The legacy of mental illness: Are you okay?

Firstly, apologies for the sporadic blogging of late. As you will know I've been busy campaigning with Team Princess and that took a lot of brain power so lately my head has been a bit spaced out. Just today I tried to bring up the app screen on a bar of chocolate. Maybe I shouldn't admit this on a post where I'm writing about convincing everyone my mental health is fine but oh how I laughed at myself. On a good note while my brain is fuzzy, on days where my health has allowed all my energy has gone into living life to the fullest that I possibly can. More on that in the next post. So I hope you'll forgive the absense. I hope to be back to a blogging schedule soon, because I do miss it. Anyway on with the post....

When you have suffered from a mental illness in the past the chances are you will feel haunted by it long past your recovery. Some how no matter how positive, happy and confident you become there is often a nagging in the back of your mind "remember me? This could happen again." And for all we know it could happen again. An addict will always be considered suseptible to weakness and retriggering a habit and so they learn to avoid temptation as much as they possibly can. However with mental illness, even those that were triggered by addiction, it's very hard to avoid circumstances that could lead you to be more suseptible again. As they say, you can't stop life from happening. Avoidance stratergies for non addicts is futile to a full recovery, because you are still living in fear and not fully overcome the issues that bought on your condition. However of course the more we open ourselves up to the world the more of a chance we may feel we have of giving all those past feelings a green light to come interupt us once more.

There is also the prejudice of having a history of mental illness on your medical records. Sometimes doctors will see that and focus too much on it. Even if your symptoms are physical and years could have passed since you have suffered. When I was admitted to hospital after collapsing and being pretty much asleep for 3 days back when M.E hit me, because it was relatively close to my serious bout of depression where I had gone to A&E a couple of times or been sent for psychiatric evaluations at the hospital (yes I know that sounds bad but it really isn't when you desperately want help) they could obviously see this on my recent medical notes. Because of this once they had ruled out things like meningitis they began suspecting it was of my own accord, that I had overdosed or drank myself into oblivion, or just shut myself off from the world. I had been to a Summer ball the night before I collapsed, so of course this lead them to believe the former even more. Even though I didn't have any alcohol or drugs either for that matter so they could obviously see that in my blood work. It also helps that the junior doctor actually knows the difference between 2 paracetemol for the pain in your neck and enough paracetemol for an overdose, rolls eyes. I had to be asssessed by a psychiatrist again, although all I needed to say was I was not suicidal that I had been having the time of my life then bam my physical health knocks me down. Luckily that was it and he probably felt like they had wasted his time. No matter what you say though, because that is on your records they are going to ask about it. It's going to be a line on enquiry, or possible diagnosis until they have more answers. And that can feel really unfair. It can be upsetting because you feel scared and overwhelmed by these physical symptoms and those you go to for help will in part think it's all in your head. To be fair they have not seen the progress you have made, or how happy you have been, but it still feels like a kick in the teeth. You want to shout " you know why I'm doing okay now? Because as you can see from my records I sought help."

I know that I have all the tools and tricks to lead a positive life now that I consider myself to be recovered. Making sure that I choose to be positive as much as I can and make opportunities happen. Not bottleing things up and being open about my feelings. However I also know that depression can take control even as I fight to keep it a distant memory and that's not because I'm personally not strong enough, because in all honesty I think I am. It's our brains chemistry. My most serious bout of depression and anxiety took me at a time where I should have felt elated. I couldn't really understand how it was happening. And that in itself is a scary thought. To not have control of everything that goes on in your head. Therefore I know all too well that these conditions can creep up at any time and that I am not unsuseptible to their power. However having suffered in the past as well as knowing that that is a part of me and one that has left it's scars, I also know the warning signs and symptoms to look out for and be able to get help much quicker should I need to. Most importantly I know that I have overcome this before, that I had the strength to do so and that that strength has improved every day that I live depression and anxiety free. I feel that should I ever suffer in that way again, and there's always that chance, that I could handle it. Of course if it does happen I don't really know how I will respond but knowing that until that time, should it happen again, I feel I could cope and come out the other side stronger is a great safety net. 

We never know what is going to happen in life and therefore we really don't know how we will react in certain situations that may crop up in our future. Of course sadness is part of life. It may or may not lead to depression. But we can't live in fear of feeling emotions and sadness in particular, because we need to experience release. Avoiding those feelings will potentially cause more chance of us being suseptible. Having feelings is no bad thing.  

So I would like to say that yes I have a history of mental illness. It took over my life in a way that scared and overwhelmed me. But how am I now? Honestly, stronger and happier than ever. I know how to keep myself in check and all the warning signs I should look out for. As well as what to do should they arise. I know that it's ok to feel sad, frustrated or hard done by, especially as I have a chronic illness that has left me predominantly housebound. I worried when I was first diagnosed with M.E that I would be a sitting duck for depression. I even visited my local Mind and booked an appointment with my former councellor. But so far so good. 4 years later and I only had that one counselling session to express my anxieties about being diagnosed with a chronic illness and the effect that might have on my mental health. In the last few weeks I've also finally been weaned off my anti depressants. I haven't really needed them for a couple of years but have kept on them due to the interaction of my other medication working well for sleep and pain levels.

So if I tell you I'm not feeling good today generally I mean physically and that is probably an underestimation for feeling absolutely shockingly awful. I don't mean I feel depressed or down. And if I did I would certainly tell you, so that I can get things off my chest. So don't jump to the conclusion that not feeling good means I feel down. Accept that I will tell you if I feel sad or worried. And I will of course seek help if I feel I need it. I know my situation means I could very easily get depressed with living with a chronic illness. However, I let myself get angry and upset when I need to, allowing myself to vent. It might seem mad to actually say I'm happy, happier and more confident than I have ever felt but it's true. And I am so very grateful for that. I really do not want to experience what I did again but if I ever do please ask me if I am okay and please listen to my anwers. I promise I'll be honest and I promise I'll get help.

Sian X

Youtubers on Mental Health

As May is mental health awareness month I wished to write at least one post on the subject. I wish I could have wrote more but May is one busy month! A kind of follow on from my mini series of mental health related posts back in January. If you would like to have a read of these posts I will link to them at the end of this post. I wanted to share with you some of the videos that are out there where YouTubers talk about mental health and highlight the important role they are playing in raising awareness of these conditions. 

