How Living in Spain Affected My Health: Blood Pressure, Depression, and Migraines

 

Blazing Altocumulus: A Fiery Sky, A Soothing Evening in Oviedo*

I moved to Spain for my mental health. Associated changes began to appear later, noticed only after familiar numbers began behaving differently.

Over time, it became difficult to ignore how living in Spain affected my health in measurable ways. Not dramatically. Not magically. But consistently.

This is not a story about a cure. It’s about what happens when the body no longer has to brace itself as often.

How Living in Spain Affected My Blood Pressure

Full disclosure: I have longstanding hypertension. My father's side has all the cardiovascular disease. It became prominent in medical school and residency training when I began my low-sodium diet. Hypertension did not disappear when I changed countries from the US to Spain. What shifted was stability.

After settling into daily life here, my readings began trending lower until I was able to drop one of my two medications and became more consistent without major medication changes or dramatic lifestyle overhauls.

Blood pressure is tightly linked to sympathetic tone. When vigilance decreases, vascular resistance often follows. Living in Spain affected my health not by curing hypertension, but by reducing the subtle daily stress responses that sustain it.

Vigilance: Living in Spain and the Reduction of Ambient Threat

Spain is not perfect. But the default posture feels less suspicious.

One moment stands out clearly a few nights after I arrived in Oviedo: a young white woman was approaching me on the sidewalk. My mind switched to Black American mode. Oh, no. I know she's going to cross the street. I was in for a surprise. Not only did she not cross the street, she passed so close that she practically brushed against me as if she hadn't even noticed me. 

That reaction revealed how deeply American racial conditioning had embedded itself in my nervous system. Chronic vigilance reshapes cortisol rhythms. Cortisol reshapes blood pressure, glucose, sleep, and mood.

When vigilance drops, physiology follows.

Twice, in the early days, when I entered one of Oviedo's flagship department store, El Corte Inglés, I warily glanced back at the security guard at the door to see if he was following me with his eyes. He was not. In fact, he had shown little to no interest as I had entered the store.

Security guard at El Corte Inglés

Cortisol, Diurnal Rhythms, and Chronic Vigilance

Cortisol normally peaks in the morning, declines through the day, and drops at night to allow repair. Chronic stress disrupts this rhythm.

Among many Black Americans, studies show altered diurnal patterns—blunted morning rise, elevated daytime baseline, and insufficient nocturnal decline. This pattern correlates with hypertension, insulin resistance, and mood instability.

This isn’t about dramatic trauma. It’s about chronic vigilance.

Early in Spain, I noticed the absence of something. Walking at night, I wasn’t mentally rehearsing explanations for my presence to a citizen or police officer. Entering a department store, I expected scrutiny from security and received none. 

These moments might seem minor, but physiologically, they are not. The hypothalamic-pituitary-adrenal axis responds to anticipation as readily as to threat. When vigilance becomes unnecessary, endocrine tone likely shifts.

               The Stress Response (Hypothalamic-Pituitary-Adrenal Axis by Olivia Guy-Evans, MSc)

Living in Spain plausibly affected my health, particularly in cortisol regulation—before I consciously named it.

How Living in Spain Affected My Depression

I have lived with long-term depression for decades. Spain did not erase that.

What has changed, preliminarily, is stability. My mood feels less reactive, and more stable. Under supervision, I am cautiously evaluating whether one antidepressant can be tapered--so far, so good! This is an ongoing assessment, not a conclusion.

Depression is neurochemical, but it is also contextual. Fewer aggravating inputs make regulation less effortful.

Olive Oil and the Siesta

When I first arrived, I found it irritating that shops closed for siesta (mostly 2-4:30 PM) and that Sundays were largely shut down. My reflex was impatience.

                            

                                

What! The Apple Store closed at 

3:00 PM? Why?

