The Blog

What are your thoughts?

Over on my Facebook page we have been discussing our views on this article from Portugal Vogue which has faced a lot of backlash for it’s controversial imagery. My personal feeling is that it is not empowering to those with mental health challenges and actually depicts a time in which people were treated poorly, with no shared decision making and forced treatment. I feel there are so many other images that could have been controversial whilst celebrating some of the more taboo subjects and empowering those who have faced these challenges. For example a cover on someone with lived experience celebrating their scars and the journey they have been on would have been impactful whilst also recognising the strength involved in managing your mental health. It’s imagery we rarely see however it empowers those with lived experience and would celebrate their story.

However others have said it has generated conversation and that’s the most important thing. I’d love to hear others views on this?

You can read the article here 🙂

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What’s normal?

Something I have found to be common across a number of mental health challenges is the fear around being unwell before your’e actually unwell. I often get myself into a little stress cycle of not feeling great, then worrying that I don’t feel great, then worrying that I am not being proactive enough in response to a warning sign and then feeling overwhelmed. This is generally an unhelpful thought process but stems, in many ways, from actually being too good at my wellness recovery action place (WRAP). WRAPs are a tool to help you and others monitor your mental health, they generally talk about what you’re like when you’re well, what the warning signs are that you’re becoming unwell, what your triggers are and what is helpful or unhelpful. They are particularly good when using mental health services as they help professionals to see what you’re normally like and what is unusual for you. For example I am a fairly chatty person which some people could interpret as being hypomanic but in fact I am just that irritating all the time.

When you’ve had to use a WRAP plan regularly like I have, albeit it a while ago now, you can sometimes be oversensitive to mood changes. Sometimes I have a productive week at work and finish each day being like ‘woahhh, I smashed that’ then being like ‘hmm, did I smash that too much’? For me warning signs of becoming unwell are usually: going out too much, having problems sleeping, being super organised and productive for a sustained stint, wanting to stop meds, being lethargic and sleeping too much. The problem is that lots of those can also be within a normal fluctuation of mood. We all have times when we’re feeling super productive or conversely are just exhausted and feeling a bit more introverted. So how do you know what to recognise as a warning sign and what to chill out about?

In a couple of weeks time I am moving in with my partner to a new flat, that’s a big deal for me as many of you will know, my home is my little sanctuary in which I can manage my mood easily and implement controls that support my mental health. Living alone has been fundamental to my recovery so it is testament to how awesome my partner is that his presence has supported my mental heath rather than triggered it. Although living together was initially forced (a result of lockdown many of us have been coerced into) I have decided he’s actually pretty alright and I’d like to keep him around. Moving can be a trigger for a number of reasons: I struggle with change, it requires you to be very organised and proactive for a sustained period and in this case it is a drastic change to my living situation. This week I have burst into tears approximately 6 times for feeling incredibly overwhelmed and by default being very worried about becoming unwell.

I have felt very flat this week, been utterly exhausted and struggled to feel organised. This has followed a week of feeling very proactive and on the ball (hmmm). Compounding this has been a very busy time at work, like many I have had a quiet period at work in light of covid but as lockdown has lifted things have picked up and got exceptionally busy. I’ve therefore been required to be high energy and efficient at work and also in my personal life. This sort of stress (even when it’s a result of something positive) can often trigger a period of hypomania because it encourages one of my warning signs – being super organised for a sustained period. The fear of potentially becoming unwell during a time where I would a) like to be feeling excited and proactive and b) will be experiencing change and need to stay on top of my wellbeing is very real. It’s important to recognise that this is likely a normal fluctuation in mood and a result of some real life stresses. I can also acknowledge that my medication does not eradicate episodes but dampens them, so what could have been a major manic episode can become a more mild, shorter term hypomanic episode.  Therefore feeling incredibly buzzy and struggling with sleep last week and then feeling flat this week could be a medicated version of a smaller hypomanic episode followed by a mini low mood episode. This kind of escalation and then dip in mood is common with Bipolar.

Whether it’s a dampened mini episode or just a normal fluctuation what’s important is to kick in all the things that help, I can get a bit lax with these when things are going well but when the going gets rough the tools get going. So that means:

  1. Eating well
  2. Ensuring I go to bed at the same time and get some good sleep, if I don’t accepting I will need to take a sleeping tablet the odd night to even me out
  3. Increasing meds if necessary, I have around a 50mg tinker allowance before I need to ask a psychiatrist for support so I’ve upped my meds by 25mg just to knock it on the head
  4. slowly working through a to do list for the move rather than allowing it to be something that requires me to be a ball of stress just before. This means there isn’t as much room for an escalation of mood closer to the move
  5. Exercising, is anyone else feeling remarkably blobby at the moment? I’ve been ensuring I do at least one long ish walk a day. I even ran this week, I hated it.
  6. Pacing myself at work and recognising my capacity and seeking help where I need it rather than going into overdrive to get things done
  7. Similarly allowing myself some annual leave around the move to give myself a breather

By doing these things I can keep on top of my general wellbeing and curb any episodes. Implementing these sorts of tools are in some ways kind of boring and annoying but I also acknowledge that it is more annoying being unwell so sometimes I have to whip these things out of the toolbox. I also recognise that more and more I a) don’t need to use these tools as often and b) get better at noticing when they are helpful. It means that what previously might have escalated into a real shift in mood gets curbed nice and quick. This is all about educating yourself about yourself and being proactive in learning what your WRAP plan looks like for you. Once you receive a diagnosis you’re able to start this process straight away and you have the space to learn what works for you. The quicker you can implement your safety net the quicker you can stop yourself from falling.

