Buzz Brain

It’s been quite a while since I last wrote. I’ve been struggling with a low mood that alternates with periods of “buzz brain”. The low moods make it difficult for me to concentrate enough to read or write. “Buzz brain” is what I am experiencing now. It is when my mind is hyper alert and full of ideas but they are all shouting at the same time. They get a bit jumbled and I find myself trying to act on them all simultaneously.

So earlier my buzz brain looked like this (only more so because each idea has its own subsection of ideas and tasks and thoughts of  “oh, I could….”) :

Collage 2018-04-09 13_59_42

I have recently started to branch out into more visual forms of expression and am making video presentations. It’s an exiting new outlet for me. I try to get it so that the words and images complement each other. I think I am getting a little more competent with every project and I am also getting more ambitious.

I thought I’d share some of the videos I have made. I probably have to put a disclaimer in though because the images I use are “stolen” from the internet.

This is video number 3, and my favourite.

 

This next one was inspired by a discussion I was having about Borderline Personality Disorder. I decided that we need to raise awareness. Hopefully I have presented BPD in a way to provide an alternative to the current assumptions.  (This is video #4)

 

Whilst writing this I have been multi tasking. I get lots of days when I am able to do very little, so maximising the time when my brain is alert is essential. And as I struggle to write down the ideas into an action plan, I feel I have to act on them before they disappear. But often, halfway through one activity another thought forms and I’m off on another tangent…..

 

 

How to be Human

 

I’m learning about Childhood Emotional Neglect. This is when a parent doesn’t encourage their child’s emotional development. Most of the time it is not something that is done by design (I’m sure there may be cases where a parent deliberately inflicts emotional damage but that is something entirely different and the parent is the one who needs help as much as the child). This is something that gets passed through the generations. A child who is not emotionally aware will become a parent who is not emotionally aware and the same fate will be inflicted on each subsequent generation until one person tries to get help and begins to explore their emotions.

I always felt loved but I also always felt something missing and craved love. Which confused me and made me feel ungrateful and needy. I still need constant approval and affirmation from others. I still think the end of the world has arrived if I make a mistake. I get stuck with the belief that I can’t do anything. And if I am praised for something I am disheartened because I believe that next time I’ll let everyone down. So I don’t like being complimented and I also don’t like being criticised.

Mine is a world where two opposing ideas live side by side on a daily basis.

I got physical affection from my parents and all my needs were catered for. What was lacking was my WANTS. To some this may sound a bit greedy, but I assure you it’s not. Ambition is driven by wants. Achieving your ambitions can create a healthier, safer world for your family. But ambition dies if you are constantly told as a child that you can’t do something, or that people like us don’t do that sort of thing. Encouragement to follow your dreams costs nothing. There is no harm in trying but failing. Failing is an essential part of the learning process. It teaches us about ourselves, it shows us what skills we already have and what skills can be improved on. It also shows us which skills we will never master.

My wants were denied. Not all the time but often enough for me to learn that wanting is a luxury. I can remember being told “no you don’t” when I wanted something. So that particular want became a huge yearning. A better response would have been to acknowledge my wish but explain that it’s not possible because….. I think this is the reason why I didn’t like writing to Father Christmas. I think I was scared to write anything because I never knew whether or not I’d be allowed to have it. If I didn’t want anything I couldn’t be disappointed when it didn’t arrive.

The power of words. They can be used in such a positive way but my childhood was filled with negativity. I was told that I would never be able to live on my own. So I stayed with my parents till I was 30. The self-reliance skills were neglected. Everything was done for me – my mother bathed me till I was about 10. She decided on my hair style. I wanted long hair but got short and when I did grow it she was always commenting on how long it was in a tone of voice that signalled disapproval. Now it’s practically down to my waist and I can’t decide if it’s because I like it this way or if this is an act of silent rebellion.

It’s also the subtleties and nuances that go with the words that have damaged me. The unspoken disappointment causing confusion because the words, tone of voice, expressions and behaviour of my parents all said something different. One simple sentence could have a wealth of meaning.

Humans are instinctive creatures. We are born with a set of values which will guide us through life. But these instincts need to be valued, cared for and developed. The strange feeling that something isn’t quite right is in all of us. But some of us haven’t been encouraged to listen to this and use it correctly. I know this from experience.

Emotional development is as important to a child as physical development. With the right emotional grounding a child will have the tools required to be a parent, they will know about social etiquette and how to treat others. They will have a sense of self and will be able to make informed decisions.

There are a number of reasons a person can suffer from mental illness. Usually it is a mixture of genetics, predisposition, upbringing, life experiences, trauma, health, environment, I’m sure there are more. My belief is that a better understanding of our emotions will help to ensure that children of the future are better equipped for negotiating life. My vision is that depression is one of the diseases that will be consigned to history just as Smallpox has been.

 

 

On Music and the Middle of the Night

What is it about the middle of the night and music? For me they seem to be triggers.

I always seem to be most awake around midnight. It seems to be when I am most creative and most able to focus. I have worked from home till the early hours on many occasions and I seem to do my best thinking and writing when I should be in bed.

The music trigger is linked with lost love. When I am broken-hearted anything sad sets me off. But in the last 18 months it has gone way beyond feeling a little sad at a beautiful melody or poignant words. And another recent discovery is that the music I love is sometimes unbearable to listen to. I seem to be extra sensitive to noise.

