An overdue letter to my psychiatrist

Posted by Emily

This was on my to-do list for ages. I sent it today. For some reason, it seemed like a blog post too.

Hello

I hope you’re doing well.

You’ve been on my ‘to do’ list for some time…. I’ve been wanting to get in touch and tell you how I’m doing but there’s been ‘something’ holding me back. I think that thing is still loitering somewhere in the recesses of my mind, but regardless, I’ve decided it’s time.

When I left you at the end of June last year, I was ecstatic; I felt like miracles could happen and life was turning for me. I literally felt like a different person and I literally felt that I was seeing the world as new. What had seemed to be surrounded by fog, seemed then to be suddenly able to be seen with a clarity that I hadn’t realised existed. Or, had forgotten.

Initially I was very frustrated that my body was lagging behind my brain – every time I did something even mildly energetic or exciting, I needed to build in ‘recovery’ time – my body was still repeating the habit of hyper into hypo. It’s taken a long time, and my energy levels (or lack of) are still something which I worry about, but they are so much better and improving all the time.

During that early period of ecstasy and excitement, I launched myself into my business. I was certain that things were turning for me. I’d beaten PTSD and so I was going to crush this self-employment thing and be a huge success. I could do anything. And then, I crashed with exhaustion. Making the business successful wasn’t easy and it needed more attention and energy than I had to give it. I started hiding from the things that needed doing, just keeping up the pretences of doing and doing enough to not get found out. During that time I think I sunk into depression again, or something like it. Being alone for most of the day (and nights) didn’t help. Pulling myself out of that funk has been (is proving to be) very difficult.

I was going to write to you at Christmas. I had some special ‘Chrismukkah’ cards made for my business and I was going to send one to you with a thank you note inside, for giving me my miracle. But I didn’t. Because I felt I’d been squandering my miracle. I wasn’t a success. I was still languishing in bed for much of the days and creating a fake bravado persona for when I was with others.

The beginning of this month marked the 7 year anniversary of the rape. You know that in the past this date has caused me a lot of anguish, I’ve wound myself up into quite a state in fearful anticipation of it, really from the end of January every year. This year it was March before I really consciously remembered the anniversary was approaching. And I didn’t feel frightened. I felt sad. I felt grief for the lost years. And for the first time I think I consciously allowed myself to move on and past. I won’t ever be able to forget. But it’s not got the hold over me that it had. Thank you.

The business hasn’t worked – yet. It will. After the May Bank Holiday I’m taking a really interesting 6 month contract which will improve my skills & expertise as well as keeping the roof over my head. I’m immensely relieved. I also hope that the combined factors of routine/schedule and the company of other people will help me with staving off the depression which wants very little excuse to manifest itself in my head.

Anyhow, I wanted to write and tell you how I’m doing. I’m doing good. Thank you.

My Struggle with Positive Thinking

Posted by Emily

Positivity. It’s on my mind a lot at the moment. Very likely something to do with the fact that I recently became an NLP Practitioner, which I tend to refer to as the cult of positivity. For those who don’t know what NLP is, it’s essentially a set of tools which can help you to re-frame your reality into something more positive, and help you to achieve your dreams. I’m excited to be an NLP Practitioner, don’t get me wrong. It is a powerful set of tools which will help me to be a better coach, and I’m excited to be continuing to add to that toolset over the course of this year with Master Practitioner and Train the Trainer training coming up.

I’m also still suffering from depression. In fact, after the marriage I had, followed by the rape and PTSD, I don’t think I remember anything more than fleeting happiness. The days when I feel I can achieve my dreams, I don’t trust. Something happens to burst the bubble. Always.

(NLP would now be saying to me: “Always?”).

NLP helps you to deal with inappropriate feelings. PTSD is only diagnosed 6 months after the trauma – almost as though it’s defining still suffering after 6 months as an inappropriate time to still be suffering. So, is 9 months after being discharged from psychiatric help as ‘cured’ from PTSD an inappropriate amount of time to still be grieving for the lost me? The me I never really got to know (under all that depression from the marriage), the me that died that night, even if my heart did still keep beating? Who defines inappropriate?

Depression isn’t a state of mind. I can reframe my thoughts as much as I like. The depression is like the foundation of my soul, it’s taken up residence in every nook & cranny and it laughs at my attempts to re-programme my mind. I can (do) jump through the hoops, I can (do) feel momentarily brighter. Living in the now, momentary matters, it isn’t nothing. But the constant battle is exhausting.

NLP teaches you how to pull out of being in a ‘victim mentality’. That victim has survived for the past 2536 days, somehow, clinging on through times I didn’t think I could. I choose to honour the part of me that was the victim, that froze, that gave up the fight, that through not fighting, survived.

So, I choose another way. I choose to soothe the hurt. To let it know that it’s ok to hurt. It’s ok to still be suffering. It’s ok to still grieve. It’s ok to sometimes lie in bed and not fight the battle that day. Every breath of life is a win against the monster who tried to take it from me. Yes, there are only 60 seconds in a minute, 60 minutes in an hour, 24 hours in a day – yes, this is the same as anyone else has, and they might do more with that time, achieve more, be more. I am being what I can be. And that is ok. It is enough.

