Women and those born with female anatomy go through a life cycle where hormonal changes, bodily changes, child-rearing, and gynaecological issues impact their psychological well-being, and ability to function optimally in their day-to-day life and in workspaces. By virtue of being born with female anatomy and physiology, women experience specific issues that can impair their lives; men do not experience these as they have different anatomy.

Navigating the phases of womanhood: Physical and psychological impacts

Puberty and menstruation

When a girl reaches puberty, she becomes a woman. She starts producing estrogen and progesterone hormones, which corresponds with other changes to her physiological body. Puberty also spells the onset of monthly periods where the woman starts menstruating in monthly cycles. Every woman experiences menstruation differently; some have severe period pain, heavy periods, premenstrual syndrome (PMS), and physical discomfort.

Menopause

On the other end of the fertility cycle, menopause spells the depletion of estrogen and progesterone, and the end of the ability to procreate. With it comes a cluster of both physical and psychological health challenges which impact women’s everyday functioning, and psychological health.

The fertility window

In between the onset of puberty and menopause, women are in their fertility window, where they have monthly periods and can get pregnant and procreate, and also experience debilitating gynaecological issues. This in-between stage is the stage at which women are concurrently engaged in studying, progressing in their careers, child-rearing, or doing a combination of any of these things. All these female-specific experiences impact not only on their physical but also mental health, as well as their ability to always function optimally in workspaces.

Women’s health issues in high-pressure work environments

While every woman must deal with and cope with the consequences of the gynaecology-related issues, women in corporate and highly demanding environments who are expected to perform highly at all times, experience additional stress and anxiety which can further diminish their mental well-being. They are expected to perform at the same level as men, who do not share the same experiences as them.

There is a myth and misconception that men are better leaders, which is not true. Many women’s performance and career progression are hampered by issues related to female-specific issues, which do not affect men. In my experience as a therapist, l have seen the harm the lack of awareness and support causes to these women. It’s imperative that we explore how these female-specific issues can impact on mental well-being, and how women can be best supported in work environments.

1. Menstruation

Many working-age women are in the fertile stage of their lives, and they have monthly period cycles. For some women, periods can be very painful and traumatic; they may end up seeking medical support. Bloating, period pain, PMS which causes mood swings and irritability, and flooding can all become very challenging to deal with while working parallel. These are not just physical manifestations, but they have a psychological impact. Being expected to perform optimally when you are going through heavy and painful periods is incredibly challenging for some women. The need to perform while under duress can be detrimental to these women’s mental well-being.

2. Pregnancy and childbirth

Working-age women are also in the child-rearing stages. This means there is potential for pregnancy, at times fertility treatments, childbirth, and managing childcare. The trajectory of career progression for women is very different to men, as men do not have to carry pregnancies and give birth. Only recently men can take paternity leave; traditionally it was the mother, the woman who was expected to take maternity leave and pause their careers. These are some of the reasons why some women delay having children, which can be a negative considering the fertility window narrows down as women get older.

Many women do get pregnant and continue working while pregnant, and they are still expected to perform optimally during pregnancy. Stress and pressure can negatively impact both mother and unborn child. Pregnancy is a very vulnerable time for women, which also means dealing with pregnancy symptoms, and adjustment to the new impending mothering role. Some women have complicated pregnancies that require close monitoring. Pregnancy is, therefore, a women-specific issue which impacts on their performance at work, career trajectory and mental well-being.

3. Menopause

Menopause is an incredibly challenging time for many women, as it comes with a range of physical and psychological symptoms, which translates into poor mental health. Many women who are perimenopausal or menopausal experience hormonal changes which leads to increased stress, anxiety, depression, mood swings, acopia, insomnia, weight loss or weight gain, fatigue and a feeling of loss. Working-age women who are going through menopause can find this period particularly challenging emotionally. Their ability to perform can be hindered, and their mental health deteriorates as well.

3. Chronic gynaecological conditions

Many working-age women live with chronic gynaecological conditions such as fibroids, endometriosis, PCOS, ovarian cysts and ovarian cancers. These can be impairing as these conditions present with both physical and psychological symptoms. Many gynaecological conditions manifest in pain, discomfort, excessive bleeding during periods, bloating, anxiety, low mood, fatigue, nausea, facial hair growth, and weight gain. They require active ongoing treatment which has its own host of side effects. Unlike men, all these female-specific health issues shape their ability to function optimally and their mental health.

