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Saturday, 28 May 2016

In Defense of Medication

'Medication' by Antti Lehtinen via Flickr 

In one of my earliest posts, I spoke about how I was first encouraged to speak to a GP about my mental health concerns. After two personally frustrating meetings with the same doctor I was prescribed medication for my anxiety. It was a medication called Propranolol, a beta blocker type more commonly used to treat heart arrhythmias but also useful for anxiety and stage fright because it mediates the fight-or-flight response. A medication that, after some research, I refused to take.

This isn't to say that the drug itself is bad in any way; in fact a more accurate thing to say would be that I did the research to prove to myself that the drug wasn't bad. I already had bad feelings about the prescription because my meetings with my GP were rushed and not particularly thorough. There was no real question as to the severity of my anxiety, more questions about what about my lifestyle was encouraging it which...hey, I'm not a doctor, but surely not everything can be linked back to my being overweight?

I digress.

So I wasn't sure I had been prescribed accurately, plus I have friends around me that had dealt with negative side-effects to medication for their mental health problems (worsened symptoms, breakdowns, misdiagnoses, etc.) so I was already frightened by them. My self-deprecating mind, reinforced by cultural expectations of me which I'll delve into another time, made me think that all I had to do was think hard enough and I could cure myself. I made myself feel like taking medication was akin to giving up and admitting I didn't have any control over my thoughts (spoiler: I didn't.) So I went to the internet looking for descriptions of what the drug is and how it works, as well as personal accounts from people who have used it.

Results were overwhelmingly either positive or neutral, with very few people complaining of side-effects. I found out it was dangerous to operate heavy machinery whilst on Propranolol, which would have made work slightly difficult at the time, but other than that it was either people describing how it had changed their lives for the better or that it was a pretty simple, low-risk anti-anxiety medication.

Found un-credited. Please let me know the source of this image

I should say: using the internet as a doctor by no means the best course of action, and you should always speak to a professional when medicine is concerned, but please understand that I had no desire to go back to my GP after feeling like I had been assessed carelessly. I didn't act in the smartest way, but it's what I did.

The results of my searching made me feel like the doctor had, at least, given me something seemingly low-risk. There didn't seem to be any danger of my symptoms worsening whilst on these pills, and the dosage I was given was less than most of the people whose personal accounts I had read.

Still, however, I refused to take the medication because I knew there were other options. I wanted to try talking therapies, work with IAPT or with Mind, and use the medicine as a last resort option. Whether I regret that or not I can't say because I don't know whether it would have benefited me more than CBT or Mindfulness have.

I will say that when people ask me whether they should consider medication for anxiety, depression, OCD, PTSD, psychosis, or any other mental health disorder that can be treated or have the effects mitigated by medication my response is always something along the lines of:

 "Talk to your GP, talk to a psychiatrist, get a second professional opinion if something doesn't seem right, and decide that way. My experience is not yours."

I could have operated in a smarter way, but at least I went from my GP and my own research to an NHS organisation (IAPT) who evaluated me and decided what treatment would be best for me. Relying purely on 'my friend said' or 'the internet said' or even 'my parents said' can end up doing much more harm than good because people have biases and misconceptions and all kinds of space for error to occur.

Not only that, but if you yourself have had a negative experience with medication or a specific medical professional/organisation it is of course a fantastic thing to spread awareness of potential dangers. However, it doesn't make you an expert on the thoughts and feelings of others. Don't warn people off something that might safe their lives because it didn't work for you or someone close to you. Let them know the risks, absolutely, but always encourage people to seek professional advice.

I was surprised by how many people had benefitted from propranolol, even had their lives changed for the better, because I had a stigma against anti-depressants and anti-anxiety medication based on other people's experiences. What If I had really needed it though? What if I had spurned life-saving medication because of preconceived ideas? Perish the thought.

