Friday, 10 November 2017

Mind Maintenance, Let's talk!

Because I had such an overwhelmingly positive response to my Facebook posting yesterday I thought I would expand on my experiences with Mental Health Services. I know some people do prefer to keep these things to themselves but personally, writing things down is almost like a form of therapy for me. Once it’s on the page its out of my head. What I found most surprising from the FB comments and messages I received was the amount of comments saying that people just don’t talk about their Mental Health challenges. I didn’t think that was the case so much these days but maybe that's just because I know a lot of people who have been through it. If it's not discussed, it continues to be a ‘dark secret’ not to be given the light of day which makes things far worse as so many mental health challenges are magnified by a sense of isolation and loneliness  If we can talk and share and give support OPENLY, that would be beneficial to many I’m sure. Different perspectives can get you off of your own hamster wheel of negative thoughts. It's a small thing, but this year I have really tried to actually speak to people on the phone rather than text. It's quite a retro idea I know, but makes me feel much closer to my friends than a quick text. We are cutting ourselves off from each other all the time without even thinking about it. We need to TALK to each other. We need to ENGAGE and we need to make this a normal form of communication again. 

I am not the first person to think this I am sure, but we certainly need to change the language that we use to discuss 'Mental Illness'. If you look at a Thesaurus for Definitions of the word 'Mental' you will see words including:

Abnormal, Different, Bizarre, Deviant, Weird, Odd, Crazed, Hysterical, Peculiar, Strange, Unusual.....I could go on.

All these words and connotations are negative and derogatory and these are just the tip of the iceberg. No wonder so many people want to keep their feelings / thoughts / fears behind closed doors. If you are already feeling vulnerable and isolated why would you want to bring attention to your "Abnormalities"!!!.  However, if we changed the language we use and lost the negative connotations we might be able to look at what I will call 'Mind Maintenance', as a good, healthy thing. Personally, I'm glad I gave my brain a chance to have an MOT via medication and Therapy. Doesn't everyone just want to be the best person they can be? I know I do, but unfortunately life and events and other people can knock you off that path. Why are we so ashamed and uncomfortable talking about the help we might need to get us back on the path we want to be on. The path we deserve? The Brain is a most complex organ but like any other organ in the body, sometimes it needs a bit of TLC. If you needed some work doing on any other organ on your body, I bet you would have no problem at all talking about it, giving friends updates, asking for time off from work to recover if necessary, so why do we feel so differently, and not just differently but negatively, about illness with our minds? This attitude is retrogressive and harmful. 

My first experience of the Mental Health Services was when I was 14 years old. My home life was, at times, unbearable and 1 day after school, I decided I had had enough.  My ‘cry for help’ landed me in Hospital for a week but, I presume, that as I was still a minor any NHS intervention had to be agreed by my Father. He did not allow it, refusing Therapy on my behalf, preferring me instead to take medication. I don’t remember the course of pills lasting for long, and there was no follow up from any Medical Professionals, or if there was, I didn't know about it. My Father would never discuss the 'incident' with me but did occasionally refer to it in a dismissive, belittling way to me. This was one of our family's  ‘dark secrets’. I do not blame him for this, he was of a completely different generation, perhaps a generation that brushed emotions under the carpet but I would argue this attitude only exacerbates issues. This attitude of hiding 'Mental Health' issues, not talking, not listening, not being allowed to be open, simply does not work. 

My second experience was in 2010 . I had been in my job for almost 7 years when one day, without warning, I was ‘replaced’ in my role by someone else in the office. My boss never discussed it, and would never discuss why. Had I fucked up at work? Was I just really bad at my job? Had I offended him in some way? I will never know. Any attempt by me to talk about it hit a brick wall. To this day, I don’t understand what happened, and now I couldn't care less but looking back, I was basically ‘Gaslighted’.

Wikiepedia explains:

"Gaslighting is a form of manipulation that seeks to sow seeds of doubt in a targeted individual or in members of a targeted group, hoping to make them question their own memory, perception, and sanity. Using persistent denial, misdirection, contradiction, and lying, it attempts to destabilize the target and delegitimize the target's belief.

Effective gaslighting can be accomplished in several different ways. Sometimes, a person can assert something with such an apparent intensity of conviction that the other person begins to doubt their own perspective. Other times, vigorous and unwavering denial coupled with a display of righteous indignation can accomplish the same task”.

