me to this point (spending time with my partner).

But could I really be to blame for seeing a loved one, even when that decision was taken against the advice of health authorities?

As a Los Angeles resident, I had been living under a dark cloud of COVID-19 isolation, anxiety, and uncertainty for the better part of a year.

Infection transmission and financial security remained a constant concern and watching the cyclical surges in case numbers was enough to leave most people stricken with helplessness.

For these surges were the product as much of a select few choosing to gather on holidays, as they were lax enforcement of rules.

If the public and the authorities weren’t willing to take the necessary measures to stem the tide of infection, then what hope did we ever have of getting the pandemic under control?

In my imagination, I saw these individuals poking holes in a life raft the rest of us were frantically trying to bail out.

Certainly, in refusing to get tested, communicate their status, social distance, and take all the other necessary precautions, these people were acting as saboteurs.

But after so long spent in lockdown amid a national and global climate of chronic risk and uncertainty, was it really fair to fault people for wanting to spend their holidays with family?

Seeking soothing in a time of disaster stress

“COVID fatigue” (not to be confused with the actual COVID symptom) refers to a feeling of exhaustion with “being cooped up…being careful…being scared”. According to a UC Davis Health psychologist, it’s just another name for long-term disaster stress.

As a passionate advocate for mental health, I know that engaging with one’s social support network is a healthy means of coping and maintaining psychological well-being in times of crisis.

Polyvagal Theory argues that human beings’ autonomic nervous systems—the same system responsible for our fight-or-flight responses—are geared towards acting in service of their own survival through “co-regulation”.

Psychologist Deb Dana describes co-regulation as the “reciprocal regulation of our autonomic states” through social relationships.

It makes sense therefore that people burdened by disaster stress and long periods of isolation might want to seek the company of loved ones.

Video calls thus far have been the closest approximation for in-person companionship. Poor a substitute they may be, they are also a necessary evil when it comes to safeguarding loved ones against COVID-19 transmission.

Even so, why are people still taking risks?

essy knopf gay toxic covid-19 shaming coronavirus

How ‘optimism’ grants immunity to COVID-19 shaming

For the better part of a year, Los Angeles residents have been in a holding pattern, care of the ever-shifting restrictions and lockdown conditions.

Staying home and alone for such a long period is enough to exhaust anyone’s limited store of willpower. Given the high reward involved—reclaiming a former freedom—it’s no wonder some people might choose to stop adhering to COVID restrictions.

These people may be further motivated by optimism bias—that is, the belief that we individually are less likely than others to experience an adverse life event, like say, catching coronavirus.

There are also conflicting feelings around being told not to fulfill a personal right which, under any other circumstance, would be socially sanctioned. That is, spending time with family and friends.

As health authorities advised families against gathering on key holidays like Thanksgiving and Christmas, some may have chosen to deal with the resulting cognitive dissonance by seeking to justify or explain away their actions.

The stress of dealing with two conflicting pieces of information doubtless led many to suspend critical thinking about the potential repercussion of their actions.

The rise of COVID-19 shaming

In May last year, a viral video emerged of shoppers at a Staten Island grocery store hurling abuse at a woman who refused to wear a face mask.

New York City was deep in the throes of the COVID pandemic, so residents were understandably angered by the selfish and potentially dangerous actions of this individual.

Shoppers at the time appeared to be trying to socially shame the woman into donning a face mask, but however justified they may have felt, their actions carried the whiff of mob behavior.

Social shaming can be a powerful means of enforcing shared rules, especially those relating to the pandemic. In the words of shame researcher Dr. D a niel Sznycer, “The function of shame is to prevent us from damaging our social relationships, or to motivate us to repair them.”

The idea here is that shaming—a response to others’ disregard for COVID-19 safety precautions—should compel offenders to abandon their antisocial ways in service of the collective good.

Yet so often social shaming turns into outright abuse. As the popularization of terms such as “covidiot” indicates, the discourse tends less towards leveraging guilt (“You did something bad”) to inflicting toxic shame (“You are bad”).

Author Brené Brown counsels against weaponizing shame, noting that “shame corrodes the part of us that believes we can change and do better”.

When COVID-19 shaming turns toxic, it creates defensiveness and disconnection and sends the accused into fight-or-flight.

Looking at COVID-19 shaming through the lens of gay trauma

The gay community has also seen its share of toxic shaming in the wake of the coronavirus.

The popular Instagram account, Gaysovercovid, for example, has worked to name and shame those responsible for flouting coronavirus regulations.

COVID-19 shaming accounts like this work to reinforce social norms, using the fear of being “outed” on social media to dissuade would-be attendees of international circuit parties.

What they fail to acknowledge though is the purpose such behaviors may be serving for those who engage in them. Namely, nervous system regulation.

Gay men have a unique legacy of trauma, and therefore a greater need for regulation. Some chose to meet this need through the party lifestyle—a lifestyle the current global situation has rendered difficult, if not impossible.

Those who self-medicate with substances, compulsive sex, and other forms of self-gratification, are being abruptly forced off their hedonic treadmill, and this can be enough to trigger a state of collapse.

Survival in this sense is tied to the endless pursuit of distraction. For without distraction, there is introspection and realization of buried trauma and identity shame.

When confronted by the condemnation of others from within our own community, we’ll feel only more compelled to seek distraction; to maintain our place atop the treadmill.

COVID-19 shaming in such instances is limited as a mechanism for change, and may in fact have the opposite effect.

Seeking peace through compassion

If this situation tells us anything, it’s that our anger over this kind of behavior is an attempt to regain some sense of control and fairness in a world that currently seems void of both.

Authorities have shown themselves to be incapable of adequately responding to the coronavirus pandemic and curbing its widespread impact.

