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.
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:
Diminished interest or pleasure in activities
Decrease or increase in appetite
Subjective slowing down of thought and movement
Fatigue or loss of energy
Feelings of worthlessness
Diminished ability to think or concentrate and indecisiveness
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
I 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.
TW – Trigger warning for detailed content about suicide and suicidal feelings.Please considering moving onto a different blog if you may feel particularly distressed reading about these subjects. It’s important to practice self care and only read content on the internet that will benefit you.
While Covid-19 is spreading through our society, we’re being asked to stay at home to keep safe. But this is only keeping us physically safe from a virus. I do understand that this virus is especially contagious and virulent therefore physical safety at this time is a priority but I want to spend a few moments reflecting on the meaning of safety and it’s different forms.
A feeling of safety can be captured through routines and familiarity, this is why people so often struggle with change. Nearly all of us are coping with huge upheaval as Covid-19 is sweeping across our nations. Working from home, not working at all, stopping social activities, home schooling our children, doing more or fewer activities than previously – some of these may have positives, negatives or a mixture of both but change is always hard.
Cortisol is our stress hormone. Usually it is released to help us cope with a peak in stress and it aids managing the stressful situation. However at times of long term stress, cortisol being released over a prolonged period leads to all sorts of side effects such as fatigue, irritability, headaches, intestinal problems, anxiety, depression, weight gain, increased blood pressure, low libido and erectile dysfunction.
Lots of people are being brought to our attention as people who need care/support: the elderly, those living with an abuser, the unemployed, the homeless, people with chronic illnesses and many others – each group has its spokes people. But I fear for those we don’t hear about – who’s helping the people we don’t know about?
There have been many occasions in my life when I’ve felt unsafe and it’s been my own thoughts that have been working against me. Mental health crisis is hard to explain, trying to explain what it’s like being suicidal is like trying to describe colour to someone who’s been blind from birth.
Being suicidal feels like all your senses have been taken away included your senses of dignity, perspective and reality, it feels like one by one everyone is giving up on you and this makes sense because the situation is completely hopeless; you’re a worthless human being with nothing to live for, gradually the grey numbness you’ve been feeling for a while turns to an active hot feeling of desperation – “whatever this is, it is unbearable and it just has to end.” Eventually calmness and serenity is felt once a plan to end the suffering is in place. (At least, this is what it was like for me.)
So, this lockdown (in whatever form it’s taking in the country you’re in) is designed to prevent the spread of a virus but at what cost? I‘m definitely not saying we shouldn’t be following government advice – I’m the first to do as I’m told! What I am saying is we need to ensure we look after our physical and our mental safety.
Specific links about how to look after our mental health during the lock down can be found at the bottom of the page.
A “place of safety” is somewhere designed to help an individual through a mental health crisis, to support them while they’re feeling suicidal, to prevent them carrying out any plans they may have made to end their life. Usually this is a specialist mental health unit but it can be A&E or a police station. Unfortunately I have been detained in a police cell; I was scared, yes, but realising I was too unwell to make decisions about my care myself, it was a relief that they took over responsibility for my safety when I couldn’t do it myself.
I recently returned to therapy because my mental health has been challenged. For me, the therapists room is a place of safety because it’s somewhere I can be myself. Most people are different versions of themselves in different environments but when suffering with mental illness most people are familiar with the feeling of putting on a mask. Most of the time this mask ensure the world has no idea what’s going on underneath. At work I’m professional, competent Frances; socially I’m friendly, pleasant Frances etc. In the therapy room, my therapist doesn’t judge me for being anxious, confused, angry, annoyed – it’s safe to take my mask off.
As the weeks of this pandemic drag on, people start to talk about cabin fever or “going stir crazy”. These phrases refer to feelings of being cooped up too long. This place that was meant to be keeping us safe has become a prison! This is exactly why most lockdowns include being permitted to go out for exercise and it’s vital to take advantage of this if possible. If it’s not possible, sitting in the garden or by an open window as often as possible is really important.
So, if you’re doing as the government has asked and you’re staying at home, thank you for keeping your community safe from the virus. But it’s really important to spend some time thinking about what makes you feel mentally and emotionally safe:
Keeping busy? – try learning something new
Seeing friends and family regularly? – connect with them however you can.
Having time and space to yourself? – timetable 15-20 “me time” in a separate room and let other people in your household know that’s what you’re doing.
Keeping familiarity and routine? – build some habits into your day to build a new routine.
Having freedom to move around? – use the permission to exercise daily if possible.
A hug? – whether it’s someone you live with, a pet or a cuddly toy it’s ok to to give it a really good squish everyday!
Having autonomy and control? – focus on what you can control not what you can’t. I find the serenity prayer helpful!
If you’re feeling unsafe or uneasy, can you work out what’s missing? Whether it’s about feeling empowered and in control or being allowed to be vulnerable and looked after for a short time. Perhaps at the moment it’s not easy to get exactly what we need but can you simulate it? Maybe we don’t have freedom to move around but how about planning a holiday for when it’s over because, this is going to end. We don’t know when, but it will.
It may also be important to take things out of your daily routine that is harmful to your mental and emotional safety. These links provide really good hints and tips for looking after your wellbeing during this time of uncertainty.
Mind – a wide variety of information including managing wellbeing, work, anxiety and social care rights