When I deliver talks on mental health, I show a slide depicting all the things that keep me mentally well. I talk about how, for me, my ongoing anxiety disorder feels broadly the same as if I had diabetes. I take medication, I’ve had to make changes to my lifestyle, it’s always in the back of my mind – but as long as I am vigilant, it doesn’t define who I am or stop me from doing the things I want or need to do.

Yet recently, as I look back from the audience and glance at this slide, my overwhelming thought is: Not everyone could realistically do this. The fact that I am able to sustain a state of wellness is symptomatic of my privilege.

Don’t misunderstand: I’m not taking myself off to exclusive retreats every weekend to have a bespoke remedy of crystal-infused saline injected into my eyeballs by a dude in white robes calling himself a ‘shaman’; I’m neither that rich nor that gullible. My recovery plan consists of simple solutions that should be universally accessible in a civilised society, but that instead have barriers that can only be overcome with a certain amount of privilege. Let’s break them down. 

The debate around mental health medication has become far too binary. Sure, there are those for whom medication is unnecessary, or it does harm. SSRIs are certainly prescribed too readily and often before exploring other options that could be more helpful. I, however, fall into the often-overlooked category of people for whom taking meds has been life-saving.

I tried other brands and dosages before settling on the one that most agreed with me: 50mg of Sertraline every day. Each time I tried a new type, I had to give the medication three to six months to work its way into my system. It was crucial to undergo this process under close medical supervision – my GP would see me once a week and ask about my symptoms, adjusting according to my feedback.

I simply cannot imagine most GP practices having the requisite resources to be able to give me this kind of care in 2024. According to official NHS figures, 50,000 people a day are having to wait more than 4 weeks to get a GP appointment in the first place (that’s around 17.6 million). Approximately one fifth of NHS appointments during 2023 were between 1 and 5 minutes, owing to time constraints. 

My parents funded the first therapy sessions I had for bulimia, in my 20s. It was almost a grand for three private sessions. Although they stopped me binging and purging, I was still in a lot of distress afterwards. I now know that’s because my eating disorder was a ‘secondary’, i.e. arising a result of my primary mental health issue (anxiety).

I didn’t get a diagnosis of panic disorder until 2013. By that stage I was working in mental health, so the six sessions of CBT I was fortunate enough to receive swiftly through the NHS were no help whatsoever. The therapist couldn’t believe how quickly I was understanding what they were telling me. I was sitting there thinking ‘yeah, that’s exactly what I would say’.

So, it was back to private options: I had talking therapy to explore childhood experiences, then later EMDR (eye motion desensitisation and reprocessing) to ‘reset’ my responses to those triggers and memories. All in all, I had about 50 sessions over the space of two years. Each time, I was shelling out £75.

When people baulked at the cost, I responded by (truthfully) saying I knew people who spend that amount of money on beauty treatments. I hadn’t had my hair cut in years. I never got facials or manicures. “It depends on your priorities,” I’d declare, piously.

Living as I do in a highly populated area, today I’d likely be amongst the one in ten people who have been waiting over a year to receive treatment on the NHS, according to Mind. Even this might be a generous reading of the data, since therapists have said it is skewed by the number of people who give up and drop out of the waiting process.

As for going private, the cost-of-living crisis has rendered this an impossibility for many. In fact, the percentage of families with no money left at all by the end of each month increased nearly twofold between 2022 and 2023. 

Daily movement is not only a crucial outlet for anxious energy, it also connects me to my body in a way that stops me lapsing back into disordered eating. Experience has taught me that I cannot compromise on this. I have to find a way to carve out at least 30 minutes – but preferably an hour – to run, dance or (my personal favourite) do yoga. There’s also all the paraphernalia around exercise (getting changed, showering, washing hair after a particularly sweaty session, reapplying makeup). In reality, it’s more like 90 minutes. Sometimes, making time for that has involved saying ‘no’ to work opportunities.

Many aren’t in a position to maintain this kind of work/life balance. Two in five people are working longer hours as a consequence of the cost of living crisis. 16% of workers in the UK have taken on an additional job to help pay for the cost of living increases. 30% will need to take on an additional job if costs continue to rise.

I also don’t have kids – if I had to juggle childcare into that mix it’s safe to say I’d be too knackered for downward-dogs. 

Speaking of dogs, there’s tonnes of evidence to suggest having an animal companion improves mental health. For some it’s about routine, for others having another soul relying on them gives them a sense of purpose. For me, it’s the non-judgmental companionship.

Yet the number of people who cannot afford to keep their dogs is on the rise according to The Dogs Trust. Pet foodbanks have also begun to spring up in the UK.

Escaping into my imagination is the final piece of my recovery puzzle. I read fiction voraciously, inhaling an average of one novel – at a cost of about £10 - per week.

‘But there’s libraries!’ I hear you cry. Well, austerity measures have seen 764 local British libraries closed since 2010. 

I’m not super-rich by any measure. However, I am fortunate enough that I don’t have to worry about money most of the time. That’s not only allowed me to build this life that nurtures my mind, it also means I don’t endure the negative mental health impacts of poverty.

The government have recently been maligning those with mental health issues because their inability (or, as they would frame it, unwillingness) to work is having a negative impact on the economy. It’s long-past time we started inverting that thinking and focussing on how the economy is affecting the nation’s mental health. 

Frame Of Mind is Stylist’s home for all things mental health and the mind. From expert advice on the small changes you can make to improve your wellbeing to first-person essays and features on topics ranging from autism to antidepressants, we’ll be exploring mental health in all its forms. You can check out the series home page to get started.

Images: Jonathan Donovan; Ellen Jones