Over time, that shifted. If everything is closed, there is nowhere to go. If there is nowhere to go, there is nothing to chase. So Sundays, when so many places are shut, it's a permission slip to sleep in, have a leisurely breakfast at a café (those don't close!), or Netflix and chill.

The culture imposed a pause and I learned to embrace it as a way to slow down..

That matters. Structural limits on productivity reduce structural arousal. Taken together, the cumulative effect is not trivial.

How Living in Spain Affected My Blood Sugar

My fasting glucose has hovered near the borderline range for years. Recently, those numbers have begun to resemble values I last saw two decades ago. The trend is encouraging, although the verdict is still out, and long-term monitoring will tell the real story.

One change has been the quality of dietary fat. In Spain, fresh, high-polyphenol extra-virgin olive oil is standard. The bitterness and peppery finish signal the presence of antioxidant content rarely encountered in typical American supermarket oils.

Olive oil alone does not explain improved glucose trends. Stress hormones likely play an even larger role.

Olive Oil in Spain vs. Olive Oil in the United States

One dietary difference deserves more precision.

In Spain, especially in producing regions, fresh extra-virgin olive oil (EVOO) is widely available and often locally sourced. Varieties like Picual are unapologetically robust—green, bitter, peppery, sometimes almost aggressive to an unaccustomed palate. That peppery sensation in the throat is not a flaw; it reflects high polyphenol content, particularly oleocanthal compounds associated with anti-inflammatory effects.

For many Americans, the first taste of fresh Picual EVOO can be startling. It does not resemble the neutral, soft, sometimes flat oils commonly sold in U.S. supermarkets. It can feel sharp. Almost too sharp. That reaction itself says something.

                                          A bottle of early-harvest Spanish extra-virgin olive oil 

“Primer Día de Cosecha 2025” indicates oil pressed from olives harvested on the very first day of the season. It is extra-virgin olive oil made from the Picual olive variety, produced by the renowned Castillo de Canena estate in Andalusia. As in this case, EVOO should be in a glass bottle (never plastic) or a metal can.

In the United States, olive oil quality is highly variable. While excellent oils certainly exist, much of what is sold in large supermarkets:

• Is blended from multiple countries

• Has been stored for long periods before purchase

• May be past peak freshness by the time it reaches consumers

• Often lacks harvest date transparency

Several industry investigations over the past two decades have shown that some imported oils labeled “extra virgin” fail to meet strict chemical and sensory standards. Oxidation during transport and storage is also common, reducing polyphenol levels and altering flavor. The result is that many Americans have never actually tasted high-polyphenol, freshly pressed extra-virgin olive oil. When they do, the bitterness and throat sting can come as a shock.

Why does this matter clinically?

Polyphenols in high-quality EVOO are associated with:

• Improved endothelial function

• Reduced oxidative stress

• Better insulin sensitivity

• Anti-inflammatory activity

How Living in Spain Affected My Migraines

Finally, migraines have been another long-standing health challenge. For years, nocturnal headaches were a regular feature of my nights, often followed by daytime episodes severe enough to interrupt normal activity, including, significantly, my writing: hours looking at a laptop screen is a strong migraine trigger. This wrecked my novel-writing throughout 2025.

Under the skilled guidance of a highly regarded Spanish neurologist, that pattern has changed markedly. My nighttime headaches have fallen by roughly 75 percent, and daytime events are now far more manageable. Occasionally, a severe episode still forces me to lie down for an hour or two, but those disruptions have become uncommon.

The story is still unfolding, but the direction is encouraging. Better medical management—including thoughtful medication adjustments—may be contributing to the improvement, as may reduced stress signaling.

Migraines and depression are also closely linked. Migraines can trigger depressive episodes, and depression can lower the threshold for migraines. Stabilizing one often helps stabilize the other.

Final Thoughts

Spain did not cure my hypertension. It did not eliminate borderline glucose levels. It did not erase depression. However, all of these are trending in the desired direction. What it appears to have done is remove a layer of chronic strain.