The result has been an entrenched sense of uncertainty, helplessness, and pessimism.

When we perceive our personal safety and financial security to be potentially threatened by others’ shortsightedness, we naturally turn to anger.

But that anger promises no peace of mind. Instead, we would be better served by engaging in self-reflection.

If you find yourself hooked by the desire to shame, ask yourself: how are the actions of others triggering me? What emotions are they evoking, and why? What steps can I take to start feeling better?

Instead of giving in to COVID-19 shaming, consider building a self-compassion practice. Self-Compassion author Kristin Neff has provided the following exercises and guided meditations.

Once self-compassion has been achieved, compassion towards others becomes truly possible. The Buddhist meditation practice of tonglen (“taking and sending”) may prove a valuable aid here.

You can also consider following some of the steps I outlined in my previous article, “How to keep mentally well during the coronavirus pandemic“.

Our goal in striving for such mindfulness is not to accept others’ reckless actions, but rather to break the stranglehold of negative feelings.

What this global catastrophe calls for is not assigning blame, but a recognition of the universality of our suffering.

It is only through such recognition that we can strive together towards a new social consciousness grounded not in self-interest, but concern for the collective.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

How to live your best life after an irritable bowel syndrome diagnosis

Essy Knopf Leave a comment

Reading time: 8 minutes

Chronic health conditions like irritable bowel syndrome (IBS) may seem like a life sentence—that’s certainly how I felt in the first year after my diagnosis.

And yet after many nights spent doubled over on the floor, waiting for waves of agonizing gut cramps to subside, I was more than ready for a change.

Emptying out my pantry and throwing out common ingredients now identified as the culprit behind my many symptoms, I found myself wondering, “So what exactly am I supposed to eat now? Air?”

After a few weeks and a truckload of futility, I had formed a solid dependence on a sludgy meal replacement powder.

Choking down this sad substitute for food, it became apparent that if I was going to achieve anything approaching my pre-IBS quality of life, I would need to explore all my options.

What do we know about irritable bowel syndrome?

Irritable bowel syndrome is a chronic, disabling condition for which there is no definitive treatment. The condition reportedly accounts for half of all visits to gastroenterologists in the US.

IBS is classified as a Functional Somatic Syndrome (FSS), meaning it’s not unlike chronic fatigue or fibromyalgia syndromes.

A FSS in scientific terms is “characterized by the presence of one or multiple chronic symptoms that cannot be attributed to a known somatic [bodily] disease”.

The development of irritable bowel syndrome is believed to be multifactorial. That is, the condition has multiple contributing biological and psychological causes.

One such cause is a disruption and impairment of communication between the brain and gut as a result of stress. More details on the specifics in this clinical review of irritable bowel syndrome.

Living your best life after an IBS diagnosis

Typically after a diagnosis, you’ll work with a dietician to identify all your trigger foods, usually via the low-FODMAP diet.

Together you’ll then reintroduce individual FODMAPs to test tolerance for each, a process that can take weeks, if not months.

An appointment at the gastroenterologist’s office may also need to be set up for you to be screened for other conditions, such as SIBO.

After these processes of elimination, the way forward however starts to get a little hazy.

Our knowledge about irritable bowel syndrome is far from complete. Symptom causes and treatment can vary from individual to individual. What works for some may not work for all.

Through my experience as a long-term IBS sufferer, however, I have found that symptom relief success is largely determined by three things: education, experimentation, and self-advocacy.

In the next few sections, I’ll list some of my hard-won personal insights, citing a range of publicly available studies.

It is important to note however that I am not a medical professional. Any statements made here regarding the efficacy of particular treatments pertain to my personal experience only.

All changes to your personal treatment protocol should be conducted with the support of your medical doctor, dietician, and/or gastroenterologist.

First stop: the low-FODMAP diet

Food plays a key role in shaping symptoms among IBS sufferers, and the low-FODMAP diet is a common go-to.

The low-FODMAP diet involves restricting the intake of certain carbohydrates known by the acronym FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).

FODMAPs are present in anything from bananas to yogurt, to tea and garlic. Consuming more than the recommended amount can cause unpleasant symptoms, including diarrhea, constipation, cramps, gas, and bloating.

Some of the more well-known FODMAPs such as fructose and lactose are even known to trigger reactions among those without IBS.

The prevalence of lactose intolerance, for example, has already given rise to an entire industry of dairy alternatives, with products ranging from soy-based cheese, nondairy butter, and nut milks.

Given the complexity involved in low-FODMAP eating, it’s was with great relief that I discovered a smartphone app designed by the diet’s creators.

The Monash University FODMAP Diet app provides measurements of the FODMAP content for individual ingredients, as well as serving size recommendations.

The app is updated regularly, and serving size recommendations are known to sometimes change; in some cases, the kind of FODMAP listed may shift to another entirely.

For this reason, it’s crucial to always check the app when planning your next meal.

While the low-FODMAP diet can bring many with irritable bowel syndrome some relief, tolerances for each FODMAP, and other possible IBS trigger foods will still need to be monitored.

One effective way to identify one’s own triggers involves keeping a daily record of everything eaten, and the symptoms.

Not all IBS sufferers report resolution of symptoms while on the low-FODMAP diet, and so I must emphasize again the importance of working with a dietician to identify your triggers.

Other dietary suggestions for irritable bowel syndrome

Intermittent fasting: I have personally found that intermittent fasting (8 hours on, 16 hours off) can ease digestive distress by ensuring my gastrointestinal tract isn’t forced to work overtime.

Three meals maximum within this period I have found to be usually sufficient at keeping my appetite sated. I try to evenly space the meals out, with one meal at the beginning of the eating window, one in the middle, and one at the end.