I was not the first employee at that Company who’s life was made so uncomfortable they walked out and I’m sure I wont be the last. After 9 months of the silent treatment I quit. With no job to go to, no rights (in Production I have never had a contract or worked anywhere with an HR Department), no Au Revoir + Good Luck card from my colleagues, just totally broken and confused.  So I went to the Dr and was offered CBT. I had never heard of it before but agreed to give it a try (I have always been very anti medication, no idea why).

CBT (Cognitive Behavorial Therapy) is explained by the NHS as:

CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected and that negative thoughts and feelings can trap you in a vicious cycle.

CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You're shown how to change these negative patterns to improve the way you feel.

Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

What happens during CBT sessions

If CBT is recommended, you'll usually have a session with a therapist once a week or once every two weeks. The course of treatment usually lasts for between five and 20 sessions, with each session lasting 30-60 minutes.During the sessions, you'll work with your therapist to break down your problems into their separate parts – such as your thoughts, physical feelings and actions.

You and your therapist will analyse these areas to work out if they're unrealistic or unhelpful and to determine the effect they have on each other and on you. Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.

After working out what you can change, your therapist will ask you to practise these changes in your daily life and you'll discuss how you got on during the next session.

The eventual aim of therapy is to teach you to apply the skills you've learnt during treatment to your daily life. This should help you manage your problems and stop them having a negative impact on your life – even after your course of treatment finishes.

Pros and cons of CBTCognitive behavioural therapy (CBT) can be as effective as medication in treating some mental health problems, but it may not be successful or suitable for everyone.Some of the advantages of CBT include:·       it may be helpful in cases where medication alone hasn't worked ·       it can be completed in a relatively short period of time compared to other talking therapies ·       the highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books and computer programs ·       it teaches you useful and practical strategies that can be used in everyday life – even after the treatment has finished Some of the disadvantages of CBT to consider include:·       you need to commit yourself to the process to get the most from it – a therapist can help and advise you, but they need your co-operation ·       attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time ·       it may not be suitable for people with more complex mental health needs or learning difficulties – as it requires structured sessions ·       it involves confronting your emotions and anxieties – you may experience initial periods where you're anxious or emotionally uncomfortable ·       it focuses on the individual’s capacity to change themselves (their thoughts, feelings and behaviours) – which doesn't address any wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing Some critics also argue that because CBT only addresses current problems and focuses on specific issues, it doesn't address the possible underlying causes of mental health conditions, such as an unhappy childhood.

My course was at a Hospital in Hackney. It lasted for 6 weeks and I gained so much from it. I turned up to the hospital every Friday morning, filled out a form regarding how I had been feeling that week regarding various everyday tasks (answers based on 0 to 9, 0 being not affected, 9 being most affected) and then logged onto a laptop. I never saw a Dr once, it was all online. Each session, I was presented with different case studies and had to respond to how they made me feel. Based on my answers, someone in the ‘ether’ assessed my answers and decided if I needed a further course. At that point the 6 weeks was enough. I had ultimately removed myself from the environment that had made me ill and started working Freelance.  CBT, definitely helped me to move on and gave me another way to look at the world. I liked the fact that it didn’t dwell on past events, which are often painful to relive, I wasn’t interested in opening up my head and stirring my brain up, talking about long ago events that would never be changed to someone who was being paid by the hour.  At that point and still now, I don't feel that I would gain from that type of Therapy. I wanted to take control back of my life and move forwards. I found it so useful I think it should be taught in schools, if anyone gets offered a course of it, I would urge you to give it a try.  You’d have nothing to lose my giving it a go! It is not a probing, emotional form of Therapy at all. 

Then cut to March this year when I had another metaphorical bomb dropped on me, I recognised the signs that I needed to get help. I had been drawing on my CBT knowledge since 2011 to get me through some huge life events. (Having my baby taken into Special Care, moving out of London after 20 years, family deaths, family near deaths, family nervous breakdowns, the last 5 years have felt like a barage of shit). But by March this year, I was all out of reserves. We have fantastic Medical Care here. If you need to see the Dr, you get seen that day at the surgery. It was not a hard decision for me to make the call (even though I hate going to the Dr) when I thought about my son. He is my Prize in life and I never want to neglect my own health enough that I can not be the Mum he deserves. I know I was lucky to still be in the right frame of mind to think like that as I know some people go beyond that point. He was and will always be my motivation. I am so lucky to have him in my life there was no question I would not force myself to address how I was feeling. It had got to the point that I could just about get him to school most days. My whole body ached, I had chest pains almost constantly, I physically shook, couldn’t sleep and could not stop crying. Throughout all of it, thankfully there was a small part of my logical brain that realised these physical symptoms were my body's way of screaming out that I needed help.  So, I made an appointment.  Since my initial CBT CourseI have this little voice in my head that says “What’s the alternative?”. I really find it useful in hard times to listen to this voice and really consider what ARE the alternatives? People suffering from Depression and Anxiety often Catastrophise (I used to do this all the time) but now I stop my automatic thoughts and question them. 