For more information on WRAP plans you can read my post HERE 

You can also access templates and more information HERE 

The value of lived experience…

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Lived experience refers to someone who has a personal experience of something, often bereavement, mental health challenges or challenges with addiction. Although not always the case it’s generally considered to be a positive, that someone with lived experience is better able to connect with others going through something similar. Peer support is essentially the act of connecting over shared experience and helping one another. You would therefore think that talking about lived experience can only be a good thing but over the past couple of years I have found this to be circumstantial.

When I set up this blog I was still very unwell and my Bipolar dictated everything iI did; my lack of paid employment, struggles to hold down a solid relationship and an inability to socialise like a regular human being. When I met someone for the first time I was quick to share my lived experience because I felt I needed to justify all of the above. I had graduated from a top University and in theory should have been embarking on some kind of successful career, walking to work in trainers like Working Girl and eating buddha bowls for lunch. Instead I was living at home, watching a lot of Fraiser and just trying to get through the day. The fact that most conversations start with ‘what do you do?’ made socialising with new people draining and I only ever came away feeling worse about myself.

Even once I began to upgrade some of my life; moving out into a small flat down the road, picking up some volunteering and aiming for a 70% turn up to meeting friends, I still felt behind. My lived experience still dictated a lot of these things and although I had enhanced my response to ‘what do you do?’ it still didn’t feel like enough. My friends were becoming Teachers, working for the Civil Service and developing careers that required them to climb metaphorical ladders. They went out clubbing, for after work drinks and to yoga classes and I was going for swims alongside the over 60s at 10am. I couldn’t relate to my friends although I desperately wanted to and I felt so much more alone and inadequate. I couldn’t imagine ever working and I wanted to work. People would argue that I went for walks, painted and swam, that I did do things, they just weren’t the norm for a 24 year old. I loved these activities and continue to do them now but I was spending the majority of my day alone. I was living a retired lifestyle whilst my friends worked all day. I instead drank a lot of tea in the pool cafe with ladies who had finished aqua aerobics. So I had to tell people about my lived experience because I was embarrassed about the life I was living.

Someone who worked as a Peer Worker once told me they felt they had shared their story less and less the more well they had become because it became increasingly irrelevant to the choices they made. Since starting work and feeling I have something to say for myself there has been a shift from a boundaried but therapeutic sharing to one which is largely educational and about holding hope for those suffering. My lived experience isn’t shared to justify my lifestyle but to celebrate  the hard work that has been involved in getting to this point. I want to encourage others to feel more comfortable sharing their experiences but also educate those who don’t have lived experience. This isn’t their fault, they simply don’t know, and we have created an aura of mystique around mental health that means it is harder to ask questions.

We might be curious about why someone might feel suicidal or want to harm themselves, we might want to know what it feels like to see or hear things and what taking medication is like. But we have brushed these kinds of topics under the carpet and instead focused on the more palatable wellbeing topics like anxiety, insomnia and depression. These are still important themes but we need to build on the openness they have created and embrace the opportunity to address some of the diagnosis like Bipolar, Borderline Personality Disorder and schizophrenia. These are still loaded with misconceptions and inaccuracies. For those with lived experience who are comfortable sharing their story now is the time to embrace the opportunity to share these experiences in a safer landscape and make a real difference.

These days my lived experience is also an opportunity to encourage hope, I have been extremely unwell, and not for a short bout or a blip but for a sustained period of several years. I have had significant psychiatric input and have been unemployed for the duration. But here I am, incredibly grateful for the the things I have and have worked hard for. I am in a job I love that I probably would not have stumbled into had it not been for my lived experience, I have a lovely flat, a stable relationship, and amazing friends and family. Lots of people have these things but the battle I’ve undertaken to grab them makes them all the more meaningful. My very existence is testament to the possibility that you can come out of the darkest times, bruised and not without ongoing maintenance, but here and well all the same.

For those who have lived experience and are comfortable sharing we should do so. This is harder in different settings; we all know someone who opened up at work only to find they were treated differently or was hung up on in an interview when they revealed their challenges (o yeah, true story). We also know of people whose new relationships were ended when they revealed their diagnosis or whose friends stepped back when they told them they were struggling. But without information these kinds of situations will continue. If your friend, partner or workplace are educated in what it means to have lived experience and the value it brings hopefully we can change the conversation.

For those without lived experience there are things you too can do to make a change. Create a safe space for someone to share, ask questions if appropriate or do some research (Mind are a great resource). Not having lived experience is one thing but choosing not to learn is another. Now is the perfect time to do this, it’s Mental Health Awareness Week and we are largely sat at home in pjs, you literally have nothing else to do. So lets really embrace Mental Health Awareness week and change the conversation to one of hope and learning.