I feel like, because I talk exclusively about ways to combat mental health issues without addressing medication, it would be a good idea to make my stance clear. A single mental illness can affect different people in a variety of ways, so of course treatment depends on the person and how the illness affects them. Some people requite a mixture of treatments in order to get the results they seek. So if meditation helps you a little bit, medication might take you the whole way, or if medication helps you in one way then something like talking therapy might help you in another. Maybe all three or more work for you, maybe none. The key is to listen to your personal needs, and not to feel like you're wrong or broken on not working hard enough if my advice, or anyone else's, just does not work for you.

Credit: runningmandz and icantdrawbutdontcare via Tumblr

Monday, 23 May 2016

#MHAW16 - Affirmations

We're at the end of our daily blogs! I've had a lot of really wonderful feedback for these posts and I'm glad those of you that read this blog have enjoyed this week! It's been tough to get everything out in such rapid succession but it's also helped spark much more creativity in me so I'm glad I decided to do it. I often have anxiety (surprise surprise) about the upkeep of this blog and have come close to just letting it die off out of fear. It's like people always say about fears, though -  you get over it by just pushing through and doing the thing, and though I don't think that always works I think it did here! Which is wonderful.

So the last thing I'm going to talk about this week is affirmations. I've probably talked about them in previous blogs, but they're essentially words or phrases you can use either through the day or specifically during meditation to ground you in the present moment and remind you of whatever it is you need. Similar to mantras but not necessarily with the same spiritual meaning behind the words.

For example, I have an affirmation I use for meditation that is simply: "I am here." The reason for this is because often times in panicked situations I can dissociate from my body and feel like I'm floating just outside it, like nothing around me is real or meaningful.

 It's as frightening as it sounds.

To combat this I will do things to remind me that I am alive and present. I used to grab onto things nearby, remind myself that they're tangible, but that isn't always possible to do without attracting attention. Having a silent phrase helps this.

Not only that but it reminds me not to panic about the past or the future, to remember that right now the only thing that exists is the moment I'm present in right now and so that's what is most important. I.e.: mindful thinking.

So, as a close out to Mental Health Awareness Week, I think it would be a good idea to think about something that maybe you need reminding of. Something that grounds you, makes you feel safe or changes your perspective in a positive way. It can be a word, a phrase, maybe even humming a melody. All that matters is it works for you and is memorable. 

Try it out along with a short meditation (I would recommend the wonderful Three Minute Breathing Space) and see if it helps. Let me know whether it does or doesn't, and experiment with different affirmations for different feelings or needs.

A final thank you for joining me on this journey, I hope you're all well, and do let me know what your experiences have been with this blog post and with the week in general!

'Affrimation'  by David McCreath via Flickr

Sunday, 22 May 2016

#MHAW16 - Mobile Self-Help

 This morning I wasn't feeling so great. It wasn't for any specific reason, it just happens sometimes and I don't do anything to bring it on. When I can feel it, however, it's so difficult to stop myself from spiralling lower and lower and just allowing it to happen. For this reason, as I showed in my most recent update blog, I have an envelope pinned to my cork board titled "What To Do if I'm Not Okay". For me, it's important to have self-help tools and techniques within arms reach, so it's easy for me to stop the spiral before it gets out of control.

Thinking about this, and thinking that maybe other people feel the same, I wanted to talk about the self-help apps I have on my phone in the hopes that one of them may be of use to you all. These days we all have our phones with us at all times, so why not store something on there that can help you relax and work on your mental health in as convenient a manner as possible?

1. SAMApp

I've spoken about the SAM or Self-help for Anxiety Management app in much greater detail on my blog before, so I would recommend reading that post after this one. It's an app that does as it says, provides the user with techniques for self-help and anxiety management. The UI is pretty straightforward and in bright, calming colours mostly blue and white. It comes with a large amount of features for just one app, including a tracker to track your anxiety levels at as regular an amount of intervals as you would like. There are various calming activities like colouring in images, typing out things that make you anxious and tapping the screen to blow them up, educational information, and contact information for emergency help to name just a few things.

