Motherhood, mental illness and beyond

Posts tagged ‘anxiety’

Recover or else?

This morning I read this news story with a mixture of exasperation, anger and fear. The British government, having already made life close to unbearable for disabled people, are now turning their attention to another extremely vulnerable group: those with mental illnesses. It seems that spending 15% of the welfare budget on the sick and disabled is unsustainable (but apparently spending 21% on low income workers and 42% on the elderly isn’t a problem). So government ministers have come up with the idiotic brilliant idea of forcing people with depression or anxiety to attend therapy, and stopping their benefits if they’re unable to.

In response to this article I dashed off several quick objections to this proposal:

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It’s proven very popular on Twitter, having been retweeted over 200 times now, but now I’d like to explain these points properly.

1) You can’t force people into therapy and then expect them to get anything out of it. Whether it’s cognitive behavioural therapy, talking therapy or anything else, the individual has to be willing and able to undergo what can often be a traumatic and upsetting experience. Forcing someone who isn’t ready to go through this would be highly counter-productive, exacerbating the problem and further alienating the ill person.

2) No-one will trust a therapist who they know is focused on declaring them fit to work, come what may. Just as you wouldn’t automatically trust someone you met on the street, you don’t automatically trust a therapist. A relationship has to be built, slowly and cautiously, and trust must be earned. If you know that the person you’re supposed to be baring your soul to isn’t focused on what’s best for you but only on telling the government that you can work, that trust will be non-existent. In addition, the basic principle underlying psychotherapy is that clients give voluntary (ie not forced), informed consent; would therapists even be allowed to treat patients who attended under duress?

3) In most areas there’s a long wait for talking therapies and CBT, often a year or more. Are the government going to conjure therapists out of a hat as though they’re well-qualified rabbits? When funding for mental health services have already been drastically cut, how can thousands more people be forced into a system that’s already bursting at the seams?

4) “We know that depression and anxiety are treatable conditions”. Wrong – they *can* be treatable conditions. There are all kinds of depression and anxiety and some of them are permanent. Whilst most of the time depression and anxiety can be transient illnesses, passing with the right treatment, for some they are merely manageable with treatment and don’t go away. Being forced to attend further therapy is only going to make these illnesses worse.

5) “Cognitive behavioural therapies work and they get people stable again”. Wrong again – they *can* work. For some people CBT is an utter waste of time, as I can attest. There is no panacea for depression and anxiety, no one-size-fits-all cure. If there was then we wouldn’t be having this discussion!

6) Most of the welfare budget actually goes to the working poor through tax credits. Instead of targeting the ill and vulnerable yet again, why not legislate for companies to pay a living wage instead of having to top up incomes via welfare? As I wrote at the start of this post, only 15% of the welfare budget is paid to those who are sick and/or disabled. Why aren’t the government ensuring workers are paid a proper living wage, instead of having to pay 21% to people who work but are paid so little that they’re still impoverished? It couldn’t possibly be because vulnerable groups are easier to target, could it? Or perhaps ministers have fooled themselves into believing their own “scroungers” rhetoric.

7) Oh and let’s not forget the billions of pounds lost through legal tax avoidance, why not close that loophole while they’re at it? The Telegraph article states that “Estimates based on government figures suggest the state spends up to £1.4 billion a year – more than £3.5 million per day – on ESA for these claimants with mental health issues”. But other government figures have shown that over £5.1 billion a year is lost through tax evasion. The government is targeting the vulnerable instead of those who think they’re too good to pay taxes.

Many ill and disabled people have died within 6 weeks of being declared fit to work by ATOS, the company contracted by the UK government to reduce disability payments. How many more will die if this ill-considered idea is actually put into practice? Sadly we may soon find out, as pilot schemes are being rolled out in the near future.

One last thing. You are only one illness, one accident, away from becoming disabled yourself. 1 in 4 people in the UK will have a mental illness at some point in their lifetime. Although this government’s barbaric policy of targeting the ill and vulnerable may not affect you today, there’s no guarantee that it won’t tomorrow.

To my children

I know that you may never see this, but I need to write it even so. Because you are my wonderful, funny, loving children and I feel that I owe you this.