Reawakening

Posted by Emily

I’ve been meaning to write this for a while but for some reason I’ve been putting it off. I think I’ve just been wanting to let it settle on me, be a bit clearer about what I think about it all. Because the world doesn’t really make sense, this doesn’t really make sense, not even yet, but it is getting clearer. I suppose I don’t really believe it yet, not truly, but maybe writing it down will help me to start.

I’m starting to notice the signs that I’m better, it’s almost like I’m waking up from a deep, but deeply unsettled, dream. Trying to figure out who I am, what I am, what I love, what I hate, how to be, post PTSD is no easy task. I’m a new version of me, I’ll never be the person I used to be ‘before’ again (and I can’t even recognise her as someone who I used to know, but that’s ok as my memory is conveniently erasing it all anyway) and the person I became ‘after’ was a chameleon shell clinging onto the raft as it battered against the rocks. The person I am ‘now’ is still being determined, a work in progress. I’m consciously trying to create new habits and new experiences, to discover what the things are that I enjoy. I’m experimenting with new sensations – smells & scents through essential oils, touch & the language of the body through massage; exploring my creativity through writing and through learning to sew; and the revelatory discovery that exercise can be fun (through cycling and swimming).

It’s now 4 months since I was discharged by my lovely psychiatrist, a full bill of health, no longer suffering from either depression or PTSD. It’s been a very odd 4 months, with starting my own business, not having the routine of paid employment; I’ve swung wildly from over-doing it to days of doing very little at all, struggling to find the balance. I’ve noticed that whilst my head is definitely better (breaking a glass on the floor doesn’t leave me in floods of tears, but I can swear, shrug & clean it up without a problem), my body is lagging behind. I know my still-unfitness (despite lots of attempting to rectify) is a contributing factor, but the fatigue I get is definitely correlated to the exertions of energy – it’s as though now my head has unlearned the hyper-panic response, my body still needs to unlearn the hypo-disassociate response. Whilst I’m not really in hyper at all anymore, my body is still associating exertions of energy (for example when I pack too much into a day, or over-do it on the attempting-to-get-fit front) with hyper and so crashing into hypo at any given opportunity. I know it’s a habit that my body needs to unlearn – but when you’re lacking in energy, it’s really not so easy.

I’m very glad I’ve had the chance to take it when I’ve needed to, being largely in charge of my hours with the new ‘emventure’ – I really don’t think I’d have been able to do 5 days a week without crashing every weekend. And I vowed that the point of the new business was to have the opportunity to find a different balance to life, to be able to look around me and see the world without letting it just fly by. Of course, I’m nervous that I’m not exactly earning at the moment, and the money will be gone before I know it if I’m not careful. I’m worried that whilst I believe in emventure, maybe others won’t and I therefore won’t be self-sufficient. I know that my CV and past experience doesn’t get erased by trying to go my own way – but of course I worry that the job market is a very competitive place. Keeping the belief in myself is key; keeping the belief that I am better, that this ‘remission’ will prove to be lasting, is key.

I’m about to face a very big test of whether my betterness is real. I’ve faced some difficult tests (family relationships are improving, as much as they ever might) but this one is a doozy… After the divorce and the end of the white-picket-fence dream, I didn’t know where to be. I chose a place and it was in that place that I was raped. Following that, I moved 6 times in 3 years, not doing much more than 6 months in any ‘home’. Three & a half years ago, I found the flat where I’ve been happy, felt safe, felt like I’d made a home. Economic times being what they are, and house-prices & rents sky-rocketing has meant that my landlord is selling my flat for an obscene amount and I need to move. So, I’m moving. This will be a test of epic proportions. I’m staying in mostly the same area (I won’t need to change my doctor, my dentist, my hairdresser or my gym) and I’m moving closer to a friend, who loves the immediate area so whilst I don’t know it so well (yet), I’m reassured that I’m making a good choice. The flat is smaller, costs a little more, is further away from the hustle of my current corner of the world, but it’s full of character, been done up new by the landlord and has a garden. Rationally, it’s a sensible choice. Emotionally, I don’t know. Emotionally, I’m worried that the stress of moving, not so much because moving is stressful (although it is), but because of the past associations I have with moving will knock me off-balance.

Rationally, I know it probably won’t. Over the course of all the therapy & psychiatric treatment, I’ve learned a great deal about how to ground myself, how to notice the signs I’m feeling overwhelmed and take appropriate action. I’ve also got a lot more insight into how different scents can disrupt my senses and calm me almost instantly (which although first used by my psychiatrist, I’ve been using a lot more since then after having been introduced more widely to essential oils by a friend). I have oils to diffuse, to inhale, to apply to my skin and feel safe.

Different to the past, as well, is the discovery that I like exercise, that it can feel beneficial to me. Whilst I still maintain that exercise can’t overcome depression until your depression is ready to be overcome, I have found that some exercise can be fun (cycling, swimming) and when I do make the effort, I enjoy it and it lifts my mood. In the days when I was fitter, it used to be a great way to manage my stress; I know that it’s a tool in my armoury when I need it and I can go for a swim, and a steam after.