2. Calm

The Calm App was recommended to me by my IAPT therapist while I was still seeing her. It's a guided meditation app, voiced by a generic but soothing female American voice. There is a free set of calming meditations available, much like the body scan meditation in varying lengths depending on your need. It also utilises calming sounds like ocean waves and rainfall to enhance the experience and block outside noises when using headphones. Because there are super short minimal movement meditations available through it I actually use this for situations in which I am immediately uncomfortable or panicked like crowds or particularly busy public transport. If I don't have the option to get up and walk, this is a great way for me to quietly lower my stress levels in the midst of a busy bus or train which can be unbearably stressful. There are more meditations available behind a paid subscription, but use the free 7 days of calm, compare with other apps, and see how you feel first.

3. Headspace

Headspace is another app for the purposes of guided meditation, with many many different courses of mindful meditations guided by the soothing and personable voice of meditation and mindfulness expert Andy Puddicome. There are meditations for all aspects of life and self-improvement like improving focus, sparking creativity, help with relationships and much much more. It's a fantastic resource for ongoing self-help, and while access to these meditations does come at a price the app offers a 10-step beginner course called "Take 10" for users to try for free and decide for themselves whether or not to subscribe. While this can be used on the go I would suggest being in a place where you can really engage in the words being spoken and feel entirely comfortable with meditating, unlike the Calm app. The results are honestly worth it, however. It's a really accessible way of taking on board mindfulness techniques and I absolutely love it, not to mention the aesthetic and the illustrations are absolutely charming.

Friday, 20 May 2016

#MHAW16 - What are you good at? That's awesome.

I'm mostly just about a display I put together at work, and I mostly wanted to show it off in today's blog. Is that okay? Okay.

So the display was all about Mental Health Awareness Week and Dementia Awareness week. I filled it with books on the subject as well as leaflets and posters of information about mental health services, resources for carers, and resources for the elderly to read through. I worked on it a fair amount, and although it's quite simple I'm proud of the way it turned out. It's informative, visible, and most importantly useful to the general public. I feel a little sense of pride when I see someone observing it or picking up books to borrow. That might be the start of something new and fantastic for this person, and how wonderful for me to have had a small hand in something so awesome.

Realistically, it's just something small in the grand scheme of things that can be done for people with mental illnesses in my borough, let alone at large. But it is something, and that's an important thing to rememeber.
Sometimes I get discouraged from writing because I feel like there is so much more that I should be doing. I beat myself up about it, telling myself that I don't care enough and that if I really did I would be doing more active things, giving more money to charity or volunteering constantly. Starting hashtags and banging on the doors of Number 10 day in and day out.

Thing is, those things are fantastic, and the people who do or create or think of them are priceless assets to the movement. Let it be known that the love you must have for other people in order to dedicate your life so entirely to a cause is enviable. But they need supporters, they need signatures on  a petition and mouthpieces to spread knowledge and information in times where they cannot. They need people twirled in and around our society that can help them normalise the discussion of mental health. When governments make claims about creating a 'parity of esteem' between physical and mental health they need people all over the country and the world vying for that goal, and holding them accountable if they do nothing to reach it, and that's something we can all do in a world where your voice is more audible and important than ever.

So, rather than moping over what you haven't done (maybe not yet, anyway) we should take a second to list all the things we can and have done for both individuals and the wider world. If you want to do more, start making a game plan to figure it out.

Every example is important and worthwhile, just as you and I are.

Thursday, 19 May 2016

#MHAW16 - Where did you Start?

I recommended IAPT and Cognitive Behavioural Therapy to a woman last week, and I can't get the moment out of my head.

I've been thinking about the interaction for various reasons, but the one I have been mulling over a lot is that I have a lot of admiration for the woman I was speaking to. I was helping her out with some work and she seemed a little frantic in her speech and her movements. However, when she confided in me and my colleague about her struggles she spoke so clearly, so honestly, and with direct eye contact. I was surprised by that kind of blatant honesty to a total stranger, it's not something I've ever felt comfortable with.

The funny thing is, her honesty made me feel comfortable doing the same. You've been struggling with panic? So have I actually, here is what worked for me. The dialogue was so easy, I felt nervous but I also felt that same tremulous energy from her and in a weird way that set me at ease.