If you’re eating foods with moderate amounts of FODMAPs, be warned that eating overly large portions or snacking in between can slow the transit of food through your system, resulting in FODMAP build-up and symptoms.

A low-FODMAP tea is helpful with managing your appetite during “off” hours. White, green, peppermint, mint, rooibos, honeybush, and licorice are all listed as safe.

Consider also adding a sweetener such as stevia if required. It’s zero-calorie and won’t break your fast.

Resistant starch: Resistant starch (RS) is a naturally occurring fiber. Some IBS sufferers report finding it can help with symptoms.

RS can be found in some milled grains, legumes, underripe bananas, cooked and cooled bread, potatoes, rice, and pasta, to name a few.

RS ferments slowly in the large bowel, compared to the rapid fermentation that results from eating FODMAPs, leading to the usual symptoms.

There are multiple forms of RS and your tolerance to each kind can vary. RS has been known to produce symptoms in some IBS sufferers.

RS as it turns out is my personal nemesis; nevertheless, I have found I can mitigate some RS-related symptoms with the help of the herbal remedies listed below.

Spicy foods: Spicy foods are a well-known IBS trigger. Chile is completely out for me, though I’ve found I can tolerate pepper and mustard.

Acidic foods: Vinegar is a big culprit here, to the extent that I’ve had to stop eating salad dressing.

Citric acid is another culprit that turns up in a variety of food, from candy to canned tomatoes. These days, I avoid it completely.

Caffeine: Caffeine is also a trigger. Even decaffeinated, it’s a no-go, probably due to the fact it contains compounds known to cause gastrointestinal upset.

Fat & oils: Eating anything high in fat or containing small amounts of oil I’ve found to be a major trigger. And apparently, I’m not the only one.

Note that cooking without fat and oil is possible, but requires some creativity. For example, I have found frying vegetables using a wok using a small amount of water can work.

When it comes to baking, you can also consider substituting oil with a low-FODMAP pumpkin variety or mashed unripe banana.

Medicine & supplements

Antispasmodics: Drugs such as dicyclomine (Bentyl) and hyoscyamine (Levsin) are commonly prescribed treatments for gut cramps. I make sure to carry a few pills with me at all times.

Antidepressants/Antianxiety medications: One meta-analysis found that tricyclic antidepressants can help soothe global IBS symptoms.

Another study concluded that selective serotonin reuptake inhibitors (SSRIs) are effective in treating co-occurring anxiety, depression, and psychological distress. This may in turn lead to improvements in global IBS symptoms.

A psychiatrist will be able to assist with determining whether this form of treatment is appropriate for you.

Fiber supplements: These can help ease IBS symptoms for some, although more studies are required.

One study recommends consuming no more than 5g of whole psyllium husk daily. I have found fiber supplements only exacerbate my symptoms.

Probiotics: A course of antibiotics is usually recommended when treating secondary conditions such as small intestinal bacterial overgrowth (SIBO). Probiotics can help counteract the havoc these drugs wreak on your gut microbiome.

There is evidence multi-strain supplements taken over an eight-week period can improve IBS symptoms regardless of antibiotics, though I have not experienced much success in taking them.

(Interestingly, fecal microbiota transplants are being explored as a possible treatment for IBS.)

Peppermint oil: This product is available in capsule format and can treat IBS-related symptoms. On the rare occasion I dine out, I’ll take two pills to minimize the impact of eating high-FODMAP ingredients.

Carminative (anti-gas) herbs: A new study has found that a herbal compound containing essential oils derived from Shirazi thyme, ajwain, and dill can significantly improve IBS symptoms.

When consuming foods high in resistant starch I usually take half a teaspoon of a similar three-seed combination: ajwain, dill, and anise.

As Shirazi thyme is not widely available online, I decided to sub it with anise seed, another carminative.

Note that the exact FODMAP content of these seeds has not yet been measured. It is possible that consuming them could cause you to exceed your FODMAP limits.

Activated charcoal: There is some evidence that activated charcoal can help with the absorption of gas in the bowel. I take 3x 780mg charcoal pills, twice daily, along with the three-seed combo described above.

Digestive enzymes: Broad-spectrum enzymes may support digestion among some IBS sufferers, but again more studies are required.

The good news is that there are commercially available enzymes targeting select FODMAPs: xylose isomerase (for fructose), alpha-galactosidase (for galactooligosaccharides, or GOS), and lactase (for lactose).

While I avoid dairy completely due to the fat content, lactase is an effective aid for those who suffer lactose intolerance.

There is evidence that enzyme treatment using alpha-galactosidase enables IBS sufferers to consume nuts, legumes, and beans without any of the usual side effects. Taking one 400 GALU tablet with each meal has proven a godsend for me.

For a complete list of which food items the alpha-galactosidase enzyme targets, check out the Monash University FODMAP diet app.

I have found taking a handful of highly concentrated lipase tablets can help mitigate some of the worst symptoms from eating fat.

Addendum: As the resistant starch and fat content of nuts, legumes, and beans can cause symptoms for me, I continue to limit my intake.

Exercise

In one trial, increased physical activity over a 12-week period was shown to improve irritable bowel syndrome symptoms.

For those of us who spend too long sitting, the current recommendation is to get 30-40 minutes of vigorous exercise daily.

Exercise is also known to improve general mental health. Given many IBS sufferers experience anxiety and depression, there’s a strong argument as ever for getting your daily steps in.

Stress

Stress: IBS is a stress-sensitive disorder that can bring your GI tract to a standstill, triggering symptoms such as gas and bloating.

I have found strenuous activities like hikes, traveling long distances, or attending an unfamiliar or anxiety-inducing setting can trigger tummy upset.

