Coping with ‘coronaworries’

U of T psychology, psychiatry professors share advice on adapting to the new normal

Coping with ‘coronaworries’

Widespread lockdowns, border closures, self-isolation, and quarantines have become the new normal around the world as people adapt to the realities of COVID-19. These changes to our lives, along with the uncertainty of how long the spread of COVID-19 will last, can have a detrimental effect on mental health.

However, according to psychology and psychiatry experts at U of T, there are practical ways to take care of yourself during these challenging times.

It’s normal to feel anxious 

Dr. Steve Joordens, a professor of psychology at UTSC, said in an interview with The Varsity that the current pandemic is “a prototypical situation” for anxiety to manifest. 

He explained that anxiety tends to appear when we feel like we’re under threat and we can’t do anything about it, just like during this pandemic.

In such situations, your sympathetic nervous system activates the fight-or-flight response, making you feel on edge.

Joordens went on to say that students, whose lives are generally structured around classes, can begin to feel adrift when that structure and organization is gone.

“And when those things are taken away from us, we can feel a little adrift,” Joordens said. “Like a boat without an anchor where we’re not sure what we should be doing.”

The lack of human contact as a result of self-isolation, and the constant exposure to the news can also feed into this anxiety.

Further, quarantine can lead to severe psychological consequences: a review in The Lancet found that quarantines can cause symptoms similar to those of post-traumatic stress disorder, as well as feelings of “confusion and anger.”

Maintaining a sense of control despite uncertainty

The Varsity interviewed Dr. Greg Dubord, an assistant professor of psychiatry at U of T. He wrote that although our daily lives have been uprooted by the virus, “The behaviours that maintain good mental health are the same with or without the presence of the COVID-19 virus, and many of those don’t have to change.” 

In an interview with Global News, Dr. Vaile Wright of the American Psychological Association emphasized the importance of maintaining a sense of control. According to Wright, in a situation like the ongoing pandemic, the only things you can control are your thoughts and emotional and behavioural responses.

Stress can be managed productively: eating well, exercising regularly, and getting enough sleep can help you stay in good mental health.

According to Dubord, research has shown that spending time in cluttered and messy environments can have a negative impact on your mental health. Cleaning your room may be overdue, and it might keep you busy for some time. You’ll then be better able to focus on your homework afterward.

Creating a schedule or planning each day carefully might help you stay productive and maintain a sense of control.

Dealing with the anxiety

News can give us some sense of comfort, according to Joordens, but it can also easily turn into a source of addiction. “We are all living in this uncertainty, and information is very comforting to us, and we’d like to get a little bit more understanding of what’s going on,” he reflected.

Dubord added that although it’s “vital” to stay informed, and “most people will end up consuming an unhealthy amount of news.”

To avoid scrolling through the news all day, and hence becoming even more anxious, both Joordens and Dubord recommend balancing your exposure to the news — for example, you could check the news in the morning, afternoon, and early evening, but not right before bed — and limit your time on news websites. It is also crucial to get your news from credible sources.

Limiting your exposure to social media can also be beneficial and prevent information overload. However, you might find that following mental health accounts on Instagram is helpful, insightful, and grounding.

Grounding yourself with relaxation techniques 

In a New York Times article, Dr. Judson Brewer of Brown University recommended trying awareness techniques to stay grounded and activate your prefrontal cortex, the part of the brain responsible for judgement and decision-making. 

Brewer provided the example of reminding yourself of the good hygiene practices you’re partaking in during times of transmission-related anxiety. The brain tends to engage in processes it finds rewarding, so it might start focusing more on the pleasant feelings good hygiene brings about, rather than the negative feelings of anxiety.

Joordens further suggested finding guided relaxation techniques that work for you and designating a cue word that will prompt you to start relaxing. “You can’t tell yourself to stop being anxious, but you can tell yourself to start relaxing.”

Other activities, such as listening to your favourite music, or singing, can also help you cope with the anxiety.

Reading can be a calming activity, too. “Hopefully your future self can look back upon the COVID-19 self-isolation period with some pride based on having read a good number of good books,” wrote Dubord.

Here’s how to stay healthy during your COVID-19 self-quarantine

Tips for maintaining your workout routine and eating well during the crisis

Here’s how to stay healthy during your COVID-19 self-quarantine

It might be hard to maintain fitness and health during the COVID-19 pandemic. U of T has closed all gyms, and minimizing grocery shopping does not bode well for fruits and vegetables, which tend to go bad after about a week. However, there are still many ways to maintain your health without needing to leave the house often.