I also admired her certainty. She knew what she was suffering from, knew how long she had been, she just hadn't been guided on how to treat it. Some days I'm still unsure of myself, and when I started on my journey I had no idea if what I was feeling was really anxiety or depression, not sure whether I would be laughed out of the doctor's office, not sure of whether it has been going on for fifteen minutes or fifteen years. If indeed she does take my advice, I wonder what it might be like to start on that journey with such a clear mind. It sounds exciting to me, and I wish her all the best in it.

'start' by Jakeandlindsay' via Flickr

It just got me thinking about where I began with this whole thing, you know? Like, what if I had lied about how I was feeling and just tried my best to deal with it? What would have happened to me if I didn't reach out to someone? I needed to allow myself to be vulnerable in order to progress, and I'm starting to think that this is the key to getting mentally healthy. Allowing oneself to be vulnerable enough, if only for a moment, to let someone with the ability to help really have the opportunity to help you.

It's something that's worth meditating over for all of us: are you on a mental health journey? Where did it start? Did you need to be vulnerable in front of someone in order to get to where you are now? Why/why not?

I hope you're all having a good week and you're taking care of yourselves and allowing the time and space to take on whatever journey you might be on at your own pace.

The Long and Winding Road
The Long and Winding Road by Marie France Boisvert via Flickr

Wednesday, 18 May 2016

#MHAW16 - Mental Health Prejudices

I'm noticing a lot that when I talk about mental health, I talk about those kinds of illnesses that aren't immediately distinguishable. The reason for this mainly is because that's where my experience lies. I'd rather not make assumptions or assertions about people whose experiences I know nothing about. I know how frustrating that can be for me, so I'd rather not treat people in the same way. Imagine me writing out long, ignorant spiels on Autism or Schizophrenia with half-read, half-heard knowledge. I feel like it would be a disservice more than anything.

Still, I think it should be said that when we talk about mental health awareness we are not just talking about depression and anxiety in young adults, not to invalidate those illnesses or those people at all since I'm one of them.  We're talking about depression that people with physical disabilities often go through, children and elderly people with mental health issues that need help getting treatment. People who live within cultures where you're taught to just "get over it" or "snap out of it" but they can't, they honestly can't. We're talking about Dementia, as it's also Dementia Awareness week this week.

We need to show the love and acceptance we give to those who suffer silently to people with physical and or verbal ticks that they cannot control. We need to actually acknowledge the severity of OCD and stop equating people who have to wash their hands until they rub their skin off to people that need to keep things neat. We need to listen to and acknowledge people who hallucinate, people who have underdeveloped motor skills or verbal communication difficulties, and people who have to be under constant care.

'Subsumed' by Zander Campbell via Flickr

We need to extend love and empathy  talking to the people who might frighten some of us when we see them out and about, the people that might cause us to stare, or turn our heads away, or dismiss as "mental" or "batshit".

Not because we hate them, I know I don't, but because we often fear the things we don't understand.

It would be a good idea for us to try, however, to read and learn and grow more as people. If we attempt to learn more than just what we can contribute to the conversation we can, in turn, grow and enrich the conversation, make it more productive. That, and inviting those people who don't feel like their mental illness is the "right type" or the type that is relevant to the discussion is even more important. First-hand experiences are the best ways for us to learn and make changes.

The conversation about mental health is still in its infancy, and I'm sure my rhetoric has a lot of growing up to do. I want to be more inclusive in my thinking, and I'm trying to be so here and onwards.

As a next step, I invite all of us reading to take the time to do some learning. I've gained a LOT of insight from a series of videos on Psychology from the educational YouTube channel Crash Course, so I have a link to the playlist below. If you have any more resources, please do let me know.

