Tag Archives: physical health

How to survive Blue Monday and thrive this year

The 3rd Monday of the year has been found to be “Blue Monday”, the day when people most depressed, uncertain if the future and even hopeless. It may be pseudoscience but I think people are feeling pretty down this year. Some people find themselves in debt after Christmas, struggling towards the next payday, weather in the northern hemisphere is pretty bleak and this year in particularly, the Covid-19 pandemic has been dragging on just a bit!

I just had to respond with a blog about how we can manage this period of the year and learn some coping strategies that will benefit us for the rest of the year!

Person tiring their shoe laces

5 top tips:

  • Move everyday—some form of exercise whether it’s yoga or walk or a HIIT workout, moving your body is awesome for all sorts of reasons. It can be a good distraction, a time to think, or a time for mindfulness. It releases endorphins, the feel good hormone. You can get the whole family involved too!
  • Creativity—whether it’s poetry, pottery or a building a shed, being able to say “I made this” with a sense of accomplishment boosts even the lowest mood. Turning your hand to something new or picking up an old skill taps into a part of the brain that we don’t use everyday. Something we can all do is listen to music, while it’s not building or making anything it taps into an expressive part of the brain and can be incredibly powerful.
  • Writing—it’s been found that even just writing about what you’ve been doing each day can help build memories. For some people, writing can be a way of expressing themselves if they find it difficult to talk about how they’re feeling. If you pick up and pen and don’t know what to write, perhaps start with things you’ve done or things you can see, hear or smell, then try writing some about how you feel, it doesn’t have to make sense initially but you’ll soon get the hang of it!handwriting
  • Talking—this is an incredibly beneficial coping strategy. From talk to your a pet to choosing to take up personal therapy or anything in between. It’s important if you live alone to keep in contact—we’re incredibly fortunate with the range of technology (text, email, various video call options or good old fashioned phone call) these days we just need to use it!
  • Help others—looking after a pet or even a plant can really improve your mood and help your self esteem. Feeling depressed can make all your thoughts turn inward but making yourself look outward can bring a different perspective to your problems. It doesn’t have to be huge but once you start you might feel you want to do more and more!

A few simply dos and don’ts

  • Do express your emotions in a health way—have a good cry if you need to, punch a cushion, scream if it helps, these are all fine. Make sure you can differentiate between healthy and unhealth expressions of emotion.
  • Don’t turn to addictive behaviours—alcohol may be “socially acceptable” and may “feel nice” but it’s just a way of numbing your feelings and it’s ultimately helpful. Equally, turning to food or anything else you know is your usual coping habit is a way of pushing away your feelings. A more healthy way of coping is to find ways of being able to manage your feelings in the moment such as breathing techniques, talking or writing about them or try mindfulness. (It’s fine to have a drink but just ask yourself if you’re drinking to escape stress/feelings etc?)woman holding a glass of wine
  • Do limit time spent reading/watching news about Covid-19—make sure you know the pertinent information but beyond that don’t get sucked into the unhealthy political mud slinging that the media seem to enjoy.
  • Don’t compare your life to other people’s! You don’t see what goes on behind closed doors. Don’t endlessly scroll through social media, limit your time on social media if you can. Remember that what other people post is a highly edited version of their life and doesn’t reflect their reality. Try to only follow people or pages that bring you happiness (hide, mute or unfollow everything else—it really is that simple!).
  • Do remember you’re mental, physical and spiritual health are all linked, if you don’t look after one, the others will suffer. Doing something physical, like going for a walk or having a bath will do just as good for your mental health as it will for your physical health. If you didn’t think you had a faith but this pandemic has got you asking questions like “why would God do such a cruel thing?” perhaps it’s time to find an Alpha or Puzzling Questions course (or similar) and ask these questions. It’s ok to get angry at God, he can take it. Ask someone you know goes to church or contact your local church (or other faith community) online, they’re all doing far more online than they used to!

If you think your low mood is more than feeling a bit blue and these tips are not going to be enough, please seek professional support. It’s important to get support early.

What’s in a label?

Some say labels are just for cans and boxes but why do people search for years for a label for their illness or disability? Why does it feel so important?

When a diagnosis is finally reached, there seems to be a sense of relief, maybe even satisfaction! Almost “I told you so!” Sadly, before this point, people worry others think they’re faking or exaggerating their symptoms. Without a diagnosis you’re just a list of problems. Before a diagnosis, phrases like “it’s all in your head” are used and the patient feels like no one believes them. Doctor after doctor has said “hum, I’m not sure; you say you feel like this, but the tests say you don’t.”

Finally, the label means validation.

Fibromyalgia is one of those illnesses that takes years to diagnose and people feel they’re not being believed, they’re pushed from pillar to post as their symptoms get worse.

