Saturday 13 August 2011

The Gift of the Mind

I've been thinking a lot about mental health recently.  I mean, I started this blog as a way for me to document my progress in all things healthy - but when you say to someone the words "fit and healthy" they usually imagine the more physical side.  I know I do at times - and that's coming from someone who has battled depression and anxiety since I was a teenager.

There have been a few things recently that I've found thought-provoking.  The main one is a mental health blog I've recently started reading (purplepersuasion), with 2 excellent pieces - 1 on ten things not to say to a depressed person, and the 2nd is the upside with ten supportive things people have said.  Both are well worth reading, and give a helpful insight for anyone who has perhaps not experienced mental illness themselves.

The others have been mostly incidents I've experienced or witnessed at work.  I work at an emergency NHS dental clinic at weekends and evenings, and we generally tend to encounter a lot of patients who would probably be fondly classified by the current government (as they are wont to do) as those who have "fallen through the cracks" - the ones who aren't registered with medical practitioners and are less inclined to look after themselves, for 1 reason or another.  And some of these patients suffer from mental illness.  I have personally witnessed several of my colleagues change dramatically and start acting "cagey" if a patient has disclosed that they have a mental illness, especially if it is schizophrenia.  There was a patient today that we couldn't even see, due to a busy waiting room that would cause unknown amounts of stress to an already anxious person suffering from paranoia.  And seeing these things makes me sad - sad that there is still so much stigma and misconceptions about mental illness that even some healthcare workers don't know how to act, and sad that we're not in a position to adapt to help those that so badly need it.

I've only had a handful of serious depressive episodes in my 31 years, and the first time I was diagnosed was when I was 18.  I still remember it so clearly because (a) I had a crush on the doctor at the time, and (b) I thought the very idea that I might have depression was abhorrent.  All I remember about the diagnosis, after many bloodtests to rule out other reasons why I was so tired all the time, was the doctor saying "I've noticed you sigh a lot when you speak.  I think you have depression."  He said it so matter-of-factedly, as if it was no different to having a broken leg, and I actually appreciate that now.  At the time, part of me didn't want to believe it and yet I knew it was true.  It took a while to sink in, and of course everyone around me didn't know how to act - they found it hard, as I was always so bubbly and smiley, and I was the one everybody came to if they had a problem.  I was their rock, and now I was crumbling before their eyes, and they didn't know what to do.

I didn't either, but thankfully that same doctor insisted on seeing me every week, fortnight, month or however often I needed it and he gave me a lot of information.  He also said that talking about it helps.  Well, I didn't believe him at first, but after a while I did start talking about it.  And then lo and behold, almost every person I spoke to either had it themselves, or knew somebody close to them who did.  And it was a real eye-opener.  It also changed my life - for the better - because it made me realise that I wasn't alone, that this wasn't some form of "weakness" on my part, that it was a real medical condition that needed treatment like any other illness.

I'd like to think that I didn't have another depressive episode until I was about 27, but actually looking back I think I just somehow muddled through from the age of 18-27.  I went to university, made some great friends, but I just couldn't cope with the pressure - too much time spent worrying & drinking soon made it impossible for me to attend classes, and I started getting Ds or failing altogether for the first time in my life.  So I left, got a job, even got married.  Then I got a better job.  Trouble was, the "better job" turned out to be not so great.  I mean, in monetary terms it was good - but after an internal promotion everything just fell apart for me and I suffered a mental breakdown.  Because the management was so poor, there was no support in place, no training provided, and my own manager didn't actually "believe" in mental illness so therefore refused to acknowledge anyone who admitted having a problem.  Great guy, huh?  My own husband of that time, another part of my "support system" was actually abusing me - but because the abuse was verbal I didn't want to believe anything was wrong.  To me, domestic abuse = domestic violence = physical beatings.  So I took all the name-calling, the put-downs, the temper tantrums and silent treatment, not because I was some "weak little housewife" who didn't know any better, but because I actually believed everything he said - my opinion of myself was that low.

It took for me to have a complete mental breakdown - I couldn't physically leave my house, I was having panic attacks at the very thought - for me to receive counselling (5 private treatments through my job - yeah thanks guys, was well worth nearly killing myself to earn those!)  And in that very first session I realised that I was a victim of domestic abuse.  It should have been obvious really - I was signed off from work for having anxiety attacks and prescribed diazapam, and there I was shaking like a leaf on the sofa wondering what the hell had happened to me, and my husband just stood their screaming at me because I was on sick pay so couldn't pay off his debts.  You'd think something like that would actually trigger a "wait a minute, who do you think you are BUDDY?" type reaction.  But it didn't.  I was already oblivious to it, I had shut down.

I actually remember how this part of the conversation went:

Counsellor: "Are you afraid of him?"
Me: "Well, no.  I don't think so.  I mean, it's not like he hits me or anything."
Counsellor: "There are all sorts of abuse.  Not all of them are physical."