Tuesday 30th January was the first anniversary of my mother’s death. I got through the day without feeling sad, it was just a normal day. Then late at night I decided it was too quiet and put some music on. I have different playlists for different moods. I have a “Calm” playlist for my sensitive moments, a “Romantic” playlist for the songs that make me cry, and an “Upbeat” playlist with happy and up tempo music. On the night in question I put the Calm playlist on shuffle. A couple of songs in I started to feel sad. It was when the tears and the strange feeling in the pit of my stomach started that I turned the music off. I think I might have been listening to this:

Whatever it was, it was too much for me. But turning the music off was just the start. I tried to compose myself, but the feeling inside grew and the tears flowed. And then I realised what was happening. The last time I had spoken to my ex boyfriend was a couple of days before my mum’s funeral. I was having a meltdown moment and knowing that it was a bad idea to phone him didn’t make any difference. That particular meltdown resulted in me self harming.

So this time, once I had made the connection I started to get scared. I didn’t feel the urge to DO anything, but experience has taught me that this feeling is one that is so overwhelming that my usual “I don’t like this feeling” remedies (distraction or sleep) don’t work.

The only other option was to talk to someone. This is the hardest thing for me to do. I have a “truth” which says that other people don’t want to know about my problems. I know this to be a lie, yet I still believe it. It was the middle of the night so the only thing I could think of was to write a post in an online support group. I agonised over whether it was the right thing to do and did it need a trigger warning, the reasons not to do it were piling up. But I wrote it. I clearly stated that I wasn’t going to self harm but the immediate response was “don’t do it!”

After I had assured everyone that I wasn’t in danger, just scared, the advice was to phone a help line. My response to that was “but I don’t know what to say!”. Eventually everyone convinced me to make the call so I phoned the Samaritans. And I’m so glad I did. The man on the other end of the phone talked me through what was happening, it was virtually a free therapy session. He kept me talking until he could hear that I had calmed down.  I was able to sleep.

It’s taken me a few days to get over my meltdown. The following day involved a lot of time in bed and it took a while for my brain to fire on all cylinders. This is what happens. Meltdowns are exhausting.

But next time I feel scared I know what to do.

 

Why I am unable to work

Anxiety makes it difficult for me to perform simple tasks. It is happening now because I am worried about the letter. I am finding it difficult to focus and concentrate, which in a work environment are key skills. When I am at home writing blogs or doing research I am able to stop and watch tv or go for a nap. I am able to switch off. This is not an option in a busy office.

 


2 hours later

The television has worked its magic. My mind is clear and my thoughts unjumbled. My creative juices are flowing again.

I have resolved not to edit the first paragraph as it was written in a moment where I was not at my best. I want it to stand as a reminder of what I am able to achieve. Reading it now, it’s not too bad. It is coherent and grammatically correct, but what is different is the feeling inside. It is difficult to explain. It is the like the difference between sailing on rough seas and sailing in calm waters. In rough seas you manage, you survive. You do what is necessary to bring you to shore but it is a constant battle between the elements and your own inner strength. In calm waters the boat practically steers itself. There is very little effort involved and the journey is filled with joy. (Ha, now I’m starting to worry about my sailing analogy.  But this worry is not like earlier, it is just a momentary thought rather than the all encompassing anguish of two hours ago.)

And this is the reason why I am unable to work. Yes, I can survive the rough seas and the work I produce during those times is acceptable. But the toll it takes on my mind and my body builds up over time until there is nothing left. I start to drown. This is a process which is endlessly repeated. The drowning man comes back to life and lives again. But inevitably the rough sees return, the boat sinks….

I worked for over 20 years. I don’t recall the total amount of weeks and months I spent at home, ill with depression. And the times I worked from home because I couldn’t face going in. At home I did actually work, but I was able to pace myself a little more effectively. At home it didn’t matter if I was still in my pyjamas and if I needed a couple of hours to revitalise myself I would make up for it in the evenings. This would have been a perfect solution but my job was office based – meetings had been scheduled, help from colleagues was needed, documents needed to be printed and signed. There was always a reason for me being there.

The letter I received from the Job Centre, the reason for my anxiety, tells me that one of my benefits will end in February. I will still have my PIP, but my income is being cut by about 50%. I have savings, I own my own home, I am nowhere near destitute. My family will step in if need be. So what am I worrying about? Are my concerns justified?

I don’t think I really know. At times I am able to accept the situation, it is the way of the world, it is as it should be. Then there are times when I feel a sense of injustice. Earlier today these contrary thoughts were raging simultaneously in my head. This is the curse of being able to see things from other peoples perspectives. It leaves me confused and lost.

My solution is to see if I am eligible for other benefits. This might help in the short term. The long term solution is less clear. I do not feel ready to return to work. The idea horrifies me. It isn’t that I can’t apply myself, I am able to do “work” on behalf of CMHS.  But the key point is that CMHS is my hobby. I choose when and how I devote my time to it. If there is a job out there that allows you to do as you wish and turn up whenever it is convenient, I’ll take it. Sadly I think that the person paying my wages would want a little more from me.

Citizens Advice has a page with information on benefits which may help if you are in a similar situation: www.citizensadvice.org.uk/benefits/

I enjoyed Christmas Day. Is that wrong?