 

 

 

Acts of Kindness

As this years theme is kindness I thought I’d share some of the kind acts that have supported me in my recovery journey. Hopefully these can be points for reflection if you or someone you know has mental health challenges. When you are very unwell these things can be crucial but small acts of kindness also just make the world go round…

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For all i know this horse is drowning this dog but i like the ‘kind’ take on it

1. Friends being patient, the number of times I cancelled plans, forgot birthdays or spent 3 hours on the phone talking about only myself. My friends were super patient with me and that ensured i was more likely to make plans in the first place (I knew I could cancel if I felt anxious or exhausted from insomnia) and that I was always able to share with them how I was feeling. Having such steady friendships meant I knew I could always count on them, however shit a friend I was being and now I have solid friendships that have a more mutual dynamic.

2. Having a Community Psychiatric Nurse (CPN) who always went the extra mile and had my back (or when he didn’t it was for my own good because I was being belligerent). I was exceptionally lucky to have a CPN for such a long period, it’s now highly unusual to have the same persons involvement for several years. A CPN gets to know you and visits you in a safe space, usually your home. They can help you stay on top of medication and make adjustments if needed and get to know you well enough they can pick up on warning signs you might be becoming unwell. For example one time I stormed out of a psychiatric appointment and hid in a bush and then under my bed for fear they would find me and section me. Now this sounds kind of obvious that these are the actions of an unwell person but I didn’t see it at the time and trusted him when he suggested I perhaps needed to increase my medication. My last appointment with him he told me how proud he was of me for everything I had achieved and that he really believed I knew myself well enough now to need very little psychiatric input in the future, it sort of felt like losing a family member. His kindness was integral to getting and staying well.

3. Having a supportive family. From hiding sharp objects in the house or simply picking up on warning signs and asking me to come stay my family have been a huge part of my ability to get and then stay well. Right from the beginning of being unwell they were involved in meetings with my University, mental health professionals and each other to ensure I was supported at all times. I may have spent my 22nd birthday in a psychiatric Day Hospital but it could have been an inpatient Hospital had I not had family around me. In Day Hospital I learnt (and this was literally one of the few things I learnt) about the boat analogy. This is the idea that if your boat is filled with many compartments and you hit a rock, hopefully the spread of water doesn’t sink your boat. Conversely if your boat has only one or two compartments it is pretty easy for it to flood and sink quickly. You are the boat and these compartments are your support system, the more compartments you can put in place the easier it is to stay afloat when you are unwell. I am very privileged to have many compartments in the form of people but you were also encouraged to view your hobbies, psychiatric support and self care tools as compartments.

3. Having a supportive Voluntary Services Manager. My initial role as a volunteer was fundamental to building confidence and reminding myself that yes I was a competent human being. Had I not had very patient staff around me supporting me in my role and encouraging me to have faith in my ability I certainly wouldn’t be where I am today. I needed that low pressure confidence boost to get into the swing of something resembling work. I’m not sure I was always helpful at the start but by the end I was definitely contributing significantly. Had I not had a Manager who supported me in gradually building this I don’t think I would have ever gone into paid work.

4. My benefits being cut swiftly pushed me into work but it was the support of my Manager and team that helped me stay there. Starting paid work was hugely stressful, not only was I learning a new role which is always hard but I was also learning to function around human beings for 8 hours a day. Work was exhausting and I have never eaten more deliveroo in my life but it was the support of an amazing team that got me through that initial patch. Only a few years ago my friend and I spent an afternoon in Croatia talking about how I would likely never work, I just couldn’t imagine a time when that would be possible. Now I am thriving in my role and feel confident in my ability and what I bring to the job. If I hadn’t had a Manager who was flexible with my working from home, gave me the time to vent in my super long 1:1s and allowed an open dialogue about how I was feeling I couldn’t have stayed in work.

5.  The kindness found in a steady relationship. My current relationship is probably the first where I have felt totally myself and able to be open about my diagnosis and it’s smaller day to day implications. I haven’t dated someone who has been so flexible and supportive and that has allowed me to feel safe and more relaxed. Usually I find dating pretty stressful and and living on my own has been fundamental to my staying well as it has allowed me to step back from people when I need to. It is a huge testament to the relationship that a) we even contemplated spending lockdown together and b) this has worked incredibly well. I am very much a personal space person and when I don’t have that I find my anxiety levels shoot up and I feel trapped. If I feel that way he leaves me to my space without taking it personally. One of the kindest things you can do for someone is ask ‘what can I do to help?’ and he is fantastic at that. By being so flexible and understanding I am able to relax and the relationship is healthier and less volatile.

So these are just a handful of acts of kindness that have been fundamental to my recovery and staying well. You might think a lot of them should be a given; your family should look out for you, your employers should be supportive and your psychiatric team should be advocating for you. But this isn’t always the case and illustrates that when acts of kindness are shown it allows someone to flourish. It’s why it’s so important to be kind and compassionate to everyone we meet, not everyone has these compartments to their boat but we all have the opportunity to temporarily take the place of one.

