How are you, really?

This week (18th May) is Mental Health Awareness Week 2020.

Let’s be honest, 2020 is not going how any of us thought it would! Some of our lives have changed beyond recognition, we had little warning and few of us had much influence over the changes!

How do you really feel about it all?

I have an extensive mental health history of severe depression and anorexia; recently I had anxiety and stress added to this list (stress isn’t a diagnosis but inability to manage it has a profound impact on ones health). I take medication and have had therapy to get me to a good, healthy place but I’ll always have a vulnerability to becoming ill if a number of factors aren’t controlled.

I’ve written various blogs in the past about how to maintain mental well-being. I’ve discussed the importance of being honest and how talking about feelings makes them less scary and more manageable.

As a society, we use the phrase “how’re you?” or “are you alright?” as a salutation and don’t really want the other person to go into detail, however, it’s at times like this (when the world is uncertain), when asking how each other are is of vital importance.

When I say “how’re you?” I always mean it and will always set aside time for the other person if they need to open up.

Unfortunately I have not always had the same afforded to me… I continue to struggle to open up, but knowing how important it is, I try to, then when the other person doesn’t respond or invalidates my feelings, I’m crushed. But when someone does really listen, it means the world to me.

Right now, you might be loving lockdown because you’re being permitted to stay inside and do what you want when you want. On the other hand you might be feeling angry, depressed, anxious or guilty because there’s so much out of your control and you’re being stopped from doing the things you want and need to do.

All feelings are valid and need to be expressed.

A silver lining to come out of this pandemic is the mental health is now on the agenda every day. The year, mental health awareness week is about kindness. Asking how someone is, meaning it and really listening to the answer is the simplest kindness you can offer and what’s great about it is you can do it on the phone, by text, by video chat or in person, socially distanced!

You don’t need a mental health diagnosis to look after your mental health. By being more open about how we’re feeling, it’s a good step towards being able to talk about more issues around mental illness.

Reality of depression

I write blogs to share my experiences. When a psychiatrist diagnoses depression, they’re looking for a specific set of symptoms described in the DSM V or the ICD 11 all or most of the time over an extended period:

  1. Depressed mood
  2. Diminished interest or pleasure in activities
  3. Decrease or increase in appetite
  4. Subjective slowing down of thought and movement
  5. Fatigue or loss of energy
  6. Feelings of worthlessness
  7. Diminished ability to think or concentrate and indecisiveness
  8. Thoughts of death, suicidal ideation without a specific plan, attempted suicide or planned for suicide.

I understand the need to be able to diagnose in this way but this is not how people experience depression. I’m writing this blog to give some insight to what it’s really like to be inside the mind of someone struggling with symptoms of depression.

In reality, people experience the following, jumbled and apparently nonsensical feelings:

  • I don’t want to make a fuss but I’m worried about how I feel
  • I feel sad, frustrated, angry, scared and numb at the same time
  • Sometimes I feel happy and then I feel confused and guilty
  • I feel lethargic and then I beat myself up for being lazy
  • I cry about everything and nothing but then sometimes I can’t cry when someone tells me something sad
  • Lying awake at nightI feel completely exhausted, during the day all I want to do is sleep then at night, I can’t sleep, I just lie awake
  • I’m not interested in going out, I won’t enjoy it and I have nothing interesting to say so what’s the point?
  • I don’t have any friends and I can understand why, I wouldn’t want to be my friend
  • I just want this pain to stop, it’s a pain like no other
  • I feel like I’m falling down a black hole, like my life is meaningless, is there any point?
  • I’m scared I’m going to lose my job, I just get a feeling I’m doing it all wrong
  • I can’t seem to do anything right
  • My life is fine, I should be happy but I feel like everything is falling apart
  • Life feels like a slog, I don’t think there’s any point in going on
  • I notice other people laughing and realise I’m not but the next day I can laugh and I don’t know what’s different
  • I wish I could go to sleep and not wake up

It’s the job of the GP or psychiatrist to take these experiences and attempt to make sense of them to see if a diagnosis of depression fits. A diagnosis is important so that appropriate support and treatment can be given. Symptoms of anxiety, psychosis, personality disorder, obsessive compulsive disorder, eating disorders or other psychiatric conditions overlap so it’s important to understand what the symptoms are in order to offer the right support.

I always like to offer some hope in my blogs. I’m living proof that from the darkest times, if you surround yourself with the right people, do whatever it takes (therapy, counselling, medication) it may not be easy or simple but recovery is possible.