The way I was given the diagnosis of fibromyalgia couldn’t have been further from what I was hoping. It’s meant to be a diagnosis of exclusion. Ideally, you would hear “We’ve done all the tests to rule out these illnesses x,y,z… and they’ve all come back clear, this is good news. (Pause.) This means, we’ve come to the conclusion, it’s fibromyalgia. It’s good, we now know what it is because we can begin to manage it. The way your symptoms are presenting (because they present differently for each individual) we’re suggesting these treatment options…”

In my experience, there are illnesses they haven’t excluded, numerous tests they haven’t done and the news was delivered, while prodding the joints in my hand (for no reason I could understand) “Well (sigh) it could be fibromyalgia”. That was it, they offered no support or treatment. “We might have a leaflet in the waiting room you could pick up on your way out…” they’d run out of leaflets…

Oh well, ignore how I got the label, what mattered was, I had it.

Fortunately, once I had the label, I was then able to find treatment options myself; I found a clinic in London (who only see people with a diagnosis) to get some advice; I had some group session with a physio and an OT and feel I can pro-actively manage the illness myself.

Reactive vs pro-active management

Understanding without a label

“But as long as we understand the difficulties, we just need to make sure individuals get the support they need.” Said a well-meaning nurse to me recently.

Understanding difficulties someone has and the support they need takes time and effort most people are unwilling to give. Understanding what an individual really needs takes knowledge, skills, expertise and often wisdom that most people just don’t have and time people are unwilling to set aside.

This nurse was supposedly reassuring me that they would offer me the support I needed for the difficulties I was facing in the office no matter whether I had a label or not… this supper never materialised… need I say more?

Why a label matters

With a diagnosis you get treatment options – before the point of diagnosis you’re crawling down a corridor of shut doors. At the point of diagnosis, a door finally opens. You’re finally allowed to enter the world of your given disorder and explore the “options”. All you’ve every wanted are “options”, that magical word! There may not be many, but before now, there haven’t been any!

Un-diagnosis can be lonely, with a diagnosis you can often find a community of people facing similar struggles, the support can be there if you want it. In this digital age we have forums of people literally at our fingertips. Just type your diagnosis in Google and there’ll be a Facebook group if nothing else! Sometimes giving support can be just as therapeutic as receiving it.

The mental health community is full of people who say “I don’t have a diagnosis but can I join…?” Of course, you don’t need a label to join but most people find it helpful to know for sure which label fits.

Sometimes the label changes

Sometimes clinicians get diagnosis wrong. Sometimes illnesses change. Sometimes diagnostic tests change or medicine gets smarter. For one patient this could be a traumatic and confusing process, for another it might be liberating.

Without a diagnosis, you may feel like a list of unknowns, more questions than answers. Why do I feel like this? Why do the tests show this? Who am I? What am I? Why is this? Things that don’t make sense and things that don’t add up. With a diagnosis there may still be lots of questions but some of them may start to have answers.

Your illness, disorder or disability doesn’t have to define you, that’s a choice, but a diagnostic label helps things make sense, is validating, answers questions, offers options and more often than not gives you a sense of belonging rather than exclusion that’s been the pain that’s been felt for far too long.

Broken trust

Trusting medical professionals

In a recent blog I concluded that I was going to try some new medication with the support of my GP – sounds sensible and simple doesn’t it?!

Unfortunately, my relationships with medical professionals isn’t straight forward!

I’ve had mental health problems for over 20 years and my physical body has been letting me down lately too:

  • The first time I went to my GP (admittedly this was in the 90s) I wasn’t referred for the support I needed.
  • The psychiatrist I was under for my first hospital admission (2005) mis-managed my case so badly I nearly died.
  • Bed bound in hospital with a fractured spine I contracted MRSA (to be clear, I could not get up and about to go and find MRSA for myself, I was given MRSA).
  • Ambulance outside A&E departmentDiscriminatory treatment in A&E following self harm. Eg longer waiting times and derogatory comments. (Some may think I deserved this and I agreed at the time but self harm is a symptom of mental illness just like hypoglycaemia is a symptom of diabetes.)
  • During a subsequent hospital admission, I built a good relationships with a therapist but they stopped seeing me with no explanation.
  • When I’ve tried to raise concerns about my care, my version of events has been discounted.
  • Abnormal blood results have been missed. Only picked up 10 months later, when I was seeing the GP about something else. I was still really struggling with the problem from 10 months previous but why would you go back when you’d be told there was nothing wrong?
  • I came out of a consultation with a psychiatrist, having told him I was actively suicidal, with no plan to keep me safe. As far as he was concerned I was going to go home and take an overdose (of enough medication to end my life).
  • For years I was told my tiredness was due to me not eating enough. When they finally did some blood tests, they found I had an underactive thyroid.
  • During a phone consultation with my GP I was incredibly distressed (crying so much I could hardly talk) and the doctor made no reference to it. I tend to hide my distress very well, the fact I couldn’t was an alarming sign I was very unwell.
  • 3 incredibly painful cervical screening tests (I was told it was normal because I was difficult) when I’ve since discovered, if they used a small speculum it can be completely pain free (twice!)!
  • My GP “reviews” my repeat prescription without seeing me (for medications that require annual blood tests…).
  • Following an ankle operation my physiotherapist insisted the exercises that caused severe pain should be performed multiple times daily. I trusted her advice. Turns out, when I went back to see my surgeon, the operation I’d had, the no-pain-no-gain approach was not appropriate and I’d done more harm than good. (I’d been the one doing the exercises so it was my fault.)
  • After experiencing blunt-force trauma to my jaw with immediate swelling and extreme pain I was told I did not have a fracture and did not need an x-ray. 2 weeks later, an x-ray revealed a fracture needing urgent surgery.
  • I recently told my GP I’d lost a lot of weight. She checked if there was an explanation. Having fractured my jaw, we ruled out the “unexplained” (possibly cancer) but she showed no concern about the fact I have a history of a serious eating disorder and may be finding the situation problematic.

