All posts by independant82

About independant82

I have suffered from clinical depression for 12 years, and after a recent time in hospital I am ready to write about my experiences and hopefully help others on their journey to recovery

Fears over children’s mental health

A survey carried out by The Royal College of Psychiatrists surveyed 370 psychiatrists working in child and adolescent mental health services in the UK and the findings are shocking.  Eight out of ten reported safeguarding concerns while waiting for a bed, with fourteen percent of respondents’ describing cases where patients had attempted suicide while waiting for care. Urgent attention is needed to improve care as rates of referrals soar and suicide among teens are increasing.

On 12th March this year, The Times newspaper launched a manifesto calling for a revolution in young people’s mental health services.  The manifesto is produced by Professor Tanya Byron (I was lucky enough to catch her give a talk in October about mental health care), The Royal College of Psychiatrists, Young Minds and Great Ormond Street Hospital, and calls for urgent government action.  Below this blog is a link if you would like to read more or sign a pledge of support.

In January, The Guardian reported that hospitals were advised to adapt emergency procedures and admit young mental health patients into adult wards because of an acute national shortage of places for children and adolescents.  I wrote about a story a while back about a teenager who had to be taken to a prison cell because there were no NHS beds available.  Early intervention is needed and reviews need to be carried out regularly.  If you would like any further information on the manifesto please click on the link below.

Thank you for reading!  Let’s hope the government will start to take mental health more seriously. http://extras.thetimes.co.uk/public/timetomind/index.html

Being Bipolar c4 Wednesday 4th March 2014

being bipolar c4

There have been lots of programmes and documentaries which have focused on physical health, and with almost two million people being diagnosed with bipolar, this was an insightful documentary following the lives of three people who suffer from the condition.  Psychotherapist Philippa Perry wanted to uncover and understand what it is like to live with bipolar, and how far environmental factors were a cause.

Bipolar (formerly known as manic depression) is a condition that affects moods, swinging from from depressive episodes to mania.  Before the 19th Century, mania and depression were treated as separate afflictions, and people were often treated in asylums.  In this documentary, we follow three brave people to discover what it is like to live with the diagnosis.

First we meet Paul, who has bipolar I.  In his mania, we learn that he has spent hundreds of thousands of pounds in varies business schemes.  When Philippa first meets him, he challenges the label and sees himself as divine and god-like.  We dig further into his past; a talented and successful golfer and multi-millionaire.  Although Paul doesn’t believe he suffered any trauma during childhood, it becomes apparent his high expectations and that coming second was not an option – it was failure.  Towards the end of the programme, Philippa Perry suggests that perhaps developing this ‘god like’ persona was an unconscious decision to cope with not always being successful.

We are introduces to Sian, who has been diagnosed with bipolar II.  With bipolar II, delusional symptoms are rare  and the less-intense elevated moods are called hypomanic episodes, or hypomania.  She has attempted suicide three times.  The documentary examines how far genetics come into play with the diagnosis.  Joanna Moncrieff, from UCL, argues that although taking medication can be useful, it does not prove that bipolar has a biological basis.  Up until now, Sian has been dependent on her medication to try and keep her stable.  For the first time, she engages with talking therapies and finds a therapist that can help her make sense of these overwhelming emotions.

Medication and therapies have not helped Ashley.  We find out that in his childhood he showed signs of ASD and was bullied at school.  We see Ashley (who has bipolar II) swing from elation to crippling lows several times a day.  He has been taking anti-psychotic medication since he was eight years old.  Philippa Perry describes his experiences as ‘walking on a tight rope of ecstasy and pain.’  To Perry, Ashley is stuck in trauma with each depressive spell, and is re-living it over and over again.

We end with Perry examining the bipolar label.  How useful is it? Paul, Sian and Ashley have bipolar but offer very different experiences and symptoms.  Too often the label marks the end of self-exploration: it should be the beginning.  Well done C4 for raising awareness of bipolar!  I wonder if there will be a follow up?