Health is not only what we ingest or prescribe. It is also what the body prepares for. Living in Spain affected my health not through intervention, but through subtraction. And sometimes subtraction changes the numbers.

*All images by the author unless otherwise stated.

★ Don't forget to follow me on Instagram for more content @kweiquarteyauthor ★

The Unspoken Struggles of a Writer's Psyche: Ego, Doubt, and the Constant Comparisons

Kwei--Wednesday

The Emotional Toll of Being a Writer

Writing is often romanticized as a purely creative and fulfilling pursuit. But for many writers, the reality is much more complex. Beneath the surface lies a mental landscape riddled with self-doubt, ego struggles, and unspoken comparisons. The psychological challenges of writing are rarely discussed openly, yet they affect many of us. Like other artists grapple with the weight of critique and their internal battles, so do we, even if we seem outwardly resilient.

Self-Doubt and the Writing Process

The act of writing itself can be fraught with mental challenges. My first drafts are often so rough that I question whether I’m worthy of calling myself a writer. The persistent voice of doubt whispers, "Maybe you’re not as good as you think." Many writers share this sentiment as they question whether their work is “good enough” to justify their identity as creators.

Envy, Jealousy, and Comparisons

In an industry where success is often measured publicly—through book sales, awards, or social media followers—it’s easy to fall into the trap of envy. Seeing other authors achieve success can feel like a personal defeat. "Why them and not me?" is a common, though rarely voiced, thought. Even when we genuinely celebrate others’ achievements, the temptation to compare ourselves can feed our insecurities and deepen feelings of inadequacy.

The Link Between Writing and Depression

Research supports the notion that writers are particularly susceptible to depression and other mental health struggles. Studies have found that the solitary nature of writing, coupled with the emotional vulnerability it requires, can contribute to higher rates of depression among writers. For instance, a meta-analysis highlighted that expressive writing, though often therapeutic, can also bring underlying depressive tendencies to the surface. Furthermore, other studies suggest that the pressure to meet creative and professional standards exacerbates mental health issues in writers (Psychology Today).

How Writers Can Support Each Other

Given these challenges, how can we better support each other? The first step is acknowledging that these feelings exist and are more common than we think. Open dialogue in writing communities and peer support groups can make a significant difference. Creating spaces where we can safely express our struggles without judgment is essential. These small gestures can be transformative, whether it’s a virtual check-in, a casual meet-up, or even reaching out with a simple “How are you doing?”

We also need to remind ourselves—and each other—that writing is inherently a process. First drafts are supposed to be imperfect, and everyone experiences rejection. Sharing these everyday experiences can reduce the stigma around writer’s block, imposter syndrome, and creative slumps.

Moving Forward Together

In a world that often glorifies polished final products, it’s easy to forget that the journey there is full of doubts, setbacks, and mental hurdles. By normalizing the discussion of these struggles and offering support, we can foster a healthier, more resilient community of writers. Writing is challenging, but we don’t have to carry the burden alone.

 

Antidotes to depression

 Stanley - Thursday

For the past few months I've been increasingly depressed by what I read in the newspapers every day. Seldom are there any stories that are uplifting or funny or encouraging. Most stories are about something bad. To make the situation worse, many of them confuse news and opinion. And as for the quality of writing..... I gnash my teeth.

Talking of gnashing, one antidote I have been indulging in to ease my depression is sending myself into the past by listening to songs and pieces of music that I loved many decades ago. Simple pieces; pieces intended to entertain; clever pieces.

For example, one of my all-time favourite duos, was lyricist, actor, and singer, Michael Flanders, and composer and pianist, Donald Swann. They were a sort of a modern-day Gilbert and Sullivan, except they wrote revues rather than operettas.

Michael Flanders and Donald Swann

Their three best known revues were At the Drop of a Hat,  At the Drop of Another Hat, and The Bestiary of Flanders & Swann. I love most of their songs and know many by heart. Two in particular link me with my African background: The most famous is the Hippopotamus Song, which you can listen to here, and I encourage you to sing along. 