Having a comfortable environment and routine can go a long way to ensuring healthy bowel activity.

Seeking support with irritable bowel syndrome

Community: Reach out to friends you’ll know will be understanding and accommodating of your condition.

Find a community of fellow IBS sufferers online, or in your local city. Don’t go at it alone.

Psychotherapy: I can’t recommend this enough. You can find a list of effective psychotherapeutic interventions here.

Meditation: I have found 2x 20-minute meditation sessions a day helps ease stress and anxiety. Consider trying some of these free guided meditations.

Gut-directed hypnotherapy: This has been shown to have long-term benefits for irritable bowel syndrome sufferers.

A range of gut-directed hypnotherapy prerecorded tracks can be purchased online. (Alternatively, you can access several free general hypnotherapy tracks here.)

Moving forward

If you’re drowning in information right now, my suggestion would be to start small.

Trial run one or two of my suggestions. If, after a period of careful monitoring, your symptoms don’t improve, I would invite you to test another.

Pick and choose what works best for you, but always remember to seek professional insight into any new treatment protocol.

The National Center for Biotechnology Information website is a good place to explore studies regarding current, emerging, and possible future IBS treatments.

Finally, know that experimenting brings with it the possible reoccurrence of symptoms.

Demoralizing as this can be, take heart in the knowledge that every risk faced on the path towards healing, within reason, may ultimately prove a risk well taken.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

How 2020 became the year of the introvert

Essy Knopf Leave a comment

Reading time: 4 minutes

One day, we may look back on 2020 as one of great turmoil—but also a moment in history in which the humble introvert came into his own.

Initially, it may be difficult to look past the frightening headlines: massive bushfires in Australia, a global COVID-19 pandemic, and Black Lives Matter protests, to name just a few.

Yes—coronavirus has cost many their livelihoods…and even their lives. But in the West, as countries were locked down and stay-at-home orders were issued, the wheels of a “Quiet revolution”—to use the term coined by author Susan Cain—were turning.

While countless extroverts bemoaned the lockdowns and the loss of freedom, some introverts viewed social isolation as not deprivation, but rather as an opportunity for quality time activities and peaceful reflection.

An introvert living in an extrovert world

In her celebrated book on introversion, Quiet, Cain notes that Western cultures tend to favor the Extrovert Ideal:

“the omnipresent belief that the ideal self is gregarious, alpha, and comfortable in the spotlight. The archetypal extrovert prefers action to contemplation, risk-taking to heed-taking, certainty to doubt. He favors quick decisions, even at the risk of being wrong. She works well in teams and socializes in groups.”

The extrovert for this reason is held in hallowed regard, in favor of the many quiet and invaluable achievements introverts have made to society.

Consequently, when we introverts are measured against the Extrovert Ideal, we are often found to be lacking:

“Introversion—along with its cousins sensitivity, seriousness, and shyness—is now a second-class personality trait, somewhere between a disappointment and a pathology. Introverts living under the Extrovert Ideal are like women in a man’s world, discounted because of a trait that goes to the core of who they are. Extroversion is an enormously appealing personality style, but we’ve turned it into an oppressive standard to which most of us feel we must conform.” (Cain, 2012)

Growing up in societies that celebrate the Extrovert Ideal and mislabel anyone who doesn’t subscribe to that Ideal as “antisocial” has left many of us with feelings of inferiority.

Despite the fact our brains are wired differently from birth, the introvert’s preference for contemplating life instead of diving headlong into it often earns us dismissal.

The ‘Quiet revolution’ is here

Under scrutiny, introverts have been long forced to conceal and overcompensate for their unique natures.

Then, almost overnight, the coronavirus pandemic made social isolation the new norm, one infinitely more comfortable to the introvert.

Those privileged enough to hold onto their jobs and allowed to work from home were granted a reprieve from open-plan offices and thus sensory and small talk bombardment.

Suddenly, we were allowed to attend Zoom meetings from the comfort of our bedrooms—often while wearing pajama bottoms, no less.

As someone myself who is on the autism spectrum and has sensory sensitivities, Zoom has become a cherished substitute for face-to-face interaction.

(And let’s not forget other fringe benefits for the socially anxious, such as having acquaintances’ names listed below video feeds, in the event we forget).

For introverts, remote working seems like a no-brainer evolution of our current, counterproductive workplace culture. We have, after all, known for a while now the many benefits of remote working—benefits that are by no means restricted to the introvert.

The rise in remote working has put a pause on the much-loathed commute. Where before we introverts may have felt forced to spend a lot of our downtime recuperating from these various stresses, we can now apply ourselves to our activities and interests with renewed energy.

Meanwhile, social lives that might have once entailed exposure to overstimulating circumstances have also been placed on hiatus.

Introverts can now pick how and when they engage, measuring out social interactions in thimble-sized doses, over the phone, instant messages, or at a socially distanced hangout.

Extroverts living in an introvert’s world

Separated from the social contexts in which they have long excelled, many extroverts have understandably floundered.

Those who previously maintained their sense of self—and in turn their personal wellbeing—through social interactions have been forced to adopt a more solitary lifestyle.

The struggle of this transition is most visible in the endless parades of newfound skills on social media, the most prominent example being baking.

This phenomenon I believe is less an act of social performance than proof of the extrovert’s continued existence. It speaks as much to an existing sense of isolation that predated coronavirus (and which was accelerated by the rise of social media) as it does the degree to which that isolation has since grown.

But extroverts alone are not suffering from the side effects of our new lockdown culture.

Coronavirus has triggered a pandemic of a different kind altogether. Anxiety, depression, and suicidal ideation are reaching new highs.