Now, during a global pandemic (whaaat!?) we need to be mindful of this more than ever. I have seen far too many videos shaming people in parks or visiting family in their gardens and this needs to stop. We need to be kind to one another, not make assumptions and recognise that we are all managing the best we can. We should remind ourselves that we are physically distancing, not socially distancing and say hello and give one another a smile in the street. We know peoples mental health is being significantly effected but people proclaim that ‘well it’s this or dying’, that may be true but we enter dangerous territory when we think like this. It means we begin to compare physical and mental health again in a way we have tried to move away from in recent years.

For some people the effect of isolating on their mental health is profound and we shouldn’t dismiss those feelings. This isn’t always easy, when I see neighbours in and out of eachothers houses or get a pang of jealousy when I see someones spacious kitchen and garden I too find it hard not to be critical. But I recognise that I am fed up of being in a poky flat and sharing a small space with a large office chair that dominates our living room. That I am projecting these feelings onto others, people whose circumstances I really know very little about. It’s ok to validate feeling pissed off, claustrophobic and frustrated whilst also recognising that many of us are privileged to be somewhere we feel safe. If we all exercise kindness not only are we greeted with an opportunity to make someones day but we also lighten our own load, after all, carrying around negativity is pretty exhausting.

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Mental Health Awareness Week 2020

Happy mental health awareness week! 

I thought I’d kick off the week with an overview of Bipolar seeing as that is what makes mental health awareness so relevant to me! Bipolar is still very misunderstood so I think it’s crucial people have a better understanding of what the diagnosis entails. Particularly one that is not all doom and gloom like the many biographies I read when I was first diagnosed. If anyone has any questions I’d love to hear them! You can either comment below or ping me a message via my contact me page or through my Facebook group ‘P.S Bipolar’.

Having Bipolar does not ‘make you Bipolar’, it is is just one of your many labels, along with sister, friend, partner, family member..

So first off Bipolar is generally split into two types, 1 and 2, Bipolar 1 is usually characterised by more mania than depression and Bipolar 2 is usually more depression than mania. For Bipolar 1 the mania usually lasts longer than a week, this may sound like no time at all but when you consider the symptoms of mania as opposed to hypomania you’ll quickly see why it’s not ideal or sustainable to be in this state for long. My Bipolar is type 1 because I initially experienced far more mania and hypomania than depression although now I tend to only experience hypomania and depression because my medication regime is aimed at curbing the mania. Because of the depression element of Bipolar it is often hard to diagnose initially because most people will go to their GP because they feel depressed, not because they feel great (although we’ll explore some of the nuances of that), the Doctor therefore sees their depression, offers them an anti-depressant which will usually send someone with Bipolar high and the cycle continues until someone is able to get an overall picture of how the person is fluctuating over a period of time. This is why I’m a big advocate of CPNs (community psychiatric nurses) because they get to develop a rapport with someone in the community which allows them to notice this in a way that GPs who see someone for short bursts erratically would not.

I would suggest that there are around 6 states for someone with Bipolar, severe depression, low mood, ‘normal’ or stable, hypomania, mania and mixed state. Normal or stable mood is essentially what everyone experiences and doesn’t mean there is no mood fluctuation at all because that would be creepy and weird and a little robotic. Normal mood for everyone involves highs and lows which are healthy and responsive to what is going on around them, it would be strange for someone to have a breakup and not feel rubbish and similarly a birth or a wedding would make most people feel pretty good. Once someone is diagnosed with Bipolar they can struggle to work out what is a normal mood and what is a warning sign for an episode, even I still struggle with this because the fear of getting unwell is so high. What someone is like when they are stable will also vary because we all have different personalities; someone who is naturally quiet and introverted might be deemed to be isolated and depressive but their stable state might simply be that they prefer their own company. Similarly I’m normally very chatty and bubbly which could be interpreted as hypomania but just means that my stable state is a bit excitable!

Low mood is essentially feeling flat but looks different for different people, it’s outside the normal fluctuations of a stable mood but it’s not acute. Someone might feel lethargic, struggle to get out of bed, not enjoy the things they usually do, feel tearful and not take care of themselves. Low mood isn’t usually linked to suicidal ideations (thoughts rather plans) but if it goes on for a long time these might develop. Low mood can be hard to distinguish from generally feeling a bit down but I would say it tends to be more prolonged and isn’t always in response to something. When I first began to feel down the most scary thing was that nothing seemed to be causing me to feel this way and up until that point I had never felt so low without it being in response to something. That can be frightening because if the mood isn’t in response to something you can feel helpless and out of control.

Severe depression is characterised by all the of the above but more intensely and can often have anxiety mixed in. For a lot of people their severe depression can be very lethargic but for me severe depression manifests in a very anxious and agitated way. I tend to feel very trapped and out of control and I struggle to regulate or self soothe at all. My severe depression can sometimes include psychosis but this usually features in my mania. For me I am most anxious when I feel this way because the feeling is so intense and awful I feel very trapped in my own skin and unable to escape the feeling. Because severe depression within Bipolar doesn’t have to be in response to stimuli (something causing you to feel this way) it can feel like there is no end in sight which can feel very overwhelming and scary. The best way I can describe severe depression is like the early stages of grief but with no clear cause and no sense that this is a natural response that will get better. My severe depression felt acute and terrifying and I used self harm as a way of feeling in control because physical pain felt more understandable than mental pain. The longer I have had Bipolar the more I understand that an episode will end and the fear around what is happening has lessened although that doesn’t stop it from feeling awful.