So, I know it’ll be a test; but awareness is half the battle. And I know that I have ways that have worked in the past, and will therefore likely continue to work, that mean I can rely on myself for support. But I also know that I’ll still have the support of all my lovely friends who helped me get this far and aren’t about to disappear just yet. In a ‘practice’ coaching session recently, I hit upon a very visual description for how my journey towards this reawakening feels – it was a very dark, stormy night, then for a long time I was in a fog, now that fog is lifting, it’s just a light mist and the sun is clearing the way for bright blue skies.

Mental Health Week 5: Resilience

Posted by Emily

Today’s focus is on Resilience. I’m on holiday so I’ll be posting this up – and I suppose I’ll see what you all think when I log back in on Monday…

I have some very personal sensitivities around the word ‘resilience.’ Before I joined this company, I was told by a manager that I lacked resilience; my future emotional state could not be trusted and so could I please resign. I did, but not without rather a sizeable pay off. It is contrary to the equalities act to discriminate on the grounds of disability – and resilience is a term which smacks of discriminatory judgement. (As an aside, I saw at least one directorate job role advertised in the recent restructure which listed resilience as a required EQ trait. I checked this out with an HR friend of mine (external) and she confirmed, at best it was ‘problematic’, at worst it was discriminatory. We can do better than that).

So, why, those personal subjective reasons aside, do I hate the term?

It is a judgemental word – the opposite of resilience is weakness; calling people who are suffering from anxiety (or any mental illness) anything which can be construed as weak just adds to the stigma attached
People who are suffering anxiety (or other mental illness) are fighting more battles just to keep going, so are actually (in my opinion) more resilient than those who are not suffering in any way – the person who has an anxiety attack before arriving at work, but arrives at work anyway; the person who is still living but doesn’t want to; the person who is facing into their fears and demons despite panic attacks – these people are more resilient than those who are not fighting those battles
The concept of the ‘stiff upper lip’, ‘facing down anxiety’ is actually very counter-productive – if you do not acknowledge you are ill and try to get by, you are likely to become more ill. Anxiety, like depression, does not just ‘go away’ if you ignore it – it will only get worse.

The concept of resilience seems to suggest that if you take practical steps to develop resilience (through mental and physical self-care) you can somehow avoid mental illness – that someone who is resilient will then be immune to depression or anxiety, or worse. Health-freaks still get colds. In fact, health-freaks still get cancer. Depression can hit for no reason – there doesn’t have to be a big life-event like divorce, or unemployment, or money worries to mean you get depression, it can just happen. That’s a very scary thought for most people, of course it is, but it’s the truth.

I asked my psychiatrist last Friday what she thought about resilience. She is one of the leading trauma specialists in the country, not some quack. She says it has become a very fashionable term, but it failed to take into account that other factors will always impact how severely an individual is affected by anxiety, stress, or any mental illness – especially factors in early-life which will have impact on the adult. She also pointed out that neuroplasticity which causes changes in brain function, takes months and not weeks to take effect. CBT (cognitive behavioural therapy) which is very popular as a tool in building resilience generally fails to provide any lasting solutions because it is usually only carried out over a period of on average 10 weeks (and it’s only allowed via NICE on the NHS for 6-10 weeks). It does help some people, but not many. But it’s cheap and so it’s usually the first line of attack. Businesses love it – NLP is mostly just CBT under a business and not a psychologist guise. Work hard, work longer and if you start flailing, have some NLP coaching, keep going, if you don’t you’re not resilient, you’re weak. Like I said in Monday’s blog – your mental health is just not worth losing over a powerpoint presentation.

I am still here, on this earth – I’ve developed the self-confidence and risk-taking necessary to decide to leave in 2 weeks to start my own business; I haven’t put into practice my plan B yet, and don’t intend to. My survivor-mechanism has kept me clambering up the walls of the abyss every time I’ve slipped down. I’m resilient because I’ve had something to be resilient against. Next time you question someone’s resilience, ask yourself, what do you really mean by the term? What are you really saying?

Mental Health Week 4: Self-Care

Posted by Emily

Today’s theme for Mental Health awareness week is winding down. Over the years of being in and out of various forms of therapy & counselling I have had lots of advice for how to take care of myself. Self-care is critical – even when something doesn’t seem to actually improve the situation just the very fact that you are taking care of yourself, doing something nice for yourself can have a really positive impact on your state of mind.

Today is my birthday, so I’m not in the office, and I’ll be doing a lot of nice things for myself today and over the next few days. Here is a collection, in no particular order, of some of the things that I have tried, with various success, over the years. Some may work for you, some won’t. The trick is to try until something does.