In typical British fashion, it was adapted for performance at one of the Proms concerts. You can listen to that version here.

The second song I like is titled A Gnu, which takes me back to the gnashing. Enjoy it here, not in the original but performed by the muppets.

I can't resist adding one more Flanders and Swann classic, to which most of us will resonate: The Gasman Cometh.

The second activity I've been doing to lift myself from my news misery is cooking, often while listening to Flanders and Swann or Gilbert and Sullivan or Mahler's Second. I've been focussed on the cuisine for which Cape Town is famous: Cape Malay food, which had its origins among the slaves brought to the Cape by the Dutch East India Company three-hundred years ago. It is gently spiced, more aromatic than hot, often with a hint of sweetness. Here is a simple chicken recipe I've adapted from one I found on BBC Good Food. Cook it while listening to something you enjoy; eat it with someone you like. Bon appétit.

Cape Malay Chicken Curry at Chez Stan

Cape Malay chicken curry with yellow rice 

2 tbsp (30 ml) canola oil 

1 large onion, finely chopped
5 large garlic cloves, finely grated 
3 tbsp (30 ml) finely grated ginger 

6 cloves
2 tsp (10 ml) turmeric
1 tsp (5 ml) ground white pepper
1 tsp (5 ml) ground coriander
1 tsp (5 ml) ground cumin

Seeds from 8 cardamom pods
2 cinnamon sticks
14 oz (about 400 gm) can chopped tomatoes
2 tbsp (30 ml)  mango chutney
1 chicken stock cube, crumbled

A deseeded, sliced red chili, or cayenne to taste. Should not be very hot.

12 bone-in chicken thighs or 6 large chicken breasts or 12 drumsticks or a combination thereof. Remove the skin.
About 17 oz (500 gm) potato, cut into chunks

Small bunch fresh coriander, chopped 

Yellow rice recipe

1 oz (50 gm) butter
12 oz (350 gm) basmati rice
1 oz (50 gm) raisins
1 tsp (5 ml) brown sugar
2 cups (500 ml) lukewarm water
1 tsp (5 ml) turmeric
1⁄4 tsp (1.5 ml) ground white pepper
1 cinnamon stick, snapped in half 
12 cardamom pods, lightly crushed 

1.    Heat the oil in a large, wide pan. Add the onion and fry for 5 minutes until softened, stirring every now and then. Stir in the garlic, ginger and cloves, and cook for 5 minutes more, stirring frequently to stop it sticking. Add all the remaining spices and the fresh chili, stir briefly, then tip in the tomatoes with 2 cans of water, plus the chutney and crumbled stock cube. 

2.    Add the chicken, pushing the pieces under the liquid, then cover the pan and leave to cook for 35 minutes. Stir well, add the potatoes and cook uncovered for 15-20 minutes more until they are tender. Stir in the coriander. 

3.    About 10 minutes before you want to serve, make the rice. Put the butter, rice, raisins, sugar and spices in a large pan with 2.5 cups (550 ml) water and 0.5 tsp (3 ml) salt. Bring to the boil and, when the butter has melted, stir, cover and cook for 10 minutes. Turn off the heat and leave undisturbed for 5 minutes. Fluff up and serve with the curry. 

If you want to cook the dish the day before serving, for example, reduce 2 above to 5 minutes. Then refrigerate when cool. Before serving, heat until simmering and cook for an additional 15 minutes.

Serve with a nice sparkling or dry white wine and a big smile.

_______________________________________

UPCOMING EVENTS

September 1; launch of A Deadly Covenant, Detective Kubu #8, in North America

Early November: worldwide release of the audiobook of A Deadly Covenant

December 8: launch of A Deadly Covenant, Detective Kubu #8, in the rest of the world

My anti-depressant song list

Stanley – Thursday

Just as I sat down to write my blog yesterday, I turned on the TV to distract myself – a typical writer’s ploy.  I shouldn’t have done it because there was breaking news of another mass shooting in the USA.  This time at the unlikely place where San Bernadino County in California helps people with developmental disabilities.  At that time, twelve people were feared dead.