Hypomania is feeling elated beyond normal mood fluctuation and the best way to describe this for me is like you’ve had a couple of drinks. Hypomania feels very buzzy and productive (although the reality is that you’re often more chaotic than you realise), you have more energy and you might feel like you don’t need much sleep or food to sustain you. You might go out more (for me that’s a warning sign in itself because I do not go out and choose to live like an elderly lady in a retirement home) and you might find it harder to get drunk because alcohol doesn’t effect you in the way it usually would because you’re already feeling high. Hypomania can often cause people to overspend because they are living in the moment and not seeing the consequences of their actions, namely ‘o shit I’ll actually have no money if I do this’. Similarly people can be hypersexual which can cause them to be promiscuous or be sexually reckless such as sleeping with people they wouldn’t usually or not using contraception. People can feel more confident and assertive although in reality they might seem a little intense and full on to others. Frankly hypomania feels pretty great and my flat is usually the cleanest it can possibly be during this period because I am up cleaning cupboards at 3am but it’s hard to contain it which is why it’s important to recognise and do something about it. When you’re hypomanic you can usually still function but you’re probably more chaotic than you realise and it’s helpful for people to pull you up on that otherwise it’s easy to be like ‘hey I’ll ride this awesome wave forever and be a superhuman’ when the reality is you’re probably going to crash.

Mania can be experienced in very different ways but usually will culminate in feeling

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A painting on mania

agitated and uncomfortable. Mania is like hypomania on speed, so all those good feelings and productivity become more intense and eventually unmanageable. Where you were maybe feeling hypersexual you may now be actively engaging in and seeking out risky situations. What was productivity becomes chaotic and out of control with thoughts that feel rushed and difficult to hold onto; you might become frustrated with yourself and others for not being able to keep up. You may also not realise to what extent this is happening so whilst you may feel hugely energetic and a little buzzy you might not realise that you are talking too quickly or sounding as intense as you do, you might even be saying things that are inappropriate or massively out of character. You might also feel that you are powerful and even have superpowers, that you are untouchable or someone special or chosen. Mania can include psychosis and people may feel that things are talking to them or they are being watched. My mania feels exciting but quickly feels very chaotic and stressful and it was interesting to me when I spoke to other people with Bipolar that some of them found it as euphoric as they did.

Mixed state is not experienced by everyone but is essentially a combination of low mood and hypomania, it can feel really confusing because you are experiencing so many different emotions and sensations and they don’t naturally fall into a particular state. I  feel really agitated during these because I am experiencing both hypomanic and anxious states in very quick cycles and I am not sure how to respond or contain it. People can often feel more suicidal and more likely to act on suicidal impulses or ideations because they have the energy of hypomania with the anxiety and agitation of low mood.

As you can see there is a huge amount of variation between episodes and this is why it’s really important to steer away from using terminology that implies Bipolar relates to feeling happy or sad. Images like this are not super helpful and are just misleading..

But things like this are a little better at exploring some of the nuances…

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Hopefully that’s been a helpful overview! Please as always feel free to share! If you have any questions just drop them in the comments section below 🙂

Recognising the small things…

received_207373927265897Well hello and good morning and what a strange new world we are living in. Here in the UK we are on the second week of a partial lock down which we kind of knew was coming but still was a bit of a shock to the system. I have started to settle into this new way of life but I know being a homebody by nature definitely helps. I have also spent around 6 years on disability benefits so I’m pretty used to 8 hours a day on my own and periods of time without seeing another human. That said these are scary times and I’m glad to now have someone staying that I can have little meltdowns with.

These are difficult times for everyone let alone anyone with existing mental health challenges but there are some things I am specifically worried about. The first is access to medication; GPs and other healthcare organisations have clearly cottoned on to the fact that if we cannot be trusted with loo roll we probably cannot be trusted not to stockpile medications. Luckily I recently picked up a 3 month prescription but the idea of not being able to get hold of medication easily at some point in the next few months is very stressful. I’ve been told to give a weeks notice when I’m running out but I will only be able to have a month at a time moving forward. As we all know from this post I have worked very hard to get the right medication and the downside to running out of medication for me is a) a deadly rash b) getting put on another medication to balance out my mood as I build up the old medication to it’s normal dose. This is very much a lose lose scenario for me and I have already eaten too much chocolate in confinement, I am keen not to add a new psychiatric medication into the mix and balloon into an easter egg shape. My solution to this is to become very organised and start counting my medications, my recommendation to anyone else on psychiatric medication is to get organised, work out what you have and stick a reminder in the diary when you need to order!