It is only within the last year that I have fully come to understand what an impact Youtube is having on modern day society. I readily admit I always thought it was an online version of You've been Framed, a place to post funny videos, mostly of animals, or home videos (no not that kind!) of people doing awful cover versions of well known songs. Little did I know that Youtube is now a genre of entertainment all to itself, that vlogs are becoming the new reality television and that there are people making YouTube videos as their full time job. From people vlogging their daily lives to beauty and fashion advice. Where were these videos when I was a teen, teaching me how to pluck my eyebrows properly and how to apply eyeliner?? 

However on a more serious note, YouTube has also become a place for advocacy and awareness. Just the other day I was watching some interviews about new M.E research (not that that is related to mental health of course) and I thought to myself, how great is this? During my YouTube initiation I've come to learn that many of the Youtube big names have mental health conditions such as anxiety. I think the mistaken perception is that given they make a living out of making videos and posting them on the internet that they must be extremely confident and comfortable. Therefore to learn that they suffer with anxiety and panic attacks can come as a shock. Some people sadly might not even believe them. However it's important to realise that no matter how much we think we may know people we only really know what they choose to share. These are real people who choose to share parts of their lives with their audience and although it might be scary to share I think that by sharing the fact they struggle and are open about it is actually just what needs to be happening in order to break down the stigma and isolation of these conditions. As well as let others know that these conditions are common and there should be no shame in admitting that you suffer too. 

Zoella

Starting with the Princess of YouTube Zoella. Below I've shared 3 videos from Zoella on the topic of mental health. It's well known that Zoe suffers from anxiety and panic attacks and has done since her teens. I'm not sure though people understood just how much it affected her until her vlog "Sometimes It All Gets A Bit Too Much" https://www.youtube.com/watch?v=AX92z4Bny50

 where she filmed herself during a low time and letting herself be more vulnerable in front of the camera than ever. Before this Zoe had filmed a video about 2 years ago on anxiety and panic attacks "Dealing with Panic Attacks & Anxiety" https://www.youtube.com/watch?v=7-iNOFD27G4 In this video Zoe talks about having suffered from anxiety and panic attacks for 9 years and how it got so bad that she isolated herself, too scared to do things that could cause her to have a panic attack and consequently turning down a lot of opportunities. To the point that she actually just wanted to stay in all the time for fear of having a panic attack. When she sought help from her GP she found them unhelpful, which is sad. Please remember though that if you are seeking help for anxiety or any mental health issue your GP is usually a good first point of call. They see hundreds of patients every week with the same symptoms and will only prescribe medication if it is really needed, there are plenty of other ways they can help. And if you don't feel comfortable with them ask to go to another GP. In light of this Zoe talks about how she helped herself to control her anxiety and start living normally again. Anxiety is an illness that you have to really dig deep and work hard to control and it really is not a case of snapping yourself out of it. Even with the best help in the world, from doctors and even medication, ultimately you are the one that your success depends on. Learning to be stronger than that voice in your head that says "no you can't" or "what if?" More recently she has also filmed "Anxiety Q&A" https://www.youtube.com/watch?v=Sjuk3WMZByo in which she answers viewers questions about what anxiety and panic attacks are and what they are like to experience. As well as questions from other sufferers asking for her tips and advice on how to cope. It's a great comprehensive video that sheds a lot of light on the condition. Zoe has recently been named as online ambassador for MIND (a mental health charity) in recognition of all the awareness she has raised and how she has got people talking about mental health.

Pixiwoos

"What Anxiety is like for me" https://www.youtube.com/watch?v=Ty74fmcNUFE

In this video Sam talks about how she deals with anxiety and how she worries it's getting worse. Mentioning some of the situations that trigger her anxiety. She speaks about not being worried about seeking help if you feel your anxiety is becoming worse or having a bigger impact on your life. This video is also informative for non sufferers that may or may not know someone with anxiety as it is also from the perspective of her sister Nic. Discussing how she has found ways to help when she knows Sam is feeling anxious and the signals she picks up on. Having someone with you that really has an idea what you're going throgh can be invaluable. It's not easy for those that don't suffer to really understand however hopefully this video will provide an insight into things you can discuss during calmer times in order to help.

Ingrid Nilsen

"Working through travel anxiety" https://www.youtube.com/watch?v=sgGMN8f6Hs4

I wanted to include this one because it speaks about the kind of anxiety and nerves that a lot of people will be able to relate to, that of travelling. Let's face it travel of any kind can be stressful but air travel can be all the more so. Whether it's the crowds at the airport, the stress of security, fear of not having control or claustrophobia, air travel can bring about anxiety. In this video Ingrid has cleverly edited the video so that you follow her from leaving her house, through the airport and and onto the plane with a voiceover of all the tips and advice she has for reducing anxiety during each stage, which you can see her use. I think it's a video that could really help anyone that feels stressed when it comes to travelling and inparticular for anyone with anxiety and panic disorder. Just a sidenote if you do suffer from anxiety or panic attacks and need to travel you can request special assistance, requesting that you board the plane separately (first or last depending on the airline) so that you don't put yourself in a situation where a panic attack could manifest, especially if waiting makes you worse. This is also useful for anyone with learning disabilities such as autism. Don't be made to feel like you shouldn't be using the service because you don't have a physical disability, you don't have to declare your condition when you book the assistance. Making sure you are comfortable and as calm as possible is what matters most.

Jonathan Joly

"Draw My Life" https://www.youtube.com/watch?v=qnKVnFlRkAk

Anyone that watches the Sacconejolys vlogs will know that Jonathan or Joffee Jokes as heis also known seems like a great person to hang around with, someone you'd be guaranteed to have a good laugh with. However from a very early age Jonathan suffered from depression and felt very isolated and insular, as a result he was horribly bullied. In this draw my life video he talks about that time and how he had to go to a specialist school for children with emotional needs. He also talks about how he has tried to turn his life around and found ways to keep the depression at bay even though it has been a real struggle at times. I think because of this struggle he is super appreciative of all that he has today and is a real champion for life's underdogs. I wanted to include this video because I thought it included some great lessons on learning to never write yourself off and how deserving of happiness you are.