Tuesday, 17 May 2016

#MHAW16 - How not to be Overwhelmed by Work

From printable leaflet via the Mental Health Foundation

My mental health journey started with my transition from University and into the working world. I went from drawing more and more inward while I was unemployed to finding a job, feeling that high of accomplishment, and quickly becoming overwhelmed. Not that I hadn't worked before, but just that there was always the constant of school to ground me in something comfortable, and to satisfy the part of me that needs validation. Suddenly everything was different, I had nothing to weigh my self-worth on except this job I didn't even like, and it felt like all the things I loved before then were eluding me and would do so forever.

I felt like I had nothing to relieve the pressure from me, so I cracked. And while that low point helped me progress, not everyone might be so lucky. There are quite a few things I know and have now which stop me being overwhelmed by my working life, some of which may be complete common sense to you. Still, I had no idea then and maybe some of you have no idea now.

(Note: of course, the number one solution is to find a job you love, but of course this just isn't an option for everyone. Not only that, but even the work you love can get stressful!)

1. Keep people around you that love you

from printable leaflet via the Mental Health Foundation
I went out less and less as time went on because I always felt drained. I would flake out on going to meet friends or make up excuses because I had this constant feeling of exhaustion and just wanted to be in bed by myself, or with my partner at the time. Of course he supported me, he was the person that suggested to me that I might need to see a doctor about my anxiety, but shutting myself off from all the other people around me in an attempt to "rest" only made my life more stressful. I was always at work or thinkig about work, so I never really got to relax but having friends to vent to and look forward to seeing and to support you is a great way to actually give you more strength and energy.

Also, having people around you is great but if those people are adding to your negative feelings more than they are helping you move in a positive direction...consider letting those people out of your life. Know the difference between people that tell you things you don't want to hear but need to, and people who tell you things you don't want OR need to hear. Get rid of the latter.

2. Prepare for work the night before

Part of the reason I would get so stressed even before I started my shift was that I was rushing to find my uniform, get my lunch together, make breakfast, shower, do my hair, and get all my things together in the morning before work. That as well as keeping an eye on the time so I'm not late for my bus and all the while milling over all the things I'm probably going to have to do at work and desperately not wanting to go in. If I wake up with my anxiety at a 2, it's already at a 5 by this point. Add morning public transport to the mix and I'm already over halfway to breaking point by the time I step through the doors. Take some of the pressure off by getting as much as you can ready to go the night before, so you can wake up and move at a less frantic pace.

3. Eat Breakfast

'cereal'  by plkakaka via Flickr
My initial way to combat this was to remove whole chunks from my morning routine, one of those chunks being havig breakfast. Poor idea, because all it does is make me super hungry so I eat even more later, making it harder for me to lose weight, or it makes me hungry and tired and irritable. So while I have a small amount of time added to my morning this is counteracted by added stress from not eating properly.

4. Get up Early

After a while I was barely a person when I got up for work. I would peel myself out of bed at the lastest time possible, shower for as long as I could manage, wouldn't eat, would barely do anything to my face or hair, and just about managed to exist before I got home and crashed again. Doesn't that sound miserable? That's because it was, and honestly the way I've fixed it is by waking up even earlier and going to bed earlier too. Now I have time in the morning to get everything done at the pace I would like, leaving me space to get into to work with a minimal amount of anxiety so I don't immediately feel burned out.

5. Have a hobby

'Elijah' by Clemente De Muro via Flickr
Even during university I had started to slowly trim away at all the things I did for fun. First year I was constantly writing poetry, I went to open mics, I started a band, I was trying to make music and craft stories and a whole bunch of creative things. As I focused more on school those things fell away, or other commitments made it more difficult for me to hold onto them. By the time I really needed those outlets as a way to relieve stress and find validation and joy in something else I was afraid of them. I had been away for too long or I wasn't good enough, mostly I just convinced myself that there was no time for me to engage in anything fun. However, the more you egage in things outside of work that inspire or excite you the more energy you actually have to go in and get work done. Inactivity is a sure fire way to prolong depressive episodes and make you even more exhausted.