An example, if you are meeting a friend for a drink after work and they don’t turn up, do you think:

* Oh no! They must have been in an accident that’s why they aren’t here!
* They’ve blown me out on purpose, I knew they didn’t really like me.
* They probably just forgot, never mind, I wanted an early night anyway.

Probably not the best example but I’m trying to show that there are several different responses to the same scenario. What makes your response the right / most probable one? Do you ever question your automatic thought responses? What are these thoughts based on? Previous experience or imagined worse case scenarios? If you don’t question yourself, you should! Your brain is a most magnificent organ but can also be your worst enemy at times. Its not always giving you the right information. You always need to question your thoughts.

So basically, when I asked myself what the alternative was of NOT going to the Dr, I worked through the options and came to the conclusion there wasn’t an alternative. What I believed to be my brains’ ‘plan’ to ignore how I was feeling and just muddle through  (which I had been doing for a few weeks) clearly wasn’t getting me anywhere except deeper and deeper down a road I did not want to go down.

As I said on FB, I was prescribed Citalaopram which I really didn’t want to take. The possible side effects on Google read like a horror story:  drowsiness, insomnia, nausea, weight gain, vivid dreaming, frequent urination, dry mouth, increased sweating, trembling, diarrhea, excessive yawning, severe tinnitus, fatigue, vomiting, cardiac arrhythmia, blood pressure changes, dilated pupils, anxiety, mood swings, headache, and dizziness. Rare side effects include convulsions, hallucinations, severe allergic reactions and photosensitivity.

And then they can take 4 weeks to kick in. But sadly there is no quick fix to a mind that needs some maintenance.

It wasn’t pleasant but I’m so glad I persevered. After 4/5 weeks of trying different doses, a few sleeping pills thrown in for good measure and a lot of fatigue the new battle ready me, emerged. Citalopram was incredible. I knew I didn’t want to be on it long term, but if t got me though our house move that was enough for me. I would never usually recommend anyone to take medication but speaking from my own experience, it was a god send. The medication in conjunction with weekly one to one Therapy has got me out of the fog. I obviously can't say that I will never need to go back to the Dr again as no one knows what cow pats life will throw in your direction but for now, I am feeling happy and hopeful. I have also decided our life needed simplifying. When you are at rock bottom, feeling hopeless and that life is out of control, it focuses the mind on what things in life make you happy and actually, you don't need much to make you happy. The things I know make me happy are:

Being with my son.
Being outside in nature.
Making things.
Working when I can but not all the time and not putting work before my own life.
Being able to provide a happy safe environment for my son.
Being with friends who make me feel good.

And that is pretty much it. A short, unimaginative list. But at this point, its the extent of my ambitions. Anything else is a bonus. Life can be so competitive and fast and I have been sucked down a route in life of things that, on reflection, don't make my life easier or calmer or simpler. But I am only able to think like this now as I asked for help and allowed the treatment to run its course. I have been extremely lucky, the Therapies I have received have been in short bursts, to be at this point now after only 6/7 months is great. Sadly, I know people who's lives have been destroyed by ill health and still we feel we can't be open and honest. I won't ever shy away from talking about this to anyone who wants to listen. Its an important conversation to have and ultimately I want to set a good example for my son. 

So, I've not studied the mind, I've not read much about different Therapies, but this is my experience and it's all been positive. I know when you are in the fog and feel lonely, and scared and can't see a way out, it can be the most terrifying feeling imaginable, and the physical symptoms can be debilitating BUT our wonderful, magnificent NHS does have options. There is always someone you could talk to IF you are able to pick up the phone, or someone to meet you IF you can let people know how you are. Don't be ashamed! You WILL feel better :) 

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