If you’re in a very low place, it can sometimes help to try to shift your reality by getting involved in a different reality:

Try a movie that brings a smile to your face – for me, that’s something that requires almost no concentration and has a happy ending. Maybe it’s a Reese Witherspoon thing but both Sweet Home Alabama and Legally Blonde work perfectly for me, everytime. Afterwards I might still be low, but for the 2 hours or so that the movie was on, I had forgotten my reality
Music can work too – it’s cheesy, but 80s pop tracks, or ABBA, or something equally wrong, can do wonders to make you want to sing a long, dance and forget the world
Friends – sometimes you really don’t want to see anyone, sometimes even the thought of seeing someone is really overwhelming. But actually, once they are there, with you, they are awesome. It’s an absolute fallacy to think depressed people can’t laugh. You can, and it helps, only for the moment, but when you’re low, each moment conquered matters

If you’re feeling really stressed and anxious, it’s important to try to find a few moments where you can have some respite and take time for you:

A long bath with bubbles, and candles and some calming music can work wonders. Put some lavender oil in the water. My go-to music for this is the Twin Peaks soundtrack. Don’t judge me, it’s beautiful and just transports me to another reality.
Creating a little oasis of calm where you can in your home is really useful – light a tea candle, put some flowers in a vase, and sit quietly watching the candle burn. Whilst you’re doing this, you can also try –
Meditation – I’ve had mixed success with this one, it’s very very hard to quiet the mind and not let it run off on one! If you can just observe that your mind wants to think about other things, without judgement, and just try to concentrate on your breathing, breathing in good, breathing out bad stuff, then it helps. And you can also try –
Affirmations – saying something positive to yourself again and again. It’s important that it’s phrased just as a positive (i.e. not I am not stupid, but instead, I am bright). My own affirmation was given to me by a friend who is also a life coach (oh, I’ve tried everything!) and it is “Whatever I do, I totally & completely accept myself exactly as I am right now.”
You can also get Angel cards or other affirmation cards which will give you a new one every day
And there are loads of meditation apps (& you tube videos) which are worth trying until you find one that works for you
With my current psychiatrist, I have worked through a very detailed visualisation for my safe space, which is what I focus in on whenever I need to now. I imagine myself walking down the lane, opening the gate, and sitting in the bright yellow lawn of daffodils, the birds overhead, the breeze on my skin, the dampness of the grass, the dogs & ducks in the distance… Pick a happy time where you felt really safe and calm and peaceful. Add detail. Close your eyes, transport yourself there. It’s a wonderful resource, an oasis of calm in a noisy world.
Yoga is a great way to relax & unwind; you need to focus on your breathing which helps with stress, and you can do it at home so you don’t need the added stress of being around people, or leaving the house.
And, if you’re up to it, then exercise does have some benefits – it helps to clear the lungs so they have to breathe more deeply. As I’ve said, I don’t believe that exercise can make stress or depression go away – and if you’re in a deeply depressed state, exercise is just going to tip you over the edge. I’ve tried running when depressed and it’s made me feel even more low because my body and my mind just wasn’t ready for the jolt. So, don’t do too much, listen to your body, and do what’s good for you.
And tea. We’re British after all… (or not, but, tea).

If you’re feeling overwhelmed and in a state of high anxiety, or feeling panicked, then you can try:

Grounding yourself – feel your feet on the ground, your back supported by the chair, straighten your back, relax your shoulders. Be aware of your body, in the present.
Using your left hand, grip your right wrist, just lightly… be aware of how it feels. Pat up your arm, to your shoulder. Do the same right hand, to left wrist. Do the same with your left hand to your right ankle and up your leg. And vice versa. This gives you a sense of being in the present, your body is here, attached to you. Very useful if you’re starting to feel that floating out of body experience which is common with panic attacks.
Orient yourself to your surroundings. Notice the colour of the carpet, the walls. Say to yourself, that is a chair over there. Notice if the sun is shining. What are the noises you hear? Just focus on the things, the noises, the tastes, the smells. This will give you time to not be thinking about what’s panicking you.
If you find yourself being panicked at your desk (or in your home) have something that you can focus on that brings you calm. On my desk I have some postcards, one is of Vancouver where I love, and some sunsets. Also Pooh with some honey.
Similarly, you can keep something in your pocket to hold onto – a stone perhaps, which just grabbing in your fist can help to ground you. Or a piece of jewellery. I have a bracelet which I focus on, and also a necklace which I wear most days which actually symbolises the grounding chakra.
Smell is the quickest sense to adjust – I carry rosemary oil with me everywhere I go, it’s quite an energising smell and it’s one I now associate with being safe. Choose one that you like and inhale whenever you need. By my bed, I keep lavender oil, as it has a soporific effect too.
If what someone is saying is making you feel either stressed or triggered, then try visualising them with a goldfish bowl in front of their face. Focus on the goldfish swimming around. Their face will be distorted through the glass. It’s surprisingly effective 😉

If you’re having trouble sleeping, which tends to go hand in hand with stress, it can be a double whammy because when you’re feeling tired, everything is worse. I can’t say I’ve cracked the insomnia code yet, but some things I’ve tried (and trying):