My mother died in January. This was the first Christmas without her. And I enjoyed myself. I felt a wee bit guilty afterwards, so this article can be my self therapy. A way to tell myself that I am allowed to have fun.

Since my mother’s death I have found out a lot about myself and my family. I am accepting the fact that as children my sister and I lived in an atmosphere of control which continues to influence our lives. Together we are working through our past to understand our thoughts and behaviours and to change them. We are making progress.

This could not have happened, for me anyway, whilst my mother was alive. I remember that whenever I met a new therapist or psychiatrist I would be asked about my parents. My response was always that my family life was a loving and happy one. The only concession I would make would be to say that my parents were a little overprotective, but under the circumstances it was understandable. End of conversation.

And I believed it.

Until my mother died. By this time I had already repaired the fractured relationship with my sister. We had spoken about our childhood and things which had been said and done, and though my brain believed, understood and agreed, my heart always sided with my mother. I found excuses for her behaviour, but towards the end of her life these excuses were more difficult to hold on to.

My childhood beliefs, put there by my parents and which I am beginning to challenge, include:

Only perfect is good enough (and even then there’s something slightly wrong and it isn’t perfect after all)

There is only one way to do things, anything else is wrong

I am different

I am not important

I am not capable – of anything

I am responsible for other people (their feelings, behaviour, words, everything)

I am not likeable/loveable

I am not allowed to tell people my problems, because they won’t be interested/won’t want to be my friend

There are more, but you get the picture.

This is how Christmas used to be. A few weeks before Christmas my mother would tell me that I was invited to my sister’s for Christmas. My sister and I were estranged and communicated through my mother. I would send my acceptance in the same way.

Christmas Day would be, not awful, but moments of joy interspersed with moments of awkwardness and anxiety. And thoughts of “when can we go home?”. Drinking didn’t help me either. I would be on my best behaviour, a don’t show myself up in front of the family mindset. My alcoholic brain would be saying more, more, I need more. My anxious side was agreeing with this sentiment, get drunk so that nothing will matter any more. But I was fighting these feelings and trying to moderate my alcohol intake – it’s too soon to have another glass of wine, it’s not polite. It will look bad, mum will get upset. It was uncomfortable. And since my sobriety everything was the same except for the alcohol battle. This was replaced with trips to the garden to smoke. Which were similarly disapproved of. I still felt shameful.

This year was different. My sister and I discussed the arrangements together. I offered to supply the crackers and the chocolates. We agreed that Dad and I would get a taxi to her house and back home again. Which I arranged. (My dad’s driving is his lifeline, but I know that he struggles with it, even if he doesn’t acknowledge this himself). This also made things easier for my sister. She was concerned about having the family over and all the stresses that entails for her, so having a fixed time for us to leave made her feel more comfortable.

Christmas Eve was a late night for me. I was up till 2am finishing presents. Christmas morning I dragged myself out of bed, had a shower (I couldn’t justify not doing so, however hard I tried) and got ready. I was at my fathers house half an hour before the taxi was due. The taxi arrived early and the driver helped me load the presents in the boot. Once dad was ready we set off. And the taxi driver was so lovely. He was helpful and he knew where he was going and how to get there (believe me, this isn’t always the case). He also helped with the presents at our destination.

A little side note here. My father is hard of hearing. One to one conversations are generally not too bad, although if he can’t understand what I’m saying he sometimes says random things like “why are you talking about bananas?”. I wasn’t. In a group of people he finds it even harder to follow the conversation. He has a hearing aid for each ear, but doesn’t like to wear them because he says that the background noise is annoying. I could have suggested that he take his hearing aids, but based on previous experience this would most likely have produced an annoyed grumble which could have spoiled the whole day. So I didn’t, and the result was that he didn’t interact with us much. I feel a bit bad about this but he knows where they are and is capable of making his own decisions…..?

Where was I? Oh yes, at my sister’s house. The day was lovely because everybody was relaxed and happy. There was no tension, no doing what is expected of you. It was perfect because we weren’t trying to make it perfect.

Everyone helped my sister with the cooking (this is not normal) and my sister enjoyed her dinner (I don’t remember this happening before). And the best bit? The crackers. Inside each cracker was a wind up Santa. There was a board with starting positions and the aim was to release all the wound up Santas at the same time and see which one reached the North Pole first. It was hilarious!! Some of the Santas went everywhere but the North Pole, and the ones that did reach their destination carried on walking away from it. My sister and I were laughing hysterically.

 

If someone else were to tell me that they were worried because they had enjoyed their first Christmas after the loss of a loved one, I would say, “but you are allowed to enjoy yourself. It doesn’t mean that you are not sorry your loved one is not there”. Telling this to myself is hard. I know it is true but I have trouble believing it in my heart.

One day……

 

 

Why is my face a strange colour?

Hello.

Last night I noticed something about myself which intrigued me and I want to share my discovery. I have to warn you that the contents of this piece are quite dark and possibly a little disturbing.

My therapist spent years trying to get me to recognise my thoughts and emotions. When I first started seeing her I could tell her that I wasn’t feeling good, but I couldn’t tell her exactly how I felt or why. I can now recognise thoughts and feelings most of the time. Sometimes I am able to do this by myself and sometimes it takes a conversation with another person. This for me is a huge step forward.

