It’s been a while…

(For the background to this post please read Consequences).

Well, after a month or so without blogging or feeling comfortable talking openly about my mental health on Twitter, I’ve had enough. I refuse to hide any more. The woman who reported us has contacted me in order to confess; it seems that she genuinely (however misguidedly) believed that the children truly were at risk. Thankfully Children’s Services have made it very clear that they have absolutely no concerns and have indicated that they will treat any future complaints from this woman with caution.

So after having a break in order to think things through, I’m back. Through the unwavering support of pretty much everyone I know, whether online or off, it has gradually become clear to me that the importance of speaking out against the stigma of mental illness far outweighs the risk of another misguided report to the NSPCC. That this happened at all (despite the fact that I am stable, that DH and I are both in regular contact with healthcare professionals and that we have family close by who both help and support us) merely shows just how far we still have to go before mental illness is treated the same way as physical illness.

Of course, the irony of all this hasn’t escaped me. My writing about mental illness and its stigma has led to DH and me being accused of being unfit parents because of the stigma surrounding mental illness. It’s almost funny. Almost.

Consequences

Recently I wrote about being reported to the NSPCC and consequently Children’s Services in these two posts: The Letter and The Letter – part 2. If you don’t have time to read them, the short version is that the NSPCC received 2 anonymous reports from someone who was concerned that my and DH’s mental illnesses meant that our children were at risk. Children’s Services investigated and quickly concluded that the reports were groundless. That, I hope, is the end of the matter.

Except that it isn’t, not really. Although I choose to believe that the reports were made due to genuine (albeit misguided) concern rather than malice, knowing that someone has read my blog and my tweets and concluded that I am an unfit mother, DH an unfit father, has been profoundly distressing. For me it has caused heightened anxiety and stress-induced insomnia, DH is struggling with an abrupt plunge into low mood. I hope that in time these will pass, and of course the children are still entirely unaware of the whole situation and its effects, and will hopefully remain that way.

I have always prided myself on being open and honest about my mental health, both here and on Twitter. Stigma is increased by ignorance, and by speaking out I hoped that in a small way I could help reduce that stigma and the alienation that many people with mental illnesses suffer. But to have that honesty turned against me and wielded as a weapon has been a horrifying experience. I’ve never hidden the fact that I find blogging to be an extremely therapeutic way of dealing with my illnesses, both mental and physical. I have also found a wonderful support network on Twitter, where I can be honest and speak of my experiences to those who understand and empathise as well as to those who really have no understanding of what mental illness can be like. In return I’ve been able to offer sympathy, advice and comfort to others who struggle with their mental health. But I’m not sure that I can continue to do so.

Despite our swift and complete exoneration by Children’s Services, this experience has left its mark. I no longer feel safe blogging and tweeting honestly about how I am, how my day is going, how DH is. Even as I write this post I’m wondering whether it will be turned into a stick to beat me with, whether it will prompt yet another report to the NSPCC. I have lost my sense of safety, of refuge, and of course that means that I have lost my online support network. This is no trivial thing; in the past the support I’ve received from individuals online have literally made the difference between life and death. But now that’s gone. I feel watched, I feel harassed and I feel as though my honesty has endangered the happiness and wellbeing of my family.

I don’t know whether these feelings will fade as time passes but I certainly hope so. I will miss the catharsis that blogging can provide and I will miss being able to interact with the mental health community in a meaningful way. It’s been very important to me that I speak out about mental health issues and I hope that I will be able to again, but for now my voice has been silenced.

The letter

For the last 12 days DH, the children and I have been on holiday. We’ve had a wonderful time staying with DH’s family and having lovely days out. Today we came home and once we’d brought everything in from the car I sat down to check through the post for anything that needed urgent attention. And there it was.

Children’s Services have received a referral from the NSPCC. The referral has raised concerns for your children’s welfare. Please contact the Children’s Access Point on the above telephone number so we can discuss the matter further. You will need to speak to the duty social worker.