Sprinkle of Glitter 

"Self Harm Your Questions Answered" https://www.youtube.com/watch?v=22_kotDLxdY

A video breaking down the stereotypes about self harm. Such as the types of people that self harm and why. Sadly we see all too often trends pop up on social media where cutting is used for attention and in a way a horrible bullying tactic. The "cut for Zayn" hashtag inparticular caused much upset, set up to encourage fans to self harm after hearing the news that he had left One Direction and post photos to social media so that he would see how much he had hurt his fans and consequently return to the band. To be honest that is something that I find scary about todays society. Social media has bought about a whole new all encompassing social pressure. But at the heart of this issue was a vindictive plan to guilt trip him. A young man who was already clearly struggling and felt leaving the band was best for his own mental health. This trend showed no sympathy for him or indeed for those that were upset he had left. Those vulnerable enough to not understand the seriousness of cutting could easily have got swept along.

This video explains that self harm is far more than cutting yourself to seek attention as the above trends suggest. Often it can be a cry for help but given that self harm is often covered up and hidden it is far from attention seeking. Louise explains more about the different ways people self harm, that people don't just harm themselves through cutting; who is likely to self harm and why they would do this. Importantly it also gives first aid advice gleaned from the British Red Cross should you ever be in the unfortunate situation of finding someone that had self harmed. As well as what you can do if you want to help someone you know to get better and get help.

Links to Mental Health Charities:

www.mind.org.uk

www.rethink.org

www.time-to-change.org.uk

www.samaritans.org

Links to my January Blues posts:

January Blues Introduction

Signs and Symptoms

Why do I feel so bad?

Where can I get help?

What help is available?

I need help now!

Please remember it's important to talk about what's happening and there are people out there that can help. Asking for help is a sign of strength not weakness.

Sian

X

January blues: Crisis Teams

 

Ok it's technically not January anymore but I've been working on this post for a while and it follows on from my last post on accessing urgent help. Actually I have a few more mental health posts in various draughts but I am planning to publish them in May now, as part of mental health awareness month. As I want to start a new mini series for this month (details coming soon.)

I think the fear with having a mental health crisis (as defined in my previous post) is that you will end up locked away and sectioned under the mental health act. And while some people will, the shortage of beds and the advance of more community based care means there are more options available. The decision to section a patient is a serious one and there are strict procedures in place to do so. And in act the majority of patients at inpatient facilities for mental illnesses are not sectioned and are there voluntarily. And likewise with people in eating disorder units only some will be sectioned.

However in most cases there are other options available. In this post I'm going to be talking about an option that is available for care and treatment for those more severely affected by their mental health.

If you have sought support through you're GP or seen a psychiatrist following a trip to A&E in a crisis then they may make a referral for a community or crisis team.

Crisis teams or home treatment teams as they are also called (there are also other names depending on your area) are designed to help patients in crisis without them being admitted to a psychiatric unit. They often refer to themselves as a ward within the community. And offer treatment to patients within their own home. Meaning that patients can live in their own comfortable and familiar surroundings (where it is safe for them to do so) but still receive all the benefits of regular contact and treatment. This can be daily or every other day or even once a week depending on the level of support you need. Every area should have a crisis team or home treatment team. And they can be accessed through referral by your GP or hospital after an assessment. Or you may be referred to them as part of your intergration after being in a mental health unit.

Following an assessment by the crisis team you will be allocated a mental health nurse or team who will be familiar with your case. On your first visit, or on other visits, you may also be seen by a psychiatrist, especially for medication reviews or to be prescribed any new medication.

Together with the team you will develop a care plan to help you overcome your crisis; in which you identify the key areas in which you need help in order to function more normally again and manage your day to day life. This can include medication, relaxation techniques, CBT, distraction techniques, ways of controlling anxiety and self harm. As well as who to contact if you are in desperate need of help.

Depending on your situation they can also help with more specific problems that have arisen due to your mental health and help you to access services that could be beneficial. These could be help for mental health problems as a result of alcholism or drug abuse. But also more basic needs too. MIND have produced the following list of examples:

managing money, such as budgeting or paying the bills

housework, such as cleaning, cooking or shopping

using local services, such as peer support groups, employment services, or day centres

transport, such as using a taxi, minibus or bus pass to attend appointments or services

managing relationships, such as relationships with friends, family or neighbours

aids and adaptations to your home or help with mobility issues

personal care, such as washing or dressing

benefits and housing, such as help with applications, attending appointments or getting advice or information

accessing or staying in training, education or employment

support from a specialist social worker or support worker

For cases of social anxiety your team can help you intergrate and manage social situations. This may be through exposure therapy; taking you out and helping you to put into practice coping stratergies you develop with your team, whilst having the safety of a team to help you through it.

At times with this care you have to be prepared to put in a lot of effort and hard work in order to help yourself to get better. And it can be frustrating. However it is an investment in your health and wellbeing and you deserve to find that peace. For more information about crisis teams and the role they play visit MIND's dedicated page. You can also find out what services are available in your area through your GP, council website or local MIND service.

I hope that this series of posts has been beneficial to either yourself or someone that you care about and if not now, then perhaps it will in the future. Mental illness can be a very lonely place, and one that it can be very hard to recognise that you need help, or even to physically form the words to ask for it and try and put the whirlwind of thoughts into logical sentences. Recognising that you need help is a huge step forward, and one that can be difficult to take. However in doing so you are opening yourself up to the world of help that is out there. Help that you probably didn't know about. Take it, use it and regain yourself in the process. 

Like I said I will be reposting more mental health related posts in May. If you have any suggestions for posts you would like to see, or would like to share your story through a guest blog post then please get in touch.

Take care everyone

Sian

January Blues: I need help now!

 

So far this series has looked at identifying depression and anxiety, knowing where to get help and the types of help that are available. Mainly concentrating on depression or anxiety in relation to a life changing event and depression that you may struggle to identify a cause for. Most of the information has been in relation to the onset of the illness and relatively mild to moderate in severity.

