Tag Archives: Mental Health

Standing up to stigma – why I blog about work, projects & my mental health in one place

Pressing pause

Linked in

Should my LinkedIn link to my blogs too?

Every time I go to press ‘publish’ on a tricky post exploring my mental health I pause for a moment. The way my blog has developed means that my personal struggles and successes sit alongside blogs about my work and details of my skills, training and experience.

Should I keep them separate? Will employers reject me if they read that I took Citalopram for 15 years or that I use exercise to manage my anxiety?

I know stigma and discrimination around mental health in the workplace exists. I spent 2014 time to changeproviding evidence based reports on mental health policies and support in a number of organisations across a range of sectors for the Time To Change Organisational Healthcheck programme. Tom Oxley writes a good piece about how the programme worked on pages 10 and 11 of this newsletter.

I spoke to people in every workplace who said that they wouldn’t tell their manager if they were experiencing a mental health problem. Many said they would lie about taking time off.

”I’d probably say I had a migraine or something”

Those who had been honest about taking time off for a mental health problem said they felt that now they had more to prove.

Unfortunately in some cases I could understand why. Some managers said they felt people with mental health problems couldn’t ‘cope’. Others saw investment in employees’ mental and physical health as a burden rather than something that makes moral and business sense.

”You’ve got to be careful or people will just take advantage, start using ‘depression’ as an excuse.”

”We need people on top form to do this job – if you’re depressed you just won’t be able to cope.”

1 in 6 employees are currently dealing with a mental health problem. Like colds, flu, delayed trains, bereavement and accidents it’s always going to be part of a workforce. It’s how employers deal with it that counts.

My mental health is part of what makes me. It’s part of what makes a life – and in many cases it’s part of what makes me good at the work I do.

Pressing publish – every time

In the run up to Time To Change’s Time To Talk Day on Thursday I thought I’d share some of the reasons why I press publish on those tricky posts every time.

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The Regret Tape and the I’m Not Good Enough Mix – new metaphors and thinking tools for managing anxiety and depression

I’ve recently come off Sertraline after 15 years on various SSRIs. It’s been a long and tricky journey but I think I might be almost there. I’ve written a bit more about that here.

Using metaphors to identify, share and understand my mental health

Mix tapesDuring this period I’ve found two metaphors very helpful.

I love a metaphor when it comes to managing my day to day mental health. Metaphor helps me identify and pin down my experiences. This is a step towards understanding and managing them. It helps me regain perspective and use the language of shared experience to transfer and talk about some pretty intangible feelings.

Getting my nose away from the oil painting

I haven’t had much perspective recently. Feeling anxious seems to magnify individual moments. It’s as though I am living life too close up. I don’t have the capacity to see beyond the worry I’m experiencing right now.

van goghMy nose is right up against the canvas rubbing in all the tiny flaws and bumps. From here they look huge and distorted. But we all know an oil painting looks better from afar. The swirls of dark colour and the lumps of paint add texture and depth to the bigger picture.

I’m not saying that this kind of anxiety is necessary or important to make up the picture of a life – it really isn’t. BUT I have found that whispering ‘remember the oil painting’ to myself has reminded me to step back and question whether the worry that’s causing overpowering anxiety right now will matter at all in a year (or even a month or a week). It’s helped stop those tricky surges of panic become uncontrollable.

My anxiety and depression have a tape collection

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Coming off anti depressants – withdrawing from Citalopram and Sertraline

Day six in Foster’s brain and all is reasonably calm…

trainers and pillsAs I write I’m on the sixth day without any form of SSRI at all. This is new territory for me. I’ve taken them every day for 15 years (with terrible healthcare making it much trickier).

Three months ago I moved to Sertraline. Two months ago I was down to 1/4 of a tablet per day. Then I started alternating days. One month ago I moved to one day on and two days off.  Over the Christmas break I’ve been attempting one day on and three days off.  This time round when it got to day four off I decided to keep going.

