Mental Health Awareness Week 2020

I have several chronic health conditions, but the ones that have dogged me from a very young age are depression and anxiety. So this is my blog for Mental Health Awareness Week 2020. 

I’ll start with a couple of caveats. This is about MY experiences with living with chronic illness, specifically living with mental health conditions – and everyone’s experiences are personal to them. My second caveat is that one of my coping mechanisms is humour – not because I don’t think mental health is a serious issue, just in the same way that many emergency services staff use “gallows humour” to deal with what they experience.

Lots of people think they know what poor mental health looks like. It looks like this, right?

😟   😢  😡

Wrong. It can look like that, but people with mental health conditions can also laugh, joke, run marathons (not me, but some weird people like running!) etc.

Depression and anxiety can manifest in many ways. It can sap you of all energy and motivation; it can strip all of the joy from activities you have previously enjoyed, or been comforted by; it can lead you to put others before yourself at the expense of your own sanity or health; it can make your brain full of “shoulds”, and “musts”, and “why didn’t I”? and “why did I do that”s, and a constant replay of things you could have done better; it can lead to sensory overload and feeling totally exhausted by “peopling”; it can make you obsessive in your need to do more, be more, achieve more; or you can literally not have the motivation to get out of bed, let alone get to work or have a social life.

I mentioned above that poor mental health does not manifest in one specific way. A lot of people with poor mental health (especially those of us that have dealt with it for a long time) have one thing in common (in the same way as sufferers of lots of other “hidden” conditions). What is it? We’re flipping good actors a lot of the time.

You may assume that those of us with mental health conditions may be quiet, reserved, socially distant, uncooperative, uncaring towards others etc. etc. And whilst it can manifest in those ways, it can also be hidden behind a façade of being sociable, funny, sarcastic, providing service to others, and nothing being too much trouble in a constant need to “prove” ourselves as worthy of the respect of others.

Just a handful of comedians that suffer/ed with mental health issues for context on the façade front:

Jason Manford; Ruby Wax; Robin Williams; Catherine Tate; Caroline Aherne; David Walliams.

Some people manage poor mental health with meditation, herbal tea, gratitude journals, yoga etc. and find that works well for them and no other input is required. Some people, (like me) use a variety of coping mechanisms. I use (amongst other things) dance, humour, music, blogging, reading, and medication. I have been on medication all of my adult life, and I may well be on it forever. Some medication has worked better than others over the years, but it helps me. Some people believe that you should only be on medication for short periods of time, and they’re entitled to that belief. I’m also entitled to do what works for me.

Sadly, even in these so-say enlightened times, in a “first world” country, pretty much everyone I know that has any kind of mental health condition has faced stigma at some point. Some people are still scared of mental health issues, especially if they have no experience of them themselves. I think there is an assumption that if we are struggling, then we want/need someone to fix us. And therefore, if you don’t have any understanding of mental health issues, people think that they’re “not qualified” to provide support, so don’t say anything.

But it’s ok, right? Because our friends and family will always support our struggles, won’t they? No! Whilst some people have excellent support networks for their “bad” days, no matter how many times they try to explain to certain people what they’re going through, said people will say “pull yourself  together”, or “there are people in the world way worse off than you, so what are you complaining about?”. That’s not kind, nor is it helpful. That is also not how depression and anxiety works.

The theme of this year's Mental Health Awareness Campaign is "kindness". So what does being kind look like? It doesn’t have to be about the big gestures, like whisking someone away for a spa weekend, or buying someone an expensive gift. Being kind can take a matter of minutes, cost nothing, but absolutely mean the world to the recipient. It’s about picking your timing, your location, and relevance. What do I mean by this?

Well, I’m normally pretty good at putting up a front and coming across as bubbly and sociable. If I’m in a meeting and I am quiet, reserved, react differently than I normally would etc., that meeting would not be the time to see if I’m OK. I do not want to be asked what’s up with me in a room full of people – that would be humiliating. However, were you to pull me aside quietly after the meeting and ask if I wanted to go for a cuppa just to have a catch up - that would be fine. If I then feel comfortable opening up to you, I will. If I don’t, then just going for that cuppa and having a general chat might just be enough of a distraction to get me through the day.

So, what do I mean by relevance? Think about the things you know your colleague/friend/family member etc. likes. What makes them happy? Do they have a favourite comedian, actor, musical artist, or author? What makes them smile?