At the time of writing you, DD, are just a couple of weeks away from your fifth birthday; you, DS, are two and a half. You’re both loud, boisterous, confident and happy children and I love watching you play together. Your peals of laughter and the tenderness you show each other melt my heart; so too does the way you snuggle up together with a storybook. I love you both more than I can ever say, and more than you can ever imagine (and yes DD, even further than the edge of space).

At the moment Daddy and I are having a tough time because we’re both a bit poorly. We’re both a bit grumpy at times, Daddy often can’t play with you as much as you would like and I’m not as good at funny games as I used to be. You’re both very accepting of this but I know you don’t really understand. And why should you? You know that I always have a sore back but how could you possibly understand the vagaries of mental illness?

I can’t figure out a way to explain to you what bipolar means, or that Daddy’s medicines keep changing because his psychiatrist is trying to find the right balance to bring him back to himself. I don’t want to tell you that sometimes medicines can make you feel worse and not better, and that that’s why Daddy has barely left the house for the last fortnight. You don’t yet need to know about anxiety, or panic attacks that are sometimes so bad that Daddy has to shut himself in the bedroom for a while so you don’t see him shaking and crying for no apparent reason.

If this was all that was wrong, if you had a mentally healthy mother, perhaps I wouldn’t feel so bad. But having to look after Daddy all the time as well as trying to stay bright and cheerful for you is taking its toll.  My cyclothymia, usually fairly well controlled by anti-depressants, is flaring and my moods are all over the place. I can be happy one day, one hour, one moment, and cast into the depths of despair the next. It makes taking care of two lively children very difficult at times and I hope you never realise just how much I sometimes want to scream at you to leave me alone because your questions, bickering and noisy games make me want to claw off my own skin. I’m deeply ashamed of feeling this way and I worry that occasionally you might have an inkling of what I’m thinking, that you might catch a glimpse of the distress I’m trying so hard to hide from you.

I know that I’m not a dreadful mother and that you could be in a far worse situation (and that many children are). On the whole you’re happy, bright and playful children who are capable of making me laugh until the tears roll down my face. I know you love each other (even when you’re arguing) and that you know that Daddy and I love you very much. I just can’t help wishing that things were different, and feeling guilty because they’re not.

The day’s not far off when “Daddy’s just not feeling well” and “I’m a bit poorly today” won’t be enough of an excuse. DD, already you’re questioning why Daddy is ill so often and soon I’m going to have to work out how to explain a little bit more of what’s really happening. But I want you both to stay ignorant of this reality a little while longer. I don’t want you to know that there are some things that can’t be fixed, and that having a kiss and a cuddle doesn’t always make everything better. I want to protect you from this difficult truth, because once you learn it your innocent trust and faith in the omnipotence of your parents will be forever tarnished. And I’m not ready for that just yet, so please let us carry on this deception a while longer. I love you both, always.

Mummy.

It’s time to talk

Today, the 6th February 2014, is “time to talk” day. This is run by the charity Time To Change, which is led by both Mind and ReThink (mental health organisations). The idea behind today is to open up and be honest about mental health, to start a conversation and to help break down stigma. This is my contribution.

I’ve had mental health problems almost all my life. As a child I self-harmed and binged; I’ve had depression since my early teens. My current diagnoses are cyclothymia with underlying depression,and generalised anxiety disorder (GAD). But what does this actually mean?

Cyclothymia is a mild form of bipolar disorder. Where most people’s mood averages out as a straight line with occasional fluctuations up or down, this is what my unmedicated moods look like:
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The psychiatrist who diagnosed me explained that cyclothymia often requires treatment with mood stabilisers as the hypomania (the highs) can be pretty disruptive. But because I have the peculiar combination of cyclothymia and depression, my base line is lower than most people’s. For example, at the moment I am a bit hypomanic. But instead of displaying the usual symptoms of hypomania I am what most people would consider to be normal. I’m enjoying playing with my children. I’m getting the housework done, I’m singing along to the radio and I’m able to talk to other parents in the school playground. I still find it hard to sit still without fiddling or fidgeting, my thoughts race and I constantly have new (usually impractical) ideas about what I want to do next. But for the most part I am “normal”.

Of course unfortunately this means that my low moods are lower than the average. When I’m in a trough I struggle to get out of bed, I struggle to interact with anyone and playing with the children is an almost unbearable ordeal. But this is also a kind of normal for me; this is what I’m like when I’m unmedicated and the depression strikes.