And that was pretty much it.  As soon as I realised I was in a domestic abuse situation, I wanted to change it.  I felt ashamed - I put off telling my own parents for weeks, for fear of how they'd react.  And all I could think of was how much money they'd spent on the wedding.  I also dreaded talking to my husband about it.  I was so sure that he'd had no idea what he'd been doing to me - that if I sat him down and we talked about it, he'd change.  I spent ages trying to think of a "right" way to bring it up, how to speak to him so as not to aggravate things.  And when I eventually did, I put it in such a way that I pretty much said "I don't think you realise this, but...." and his reply?  A very nonchalant "Oh yeah, I know".  And then something about how a woman is meant to fear her husband anyway.  I was so taken aback, I didn't know what to say.

Things slowly went from bad to worse after that.  I wanted to change, I wanted to leave - but at the same time I was too scared.  That's the crazy part about being in an abusive relationship - by the time you realise what's going on, you've been so belittled into thinking you're no good and can't survive on your own that you're too scared to go.  But I was lucky - I used all 5 of my counselling sessions.  And although they didn't even begin to touch on the real issues, they gave me enough confidence to actually start tackling things.  I tried asking my parents to let me move back in with them.  But of course my husband had been talking to them behind my back, making them think that I was actually exaggerating the problem because of my "gaming addiction" (my gaming addiction, to him, was simply the fact that I dared to be on my xbox when he got home from work), so they did what they thought was right and encouraged me to work at my marriage.  After all, we'd only been married 3 years, so it couldn't be over so soon...could it?  So then I tried registering with the local council for housing, but what I didn't realise was that my husband had been hacking into my emails and stopping my application from going ahead.  And all the while it was slowly making him angrier.  Of course, we had separated by that time - well, at least I considered us separated.  He refused to accept it.  He was so concerned with appearances that he wouldn't tell anyone we were having problems, in fact he would go out of his way to tell people how perfect we were, that we never argued or fought over anything.  He completely lost it when I set up my facebook account and put "it's complicated" instead of married for my relationship status.  But by this point, the more he did to put me down, the more I wanted to fight back.  We were still living under the same roof, as I had nowhere else to go - he had seen to that.  But we were in separate bedrooms - I refused to share a bed with him any longer.  I had been consulting a lot of websites that provide support for domestic abuse victims, and of course he had also consulted them - but not to sympathise with me, oh no.  He actually tried using the "Reasons why people find it hard to leave their abuser" type pages to manipulate me further into staying!

There are 2 days that I remember vividly towards the end of my marriage.  The 1st was when he'd given me the silent treatment for an entire evening, then the following day I dared to ask what he wanted for lunch and he started on about "did I think he was just gona let it go, blah blah" and I turned around and said "you know what, I don't really care anymore!", and he started screaming in my face and threw some of our metal shelving across the kitchen.  I told him then it was over, and all of sudden he was on his knees crying, asking me not to leave.  I told him we'd talk about it when he came home from work - but of course we never did, because he was like jekyll & hyde, and acted as if the whole thing had never happened.  And so things continued on as before.

And to make matters worse (but also better!) I became friends with somebody I'd met online while I was gaming.  The timing couldn't be worse, but he was a guy, I was a girl and yep, we were attracted to each other.  The timing couldn't be worse because I was trying to get out of the Marriage From Hell and it's apparently a big no-no to get involved with a married woman, even if she is, to all intents & purposes, separated & trying to leave her abusive husband.  And the timing also couldn't be better because finally I'd found a wonderful guy who actually appreciated me as ME - who didn't hurl abuse at me, or put me down, or ridicule my ideas and beliefs.  In a strange way it was the final push I needed to leave my husband - finally I'd found someone who was on my side, fighting in my corner and would support whatever I wanted to do.  And we hadn't even physically met yet!

Unfortunately my husband realised what was going on about the same time I did, so while I was trying to leave him he was plotting his own schemes.  And that resulted in him hurling me against a wall, choking me and screaming that he'd rather go to prison for the rest of his life than let me out of the house alive.  That is the 2nd and most vivid day I remember from the end of my marriage.  But where my instincts had previously failed me, they now kicked in majorly - somehow I was able to get away from him twice, get my trainers on, grab my car keys and speed off.  Straight to my parents' house - who were ironically hosting my father-in-law for the evening.  All I had to do was show them the fingermark bruises around my neck - and finally I was free.  I've always been a little bit saddened by the fact that I was grateful he physically assaulted me - because finally I had the evidence I needed to show people what he was really like.

It's a funny thing, trauma.  I actually carried the trauma of that day/night with me for a long time - I was suffering from Post Traumatic Stress Syndrome (PTSD) and didn't even know it.  I really was a ticking timebomb, and it took for my next (and last latest) depressive episode for me to finally get the counselling I needed to work through things.

Nearly done, I promise!