Fitness

Although it is recommended that everyone stay inside during the pandemic, it is perfectly safe for you and others around you to go for a run. As long as you are complying with social distancing guidelines, there is no harm in engaging in most outdoor physical activities.

If you are used to running on busy streets, it may be best to find residential areas in order to maintain the recommended six feet of distance between yourself and others. Remember to also avoid drinking from any water fountains.

In terms of strength and conditioning, burpees are one of the best exercises to do at home. They are accessible to anyone at any fitness level and are incredibly efficient. However, you should also be conscious of varying your exercises as well, and should include pushups and squats into your routine. These three exercises alone make for an effective workout.

Nutrition

Grocery shopping can be difficult during this pandemic, given that many things are already off the shelves, and that canned and other non-perishable foods last much longer than other food.

When buying milk, it is best to look for shelf-stable milk, such as soy, almond, or hemp milk. These have a much longer shelf-life than regular milk, and can be a substitute for almost anything you normally use milk for.

In terms of food, beans are one of the most nutritious and cost-efficient items to buy. Dry beans are cheap and can be bought in large quantities, but canned beans work well too and are much more convenient.

Although many fresh vegetables spoil quickly, there are many that you can buy frozen, such as corn, peas, and broccoli. The freezer is also a great way to keep many of your meals fresh for a long time.

One last trick is to smear your pasta sauces, lentil and bean soups, chilli, or other stew-like meals into an ice tray, freeze them overnight, and put the cubes into a plastic bag the next morning. This saves a lot of time in having to thaw meals, and can be reheated in the microwave very quickly.

Mental health

Eating healthy can positively affect one’s mental health. This is important during a time of crisis that causes a dramatic change to routine — especially one that requires self-isolation.

Dark leafy greens, asparagus, legumes, nuts, and whole grains help keep your blood sugar stable, which helps reduce anxiety. Anxiety can also be curbed by antioxidants, such as blueberries, acai, and foods with Omega-3 fats, such as salmon.

For a treat, chocolate can be a stress minimizer as well. Try to avoid foods that trigger anxiety, such as simple sugars, fried foods, alcohol, and excessive caffeine.

Dashed dreams: Varsity Blues veterans talk nationals cancellations amid COVID-19 pandemic

Graduating athletes cherish accomplished university careers, despite disappointing end

Dashed dreams: Varsity Blues veterans talk nationals cancellations amid COVID-19 pandemic

We are all living in a new ‘normal’: as U of T students, we have watched our lectures and tutorials move online with varying degrees of success. We have witnessed our graduations and end-of-year showcases get put in potential jeopardy. We stood by as our beloved clubs, intramurals, and extracurricular activities slowly dwindled away. Most jarringly, we are living in a time of deep uncertainty surrounding what the future holds, and how we will navigate it.

For some Varsity teams, however, part of their future is grimly set in stone: players watched their championships vanish before their eyes, robbing them of the chance for a moment of glory at the national level. Their most ambitious goal of the year, one they fought tooth and nail and beat the masses for, disappeared.

For men’s volleyball, it was their first chance at a national title. For women’s hockey, it was a chance at an equally elusive U SPORTS title. Similarly, the women’s volleyball team had to watch their national championship disappear. The Varsity reached out to some graduating players from these teams to discuss how they are responding to a tumultuous and disappointing cap to their careers.

“The team has had an amazing year, finishing first in the league and winning the McCaw Cup. We definitely had a chance… to be National Champions,” wrote hockey veteran Cristine Chao. Chao is title-holder of the Ontario University Athletics (OUA) Defender of the Year, Most Sportsmanlike Player, and First Team All-Star awards.

“To have it end abruptly just like that… just shocked me. I didn’t know that the game on Thursday was going to be my last hockey game ever as a part of the University of Toronto Women’s Hockey program.”

Andrew Kos of the men’s volleyball team, a veteran who has competed on the national and international stages for beach volleyball, shared Chao’s sentiment: “It is obviously quite disappointing. Having it be my last year, it was an unorthodox way to end my varsity career, but nevertheless quite memorable.”

Decorated volleyball veteran Alina Dormann is similarly disheartened. She had to anticlimactically cap off a Varsity Blues career that boasted national and provincial team experiences as well as multiple titles of OUA East First Team All-Star and U SPORTS First Team All-Canadian.