Keep a pad by the bed (and a pen or pencil) – if your mind is racing it will try to stay awake to remember things. Write them down so you know you don’t have to keep them in your head.
Diffuse some peace & calming oils / lavender so that the air in the room will help you sleep
I suffer from night terrors sometimes – I’ve got a self-made calendar thing (not sure what to call it really) that tells me what day it is, what year, where I am, how old I am. That way, when I wake up in a panic thinking I’m in a bad place, I can orient myself quickly to the present and know it was only a nightmare
Don’t keep your phone by the bed, Twitter & Facebook can be too distracting
Have a bath before bed
Don’t do exercise in the late evening – your body will be too energised
Meditate or do some of the calming activities before bed
Chamomile tea is very calming and can have a soporific effect
If you’re in a cycle of insomnia it can sometimes be helpful to use sleeping tablets to kick-start the body back into its natural cycle. Sleeping tablets can be really unhelpful too though, and even the non-addictive ones can prove to be quite addictive, making you believe you need them. And, take it from me, it’s not very good if you take a sleeping tablet, wake up in the night and in your half-drowsy state think it’s a good idea to take another, oversleep until mid-morning when you were supposed to be at VCCP to give a stratcom presentation, get there late and then explain to the group about it not being a good idea to take too many sleeping tablets…. They’ll think you’re crazy. They might be right, but it’s not a great outcome.
I’ve also tried Valerian as a natural alternative to sleeping tablets – tastes awful but a few drops in grapefruit juice can do wonders. Tend to still wake up feeling very zombiefied though. Nytol can work too but I prefer the herbal versions. And nothing (over the counter) beats Night Nurse.

I know this is work, so probably not very appropriate to focus too much on some of the less healthy winding down techniques but I don’t think that it would be honest to discuss mental health and fail to mention that those of us who suffer from mental health issues are more likely to fall foul of things like alcohol or drug abuse. My biggest failing is comfort eating and carbs are my enemy. When stressed, anxious or depressed, it’s important to be kind to yourself – but that doesn’t always mean another macaroni cheese or glass of red wine. Everything in moderation. Except breathing, always remember to breathe.

Mental Health Week 3: Supporting Others

Posted by Emily

Today’s theme for Mental Health Awareness week is Supporting Others. As someone who’s been at work on the spectrum of depressed to severely depressed, and anxious to having full-blown panic attacks in the middle of the office, I can’t really put into words how valuable and necessary the support I’ve received from the few that have known has been.

Mental health issues of one type or another can affect 1 in 4 of us at any moment. In fact, it will be very rare for someone not to experience a mental health issue, either themselves or a loved one or close family member. Depression and stress tend to be talked about most and these have become the acceptable public face of mental illness, caused by the pressures of western living – divorce & relationship problems, financial pressures, job woes – all of these are ailments of modern life which everyone can relate to, and so are often cited when trying to break down the stigma of mental health.

And there is a stigma to mental health. Many mental illnesses are not so ‘acceptable’ to be talked about publicly. The myth of the unhinged schizophrenic off their meds and going wild killing people is still common. But people with mental illnesses are four times more likely to be the victims of violent crime than commit it. Did you know that schizophrenia affects 1 in 100 people in their lifetime, and it’s not ‘incurable’ – some people will recover? Again, Bipolar Disorder will affect 1 in 100 people, sometimes called manic depression it means sufferers have very high highs, and very low lows. But actually, the enlightenment and energy during the highs can result in amazing productivity and the lows can generate a great deal of thinking time – just imagine if we could encourage our people with bipolar to be open about where they are in their peaks or troughs and help them to get the most of those periods. Some people’s bipolar results in frequent highs and lows; for others they will be in one state for longer periods.

Some mental illnesses are developed during childhood, perhaps from birth. Others are developed due to external events. Some are curable. Some are not.

Mental health issues can affect LGBTQ people more than the norm due to external factors, such as bullying or feeling that they cannot be open about who they are, feeling isolated. Whilst I identify as queer, my own mental health issues stem from a separate traumatic event. But, as chair of the LGBTQ network, I want to shine a light on the stat’s that could be affecting those who I represent:

One in seven (13 per cent) gay and bisexual men are currently experiencing moderate to severe levels of mixed depression and anxiety compared to seven per cent of men in general
A further nine per cent of gay and bisexual men are experiencing moderate to severe levels of depression with mild or no anxiety compared to two per cent of men in general
Thus overall, 22 per cent of gay and bisexual men are experiencing moderate to severe levels of depression
Bisexual men are more likely to experience moderate to severe levels of depression (26 per cent)
In the last year, four in five (79 per cent) lesbian and bisexual women say they have had a spell of sadness, felt miserable or felt depressed. This increases to 84 per cent of bisexual women and 86 per cent of black and minority ethnic women
In the last year, three quarters (74 per cent) of lesbian and bisexual women say they felt anxious or nervous. This increases to 78 per cent of bisexual women and 81 per cent of black and minority ethnic lesbian and bisexual women
More than half (55 per cent) of lesbian, gay and bisexual young people experience homophobic bullying in Britain’s schools; two in five (41 per cent) lesbian, gay and bisexual pupils who experience homophobic bullying attempt or think about taking their own life directly because of the bullying
More than half (56 per cent) of gay young people deliberately harm themselves, which can include cutting or burning themselves. Lesbians and bisexual girls are twice as likely as gay and bisexual boys to self-harm (72 per cent compared to 36 per cent), with girls who are black or minority ethnic at greatest risk at 83 per cent

(More details can be found in Stonewall’s Mental Health briefing, available for download on their website).