Another mass shooting?  The 355^th one this year.  Yes, more than one a day.  How depressing.

And there was more breaking news: ISIL had just beheaded a Russian journalist as an up-yours to Putin.

And Putin had just accused President Erdoğan of Turkey, of helping ISIL by allowing the sale of oil through Turkey.

How the hell, I wondered, does anyone know whose side anyone else is on?  Do we even know whose side we are on (whoever ‘we’ are)?

I sank further into depression.

Then I read that the UK parliament had okayed the Royal Air Force to bomb ISIS targets.  And just the other day, the USA had increased the number of on-ground combatants to fight ISIL.  Don’t we ever learn? I thought.  Isn’t that what these madmen want?  More excuses to recruit more people looking for virgins in heaven.

My depression deepened.

Then I wondered what I would do if I were Obama or Cameron or Merkel.  Easy to criticize, I thought.  Not so easy to come up with a solution.  I’ve no idea what I would do – much easy to know what not to do.

As I became more and more depressed, I gave up all thoughts of writing.  It would end up making me even more depressed and would likely be unreadable.

So I did what I often do when I am down and deep in a hole.  I listened to music I loved a long time ago.  Thank goodness for YouTube!

Here is my anti-depressant playlist, pretty much in order of when I fell in love with them.  Do they do the same to you as they do to me?  

Click on each of the titles to lift your spirits.

1.  Bill Haley and His Comets:  Rock Around the Clock.

     One o’clock, two o’clock, three o’clock, rock.

2.  Sheb Wooley’s The FlyingPurple People Eater.  Who can resist the lyrics?

     I said Mr Purple People Eater, what's your line?
     He said eating purple people, and it sure is fine
     But that's not the reason that I came to land
     I wanna get a job in a rock 'n roll band.

3.  David Seville’s The WitchDoctor with his Chipmunks.

     Oo ee oo ah ah ting tang walla walla bing bang

4.  Allan Sherman’s Hello Muddah,Hullo Faddah – It’ll be in my head for days now.

5.  The inimitable Flanders and Swann with Have some Madeira, M’Dear.  One thing missing from this recording was part of the line, "He slyly inveigled her up to his flat - to see his collection of stamps - all unperforated", that all all unperforated was delivered in the raunchiest tone imaginable!

6.  Again Flanders and Swann with their Kubu song:  Mud, Mud, GloriousMud.

7.  Mozart and the Papagena Papageno duet.  Actually almost any Mozart cheers me up.  Even his Requiem.

How can one not feel better after that?  Thank goodness.  Now I can write my blog.

What would your anti-depressant song list be?

The Bluebird of Happiness; the Chicken of Depression

I’m depressed!  Very depressed.

The Bluebird of Happiness temporarily absent from his life, Stan is visited by the Chicken of Depresssion

For the past several days I’ve been trying to write an important chapter in our fourth Detective Kubu novel.  And all that’s coming out of my fingers is drivel.  Unadulterated drivel.

To make things worse, this afternoon I had to send a copy of the manuscript of our third novel, Death of the Mantis, to a friend across the country.  While I was waiting for Fedex to deal with the paperwork, I glanced at a few pages.  Ugh!  The writing wasn’t as smooth as I remember it when we eagerly sent the manuscript to our editor in March.  It was choppy, and there were typos!  There were still typos after all that proofreading!!  Aargh!

As is the nature of the beast, I, of course, then had to find other things to be depressed about.  That didn’t take long.  As I approached – on foot – the house I am staying at in Mill Valley, just north of San Francisco, I started to pant.  Whether this was from the slight hill I had just ascended or in anticipation of the 45 steps and three switchbacks on the path from the road to the door, I don’t know.  But by the time I reached the door, my heart was racing, I was sweating, and my leg muscles were in need of a steam room and massage.  Where had my youth gone?  Where was the finely tuned body of yore?