Don’t get me wrong, as a qualified doctor, I’m well aware of how hard it is behind the scenes. I don’t expect all medical professionals to be perfect, everyone makes mistakes but there many other examples; I’ve been let down time after time.

The definition of trust is: “Firm belief in the reliability, truth, or ability of someone or something.”. The 4 elementals of trust are believed to be: competence, integrity, reliability and communication. It saddens me that at times all of these elements have been missing from my care leading to serious consequences (at worst, near death, at best, seriously prolonged illness).

When we trust someone we are willing to be vulnerable with them. We have no choice but to be vulnerable with medical professionals; at best we’re talking about personal issues, at worst we’re under anaesthetic! I’ve recently discovered, when on the emergency surgery list, you might never meet the person who did your surgery!

I was asked to trust someone I had never met – when we did meet, unexpectedly, in clinic 5 weeks later, he said “hmm, I recognise those arch bars… did I put those in?! Oh, I was asked to come in and help… very nice to meet you!” Turns out, the top and bottom of my jaw had been operated on by 2 different surgeons! Now, this guy was absolutely lovely and the reason I didn’t meet him before my surgery was because there was no time; he was operating while I was being put to sleep. I came out of surgery at 10.30pm and went straight to sleep on the ward and for all I know he continued operating! In clinic he then introduced himself as if building up the rapport that leads to a trusting relationship, I cannot fault this interaction one bit!

Something I find particular difficult is that when we walk into the consulting room, even with someone we’ve never met before, trust is assumed; whereas in most walks of life, trust has to be earned. Does a medical professional assume that since they’ve earned their qualifications they’ve also earned our trust? I realise I may be an extreme case but it never seems to occur to the medics I see, that I might carry baggage. If I struggle to trust, surely other people do too but it literally never occurs to them that they might need to check if I need more reassurance or explanation.

If I was still practicing medicine, I’d like to think I would have more compassion for my patients and some understanding that I could not assume their trust.

At times when I’ve been considered a vulnerable adult (when sectioned under the Mental Health Act), I’ve been in a position where my inability to speak up for myself has been taken advantage of – this is simply not ok. At times, seeing a medical professional has put me in a worse position than if I’d simply not gone to see them.

Please don’t think I’m saying we shouldn’t trust medical professionals!

I’ve had numerous fantastic experiences (I’ve definitely had my monies worth out of the NHS):

  • Multiple occasions when psychiatrists have pulled strings for me to be admitted out of area (because I don’t want to be admitted where I work).
  • Surgeons who’ve preserved my ability to walk and to see without judgment.
  • Incredibly compassionate treatment in A&E following self harm (it’s probably been 50/50).
  • HydrotherapyHydrotherapy – just wow!
  • A psychotherapist who quite literally saved my life.
  • Paramedics who’ve saved my life.
  • Hampshire CCG agreed to continue funding a Berkshire psychotherapist when I moved house.
  • Multiple intimate procedures/surgeries done with ease, dignity and compassion.
  • Multiple 2 week wait procedures.
  • Once my jaw was diagnosed (on mainland England!) I received excellent treatment! Including my consultant booking to see me on a non-clinic day to check my progress! I highly recommend Guildford Macsfax department!

Unfortunately, I’ve just had a few too many bad experiences and it’s human nature to protect ourselves from future bad experiences! I consider myself incredibly fortunate that, with my medical background and interest in the medical sector, I have knowledge that means I can manage ongoing treatments myself but should I have to?! I have to rely on the GP for monthly prescriptions but I realised, recently, I really ought to go and see them when I realised what was written on my prescription really didn’t bare much resemblance to the dosages I was actually taking! (All safe – I do know what I’m doing – not something I recommend for anyone not medically trained!)

I avoid going to see medical professionals if at all possible (generally a good rule of thumb for most people!) but this means I often put up with far symptoms for longer than is advisable! Ideally I’d be assertive and insist that they listen to what I need but feeling vulnerable strips me of the minimal assertive capabilities I have!

When it comes to it I just have to believe that the majority of professionals have my best interests at heart. Just because I’ve met a few people on their off day (giving them the benefit of the doubt) doesn’t mean the next one won’t be completely awesome!