“It was definitely a challenging end to the season, to have it end so suddenly and not have the opportunity to compete for the national championship, which is what we had been working towards all year,” Dormann admitted. The team had even travelled to Calgary, where the nationals would have been hosted. After training for two days, they were “feeling very confident and ready for the weekend.” Then, before the games could begin, they were on a flight home and the season was over.

Despite these dashed dreams, there is a common understanding that these cancellations are necessary to slow the spread of COVID-19. Some graduating athletes chose to cherish the memories of being a Blue that they do have, rather than focus on the ones that could have been. “At least we were able to win OUAs this year,” Chao reminisced. “The feeling that I had at Varsity Area that night is a memory that I will never forget.”

Dormann has chosen to adopt a similarly positive outlook: “As a team, we have been focusing on enjoying the journey that led up to that point, as nationals doesn’t define our team or take away from all the other amazing things we have accomplished this year.”

She added that as she leaves her years as a Blue behind, she will “keep the focus on all the incredible experiences and times I have had as a Varsity Blue throughout the last five years, rather than the disappointment of not being able to compete with my teammates one last time.”

How university athletes deal with stressors

KPE Professor Katherine Tamminen on how parents, coaches help athletes to cope

How university athletes deal with stressors

Varsity athletes often have a large amount of stressors to deal with that are different from those of other athletes. They often have to balance school, sport, and other factors in their personal lives. Professor Katherine Tamminen from the Faculty of Kinesiology & Physical Education studies the abilities of adolescents and university aged athletes to deal with stress in sport — and helps them face it in a healthy way.

Tamminen said that parents and coaches can play a huge role in how athletes deal with stress by “helping them learn to cope with [it],” she said in an interview with The Varsity. “And they also influenced the type of stress that they might experience. So parents and coaches might also be a source of stress for athletes… I think it’s a bit of a double-edged sword there.”

Tamminen also emphasizes that this topic is very nuanced, and that there is no one universal answer when it comes to dealing with stress in younger athletes. “There are some strategies that may be more useful in some situations whereas other strategies are going to be more useful in other situations,” she said.

“It really comes down to the type of stressor that the athlete is facing and then selecting the most appropriate coping strategy to use when dealing with that stressor.”

“If an athlete is having problems with their performance or a skill or something technical, seeking information from their coaches and from their teammates or spending more time working specifically on that skill in practice is likely going to help them to deal with that performance issue,” Tamminen said.

“But if the issue is an ongoing conflict with a teammate or if it’s an issue in a conflict with a coach, or if it’s a stressor from outside of sports that they’re dealing with, like academic demands or they’re dealing with health concerns from a family member, those are going to require different coping strategies.”

However, some athletes deal with things that they have no control over, to which Tamminen recommended dealing with one’s emotions instead of trying to control the situation. She advised “seeking social support or re-appraising the situation and trying to see the positive side of things. Practicing mindfulness.”

She continued, “These can also be very helpful strategies, whereas in situations where they have more control over the stressor, then they might do things that are more active and problem-oriented.” She said that athletes may need to spend more time on these problems, and seek out additional information.

When asked what the most important thing she learned in her research was, she highlighted the importance of social support and having people to turn to.

“The importance of having either a close friend, a teammate, a coach, a parent, somebody that you can confide in and talk to and turn to is so important. It comes up across every single study that I think I’ve ever done in this area… the importance of that social connectedness that people, that athletes have.”

What’s the carbon footprint of a medical test?

How Canadian physicians can prepare for the impact of the climate crisis on health care

What’s the carbon footprint of a medical test?

The greatest threat to health across the globe is the climate crisis.

This is the position taken by the World Health Organization (WHO) and Canada is, of course, not spared of this fact. The effects of the crisis include damage to the physical and mental health of millions of Canadian patients. This can stem from the spread of Lyme disease, uptick in heat-related deaths after prolonged heat waves, extended pollen season triggering asthma complications, lung damage from wildfires, and psychological harm from flooding and increasing climate anxiety, among other things.

How the climate crisis disproportionately impacts patients in marginalized communities

The health impacts of the climate crisis are also disproportionately felt by marginalized communities.

The Varsity spoke to Dr. Samantha Green, a board member of the Canadian Association of Physicians for the Environment (CAPE), an assistant professor at the Dalla Lana School of Public Health, and a family physician who works with marginalized communities downtown.

