Mental Health Week 2: Time to Talk

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 6th February) which was posted to (a different) external account.

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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 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.