One survey has even indicated that introverts have been suffering more as a result of the quarantine, though the reasons are not yet clear.

Being social creatures, it is safe to say that our collective need for companionship is arguably greater than ever.

Introverts’ inherent tendency towards solitary activities must thus be tempered, lest our circumstances lead to a complete lapse in social interaction.

Toward an ‘Introvert Ideal’

The coronavirus pandemic has seen some promising steps taken toward a different status quo, one that is, in many regards, shaped towards the introvert’s need for less stimulation.

It’s not yet clear how much of this new introvert-friendly normal will endure, post-coronavirus.

The Extrovert Ideal won’t renounce its place on the pedestal any time soon. And yet if the pandemic has proved anything, it’s that we introverts are not in fact operating from a place of lack.

Rather, we have unique strengths that have served us well in a time of great isolation and uncertainty.

There will come a time when an Introvert Ideal will receive its due. Until then, may the Quiet revolution continue.

To find out if you’re an introvert, check out this quick quiz devised by Quiet author Susan Cain.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

Can’t sleep? Here are some surefire steps to treat insomnia

Essy Knopf Leave a comment

Reading time: 7 minutes

As a teenager, I was anxious, isolated, and afflicted with insomnia.

Most days I spent indoors, indulging in geek interest escapism. Sometimes I would craft elaborate fantasy and science fiction stories. Other times I would voraciously consume books, movies, and video games.

Refuge could also be found, of all places, in hammering out essays at the computer. (That such projects could bring order to my otherwise unpredictable school and home life probably speaks to the systematizing nature of my autistic brain.)

The downside of my constant computer use was that relaxing became difficult. A day spent glued to my screen would inevitably leave my mind restless, my sleep broken.

Still, I continued to return to my computer, until what had begun as escapism gradually turned into workaholism.

Developing insomnia

Without friends, family, and a community to ground me, my self-worth became proportional to my productivity. There was always more to do, one more task needing completion.

Trapped in a vicious circle of feeling isolated, I sought reprieve in workaholism, which in turn only exacerbated my loneliness.

Living with constant internal pressure was motivating and could even be affirming. Just look at how productive I was being! So what if my peers at school bullied me – just look at these shiny achievements, these notches in my academic belt!

Caught on a treadmill of what I would later recognize as grandiosity, and terrified of the fall that would follow the moment I stepped off it, I became mired in anxiety and depression.

But rather than slowing down, I ramped up my commitments. At the height of my workaholism, I found myself juggling a full-time job, a feature documentary, a web series, a novel, and organizing two research trips abroad.

Getting to, and staying, asleep by this point had become an elaborate, multi-staged ritual, beginning with a double dose of Benadryl, followed by an hourlong walk around the neighborhood while I waited for it to take effect.

Sometimes I would end up at a 24-hour gym, working the elliptical until the fatigue hit me…unaware that all this activity was probably only making my objective all the more difficult.

When I got home, I’d pull my blackout curtains, slip on an eye mask, put in my earplugs, fit a pair of headphones, cue a soothing audio track, and lie down on a makeshift bed on the floor.

This, of all places, was the only place I was guaranteed to nod off, for reasons I still don’t understand. After many a tossing, turning and blanket adjustment, I’d doze off, only to wake a short while later.

Climbing into my real bed, I’d return to sleep, to rise the following morning, still tired but wired, ready to chip away at my ever-growing workload.

Some nights, however, I would doze off, only to be woken by a hypnic jerk, a kind of whole-body twitch typically preceded by the sensation of falling.

Again and again, I would doze off, only to be jerked wide awake. The steady background hum of anxiety would be cranked up into a shrill roar, putting sleep still further out of reach.

The journey towards recovery

Self-generated projects until this point had been the main source of meaning in my life, and yet they were as much a palliative as they were problematic.

The comparative ease with which others were able to accomplish sleeping – a basic bodily function – told me that something in my case had gone awry. Believing there was no recourse, however, I kept up my unwieldy sleep routine for years.

My mother’s staunch opposition to any form of dependency made prescription medication seem like a false option. Sure, I was already relying on Benadryl, but then again antihistamines weren’t habit-forming drugs.

And even supposing I could scrape together enough money to get a proper diagnosis, I would have to contend first with the fear that the professional I saw might dismiss my problem outright.

The situation reached a tipping point one night while I was doing my regular insomnia shuffle around the neighborhood, I became caught in a rainstorm.

Any sensible person would have run home, or at the very least ducked under the cover of a tree. But to return home before the Benadryl took effect would mean yet another sleepless night. So I pushed on.

The wind picked up, turning the rain horizontal. Next thing, it was inverting my umbrella, leaving me exposed to the elements.

After about half an hour of this, I surrendered and trudged home, sloughing off my dripping clothes and climbing into bed.

When sleep did not come, I grew increasingly anxious. The anxiety snowballed into hypnic jerks, which in turn fueled the anxiety.

The night stretched on, each hour punctuated by an anxious glance at my phone screen to check the time. Heavy with the dread of facing a new day unrested, I lay there, waiting for my morning alarm.

Come the following night, I still couldn’t sleep, and my insomnia ballooned into a record 50-hour spell that only ended with a no-refill script for Valium.

The doctor I saw granted me this small mercy on the condition I see a sleep specialist. The specialist in turn requested I visit a sleep clinic.

Two weeks later, I packed my bags like someone preparing for a red-eye flight and drove through the dead of the night to the evening ghost town of a local business district.

Strolling through a deserted highrise lobby I was overtaken by the peculiar feeling I was participating in some secretive, perhaps even illicit activity.

The elevator opened to the clinic’s front desk, where I was greeted by a man in scrubs who directed me to a sleeping cubicle.