People living in poverty, racialized individuals, and Indigenous peoples are most affected, noted Green. Their vulnerability is a product of historical social conditions, such as economic inequality, racism, colonialism, and systematic oppression.

She explained, “It’s all about whether you have access to resources to, for example, repair your home when it gets flooded or to access foods when there is increasing food insecurity.”

One example from her own practice is that “with heat waves, especially with people living in poverty, it can be hard to cope. You can’t afford an air conditioner… and if you’re socially isolated, or if there’s mobility issues and you can’t make it to an air conditioned environment, then it’s really hard.”

The impact of the climate crisis on the health care system

The climate crisis, however, not only impacts people, but also impacts health care institutions by damaging systems and limiting access to critical resources.

The Varsity spoke to George Kitching, a medical student at Western University, who explained it further.

“After the hurricane in Puerto Rico, there was a shortage in normal saline because that was the major production site… for Canada,” he said. Kitching explained that it’s difficult to ensure that the health care system is robust against impacts due to the climate crisis, both in Canada and around the world.

The intersection of the climate crisis and medical education

Despite the climate crisis being clearly relevant for medical education, “medical schools have not adequately addressed the urgent need for training,” according to a University of Toronto-affiliated article in The Lancet, co-authored by Kitching.

The Canadian Federation of Medical Students created a task force called HEART — standing for the Health and Environment Adaptive Response Task Force — in 2016 in order to help medical students to raise awareness around the issue of environmental impacts on health.

In response to the crisis, as reporting by Kitching and his co-authors, HEART has developed a set of core curricular competencies to be included in curriculum of medical schools across Canada to integrate planetary health education in the undergraduate medical programs.

The task force also conducted a national survey of medical schools, identifying strengths and areas for improvement for planetary health teaching in undergraduate medical programs. It’s the first evaluation of its kind in Canada, and a report of its findings and recommendations was recently published.

Kitching, who is also a member of HEART, explained that the task force “sent it out to deans at most schools. The ask was to meet with students at each school to chart a path forward to address some of the critiques and some of the suggestions that we had in the report… The next step for HEART as a task force is to support local students at each to use the report to push their faculty and deans to incorporate further training.”

However, one of the biggest pushbacks they face is that the medical curriculum is already packed, and to add one thing, another thing must be taken out in return, according to the co-authors.

To tackle this, the report recommends integrating planetary health teaching into existing lectures, for example, by including air pollution with respiratory health teaching. The report also recommends case studies to help focus on the disproportionate impact to marginalized communities.

Thinking about health care and the climate crisis

The health care industry both affects, and is affected by, the climate crisis.

A 2018 study concluded that the health care sector in Canada was responsible for 4.6 per cent of the nation’s carbon dioxide equivalents, which is a measure of environmental impact, and estimated that it resulted in 23,000 years of life lost due to illness, disability, or premature death.

The study advocated for health care professionals to adopt more sustainable practices. For example, the National Health Service Centre in the United Kingdom calculates carbon footprints of various health care activities like staff transport and waste disposal.

Health care professionals should also be trained to think more sustainably without compromising patient care, according to the report.

“We need to be learning not only about the efficacy of medications we prescribe [and] also their cost, [but] also their climate costs and environmental costs,” said Green.

How online paperwork could contribute to burnout among physicians

Time spent on health charts, patient portals linked to emotional exhaustion

How online paperwork could contribute to burnout among physicians

The time that physicians spend on online paperwork may be correlated with burnout, according to a study affiliated with the University of Toronto’s Dalla Lana School of Public Health.

The study, conducted among physicians in Rhode Island, explored the relationship between their self-reported burnout and their use of health information technology (HIT). It found a positive correlation between burnout and the use of the technology in the state.

However, these results may not be generalizable to Canada, as the research did not include Canadian participants.

What is HIT?

HIT is a broad term that encompasses different types of computer programs and resources that health professionals use for their clinical practice. Examples include electronic health records (EHR); patient portals, which are secure websites where patients can receive test results; and e-prescriptions.

The technology aims to improve the flow of information between health care providers and patients, as well as increase the quality of patient care.

Dr. Rebekah Gardner, the lead author of the study and an associate professor of medicine at Brown University, explained to The Varsity that she became interested in this topic because she has “been personally affected by [the legislation] and [has] experienced [her] colleagues’ growing pains, in terms of learning how to use EHR.”