I have now been able to identify 2 different states.

The first is where I am reacting to an event. An example of this happened a few days ago. I was feeling low but had arranged to go to the cinema with my sister. We watched the film (Paddington 2) which was funny and wonderful and sad and just plain brilliant. I was happy. Then my sister told me about a letter she had received, had I received one too, what did I think? My first thought was along the lines of “oh, it’s all my fault, what have I done?”. Over the next few minutes as my brain went into overdrive my demeanour changed to confused and scared. This is what is called catastrophising. My sister helped me to identify my feelings and after about an hour I was calmer.

The second state is what happened last night. And this is what is particularly troubling me.

During the day I had been feeling ok. I can’t say normal, because I don’t think I have a normal. But there were no overwhelming emotions, I don’t remember feeling particularly anxious. I was getting on with my day. But when I caught myself in the mirror my face looked a little scary. It is something I have seen before. My cheeks look sunken and my skin looks blue, especially around the cheekbones. My mother sometimes used to comment on my looking grey. Which I found particularly annoying because I would be feeling fine. Sometimes when she said this I was actually feeling quite alive and happy.

So yesterday I found that my face looked unwell but my mood didn’t reflect this.

Then in the evening I experienced an overwhelming sadness. It appeared to come from nowhere. And it was extreme.  It was after the feeling of desperation had overtaken me that I started to think sad thoughts. It was as if my brain said to itself, you’re feeling sad for no reason so I had better give you a reason. Which is weird, but I swear it is how it seemed to happen.

I felt as if I couldn’t live anymore. Life was too painful. For me, this happens frequently. Sometimes I feel driven to harm myself. Over the last few months (since February) I have succeeded in not acting on these thoughts. But last night I didn’t want to do anything, there was no urge. I just wanted to not be.

I managed to sit with these thoughts and feelings raging through me. It felt as if they were controlling me instead of me controlling them. I felt powerless and desperate and….. it is difficult to explain exactly how I felt.

I managed to distract myself and begin to calm down a little. It was when I was calm that my body temperature dropped. I was so cold. This often happens after an episode.

I feel the need to exhaust myself when I have had this type of experience. This involves staying awake for far too long, till I’m nearly dropping with tiredness. If I’m not completely exhausted by the time I go to bed the thoughts come back and I start sobbing uncontrollably all over again. Finally, I fell asleep. This exhausted sleep is never restful. It is filled with strange, troubling dreams and I awake hours later nearly as exhausted as I was when I fell asleep. Then I have a day of feeling numb and lifeless. Another spell in bed is often necessary, but this too can sometimes be overshadowed by strange dreams.

My question is, is this a phenomenon that other people experience? Having a strange coloured face and feeling sad for no apparent reason? Or is this an extension of not being able to recognise the thoughts that go through my head? Are they locked away so deep within my unconscious that I don’t know they’re there? Or is it some sort of chemical imbalance?

Yes, I know, that’s a lot of questions!

 

 

Me, Work and Mental Illness

BBC article – How mental health costs up to 300,000 jobs a year

I tried to do some research of my own, this proved quite difficult. So here is a report I found which had already done it for me! thriving-at-work-stevenson-farmer-review.pdf

This report mentions Aviva as having a support strategy in place. I would also like to add Unilever to that list.

My work life is littered with breakdowns, sackings and extremes of brilliance versus ineptitude. I realise that by posting this publicly I am shooting myself in the foot if I ever decide to go back to work, as my official CV glosses over the real reasons for changing jobs. But isn’t that just a reflection of the fear and stigma of owning up to being mentally unwell, and shouldn’t this be challenged?

After leaving school I went to college. I wanted to work with children and started a Nursery Nursing Examinations Board course. This involved spending a term at a local Primary pre School for the 4-5 year olds. I was an assistant to the teachers and got involved in the daily lives of the children. I loved it. But it didn’t like me. It involved a lot of creativity – having to plan and help with art projects. I love art but looking at it and trying to create it are not the same thing. Also, I wasn’t eating properly. I think at that time breakfast didn’t happen, lunch was an apple, and dinner was the least I could get away with eating in front of my parents. I don’t know why everything went wrong but it was probably something to do with the lack of food exacerbating my depression which combined to affect my concentration and performance.

So I found a job. It was local and my mother would drop me off in the car on her way to work. I was eating even less at this point and I remember one morning when I really didn’t want to go to work. Mum dropped me off, I waved goodbye to her and as soon as she was out of sight I went for a very long walk. There was no phone call from me to say that I wasn’t going in because at that time I didn’t understand what was happening and my eating disorder made it normal for me to hide the truth. The company I worked for put up with me for a year or two, but poor performance eventually lead to my dismissal. This is probably a direct result of weighing about 6 stone and being depressed. My brain was unable to function properly and I had memory problems and made frequent mistakes.

Then my mum got me a job at the company she worked for. She had worked there ever since I was 4 or 5 and I had visited her at work a few times during the school holidays. I already knew some of the people who worked there. They needed holiday cover for about 6 months. I was there 5 years. This was a job I excelled at, but I made it very difficult for myself. My drinking and sexuality “flourished” in this period. I was working in a family run business which employed about 100 people, 85% of them men. I knew everybody who worked there and they all knew me. Some better than others if you get my drift. Christmas parties were all day drinkfests until the pubs wouldn’t accommodate us any more. Then we just caused havoc in a local football club instead. I have memories of anxiety and over confidence at this time. To get to the ladies loo you had to walk through the shop floor. Sometimes this caused me huge anxiety. But at the same time I was flirting and bantering with everyone. One of my contradictory phases I think.