After having changed into my pajamas, I stretched out on the bed as countless electrodes were attached to my head and chest until I resembled some primitive robot trailing electrical cables and hydraulic tubes.

Just how exactly did these people expect me to get to sleep?

The thought of it alone caused my anxiety to surface. Palming a pill, I settled into bed and waited for the heavy embrace of drug-induced sleep.

Seven hours later, I woke to the nurse removing electrodes. Hollow-eyed, I dressed then shuffled like a zombie from the room.

Treating insomnia

“So far as I can see,” the sleep specialist said, poring over my results, “you have a perfectly normal sleep cycle.”

I frowned my disagreement.

“So why am I struggling to fall asleep?” I pressed.

Alas, the specialist had no answer for me. Instead, he suggested an alternate treatment for my anxiety, something known as biofeedback.

A round of treatment would cost something in the range of five thousand dollars – an expense my insurance company was unwilling to subsidize.

With my wallet still smarting from the cost of other, unrelated illnesses, I turned to my final recourse: pharmacological treatment.

Explaining my long-standing problem to my psychiatrist, I caught myself making excuses.

“I don’t want to rely on drugs,” I said, “but this problem has gotten way out of control.”

“Well, it sounds like you’ve tried everything else,” my psychiatrist replied. “Don’t you think you deserve some relief?”

“Maybe,” I thought, feeling nevertheless that I had, in some unexplainable way, compromised my integrity.

With there being no one-size-fits-all medication for anxiety, I would now have to navigate a gauntlet of medications.

The most popular option was selective serotonin reuptake inhibitors (SSRIs). Think Lexapro, Prozac, and Zoloft.

Mainstream SSRIs however come with certain unpleasant side effects. After a couple of doses, my libido took a total nosedive.

The next recommendation was an antipsychotic medication that left me foggy-brained. One morning, while still under its spell, I pulled out into traffic, miscalculated my timing, and was almost hit by another car.

Fearing I might not be so lucky next time, I switched to a combination of antidepressants and antianxiety drugs. Thirty minutes after taking my first dose, I fell into a deep sleep.

When I woke eight hours later, it was to the discovery that the insomnia problem I had been battling for more than 15 years was, more or less, gone.

No more frazzled nerves, poor concentration, and feeling dead on my feet. As for the constant companion that was my anxiety? His hands had now been prized from the steering well and his butt relegated to the backseat.

Before, sitting down for 15 minutes to meditate had been an exercise in self-torture, my thoughts flinging themselves in every which way in a bid to escape any semblance of control.

With the current chemical cocktail, however, I was suddenly able to achieve some degree of focus.

Insomnia is a modern epidemic

Sure, these pulls could put a cap on my anxiety and insomnia – but they couldn’t completely suppress it.

In moments of stress and overcommitment, my mood disorder would flare up again, offering proof that if I wanted to truly get better, I would need to take a more holistic tack.

This in short would involve psychotherapy, undertaking a regular meditation practice, and making daily relaxation time a priority.

It also meant addressing ongoing insomnia triggers, such as an overreliance on digital devices, and workaholism as a coping mechanism for social isolation.

My challenges as I quickly realized were not exclusive to me. Smartphone dependency and “the cult of busy” as we all know are almost universal features of modern life in the West.

Some critics have even called our times an “age of distraction”, with obsessive work and device exposure creating conditions ripe for mental illness.

Even when faced with the physical and psychological manifestations of our stress, we often try to ignore them – much to our detriment.

Finding a solution that works for you

If there’s anything my journey to overcome insomnia has taught me, it’s that we can’t ignore our problems or rely on Band-Aid fixes.

Those of us who are looking to kick our sleep woes to the curb can find some relief by adopting one or more of the following changes:

Restricting device usage: Use the wellness feature on your Apple or Android devices (sometimes referred to as “night light”). This reduces the amount of blue light emitted around set times. This light can have the effect of keeping your brain in “awake” mode. It’s also worth turning on your phone’s do-not-disturb mode and enforcing a no-device usage rule around bedtime.

Practice good sleep hygiene: Create ideal conditions for sleeping. Go to bed and get up at a regular time. Ensure your bedroom is quiet, dark, relaxing, and comfortable. As an addendum to the first point, try to remove electronic devices from your sleeping space. Employ blue-light-free bulbs. Avoid large meals, caffeine, and alcohol before rest. Use your bedroom exclusively for sleeping. More tips here.

Exercise regularly: Keep physically active during the day. Dispel depression, anxiety, and restlessness with a daily gym routine or aerobics workout.

Consider psychotherapy: Therapy can provide a safe outlet for pent-up emotional tension, which can in turn affect your ability to sleep. Therapy can also support your efforts to develop coping strategies.

Stop overworking yourself: Identify an eight-hour daily working window. Use hacks to enhance your productivity. Exercise self-discipline to stop work spilling over into “you” time.

Make relaxation a priority: You can’t be productive if you’re feeling depleted. Replenish your inner reserves every day with fun and enriching activities. Catch up on your favorite TV show, take your dog to the park, or try a new recipe. Consider doing meditation, breathing exercises, or yoga to help you unwind. Adopt what Jon Kabat-Zinn calls a “non-striving” attitude.

Consider natural remedies: While Benadryl can assist with occasional insomnia, natural treatments like melatonin, valerian root, magnesium supplements, lavender, and passionflower extract may prove equally effective.

Explore additional help: Attend a sleep clinic. Explore alternate therapy options. Seek the guidance of a psychiatrist. Investigate prescription medication.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

How to flourish in spite of chronic illness

Essy Knopf Leave a comment

Reading time: 8 minutes

As the coronavirus pandemic wears on, stories have emerged of survivors who continue to suffer chronic illness weeks and even months after recovering.