Self-esteem group therapy 2

The first part of the therapy developed our self awareness.  This included writing our fears and anxieties down when they occurred, and also identifying the negative thought patterns.  For example, were we catastrophizing? Labeling?  Using mental filters? Mind reading?  Discounting the positives?  We had learnt to acknowledge our thinking errors in the class.

The homework was demanding, but I got stuck in and relished the opportunity to do some self- discovery.  Almost everyone attempted the homework each week, with one exception.  Thinking retrospectively, this patient was too depressed to engage in group therapy.  It became tense when the two leaders, who ran the therapy sessions, questioned her.  I hope she has had the opportunity for one to one sessions.

We were introduced the the model of low self-esteem; a complex diagram where we delved into early experiences and made links to our core beliefs and negative thoughts.  This brought back some painful memories, but I recognized that these experiences have shaped the way I view myself and the world around me.  They are still too close for comfort and I can recall certain situations like they were yesterday.  Hopefully one day, I will be able to let those memories go.

To encourage us to speak out in the group, the group leaders encouraged us to work in smaller groups first.  I was still surprised that there were eight women and one man.  Perhaps it is easier for a woman to admit they suffer from self-esteem issues than a man?  We started to bond as a group.  We listened to each others  ideas and suggestions.  This bond grew stronger each week.

We started to learn about challenging our negative thoughts or our ‘inner bully’, by writing down alternative, more compassionate thoughts.  Generally, when we feel depressed, being compassionate to yourself is an alien concept.  We all felt uncomfortable with this.  What does being compassionate to yourself even mean?  Well, to be compassionate is to accept yourself; to take care, and as cheesy as it sounds, to love yourself.   After years of beating myself up, I had to retrain this part of me.

Changing the way we think is difficult.  We are creatures of habit.  Instead of challenging the thoughts themselves, it was now time to address challenging behaviour.  I introduce to you the behavioral experiment.  Our self-esteem is maintained through our ‘safety’ behaviours.  Change the behaviour, and you eventually start to see a change in your thinking.  I kept my behaviour experiments simple – going for a jog is just one example.  The experiment is split into two parts – pre and post.  I wrote down my negative thoughts surrounding the activity (I am lazy; people will look and laugh at me  etc) and then noted the predictions.  After the activity, I had to write down what had actually happened.  No one laughed at me or made rude comments.  I didn’t trip over my own feet or bottle out.  So, what did I learn from this?  I learnt that my negative views are skewed due to past events.  Just doing the behaviour experiement is not enough to get rid of the deeply ingrained beliefs.  It has to be practiced and repeated several times before any re-programming takes place.  CBT is no easy fix.

In the final weeks, I became anxious that it was coming to an end, and that I would be left to deal with my feelings on my own again.  We all wondered what was going to happen, how we were going to cope and reflected on the journey so far. Our group leaders used an analogy of being on a bus, in our last week of therapy, that would stick with me forever.  The passengers on the bus represented all our negative thoughts and our inner bully.  We were the drivers and in control of the bus.  It is up to us to not listen to the negative thoughts and our inner bully, but to steer the bus in the direction we wish to go to.

The class gave us the tools to help, now I know I have to continue that and practice each day.  I have made some wonderful friends and we contact each other regularly.  It is wonderful to message them when things take a darker turn and my feelings become overwhelming.  We have all learnt something new.  I now need to continue this journey and use the resources to take care of my mental health.  I just need to keep going.

Mentally ill teenager held in a police custody cell because there are no beds in the UK

Today the BBC reported that a 16 year old girl with mental health problems was kept in a police cell for two days because of the lack of care beds.  Mr Netherton, assistant Chief Constable of Devon and Cornwall Police, raised concerns saying that the situation was ‘unacceptable.’

He tweeted ‘We have a 16 yr old girl suffering from mental health issues held in police custody.  There are no beds available in the UK! #unacceptable.’ Shadow Health Minister Luciana Berger describes the situation as ‘an appalling reflection of the crisis in mental health.’