For example, if you bought me the most expensive tickets for the FA Cup final to cheer me up as you really like football – that would provide no enjoyment for me whatsoever and would be a complete waste of money. You’d probably feel like you’d been really generous and might be stumped by the fact that I looked embarrassed and unimpressed. However, if you sent me a meme with a quote from a comedian I like; or wrote me a card saying you knew I was struggling and that you were here if I needed anything; or made me playlist of my favourite happy songs – I’d really appreciate that.

You don’t have to know someone really well to be supportive to them. Whilst there are several stalwart friends that I can rely on in the bad times, there are also people that have really stepped up when I’ve been struggling that I would never have thought to ask for help. Sometimes the kindness of strangers/people you don’t know well can make the difference between whether you feel you can dust yourself off and battle on for another day, or whether you just want a crater to open beneath you and swallow you whole.

By the same token, don’t assume that you have a “right” to know what’s going on with someone if they seem out of sorts. By all means, ask if they would like a chat/some support, but don’t be offended if they say they’re fine, or say “thanks but no thanks”. Sometimes I need to talk through my issues, sometimes I need to listen to some angry rock music to get through a bad day, sometimes I need to hide under my duvet and not talk to anyone for a few days – what I’m saying is one size doesn’t fit all.

Being kind to yourself? Yeah, that’s the one I struggle with! I’m probably harder on myself than anyone else is. But I try, some days I’m better at it, some days I’m not so kind to myself. But I’m trying.

Some people might judge me for being more open about my struggles. Some people might say my combination of health issues make me “less than”, somehow lacking. And you know what I say to those people? Before you judge a person, walk a mile in their shoes. I’m not going to attribute the quote to a particular person as the original origin is disputed.

I may be bruised sometimes, but I am a fighter, I am empathic towards others, I am thoughtful, I am considerate and try to do right by other people. If that makes me "less than" in your eyes, then so be it.

So if you’re looking for a skill to perfect during Covid-19 lockdown, make it this: “In a world where you can be anything, be kind”.

I’ll leave you with these pictures as food for thought.

A picture of a sad, quite thin looking man, the shadow behind him shows a muscly man

       

Mad hatters, fruit cakes and black dogs

My friend is writing a blog about her experience with depression in the hope that it will help people going through a similar thing.  I think she's really brave.  But it did push me to be brave enough to share some of my thoughts about it.  In theory, these days, depression and mental illness are supposed to be much less stigmatised than they were, say 50 years ago.  In reality - I'm not sure how much of the stigma has been removed.

Whilst locking people in asylums for not conforming to societal norms is no longer de rigeur - being sectioned is a possibility. I know several people who have been going through a really rough time and felt like they were going mad and that the men in white coats really were going to come and lock them up in a padded room.  Whilst in the past, unmarried women were sectioned by their relatives for daring to bring a "bastard" child into the world (and had their child taken away at birth) and "sullying their family name".  Despite this no longer being a threat to unmarried mothers in the UK, there are still a lot of issues regarding mental health that revolve around power.

There have in recent years been several celebrities that have "come out" as having mental health issues (sometimes through choice, sometimes through being "outed" by lovely paparazzi or public looking to make a quick buck) - Catherine Zeta Jones (Bipolar Disorder), Emma Thompson (Depression), Ruby Wax (Bipolar Disorder), Stephen Fry (Bipolar Disorder), Lenny Henry (Depression) - I could go on for ages.  I have always felt that in a way, it's kind of easier for celebrities to "come out", as usually when they do, they are already well paid, well known, and get regular work for their talent/ability/skill/connections.  Their potential employers can see their previous work that established their reputation - so generally, the phone keeps ringing.

For the average Joe - you're stuck between a rock and a hard place when it comes to work - especially when applying for a new job.  When applying of a new job, there are often the obligatory equal opportunities and health questionnaires.  This puts you in a quandary.  Do you declare your health condition (in this case mental health condition), in the hope that the powers that be won't use it against you and not give you an interview (but for an entirely different reason, obviously, they can't be seen to be discriminatory)?  Or, do you not declare it, and hope that you never have to have any time off work for said health condition and that your employers end up finding out that it was a pre-existing condition that you failed to declare, and subsequently all hell breaks loose?

