13th May 2024 Blog

'We shouldn’t have to choose between mental and physical health'

Physical health •

We spoke to Julian, one of the Lived Experience Advisory Panel members looking at the link between physical and mental health, for Mental Health Awareness Week.  

He’s working with the Oxford Biomedical Research Centre, on the preventing multi morbidities theme as part of the patient and public involvement group. 

He shared why the messaging around movement needs to change, why accessible movement is key, and how to find what works for you. 

This year’s Mental Health Awareness Week focusses on ‘movement’, which is maybe unsurprising given increasing emphasis on the relationship between physical and mental health – from the impact exercise has on your wellbeing to things like weight gain while on medication. 

This means there needs to be more evidence to back up the conversations, says Julian, who got involved in research out of a desire to help others who were struggling.  

He believes that, without more specific and relevant knowledge, people’s options can feel limited. 

“I often find that when I go and see my GP, I’m having to choose between my mental health and my physical health. It’s almost as if I can’t have both, as if everything that I’m experiencing actually relates to my mental illness and current mental state.  

“When I say I have a mental illness, that I’m trying to eat healthily and do what exercise I can but I still feel lethargic and physically unwell, I’m almost compelled to say that I’m on particular tablets. Quite often the response will be ‘right, this one is a weight gaining tablet’, so there’s little I can suggest or do. I feel like I’m being told just to ‘live with it’.  

“It seems that’s about the best you can hope for. Actually, I want good physical health and good mental health. I don’t want to choose. But I think quite often people feel that they have to, that the physical health consequences of having a mental illness are so bad that you’ve just got to put up with it if you want good mental health. I don’t believe that should necessarily be the case.“ 

People translate exercise as running, joining a gym or club, taking up a strenuous activity, that sort of stuff. And for lots of people that's great, they can do those sorts of things. But for others, for a variety of reasons, they just can't.

Exercise and mental health messaging

Julian believes that one thing that would help achieve this is changing the messaging around physical health, including for what he calls ‘accessible movement’.  

“I was reading messages from various bodies and people about Mental Health Awareness Week and, whilst it’s not overtly saying this, the suggestion was basically that the more exercise you can do, the better. 

“And people translate exercise as running, joining a gym or club, taking up a strenuous activity, that sort of stuff. And for lots of people that’s great, they can do those sorts of things. But for others, for a variety of reasons, they just can’t.

“There’s issues to do with physical disability, with neurodiversity, cultural considerations and challenges some people face simply trying to get out of their own home. So, in these circumstances people are constrained into trying to do more movement within the confines of their four walls. And actually, what does that look like?” 

Leaving your house can be the ‘equivalent of a marathon’

The key is in valuing what you can do, as opposed to being daunted by what you can’t, he says. 

“Everyone can do a little bit, but it’s got to be relative to what they feel good about doing, what they feel they can achieve. So there’s not a hierarchy – like, if you run a marathon that’s the top of the tree, if you manage to walk to the shop that’s the polar opposite. We’ve got to get away from this type of thinking, I believe. 

“Going out of your house to go to the shop could be the equivalent of a marathon for one person. That could be a major achievement for somebody who has not left their home for months.  

“It’s just getting that into people’s heads, making it more accessible and helping people believe they really can do something to help themselves. It’s got to be realistic, manageable and meaningful – and, dare I say it, fun!” 

This might help when people feel trapped by their mind and believe they can’t exercise. 

“I’ve heard people talk about being in prison but still being free in their thinking. However, there’s also the converse – about not being confined in a physical sense but being restricted in your head, being imprisoned by what you just realistically cannot imagine or manage,” says Julian. 

“And I think it’s trying not to put pressure on people to achieve something that is going to be so difficult, if not impossible to do, while still encouraging them. It’s that balance between encouragement and not setting someone up to fail or diminishing their achievements.” 

When I'm struggling just to get outside the house it's not that I don't want to, I just can't. That's just the reality.

Offering movement alternatives  

This shows the importance of providing more options for people who don’t want to, or can’t, follow the more typical guidance. 

“I’ve heard stories of people going to their doctor and talking about their weight, and the response being ‘OK, we can put you on a weight loss programme. That will involve coming to classes.’.  

“Whenever I hear that and think of whether I can do it, straight away I’m thinking, there’s no way I’m going to be able to get out of my house every week for umpteen months to be weighed and measured with lots of people looking at me. I just can’t do it. But there doesn’t appear to be many other options.”   

“The sensory overload that comes with that, as an autistic man, is just scary. It makes it unmanageable. But I don’t want to come across as someone who doesn’t want to help themselves, as a person unable or unwilling to make an effort. I’m certainly not that, but my choices seem to be both limited and predetermined.

“When I’m struggling just to get outside the house it’s not that I don’t want to, I just can’t. That’s just the reality.  

“We’ve just got to be kinder to each other and to recognize the many positive things that people do on their own to ease their confinement and make them feel better, both physically and mentally.” 

Julian likens it to the messaging that often circulates before Christmas, reminding everyone that there are people who find this time of year difficult. 

“But then we don’t keep up that focus throughout the year. Christmas can be every day in the sense of the pressure to socialise, to be happy, joyful and committed.  

“Some people just can’t do that regularly or can only do it in very small measures in ways they feel are achievable. But as soon as the balance tips the other way, you can rapidly lose confidence and have little choice but to be reclusive.” 

It helps get you out, to do something slightly different, to use all your senses, to focus your concentration.

Finding what works for you

For Julian, what’s manageable and enjoyable is going outside with his camera. 

“I could be going on a walk and I’ll just be taking photographs of absolutely everything around me. It’s something I can do on my own and potentially there’s a tangible result. 

“I might get a good photo every now and again but what it does is it gets you out. It gets you focused on that cloud formation or the leaves in the trees or an interesting building down the road.  

“It helps get you out, to do something slightly different, to use all your senses, to focus your concentration. It can serve as a distraction. It may not be for everybody, of course. But for me, it works every time.”  

After working in academia and then in rugby league development and promotion, Julian Harrison has spent the last twenty years of his life working in community engagement, development and in the specific areas of equality, diversity, community cohesion and human rights.  

He is also an acclaimed writer, publishing books on rugby league, the Holocaust and – most recently – a diary of a year living with mental illness, called ‘A Year in Melancholia’. 

Visit his website to find out more.

Find out more about the projects