Grrr. I was dealing with depression and stared at my therapist in pure frustration…
- Why was she still going on about routine, eating patterns and how much I was sleeping?
- Why did it matter to her so much when I was struggling so much with flashbacks, nightmares and overwhelming pain?
- Couldn’t we just get on with talking about the important stuff?
I was broken. Suffering from a severe depressive episode and PTSD for the first time in my life, my world had shattered into billions of pieces. I needed her to rebuild me. Not go on session after session about life’s basic needs.
Basic Needs When Dealing with Depression
Eighteen months on, at a positive stage of recovery, I get it. I understand her obsession with routine, eating and sleeping. I understand why she insisted, session after session, that I got that right before she was willing to make me face any of my traumas. I also want to shout about it to the outside world. Now I fully recognize that meeting my most basic needs is fundamental to my mental wellness. And I’m wondering if you do too.
Maslow’s Hierarchy of Needs
As a teacher, I’ve often discussed Maslow’s Hierarchy of Needs (see image above). It’s fundamental to our role as effective educators to understand that students whose basic needs are not being met, aren’t going to learn well.
However, it wasn’t until I began to emerge out of that deep pit of dealing with depression and PTSD, that I started to understand how important it is for us all.
Look carefully at the bottom section of the pyramid. Food, sleep and breathing are clear physiological needs. They must be fulfilled in order to be physically well. Yet, what I have come to realize and accept is that actually if those needs aren’t met, the impact on mental health can also be phenomenal.
My mental illness first began to emerge through nightmares. Actually, nightmare is too tame a word. Night terrors. They haunted me, for months on end. During the night, I re-lived traumas that I thought were long buried. I shouted, trembled and cried in my sleep. One night, I leapt out of bed so violently that I collided with a wardrobe and exhibited a black eye for days afterwards.
By day, I shook them off. Continued to work. And convinced myself that they weren’t having an effect on me. Yet I was ignoring one of life’s most basic needs: the fundamental requirement of sleep.
This lack of sleep was the first element that sent me on the downward spiral to a complete breakdown. Weary, my coping mechanisms disintegrated. Exhausted, my thoughts became irrational. Shattered, my ability to find the positive in any element of life, totally disintegrated.
I chuckle now at my ignorance and gall. How could I have questioned my therapist’s insistence on finding strategies to help me sleep better?!
Lack of sleep and my spiraling mood, had a direct impact on my appetite. It was simple really. I didn’t have one. Food no longer interested me. It wasn’t that I didn’t like anything. It was more that it didn’t occur to me to eat.
At the time, I couldn’t appreciate the significance of this. My therapist’s suggestion that I set an alarm to remind me to have lunch when I was alone seemed excessive. It was no big deal. I missed the odd meal. It wouldn’t do me any harm.
Yet it wasn’t the odd meal. It became most meals. When I was alone, I didn’t think about eating. When I was with my family, the kitchen noise and chaos was too much for me to bear and I sloped off to bed. Within a six weeks, I’d lost seven kilos and weight was still falling off me.
I was so much weaker, lacking the basic energy to function, to make any effort at all. It wasn’t only physical energy that I struggled with. Even the energy to think…to begin a line of thought and to reach the end of it…became impossible.
Again, I look back and I’m startled by my ignorance. ‘Why does it matter what I’ve eaten’ were the words I wanted to yell at my therapist as she insisted on knowing about my eating patterns; and made suggestions about how I could improve them. Surely my night terrors, my fears and my pain were far more important than that? How wrong I was!
Suffering from PTSD has involved intense moments of panic. Moments in which my breathing becomes irregular and my chest becomes tight. It’s a sensation that has often been compared by others to having an elephant sitting on your chest. And that image works well for me. It feels just like that.
Yet I was still skeptical when a mindfulness coach I was working with, emphasized over and over again the importance of breathing. Surely that’s just a natural process we all get right without thinking about it, I thought. How on earth can thinking about my breathing change the way I feel about things?
But she planted a seed. And as she repeated it every week, I slowly began to think that maybe this focus on breathing wasn’t so daft after all.
Unexpectedly, a friend then sent me a hypnotherapy recording to help me sleep at night. By this point, I’d moved on from night terrors but often found it hard to relax before going to sleep and still dreamed vividly. Believing in this friend, I followed the instructions diligently; even though I struggled to understand how it would make much difference. Breathe in deeply, hold it, breathe out slowly and release the day’s stress. Repeat. Do that a few times and then take some random journey down some steps, counting even more slowly from twenty to zero as you go.
Unconvinced (and secretly a bit cynical), I decided I’d try for three nights before giving up. Yet only one night was needed. I began the breathing, then I walked deliberately and slowly down each step, and my head became a bit hazy… and then…well, then it was morning. What? It was morning?
I woke up feeling rested. I hadn’t battled my thoughts before falling sleep. I hadn’t had vivid dreams. I’d simply drifted off to sleep, without even realizing it.
Sleep, Eat, Breathe
So, what did I learn from all of this? Well, number one, was that my therapist was absolutely right (that’s been the slightly annoying reality I’ve often had to accept). Much as I was desperate to face the traumas and pain I had experienced, so that I could just get over them and move on very quickly, I couldn’t do that until my basic needs were being met.
You see, once I was sleeping properly, eating well and yes, able to breathe, then, and only then, was I in a fit space to face and deal with the issues I was struggling with. Eighteen months on, I am so much stronger than I was and, the minute I feel I am struggling again, I assess if I am meeting those basic needs. Invariably, I realise that sleep hasn’t been the priority it should be or that I’ve been eating the wrong things. So, I take a step back from the busy world I am once again a part of and make sure I redress the balance.
My advice to you? Next time you are struggling mentally*, take a look at Maslow’s Hierarchy of Needs. It’s faced a fair amount of criticism in its time. But I suggest to you that if you focus on the physiological needs it shows in the first level of the pyramid, then you will be more prepared to confront any mental health difficulties you might experience.
Give it a go. It worked for me. It might just work for you too.
* I must stress that although this is important for everyone, I am not in any way suggesting that it will resolve mental illnesses. Looking after our basic needs is vital, but so too are talking therapies and medication for so many people who are battling mental illnesses. This is a vital piece in a puzzle but it is certainly not the only one.
Raw, honest and open as a mental health warrior. Keen mental health advocate. Writer, poet and lover of words that encourage and inspire. Third culture, bilingual kids in a fab family of four + one (four-legged fluff ball that barks). Identical twin and mother of twins. Lived in UK, Italy and The Netherlands. Passionate primary school teacher. Mad about sport – cycling, squash, swimming, tennis, football – it varies. I just need to move!