The study in focus

Due to the lack of research before widespread implementation, health centric advisors developed a survey — as mandated by the Rhode Island government — to measure the impacts of this technology on practicing physicians. This survey was sent to all physicians in Rhode Island, asking them to rate various feelings related to burnout on a one-to-five point scale. Forty-three per cent of the subjects — 1,792 physicians — responded, and of those respondents, 26 per cent had experienced burnout.

Burnout is defined in the research paper as a set of symptoms or feelings that people have, such as emotional exhaustion or decreased job satisfaction.

These results are important to understanding the scope of the problem, because burnout has adverse impacts on the health care system. It is associated with increased medical errors, absenteeism, reduced quality of work, higher rates of turnover, substance use disorder, and medical malpractice.

This study demonstrated the widespread prevalence of technology related stress and the measurability aspect of technology-related stress. Participants who reported insufficient time when it came to documentation had a 2.8 times higher likelihood of suffering from burnout.

Potential reasons behind the conclusions

Gardner explains some potential reasons for this result.

“Documentation is very time consuming and [can create] a lot of extra desk work for every office visit with a patient… this cuts into time spent with family or time spent sleeping,” she said. Physicians are generally not reimbursed for this time spent, according to the paper.

“Technology can metaphorically and literally disrupt the interaction between patients and doctors, and patient interaction is often an antidote to burnout.”

Burnout can also create a burden on the health care system.

“Burnout can result in unnecessary tests ordered and absenteeism requiring alternative sources to cover a physician’s shift,” said Daniel Harris, a co-author of the study and a second-year PhD student at the Dalla Lana School of Public Health, to The Varsity.

Nonetheless, not all physicians found using HIT to be stressful. Gardner found that some physicians believed HIT was extraordinarily useful. She also found that not all burnout was related to technology and burnout differed across various specialties.

“In other specialties, you’re going to miss the mark [if you just focus on HIT],” said Gardner. It may be productive for researchers to focus on different factors to “get to the root of burnout in that particular physician cohort,” she continued.

Future steps of research

However, there are limitations to this study. Harris explains that because this survey was cross-sectional, researchers are unable to establish causation.

Researchers must ensure there is a temporal sequence to establish causality, he noted. “We don’t know [whether HIT or burnout] came first,” he said, due to the design of the study. “You could potentially imagine a situation where someone is already very burned out, and that leads them to then use their EHR more at home.”

In addition, Gardner highlighted the lack of anonymity in this survey as potentially impacting the results of the study. Physicians may not have been able to, or wanted to, share the full extent of their burnout without anonymity.

Future steps include perhaps recruiting a larger sample across various states or health systems, exploring the factors that contribute to burnout in greater detail, and anonymizing the survey.

While future research is needed to generalize these results Canada, HIT is pervasive in health care and it could be a factor that contributes to burnout in Canadian health care providers.

How welfare cuts in Germany worsened health outcomes of unemployed persons

U of T-affiliated study results could have implications for social welfare in Ontario

How welfare cuts in Germany worsened health outcomes of unemployed persons

One of the most drastic changes to Germany’s welfare system, the 2005 Hartz IV reform, worsened health outcomes among unemployed people, according to a U of T-affiliated research study.

This specific reform in Germany’s welfare policies affected unemployed Germans who received needs-based unemployment assistance. Prior to 2005, this financial assistance amounted to 57 per cent of the recipient’s previous earnings. After the Hartz IV reform, however, the German government replaced these percentage-based payments with a flat-rate of 424 euros every month, cutting the average recipient’s benefits by 25 per cent.

The study’s methods and results

The co-authors examined the direct effect of this welfare reduction on the self-rated health of those who received these benefits.

To carry out this study, they compared a group of unemployed welfare recipients to a control group of unemployed persons who were similar to the experimental group, but did not rely on the specific benefits that were reduced by the Hartz IV reform. This statistical technique is known as a difference-in-differences approach — a comparison of two groups that are nearly identical in all but the trait of interest, in order to minimize the effects of confounding variables.

By comparing the self-rated health of the two groups before and after the reform, the researchers found that both groups experienced worsening self-rated health after the reform. However, the group of welfare recipients reported an additional 3.6 percentage point increase of poor self-rated health.

