Motherhood, mental illness and beyond

Posts tagged ‘depression’

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.

Suicide isn’t selfish

Trigger warning: suicide

Last week this image caused a bit of upset on Twitter:

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It’s from the American Foundation for Suicide Prevention, a non-profit organisation that seeks to understand and prevent suicide through research, education and advocacy. They also aim to help those affected by suicide. It seems to be a good organisation with good intentions, but out of context their image (originally posted in 2012) raised some hackles in the British mental health community. Why? Because it removes the focus from the suicidal person and it seems to feed into the “suicide is selfish” idea. This belief is unfortunately common. Killing yourself is often seen as selfish, cowardly and weak. It’s yet another part of the stigma that surrounds mental illness.

I recently shared this image (from Boggle the Owl)  on my blog:

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The response was overwhelming. So many people contacted me to say that it had made them consider suicide and/or mental illness in a different light. I’m so glad, because it did the same for me when I first saw it. Despite having been mentally ill since my early teens I too had bought into the “suicide is selfish” rhetoric, and realising that my suicidal urges didn’t make me selfish was a huge step. It lightened the load. Because in my experience, that’s what suicidal urges are, an enormously heavy burden that weighs you down. And it’s one that is incredibly difficult to he honest about; during my most recent crisis, in February/March this year, I hid my increasingly suicidal thoughts and feelings from almost everyone. The previous times I had felt suicidal, and the one time I seriously attempted to kill myself, absolutely no-one knew.

There’s a lot of ignorance about suicide. Firstly there’s the idea that people who talk about killing themselves will never do it, when in fact most people who kill themselves have told at least one person that they want to do so. Then there’s the suggestion that telling someone you’re suicidal is just attention-seeking. Can you imagine that? Your world has shrunk to the confines of your own mental torment, your existence is so unbearable that you’re considering ending it, you pluck up the courage to tell someone how you’re feeling because you know you need help, you’re drowning in pain and BAM! You’re dismissed as attention-seeking.

Equally as bad is “You owe it to your family/friends/hamster to stay alive” and “It’s a permanent solution to a temporary problem”. I’ve had mental illnesses since my early teens – what’s temporary about that? While for some people depression and suicidal thoughts may be relatively fleeting, for many they are a recurring or constant problem. Imagine 2, 5, 10, 20 or more years battling your own mind, your mental pain, every single day. Or maybe it’s physical pain and illness that you’re fighting against. While holding down a job, bringing up children, maintaining a facade of normality for the outside world. It’s exhausting. And being told that you “owe it” to other people to keep yourself alive? No. Just no. That’s implying that they are more important than you, that their feelings trump yours and that your anguish doesn’t matter. All that matters is how your death will make others feel.

Lastly there’s the nasty sentiment that people who jump in front of trains or off motorway bridges are just a selfish inconvenience to others. Let’s think about that. Another human being, someone who loves and is loved just like you, has found their life to be so unbearable that they saw no alternative to ending it. Their pain was so immense that it blocked out all other thoughts. And you’re complaining because your journey has been delayed?! That’s the true act of selfishness, to me. Seeing someone else’s pain, suffering and death only in the context of how it affects you.

So no. Suicide isn’t a selfish act. It may be a desperate one but it is not selfish.

For further understanding please read these incredible posts from BipolarBlogger: Count no blessings: How a suicidal mind works and Ten things not to say to a suicidal person.

If you are suicidal or know someone who is and you need support, please check out the “Want to talk to someone?” bar at the top of the page.

My net

Trigger warning: suicide.

For ages now I’ve been pottering along, coping ok with the usual day-to-day stuff and seemingly well thanks to my anti-depressants. Until a few weeks ago, that is. For no discernible reason my mood took a nosedive and I began to have suicidal thoughts for the first time in almost 3 years. I’m not saying that I wanted to kill myself, I didn’t. But thoughts of suicide were continually popping into my head and I found myself dreamily considering ways of ending my life. Needless to say, this terrified me. Which, in a way, was a good sign – when I’ve been truly suicidal these kind of thoughts have been welcome, even comforting. But this time they were intrusive and frightening.