It’s been a LONG time coming. I’ve been bobbing around the 20-30mg mark for years. I tried to come off them in 2008 but didn’t get below 10mg Citalopram before an abortion and a move to London meant I needed more support again. I tried in 2012 but again couldn’t drop below 10mg. In  2014 I got to 5mg before it became unbearable and ended up slowly and frustratingly working my way back up to 20mg.

Dealing with withdrawal symptoms

My chest sometimes feels uncomfortably tight and I’m still welling up at the slightest thing but I haven’t had any big uncontrollable surges of irritability (horrible), anger (scary) and panic (painful) since before New Year. The worst day was the first time I got to three days without. That afternoon there was little to be done except pick my sobbing self up off the bathroom floor and breathe deeply in showers as hot as I could bear. I would lie completely still in bed hoping for sleep but fearing the threat of my mind building, rushing and slipping away into a place of panic and pain that felt unknown and terrifying. It’s really scary to feel genuinely out of control of your mind. Luckily there was only one afternoon that bad.

I only feel completely safe when I’m exercising and in the calm and blissful hours afterwards when I’m myself again. I’ve ran hundreds of miles. When my knee gave out I cycled hundreds more. I discovered spinning. I’ve been chaining Kalms and I haven’t had a good coffee or a glass of wine in weeks (interestingly when you’re recently married and of a certain age people tend not to push alcohol on you, even at Christmas!). But I’m nearly there. I really think I might be.

Luck, love and incredible patience

I’m  very very lucky to have such supportive and loving friends, family, work and (most of all) my husband Alex. My family love me unconditionally even when I’m unforgivably difficult. My friends make me feel myself again just by being in their company. But Alex is endlessly patient. Those surges of anger and irritability disguise themselves as reactions to things happening day to day. They show their ugly faces in snippy comments, slamming doors and helpless tears. He recognises these as symptoms. He knows that deep down they’re not my fault. He doesn’t react to them as if they are.  This is perhaps the most helpful but also the most difficult thing someone can do to support your mental health. He’s an absolute hero.

(I’ve also written about managing depression and anxiety in relationships here)

New understanding and techniques to manage my mind

There’s been plenty of dramatic lows and a few proud highs in this particular journey. But a lot of the experience of living with and managing this stuff is the day to day mental grunt work. Looking after yourself. Recognising triggers and identifying negative thoughts. I’ve been doing a lot of that too.

I love a metaphor when it comes to managing my mental health.  Metaphor helps me identify Mix tapesand pin down my experiences. This is a step towards understanding and managing them. It helps me regain perspective and use the language of shared experience to transfer and talk about some pretty intangible feelings.

Over the last few months I’ve found a couple of new ways of thinking about my experiences which really help day to day. The tapes and the oil painting. I’ve written about them here: The Regret Tape and the I’m Not Good Enough Mix – new metaphors and thinking tools for managing anxiety and depression.

I don’t know what’s going to happen next and I’m going to try not to beat myself up if it doesn’t go quite as planned. But I’m cautiously pleased and proud to have made it this far. The sun is shining and I’m off out with the dog (he helps a lot too). I might even treat myself to a (decaff) coffee.

P.S – An important extra

It’s worth emphasising that I spent a long time reducing my Citalopram and then Sertraline slowly in 2015. I did the withdrawal and reduction with advice from my doctor. This is a personal account of an individual experience. Mind has a lot of great info on coming off psychiatric drugs which it’s worth looking at if it’s something you are thinking about.

APP’s online peer support services: vital and life changing

“I’ll always remember the first time I met a ‘PP lady’. It was a very special day.”

“I had lots of friends who were mums but none of them understood what I was going through. I felt weird, lonely and isolated. When I found the forum I was like ‘Oh my god. People understand.”

APPLast Saturday I was invited back to run a third online peer support training session for Action on Postpartum Psychosis’ peer supporters.

Every year it is a moving and inspirational day (you can read about what we covered here). As I listened to the co-ordinators speak to new volunteers I was struck once again by just how important their peer support programme is.

In fact I think their services are a really good example of the life changing benefits that online peer support can provide. Peer support can be valuable for everyone but it is absolutely vital for APP.