“Using our [difference]-in-differences design, we [can] attribute that 3.6 [percentage point] increase in poor self-rated health to the effect of welfare reform,” said Dr. Faraz Shahidi, the lead author of the study affiliated with U of T’s Dalla Lana School of Public Health, in an interview with The Varsity.

Applicability of findings to Canada

While this study focuses on Germany, the findings are generalizable to high-income countries that provide financial assistance to low-income populations, such as Canada. Like Germany, Canada has also reduced its welfare benefits over time. In 1995, for example, Ontario cut social assistance rates by 22 per cent, causing the province’s welfare recipients to lose one fifth of their main income source.

“Since the 1990s, no [Canadian] jurisdiction has made a serious effort to increase welfare rates. On the contrary, benefits have either stagnated or borne the cost of additional austerity measures like the one we examined in Germany,” said Shahidi.

“As a result, the millions of people who [rely] on social assistance have seen a substantial decline in their absolute and relative economic standing over the last few decades.”

It is clear, through this study, as well as numerous studies conducted in other countries, that there is a negative correlation between regressive welfare reforms and the health of welfare recipients. Shahidi pointed out that welfare cuts have previously been associated with “elevated rates of mortality and mental health conditions.”

Welfare reductions can also force former welfare recipients to take unreliable, low-wage jobs to replace the benefits they have lost, according to the co-authors.

Potential cuts in future Canadian welfare

Some Ontario politicians continue to push for reduced spending in social assistance programs, such as Ontario Works, Ontario Disability Support Program, and the Transitional Child Benefit. In November 2018, the provincial government announced its plan to dramatically reduce its spending on these programs.

However, in late 2019, the government cancelled these cuts and retained the current system, in part due to advocacy efforts like the Campaign Against the Cuts to Social Assistance. The Ontario government continues to propose a limitation to those who will qualify for financial support under the Ontario Disability Support Program.

Clear science, complicated politics

The continuation of government policies that reduce welfare benefits highlights an important contradiction between scientific evidence and political actions. “Put simply, welfare reform is not [an] evidence-based policy… Power, ideology, and interests are often more decisive factors driving the agenda,” Shahidi said.

While Shahidi suggested that it would be beneficial for future researchers to investigate the underlying causes of the relationship between welfare reform and negative health outcomes, he believes that there is a strong enough base of scientific evidence to support the expansion of social welfare programs that are known to protect recipients’ health.

What complicates the implementation of these regressive reforms is the question of “who stands to gain and who stands to lose?” The available evidence points to “a straightforward answer to the second half of that equation,” Shahidi noted.

“In addition to posing a measurable threat to the health of economically vulnerable households, benefit cuts and related austerity measures impose substantial economic costs on… impoverished families, their communities, and even society as a whole.”

This body, my body

A reflection on life with a chronic illness

This body, my body

The sun hung heavy-lidded in the sky as I rested on an outcropping of rock overlooking one of the shallow valleys that dimpled the woods outside the ancient village where I’d been staying. I’d sprinted through the vineyards outside the house, chasing a runner’s high over the steep and twisted hills surrounding our small corner of the world. But something in the air had told me it was time to stop, time to rest for awhile.

Fifteen years old, a year from high school graduation, two hours outside of Paris, and 6,000 kilometres from home, I turned a corner and came up short. Tentatively, I explored my mind, coming up with something unfamiliar: freedom. I had finally managed to outrun it all: the father who told me I’d only ever be loved if I made myself small. The mother who seemed to be fading into black and white. The sense that I was destined to disappoint and to be disappointed.

It fell away — all of it. All that was left was peace, clarity, the beauty of the dusk-painted valley, and the exhilaration of a reckless run through an unfamiliar forest that just as well could have ended in a broken limb.

As I sat there, two simple truths settled over me: I was grateful for my body, and I was grateful to be alive.

The pain arrived nearly four years later.

IRIS DENG/THE VARSITY

As the snow retreated and the wind blew more kindly, agony hit me like a hammer. It fell upon my joints, neck, limbs, and hands in unpredictable, asynchronous beats. There was fatigue too: a heaviness I couldn’t shake. Suddenly, this body, my body — this thing that hurt and protested and was both me and not me — became an enforced horizon, an inescapable vantage point on the world. This pain — what causes it, worsens it, calms it — has come to shape every facet of my life and my thoughts. It ebbs and flows, but even in its absence, its echo is resounding.