Tips to improve mental health in women

Self-advocacy and prioritising well-being

Women should feel empowered to seek help and adjustments to their work if they are struggling with female-specific issues. Women should prioritise their well-being and advocate for themselves if they are struggling with female-specific issues that do not affect men.

Supportive work communities

Women in high-pressured environments could create supportive communities where they can share their experiences and heal collectively.

Seeking psychological support

If anyone in these workspaces is struggling, and you are not getting the right support, seek psychological support through therapy. Delaying getting support will only make things worse.

Male colleague education and empathy

Male colleagues and peers should have more education around female-specific health issues and how they translate into their ability to function and their mental well-being as a whole. Male colleagues should have more empathy and support towards women and take their concerns seriously when they are struggling.

Corporate initiatives

Corporate companies could give more incentives to women to enable them to manage their female-related issues, without feeling pressured to perform highly at all times. Allowing women to have more breaks and a more supportive stance goes a long way.

However, money is an inescapable reality in romantic relationships. In situations where partners have big financial differentials, or where the woman earns far more than the man, this can create real challenges that need to be navigated in a delicate manner.

It’s important that partners can openly discuss these issues of income disparities in a constructive, empathetic, and compassionate way which serves the relationship. Not addressing it can cause a slow death of the relationship as the financial disparities shape the relationship. As a couples therapist,  who has worked with many people who approach therapy to address these issues, l have a deep appreciation of the significance of money in intimate relationships and the strain it often causes.

Patriarchy and paradigm shift

While l acknowledge that money issues exist in same-sex relationships, I will pay attention to the male/female dynamic as it highlights some of the changing patriarchal views and notions in the world we live in. Our world is fast changing, and women are no longer the stay-at-home child rearers, and home keepers as they did in the traditional days. Women are becoming highly educated, and some are working their way to the top of the ladder, occupying high-status roles in big companies. Others who own businesses are very successful and effectively earn substantially more than men.

This  means that there is a potential for these high-earning women to end up in relationships or marry men who earn much less than them. Without acknowledging this paradigm shift, some women get stuck against the odds, waiting to date men who earn more than them. At times there is a man who earns significantly more than their partner, which  creates issues in terms of spending, decision making, and making plans. These realities challenge the patriarchal views where men are meant to be the breadwinners, and women are looked after, or earn less. If partners who have an income gap come together, they have to accept this shift and work together in navigating these disparities in a constructive way.

High-earning female partner vs low earner male partner

This type of dynamic typically creates an imbalance where partners need to carefully negotiate how they can proportionately spend and spend responsibly too. Without doing so, it’s very easy for the low-earning man to feel emasculated, and carry a lot of shame in the relationship, which is detrimental to the relationship. The high-earning woman can end up carrying a lot of guilt and frustration which again needs to be addressed by way of communicating with their partner.  Women are innately care takers; the high earner female partner-low earner male partner  relationship can easily create a parent-child dynamic where the  woman feels responsible for the man and must make important decisions which would naturally fall onto the man. This is present especially if children are involved.

The high-earning female partner dynamic can  at times create a power dynamic where respect and honour for the man is erased, which is detrimental. We tend to equate money with power, and masculinity with money, which undermines the mutual respect each partner should have for the other. There is more to the relationship to keep it balanced and wholesome, which requires both partner’s investment, not just financially. However, it’s also true that money is a currency in the relationship, and it cannot be viewed independently.

High-earning male partner vs low earning female partner

This dynamic typically fits the existing and acceptable societal frame.  However, there are times when the man earns significantly more than the woman creating a huge gap. This can also lead to the same feelings of shame in the woman and guilt in the man. While it may be comforting for the woman to have a man who earns more and gives her a good life, it can also lead to feelings of inadequacy, and loss of identity where one feels they are highly dependent on their partner and therefore insufficient without them.

Do we talk about money?

