Stop!

 

In this busy world that we live in in which life runs at break neck speed and we have all the information we could possibly need at our finger tips (thanks Google) it can be very easy to kept swept away by it all. Everyday life can become a series of  connected patterns and rituals. You get up each morning having set the alarm for the same time each week day, shower, get changed, grab breakfast, then leave for work at the same time each day. They just become integral parts to our day and become so embeded, due to their frequent use, that you don't even give them much thought anymore. You just do them semi automatically, drawing on muscle memory. Going through the motions as they say.

 

 

However while having these patterns are effective and necessary living life in a constant pattern or as though you are following a check list it can also push out emotion. So every now and again it's really important to say stop! Stop the ride. And do a spotcheck to ask yourself some important questions.

 

Am I happy?

 

When was the last time I felt truly happy?

 

When was the last time I had a really good laugh?

 

Do I have good friendships?

 

Do I feel supported?

 

Do I feel loved? (not just romantic love)

 

Questions that get lost in all that daily grind but questions that we need to ask ourselves from time to time.

 

 

Hopefully the answer will be yes. But if it isn't then it's time to start asking yourself why? Why aren't you as happy as you perhaps should be? Perhaps the answer is something simple or maybe it's something a bit more life changing. Either way there's some decisions to be made and a good deal of thinking time. But you know when it comes to investing in your happiness it's certainly worth the time. And if you don't think so well then think about that too. Because unless you're a really really terrible person (and I'm talking the really bad stuff) then you deserve to be happy.

 

Sian x

Love February

 

First of all have you seen my new blog banner? Talk about love. Thank you so much to the fabulous Charlotte for creating this illustration. Her blog is http://mookpixie-chronicills.blogspot.co.uk/, so go check it out.

 

February is the month we most assossciate with love. Although I could argue that December is more worthy of the title with it being the month of spending Christmas with family and friends and showing them how much you care. But anyhow... February is still a month when love in all it's red roses and heart shaped ballooned glory is celebrated.

 

Following on from my January blues series of posts on mental health I wanted February to be a month of facing those issues raised in my January posts and deal with a love that many of us forget about. And that is the love we have for ourselves. Sound arrogant? Well no, this is not about arrogance it's about self confidence and self worth. Sound cheesy? Ye, maybe. But loving ourselves is important and can trigger a deeper sense of wellbeing.

 

And it's not about being selfish. Because actually although you need to think about yourself, being generous and devoting times to others can promote that sense of well being. As long as it's done genuinely of course.

 

So things will be getting a bit warm and fuzzy around these parts (and oh boy does that sound wrong). I'll be chatting confidence, self worth as well as some fun posts on things to do to to promote happiness for yourself and others.

 

I'd love to know what you do to make yourself feel good. Or what makes you feel more confident.  Leave me a comment.

 

Take care everyone

 

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.