As anyone living with ongoing symptoms can attest, the challenge is never strictly physical. Being sick often carries a psychological toll, fueling stress, anxiety, and isolation.

Having myself suffered a gut disorder since my early teens, I know firsthand the restrictive – if not crippling – effect ongoing health problems can have.

What these experiences ultimately taught me however is that even when overcoming illness might seem impossible, fighting your own definition of “betterness” certainly isn’t.

An ailment unknown

From the age of 12, my stomach became permanently bloated and tender, my digestion troubled.

After a family dinner, I’d usually wind up locked inside the bathroom as my gut purged itself. Sometimes the voices of my siblings would drift out of the kitchen, and I’d hear their complaints that I was deliberately shirking post-meal cleanup. How little they knew.

Stabbing pains came and went often at random. One moment I’d be sitting at my computer, and the next I’d be stricken, doubled over, or collapsed on the floor.

These spells of agony sometimes lasted for days. During a family cruise vacation, I was afflicted by fluctuating blood sugar levels, and caught myself returning to the buffet repeatedly, wolfing down one dish after another.

Then, halfway into the trip, my digestive tract gave out. For three days I lay in the fetus position in our windowless cabin in a cocoon of darkness split by red lightning-strikes of agony.

“It’s just the stomach flu,” my mother said when I asked to be taken to the onboard doctor.

“Mum, something’s really wrong,” I insisted. “My body isn’t digesting anything.”

“They’re going to charge me $100 and all they’ll do is give you an aspirin,” she complained. “Just rest. It’ll pass.”

But 72 hours later, the symptoms had failed to ease. The constant pain and nausea had robbed me of my appetite, and after three days of fasting, my mother’s seeming indifference turned to concern.

She thrust plates of salad in my face, insisted on feeding me forkfuls despite my protests.

Days later, back on solid ground and mostly recovered, I looked back on the hellish episode as a freak incident. But chronic illness persisted.

Sticking with self-diagnosis

For the next decade, the same symptoms came and went with the suddenness and ferocity of summer thunderstorms. Their cause, at first a mystery, was eventually identified as wheat.

The symptoms after all were on par with those of Coeliac disease. And when I indeed subtracted wheat products from my diet, the symptoms eased to the point of being manageable.

My doctor suggested I get an endoscopy so I could be formally diagnosed. She explained that in order to avoid a false negative, I would need to start eating wheat again.

Having already tasted freedom, I had no intention of going back into dietary bondage. Besides, what would the test prove, other than what I already knew for a fact?

My resistance to getting tested was in part due to my parents once dismissing my symptoms as psychosomatic.

My antique distrust of authority figures, and the fact I alone had championed my own health, left me somewhat resistant to the doctor’s suggestion.

It was I, after, all who had determinedly spent three hours Googling symptoms; I who had found the name for my chronic illness.

It followed, therefore, that only I could determine what was best for my own health.

“You have no way of knowing for certain,” the doctor said when I declined the offer of an endoscopy. “It could be Coeliac disease. Or it could be something else entirely.”

“I’m good,” I said. “Thank you.”

“Well, it’s your health,” she replied with a shake of the head.

“It is,” I snapped back. Just who did this woman think she was to question my judgment like this? A qualified medical professional?

No one and nothing was going to dissuade me. Defiant, I marched out of the doctor’s office, clutching my self-diagnosis to me with the kind of protectiveness reserved for a newborn.

The struggles of identifying chronic illness

Still, I never achieved complete symptom clearance. All it took was a handful of nuts or a glass of milk to kick off a round of wind and intestinal purging, while beans had the opposite effect, bringing digestion crashing to a halt.

A dietician suggested that maybe I was eating too much fiber. She proposed I try cutting back on certain trigger short-chain carbohydrates like lactose and fructose, known by the acronym “FODMAPs”.

But by the following week, I was embarking on a month’s long trip overseas, and soon forgot the dietician’s proposal.

Later, believing I must be suffering some kind of allergy, I attended a leading clinic. If I was hoping to come away with a diagnosis, I was instead left only with a patch of irritation on my left forearm, something akin to a mosquito bite.

The allergen prick test revealed I was reactive to American dust mites, but not wheat and diary.

The clinic recommended nevertheless I switch to a diet low in certain naturally occurring food chemicals called salicylates, amines, and glutamates.

These chemicals are present in anything from chocolate, to coffee to cheeses. Eliminating them completely naturally proved quite the chore, and even once I did, my condition scarcely improved.

After a few months of attempting to be vegan, things only worsened, my belly swelling as tight as a drum.

When a rash surfaced on my back like an inflamed continent, I conceded that maybe my self-diagnosis was wrong.

Previous adversities had left me reluctant to ask for help, to trust that others really had my best interest in mind. Yet this same reluctance meant I had inadvertently prolonging my chronic illness.

chronic illness COVID coronavirus thoughtful gay

Seeking treatment

A somewhat lengthy and expensive battery of tests confirmed that I indeed had been wrong about having Coeliac disease. What I was actually suffering from was Irritable Bowel Syndrome (IBS).

While both conditions share common symptoms, what my body seemed to have been reacting to was not the wheat protein gluten, which typically causes the immune reaction in Coeliacs sufferers.

My triggers were in fact FODMAPs, the carbohydrates previously identified by my dietician. This explained why my body responded adversely to high-FODMAP foods such as wheat, milk, nuts, and beans.

Had I listened to the dietician and trialed the low FODMAP diet, I would have been spared not only my usual raft of symptoms but the development of a new, secondary condition: small intestinal bacterial overgrowth (SIBO).