Today I want to talk about mental health crisises. How to recognise that you are in crisis; and where you can access help.

 

How to recognise that you are in crisis:

A crisis can occur whether you have previously been diagnosed with depression or other mental illness such as bipolar, schitzophrenia or obsessive compulsive disorder. Or it may well come out of the blue and you were otherwise previously healthy as the first episode of a mental illness.

MIND the charity says that Mental health crises include:

 

suicidal behaviour or intention

 

panic attacks/extreme anxiety

 

psychotic episodes (loss of sense of reality, hallucinations, hearing voices)

 

other behaviour that seems out of control or irrational and that is likely to endanger yourself or others.

 

In a mental health crisis help is needed more urgently. However where as the majority of us know what to do in a physical emergency most of us wouldn't know where to get help if we or someone else is in serious mental distress. And the NHS infographics, such as the one below, don't cover mental health either.

 

Please note the above photo mentions NHS Direct which has since been replaced by 111. You can read more about this new service below.

 

Helplines

 

I know I have mentioned helplines in most of the posts in this series but that's because they have a real role to play and are recommended by doctors and mental health charities. If the crisis is a part of an ongoing problem you may already be receiving care from a crisis team (which I will talk more about in my next post) and have numbers to ring for those directly responsible for your care. However if it falls out of those contact hours or you do not currently recieve crisis care the best helpline and one that is manned 24/7 is The Samaritans. Contact them on 08457 90 90 90 

 

Your GP or Out of Hours

 

During the day you may be able to contact your GP surgery for an emergency appointment or phone call consultation. However this might not be guaranteed and you might have to wait longer than you feel you can. In which case the receptionist might be able to advise you where to go.

Outside of surgery hours you can contact your nearest out of hours service for an appointment.

I would say both above situations might be most beneficial in slightly less of a crisis, where you are worried but can wait longer. For example you might have self harmed and feeling a bit calmer but still want to report it and get extra help. As long as you can stop any bleeding. If however it is more severe or you have a more serious injury or burns then seek more immediate help, such as those listed below.

 

Dial 111

 

111 is the new service that replaced NHS Direct. It is to be used in more urgent circumstances where you cannot access your GP but where the situation is not presumed life threatening. In which case of course you would ring 999. They can also inform you of what action to take and where you can access the level of help that you need based on the information that you present them with. Whether it be for yourself or if you need to take action on behalf of someone else. From there they can  make direct appointments for you or put you through to more specialist services such as A&E, out-of-hours doctors (and others depending on the case.) In some cases they can also send for an ambulance.

 

Ring 999

 

If you have seriously harmed (bleeding profusely or severe burns) yourself through self harm, injury or overdose or come across someone that is unconscious or unresponsive as a result of their actions then dial for an ambulance.

 

Go to A&E

 

Going back to those NHS info graphics they are designed to help stop unnecessary use of accident and emergency services because there are too many patients attending that could have been treated elsewhere, which in turn reduces waiting times and how quickly those in real need get treated. However like I mentioned they only cover physical health. Just like you would a physical emergency going to A&E if you are experiencing a mental health crisis is a real option and Accident and Emergency units do have policies and procedures in place for patients that present with the symptoms of a mental health crisis. In some cases if you have previously sought help from a doctor or NHS 111 they might even have told you to go to A&E. Go to A&E if you are also in need of physical treatment as a result of your mental state, such as deep self harm, injury or overdose.

 

There they will assess you and sometimes check for any infections that might be causing any symptoms (such as hallucinations) through a blood test and urine test. As well as treating any physical symptoms if you have any. If you're symptoms are beinv made worse by the waiting room environment (which are never easy to cope with anyway) ask if you can wait somewhere quieter. In some cases they will do this automatically. They will also keep a note of your clothing and physical description for security purposes. Should anyone in severe crisis leave the department. You should also be assessed by the psychiatrist on call, alongside a mental health nurse. Unfortunately crisis care at A&E can vary. Sometimes depending on how busy they are. I always used the same one but the experience differed on each ocassion. Ideally you should be treated as stated above. Put in a safe place and treated with compassion and understanding. You can be waiting a long time too to see a psychistrist depending on the time of day and how much other work they have with inpatients etc. But know that you are entitled to be assessed by a psychiatrist and that you have every right to be there. Even if you have no physical injury. Knowing your rights and where to get the help you need is really important

 

I remember during the times that I was in crisis and although the thoughts to do harm were overwhelming, on most occasions there was also a real fear. I was just so scared of these feelings. Personally, I saw that fear as a ray of hope, which might sound strange, but I kept telling myself that as long as that fear was there it meant that a part of me was fighting back; saying get yourself some help, get yourself 'somewhere' safe. However I also know that that fear also escalated those feelings of anxiety making my symptoms even worse. Panicking that I would totally lose control. But I am glad that through that I could say "I need help, now!" In hindsight I can see that the really scary times were those of total clarity and intention. The actual planning of 'I am going to harm myself.'

 

If you ever feel like that or come across someone that does then I hope this post has helped inform you of what you can do.

 

In my next post I'll talk about what care options are available for more severe cases.

 

Sian

January Blues: What help is available?

 

In my previous post on where to get help if you think you may have depression I referred to a questionnaire that your GP should supply you in order to form an assessment of how much depression is affecting you. You can see an online copy of the questionnaire here http://www.nhs.uk/Tools/Pages/depression.aspx  It is important that you fill it out honestly and that you can provide as much other information as possible in order for your GP to suggest treatments they feel will most help you.

 

Possible Treatments

 

See how it goes:

If your depression is relatively mild then after your initial talk with your GP you may feel a bit more empowered and much lighter for having got things off your chest. If this is the case then make a follow up appointment for a week or two to see if this continues. But remember if you continue to feel worse then go back to see them sooner. Furthermore speak to someone that you can trust and open up to regularly. Also remember if you are feeling at the end of your tether with it all then seeing how it goes might to you sound like a cop out. In which case work with your doctor to come up with a more proactive care plan.