So, when it comes to Mental Health, what can you do to help?

The first thing is, if someone opens up to you, acknowledge that it was probably hard to do. Be empathetic, even sympathetic. It might be hard to know what to say, but saying nothing will likely feel like a rejection and a negative judgement.

Be aware of how people might be feeling – I’ve always been surprised at how people comment about my always smiley face; how little they knew! When you know that they’re feeling down, don’t be trite and tell people to think positively (actually, there’s an awful lot of research which says that thinking positively is more harmful) and be aware that lateness and tiredness is possibly not down to too active a social life but could be the result of insomnia. Checking-in with colleagues (you know, that thing friends do) is really helpful and can make work feel like a more friendly & safer place to be. Allow flexible working as much as the person needs – regardless of my PTSD I’m an introvert (I know, you’d never guess) and being around people all day really takes it out of me (the detrimental side of open plan offices); working from home 2-3 days a week has been a lifesaver for me and helped me to carry on with my role at even some very tough times. Oh, and never, ever, creep up on someone and make them jump out of their skin! When I was going through a particularly panic-prone time this gave me an attack and I hardly managed to hide it from the poor person who’d thought he was being funny.

If you suspect that someone is suffering from any mental illness, be aware they might not want to open up about it. Work needs to be a safe space – a shelter from some of the other problems being faced by the person. Pushing for openness has the potential to do harm. Be aware there is still a stigma about mental health – a stigma that the person suffering may also believe. Sometimes we put on a shell of armour to get through the day – don’t break that shell without permission from the person, or they might not trust you again.

Be aware of your language – off the cuff comments that appear to be disparaging or making mental health the butt of a joke are not going to encourage someone to open up about how they are feeling.

But the best way of showing support? Be a friend. Work may be a ‘professional’ environment. But we’re all human beings. Treat each other as you would a friend, and everyone (the world) will be better for it.

Mental Health Week 2: Time to Talk

Posted by Emily

Today’s theme for Mental Health Awareness week is Time to Talk. Below is an edited version of a blog I wrote on Time to Talk day (Thursday 6^th February) which was posted to (a different) external account.

___________

I’ve been feeling so very conflicted about Time to Talk day, the campaign being run by Time to Change in association with Mind and Rethink Mental Illness to encourage a million conversations about mental health to end the stigma associated with mental health problems.

The thing about having a conversation about mental health – you need to feel safe to do so. At work, which is one of the companies mentioned on the Time to Talk website, we are supporting the campaign by asking our staff to post a photo of ourselves on our internal social media platform having a cup of tea with someone, having our ‘time to talk’ conversation. It’s not so much actually talking, but posting pictures to claim we’re talking. I suppose I could do that, but what would the point actually be?

If I were to actually talk, I don’t think people would know how to react. Because my experience so far has been that people don’t know how to react. The people aren’t bad, or unfeeling, but when I share, they feel uncomfortable. And so they avoid. I’m a fairly open person, more likely to over-share than be comfortable keeping things to myself. So, not feeling able to share what feels like the biggest thing about myself in my work-life for fear of what people will think, how they will judge, does not feel congruent with the real, authentic, me.

The authentic me is on my mind today. Because today I went to a Stonewall workshop on how to be an Authentic Role Model. And I want to be that person, the one who lives true to her ideals and values, who acts & behaves in a way in which she believes.

I made a resolution at the start of this year to be more open about my mental health. Recently I shared with a colleague the general details of why I leave early on a Friday afternoon (to see my psychiatrist), and why I take the opportunity to work from home when I can, because being around people too much is exhausting and I need to take care. He didn’t even acknowledge it. When asked to participate in the Time to Talk campaign by the organisers (because I am active through my work with the LGBTQ network on our Diversity & Inclusion Council, and in that forum I expressed an interest in progressing how mental health is handled within our company), I wrote back saying I was uncomfortable, and I gave my reasons, as well as sharing my diagnosis. Again, no acknowledgement.

I recognise that when people share mental health problems, this makes the other person unsure how to respond, and possibly makes them feel uncomfortable. But how difficult is it to say the words, “I’m sorry to hear that”, or, “thank you for sharing that with me, I know you’re showing me trust in sharing”, or, “oh, that’s horrible.”

It’s all very well having a time to talk campaign. But what about those who are listening? How do we teach them how to listen in a human way, with empathy, even with sympathy?

But, as I said at the start, I’m conflicted. I know that change only happens when there is a groundswell of change, a tipping point. And that only happens if people start speaking up, and someone does need to start the conversation, sometime. In the early 1970s Harvey Milk asked the gay people of San Francisco to speak up, to demonstrate to the straights that they would all know someone gay, to help normalise what seemed at the time abnormal. The thing is, outing yourself, being open, that is a privilege for those who can afford to pay the price.