Hands shaking, I showed the letter to DH before shutting myself in the bedroom to make the call. The duty social worker was very pleasant and explained that someone had contacted the NSPCC anonymously to report that they were concerned about my children’s welfare. Apparently the complaint was very detailed but of course the social worker couldn’t tell me too much in case it helped me identify who the individual was. Which is fair enough. What he did say, though, is that this person was very concerned because a) DH and I both have mental health issues, b) I am open about my mental health “without considering the impact it may have on the children’s welfare”, and c) because the children suffer from “poor nutrition”.

I have to admit, I find the third one mildly amusing. Anyone who has seen how healthily my children eat and how much they can pack away (second helpings are common and third helpings have been known on occasion) knows that they’re definitely not malnourished or lacking in any kind of nutrition. I’ll be honest, a lot of the time they eat better than DH and me! They’re both slender but full of energy, and no-one in a position of responsibility (doctors, teachers, children’s centre staff etc) has ever expressed any sort of concern about their wellbeing.

I gave the social worker a brief summary of DH’s and my mental health: our diagnoses, that we’re both stable on medication, that we both see our GPs regularly and that DH sees his psychiatrist every month as well as going to support groups each week. I explained that we both have supportive families who we see regularly, as well as some very supportive friends. I gave the social worker the contact details for our GPs and DH’s psychiatrist, and we both gave full permission for them to tell Children’s Services whatever they need to know.

Now, a few hours later, the shock has worn off and to be completely honest, I’m not angry so much as sad. I’m sad that someone who seems to know us had concerns about our children but didn’t talk to us about it. I’m sad that once again the stigma that surrounds mental illness has touched our lives; would the person have called the NSPCC about my physical illness, which actually has far more of an effect on the children? I doubt it. I’m sad because the comment about the children’s nutrition makes it seem as though this is a malicious complaint rather than someone who’s genuinely concerned but perhaps a bit misguided. But most of all I’m sad because Children’s Services are now wasting their precious time investigating me and DH instead of spending it helping children who are actually being abused, neglected and ill-treated.

I have absolutely no intention of keeping quiet about mental illness. If anything, this has made me even more determined to speak up about it. I disagree that being open about mental illness will have a negative impact on my children; I think that hiding our illnesses and lying about them would be far worse. Particularly when there is evidence to suggest that depression and bipolar disorder may be inheritable! The children aren’t aware of mental illness yet but as with everything else we will answer the children’s questions honestly and at an age-appropriate level when they’re asked. And we will continue to teach them to accept everyone regardless of illnesses, disabilities or any other differences.

I’m confident that after the investigation has run its course the complaint will be dismissed. Of course there’s still a small voice whispering “But what if they decide to take the children anyway?” in the back of my mind; this is precisely the kind of situation that my anxiety is centred on but I’m doing my best to ignore that. My children are happy, healthy and well looked after, and I know that social workers aren’t the big bad child-snatchers that they’re often suggested to be. I hope that this will be resolved quickly, and that whoever called the NSPCC can rest easy knowing that my children are absolutely fine.

Suicide isn’t selfish

Trigger warning: suicide

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

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:

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.

Is honesty the best policy?

When you meet someone new, how long do you wait before you do it? Do you do it? Or not? I’m talking about taking a deep breath and being honest about your mental health.

Despite having had mental health issues from childhood it’s only in the last year or so that I have begun to be honest with friends (and some family) about the extent of my illness. This is largely due to to the Time To Change campaign and discovering the incredibly supportive and vociferous mental health community on Twitter. But I’m still fairly cagey about it, mostly through a lifetime’s habit. I’m still prone to self-stigmatise and feel (needlessly) ashamed or embarrassed.

Now that my daughter has started school I’m coming into contact with a lot of new people. Some of them I’m becoming quite friendly with and I’m starting to wonder whether, if the opportunity arises, I should casually mention something about my mental health. The main reasoning behind this is that I have days, or sometimes weeks, when despite being fairly stable thanks to my medication I just cannot face seeing people and being sociable. Or there are days when I’m profoundly uncomfortable being out in public but I can cope just chatting on a friend’s sofa. It might be useful for new friends to know this in advance, so that my occasional last-minute cancellations, nerves or reluctance to commit to a meet-up aren’t misconstrued.