Cyclothymia isn’t just having hypomanic highs and depressed lows, though; there’s a reason it’s also known as “rapid cycling bipolar”. Although moods can last for days or even weeks, they can also change in the blink of an eye. Some days I can cover the full mood spectrum in a matter of hours, never knowing how I’m going to feel from one moment to the next. This isn’t in response to anything – I can be having a really good day and suddenly plunge into the depths of depression. It’s unsettling, not just for me but also my family.

Then there’s the anxiety. Mostly my anxiety focuses on my family – I live in perpetual terror that someone I love is in danger or about to die. If DH is late back from the shops he must have been run over. If the phone rings it’s obviously going to be DD’s school telling me she’s had a serious accident. At night I wake up repeatedly to check that 2yo DS is still breathing, and his recent surgery was almost more than I could bear.

The minor focus of my anxiety is quite common: I often struggle with social situations and talking to strangers, which is utterly ridiculous when you consider that I worked in the civil service for 6 years and used to present at high-level meetings and international conferences! But for now that’s how it is at the moment. I recently had to describe my social anxiety to a friend:

“Chatting to people at playgroups, in cafes, even the school run can be torture. When I have to speak to someone unfamiliar in a social situation my heartrate increases and my breathing gets shallow. My mouth goes dry and I feel as though my throat is closing up. If I can’t escape then I usually end up having a full-blown panic attack”.

Obviously this causes problems when it comes to having a social life of any kind! Although I sometimes manage to meet people for a casual coffee, in the last year I’ve only managed to go out with a group of friends once. Just once, to a local restaurant, and even then I could only stay for about an hour and a half before getting overwhelmed and having to leave.

So there you go. That’s me. Mood zipping around like a demented pinball and perpetually anxious. 🙂 I’m happy to answer any questions or comments that you may have, both here and in person if you know me. So come on – let’s talk.

Is it me?

I’ve had mental health issues for as long as I can remember, from compulsive binge-eating and self-harming at the age of 7 to depression which began in my early teens and my current diagnoses of cyclothymia, generalised anxiety disorder and binge-eating disorder. Despite my mental peaks and troughs I’ve always been able to function, hold down a good job and socialise with friends.

Until recently. The birth of my daughter, four and a half years ago, plunged me into a pit from which I’m still struggling to escape. Not because I didn’t want her or love her, but my postnatal depression (PND) was so absolute that it seems to have altered my mental state almost permanently. After a couple of years and several therapies I felt pretty recovered, only to succumb to antenatal depression (AND) while I was pregnant with my son. Unsurprisingly after his birth I was once again plunged into depths of PND. Once that was resolved I was referred to a psychiatrist who diagnosed me as having cyclothymia (or rapid cycling bipolar disorder) as well as anxiety issues.

At the time of writing I am fairly functional most days thanks to medication and a heightened awareness of my mood state. I do however really struggle with social situations and talking to strangers, which is utterly ridiculous when you consider that I was in the civil service for 6 years! But for how that’s how it is at the moment. I recently had to describe my social anxiety to a friend:

“Chatting to people at playgroups, in cafes, even the school run can be torture. When I have to speak to someone unfamiliar in a social situation my heartrate increases and my breathing gets shallow. My mouth goes dry and I feel as though my throat is closing up. If I can’t escape then I usually end up having a full-blown panic attack”.

Obviously this causes problems when it comes to having a social life of any kind! In the last year I’ve managed to go out with friends once. Just one time, to a local Thai restaurant, and even then I could only stay for about an hour and a half before getting overwhelmed and having to leave.

My current state seems to be hard for friends to cope with. Over the last few years I seem to have misplaced quite a few peripheral friends but also 2 very dear, loved and trusted friends. These friends knew everything about me, about my struggles with mental illness, and encouraged me to be open with them. But in the end the burden of my problems became too much for them to deal with on top of their own lives, and they disappeared. Now I may be losing another good friend, someone I’ve been friends with for over 20 years, because of my mental ill health.