But, still conflicted. Someone needs to stand up, many of us do. And I stood up in Trafalgar Square in front of hundreds of people, and said that. I said that silence hurts us. And yet I am being silent. Am I a hypocrite, unable to do as I say?

But if I were to talk, this is what I’d say.

*raises hand* Hello, my name is Emily and I suffer from PTSD and depression. Some days I’m fine. Usually, I’m pretending to be fine. Pretending is exhausting. And it’s not very authentic. Some days, I can’t get out of bed. Some days, I’ll have an anxiety attack just thinking about leaving the flat. Some nights, I don’t sleep. Many nights, I’ll have nightmares and wake up screaming, or in tears, or shaking. Sometimes, I’m triggered and get taken back to the time when the trauma happened. I think about it every day.

I have so many coping mechanisms: I mistreat food; I haven’t cut in a while, but it’s always on my mind; I think about how I’ll choose to die, although recently I think it’s an improvement to merely be thinking about disappearing; when I drink, I drink far too much; I’ve been known to take too many pills, usually by accident, but sometimes, just to shut out the world.

I see a psychiatrist every week, and we’re going through trauma therapy; this means I am voluntarily taking myself somewhere to voluntarily re-live the trauma, again and again, and again, in order to build new brain waves, and to de-sensitise the reactions. I’ve spent over 6 years in various talking therapies & counselling; which only help you maybe cope with the trauma, it is only trauma therapy that can possibly find a way through to the other side – but of course, no-one tells you that, because that’s expensive. I’m lucky, I have private medical insurance, and finally realised it might be covered. I wouldn’t get it on the NHS. I’m also lucky that my psychiatrist is telling my GP what to prescribe me. Anti-depressants have become a vital & necessary part of my recovery, or being able to just be. But sorting through to find one which doesn’t have debilitating side effects has taken almost a year. One type made me sweat like a human shower. Another made me into a daytime zombie.

If I had a penny for every time someone suggested that exercise might make me feel a bit better, to get some fresh air, to laugh, to just pretend I felt better and I magically would… well, then, I’d be rich. Depression isn’t just feeling a bit down, and needing to be kick-started out of it. Yes, I can give a really good impression of being fine when you need me to, but I pay the price for it afterwards. Depression is isolating because you can’t face being around people, the energy it takes to pretend. It’s isolating because actually, no matter how much your friends love you, no-one wants to be around a sad person all the time. PTSD is isolating because you’re anxious, on edge; I’ve found I’ve lost relationships with people who obviously weren’t friends in the first place, because they simply don’t believe that the trauma I experienced which resulted in the PTSD could be real. I’ve removed myself from close relationships with my family because the reasons why I have PTSD are too emotional for me to handle on their behalf. If you have PTSD, if you have depression, you believe the rest of the world is judging you, thinking you are weak, you should be stronger – you aren’t resilient. If people know, you feel exposed, vulnerable, unsafe. And if they know you have PTSD – do they also judge the reasons why?

I’m the most resilient person I know – because I’m still here. And at the same time as all this, I am trying to hold down a job. Mostly, I’m winning. My social life has faltered quite a bit, I don’t have energy for much else beyond recovery and work, and I sleep most of the weekend. If I had a physical injury, a broken bone, cancer, people’s reaction would be much more sympathetic, people wouldn’t expect me to put on my brave face and do a day’s work. But I don’t have a physical injury. Just as you can’t see that I like girls as well as boys, you can’t see the mess inside my head.

Do you still want to talk?

And, more importantly, will you listen?

Mental Health Week 1: Anxiety

Posted by Emily

Posted on my work intranet site on Monday 12th May

Today is the start of Mental Health awareness week and I have decided to support the campaign by blogging every day about my personal experience and views about mental health. I feel very vulnerable in doing this; there is still a stigma attached to mental health, but I think it is important to ‘lean in’ and ‘step up’ and ‘speak out.’ I have felt inauthentic in not being brave enough to comment in the past – and I know that one of the only reasons I am doing so now is because, like the gay footballer who only comes out at the end of his career, I am leaving the company at the end of the month. But [redacted] has been a very good home to me for the last 4+ years and if my speaking out can help others or make a positive impact on the culture with regard to mental health just a little bit, then it’s worth my feeling a little uncomfortable.

Today’s theme is Anxiety. The focus of this will be around being aware of what causes anxiousness, how to handle it, manage it, cope. My experience of anxiety has been intense: I have Post Traumatic Stress Disorder (PTSD) as well as depression. My PTSD is thankfully no longer the severe diagnosis that it was a year ago (I am only two points above mild in moderate now, whoop!), but it is still a daily feature of my life.

The Mental Health Foundation defines anxiety as “a type of fear. It is usually associated with the thought of a threat or something going wrong in the future, rather than something happening right now”. Whilst PTSD is much more about being stuck in a traumatic event in the past which feels like it’s happening in the now, I have also suffered from anxiety as a side-effect of PTSD: a lack of trust that something won’t go wrong again, anxiousness that I’ll experience a triggering episode, fear of going to sleep just in case I get night terrors. Over the years I’ve learned to distinguish between when I’m feeling ‘anxious’ or ‘overwhelmed’ and when I’m panicked. For me, an anxiety attack is very different to a panic attack (which will transport me to the trauma in the present) but fear of which can take over life in a very similar way.