However, I’m profoundly nervous about being honest as I have a deep-seated fear of rejection. I’ve already lost a couple of previously close and well-loved friends because they simply couldn’t cope with my problems. And if they, who knew me so well, felt the need to walk away from me then what’s to stop a relative stranger from doing the same? Mental illness is still remarkably stigmatised and misunderstood despite 1 in 4 UK adults having it, and I have no wish to become the playground bogeyman (or bogeywoman if you prefer!).

Interestingly I recently came across the NHS Attitudes Towards Mental Illness 2011 Survey Report. According to this report:

12% of people agree that it is frightening to think of people with mental illness living in a residential neighbourhood;

12% of people think someone with mental illness doesn’t deserve sympathy;

16% of people believe that one of the main causes of mental illness is a lack of self-discipline and will-power.

These may be relatively small percentages, but as someone who is mentally ill I find them worrying. People don’t wear helpful t-shirts with the slogans “I’m educated about mental illness – talk to me!” or “I’m ignorant, don’t open up to me!”. I have no way of knowing whether the person I’m having regular coffee dates with falls into category A or category B.

I sometimes wonder whether perhaps it would just be safer and easier to keep things to myself, to lessen the risk of rejection and stigma. But the thought that torments me is that there’s no way of me knowing whether the person I’m friendly with falls into category C – someone else with mental health issues. Maybe they’re struggling with the same dilemma that I am. After all, we don’t wear helpful t-shirts either!

On the whole, I think I need to take the risk and be honest. I owe it to myself to not be ashamed or afraid of what others may think of me. I owe it to all the other people with mental illnesses to be open; to stand up and be counted, maybe even to educate. My mental illnesses (I have several conditions) impact most areas of my life and so they’d be a fairly significant secret to keep.

I don’t worry about telling people that I have degenerative disc disease and need to use a walking stick. I shouldn’t be worried about telling people that I have mental illnesses and need medication.

Fear me! (Asda says you have to).

“Hey everyone! Want to really terrify your friends this Halloween? Why not buy this horrifying “diabetic” costume?”. I expect you’re a bit puzzled – that doesn’t make sense, what’s so scary about someone with diabetes? Why would dressing up as someone with a debilitating illness be appropriate for Halloween (or ever, for that matter)?

Well I’m just as bemused as you but Asda (the British supermarket owned by the American Walmart) seem to think that this is perfectly acceptable. So much so, in fact, that they’re selling a costume that does just this:

Yes, you read that right. This is a “mental patient” costume. The description reads Everyone will be running away from you in fear in this mental patient fancy dress costume. Comprising of a torn blood stained shirt, blood stained plastic meat cleaver and gory facemask it’s a terrifying Halloween option.

Wow. Just wow. Mental illness affects 1 in 4 people every year, making it one of the most common life-altering illnesses in the UK. And yet it is stigmatised to the point where a leading supermarket thinks that selling a costume that perpetuates that stigma, is absolutely fine. No problem. Expect that of course it is a problem. The mentally ill are a vulnerable group, far more likely to be victims of violent crime than offenders. We are seen as “other”, as apart from society, as something to be avoided. This incredibly offensive costume not only encourages that view, it specifically endorses the idea that someone with a mental illness is violent and to be feared.

Still, every cloud has a silver lining – now that I know how utterly terrifying I apparently am, I won’t need to buy a Halloween costume this year.

Update: In the last few minutes Asda have tweeted an apology:

My inner critic

I’ve written before about the stigma surrounding mental illness and how the mentally ill are perceived, approached and treated differently to the physically ill. I am a strong and vocal believer that this needs to change, that we need to be more open and accepting when it comes to mental illness. I am always open about my problems when I write online, whether here or on social media.