There are only so many times DH can tell me that these losses are not my fault but theirs, before it starts to ring hollow. If it’s not my fault then why does it keep happening? Maybe I don’t try hard enough – I’ve been told in the past that I wallow in my depression instead of fighting it. Or maybe I’m too truthful, I’ve been told that by being honest about my struggles I’m making others miserable and overwhelmed. I wonder whether it would be the same if I had a long-term physical illness? Would friends still drift away or would they cope? Am I the problem? Am I asking too much of my friends? Am I too needy, too confiding, too overwhelming? Because to be blunt, it’s pretty bloody overwhelming being trapped inside my mind day in and day out. At times the despair (will I ever recover?), the self-loathing (I’m so pathetic!) and the constant self-examination (is that a rational thought or is it my illness talking?) are so overwhelming that I would do almost anything for just a few minutes peace. Even my nights aren’t restful, thanks to frequent and vivid nightmares.

Whatever the reason may be, with a couple of notable exceptions I’ve stopped confiding in friends now, and even with those exceptions I’m careful about what I say and how much I reveal. I have a couple of trusted family members and of course I’m completely honest with DH, but as I explained in my last post he has his own issues to deal with at the moment. My only other real solace is Twitter, where hundreds of people who barely know me are kind and supportive. How odd, that I can be so open with virtual strangers yet have to be so wary around friends.

Hollow and hopeless

I admit it – I’m struggling. I’ve not written about my mental health for a while because I’ve seemed stable on the medication I take and it felt like I was coping ok. But I’m starting to realise that I’ve been fooling myself and using too many crutches to get through each day.

This last week has been an eye-opener. 2yo DS had surgery on Monday; it was only a minor operation but involved general anaesthetic and that pushed all my anxiety buttons. Then he developed a stomach bug the same night and the next 3 days were filled with more vomit than a high street on Saturday night. After a few days DH and DD got it too. Everyone’s pretty much recovered now but I’m still struggling. I feel like I’m constantly full of adrenaline, buzzing and unable to sit still, but at the same time lethargic and morose.

I hadn’t realised until recently just how much I rely on DH to take the strain when I’m having a hard time. We’ve always done equal shares when it comes to parenting and running a home (especially while he’s unemployed), but there are times when I just cannot cope and he takes over for a bit so that I can be alone or whatever it is that I need at the time. However, just before Christmas he was diagnosed as having bipolar disorder and is now on new regimens of drugs and therapy while the doctors explore what works. I think this has prompted him to be far more open with me about his mental health than before and it seems that he’s been hiding a lot from me. Now that I know how he feels, how he’s been fighting his own battles, I no longer feel that I can rely on him as much as before. Not because he’s suddenly unreliable but because it seems unfair to give him sole responsibility for the children when he’s having as hard a time of it as I am. I feel guilty and selfish that I didn’t realise before.

I’ve been trying my hardest to put on a bright and smiley face for everyone, particularly the children, but the mask is cracking. I am cracking. I have a very short temper atm and the slightest thing makes me rage (internally, thankfully). The children’s chatter is like fingernails on a blackboard. Their bickering makes me want to break things. Their simplest request, for a toy or a hug or help turning on the light, is infuriating because I just want to be left alone.

I try to hide how I’m feeling and be their kind, playful, loving mother but I think I’m failing. I think they’re starting to realise that I’m hollow – fake happiness on the outside, a yawning chasm of despair inside. They don’t deserve this. They don’t deserve a mother who has to bully herself into playing with them, who counts down the hours and minutes until bedtime. They deserve better, the best.

I’m not entirely sure if there’s anything in particular that’s prompted my plummeting back into darkness but it has been a stressful time lately. If I’m completely honest there’s a part of me, a very small part, that is angry with DH for being diagnosed with bipolar disorder. How ridiculous is that? It’s hardly his fault. But in the past I’ve always been comforted by the thought that when things became too much to cope with and I eventually killed myself (I’ve come dangerously close to this several times) the children would have a strong, stable parent to take care of them. But I can’t do that to DH when he’s having his own problems. I feel as though my safety net has vanished. I’m not saying that I’m suicidal at the moment, I’m not. But it was always reassuring to know that if things ever became that bad again, I had an escape route. Now I don’t and there’s no hope of oblivion for me any more. I’m stuck in this defective body, in this tormented mind, until age, infirmity or an accident carries me off.