If IBS could be at times unbearable, SIBO had the effect of only exacerbating the symptoms.

Treating the SIBO with antibiotics decimated my gut microbiota. It also triggered a secondary infection of a parasite known as blastocystis hominis, suspected of stowing away on my body during my trip abroad.

The blasto infection sent me running to the toilet every hour, and could only be bested with still more antibiotics.

Suffice to say, it was months before I returned to any semblance of digestive normality.

Accepting what can be changed

Part of the problem was that IBS is a condition whose triggers vary from individual to individual. One person may digest a slice of cheesecake with ease, while another will be stricken by paroxysms of diarrhea.

When I expressed my desire to “get better” to my gastroenterologist, he laughed. IBS was a “functional” condition, quite unlike more serious conditions like Crohn’s disease. Expecting complete recovery simply wasn’t reasonable.

Was this, then, what I was paying this man for? A tidy response absolving him of any responsibility? Yet another “hypochondriac” dismissal?

Certainly, chronic health conditions are often complex, and the problems they throw up insoluble. But if my gastroenterologist wasn’t interested in helping me explore the possibility at least of improved health, then it fell once more to me to try.

To this end, I explored all manner of remedies: antidepressants, antidiarrheals, antianxiety medications, fiber supplements, peppermint capsules, digestive enzymes, natural supplements, antispasmodics, probiotics, exercise, hot pads, meditation, acupressure, and hynotherapy.

By isolating potential trigger foods, I discovered that the recommended fiber supplements were actually making things worse.

Another contributing factor was a substance known as resistant starch, which can be found in many IBS-friendly staples. As it turned out, something as seemingly innocuous as reheated rice or potatoes often was more than enough to ruin my digestion.

The modifications I eventually settled upon involved quitting coffee and curtailing fiber, fat, oil, sugar, and resistant starch. Intermittent fasting, which involved restricting my eating to an eight-hour daily window, proved infinitely helpful.

Meals were kept to three in total and limited to reasonable portion sizes, taking the pressure off my admittedly delicate digestive tract. Adding peppermint supplements, enzymes, and anti-diarrhetics further supported my digestion.

Lifestyle changes were also in order. There was to be no more round-the-clock workaholism. Time would need to be made now for a regular exercise routine, daily meditation, and relaxation.

As it turned out, the gastroenterologist had indeed been wrong for laughing off my complaints. A better state of health was indeed possible.

While some health conditions may be in part or completely out of our control, management or easing of symptoms is always possible. Quality of life is never an unrealistic goal.

Identifying a key need and a strategy

“What do I need most?”, “Is it realistic?”, and “How do I achieve it?”

For those of us suffering from chronic illness, these three questions can be the determining factor for both our physical and psychological wellbeing.

In my case, my foremost need was being able to eat nourishing, delicious food without getting sick.

The dietary limitations imposed by IBS meant eating out was a fraught affair, so avoiding tummy upset going forward would require I make all my meals from scratch, going forward.

Even after I threw out all my current go-to recipes, many of the IBS-friendly alternatives I found online contained other foods that were triggers for me, such as oil.

The only way I was going to fulfill my tasty food cravings therefore was by getting creative. So for the next year, I recipe tested like heck, substituting problem ingredients with symptom-free alternatives.

Most meals I produced during this period were, for the most part, healthy, if a little bland. But by the second year, my culinary game was on the up, and I had at least four passable meals under my belt. Then suddenly they weren’t just passable – they were delicious.

As cooking IBS-friendly meals from scratch could be an expensive and time-consuming process, I began bulk-buying and batch-cooking.

This strategy ensured I spent less time in the kitchen carefully measuring ingredients. Instead of or shuffling through the supermarket, poring over the price tags of often more expensive low-FODMAP alternatives, I was now able to spend more of my time savoring the fruit of my labors.

Seeking support with chronic illness

Being forced to carefully monitor everything I eat, while managing occasional flare-ups can at times be stressful.

Sometimes I’ll catch myself trying to “silver lining” the situation, reassuring myself of the benefits of having IBS. The forced dietary changes for example have rendered me permanently lean.

Some fitness fanatics might consider this an ideal result, but practically speaking, not having “rainy day” body fat can be a problem during periods of illness when I’m most prone to rapidly dropping pounds.

Chronic illness has brought many periods of frustration and despair. Key to our endurance in such instances is having someone we can talk to about our difficulties. As the old adage goes, “A problem shared is a problem halved”.

While loved ones can ever truly know what it’s like to walk a day in your moccasins, they can certainly empathize. But if you find no respite in venting to friends and family members, a sympathetic-ear-for-hire may be another option.

Therapists not only provide a supporting environment – they are specifically trained to help clients with identifying custom-fit coping mechanisms.

Therapy for some isn’t financially tenable, while others may not be comfortable opening up to a stranger. In such instances, it’s worth exploring other avenues, such as online communities or support groups for people with your condition.

Failing that, a daily “mood” diary is always a great fallback. In moments of stress or high emotion, consider jotting down in detail what you’re feeling, why, and the circumstances or situations surrounding these feelings.

Diary writing when suffering chronic illness can be cathartic for the sheer reason that it allows us to divest ourselves of burdensome thoughts and feelings. Without an outlet, they may otherwise continue to rattle around inside our brains, draining our strength and impeding our wellbeing.

Diary writing in this sense is preventative, acting as a pressure valve. It allows us to release what we are carrying in a safe and constructive way, offering us valuable perspective on our difficulties.

Takeaways

Be open to help – and self-advocacy.
Change what you can, accept what you can’t.
Identify one key need and how you can fulfill it.
Seek emotional support. Keep a diary.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.