Since money is a very contentious subject, many couples quietly make the detrimental decision not to ever bring it up at the beginning of the relationship, or as the relationship starts to become serious. This means that the realities of financial disparities become more real when the couple is already established in the relationship. This delay makes it harder to address these issues and when it gets talked about there is disappointment, disillusionment and a need to reframe their idea of a relationship, or a partner.

This critical moment can also spell the ending of a relationship for some as these disparities cannot be consolidated. Where disparities exist and are not acknowledged, things that should be enjoyed together for example holidays and dinners out can be a source of stress for the low-earning partner. These activities can also become burdensome for the high-earning partner who may feel that they have to carry the other along.

It is absolutely critical that couples do not shy away from talking about finances, and they can create a safe space to discuss it and find a way of making things work for both of them. Proportionate spending is one way of making this work in a fair and equitable way- pay what you can afford. Some couples find it easier to create a framework and model- 80/20 70/30 60/40 50/50 whichever way works for them. That way each partner is holding themselves to account and contributing to their shared life.

This frame is significant if you have to save money for bigger projects, for example, house buying. Having a written agreement can also be helpful especially when couples are making huge life decisions and unmarried. You would agree that it’s unfair to have a 50-50 frame when one partner can’t afford it. It then creates relationship stress and resentment which erodes love and goodwill that should be the foundation of any healthy relationship.

Tips for navigating financial differentials:

• Try not to view money as a taboo. It is real and if you are getting serious as a couple, it’s important that you create safe spaces to discuss your finances.
• When discussing finances, it’s important that it’s done in a gentle, non-confrontational, non-interrogative, but compassionate, empathetic and supportive way.
• Do not follow other people’s frames or ways of doing things. Our lives are very unique, therefore you must not simply follow other people’s way of doing things. Do what works for you as a couple.
• Have regular reviews of your finances to make sure that you are both still on the same page, otherwise, you end up with one partner who becomes more and more resentful of the other, either because they feel they have to do more in the relationship- or feel that they are being belittled and controlled because they earn less.
• For women, it’s important to acknowledge the place we are in society and come to terms with the fact that if you are a high earner, your future partner may earn less than you. Without this level of acceptance, you risk ending up alone and lonely.
• For men, if you are a low earner, it’s important that you also come to terms with the fact that you may end up with a woman who earns more than you. It’s not a negative and a sign of your masculinity, it’s how you navigate it that matters.

Main Image Credit to Luca Laurence- Unsplash

We are mortal beings, our life on this world is temporary. One thing for certain, and non-negotiable in life, is that we all get old, and eventually die. Our physical, mental and psychological needs change throughout the course of life from infancy, latency, adolescence, adulthood, and older adulthood.

The World Health Organisation reports that there is an increased life expectancy, and a decline in mortality which means there is a huge ageing population. In the UK, the Office of National Statistics states that 18% of the population are people aged 65 and above, with that number expected to rise in the coming years.

Even though people are living longer, the mental health and psychological needs of older adults are not given as much attention as their physical health needs, and in comparison, to the needs of other age groups. This may be because of our avoidance of facing the reality of death, mortality, and the fact that life is not infinite.

Old age defines slowing down, deterioration, regression, weathering away, and a decline of physical stamina, and a waning in mental faculties. Resultantly, the needs of older adults are unique in comparison to any other age groups, and far too complex. These needs are typically aimed at the long-term management of diseases, and preserving life.

The marginalisation of older adults, and prioritisation of their physical health needs over their mental health and psychological needs, has the effect of leaving many older adults experiencing serious and at times enduring mental health and psychological problems, without receiving the mental and psychological support that they need.

The intersection between physical and mental well-being is even more critical in older adults, as the physical health problems tend to cause distress which translates into mental and psychological problems. The physical decline is inevitable as old age makes our bodies less robust, weaker, less healthy and harder to repair and heal, in the same way as they did when we were younger.

By unpacking the issues older adults are likely to experience, we can better understand their challenges and formulate the best support to meet their needs.

Issues that affect older adults’ mental health

Loss and depression

Old age is the stage in life where we are confronted with a lot of losses and a need to make life adjustments. There is a loss of the agile healthy self, loss of identity as a functional adult, loss of independence, loss of vitality, and a loss of role when one retires and starts getting a pension. Many older adults also experience loss of their sexuality – older men tend to experience erectile problems and libido issues, while older women tend to experience dysfunction in sexuality, all due to the changes to the male and female bodies respectively.