The second is that a lack of routine and structure is particularly difficult and makes me feel quite anxious, although I did this for several years on benefits I worked hard to introduce a structure into the day so I didn’t just become a blob on the sofa watching daytime TV. Part of this was my latent guilt about being a ‘benefits sponge’ but it was also that I start to feel irritable and generally a bit anxious and gross when I don’t have some kind of plan to the day. Luckily for me I am working from home which naturally generates some routine although I miss proper tea breaks and jacket potato lunches in the cafe. I am very fortunate to be in that position and I imagine it must be particularly difficult if you are currently not working from home, for whatever reason. Implementing structure is really important and will make you feel you have been productive at the end of the day, which ultimately gives us a sense of meaning and purpose. It’s particularly hard when you cannot go out and do the things that would usually fill time like a long walk, exercising at the gym or a swim, having a potter about town, meeting a friend for coffee…So it’s important to find ways of introducing those things in a way which works for your set up and y’know, keeps you from breaking government guidelines.

I am also worried about sleep which is a major trigger for me, at the moment I am definitely not doing enough exercise to activate any kind of significant sleep mode at the end of the day but my mind is also generally ticking over. My flat is quite small with 2 rooms so although I aim to hide most of my work related bits at the end of the day I am still existing in the same small space that I am eating, working, relaxing and sleeping in. I have also got into the terrible habit of being worried about sleeping which means i stay up until I am exhausted and don’t properly wind down and read and have some non screen time, this is SUCH bad sleep hygiene and I really ought to know better. My aim moving forward is to go to bed at a semi reasonable time before I am too tired to engage in self-care and actually have some time out.

Speaking of screen time I am also acutely aware of the amount of screen time I am having, I seem to glide from one screen to another during the working day which is also no good for you.  I live fairly central near a lovely common, at the start of all this I thought ‘excellent, I’ll be able to go for nice long walks and get some fresh air’ however like the scenes of Cornwall and Wales people are going out en masse with the same thought. Following a very stressful human obstacle course one warm afternoon on my way to the pharmacy I decided daylight walks are not enjoyable and I simply come home feeling more anxious than I did pre-walk. I now live like a vampire and go out only in the evenings for a walk; on sunny days I open the large windows in my living room, plonk myself on an IKEA poang chair and pretend I am outdoors. My freckles are responding to the small amount of sun their receiving as a result so I  can only conclude I am getting the vitamin D I need.

I could sit here and preach about all the great things you should be doing to stay well but  it is only week 2 and like most people I am still transitioning from knowing what I ought to be doing to actually doing it. However I can celebrate the small achievements I have made for sure:

1.I have picked up the gratitude journal again, for those of you who are unaware of what this is it’s essentially a way of forcing you to be positive about the day. For me I commit to recognising 3 things I am grateful for and I then draw them in a bid to stay creative. Some days these are wonderful moments, some days these are organising my sock drawer:

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2. I have been doing the 30 day illustration challenge to stay away from screens and force me to spend time doing something I actually enjoy:

3. They are vampire walks but they are walks nonetheless, yesterdays was about an hour and a half ambling through the deserted streets of town. Slightly creepy and apocalyptic but I did stumble across this in a crepe cafe which tickled me:

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I’d love to hear/see what you’re all up to, remember you too can acknowledge the little things.Stay safe and stay at home x

Happy New Year!

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New Years Eve – Literally the first time I’ve ever been out for it..

Happy New Year everyone and apologies it’s been SUCH a long time! Now that I’m working full time (which weirdly I still feel like I notice) I find that at the end of the day I want to binge watch Netflix whilst eating gluten free hobnobs and not stare at yet another computer (yes I acknowledge that the TV is simply a larger screen and there really isn’t a huge difference). I therefore continue to put off writing unless it is 6:30am and I am yet to be stuck with my nose to a computer for another working day.

I have also found Christmas this year really difficult and anxiety provoking and it’s taken me a while to shake it off. It’s funny because there were lots of memes going round over the Christmas period about the importance of looking after yourself and taking time out and I seemed to share these with enthusiasm but not actually take any of them on board. I am probably best described as an ambivert but appear to most people to be an extravert because I talk a lot and and am happy to lead in social situations. This is misleading because I find other people kind of exhausting and I’m a real ‘personal space’ kind of person so spending a few days cooped up with literally no room to take yourself off to is hard. In an ideal world I’d spend about 60% of my time with people and 30% on my own; seeing as my job is so social I pretty much hit that 60% at work so I choose to retreat into my house like a little hermit crab most of the working week.

As my immediate family is so big there really wasn’t a spare room to coop up in over Christmas; I started Christmas eve in my mums bed due to a lack of actual sleeping spaces but my insomnia forced me to sneak out in the middle of the night, looking for any kind of available space to be awake in I managed to end up in my 13 year old brothers high bed (very rickety and terrifying, wobbled like it was about to collapse with every movement) and then the mattress on the floor of my 15 year old sisters room. We have all spent Christmases on semi deflated air beds, part of a larger tetris of sleeping bodies crammed into a study and it is this lack of physical space to take ourselves off to as well as the pressure to have a great time for an entire day that can be challenging for all of us. However much we love our families being totally mashed together isn’t good for us.