I’m lucky to have a great GP, who managed to squeeze me in at short notice. She listened sympathetically, checking that I felt able to keep myself safe and that I had people I could turn to if that changed. She increased the dosage of my anti-depressants and fired off an urgent referral to the community mental health team (CMHT). Much to my surprise they called me later the same day and offered me an appointment with a mental health nurse the following morning. The appointment went well and the nurse was reassuring. She agreed that I seemed able to keep myself safe despite the suicidal thoughts, and gave me the details of the CMHT helpline in case I started to have difficulties with that. She also referred me back to a psychiatrist for mid-April, just to be on the safe side.

Gradually my mood began to improve, and I went from barely being able to move off the sofa to throwing myself into the housework with an enthusiasm that’s most unlike me! I haven’t had any suicidal thoughts for days now. I’ve seen my GP again and she’s happy that I’m safe and managing far better. For now I’ll continue on the higher dosage of anti-depressants, but if I start to get too high or notice an increase in hypomanic episodes we’ll try lowering it again.

I consider myself to be very lucky. I have nothing but praise for the NHS, my GP and the CMHT, who saw me so swiftly. DH is my rock, and my wonderful sister and parents are supportive. My dear friend Sutton is a treasure beyond compare and I also have some amazing friends on Twitter who, although we’ve never met, are kind and caring and incredibly supportive (you know who you are!). I am so grateful to all these people; for listening and reassuring, and for being the safety net that stopped my headlong plunge into darkness. I really don’t have the words to express how thankful and humbled I am by their love and support, so I’ll just say this, from the bottom of my heart:

Thank you.

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.

Peering through the black cloud

Today is the worst day I’ve had in a long time. There’s no reason why it should be; it’s no different to yesterday or any of the days before. But for some reason today is a black day.

I woke this morning and spent 45 minutes trying to find the energy to move. I don’t just mean that I was physically tired, although I am. I just wanted to sleep, to hide under my covers and shut out the world; I couldn’t find the mental strength to force myself out of bed. Luckily my wonderful husband is more than capable of looking after the children and by the time I eventually made it out of bed DD was almost ready for school. I explained to her that I wasn’t feeling well (how else do you explain a trough like this to a 4 year old?) and she gave me lots of hugs and kisses before cheerfully heading off to school with DH.

It’s now mid-morning and I’m curled up on the sofa in my pyjamas and dressing gown. I don’t want to eat, or watch tv. I’m struggling to play with my chirpy, bouncy toddler – I just can’t muster the enthusiasm. I can do kisses and cuddles, and luckily he’s happy with those, but for all the use I am today he may as well be playing on his own.

It’s hard to explain this kind of mood to someone who’s never experienced it. I’m sure there are people who’ll read this and think I’m just being lazy or wallowing, that I just need to pull myself together and get on with things. But days like this are unbelievably hard. It’s like wading through treacle; everything just takes so much effort, I have to spend ages gathering the energy to do the slightest thing. I feel as though I’m wrapped in a black cloud, only catching the occasional glimpse of normality.

On days like this I’m incredibly grateful for my smartphone and social media. I don’t feel so disconnected when I can dip in and out of conversations on Twitter and Mumsnet, even though leaving the house and talking to people is beyond me. I can sit huddled under my blanket and chat with strangers, acquaintances and good friends I’ve never met. This connection is vital to me, keeping my mind active and penetrating the miasma of lethargy and apathy.

In the past there were occasions when I would be bedridden for days at a time by this kind of misery, the depression weighing me down. I’m fortunate that thanks to a combination of my caring and uncomplaining husband, my cheerful children, medication and online chat, this cloud should pass fairly quickly, hopefully in a day or so.

An analogy that I often use to explain my depression is that it’s like the beginning of the Wizard of Oz film; everything is drab, shades of black and white and grey. It’s only when life bursts into glorious technicolour that I realise quite how gloomy things were. Today I view the world in black and white but at least I know that the technicolour bit is ahead.

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