There are also other losses older adults uniquely experience, for example, loss of their life partners, through actual death, downsizing a home, children moving away from them, loss of friends through death, and at times loss of cognitive faculties due to old age – one may not be as sharp as they used to be which is a form of loss. Loss is a process which involves grieving and coming to terms with the new reality. This loss and grieving process can be incredibly challenging, especially if one is isolated and unsupported. Without the right amount of support, unresolved grief can turn into depression, which is prevalent in older adults.

Loneliness and isolation

The NHS has highlighted that older adults are vulnerable to loneliness and isolation, which does have a negative impact on their mental health. Age UK, a charity which supports older adults, also reports that in the UK, more than 2 million people aged 75 or over live alone, and 1 million of these people report spending more than a month without any form of contact from family friends, or neighbours. These stunning statistics highlight the prevalence of loneliness which also translates to poor mental health.

Older adults who are isolated from the world tend to struggle with coping with day-to-day life due to physical decline. Many others experience co-morbid physical and mental health problems which they tend not to seek help for. Older adults are also likely to experience accidental falls due to physical frailty, and other forms of accidents, and poorly manage their medication regimen which puts their lives at risk. Loneliness and isolation lead to depression, anxiety and other secondary mental health problems.

Loss of mental faculties

The decline of the physical body also corresponds with the decline in cognitive faculties for many older adults. For some, it’s a mild slowing down, while for others the decline is more severe and manifests in the form of dementia.

Dementia is an illness which mostly affects older adults, although some people are diagnosed much younger. It is denoted by a loss of cognitive abilities and a decline in physical functioning. Dementia can be managed but it cannot be fully treated as it is progressive and degenerative.

The decline in cognitive abilities means some older adults find it difficult to engage in mental activities, and physical activities of daily living in the way that they have done in the past. This is experienced as a loss of identity, and depersonalisation, which precipitates depression. People with cognitive decline and those who received a formal diagnosis of dementia are likely to experience depression. Dementia is known to co-exist with depression as living with memory loss and functional decline induces depressive feelings.

Poor physical health

As we get older, our bodies as a system slows down. Old age defines the decline of physical health; many people in older adults experience multiple co-morbidities, for example, high blood pressure, hypercholesterolemia, arthritis, heart problems, age-related poor liver function, diabetes, cataracts etc. Cancer is also highly common in old age.

Some of these chronic physical health problems can only be managed and not fully treated, which puts a demand on older adults’ needs to have regular physical health monitoring. The decline in physical health as well as the nature and severity of one’s physical health also has an effect on one’s mental health. Poorly managed physical health can lead to psychological distress which can turn into anxiety, depression, insomnia and other secondary health problems.

Stress and anxiety

Stress is pervasive in older people due to the changes in their lives, which often leaves them feeling out of control. Other causes of stress are loss of support, loss of independence, physical pain, living with chronic physical health issues and stress around death and dying. Stress in old age can also be secondary to managing day-to-day life, and having to make necessary adjustments which can lead to one feeling disempowered and inconvenienced.

Shame also compounds the stress levels, for example in the event where one has to start using incontinence pads due to a weak bladder which causes urinary incontinence. Stress is the mother of anxiety and depression. Increased stress means there is an increased likelihood for anxiety and depression.

Existential reality

The reality of death and dying becomes even clearer in old age. Although death can happen at any stage in life, we become closer to death and become acutely aware of our mortality in old age. This can also trigger existential crises and profound contemplation. Feelings of guilt, regret, shame, anger, fear, and many conflicted feelings about how one has lived their life come to the fore. This can also be a time of coming to terms with the reality what acceptance of what is, and what could have been. This state of reflection and contemplation can tip some older adults into a deep depression.

9 ways to improve mental and psychological well-being in old age

There is an urgent need to promote mental and psychological well-being in old age. Here are some of the ways of improving mental and psychological well-being in old age:

1. Live an active lifestyle

A healthy body translates to a healthy mind. Exercise regularly and do what feels manageable and safe without putting too much pressure on your body.