So that leads me onto my most recent depressive episode.  I call them episodes because they feel like chapters in a book to me - they help shape the story, and while I don't feel they are defining moments in themselves, they do alter me slightly and give me the experiences that lead me to where I currently am.  Ironically this last depressive episode happened while I was working in healthcare, in a role that promoted health!  But the job I'd applied for (I naturally quit the last one, then moved 400 miles away to live with my current boyfriend - yep, the one I'd met online) turned out not to be the one I got, in a sense.  I applied for a role that was advertised as challenging, in a busy environment that was always interacting with others.  With me new to the area I thought it'd give me a chance to make new friends, start over.  But the job I got turned out to be me in a room that nobody knew existed, while the rest of my team was at another location at the opposite end of the county.  I saw my manager 3 times a year if I was lucky - and yeah, I was on my own after my 2nd day in the job.  So of course, what do you get if you put me in a room that's practically hidden away from the rest of the world, 37 hours a week, with hardly so much as a phone call and nothing to do?  Yep, depressed & anxious me.  And to pile that on top of the PTSD I was already suffering from, it wasn't a good combo.  Before I knew what hit me, I caught myself having thoughts about walking in front of buses as there was no point to my life....I struggled with this for a couple of months until I realised there was a very real danger that I might act on it, and funnily enough I didn't actually want to die.  So it pushed me to the docs again.

This time I was offered CBT before meds, but it took a while to get the referral processed (not from the docs end - he sent it off same day and marked it urgent - it was at the other end, they were so snowed-under with requests for counselling it took over 2 months from when I went to the docs to actually get my first appointment secured) so I had to start taking the meds.  That was a rollercoaster of fun - Citalopram, my previous anti-depressant "of choice" this time gave me pretty much every single side-effect listed on the leaflet.  So they lasted about a month, and I had to go through the brain-whizz withdrawals that made me feel like my eyes were actually rolling back in my head while I was being electrocuted.  Very weird feeling!  Then I changed back onto Fluoxetine.  It had never really done much for me before, but this time it actually worked.  And then the CBT came through, and it literally saved my life.

It was bloomin' hard work though!  But for anyone who is hesitant about CBT, please please give it a go.  Just be prepared to dig deep.  I had a lot of stuff to work through, which left me with red, swollen eyes and a snotty nose after every session.  And I had homework - lots of it!  All of these sheets to work through, trying to get down to my base thoughts & feelings.  I don't actually remember a lot of what we covered in my sessions, although I'm sure my sheets are still around here somewhere, but there are a couple of things I DO remember my counsellor saying:

1.  Be kind to yourself (this is my absolute fave, and anytime I feel down or am about to berate myself mentally I hear her saying this to me).
2.  Is it bad enough yet? (this one is actually what her counsellor taught her - when you feel like things are pretty rough, ask yourself this and you'll know if it's time to start making changes).
3.  Counselling is not there to solve all your problems or make them go away.  It doesn't rid you of bad memories.  What it can do is change your perspective - if you imagine your mind as a backpack, and the things that trouble you are the luggage, sometimes it can feel as if it's all lumpy and poking into you.  Counselling helps you re-arrange that luggage, so that it fits better in the backpack - maybe making room for more stuff, and certainly making it comfier for you as it's no longer poking into you (this idea is great, cos now I can actually picture it in my head).

I've thought long and hard about what to call this post.  I know a lot of it has just been me "sounding off" on my experiences, and I must admit I'll be pleased if just 1 person makes it this far, but I think it was inspired by a question posed by Rethink recently - "Is mental illness ever a gift?"  I think in my case it has been, several times - it's helped me face up to many things, it was a catalyst in helping me escape an abusive marriage, and I now realise that every time I have a major depressive episode it's my mind's way of telling me to slow down, step back and look after myself.  And that is a gift I will always cherish, in my own crazy lil way ;)

3 comments:

  1. Thank you for sharing your experiences, I'm sure your story will help many people. Best wishes. :) Jim Wilson (Jimmy Couplet).

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  2. Wow. That's a lot of crap for one life to deal with. But it all sounds so familiar to me. Lucky you getting to see a mental health team within two months. I've been waiting over a year and (to be honest) I don't have much faith in the student they've put in charge of my case but I'll read my handbook and do my homework and see where we get to.

    Good luck with your latest stage. Keep doing the CBT exercises!

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  3. Thank you very much for your comments. I hadn't planned on writing so much for this post, but it just seemed to "come out" so I think maybe the time was right, and if it helps someone realise they're not alone, that there is hope, then I'll have achieved my goal.

    So sorry to hear about your long wait AJ - it's awful that people have to wait so long for help with mental illness (especially as so many are already at "critical stage" before they work up the courage to ask for help). You've done so well to manage over a year - you must have a lot of inner strength that's kept you going all this time, I'm not sure how I would have coped! I really hope it works out for you though - my counsellor was also a student of-sorts (she had experience as a counsellor, but was new to CBT) and we didn't get off to a great start as I'd had to make a complaint about the service just to get an appointment, after lots of promises of calls that didn't happen, but by the end we were sharing cakes & hugs :)

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