However it was brought home to me today that although I deplore the misconceptions and judgements that are made about those with mental illnesses, I am nonetheless guilty of having an unacceptably unforgiving attitude. Not towards others who are ill but towards myself.

I encourage others to recognise that having a mental illness is nothing to do with mental strength or attitude; yet I despise myself for being weak. I encourage others to be open and yet I am ashamed of my illness. I am honest online but I shrink away from admitting my illness to real life acquaintances. I explain to others that mental illnesses often have a physical cause and yet I berate myself for being unable to just pull myself together.

Why this division? Why can I be kind and supportive towards others and yet so harsh and judgmental about my own illness? Why am I unable to make the same allowances for myself that I make for others? Why do I acknowledge with one breath that mental illness is not my fault, and yet with the next admit my guilt for being so weak?

Any thoughts gratefully received…

But you don’t seem the type…

Friends are often surprised when I mention my mental health problems. To me it feels as though I’m walking around with a brand on my forehead, marking me as separate from all the ‘normal’ people. But others never seem to see me this way; typical responses include “But you’re so cheery!”, “I would never have guessed” and my personal favourite “But you don’t seem the type!”.

Then once it’s out in the open a lot of people never mention it again. Which is good in a way, because it hasn’t affected our relationship. But it also means that I don’t know what that person is thinking – whether they are comfortable around me still or whether they’re just going through the motions, waiting for me to  ‘go mental’.

In contrast to this are the reactions I get to my physical disability. I have degenerative disc disorder and frequently need to use a walking stick. I get a lot of sympathy and friendly interest from strangers as well as friends. No-one has ever told me that I “don’t seem the type” to have a physical condition, although as a woman in my thirties using a walking stick I do sometimes get odd looks. 🙂

So what’s the difference? Stigma, misconceptions and ignorance. One in four people will suffer a mental health problem at some point yet it is still taboo; people talk about mental illness in hushed tones and using euphemisms. Depression is often seen as a sign of weakness and thanks to misconceptions and inaccurate media portrayals many people are scared by illnesses like bipolar disorder or schizophrenia.

A physical injury or illness is usually more obvious than a mental illness and more easily understood. Because of the taboos surrounding mental illness quite often people don’t understand what it can be like. You can understand what it would be like to have a broken leg, right? Can you understand how it would be to have depression so badly that it’s impossible to get out of bed or speak to people?

Mental illness is often viewed as a sign of weakness, that if the sufferer merely pulled themselves together they would be fine. But no-one thinks this way about physical illnesses because it would be ridiculous. No-one tells a diabetic to stop taking insulin and yet people taking anti-depressants are often encouraged by friends and family to stop.

Is there a point to this rambling ranty post? Yes, a very simple one. If someone tells you that they or someone they know is suffering from a mental illness, please pause before you react. Think, would you react this way to news of a physical illness? Having a mental illness can be incredibly isolating and a lot of sufferers feel ashamed – together we can change that.

Stigma (n.): from Latin ‘stigma’ meaning to mark or brand

When you hear the words “mentally ill” what’s the first thing that pops into your head? I bet for most of you it wasn’t a friend, neighbour or colleague but someone violent, scary or strange, possibly in a straitjacket or shuffling around like a zombie because of medication. And yet at any given time 1 in 4 people are likely to suffer from some kind of mental illness. So why is there still such a stigma about it? Why the stereotypes and ignorance?

It’s a complex issue but I think that it may be partly due to unease that our ‘sense of self’ can so easily be altered. We humans live inside our heads and have a self-awareness that is unique. We are acutely aware of who we are and our place within a group, and yet mental illness can alter that ‘self’ very easily. This makes people uncomfortable. And when something makes people uncomfortable they often seek to distance themselves from it.