2. Engage in old hobbies and make new ones

Hobbies make life more meaningful, and you are likely to meet new people and build relationships with others, which minimises the risk of loneliness.

3. Maintain social connections

Combat loneliness by maintaining social connections and building a community around you. Try to connect with family and friends. If your biological family is not as close, or not reciprocating your efforts, make connections with ‘chosen family/s’ and be a part of it.

4. Optimise your physical health

Optimise your physical health by having regular GP checkups. Poorly managed physical health can be a source of distress which has an impact on mental health.

5. Tick things off your ‘bucket list’

Reflect on your life and the things that you always wanted to do ‘bucket list’ and engage in them. If it’s a holiday, go and travel if you can. If it’s an art class, join an art class, if it’s a salsa club, join the salsa club – the list is endless.

6. Dating

Never be too shy to look for love in old age. Most people believe dating is only for younger adults, which is problematic. If you are single or widowed, and feeling lonely in old age, consider dating again and meeting like-minded people who have similar interests – you may find a special someone and share the reminder of your life with them. Research suggests people who are attached have a better quality of life than people who are single. Life becomes more meaningful, joyful, and purposeful if it’s shared and not lived in isolation.

7. Engage in mentally and cognitively stimulating activities

Read books and engage in cognitively stimulating activities. If you like to remain intellectually stimulated, the University of Third Age is a great place to connect with other like-minded intellectuals who have similar interests

8. Therapy

Therapy is not only for younger adults, older adults also need therapy, too. If you are struggling with your mental health or there are some issues you need to address and work through, seeking therapy to get psychological support is a positive. Therapy in old age is hugely beneficial as a way of addressing some of the existential issues, but also addressing loss, depression, anxiety and loneliness.

9. Spoil yourself

Life is too short to not spoil yourself. Age is a number, it’s how you feel that matters.

Breadcrumbing is one of the numerous new buzzwords emerging in the contemporary dating scene. The ways in which people meet has changed over time which is also reflected in how people are approaching dating, typical behaviours in dating, and the language used around it. The Millennials and Gen Zs generations experience dating very differently from the earlier generations as they have grown up with access to technology, the internet and social media and are therefore digitally literate. This paradigm shift spelt by technological advancements has also seen online dating being the preferred form of meeting new people and dating.

Other forms of contact – texts and social media – mean people can connect without necessarily being in the same environment. There are scenarios where people go into a full-blown relationship without having met each other in real time, and in person but conversing remotely. All these changes have led to certain dating codes, new concepts, behavioural patterns, and phrases being coined and used to describe experiences in the dating space.

Breadcrumbing, ghosting and orbiting are some of the new and popular buzzwords that don’t feature in our traditional dictionary and are accepted in the dating space. These concepts are here to stay, and some of them now feature in the urban dictionary; they need to be explored. As a therapist, it is important that l keep abreast with the changes in the use of language, and growing trends, as many people are coming to therapy having been breadcrumbed. Breadcrumbing is indeed one word that captures a dating pattern which has left many people emotionally wounded.

What is breadcrumbing?

Breadcrumbing is when someone pursues you and gives you attention- flirtations, compliments, sexting, and hints of being interested in you, without the intention of dating or “leading you on”. The attention is typically sporadic and when it happens it is characteristically via online channels, meant to create a sense of interest and desire to know the other person without the actual intent to do so. The individual who breadcrumbs then withdraws, spelt by avoidant behaviours – not responding to messages, not responding to calls, and then reappears out of the blue.

When the individual re-emerges and comes back after a while, they repeat the same cycle of raising hopes & dropping the other person when they were starting to feel even closer, and hopeful of something further developing. The individual typically disappears when you bring up important topics that involve feelings and emotions, seeking clarity, the possibility of a relationship, or some sort of commitment.

The breadcrumbers are good at acting as the perfect potential partner who showers compliments, and at times even takes one out on a date before disappearing into the abyss again. This behaviour is indeed a form of emotional manipulation as it puts the recipient of the crumbs in a conflicting place of feeling desire and loved, and rejected and abandoned at the same time.  Apart from the disappearing acts, breadcrumbers are good at deflecting and sweet-talking to vindicate & absolve themselves. They don’t have much to prove or explain after all, as they are not in a relationship, you are simply picking up their breadcrumbs.