But, what are the government going to do about it?  When I read this, I was absolutely appalled and angry.  What kind of message does it send out to people about mental health?  Since the report has been published, the teenager has now found a bed, and will hopefully receive the care that she needs.

Another report recently said that at least 8 people have completed suicide in the last two years because they have not had access to psychiatric care.  According to Community Care, 468 beds have been closed in mental health trusts over the past year, while more than 2,000 mental health facilities have been shut down since April 2011.

The government are aware of the facts that mental health issues are on the rise and getting younger and younger, yet it is still underfunded and understaffed and not a priority.  I fear what Dr Tanya Byron says is true – that these statistics will just increase and mental health will never be a priority.  What can we do?

Self Esteem Group Therapy Part 1

When I was in hospital, I received a phone call from the local Complex Care Team.  They told me I had an assessment for group self-esteem classes.  I was relieved at this news because I had heard so many stories that after you are released from hospital, there is no care at all.  I jumped at the chance.  After hospital, you really do feel alone and although my care was transferred back and forth, the people that interviewed me didn’t realise I had admitted myself to hospital.

I was anxious about attending and also felt extremely low after admitting low self esteem was a significant factor in my depression.  Admitting you had low self esteem was humiliating, but facing up to the consequences of all the things I have done in the past due to low self esteem made me ashamed.

There were nine of us initially; all different ages but eight females and one male.  For our first session we introduced ourselves and started discussing what self esteem meant.  Self esteem for us was a sense of self worth and being compassionate to others, but most importantly, ourselves.  Compassion would play a greater role later on in our therapy.  Looking around the room, I had trouble understanding why people were there.  As I later found out, everyone had felt the same.

I knew were had to complete homework each week.  I have had CBT before. so being proactive in your own recovery was essential.  For the first three to four weeks, classes felt stilted.  It was difficult to open up and when people did, it triggered some others, which was upsetting.  One person in the group was so upset that we never saw her again.  I hope she is getting the treatment that she needs.

We were introduced to ‘thought diaries’, so we could write down our thoughts and then later made links to our behavior.  I enjoyed the links between  our thought, our behavior and feelings.  Identifying negative thought patterns were key and we could all relate to this as a group.  This linked to a model of low self esteem that included our childhood, which struck a chord with all of us.  I realised how ingrained my own feelings were and with regards to my childhood, they were too close to the surface.

As the weeks went by, we started to relax more and volunteer to speak in discussions.  Acknowledging feelings, fears and thoughts were only the first stage of our recovery, taking action was much later.

Life inside a Psychiatric Hospital

I had been feeling suicidal for a while and had to phone a friend for help.  I can’t quite put into words what these feelings are like but I was afraid because the impulse to no longer be in this world was too strong.  After spending 16 hours in A&E, we finally arrived at the hospital.  All I kept thinking was, what is this place going to be like? And what are they going to do to me?

The first person I met was Pedro, who had been at the hospital for two years.  He was the sweetest thing and liked to wave to me.  We had lunch together, where he let me sit on his table while he gobbled up his lunch and then dessert.  He had been out dancing the day before and looked very dashing in his suit.  He has been dancing for many years now – a combination of rock and salsa.  He comes from an affluent background and belonged to the boy’s ward upstairs.  Even though that was a closed ward, he was allowed to roam freely.  He had the mind of a child, and I can’t see him ever settling independently into a community.  I wonder what his future is.  Will he be in a psychiatric ward forever?

Everyone seemed to know each other and it seemed quite intimidating at first – feeling slightly like the outsider, sitting on my own.  We had to take our meds at 10pm each night and 8 in the morning, just before breakfast.  There were 17 rooms in this place, surrounded by beautiful greenery; it felt more like a retreat than a psychiatric hospital.  The sun shone a lot, and as we sat in the garden I got to know more patients, who quickly became friends.  People were there for all different reasons; depression, anxiety, self-harm, alcoholism, drug addiction, drug induced psychosis and Bipolar Disorder.