There’s also the problem that mental illness isn’t easily fixed the way a broken leg can be. The human mind is unbelievably complicated and we are still only beginning to understand how it works. A common misconception about mental illness is that the sufferer should just snap out of it, switch it off, that they’re seeking attention. But who would dream of saying such things to someone with diabetes or kidney disease? Physical illness attracts sympathy; mental illness often merely attracts impatience and scorn, as though it is a sign of weakness. Anti-depressants are often demonised as being addictive and handed out far too easily by doctors. But strangely few people would make the same criticisms about painkillers, which are often available over the counter instead of by prescription.

The media is also partly responsible for the ignorance and stereotypes surrounding mental illness. I can think of very few films or programmes where a person with mental illness is portrayed sympathetically. It’s all too common to have the violent murderer, the weird loner or the crazy kidnapper. It’s not just fictional media of course, the news media is just as bad. A common incidence is when a violent or terrible crime has been committed (parents killing children for example) and the journalists will ask “Were they depressed?”, “Was there any history of mental illness?”. Now, of course people with mental illness commit crimes. People without mental illness also commit crimes. But the way that the media glibly imply that only someone who is mentally ill could do such a thing infuriates me. I’ve been mentally ill for most of my life and the most criminal thing I’ve ever done is accidentally run a red light.

Talking to friends and family about mental illness is difficult. Some will be sympathetic and understanding; some will be sympathetic but won’t understand. And of course there are those who withdraw from you as a result. Membership of the matter group isn’t always due to ignorance either, I lost a very close and trusted friend when I had PND after the birth of my daughter. This friend had also had PND previously but couldn’t cope with me struggling for so long and withdrew from me.

It takes a lot of courage to be open about mental illness. I don’t mean online – I’m very open about my problems here. But I tend to hide it as much as I can from people I know in real life. I don’t want them to look at me differently; I don’t want them to see me as a diagnosis first and a person second. I don’t want to lose any more friends. And yet there are those who know and are extremely supportive. My husband, my mother and sister, 3 friends whom I can talk to honestly about absolutely anything and know that they will still be there.

The more open we are about mental illness the less stigma there will be. But in order to be open we must run the gauntlet of that stigma, of being branded as ‘other’. It’s a difficult cycle to break but I am trying – I am starting to be more open about my problems and so far it’s been ok. No-one’s run away screaming yet. 😉

(This post was inspired by the Time To Change campaign).

Warning: may contain nuts

I’ve been thinking about labels today. Humans are very keen to label those around them, to determine which category they fit into. I guess this is an evolutionary thing: the ability to make snap judgements on whether someone is likely to be friendly or hostile, share resources or just be out to steal your goats. Even now we judge people on how they look, talk, act, dress, the music they like, the books they read – and we are surprised when we discover something about them that doesn’t conform to the category we had assigned them to.

Whilst these shortcuts can be useful, they can also be negative. This is especially true when it comes to mental illness – the stigma is widespread and as a society we are indoctrinated at a young age into the belief that unusual = scary. ‘Psycho’, ‘lunatic’ and ‘headcase’ are all perjorative terms for someone with a mental illness. ‘Crazy’, ‘mad’, ‘insane’ and ‘nuts’ are marginally less so and tend to be used in casual conversation rather more. But mental illness is still seen by society at large as something to be scared of, something other and frightening. So why am I so keen to find my diagnosis, to be labelled?

I have spent most of my life trying to hide the worst excesses of my illness and explain the more obvious, more socially acceptable aspects of it. It’s tiring working out just how much to trust someone with, whether to go the whole hog (I have depression and anxiety, but also rapid mood cycling, panic attacks, occasional visions – oh and I self-harm) or just give them the sanitised version (I have depression). I look forward to the day when I can say “I have X condition” because then I won’t have to explain so much or hide so much. If I can tell people that there is a name for what I am, a recognised medical condition, then maybe it will stop all the well-meaning “Have you tried just being more cheerful? What have you got to be depressed about?” kind of conversations.

I realise that of course there is unlikely to be a nice little box for me to slot neatly into, because people just aren’t neat like that and mental illness is even less so. But right now I’m holding out hope for something more definite, more certain, than I have at the moment because I am tired of my my mental state being a nebulous and ill-defined mess. I want a label.