There is an initiative called "Time to Change" www.time-to-change.org.uk/ which is a Department of Health initiative (funded by the Department of Health, the Big Lottery Fund and Comic Relief) which is led by Mind ( www.mind.org.uk/) and Rethink Mental Illness (www.rethink.org/).  The idea of the initiative is to reduce the stigma relating to mental health problems.

This, in theory is a very good idea.  In theory, health providers are intended to get behind the campaign - GP's, Health Centres, Mental Health providers etc.  But you can't remove age-old stigmas overnight.  Many staff in the NHS, and specifically in Mental Health Trusts, suffer from some form of mental health condition - most frequently depression.  Sometimes, staff become service users (the politically correct term for patients), in worst case scenarios they become in-patients.  However, I know that staff have been let down by those same Trusts.  When prejudices do result in you not getting a job or a promotion, or being judged as a certain type of person, or as unreliable, or just generally going unsupported during a difficult time. 

In theory, an employer will say "if you're unwell, take time off work".  But, you're not in a hospital bed, recovering from an operation, so, a quick phone call to ask you something is surely OK, right?  You don't have flu, you can get out of bed, so you should just be able to answer a few emails.  All this serves to reinforce the thought that you are hugely inconveniencing your employers.  It piles on the guilt that you are already feeling, feeds the dislike that you already for yourself, and feeds the idea that you are just one big burden.

Guilt is a big thing with regards to mental health issues - from my own experience and many, many people that I have spoken to.  A good way to lift your spirits is doing something that you have previously enjoyed - whether that's listening to your favourite songs; going out for a walk in the sun; seeing your friends; going fishing - whatever.  But problem is that no-one can see that you're hurting/feeling worthless/wondering if you're ever going to be "normal" again.  So you feel guilty for daring to leave your bed/sofa and, God forbid, leaving the house, lest someone see you and make the assumption that you're pulling a fast one and actually you're right as rain.  And don't, for goodness sake get caught smiling or laughing!

A lot of people assume that if you have a mental health condition, you have an understanding family/group of friends to support you.  Even if you are close to your family (which not everyone is) and/or your friends - they still won't necessarily understand what on earth you're going through.  I was asked when going through a horrendous withdrawal from medication (that the side effects of doing so are apparently akin to coming off a class A drug cold turkey - paranoia, hallucinations, massive anxiety) if I could "behave myself" for an evening so my then partner could be taken out for a night out drinking.  Words failed me - this request came from someone I cared about and trusted - as if I wouldn't turn off how scared, freaked out, physically ill, and depressed I felt if I could.

I am not naive enough to think that a person's depression has no effect on their nearest and dearest - I have been on both sides of the fence - the "patient", and the supportive friend/partner.  I know that it can be difficult to try and support someone who is suffering from depression or other mental illness.  And I know that carers need time out. But choose your words wisely, for you never know how deeply they can wound.  Whilst I have had some great people in my life, who have been very supportive, you still don't want to bother people with your troubles, to be a nuisance. 

Winston Churchill is well known for referring to his depression as a "black dog".  The origins of this link go way back in time, but he is the most well known person in modern time to be associated with the link.  Although it is a term that I have used myself, I always think that the terms people use regarding mental health are quite interesting.  To me, dogs are friendly, comforting, and I have known some very nice black dogs.  I don't know why Churchill made the link, but I'm guessing it had something to do with the fact that it stays by your side, is difficult to shake off - like a loyal dog.

And some of the terms/insults people use for people with mental health issues are ironic because several of them are food related - and when you're feeling low you often use food as a comfort.  Personally, I'd rather be referred to as "crackers" than a "fruit cake". To me, fruit cake is dry, stodgy and bleugh, whereas crackers are tasty with some butter and a nice bit of cheese :) - and nutcase? well, I don't like nuts - and what if you're allergic to nuts?  Imagine having anaphylactic shock in response to yourself  - #Awkward!

Joking aside - why is it still so common for people to be discriminated against for what is a medical condition?  It's no wonder people are scared to ask for help - they are scared of being derided by their friends and family, let alone strangers.

Mental illness doesn't stigmatise - why should you?

So is it time to change?  Too bloody right!

/http://www.blackdogtribe.com/

http://www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx

http://www.depressionalliance.org/
http://www.carers.org/help-directory/mental-health-conditions