At the beginning of my stay, I woke up often feeling groggy and sleep deprived.  This was probably because when I was first admitted, I was on 15 minute obs.  This meant that during the night and day, staff regularly checked on me, possibly to make sure I didn’t hurt myself in any way. At the beginning, I didn’t know what each day would hold and often felt unsure of myself.

I often ate with Pedro and Sundays especially were my favourites in the restaurant.  A lovely nut roast!   Alex, the male nurse, sat with me with a colleague, and we talked about how I was settling in.  I leaned over and admitted to him that I thought it would be like One Flew Over The Cuckoo’s Nest and he laughed and nodded.  I guess he had heard that before!  He had lead quite an interesting life from what it sounds, studying English Literature at the University of Arizona.  We discussed the stigma and government cuts to the mental health services – he was right; if they recognised the significance of mental health then surely the government would save money.  It must cost the government billions for sick pay!  He said that he was very open minded to more Eastern ideas of treatment.

After the first two weeks I felt calmer than I have done in years, but  I worry that I have let my family down by going into hospital and what mum thinks of a daughter of hers being treated in a mental health hospital.  How can I explain my feelings pre-hospital?  A complete belief that I wasn’t safe and that I shouldn’t be here; an intense feeling that I was going to harm myself or do something stupid.  There was no future, just pain; circles.  But things are turning around slowly.  And I felt safer than I have done in years.  Safe behind that big wooden fence, hidden from the dangers of the world and from the prejudice of others.

I gradually started to talk to more people.  I met Jennifer, who said I had a pink voice; nice and girly.  She liked to touch people’s arms and name them. Claire had Strawberry arms, I had Pink Champagne arms.   Crocodile Dundee (Patient) believed in Angels and said there is 1 angel to every 30 people – a bit like teacher-pupil ratio.  Crocodile was more of the ‘stereotypical’ patient, and often tried to hide from the big elephants, waiting for him behind the bushes.  He laughs hysterically, striding round the garden with his Crocodile Dundee hat on.  It was only much later that I found out he has a list of qualifications that are as long as his arms, and that he is a published poet.  He is at one with his madness.

I looked forward to the visits from friends and loved ones.  That was always a nice treat and I learned very quickly how to make a decent cup of tea!  I felt tired a lot of the time in the first week and often wanted to drift off to sleep.  Sleep helped to block things out and then I wouldn’t have to deal with anything anymore.  I couldn’t make decisions, life is a hurricane and I felt stuck in the middle – like Dorothy from The Wizard of Oz.  Life was going on and I just didn’t know how to deal with it all – it was swirling and I felt caught up, dizzy and sick.  It felt like something out of a Satre novel, where all the words are swimming around and life just doesn’t make sense.  Like the standard literary form and structure is screwed and it is all just words, tumbling, falling over each other.  Nausea, that is what the Satre novel is called.

Can it get any worse than admitting myself into hospital?  What do I want to get out of this and what are my goals?  I wanted to meet like-minded people and learn to be open about my feelings.  I wanted to recognise the signs before it got to the panic stage where I don’t know my own mind anymore.  I wanted to be able to have some control and feel in control of how I am feeling.  I wanted to be able to cope with my thoughts.  They are my thoughts, they are not me as Ekhart Tolle suggests in his book, The Power of Now.  I wanted to be able to trust myself, believe in myself and be confident in who I am.  I wanted to feel like I am living but not constantly in pain.

There was quite a strict timetable that we followed there and I enjoyed it.  Perhaps it was because it gave me a structure that I didn’t have I my life.  We woke up, had breakfast, went to our two group therapy sessions, had a break; which involved smoking far too many cigarettes! After lunch we then had two more group therapy sessions and then it was time for dinner.  The evenings were ours and we shared some great times, whether it was listening to music in the garden or watching the world cup.  We came together and bonded.