Online peer support that connects those who’ve been there

Research by APP shows that women desperately want to meet other people who have been APP trainingthrough PP, to share symptoms and have time to talk. Partners said the same.

Everyone needs to share stories, to be accepted and understood – especially if you’re going through or recovering from severe mental illness. Unfortunately, because PP is relatively rare, friends and family don’t know what is is or what it feels like. There is unlikely to be someone living near you who has been there. Some people may be scared to speak about their experience for fear of stigma and misunderstanding. For most women the APP Peer Supporter training sessions are the first time they have been in the same room as someone who has also experienced PP.

APP’s forums provide that link. They connect people with hundreds of others who can support them. When someone signs up for APP’s one-to-one email support service they are actively matched with someone who has had a similar experience. The chances of finding that offline are very very small.
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PMT, hormones and withdrawal – treading on mood eggshells

Mood eggshellsIt’s fair to say I’m not compleeetely on top of things today.

The doctor moved me from Citalopram to Sertraline last month (slightly better for any potential pregnancies) and suggested I try and reduce the dose a little (again in preparation for the same). I wasn’t sure whether this was a good idea considering I’ve been struggling more recently – but also felt it was worth another go given a) things have started to be a little easier and b) the doctors are always telling me my old dose was sub therapeutic anyway (pah!).

Hormone smash

It was actually going pretty well until my period hit. Then those hormones smashed into me with a force I haven’t experienced for a while. Saturday was a real struggle, slow moving, anxious and crying on the kitchen floor (poor old confused Watson). Sunday was a little better – I felt exhausted and raw but calmer. We went to the Wildlife Photographer of the Year – it was good to get out of the normal routine but the crowds made me anxious and I cried in the bakery afterwards – overwhelmed by food choices for a birthday breakfast today. At least afterwards Al and I could laugh at some of my more ridiculous tearful utterings –  “I just want some nice bread” (sob).

Mood swings

And today I’m struggling with some serious mood swings. One moment I’m feeling calmer. I’m more on top of things and able to see ahead to all the joy in my life. The next it’s really black. My chest feels very tight, there’s no good memories anywhere and I can’t see a way through at all – the mental trickery of depression taken to an extreme. It seems to take almost nothing to trigger the change. I’m treading on mood eggshells and wary of the world. It’s tricky to trust in any individual moment.

It seems that both medication withdrawal and day to day management of my mental health is massively exacerbated by hormones at the moment. The worst weekend in October was a period weekend too. I need to recognise it and ride it out but it’s hard hard hard. Hopefully the worst will be over this month.

Writing, running and cake

Writing things down has helped – but on days like this I only feel myself when running. So I’m going to run and run and breathe deeply and listen to the world and watch Watson chase squirrels and hope I come back calmer – and ready for some birthday cake.

Exercise addiction and eating problems – good days, bad days and thought gremlins

A non-artists impression (!)

Thought gremlins – a non-artists (!) impression

It’s been a few months since I last wrote about the tangle of eating, exercise and emotions I have found myself in this year.

I’m tired. More than anything I’m tired of thinking about food, eating, exercise and what I ‘should’ be doing. It’s just so tedious. Meditation, interesting work, DIY, time spent with friends and crafting gives me a break for a while but I can’t just turn it off completely.

I’m working on accepting that this particular punishing thought gremlin will take up brainspace for a while yet. I’m not going to waste the space I have left worrying about how much he’s around. That seems counter-productive.

Instead I’m trying to tame him by guiding  my thoughts in a healthier direction and gradually diluting them with new perspectives and approaches. Sometimes this works. Sometimes it only gives me glimpses of how things could be. This makes it worse when he grips back hold.

In the grip of the thought gremlin

When he’s got a grip he still sets tests for me and makes me feel awful for failing them . Do certain clothes fit? Do my fingers fit around? How does my body look and feel?

When I ran a 5k 10 seconds slower than my PB he whispered that it was because I was getting fatter. He didn’t care that it was still a sub 20 minute time. Achievements and compliments slide off him and fall forgotten.