I have fibromyalgia. It’s a chronic disorder characterized by widespread muscle and joint pain, fatigue, cognitive issues such as ‘brain fog,’ and, although their exact source isn’t known, depression and anxiety. Most people with fibromyalgia have a litany of symptoms; no two people experience it exactly the same way. For me, I have a lot of the usual suspects: widespread pain that oscillates chaotically between dull, localized aches and lightning-fast lashes of agony that splinter across my body; extreme fatigue, as though I’m swimming through Vaseline in a space suit; and a wooly mental fog that descends at random.

Fibromyalgia is a chronic illness; it persists over time and has no known cure. There are only ways to manage and minimize the symptoms. Like many other chronic conditions, fibromyalgia is an ‘invisible illness’: its impact typically isn’t visible to the naked eye. All else being equal, sufferers tend to look perfectly healthy; there is nothing visibly amiss.

Though every person experiences chronic illness in a different way, I hope that my experience can shed some light not only on what it’s like to live with a chronic illness, but also on a deeper issue. Most of us, especially at a competitive university in precarious social and economic environments, are terribly unprepared to treat ourselves with kindness. At the end of the day, we all have to ask ourselves this question: are you ready to love yourself when everything, including everything you think you are, goes to hell?

I wasn’t. I’m still not ready.

IRIS DENG/THE VARSITY

When it comes to fibromyalgia, the idea of living ‘with’ a chronic illness can get quite literal. It’s hard to explain, but it’s rather like sharing a body with another person. There’s me — the reasonably well-adjusted, high-achieving, and with-it student — and the other one, my illness. It’s far from an even balance. I’m stuck in my body with something like an apocalyptically emotional two-year-old who’s prone to random meltdowns which rival the dynamism of unstable nuclear reactors.

A simpler metaphor: living with this pain is like being on the wrong end of a voodoo doll.

One way to think through the constraints of chronic illness is by looking at the number of ‘useable hours’ a person with a chronic illness has in a day. Before I got sick, I’d say I had between 10–12 usable hours total each day. These were hours in which I could study, attend classes, see friends, take care of myself, make food, read books, or exercise, with energy to spare. This was the time I had to live the way I needed and wanted to, effectively and healthily.

Now the number of usable hours I have in a day is unpredictable and, typically, fairly limited. On an uncommonly great day, I’ll have eight. On a normal day, I have six. And on my bad days, I have anywhere from two usable hours to none at all. Exceeding this vague limit every day has a ratcheting effect, decreasing my baseline of health and charging interest on the time I spend trying to function as a human in this world.

I often wake up with a sense of panic, wondering how on earth I am going to get through the day. Having a chronic illness involves making an unexpectedly high amount of mathematical calculations, though none of them are precise. My already-depleted energy minus class, readings, work, meetings, human interaction, getting from point A to point B and back again, equals an emphatically negative number.

Sometimes it is possible to take a step back and rest. Within the intense, demanding, and often de-personalized environment of this institution, I have often had to make a conscious decision to push myself to a place I know will cause me days of pain.

Bad days can happen at random, but they tend to cluster in periods of high stress. Indeed, almost all my symptoms are tied to stress, both physical and emotional. This is, of course, highly inconvenient; ‘stress’ is the university’s unofficial slogan. The periods with the highest stress of the academic year coincide almost perfectly with the periods in which I am least equipped to handle them.

Now, every semester, I play chicken with my body. The goal is to reach the finish line, in an ever worsening state of health and morale, without falling apart entirely. It’s not a very fun game, and it can’t go on forever; one day, I know I’ll lose.

IRIS DENG/THE VARSITY

Before I developed fibromyalgia, I had internalized all the worst ideas about personal value and success that advocates of mental health reform at U of T, myself included, critique as emblematic of our toxic campus culture and academic environment, not to mention our society and economic system at large.

I worked for the sake of working and I wore my exhaustion proudly, habitually pulling 12-hour work days. I stuffed my résumé with commitments and achievements in the hope that, one day, I’d look in the mirror and see someone I thought mattered. I sacrificed relationships, activities, and experiences for my GPA, waiting for a payoff that, it turned out, would never come — not like that.

I thought that if I pushed myself hard enough, I’d finally be happy. And not only that: I’d finally deserve to be happy. And then I got sick.

If I’d gotten 50 steps down the path, it isn’t that I’ve gone back 51. It’s just that I’ve been suddenly transplanted — quite violently, and with no small amount of protestation — to a different path entirely.