Possibly because of my mum’s relationships with the directors of the company, my absences due to depression and hospitalisation weren’t an issue. Until I got a new boss. I don’t entirely understand this, but I didn’t like my new boss. I’m usually a very easygoing, accepting person, someone who is not quick to judge. But there was something about this woman who rubbed me up the wrong way from the start. Then I needed time off for medical reasons. Whenever you were absent from work due to sickness you had to complete a form stating the medical reason for your absence. I didn’t want people to know, so I decided to ask for a day’s holiday. I thought that no one would ask questions that way. But my boss refused to let me take holiday that day and I didn’t understand why. I can’t remember how it got resolved, but I attended my medical appointment on a Friday and was back to work on Monday. I probably shouldn’t have been because I remember being in pain until the following day, but I soldiered on.

On the Wednesday I felt a lot better. And that is the day I had a huge argument with my boss. I had gone ahead with something without allowing her to check it first (maybe this was what troubled me about her, she didn’t trust me to be able to do things on my own?). I flipped massively. I made a huge fuss and said I didn’t want to work with her and I left. There and then, I went for a walk to calm myself (didn’t work).

I got myself another job. There was a similar pattern of mostly good work interspersed with weird, inept moments. A similar pattern of depression and drinking. I was made redundant, which I think is the only true reason for leaving on my CV. Another job followed, this time in the film industry. I was working in a support service in a film studio complex and loved it. I got an insight in to the world of film and we visited a couple of film sets. The team I worked with was small and very supportive. It was like a little family. Then one of my clients head hunted me. This was my opportunity to combine work and pleasure and get paid huge amounts of money. The film industry then was a closed, uncertain, stressful world. It was mostly about who you knew, and each project lasted a matter of months. I don’t think I thought about the between projects moments. My first film job was for a BBC production. I got on well with my new boss and we went on set a couple of times. I met the cast and crew. I was working hard but having a great time. Then we moved on to a Hollywood film which was being shot on location in England. I joined at the pre-production stage. The work was manageable to start with, but as the production moved forward I was asked to do more and more. I was under quite a lot of pressure and responsibility. I would start at 8am (I still don’t know how I did this, as getting out of bed in the morning is not one of strong points) and a 12 hour day was the norm. Then I would go home, get drunk, go to sleep and turn up at 8am the next day.

Then one Wednesday I arrived at my desk and burst in to tears. The pile of paperwork had grown overnight and I crumbled. Massively and publicly. The nature of the industry being driven by time schedules and money, there wasn’t the option for me to take a couple of weeks to recover, so that was the end of my dream job.

It hit me hard. I remember feeling broken for months. I would stare in to space for hours, I had the shakes and I felt constantly nauseous. I withdrew into myself and communication was difficult.

I was conscious that I needed to work. I had just moved house and bills needed to be paid. I had lived for a while on my savings, but knew they wouldn’t last for ever. So I got another job. It lasted a week. I wasn’t really ready to go back to work. I remember not really knowing what to do. I would look at the paperwork in front of me and it just looked like gobbledygook. Sacked again. Then I started temping. This was easier. Every couple of weeks I would have a new challenge and I was never in one place long enough to allow them to see my true self. I worked, got praised and moved on.

So now we come to Unilever. It started as another temporary role. I stayed 10 years. I think I was made permanent after about a month.

William Hesketh Lever started a soap factory in Warrington in the late 1880s. He was a forward thinking employer, he built a small village for his workers and was interested in their welfare. Now a multi national company, its emphasis on employee welfare has continued.

We had an on site nurse. Once a month I had to work in a small room with a very noisy, temperamental machine. We were given earplugs and all trooped down to the nurse for a hearing test. I became a regular visitor, but for other reasons.

I don’t remember exactly how my visits to the nurse started, I think I was told to go and see her. There was a redundancy scare. I reacted badly and found myself becoming ill and taking more and more time off. The nurse referred me to the company Doctor, who I also got to know quite well, and I was also referred for Cognitive Behaviour Therapy. All of these appointments were office based, I’d just go downstairs to the Occupational Health Department and then go straight back to work. I think this is the best thing that had ever happened to me. Over the years I had seen various counsellors, psychotherapists and psychiatrists, but it was sporadic. I would decide that I didn’t want to see them any more because it was too upsetting and I would be tearful and low for a few days.

But with Unilever it was different. Some of the sessions were still quite painful, but I had developed positive relationships with the whole team. I don’t know why this worked when everything else hadn’t, perhaps it was the support network and the understanding of my line managers. Maybe the ease of access had something to do with it.

I was also encouraged to use my private healthcare for psychiatry treatment. I had a whole team of people helping me to understand myself and create a way of living that worked for me. And at the same time I was working hard and creating a good impression. My psychiatrist decided that I had an alcohol problem. I don’t know how he reached this conclusion because I don’t remember ever discussing my alcohol intake with him. He suggested I go for treatment. No thanks.