 

Self care:

 

Your GP may also write you a book prescription for a self help book about depression/ anxiety that they recommend. You simply take the prescription to your local library and they get a copy of that book for you to lend for a few weeks. It doesn't matter if you are a member of that library or not. You may find it difficult at times to  concentrate but take it bit by bit. Alternatively they could recommend good websites to use that have detailed and useful information. Sometimes just knowing you are being that bit more pro active can lift your mood slightly.

Other tips that may help you is to try and see a bit more day light and get more fresh air. To do gentle excercise. Eat more healthy foods. Even just pampering yourself a bit. Having a bubble bath, putting on a face mask or painting your nails. Listening to your favourite songs or watching your favourite tv show or film. Many a counsellor will tell you to avoid the news and soap operas as they can often make you feel worse. They might sound trivial but they can work to help boost your self esteem and also as a distraction technique, to prevent you thinking as much about your troubles. I would also recommend keeping a diary to help you rate your mood and to notice if anything helps to improve your mood. Even if you simply write:

 

Mood before activity (going for a walk):
Mood after activity:

 

Assigning your mood a number. 1 being the lowest mood imagineable and 10 being the best mood.

 

Talking Therapy:

 

As mentioned in my former post counselling is one of the most recommended forms of treatment available for all kinds of patient and problems. It can help you to gain perspective and to make you feel that you are not alone in dealing with your emotions, feelings and problems. You may benefit from talking to a friend or family member however the added advantage of receiving counselling is that you can talk to someone who is trained to listen and have specific advice to help you cope with this difficult time. Plus, because they don't know you they do not have any preconceptions of you nor pass any judgement. Usually counselling is one on one but there is also the options of relationship counselling, family counselling and group therapy depending on your needs. I spoke in more detail on what types of counselling are available and where you can find counselling that is right for you in my previous post (linked above).

 

Cognitive Behavioural Therapy

 

Or CBT as it is known, whilst controversial for it's choice as a treatment for physical illnesses, can be an effective treatment for mental health problems. It may be used alongside counselling or often combined with it in each session. It is a way of analysising the way in which you think about things and how we form patterns of thought. It looks at ways to prevent some thought patterns that lead to feelings of depression and anxiety from occurring.

 

For example I found CBT extremely useful in helping me to stop negative thoughts from escalating into depression or anxiety and panic and each time it did I would automatically think about self harming. So through using CBT in my counselling sessions and other help I recieved I was able to identify triggers to these feelings and with time learn to rechannel those thoughts. And I can honestly say now, 5 years later I'm still very grateful for each time I can feel down in the dumps or alone etc etc and not have thoughts of self harm. So I think this is a good treatment for anyone that as a consequence of their feelings wants to harm themselves (or others) in anyway be it through cutting to starving yourself. Obviously the greater the feeling to do harm is CBT may only be part of a treatment plan and combined with other treatments.

 

It is also a good treatment for anyone that is having real difficulty in coping with change in their lives. Be it feeling lost after retiring to having to cope with being diagnosed with a long term illness. It won't improve the symptoms of a physical illness but it may help you to have the strength to adjust to having your life uprouted. For example if you feel that as a result of your illness that your life no longer has meaning. In some ways I think had I not learned to have greater control of my thoughts (even though it was a while before being diagnosed with M.E) I would struggle more emotionally and be at greater risk or relapasing into depression.

 

Medication

 

Many people have opposing views on the use of medications such as antidepressants and benzodiapozines (such as xanax and diazapam) to treat depression or anxiety. Some will say they disliked them, that they gave them a false sense of reality and simply masked their emotions; leaving the feelings unresolved and likely to return. While others, myself included, will say that they were a big help in winning back the emotional fight. That they help calm things down so that you can deal with the emotions and any triggers that you identify through talking therapies. Either way using talking therapies too will allow you to deal with any triggers to the way you are feeling that antidepressants alone can't solve. Of course it is entirely your own choice if you want to go down that route. And I do not wish to influence anyones choice as everyone is different.

 

It's a decision that should be made solely between you and your doctor. You might be worried that by taking antidepressants your problems seem to be much more frightening. A kind of "well I must be really bad if I need loony pills". Or you may be scared in case someone sees you taking this medication and will therefore associate you with being mad. Another fear may be that you are worried about the side effects, which some patients may experience. However each patient will react in different ways. The same goes with fear of the withdrawal process, which can cause it's own problems. It can be helpful to reassure yourself that it is your body readjusting to less chemicals and not be filled with fear that you are adjusting. Be sure to thoroughly discuss likely side effects with your doctor so that you can be fully aware of what to expect. And when the time comes that you feel you could cope without them your doctor will advise you on how to do so gradually and safely. But be aware that it may take some time. It could even be years in some cases (I'm still on a low dosage, 5 years later.) And if you want to make the decision about proceeding with medication at a later date then it's up to you.

 

Types of medication

 

There are several types of antidepressants. However they are all designed to act on the same brain chemicals. I won't go in to chemical speak but basically they work on prolonging serotonin, the chemical associated with good mood, as people suffering from depression can have low levels. These are known as SSRIs. More modern antidepressants also work on norepinephrine another chemical that is responsible for energy and alertness. These are known as SNRIs. These may also have less side effects.

 

Tricyclic and tricyclic-related antidepressants were invented in the 1950s and work by prolonging the action of seratonin as well as noradrenaline in the brain. These can cause a few more side effects.

There are also Monoamine oxidase inhibitors (MAOIs) however these are less common, mainly after other types of antidepressants have been tried and are only prescribed by specialists.

 

Benzodiazepines are sometimes used to help manage anxiety, panic attacks and obsessive compulsive disorders and sometimes during alcohol withdrawal. They work on the chemical in the brain that helps us to feel calm and to help the cells pass on the message that we are not in any danger, that has been triggered with an anxiety or panic attack. However they will only ever be prescribed for short term use due to their association with addiction.Also because they do not help with the route cause of anxiety nor help you to feel better in the long term. They're only effective for a short time when your body is at peak distress. Other treatments such as counselling, CBT or antidepressants will be recommended as more effective ways to stop the anxiety from building and help you cope more long term.