Sometimes he chooses to berate me about how stupid I am to worry about it at all when so many people are dealing with astronomically more pressing problems. He’s not going to let me cut down on exercise too much right now – but he’s going to try and stop me enjoying it by telling me I’m doing too much as well.

A bad day

A tyranny of bartering and balancing. Reassigning guilt and promises. Negative and positive calorie credit. Pinching, pulling, judging and comparing.

Trapped by a grotesque distortion of natural processes that mend and fuel, store and burn energy. That keep me alive and moving hard and fast and well. I’ve hated every inch of skin. I know every fold and dimple intimately. Every tiny growth, bulge or change tells me I should be better.

What I have eaten today? Lost track, list it again. Over and over. Test my wrists, check my bones. If I list it in sections and move the biscuits to mid morning it sounds ok. Doesn’t it? Lost track, list it again. Maybe write it down. It’s ok that it looks like a lot, I ran yesterday and went spinning this morning. But that was to make up for last night when I had pudding. And couldn’t stop eating it (“because of your pathetic lack of self control” – thanks thought gremlin!). So I’m not really in credit, I should run this afternoon. But my knee. My bloody knee aches. If I was sensible I’d rest it. Even thinking of running on an injured knee shows I have a problem. But my trousers feel tight. I feel enormous. My wedding ring feels tight. I could swim. But that doesn’t burn as many calories. It doesn’t give me the FEELING. If I could just run today then that would reset everything. I can start being sensible tomorrow. If I cut down on food then I won’t have to exercise as much. But I don’t want to get back into restricting, it takes up too much headspace. I just want to eat normally. All this exercise makes me hungry. Maybe my knee is ok anyway. I’ll have a cold bath afterwards. Then I can have a nice dinner without worrying. Then the thoughts will calm down for a while and I’ll be able to focus on other things.

I refuse to restrict any more. I’m holding on to normal that way. And I’m HUNGRY. Instead I fight the urge to run and run and spin and swim and drain my body of energy then, as the voices quiet and I feel free of guilt, eat my way back to the same cycle.

On days like this it feels as if even a good day is one where the judgemental voices are appeased not forgotten. How do you stop when eating and exercise are always going to be part of life?

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Engagement, co-design and community moderation on the Elefriends community at Mind

elefriendsI’ve just finished 9 months working on the mental health peer support community Elefriends. The role was a maternity cover post and focused on community engagement as well as moderation training and support.

So what did I get up to?

Six co-design workshops with community membelefriends co designers

I organised and co-facilitated six co-design workshops with community members and local Minds. All the workshops had an online consultation component.

  • Two workshops to co-create community content and ‘themes’ functionality for Sport England funded project Get Set To Go.
  • co designTwo workshops to co-create community content and functionality for Big Lottery funded peer support project Side by Side
  • Two workshops to co-design a mobile app for the community. The Apple version is in the app store now.

I worked with agencies PAN and Yoomee to create and test content and functionality initially developed in the co-design workshops.

This included three animations to encourage community members to get more active. You can see the first one here.
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Exercise addiction – managing the tangle of anxiety, eating and exercise.

Last Sunday I spent all day exercising

ImageIt started when I pressed snooze at 6am and cancelled my spinning class. I’d been in the gym at 6.30 all the previous week and had just returned from a busy couple of days running and walking in Cornwall. I was exhausted. But I didn’t get back to sleep. Anxiety levels rose. Getting dressed I was acutely aware of all my clothes, how they pressed against my skin. I couldn’t find anything I felt comfortable in. My hands felt swollen and my chest tight. My mind was whirring with calculations and lists.

It wasn’t until after a session on the cross trainer, a long swim and walk with the dog that I felt like myself again. A combination of relief from thoughts about overeating and, much more importantly, relief from the anxiety that made it matter so much in the first place.photo (1)

Yesterday evening I ran a very long way* because I ate some cake and chocolate buttons at work. The morning spin class stopped being enough.