But the idea stayed with me. I carried on drinking and after a series of alcohol related injuries I decided that perhaps I did have a problem after all. My psychiatrist arranged for me to be a patient at a well renowned private hospital and Unilever backed me all the way. In the end I was in hospital for 5 weeks and Unilever agreed to fund me through private healthcare for the extra week. Then there was about a month where I was on day release, a few days at hospital as an outpatient with a staggered return to work.

That was 2008 and they got 5 more years out of me. In that time I continued with CBT, continued with private psychiatry and continued to be supported and understood at work. My colleagues accepted me for what I was. Having been a party animal one minute and then coming back to work sober was hard to ignore. And my absences for medical appointments together with some of my mood swings and physical appearance were all too apparent. But I was accepted and supported by everybody. Even new colleagues who weren’t aware of my history were aware that I suffered from depression, but it never held me back in the workplace.

Then in 2013 a family event triggered an attack of anxiety. Taking time off work for my depression/bipolar/Borderline Personality Disorder (diagnoses changed from time to time) was nothing new. But this was different. I was unable to contemplate ever going back to work, and a couple of weeks became a couple of months, became a year. All this time Unilever were supporting me, for a lot of the time they were still paying me, and we had regular meetings to try to find a way to get me back to work. They never gave up on me. But I made a decision. I was feeling guilty that they were putting all this effort in for me and I was still feeling scared about the prospect of returning to work. So I was honest with them and the result was termination of employment on mutual grounds.

So now, here I am today. I still have no desire to work, I don’t think I could. Yes, I have moments of productivity, but they are interspersed with naps during the day and periods of low mood. I am able to be productive at my own pace. There are no deadlines or responsibilities and the only pressure is that which I inflict upon myself. This piece has evolved over 2 days. Yesterday was particularly difficult as there were a few moments of emotional overload. And I’m thinking that maybe once this has been published I might go for a little nap. I get drained quite quickly.

Writing this has shown me that a supportive work environment makes a huge difference. It didn’t cure my depression but it provided me with the tools to be able to cope. People with mental illness are driven, creative people. They just need an environment where they are allowed to flourish.


If you would like your employer to create a supportive workplace, here are some tools to help you convince them to sign the Time to Change Employer Pledge.

Health Committee One-off session with the Secretary of State

Link to video of debate

Yesterday the Health Committee met with the Secretary of State, Jeremy Hunt. I watched the broadcast and made comments on the Facebook page about my initial impressions. Here you will find a summary of the items related to mental health. It is not intended to be a word for word account but I have attempted to keep the context of the questions and responses. There are a few links in this piece to documents of interest.

To start, below are the members of the committee:

Health Committee

Dr Sarah Wollaston was elected as Chair of the Health Committee on Wednesday 12 July 2017.

The remaining members of the Committee were formally appointed on Monday 11 September 2017.

Member Party
Dr Sarah Wollaston (Chair) Conservative
Luciana Berger Labour (Co-op)
Mr Ben Bradshaw Labour
Dr Lisa Cameron Scottish National Party
Rosie Cooper Labour
Dr Caroline Johnson Conservative
Diana Johnson Labour
Johnny Mercer Conservative
Andrew Selous Conservative
Maggie Throup Conservative
Dr Paul Williams Labour

Overall I found it to be an interesting and constructive meeting. I sensed a few areas where Jeremy Hunt seemed uncomfortable and defensive, but I generally got quite a good impression of him.

To help with some of the acronyms used:

JH = Jeremy Hunt

CQC = Care Quality Commission

CCG = Clinical Commissioning Group

NICE = National Institute for Health and Care Excellence

The mental health questions start about an hour into the video:

Questions from Luciana Berger

Luciana Berger
Luciana Berger

Q According to NHS Workforce statistics there are 5,168 fewer Mental Health nurses and 106 more doctors. In a recent interview JH quoted 4,000 more people.

Response

There are 4,300 more people working in NHS Trusts than 2010 and 2,700 people in Talking Therapies

Q Who are these people?

Response

There is a whole range of skill sets involved in an NHS Mental Health Trust. The reduction of nursing staff is a consequence of the Francis inquiry into Mid Staffs. Nurses were put in to hospitals which had a direct impact on mental health nursing. But the NHS are treating 120,000 more people every year than 3 years ago which equals 1,400 more every day. There has also been an expansion in therapies.

{Later on in the meeting the Chair requested details about the extra mental health staff and the talking therapies}

Q Why are we seeing an increase in children and adults presenting at A&E in mental health crisis. There is a 47% increase in people being detained under the Mental Health Act

Response

Professor Sir Simon Wessely has been asked to review the Mental Health Act, how it works and whether it needs to be changed. {A copy of the details of the independent review can be found here.}

The Health and Social Care Act 2012 legislation regarding Parity of Esteem between physical and mental health requires that a mental health crisis is dealt with as seriously and quickly as that of a physical health crisis. The NHS are rolling out crisis care including liaison psychiatry across the country. Currently half of the total A&E departments have mental health liaison services. This is part of the Core 24 Standards.