 

Other Treatments

 

Arts therapies

 

Arts therapy is a less intrusive more complimentary treatment. And is designed to allow people that have difficulty in expressing their feelings to do so in a different way. It is often used when treating children, for example to help them come to terms with grief or divorce. It can be useful with this age group due to them not having the learned the right words to express how they feel or how to process the new information. But can also be effective for people of any age. Different art forms such as   music, art, dance or drama can be utilised to help the sufferer to express their feelings in a way that does not feel like therapy. Each session will be run by a trained therapist who will help you to interpret your work and be there if you want to talk about the emotions it has conjured up. Your GP, specialist, counsellor or local MIND centre should be able to tell you where you you can locally access this kind of therapy.

Alternative medicine

 

Depending on your beliefs you may wish to try alternative medicine or treatment. It will also depend on the GP that you are with what information they have about this. Some way have recommendations and others won't because it doesn't necessarily fall within their remit. However like with anything you undertake be sure to know how it will impact you and whether it will interfere with any medication you take. Just because something is natural or alternative does not mean it won't give you side effects (again it differs with each case). I would recommend that anything you do try you disclose to your doctor as a way to regulate how the treatment is going. Also remember that you will need to pay for any medication or treatment yourself.

 

The treatments I have mentioned here are for relatively moderate depression or anxiety. If your condition becomes worse or you become more at risk of doing harm to yourself then there are further options available. Also if you are diagnosed with another type of mental illness such as bipolar disorder, paranoid schitzophrenia or Obsessive Compulsuve Disorder then more specialized help is available. But in the most instances most depression or anxiety patients will be treated with one or a combination of the above treatments and will find them effective. And if any time you feel you are getting worse or experience nasty side effects then be sure to get back to your doctor as soon as you can.

 

Of course what is important to remember is there are no quick fixes, getting better will take time. And that may be incredibley frustrating at times. Try to have patience and think that each day is a step in the right direction. Think of it like a physical illness or injury if needs be. If you broke your leg or had appendicitis you would need at least 6 weeks to be heeled again. Having a mental health problem is no less real and the mind is a much more complex place.

 

Sian

 

* The information contained within this blog post is for self education purposes and should only be used in conjunction with that of a doctor that understands your personal circumstances.  All information in this blog post has been researched from MIND's website and the NHS website. With some personal experience. Please note that every patient is different  and all medical choices are best decided between you and your medical professional. I do not wish to influence anyone's choices, as it is down to each individual. This post only stands to point out what help is available out there.

January Blues: Where can I get help?

 

Firstly I want to say a very big thank you for all the comments and support I've received so far about this mini series. I'm glad many of you have appreciated it. This post is going to be a point of reference of sorts, should you ever need the information. Actually the post was getting so long I've had to split it into a few posts. One that's more general (which is this post) and another for more of a crisis situation (which hopefully will be published soon) and a post on what treatment options are available.

 

When you are battling with your mental health the hardest thing it can seem to do is to ask for help. Because it can be really difficult to actually admit that there is something wrong. Especially bad enough for you to need help. And of course the thought of needing help can also fill you with fear. Thinking that if you actually told someone what you are feeling then they may think you're crazy, mental or those horrible names nutjob or psycho. And consequently that you will be locked away and sectioned under the mental health act. However in reality this is very rarely the case.And what you are experiencing is something many others are also going through. 1 in 4 people will experience some kind mental health problem at any one time. So try to reassure your self that you will not be locked away.

 

However when you feel like that asking for help is the biggest step you can take. You may have had people telling you that you need help for some time. And perhaps you dismissed them. However deciding to get help needs to be very much your own want and recognition that you need that help. If you are concerned about a friend or family member there is a specific page on the MIND website for advise http://www.mind.org.uk/information-support/helping-someone-else/

 

But where do you turn to when you want help? Would you know? Would you know how to help someone else that is suffering or in crisis? Below I have shared some options of where to get help in the early stages.

 

Talk to someone- firstly you might just want to talk to a friend or family member. Think who will understand and will listen without judgement. If there have been people who have been wanting you to seek help then they might be a good place to start. As long as you feel that they will listen and genuinely care about you. It may be that that is all the support you need. Just getting things off your chest and maybe thinking up solutions with a friend can be a big help.

 

Talk to your GP - when you have a mental/ emotional problem you may think that going to the GP is a waste of time. That they can only help for physical problems. However, in truth GP's see a large number of people with mental health issues each day. One GP once told me (after I had said that I felt that I was wasting his time) that it was actually about 80% of his job. That being said you need the right GP. One that you feel comfortable with and one who you feel actually really listens to you. Those 2 factors are very important. So if you feel uncomfortable with a certain GP or that they haven't treated you with compassion then ask to see another GP in your surgery. Do not let a bad experience affect your right to be listened to and to get the help that you need. And if you burst out crying in there don't worry about it. They should get you to complete a questionnaire that they can use to assess how you're mental health is, you can find an online copy of it here http://www.nhs.uk/Tools/Pages/depression.aspx Fill it out honestly. That way they can help you on a course of treatment that is right for you. I am preparing a separate post on what help and treatments are available.

 

Counselling- Counselling is one of the course of treatments that could be suggested for you. But as it is not exclusive to needing to see your GP first I wanted to mention it in this post. Counselling on the NHS can have long waiting lists due to the high amount of people that need it. The NHS are trying to put more counsellors into GP surgeries to reduce waiting times for this much needed service but wait times can still be long. Especially for a service where the sooner the better. However if you feel you cannot wait that long then there are other options available.

If you are employed then your employer may be able to get you a counsellor through occupational health. And this in no way should affect your standing at work or make you feel less employable. It is a service they can provide to look after the wellbeing of their staff. So if you are experiencing any problems, even ones that are not work related, then ask your boss if an appointment can be made for you. You don't have to tell them the reason either unless you feel you want to.

If you wish to see a private counsellor then you will need to pay.As with most service providers nowadays a simple search on Google can tell you where there are local counsellor's in your area. Along with a pinpoint to their location and contact details. I simply typed in "where can I find a counsellor?" and a list of local places came up on my phone.