Most people in the ward hear voices in their heads, telling them to do something evil to themselves.  They aren’t a danger to anyone else, apart from themselves.  I saw Claire’s cuts and scars on her arms – wounds so deep that it hurts just to look at them.  The voices tell some of the patients to get angry with them and self-harm.   I liked the refreshing honesty but found it all so scary.  The mind seems so dangerous. But we cannot blame ourselves for other peoples’ actions in the past.

Group therapy was tough.  Although we were such a diverse group it soon transpired that we were frightened of the same things.  Those ‘things’ included the world outside of the wooden fence, the fear of relapse and what life on the outside would be like – would we be ready?  The groups included regular Creativity classes, CBT, Self-Awareness, handling our emotions, goals for the week and dealing with our recovery. The class that you take depends on your care plan and what the doctors recommend.

It took me a while to let anyone in or properly let go in those therapy sessions and I remember that one class where, for the first time in years, I expressed my anger towards people from my past.  It was an eye opener because for years I internalised that anger, which turned into self-loathing.  Perverse isn’t it?

The turnaround was quick, too quick for my liking.  As soon as you made a bond, then just like that, someone gets carted off to another hospital or released into the wild.  Before he went, I started to connect more with Crocodile Dundee.  He gave me a book of his poetry, which I read over and over again, and found it truly inspiring.  Especially the poem about the birth of his daughter.  When he was at the hospital, he never received any visitors, and now I wonder if his family abandoned him because of his illness?  I got a text from him recently, and you will be pleased to know that the angels still speak to him.  I hope they look after him.

Although in group therapy, they stressed that close bonds shouldn’t be formed, it was inevitable.  In such a tense environment, we all grew close.  I like to think that the people I met in hospital will be lifelong friends, and I often wonder about them now.

Most patients (including me) were NHS and a handful were private.  Some patients had come from as far as Birmingham and Cornwall because there were no NHS beds in the area.  This meant that that as NHS patients, we could be carted off at any time to a ward.  That was terrifying!  One of my friends had been ‘taken’ by surprise which made his Bipolar worse, and prompted an episode.

I responded well to treatment and changed my medication.  Life seems brighter now and finally there is some light at the end of the tunnel.  I am so grateful to have been taken to hospital, to have experienced what I have and made new friends.  I am grateful for the help and support I have received in and after hospital.  I know now that depression will always be a part of me, and that I can’t fight it because I will lose that battle.

For the first time, in a very, very long time, I am grateful to be alive.

Powerful, poignant and a tale of courage

DSC_0112[1] DSC_0113[1]

I was privileged to attend a talk between Hope Daniels (Author of Hackney Child) and Dr Tanya Byron (The Skeleton Cupboard), as part of the Highbury and Islington Literary Festival on Monday 15th September 2014.

Hope’s story is harrowing; at the tender age of 9 she walked into a police station with her two younger brothers and asked to be taken into care.  During the talk, it was clear that writing her story was part of her recovery.

The book is written in fragments of memory and also made up of her care notes that she had access to when she was 18.  A harrowing tale of extreme poverty, alcoholism and the care system, this woman wanted no pity but to get her story out there.

Born to alcoholic parents who were also in care, Hope has been in recovery now for 5 years and determined not to let the cycle continue.

Dr Byron has been a clinical psychologist for 25 years and her book is also a fascinating read, giving an insight into what it is like to treat a number of patients and adolescents with mental health problems.  She could not hide her disgust with how mental illness is being dealt with in this country, describing it as the poor cousin of illness.

From personal experience I know how underfunded and understaffed the services are.  Each time the Crisis Team came to my flat, they were apologising that they could not come sooner – they are constantly inundated with others in crisis.

Some interesting discussions are to be had following the talk:

  • Why, in such a developed country, do we have a third world health system?
  • Why are beds closing when more help is needed?
  • Why are mental health services so fractured?
  • Why is there no aftercare when you leave the care system at 16,17,18 years old?

Something needs to be done, but I’m not feeling very hopeful…