Q Why are so many people are turning up to A&E in crisis who are often having to be detained, instead of being dealt with prior to this through prevention or community services

Response

There is a core responsibility to deal with both crisis and prevention. Resources are being put in to place to deal with preventing crisis

Q CQC reports have highlighted many issues at all stages of accessing mental health care. In regard to resources JH has been quoted as saying that there has been an increase in resources by spending over half a billion pounds more on mental health this year. Why is it that many trusts, including Liverpool, are cutting mental health services

Response

Mental health spending is up 1.4 billion in the last 3 years. Last year out of 209 CCGs 177 spent their mental health target and 32 did not. There are discussions going on with those that did not. The overall impact was that an extra half a billion pounds was spent last year.

Q Money comes in to the trust but there is nothing to hold them to account to make sure it reaches the front line. There is not a requirement for every CCG to meet the required investment.

Response

Last years CCG funding went up. There are ongoing discussions to sort out issues. There has been overall expansions but there are still problems.

Q Locked mental health rehabilitation wards. There are 3,500 patients across the country in 248 wards. The majority are in private hospitals. The CQC report has questioned this model of care

Response

There is a concern about people being locked away in expensive high dependency settings for longer than necessary. If they are far from home they may be forgotten about. JH has had a meeting with officials who are coming up with a recommendation. As an example of good practice, JH quoted that Sheffield have eliminated their dependency on locked rehabilitation by providing better community care.

Questions from Dr Lisa Cameron

Dr Lisa Cameron
Dr Lisa Cameron

Pathway of care from child to adult services. The transition is often fragmented and difficult to streamline. Are you making progress?

Response

This is an area we need to improve. We have a children and young people mental health Green Paper coming out.

Q Access to psychological therapies. How are you monitoring time logged as being access to treatment?

Response

The target is for treatment to start within 18 weeks. This has just started to be measured. Demand is increasing and there is also the implementation of the Mental Health Forward View.

Q Target monitoring and parity of definition

Response

JH will write a detailed response

Q Mental Health in older adults. In the transition from health to social care it is important that psychological issues are addressed. Especially around depression and loneliness in older adults,

Response

This is an important issue which is not always given the importance it deserves. 40% of older people in care homes suffer from depression or anxiety compared to 20% of the older population as a whole. Sometimes mental health needs are clouded by physical health needs. The NHS are planning an expansion in the capacity of psychological therapies in order to meet these needs.

Questions from Dr Paul Williams

Dr Paul Williams
Dr Paul Williams

Q Waiting times for Autism diagnosis in children. NICE guidelines state that a multi agency assessment of a child with suspected Autism should start within 3 months. In some parts of the country families are waiting for up to 4 years. Will you consider a Waiting Time Target for Autism assessment. Diagnosis requires health services to work in partnership with Local Authorities. What can be done.

Response

We need to do better. JH will look in to this and will discuss the issues with the NHS

Follow up question from Dr Lisa Cameron

Q Do you have a map of how many clinicians are trained to diagnose autism and where there are gaps?

Response

JH will find out


The next item to be shown on Parliament TV that I am interested in is on 3 November 2017 when the second reading of the Mental Health Units (Use of Force) Bill will be presented in the House of Commons.
A video link will be available on our Facebook page from 9.25 am.

 

 

 

Report of the House of Lords Committee on the Long-term Sustainability of the NHS 24 October 2017

Committee Video

As promised, here is a summary of the Long Term Sustainability of the NHS committee meeting.

Having only ever seen Prime Ministers Questions on the news, the prospect of watching a debate was not very appealing. The idea of watching people talking over each other and cajoling and being unruly isn’t my idea of fun, but I actually enjoyed watching most of it (there was a point where my attention wandered and I wasn’t following everything they were saying). The committee was made up of health professionals who were either current or previous NHS employees as well as GPs and surgeons. There were also members of the House of Lords who had medical connections. They were all very agreeable, listened to each other and actually answered questions appropriately!

Here is the background to the report.

The meeting lasted about 2 hours and I have summarised the points I found interesting and relevant. The timings I have used are approximate as I was stopping and starting the footage to write notes.

14.35 – Summary of report

The authors of the report summarised their findings by saying that all sectors of the NHS worked in a culture where only the short-term was considered – a sort of fire fighting the immediate problems. The only long-term thinking is the 5 Year Forward Plan. Here is a link to a document about the plan. Health Education England were attempting to plan longer term but were thwarted by clashes with other ministerial objectives.

The recommendation was that the 5 year plan was not sufficient.

The Government have not yet responded to the report. The reasons given were that the Election got in the way and there was an email from the Department of Health saying that a response will be given after the Budget.

 

14.40

They discussed the recommendation to set up an Office for Health and Care Sustainability which would look 15-20 years ahead. It would be an Independent Advisory Body which would produce evidence in data form. As this would be an independent body the public would have more confidence in its findings. The lack of long-term planning was partially because Health Ministers change quite frequently and therefore do not have the motivation to think to the future. Therefore an independent agency would be more effective as it would be non political. The body would focus on:

  1. Demographic population changes which might affect health
  2. Requirement for workforce planning
  3. Prevention

14.50

They discussed forward thinking about workforce needs. Regarding the length of time it takes to train doctors and nurses it was deemed necessary to plan ahead for what sort of skills would be needed in the future.

14.55

They discussed the role of GPs, the need for integration between Primary, Secondary and Social care and the need for change in working practices.

15.13

Current Regulation is a barrier to workforce reform and workforce planning. They discussed the need for existing staff to receive on the job training to keep up with new ideas and practices.