Impact of breadcrumbing on mental health

Most people who engage in breadcrumbing dating patterns are very aware of their behaviours and motivations. A small number of them are not aware of their behaviour which may be due to poor communication skills or other constraints such as time. However, for the majority of people, breadcrumbing itself is a form of manipulating the other person, to bolster their own ego. This is a manipulation because the disappearance, reappearance & inconsistent behaviours leave the one who is giving breadcrumbs in control of the dating experience, and it gives them the power to not only control how, and when they access you but also what they do. It is often people who have low self-esteem, low self-worth, and insecurity in themselves who tend to engage in breadcrumbing others as it bolsters their self-worth & self-esteem, giving them a sense of confidence.

On the other end, the inconsistent and confusing behaviour can leave the one being breadcrumbed feeling very confused, disillusioned, lonely, isolated, rejected and hurt in the end, as this dynamic never culminates into a real relationship. Research done by the National Library of Medicine in the US has proven that breadcrumbing can have detrimental effects on one’s mental health and well-being, including increasing feelings of loneliness, and diminishing one’s overall satisfaction in life.

People with anxious attachment styles (Bowlby, 1961) are likely to find the behavioural patterns of breadcrumbing even more challenging to deal with as it heightens their anxiety states even further. The anticipation of connection or communicating, or actual communication, making plans, which is met by non-communication and silence can leave one feeling very highly anxious, on edge and in a constant state of hyperarousal.

Being in a hyperarousal state means adrenalin and cortisol are naturally being released in abundance by the body as a survival mechanism to cope with the level of stress it is experiencing. Excessive and prolonged periods of adrenalin and cortisol supplies causes the body wear and tear, and it becomes overwhelmed and overloaded as a system. The secondary health issues from having excessive amounts of cortisol and adrenalin are stress, generalised anxiety, fatigue, insomnia, and at times appetite disturbances.

People who are being given breadcrumbs are likely to engage in rumination where one repeatedly plays past scenarios in their mind, trying to reassess where things went wrong, chastising oneself. The repetitive negative thinking in rumination can cause a lot of distress and precipitate anxiety and depression. At times severe rumination does require treatment with therapy, CBT being the favoured form of treatment which helps challenge the negative repetitive and irrational thinking.

People who had little love or affection in early life can easily become caught up in the dynamic where they are either the subject or victim of breadcrumbing. Feeling loved & appreciated can leave people who crave affection to seek more & end up engaged in the cycle where they are getting the bare minimum “breadcrumbs” and wait until the next dose of it. It’s very easy for the one who drops the breadcrumbs to sense the emotional neediness or void in the other, which is what perpetuates the cycle of dropping morsels of affection here and there, and controlling when they engage again.

Conversely, the people who had little love and affection are vulnerable to engaging in breadcrumbing as it gives them a sense of satisfaction that someone loves and pays attention to them, someone is interested in them, and that they are in control, despite not having any interest in pursuing any form of relationship.

Being breadcrumbed has profound negative effects on one’s mental health as the erratic nature of this pattern often leaves the one who is being given breadcrumbs questioning their desirability and reality- gaslighting themselves eg. “Was l rude in my last message?”, and replaying scenarios in their head.  This erodes one’s self-esteem and diminished self-worth.

Ways of dealing with breadcrumbing

If you are being breadcrumbed, the best way to deal with it is to first identify a pattern in your dating experience. Who initiates contact, how long does the other person take to respond, do they withdraw when you start talking about emotions, are they consistent in behaviour and what they say?

If you answered negatively to some of the questions above, it’s important to start putting boundaries in place by letting the other person know that you are not interested in “playing games” and you do not wish to be treated as if you do not matter. This form of self-advocacy disarms the other person & on many occasions, the behaviour stops. If they are genuine and it’s a matter of poor communication, they will stop and start communicating better.

Instead of dwelling on the negative dating experience and feeling lonely waiting for them to reach out and respond to messages, find things to do to occupy your time. Engage in old and new hobbies and channel your energy into existing relationship that nourishes you and where you feel valued.