We should think before “returning to normal”

While I understand some people’s lives have not changed as the government has imposed lockdown, quarantine or social distancing measures because you continue to work on the frontline, many people have been afforded time and space to reflect on a pre and post covid-19 life and I have to say, I’ll be making some careful choices before rushing back to “life as usual” once the lockdown rules art lifted.

Some people’s lives changed over night while others have seen more gradual changes as employers have had to make difficult decisions each week as their income decreased over time; to be furloughed has become common parlance. Some are glad of the rest and try to see the silver lining while others struggle to makes ends meet and don’t know when, how or if things will ever get better. We’ve discovered children don’t need to be examined for them to continue into the next school year and actually, when it comes to it, being happy and healthy is more important than up-to-date book learning.

I’ve needed my GP more in the last month than I have done in the last year. Appointments have been available because, here in the UK, people who don’t need to see a doctor, are heeding the advice to protect the NHS. Surely, when this crisis is over, we should continue protecting the NHS? Why, pre-covid-19 were there people in A&E who didn’t need to be there? Don’t get me wrong, people who are having symptoms of life threatening emergencies, really should call for an ambulance.

I’m more connected to the people who matter in my life than I have been before. I’m not seeing them face-to-face and I want that to change but I’m connecting with some people on a daily (or near daily) basis and I like that.

People’s shopping habits give us food for thought… the initial panic caused by the unknown, when will the next trip be? And will the shelves be stocked next time? Were these actions selfish, greedy or anxiety driven?

Most people are now sharing positive changes in their shopping habits. A reduction in multi-trip shopping because people are reducing waste by using up left overs and making do with what’s in the house. People are finding locally sourced produce such as eggs and meat and having online groceries such as fruit, veg and store cupboard essentials delivered directly to their doors reducing travel. Shopping trips that are happening are less fraught because fewer people are permitted inside the shop at any one time, we’re standing back and giving each other space – surely this should have always been the case?

As soon as people realised they had more time they looked for ways they could help one another. Being community spirited should continue. Why did is take a global pandemic for me to get my neighbour’s as phone number? How come my neighbours didn’t know I played the saxophone until I played in the street as part of the Clap for the NHS on Thursdays? Why did it take such drastic measures for us to start to get to know one another?

I’ve discovered daily yoga, fresh air and being assertiveness are actually good for me. Previously I just thought they might be, since being given time and head space to actually try them, I’ve discovered it’s true! We’re all different, what’s now in your new daily routine that wasn’t before – why would you let that slip just because you wanted to “get back to normal”?

How many of us blindly accepted our daily commute but have miraculously found that it’s not actually necessary? Perhaps remote working has its draw backs but many people have found ways to make it work. A reduction in travel has reduced pollution to levels no one could have imagined. Our planet is breathing a sigh of relief.

Has there been another point in history when we’ve had daily press briefings and held the UK government to account every single day? They’re making the science accessible, answering our questions and they’re being clear about the guidance and why it’s in place.

It’s gutting that it’s taken a deadly virus to do it but mental-wellbeing is being spoken about everyday. It’s not ok that the suicide rate is increasing and no amount of money is going to resource the mental health services sufficiently but let’s keep raising the profile of mental well-being and keep checking on each other. Let’s make it a normal conversation. When you train in CPR, make mental health first aid a priority as well – it always should have been.

Are you longing for your “old life” through rose tinted spectacles? Perhaps you’re miss seeing people face to face, at the moment you’re being told “no” and that naturally makes you want to rebel but don’t make the mistake of thinking everything about “the good old days” was better…

On the 23rd March in the UK and on other dates across the world, we were forced to adopt a new normal by governments announcing lockdown measures to keep us safe. As the measures are gradually lifted, we can choose to adopt a newer, brighter normal as we bring together the best of both the old and the new.

We can choose to hug people when we see them but also stay connected in between. We can choose to shop efficiently, not give into greed, continue to source local produce and ask our neighbours if we can shop for them when we’re going. Where we need to go back to previous ways of living, can we find compromise?

Who would have thought about broadcasting weekly church services on YouTube? Faith communities are reaching beyond their building walls like never before and although returning to gathered fellowship will be cause for massive celebration let’s not lose what we’ve gained from being forced to church technologically. How can we have the best from both worlds?!

For many, there’ll be financial consequences for years to come. There are many who have no choice, they can’t go back to life pre-Covid-19 due to bereavement, redundancy or other life event. Are there choices we can make as we find our new normal that will benefit anyone less fortunate than ourselves?

If everything about your old life suits you better and that’s what you want to return to and you can, that’s your call but I just ask that you make an active decision and don’t just go back to it mindlessly without thinking carefully about the true implications.