This part surprised me as I know a Physiotherapist who works in the Private sector. She goes for regular retraining sessions which I believe is a requirement for membership of the society.

15.17

A question was asked about the effect of Brexit on staffing levels. Figures were given about how many EU and non EU staff the NHS employs. It was agreed that the culture of relying on other countries to provide staff is wrong. An example was given that hiring staff from developing countries adversely affects their country of birth as it deprives them of medical staff which they desperately need.

Retention of staff, career structures and low morale amongst staff were also discussed and the report puts forward that these issues need to be addressed.

15.24

The training issue was broached again with two examples:

  1. A Mental Health nurse not being able to treat a wound
  2. A general nurse not being able to treat mental health patients

The conclusion was that the initial training of all staff should include basic training in disciplines other than those being specialised in

15.40 Funding

This is where I zoned out a bit, but I did understand that the current situation is that the funding of social care is with Local Government but Social Care Policy sits with the Department of Health. It was suggested that the two be brought together.

They also discussed a proposal for a Social Insurance system which would provide personal funding to be spent on social care when needed. Japan and Germany already have such a scheme in place.

16.20 Public health prevention

There is currently no central strategy for keeping people healthy. The UK is 2nd in the world league table for obesity behind the USA. It was noted that preventable diseases cost the health service a lot of money in care that could be used for other people

16.25

There was a brief discussion on a prevention strategy for mental health. It was noted that the idea that mental health being equal to physical health still had a long way to go.

The topic of Mental Health funding will be discussed on 21st November. 

16.33 Patient responsibility

The report also dealt with patient responsibility. This ties in with the area of prevention and it was deemed necessary that a mixture of Government Regulation and effective education could help to keep people healthier for longer.

I will watch out for any other items of interest, especially the Mental Health Funding discussion in November.

 

 

 

 

 

 

 

Shyness

I was incredibly shy as a child. But when I talk to strangers I have no problem communicating. This got me thinking. Does my childhood shyness have a link with my adult anxiety?

I found this article on shyness and I think I have come to the conclusion that shyness in a child could lead to problems in later life.

The article says that shyness can lead to:

  • Substance abuse
  • Damaging relationships
  • Difficulty attaining goals
  • Anxiety and depression

I can say yes to all of these.

I am a recovering alcoholic, have used drugs in the past, have a history of food disorders and can get easily addicted to just about anything, including writing blogs.

I have relationships with abusive people, people who are damaged in some way. I find relationships with “normal” steady, caring people difficult to maintain

I agree with the difficulty attaining goals issue, but only after having read the explanation. Withholding ideas and opinions and letting others take credit for any I might have is a definite yes. If I am congratulated on doing something well I will often offer up the fact that another person helped me and it was a joint effort. And I know I have anger issues. I know that I don’t always know how to express anger or annoyance and can sometimes appear to behave like a small child.

I can also agree with the causes of shyness:

  • A parent or guardian who is over critical
  • Over protective parenting
  • Traumatic life experiences

I had over protective, critical parents. I believe they were over protective because of my illness as a child (traumatic life event).

I mentioned in a previous blog that as a child I was instructed in what to do and say and what not to do and say. I was told I didn’t want things that I thought I wanted. It was all a bit confusing. But I have recently remembered something else. If I went to see a friend, when I got home my mother would ask all sorts of questions about the family and what they were up to. I could only ever answer “I don’t know, I didn’t ask”. It continued into adulthood. If I spoke to my mum and said that I had met a friend recently she would ask lots of questions. I had usually been talking about the things my friend and I were interested in so I was still unable to answer. I realise that this made me feel as if I had failed in some way. And I suppose that somewhere in my unconscious I was nervous about what I should say to people. Because I didn’t want to let my mum down but I invariably did.

In my anxiety blog I went in to detail about my childhood illness and the physical and emotional fallout that resulted. I believe this is why my parents were a little over protective. They would tell me that I couldn’t do things, I think, in the belief that it would shield me from disappointment. But this resulted in me believing that I couldn’t do anything and that I would be dependant on other people for the rest of my life.

This is not true. I can do things. Sometimes not very well, but I am able to look after myself and look after other people. I live on my own at the moment, and I’m not looking after myself properly, I’m not looking after my flat properly. But this is not because I can’t. It is because of my current state of mind which leaves me feeling anxious and unmotivated to do practical stuff like cleaning and eating. I have moments of activity, but just now I’m in “I can’t be bothered” mode. And this is ok. For me, now, I am doing the best I can and that is good enough. Anyone who tells me otherwise will soon know that they have said the wrong thing!

So what is the answer?

The trick is to try to determine if shyness is making life difficult. Children will not be able to tell us. Having been a shy child I know that I didn’t realise that anything was wrong, and even if I had, I would never have spoken up about it.

So the responsibility is with adults. Parents, teachers, friends’ parents, anyone who regularly comes into contact with a shy child can quietly monitor their progress. I would like there to be an atmosphere where one adult can say to another “I’m a little worried about your son/daughter” without the parent getting defensive or angry that someone has dared to criticise or judge.

Parents do not see how their child behaves at school or with their friends. Teachers do not see how the child behaves at home. Parents of the child’s friends may not be aware of shyness because the child is probably relaxed and “normal” when playing. So everybody has to talk to each other openly and honestly. Then maybe something can be done to try to prevent a shy child from developing problems in later life.