The achievements I’ve earned at university still matter; I just can’t cash them in. I can’t continue to push myself like I used to. But that’s the thing: I was pushing myself. I was harming myself, in a way, because I was convinced that it was what I had to do to earn the approval of others, this university, our society, and ultimately myself.

Now, I have to slow down. Indefinitely.

Slowing down, however, is far from easy — not in this society, this economy, or this mind.

We live in a world that prizes and rewards productivity and individual achievement, regardless of the cost. There are no institutionalized accolades to be won for treating oneself with kindness. A body that cannot meet the demands of the current system is, we are told, a body without much value.

The story of my illness is in many ways a struggle against a system that hasn’t made room for bodies that need rest. This also applies to essentially every other kind of body that isn’t white, able, neuro-typical, cisgender, thin, straight — need I go on? It is also a story of my own struggle to resist the ways in which I’ve internalized these ideas. I’ve long decried the way in which neoliberal capitalism and a world centred around work demand inhumane things of our bodies and minds. I’ve long held that a person’s value is intrinsic: it has nothing to do with what they can produce.

I was, however, saying these things from the privileged perspective of an able-bodied person. I still hold these convictions — more strongly, now, for having directly experienced a very visceral physical manifestation of the negative effects of the way the present system values productivity. Yet, actually applying my convictions to my personal circumstances has proven difficult to say the least. I have been routinely enraged at my body for its refusal to do what society demands of it; I have called myself worthless more times than I could count.

Overcoming this paradigm, however, is an immensely powerful act, both personally and politically. Or so I hope. In all fairness, my body hasn’t really given me much a choice.

IRIS DENG/THE VARSITY

I often hate my body. This hate is more than the passive and socially mandated displeasure I’d so far learned to feel as a woman. It is not me saying: “I hate my thighs,” or “I hate the shape of my eyes,” or “I just hate my right earlobe.” No, this hate consumes me, directing itself toward everything I am. It is also hopeless: the force of my anger only causes more hurt. And in any event, how wrong and pathetic — how small-minded and mean — is it to rage against something whose only crime is sickness?

I often hate my body, but I am learning to love it, too, like a child learning to walk: often falling and failing, descending into tears, perhaps feeling too scared to try again. And, yet, instinct drives it to do just that. Though I typically fail, I am likewise driven to treat my body and self with kindness by an instinct — a memory of a time before.

Before bodies — whatever they happened to do or not do — were something to be ashamed of. Before I expected anything more of myself than what I could give. Before I learned to see my body as my enemy, as something to be managed and overcome. What I wouldn’t give to be six years old again, tracing the lines of my palms with wonder. Or 10, cross-legged beside the soccer pitch at half-time, tearing into orange slices and letting the juice slide down my fingers in small rivulets of invitation for waiting honeybees. Or a baby, flexing my fingers and toes with a curious joy.

I remember what it was to be friends with this body.

IRIS DENG/THE VARSITY

In recent months, this illness has become less of a novelty in my life. The scars are turning to birthmarks; it has begun to grow with me, like two trees pressed together from the roots. Over this time my thoughts have often strayed to that day in the forest, nearly five years ago. In my worst moments, I have wished for nothing more than to return to that time, that place, that feeling of comfort and camaraderie with my body. But I cannot go back.

And there is good in this, I think, even though it came at an unfair price that I shouldn’t have had to pay.

I am learning a new language of success. It no longer means only a perfect GPA or being ‘busy.’ Each time that I rub my aching muscles without frustration, without anger at them for their pain, is a victory. I am learning to tell my body that I know we are both hurting, and that it’s all right. “What can I do to ease your way?” I ask. “I don’t blame you,” I say. “I’m going to do everything I can to not hurt you.”

This new language I am learning? I think it might be called kindness, or what Sonya Renee Taylor calls radical self-love: a return to our original state, before we were taught otherwise, of open and loving companionship with our bodies and selves. And although I am by no means an expert, I’d recommend you try to learn it too, or at least pick up a few phrases.

Now, as I write these words, my mind returns to that day in the forest once more. I cannot go back to that time. The place itself still exists, though, and there are many others that are equally able to touch my soul. Next time, I may take a bit longer to get there. I may have to rest on my way up, and maybe this body will hurt. Perhaps I’ll have to ask the people with me to slow down, to walk with me at my pace.

But I’ll get there. I know I will.