6. Stay active

Kickboxing Class
'kickboxing class' from via Flickr

Working out, opting to walk to work or walk home rather than getting public transport if possible. All of these are good ways to get your blood flowing, get your mind awake, and fight off that stagnant, claustrophobic, depressive feeling. Classes or taking up a sport can also be a way to mix five and six into one active package. Take up kickboxing so you can literally kick depression's ass!

7. Don't agree to do everything

Now this I still often struggle with myself: the fear of saying no. For me, and many others like me, the fear of the potential reprocussions of saying no to a task you're given at work can be monumental. Even if it's something we aren't necessarily comfortable or confident in, or something we have no time to do. Know that often times it's much easier to express your discomfort and see if another solution can take place, and even if that results in a negative outcome it's still not the end of the world. You do not have to do anything that you aren't comfortable with or you don't think you can execute without more training. Everything will be okay, and you will feel lighter because you stood your ground.

8. Find a productive Mindfulness Bell

I talk about these a lot, I know, but it's only because I have found them so infinitely useful. They could be absolutely any action, and you decide to associate it being mindful. Ideally something that causes you to move in a certain way or say a certain phrase so you can associate those things with thinking about the present and being aware of evrything around you in that moment. Before I even knew what mindfulness bells were, I was able to will myself into making the act of jobsearching a relaxing exercise. I would think of it as a way to escape my situation at the time, and from that perspective it was something necessary and exciting so I was able to approach it with far more enthusiasm. Give it a go, see which action you can turn into a trigger for calm. Maybe even mix it with one of the earlier steps for two de-stressers in one!

Hopefully there was some advice in this applicable to you, and if not definitely let me know why! I always love feedback on my blog so I can improve it and create a much more useful environment for you and me also. I hope you're having a wonderful Mental Health Awareness Week, and please don't overwork yourselves.


Monday, 16 May 2016

#MHAW16 - Extending and Receiving Empathy

It is now officially Mental Health Awareness Week! This is a week all about shedding light on the effects of mental illness, and paths to mental health and wellbeing, for people everywhere. Obviously, given the subject matter of this blog, it's kind of a big deal for me. The conversation is key to allowing people to be comfortable with the idea of themselves and the people around them suffering from something that isn't always automatically visible, or even easy to understand.

Mental health is something we have been getting to grips with at least talking about more openly in the past few years. Hopefully, events like this will give people opportunities to read more, learn more, share their own experiences, and allow us to grow as a collective in favour of a less negative, frightened, or dismissive response to people's illnesses.

In accordance with the theme for this year, Relationships, I would like to talk about one of the most important ways, in my opinion, to create and maintain and strengthen interpersonal and intrapersonal relationships of any kind: empathy. Imagining others complexly, in the words of John Green.

We have no clear concept of the suffering of others, nor the joys, but attempting to think of how we would feel when presented with the same situations as them can help us gain much more understanding. It helps us to view people as just that, as people who live, breathe, think, and feel as we do. Suddenly, you might find, we take more care with others. We treat them with the love and care we would like to be treated with once we have placed our hearts in their chests. We are able to love and to feel loved, and it can often bring us closer.

'empathy' by Ton Zijlstra via Flickr 
I also mentioned intrapersonal relationships, meaning the ones we have with ourselves. I mentioned them because I believe that our ability to extend empathetic feelings to others has a direct effect on our ability to show compassion to ourselves.

When I see friends tearing themselves apart over issues that can be easily resolved or forgotten and I advise them to do so, it holds a mirror up to me.

"Do I take my own advice? Are there things that I overthink and work myself up over? If they can make steps to change that, surely I can too. And if I know it's not easy for them, it won't be easy for me either."

You might even want to take it a step further: imagine some of your negative thoughts in the voice of one of your closest friends, take it as though you're listening to some of their concerns. How would you advise them? Would that same advice work for you? If so, take it and feel accomplished at problem solving. If not, consider why not? Are the reasons also negative and anxious assumptions, perhaps?

Above all, take care of yourselves and of others, even those you find difficult in some way because loving them despite that is a sign of maturity and wisdom that I would love to reach some day.

from printable leaflet via the Mental Health Foundation