 

The following site also has a list of directories that you can use:

http://www.nhs.uk/conditions/stress-anxiety-depression/pages/free-therapy-or-counselling.aspx

 

And there is also:
Www.counselling-directory.org.uk

 

Charities

 

Mental health charities do such a fantastic job for raising awareness of mental health issues and also offering services to help sufferers.

 

MIND

 

MIND is a mental health charity that not only is an organization that fights for the rights of those with mental illness but also has thousands of branches across the UK. Each branch offers a number of services available to each community. On the link below you can see what services they offer in your area. Some even offer free counselling, which can sometimes be accessed sooner than through your GP surgury.

http://www.mind.org.uk/information-support/local-minds/

 

Other services include:

 

supported housing
crisis helplines
drop-in centres
employment and training schemes befriending

 

You can seek lots of information about different conditions and issues surrounding mental health on their website www.mind.org.uk or their infoline 0300 123 3393 or text 86463 or email info@mind.org.uk 

 

Other charities and organizations that offer specific help for different issues or clearer groups of society are:

 

Calm (Campaign against living miserabley)

 

Free support and information for young men in the UK between the ages of 15-35
0800 585858
www.thecalmzone.net

 

Women's Aid

 

Is a charity for women and children experiencing domestic abuse.
0808 2000 247
www.womensaid.org.uk

 

Cruse Bereavement Care

 

Offers specific support to anyone following the death of a loved one.
0844 477 9400
www.cruse.org.uk

 

B-eat (Beating Eating Disorders)

 

Offers advise and information on eating disorders.
0845 6341414
Youth line 0845 6347650
www.b-eat.co.uk

 

Headway

 

Offers support and advise to anyone affected by brain injury.
0808 800 2244
www.headway.org.uk

 

Relate

 

For advise and counselling for any type of relationship and the problems that can occur within them. They have centres around the country. Visit their website for all services they offer.
0300 100 1234
www.relate.org.uk

 

Helplines and other contacts

 

When you are in distress phoning a helpline can be useful. Your GP or your local MIND centre will have access to local helplines. However these might have limited hours. If you are in a more desperate need to talk to someone, then The Samaritans is a 24/7 service. Their helpline is 08457 90 90 90 or if you don't feel up to using the phone you can also email them jo@samaritans.org More information can also be found on their website www.samaritans.org 

 

In my next post I will be talking about what types of treatments are available for moderate depression and anxiety. Then a post on where to get help in more of a crisis situation.

 

Sian

January Blues: Why do I feel so bad?

 

When you feel so down and depressed or anxious and panicky it's only natural you will ask yourself "why?" Why do I feel like this? And a lot of the time the answer will be "I don't know".  Which will frustrate you all the more. It's frustrating because your logical brain is screaming "but there must be a reason!" But all you can do is cry "I don't know" some more. And this might be the case for a while.

If your symptoms are a reaction to an event, such as losing a family member or friend, a relationship breaking up or losing your job, then that can be reasoned. It's in no way easy but at least you can say "I feel this way because..." . You have a clearer idea about why you feel as you do that can be worked on to help you start to feel better.

 

There are many different forms of depression that can stem from an event, or time of year such as:

 

* postnatal depression
* grief
* post traumatic stress disorder
* seasonal affective disorder

 

All of which can seriously affect your mental health and are recognised conditions, that some form of treatment can be sought. I will get on to treatment in another post but know that they're is help that you can get for these conditions if they are having a more chronic affect on you.

 

 

However in many cases people can really struggle to find a logical and explainable reason that they feel so bleak. Made worse by feeling numb and empty. Really not knowing what is the matter at all. Only that you feel so hopeless and shut down and even the simplest of things like getting out of bed or getting dressed feel unachievable. And this can lead to thinking it's all your fault you feel that way or even that you deserve to feel as you do. Well, you don't. Furthermore you may feel that you must be a bad person; that you must have done something wrong. Which in all likelihood is also false. Only the darkness inside of you will have you convinced otherwise.

 

What can be even more difficult to comprehend is if you feel depressed at a time in your life when you are 'supposed' to feel happy. For example my own experience of feeling depressed when I graduated from university, which you can read about in my introductory post to this mini series. And another story that I often reference is that of Olympic cycling gold medalist Victoria Pendleton, who was self harming even on the night she won her Olympic gold medal; an achievement she had worked so hard for years to achieve. But the outside world only sees a projection of ourselves not all the darkness that we are struggling to ward off.

 

 

Most of the time there will be answers as to why we feel as we do, but they can be very deep set. Chances are we're reacting to something. In some cases this could be something from years back. Something that has been locked up for too long and finally needs to come out. Or in some cases (and not wanting to scare anyone) an undiagnosed illness that is affecting our neurology or hormomes. I remember during the time I was at my worst it was found that I had really high levels of prolactin, which although wasn't the main cause of my condition was certainly a factor in making it worse.

Whether you have a clear idea of what is causing your condition or really struggling to find one the best thing that you can do is to seek help. If you have friends or family that understand speak to them. But your gp is a good first point of call, and they will not find your problems trivial (well they shouldn't.) They will be able to suggest a course of action to help you find out what is causing these feelings. My next post is going to be one with more information on where to get help. But if in the mean time you require help do visit your gp or you could ring the MIND helpline on 0300 123 3393 or texr 86463.

 

Sian

January Blues: Signs and Symptoms

 

Often our mental health can be neglected and actually it can take a long time for us to realise that something isn't quite right. Unlike our physical health where we will pick up on symptoms much sooner and take action. Where as with our mental health we will carry on as usual, trying to keep up with this fast paced world we live in. Telling ourselves it's nothing. That we need to buck up or get a grip. We haven't got time to contemplate being depressed. Likewise we don't want to be stigmatised or considered weak and incapable. Or those awful labels nut job, crazy, fruit loop. Only the more you try and brush it under the table the bigger the problem is going to get. There is a reason people say "don't bottle things up" . And it's because it's true. Or we may not start to realise something is wrong until we get physical symptoms that we might not attribute to being a consequence of our mental health. And it's usually these physical symptoms that will lead us to our doctors.