[It helps I think to distinguish between stressors and triggers. A trigger is something which will have the effect of transporting you to a place of extreme fear where your ability to respond rationally is incredibly limited. Stressors can be controlled, triggers cannot].

Anxiety is like low-level noise, like a constant buzzing in the ear, it exhausts and feels like you are being physically pulled down – but you’re still (vaguely) in control: it’s possible to talk yourself out of it, or into it (and whilst no-one consciously wants to inflict an anxiety attack on themselves, internal self-dialogue can be very powerful, in a negative way). The age-old platitudes that if you can ‘think positively’ or ‘do some exercise’ *can* help with anxiety – assuming that the anxiety hasn’t debilitated you to the extent you also suffer from its close cousin, depression. To be quite honest, when people ‘helpfully’ suggest exercise as a solution, it makes me want to cry or kill, usually in equal measure.

My mental health experience has made me very cynical of people or organisations that suggest that ‘thinking positively’ or ‘moving more’ might help. Putting on a brave face almost meant my death, and I’m not being melodramatic. If you try to ignore something for too long, the pressure will one day explode, like the air in a pressure cooker has to get out somehow. I didn’t even think I had been ignoring it – I’d done counselling, I was coping, this was just my life. Apart from the first year or so after the event, when I arrived here in February 2010, I felt to all intents & purposes absolutely fine. And my work record seemed to reflect that, with Fandom directorate awards two years running.

But then there was a period where I was working 12-14 hour days, 6-7 days a week, over a 3 month period…. There were very practical business reasons for these hours – the timelines were set by Europe, I was the only one in the team, my immediate line manager hadn’t been appointed to lean on, and the supporting teams for the work either didn’t yet exist in the structure (there wasn’t for example a competitor intelligence team) or were also overworked. The work needed doing, so I attempted to do it. For anyone, this could have spelled disaster from lack of breaks, lack of sleep, no self-care. For me, it meant a breakdown and the re-emergence of my PTSD, which I’d been keeping a lid on, but which was now spilling over. When I look back, I just hadn’t faced the truth that anxiety attacks at the thought of leaving the flat were part of something that meant I wasn’t better, that moving house 6 or 7 times in 3 years meant I just didn’t feel safe anywhere, that cutting off ties with my family because I couldn’t bear them knowing meant I wasn’t at ease with my own truth and didn’t want to confront it in those I loved. Looking back, now, I think that breakdown two years ago and the help I’ve got since then as a result was possibly actually a life saver. Although at the time, it almost meant the end of my life.

That breakdown meant I was forced to confront my mental health head on. I had to share what was happening with my bosses (& my new boss, less than a week into the role when I broke the news has been continuously awesome) and it meant I had to get help; initially more counselling, latterly psychiatric help. My psychiatrist has helped me to understand the symptoms of PTSD which made so much sense to me as soon as they were explained.

When you have PTSD your ‘window of tolerance’ is much narrower than the normal person’s. If a normal (forgive the use of the word please) person is under stress they will usually be at the peak of their window of tolerance – this is what people might call the ‘stretch zone.’ Sometimes, if someone jumps out behind them they might jump and feel unsettled. When a normal person is at their bottom of their window of tolerance, they’ll feel exhausted, wiped out, they’ll probably plomp themselves down on the sofa, maybe have a duvet day. The thing is, with PTSD the window of tolerance is much smaller, and there literally isn’t a stretch zone – so what seems like a ‘normal’ amount of stress can be debilitating. The constant feeling of panic, the actual panic – these states are part of hyper-arousal and outside the ‘normal’ window. What I hadn’t understood before I saw my psych was hypo-arousal – but when she explained it to me, it made so much sense. I’d thought my chronic tiredness was just a feature of my depression, but it’s actually also an integral part of PTSD. It’s the embodiment of the freeze response, hiding from the world, not partaking, not being. And generally, following a period of hyper-arousal you will drop suddenly into hypo. Reclaiming your space in the narrow window of tolerance isn’t easy.

The work I have been doing with my psychiatrist for the past 14 months has been about grounding, setting boundaries, lifeline integration – and re-wiring my brain through EMDR therapy. It’s hell and it’s working. I feel strong enough now to flap my wings and fly, to leave this home that has been so good to me, to go my own way and create my own future how I want to live it. It’s a long way from where I was not long ago when I couldn’t envisage any future, and didn’t want to.

If you’re feeling anxiety, look after yourself. Self-care is really important. No powerpoint presentation is worth your mental health. Once you’ve lost it, it’s easy to lose it again, just like an ankle once sprained is that much more likely to get sprained again. For very real business reasons we’re all being asked to work harder, to do more, to be more. But remember you can’t be anything, let alone ‘more’, if you ignore the warning signs and break down. Don’t let the pressure build up to explosion levels. Set your own boundaries and say “no”, or “not now”, at least sometimes.