I also found the lack of routine and structure super stressful!! I should have known this because even when I have a weekend with no plans and even when I want to spend that doing literally nothing I still feel a need to do that in a formal, structured way; I choose to wear lounge clothes, cook some nice food and light some candles, I don’t seem to have the ability to just chill the frick out and lie in being a bit gross. I think this continues to be my latent ‘benefits guilt’ which is essentially that I have been told by the government for so long that I am scrounging that I feel a huge weight of pressure to prove I am not just swanning about my flat watching TV and eating junk food; even though I was more than justified to do this when I was unwell if i needed to let alone now when I work. When I was on benefits and had a terrible night of  insomnia I would rebelliously fight a nap just because it made me feel gross and dirty to be doing nothing, these days I try to remind myself that a nap is ok if I need one!

I have been reminded of this need for structure over the past two weeks whilst off work sick. Now obviously if you’re sick you need to rest but I fought against the elements most mornings, much to the frustration of my colleagues, to get into work only to be sent home on arrival. This is because a) I start to go a bit stir crazy when I have no routine AND am too unwell to implement one and b) I continue to feel a need to ‘catch up’ at work and prove my value. Again the government sits on my shoulder whispering into my ear, reminding me that I have spent a long time not working and using up public money, and that I am still ill a lot which probably makes me a burden to my organisation and team mates. I know this is unreasonable and simply not true but I continue to feel the pressure I felt when on benefits despite working full time now. Upon my return to work my Manager reminded me that I am indeed committed to my job and no one would doubt that, that I am an asset to the organisation regardless of my health that and I need to fricken look after myself better. This week I have finally called my GP, arranged a dentist appointment I’ve been putting off (turns out rightly so, they’re whipping out a tooth AND I need  filling) and am organising an eye test. It sounds ridiculous but rather than leave work slightly early to actually look after myself I power through, desperate not to be any more of a pain in the toosh than I already feel. The reality is that both my physical and mental health suffer so this years resolution is to start acknowledging that I need to apply the same work ethic I have in my job to actually looking after myself.

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What is Bipolar?

Having Bipolar does not ‘make you Bipolar’, it is is just one of your many labels, along with sister, friend, partner, family member..

Happy world mental health day!

So for this years post I thought I’d share the grownup version of explaining what Bipolar is actually like. You may remember this post that I wrote a while back for The Mighty which had to be geared for children as young as 13 which meant writing the mindful, PG version and I figured it may be helpful to write in a little more depth.

So first off Bipolar is generally split into two types, 1 and 2, Bipolar 1 is usually characterised by more mania than depression and Bipolar 2 is usually more depression than mania. For Bipolar 1 the mania usually lasts longer than a week, this may sound like no time at all but when you consider the symptoms of mania as opposed to hypomania you’ll quickly see why it’s not ideal or sustainable to be in this state for long. My Bipolar is type 1 because I initially experienced far more mania and hypomania than depression although now I tend to only experience hypomania and depression because my medication regime is aimed at curbing the mania. Because of the depression element of Bipolar it is often hard to diagnose initially because most people will go to their GP because they feel depressed, not because they feel great (although we’ll explore some of the nuances of that), the Doctor therefore sees their depression, offers them an anti-depressant which will usually send someone with Bipolar high and the cycle continues until someone is able to get an overall picture of how the person is fluctuating over a period of time. This is why I’m a big advocate of CPNs (community psychiatric nurses) because they get to develop a rapport with someone in the community which allows them to notice this in a way that GPs who see someone for short bursts erratically would not.

I would suggest that there are around 6 states for someone with Bipolar, severe depression, low mood, ‘normal’ or stable, hypomania, mania and mixed state. Normal or stable mood is essentially what everyone experiences and doesn’t mean there is no mood fluctuation at all because that would be creepy and weird and a little robotic. Normal mood for everyone involves highs and lows which are healthy and responsive to what is going on around them, it would be strange for someone to have a breakup and not feel rubbish and similarly a birth or a wedding would make most people feel pretty good. Once someone is diagnosed with Bipolar they can struggle to work out what is a normal mood and what is a warning sign for an episode, even I still struggle with this because the fear of getting unwell is so high. Recently I had to end dating someone I really liked so naturally I’m a bit mopey and miserable, that doesn’t mean I’m going down it just means I need to watch Bridget Jones and have a little cry. What someone is like when they are stable will also vary because we all have different personalities; someone who is naturally quiet and introverted might be deemed to be isolated and depressive but their stable state might simply be that they prefer their own company. Similarly I’m normally very chatty and bubbly which could be interpreted as hypomania but just means that my stable state is a bit excitable.

Low mood is essentially feeling flat but looks different for different people, it’s outside the normal fluctuations of a stable mood but it’s not acute. Someone might feel lethargic, struggle to get out of bed, not enjoy the things they usually do, feel tearful and not take care of themselves. Low mood isn’t usually linked to suicidal ideations (thoughts rather plans) but if it goes on for a long time these might develop. Low mood can be hard to distinguish from generally feeling a bit down but I would say it tends to be more prolonged and isn’t always in response to something. When I first began to feel down the most scary thing was that nothing seemed to be causing me to feel this way and up until that point I had never felt so low without it being in response to something. That can be frightening because if the mood isn’t in response to something you can feel helpless and out of control.