 

Sometimes other people, those that are closest to us, may even start to notice before us. And consequently become concerned. However the biggest step is in noticing for yourself and in actually admitting that something is not quite right. Sometimes you'll only start realising when symptoms start affecting your day to day life or again when you experience more physical symptoms.

 

 

To help you know what the signs and symptoms are the following list I refer to MIND's symptoms page, which you can see here as it's very comprehensive and they are one of the best places to go for help and advice regarding mental health.

 

Feelings

 

* I am low-spirited for much of the time, every day

* I feel restless and agitated

* I get tearful easily

* I feel numb, empty and full of despair

* I feel isolated and unable to relate to other people

* I am unusually irritable or impatient

* I find no pleasure in life or things I usually enjoy

* I feel helpless

* I have lost interest in sex

* I am experiencing a sense of unreality

 

Behaviour

 

* I’m not doing activities I usually enjoy

* I am avoiding social events I usually enjoy

* I have cut myself off from others and can’t ask for help

* I am self-harming

* I find it difficult to speak

 

Thoughts

 

* I am having difficulty remembering things

* I find it hard to concentrate or make decisions

* I blame myself a lot and feel guilty about things

* I have no self-confidence or self-esteem

* I am having a lot of negative thoughts

* The future seems bleak

* What’s the point?

* I have been thinking about suicide

 

Physical symptoms

 

* I have difficulty sleeping

* I am sleeping much more than usual

* I feel tired and have no energy

* I have lost my appetite, and am losing weight

* I am eating a lot more than usual and putting on weight

* I have physical aches and pains with no obvious physical cause

* I am moving very slowly

* I am using more tobacco, alcohol or other drugs than usual

 

People suffering from depression may also suffer from anxiety. They are both different conditions but can

 

Anxiety and Panic attacks

 

* feeling like your mind is full or busy

* having repetitive thoughts

* difficulty concentrating or remaining focused

* not wanting to go out as much

* losing interest in things you used to enjoy

* feeling self conscious

* the thought of going out or being in a crowd makes brings on physical symptoms for example sweating or feeling like you're struggling to breathe.

 

 You can see more of the physical symptoms associated with anxiety on the image below:

 

 

*  difficulty relaxing or getting to sleep

* headaches

* aching muscles

* sweating dizziness

* feeling as though you can't breath

* tightness in your chest

* gastric problems

* tiredness

* feeling generally unwell

 

If you are severely depressed: (again this information is from MIND)

 

Psychotic experiences

 

* You may start to have experiences or thoughts that others around you do not share. For example, you may hear voices, see visions, believe that you are evil, or are influencing events in a way that is harmful to others.

* You may believe that you are a bad person and you deserve to feel as you do. These are false beliefs and may be part of the depression.

 

Suicidal thoughts

 

* You may feel that life is not worth living and start thinking about ways of killing yourself.

If you would like more information you can find it on the following websites linked below. I will be doing a post on where to get help soon if you are worried about your mental health or that of a friend or relative. But if you are worried in the mean time or feeling desperate be sure to visit.

 

MIND
 Www.mind.org.uk 
infoline 0300 123 3393
or text 86463
or email info@mind.org.uk

 

The Samaritans
Www.samaritans.org
contact them on 08457 90 90 90
or email jo@samaritans.org 

 

Time to Change
Www.time-to-change.org.uk

 

Or contact your local gp.

 

Until next time. Take care.

Sian

January Blues (a mini series)

I have said it a few times in posts but I'm going to say it again I'M HAPPY! In spite of being chronically ill I really am. But there was a time when I wasn't. Really wasn't infact. At the time what was hard to comprehend was the fact that it was a time where I should have been really happy. And there are times when I fear I'll go back there.

To start off this series of posts on mental health issues I thought where better to begin than my own story. I have posted a few times about my past struggles with depression, anxiety, panic attacks and self harm but I want to reitterate some of it for the purposes of this series, to show that this topic actually means a lot to me. It's something that I will carry around with me for the rest of my life. And I'm not the only one. Mental illness of some kind affects 1 in 4 people at any time. Yet how often is it talked about? So let's start talking...

Look at the photo above. What do you see? A young woman on her graduation day. One of the biggest achievements of her life. Well sometimes photographs can be deceiving. I really wasn't sure at the time if I could even attend the gradution ceremony. Wasn't sure I wanted to. Because behind that photo was a woman who was fighting a battle against her own head. A scared shadow of myself and all that that photo should represent. Take off the layers of concealer and you'll see eyes puffy from constant tears. Look at that hair, only clean because my Mum had to wash it for me as I shook so much. Peel back those sleaves and you'll see the fresh cuts and the healing scabs that begged to be itched and scratched. The bare legs that my Mum helped do with an electric razor to stop my brain from feeling temptation.

So no I've not always been happy. I've suffered a few bouts of depression and anxiety since the age of 14. However the period after I left university and graduating was certainly the worst. It's a place I never want to be again. Sometimes I feel that I am running scared from mental illness hoping it will never catch me again. Unfortunately I can't guarantee that. However I'm extremely grateful for every day I have where I'm not battling my own mind. I'm lucky I learnt to control it. Luckily the physical scars are not too visible but the emotional ones will last far longer. I will never forget that time. 

I try to use that experience as a way to try and remain positive now, to be more grateful for what having a healthy mind means. Sometimes I even say to myself that if I can get through that then I can get through anything. Within reason of course. That has been tested a few times during turbulent flights. And of course regularly gets tested during particularly bad health flares or relapses. What's more I've learnt that mental health needs to be talked about more. That it's all too taboo and hush hush, which considering how common it is is ridiculous. And so I try to talk about it when I can in a bid to raise awareness. 

To go back to the graduation photograph to the outside world no one would have guessed what was going on in my head. And it's the same for millions of people. Sometimes though it's important to see behind those masks. To say actually my mental health problem is more real than what my photograph documents. And if I can help just one other person by blogging about my personal experiences and by doing this January Blues series then that's something positive.

If you have any suggestions for topics or conditions that you would like to see covered in this blog series then please do leave a comment. Likewise if you would like to share your story through a guest blog post. To any of you that are suffering or if you know someone that is then I hope this series will help somewhat. 

Sian