I really don’t know what I want this post to say, I’ve rambled a long way from my first paragraph. I’ve been far too honest and I’m not sure whether I should even publish it. But this is who I am and how I am. Bright on the outside, black as pitch on the inside and utterly without hope of escape.

The harshest critic

I’m not perfect. I know I have my faults and I’m honest about them. I’m honest about my bad habits too, and I don’t allow myself to make excuses. I know what my weaknesses are. I don’t like myself very much, but I think that’s pretty normal. I saw a CBT (cognitive behavioural therapy) specialist for a while and she was horrified by what she called my “character assassination”. She said I judge myself far too harshly and that I need to be kinder to myself.

But what she saw as harsh, I see as being realistic. After all, I’m the one inside my head. I’m the one thinking these thoughts, feeling these feelings. I need to be honest with myself. It’s taken 20 years for me to acknowledge that my depression is as much a physical illness as a mental one and that I will probably be taking medication for the rest of my life. I’ve made my peace with that. But I am less comfortable with other aspects of my mental health.

Take my anxiety, for example. While I know it’s a mental health problem I also know it’s ridiculous to be in a constant state of worry and consternation that my husband or children could die or be critically injured at any minute. I know that not wanting to meet new people, not feeling comfortable in social situations, is silly and limiting. I don’t feel like this about others who have anxiety, just myself. The therapist said this was self-stigmatising; I think it’s just being realistic.

The same is true of my disordered eating (I’ve blogged about this a few times). I admit that my eating is disordered and that I am struggling to cope with this. But the suggestion that I may have an eating disorder seems preposterous. So what if I tick all the diagnostic boxes? To say that I have an ED would be like making an excuse, absolving me of responsibility. In reality I am weak, greedy and lacking willpower – that’s what’s wrong, not an eating disorder. My eating problems are my own fault and nothing more.

I could go on – my self-loathing is deep and boundless. I am not the wonderful mother I assumed I would be. I’m not the successful career woman I assumed I would be. I’m not the sociable, popular individual that I used to be. The schism between who I should be and who I am seems almost unbridgable.

I know I am critical of myself, but who isn’t? Who doesn’t wish that they could change things about themselves? This post may seem self-pitying but it isn’t. I am brutally honest with myself because I need to be, I can’t allow myself to make excuses. I don’t like who I am and I need to confront myself and be truthful if I am to make changes.

On the threshold

So. This is it. This week my family’s lives change forever; DD starts school on Wednesday and our cosy time as a preschool family comes to an end. But before that comes another big change as DH starts work tomorrow after 14 months unemployed.

In practical terms we’re ready. DD’s school uniform is bought, washed and named; the ridiculously oversized Spiderman backpack that she begged to have as her schoolbag is ready; DH’s shirts are washed and hung up, ready for the week ahead.

Surprisingly enough I think we’re almost mentally prepared too. DD is still nervous about school, although she’s looking forward to playing on all the cool stuff in the special Reception playground again (we didn’t have climbing frames, tricycles and mini racetracks when I was at school!). I’m nervous too – I know I’m going to miss her dreadfully, even though as a summer baby she’ll only be going for the mornings at first. I’m going to miss DH as well, I’ve enjoyed having him at home and his presence has helped me to cope better than I otherwise might have done. My anxiety is going full throttle but I’m mostly able to mute it to an annoying buzz.

However, part of me is looking forward to the challenge. I’m looking forward to having proper one-to-one time with DS, and maybe even finding a half decent toddler group to take him to while DD’s at school. I’m looking forward to having some routine to our lives again. I’m feeling more socially acceptable; while DH was unemployed I felt like a lazy, benefits-claiming stereotype despite the fact that I am unfit for work at the moment. Now I feel as though my position as a stay-at-home parent is more justified, that I am going to be pulling my weight properly in this family instead of coasting along relying on DH.

Over the last few days, as we’ve put the finishing touches to DD’s pirate-themed bedroom and gone on a family day out, I’ve even felt happy. Right now though I feel nervous. Scared. Sad. But I also feel cautiously optimistic and strangely hopeful. It’s as though there’s finally a light at the end of the tunnel. I think and hope that this is the start of a positive new chapter in our lives, that in years to come we’ll look back and say “That’s when we started to get back on our feet, when things finally started to improve”.

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