Fortunately my subconscious had anticipated my malaise and on the way home had directed me to the local supermarket, where I purchased a packet of Chocolate Digestives – one of my all-time favourite biscuits (cookies).

As I sat sipping my cuppa tea (normally enjoyed at 4pm sharp by my family in South Africa, but today 12 minutes early due to emotional needs), I decided I’d better write this week's blog before attempting to finish my elusive chapter. 

Of course, writing a blog requires a topic, which I didn’t have.  I slouched further into my chair.  Should I write about the Motswana man, Tirafalo Mokopi – a 21-year old security guard in Matsiloje village - who claimed he’d made love to a ghost?  As he lit a match to whisper sweet nothings to his sweetheart, she disappeared before his eyes, even though the windows and doors were shut.  “She just vanished,” he said in mild trauma. 

That would be a great lead-in to a piece about Succubi, I mused with a flicker of enthusiasm.  But then my negative demeanour took over.  Who on earth would want to read about Succubi?  Obviously nobody!

I helped myself to another Chocolate Digestive.

I also pondered writing another Botswana story: of the Maun businessman and New Apostolic Church priest, Raphael Shoopara Sekele.  Although initial rumours were that he had been murdered, probably because his body was found on the back seat of his car with blood dripping from his mouth and nose, police confirmed that he had died during an illicit lovemaking session, not with his wife, but with a girlfriend.  The fact that his pants were down and his manhood exposed probably helped the police reach their conclusion.  According to The Voice, ‘the revelations of his demise will come as a shock to the community and church members, who described Shoopara as a man of multiple talents…...’ I was also pleased to read that the police returned Shoopara’s mobile phone to his widow.

Grey go-away bird

I decided there really wasn’t enough in this story to make a blog of it, even though I noticed that Shoopara was originally from Kachikau - that's the town where Moremi, the cook from Jackalberry Camp in The Second Death of Goodluck Tinubu, and his pet go-away bird saw the man wearing the hat with guineafowl feathers.

Time for another Digestive!

Then I considered the story of ‘Pumpy’ Puso, a three-year old girl from Tutume, a small town in the north central part of Botswana, not far from Zimbabwe.  Two weeks ago, around eleven in the morning, she went to play at the neighbours’ house with some friends.  A couple of hours later, her younger cousin came home for lunch, but Pumpy wasn’t with him.  Frantic, Pumpy’s mother went next door to find her.  To no avail.  She had disappeared.  Despite massive man (child) hunts by police and community, she still hasn’t been found.

'Pumpy' Puso

Pumpy’s mother is in deep despair.  She thinks that Pumpy has been abducted for muti.  In this context, muti is a potion that transfers the power in one organism to another.  For example, if you want courage, you may take muti made from the heart of a lion.  If you want to improve your sex life, you may seek out a witchdoctor to give you the right muti to accomplish that.  The witchdoctor would likely abduct a young girl (or boy) and brew a potion made from ……body parts.  Unfortunately, not an uncommon practice.

Just thinking about Pumpy threw me into a deeper depression than before, both because of the nature of the crime, but also because the chapter that I am having trouble writing is about a man whose daughter has just been abducted.  In the chapter he becomes deeply depressed, and his mental state is increasingly precarious. 

So my depression has come full circle.

And I still can’t squeeze the right words out.

So, I’ll give up trying and have another cup of tea.

And finish the packet of Chocolate Digestives.

The blog can wait.

Stan - Thursday

Postscript:  In order to clear my head and raise my spirits (but mainly for the popcorn with butter and salt), I headed out after writing the words above to see George Clooney in The American. I am pleased to report that I'm now less depressed than I was.  Even my drivel was better than the movie.