If you are still pursuing dating, start meeting new people and continue your exploration journey. Do not miss the opportunity of meeting the love of your life waiting for someone who does not care about you.

Accessing therapy, and the notion of going to therapy is no longer shunned at, which is progressive. However, many people remain unable to access therapy due to various reasons. Nonetheless, we do need to find ways of cultivating robust mental health and practising habits that support both our physical and mental well-being.

Why people may not be able to access therapy

Despite going to therapy being an act of courage in itself, many people who are keen to access therapy aren’t always able to. Here are some reasons why people may be unable to access therapy.

Cost

Therapy is not cheap, and many people have been excluded from benefiting from therapy due to cost. There aren’t many therapists or services offering low-cost fees. For some, the low-cost rate is still a huge financial sacrifice that they cannot meet. This leaves a certain group of people who could benefit from therapy excluded.

Stigma

As a society, there is a lot of stigma around mental health and therapy, leaving some feeling ashamed to seek therapy. This is a bigger issue in the minoritised communities, where therapy is taboo. We live in a world where people are meant to be “strong” and “pick themselves up” which means accessing therapy is viewed as a sign of weakness.

Based on my experience in the NHS, many young people access mental health support when they have severely deteriorated, and their families play a part in concealing their mental health challenges from society due to shame and stigma. This is an even bigger problem in minoritised communities. This means that their treatment outcomes are poor as they miss out on receiving treatment during the onset of their mental health challenges. Accessing therapy early and seeking help before the mental health challenges increase could indeed mitigate the deterioration.

Lack of awareness

Some people may not be aware of the benefits of therapy. They may not have an understanding of mental health and what therapy is. There are some communities and cultures that do not believe in therapy. They view therapy as a white middle-class invention, and an indulgent, with no value to them. This notion is reinforced by the fact that therapy is inherently a white middle-class concept and is practised by predominantly white therapists. Only in recent years, more and more people from minoritised backgrounds are beginning to have a grasp of what therapy is, and accessing it.

Poor representation

Many people are deterred from accessing therapy as they are unable to determine how to find a therapist that is a good fit for them. While this is an issue for anyone accessing therapy, it is even bigger a problem for people from minoritised backgrounds due to the lack of representation from people of their own backgrounds. The argument around therapist-client fit is never resolved as the relationship between therapist and client is key, regardless of their race, colour, class and culture.

However, it is true that many clients find it easy to talk to therapists who are from a similar cultural, racial, or class background as there are familiar references that do not need explaining. This is a real issue for people accessing therapy, which needs to be considered.

Fear of vulnerability and judgment

Therapy can make one feel exposed and vulnerable in many ways. The idea of having such an intimate relationship with someone with whom you get to tell all your secrets, and reveal shameful aspects of yourself can be daunting. The fact that therapy creates a power imbalance – as the therapist does not tell their clients their own issues, becomes even more unbearable for people accessing therapy.

Fear of judgement is a real issue, especially for people who may have had a lot of trauma, or people involved in behaviours that may be considered immoral. While therapy is not a space for judgment, this does indeed become a deterrent. Being vulnerable is not something that we all embrace, more so in the presence of an unfamiliar other. There needs to be a relationship and safety. Fear of vulnerability does indeed become a big limitation for many.

Denial

Denial is a defence against accepting the reality, however, it doesn’t make the problem go away. Some individuals may be in denial about their problems, no matter how big they are and think that they do not need therapy. This is indeed detrimental in the long term as what starts as a small issue can develop into a bigger problem if not addressed at the right time.

Time constraints

Despite therapy now being available online, which makes it easier to access, some people just don’t have the time to attend therapy. This is mainly for people in full-time employment with families. Some people do not find online therapy helpful to them as It may feel impersonal to them. While this is a subjective feeling, they miss the opportunity of doing therapy as they cannot engage online and don’t have the time for in-person sessions.

Previous negative experiences

I have encountered many people who have had negative experiences with therapists in the past, leading them to be aversive to therapy. While the experience may be related to a particular therapist, it clouds their judgment on therapy as  a whole.

Self-care tips

With these deterrents in mind it is important that we identify ways in which people can take care of themselves and cultivate their mental well-being without going to therapy.  If you are unable to access therapy, here are some useful self-care tips and why they are important.