Severe depression is characterised by all the of the above but more intensely and can often have anxiety mixed in. For a lot of people their severe depression can be very lethargic but for me severe depression manifests in a very anxious and agitated way. I tend to feel very trapped and out of control and I struggle to regulate or self soothe at all. My severe depression can sometimes include psychosis but this usually features in my mania. For me I am most anxious when I feel this way because the feeling is so intense and awful I feel very trapped in my own skin and unable to escape the feeling. Because severe depression within Bipolar doesn’t have to be in response to stimuli (something causing you to feel this way) it can feel like there is no end in sight which can feel very overwhelming and scary. The best way I can describe severe depression is like the early stages of grief but with no clear cause and no sense that this is a natural response that will get better. My severe depression felt acute and terrifying and I used self harm as a way of feeling in control because physical pain felt more understandable than mental pain. The longer I have had Bipolar the more I understand that an episode will end and the fear around what is happening has lessened although that doesn’t stop it from feeling awful.

Hypomania is feeling elated beyond normal mood fluctuation and the best way to describe this for me is like you’ve had a couple of drinks. Hypomania feels very buzzy and productive (although the reality is that you’re often more chaotic than you realise), you have more energy and you might feel like you don’t need much sleep or food to sustain you. You might go out more (for me that’s a warning sign in itself because I do not go out and choose to live like an elderly lady in a retirement home) and you might find it harder to get drunk because alcohol doesn’t effect you in the way it usually would because you’re already feeling high. Hypomania can often cause people to overspend because they are living in the moment and not seeing the consequences of their actions, namely ‘o shit I’ll actually have no money if I do this’. Similarly people can be hypersexual which can cause them to be promiscuous or be sexually reckless such as sleeping with people they wouldn’t usually or not using contraception. People can feel more confident and assertive although in reality they might seem a little intense and full on to others. Frankly hypomania feels pretty great and my flat is usually the cleanest it can possibly be during this period because I am up cleaning cupboards at 3am but it’s hard to contain it which is why it’s important to recognise and do something about it. When you’re hypomanic you can usually still function but you’re probably more chaotic than you realise and it’s helpful for people to pull you up on that otherwise it’s easy to be like ‘hey I’ll ride this awesome wave forever and be a superhuman’ when the reality is you’re probably going to crash.

Mania can be experienced in very different ways but usually will culminate in feeling agitated and uncomfortable. Mania is like hypomania on speed, so all those good feelings and productivity become more intense and eventually unmanageable. Where you were maybe feeling hypersexual you may now be actively engaging in and seeking out risky situations. What was productivity becomes chaotic and out of control with thoughts that feel rushed and difficult to hold onto; you might become frustrated with yourself and others for not being able to keep up. You may also not realise to what extent this is happening so whilst you may feel hugely energetic and a little buzzy you might not realise that you are talking too quickly or sounding as intense as you do, you might even be saying things that are inappropriate or massively out of character. You might also feel that you are powerful and even have superpowers, that you are untouchable or someone special or chosen. Mania can include psychosis and people may feel that things are talking to them or they are being watched. My mania feels exciting but quickly feels very chaotic and stressful and it was interesting to me when I spoke to other people with Bipolar that some of them found it as euphoric as they did.

Mixed state is not experienced by everyone but is essentially a combination of low mood and hypomania, it can feel really confusing because you are experiencing so many different emotions and sensations and they don’t naturally fall into a particular state. I  feel really agitated during these because I am experiencing both hypomanic and anxious states in very quick cycles and I am not sure how to respond or contain it. People can often feel more suicidal and more likely to act on suicidal impulses or ideations because they have the energy of hypomania with the anxiety and agitation of low mood.

As you can see there is a huge amount of variation between episodes and this is why it’s really important to steer away from using terminology that implies Bipolar relates to feeling happy or sad. Images like this are not super helpful and are just misleading..

But things like this are a little better at exploring some of the nuances…

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Hopefully that’s been a helpful overview! Please as always feel free to share! If you have any questions just drop them in the comments section below 🙂

Melted relax

20190923_205627Following on from THIS post…

So I recently coined the phrase ‘melted relax’ (if you’ve heard it before unhear it because I really like it and feel proud I created it) which basically refers to that sensation of being a puddle you feel so gooey and relaxed. When babysitting on Sunday evening (they are 15 and 13 so the term babysitting is loose) I was showing the kids ASMR videos and they both dozed off! It made me think that ASMR should be used as a tool to relax for everyone and not just as this kitsch thing some people utilise or know about. I was then thinking that a lot of it is soft spoken or whispering which is essentially what a bedtime story is which got me to researching and finding….THIS!!!!!

It’s literally an ASMR channel for children. For anyone with kids or for any adults who like to be read to (that’s me!) then have a gander over the below.. You can find the page HERE

ASMR

P.S I promise I’ll stop going on about ASMR soon I just really feel the need to tell you all about it because it’s PERFECT for hibernating autumn background sounds!