It’s not so much the calories – although that doesn’t help at the moment. It’s a craving for that feeling after exercise where your thoughts are calm and still, your body feels tired but deserving of care and nourishment and your mind doesn’t have to calculate or judge because it knows you’ve done enough to rest.

“a craving for that feeling after exercise where your thoughts are calm and still, your body feels tired but deserving of care and nourishment and your mind doesn’t have to calculate or judge because it knows you’ve done enough to rest. “

Immediate relief vs long term recovery

legs and knee supports

Knee supports – NOT the answer to EVERYTHING

My knees and hips ache and sometimes even crunch. They need a break.  I am finally cutting down the running in favour of spinning, swimming and cycling.

But the daily doublethink is still absurd. Cold baths and a knee support is not going to allow me to run miles and miles however much I wish it would. Immediate relief still trumps long-term sensible decisions too much of the time. Even if that relief is tinged with guilt and frustration.

I’m planning my next exercise session whilst I’m in the middle of the previous one. I try to be more sensible but those persistent thoughts keep popping up.

‘You could run tonight. You could just do an extra session on the cross trainer after spinning. You could fit in a swim tomorrow morning if you get up really early. Remember how good it feels when you’re done, how much more you enjoy your food when you feel you deserve it, how much easier it is to rest and to concentrate when that anxious energy is stilled’.

Once I imagine that feeling, it’s hard to turn away from it.

But that feeling is lasting a shorter and shorter time. When I’m exercising twice a day and feeling anxious and panicky when I can’t get moving it’s time to get some help.
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Running for Sane – Christie’s story

Exercise for mental health

I’ve been thinking a lot about sport, and running for mental health recently. This is partly due toChristies just giving page work – I’m involved in the development of Mind’s Get Set To Go programme through the Elefriends community. I’ve also written a number of posts for New Level on the benefits of exercise for mental health and wellbeing.

There’s a strong personal connection too. Exercise is a vital tool for managing my own depression and anxiety. Recently I’ve been struggling to balance my mental health needs against the need to rest and recover after physical injury (darn knees!).

It feels as if more and more people are running. There’s definitely more people out and about in the parks and along the canals. This spring and summer has seen thousands of running events across the UK. One of the best things about these events is that each one is full of people pushing themselves for charities that mean a lot to them.

Christie’s story

One of these runners is Christie Plumb. She’s running the British 10k for Sane after losing her Sane logoMum when she was 11. Christie told me she felt that the stigma surrounding mental health problems and a lack of support contributed to her mother’s death. The work of charities like Sane and Mind are helping to reduce that stigma and provide support to those who need it.

Fundraising has helped her to open up about her mum’s death, to talk about it and give people ways to support her.

But Christie has found that running has helped her too. She said that before her boyfriend suggested the NHS Couch to 5k she was convinced that running was “impossible, physically impossible for me”. But she stuck at it and found it was helping with her own anxiety, clearing her mind and improving her confidence.

I really identified with the way she described running her way out of very strong feelings of anxiety and panic.

“Within the first mile, my chest loosens up and I’m not shaking any more. It’s incredible…before the Couch to 5k I had never got past that first barrier. Now I always carry on and push through. In a way it’s an analogy for pushing through anxiety and depression. You just have to keep going, even if it feels like you can’t. You’ll get there in the end.”

In running she has found a way to honour the memory of her Mum, to talk openly about her loss to people around her, to support a charity that means a lot to her and to look after her own mental health. To sponsor her, take a look at her JustGiving page here. To have a go at Couch to 5k yourself, take a look at this page. Who knows where it might lead.

The mindfulness of dogs – a #mentalhealthselfie for Mind

Mind asked me to created a #mentalhealthselfie, a video blog about my mental health, for Mental Health Awareness Week 2015. The theme was mindfulness.

“He reminds me to be curious” – how Watson helps me practice mindfulness

As I blogged for Mind about my Mindfulness Based Cognitive Therapy course in 2012, I decided to do something a little different this time and talked about how my dog Watson helps me to remember some of the core teachings – acceptance, curiosity and overcoming reverse motivation.