Healthy diet

A healthy diet includes all the nutrients the body requires- protein, carbohydrates, healthy fats, water, iron, etc. The body and mind an intricately linked. Having a healthy diet translates into a robust immune system, healthy skin, optimal energy levels, a healthy digestive system, and regulated chemical balance. Cooking yourself a good healthy meal can also be a good form of self-care and a mastery activity which bolsters our sense of well-being.

Stress management

Stress is one of the key causes of poor mental health – chronic stress can lead to burnout. Stress increases the chances of developing anxiety, depression, insomnia, high blood pressure, migraines and fatigue. Chronic exposure to the stress hormone cortisol and adrenalin has been linked to other physical health conditions such as autoimmune disorders and hypertension. It is vital that you find ways to combat stress and give yourself time to rest. Planning your tasks in manageable chunks, and approaching the tasks in a graded manner will help you lower your stress levels.

Routine

Having a routine is hugely significant in giving your body and mind a rhythm that it can follow. Just like a baby that needs a feeding, sleep, and playtime routine, our bodies and minds respond well to routine and some kind of structure – repetition – to help regulate itself. Not having a routine leaves one in a state of dysregulation and also makes it difficult to self-regulate, something that our bodies are capable of doing for us naturally.

Sleep hygiene

Sleep is a key component of well-being. Sleep is a necessity, and it is good quality sleep that matters the most. Sleep allows our bodies and minds to naturally repair themselves, heal and reset. Sleep is also essential for emotional processing something that we do in our dreams. Sleep hygiene means engaging in habits that promote sleep as a natural process -this aligns with routine. Sleep hygiene may mean things like getting rid of gadgets, not speaking to friends on the phone late at night, getting into bed early, and not drinking coffee, alcohol or other stimulants after a certain time of the day.

Personal hygiene and self-care

The external world is typically a reflection of our internal world. You are more likely to feel good after a shower and wearing your best clothes than you do walking around unshowered, unkempt and in dirty clothes. The notion of your body being your temple is helpful here in highlighting the significance of taking care of your body, which will also feed back to your mind. Self-care is a mastery activity which can evoke the body’s natural opiates – endorphins, our feel-good hormones.

Treatment of underlying physical health issues

It is hugely significant to have checkups with your GP and dentist. Many people have or suspect they may have some health problems that they do not address in time. These may be impacting their mental health and treating the underlying condition translates into enhanced mental health.

Community and positive relationships

No man’s land is an Island! We need others, we are social beings. Having positive relationships with others around us and fostering a community is key to positive mental health. Isolation and loneliness can make small problems look even bigger – the experience of being “psychically” held by others is profoundly powerful and its healing mechanisms are what made our ancestors thrive as groups of people.

Journaling and personal reflections

Journaling is a powerful way of processing. Putting one’s personal reflections, thoughts and feelings is hugely significant and therapeutic. Journaling is something that is done subjectively, and no one has to read, judge or mark what you have written. Being able to have an honest appraisal of oneself through journaling can indeed lead to an autonomous change in behaviours and attitudes that may be problematic in one’s life.

Affirmations

Affirmations are a powerful way of expressing self-love and self-validation. We are so quick to seek validation, compliments, and words of affirmation from others, yet this is something we should be giving ourselves. We cannot fully love others if we do not love ourselves. Self-love starts with affirming yourself, reminding yourself of all the qualities that you embody and what you want to see manifest out of that.

Affirmations are a love language  “words of affirmations” and they go along with other love languages like quality time. If you affirm yourself you are likely to treat yourself with kindness and compassion and become less critical. Write a list of affirmations and use them daily when you wake up.

Identifying your values

Values are key to our sense of self and well-being. They guide how we live our lives and what matters to us. When we live a value-led life, we are likely to feel purposeful, and a sense of wholesomeness, which translates to positive mental health. Many a time, our suffering stems from leading a valueless life which makes life empty, defeated and as if you are a passenger in your own life.

Write down your values and identify how your current life aligns with your values. Note what us is you can do/change to get yourself back to living a value-led life. This can be a painful process as it may mean letting go of certain relationships and habits we have engaged with which misalign, or are in conflict with our values.