Removing the Shame In Talking About Mental Health

UntitledI have been very honest about the fact that I am in the middle of a mental health crisis, one that I am finding very difficult to manage. My usual ways of coping just haven’t been helping. A lot of the time I have been so fatigued I haven’t had the energy to do the simplest of self-care actions.

Recently, I saw the hashtag #365daysofselfcare on Twitter and followed the link to the website Blurt. I decided that this is just what I need right now. It will get my focus back onto my self-care. Posting about it each day will help me to rebuild the habit and keep myself accountable.

Its been two weeks now since I started participating in the daily hashtag and it has indeed been very helpful. I am paying much more attention to taking care of myself and making time for self-care every day. There has also been an additional unexpected outcome of posting daily, it has got me talking about my mental health.

This really shouldn’t be a revelation for me, I write and make videos about my mental health all the time. However, when I write or make a video, I do so after the fact. I do talk very openly, but it is done in retrospect. My sharing is delivered in a reflective and measured way.

In contrast, the daily sharing I am doing with the hashtag on my Instagram and Twitter is raw and uncensored. I am sharing what is happening on that day, at that moment. In posting this way, I have often caught myself thinking, “I sound like I am a right state”, worrying what people will think of me. Its been a surprise to notice that I still carry shame around my mental health, despite being so open about it.

Shame and stigma is a corrosive side effect of mental illness. It stops people asking for help and puts them more at risk of harm, isolation and worsening overall health. The shame is senseless, its an illness, what is there to feel shame about? Physical and mental health is part of everyone’s everyday life. We don’t shame someone for having a broken leg and tell them to pull themselves together, do we? We help them, supporting them whilst they heal. The same compassion needs to be extended to those who have mental health problems.

I am so pleased to see so many people and organizations talking openly this week as part of mental health awareness week. This must continue, not just this week but permanently. Living well with and recovering from mental illness, begins with removing the burden of shame.

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Coping With Stress When Your Scale Is Already Off-Balance

balance.jpgThis week is Mental Health Awareness Week and this year’s theme is ‘Stress’. Sadly, stress is a common affliction in our fast-paced world and it is something that each of us need to be mindful of. However, when you have existing mental health challenges, being mindful of stress becomes even more critical.

I experience my own mental health as a set of scales which are always off balance. My various challenges and addiction history, mean I own a set of scales which are incorrectly calibrated. It’s almost impossible to get them to level out dead centre. I have learned to be okay with this, and to find ways to get them to balance and stay stable in their offset state. This works as long as my life remains fairly consistent and stress free. However, life is life, unexpected or upsetting events will of course occur. When they do, like many of us with mental health challenges, I’m affected far more by stress than people whose scales are more accurately calibrated.

In experiencing an additional stress, I find I am triggered in all areas. The shock of a stressful event can knock me for six, my physical health begins to suffer, I can start feeling ashamed that I am falling apart where others around me are coping. If I am not careful, this can send me into a spiral and put me at risk of a crisis or relapse.

Over the last few years in my recovery, I have learnt how to better manage a stressful event so that I can look after my mental well-being until the event passes or is resolved. These are some of the things that I find helpful, in order to reduce the impact of the additional stress.

Remind yourself that it is OK to feel whatever you are feeling

Enforce your personal boundaries – clearly state your needs and your limitations

Drop anything from your life that is not important – make things simple

Use your coping strategies to administer self-care to yourself

Contact a friend or support agency for extra help

Evaluate your well-being on a daily basis – it may take a while to re-balance

Stress is often unavoidable but with careful management, it need not compromise our entire well being and we can return to own definition of balance in good time.

The shortage of NHS General Practitioners – How this compromises the health of those who have complex medical histories.

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Having a complex medical history makes a visit to the doctor incredibly difficult. The constant explaining is exhausting, and it gets in the way of addressing the actual problem itself. This is a dangerous state of affairs which puts people at risk. The answer to this is to have a regular General Practitioner who you see every time and who knows your medical history well.

However, becoming registered and managing to book an appointment with a regular GP, appears to be so much harder than it once was. I remember growing up with a family GP, who both of my parents saw and then who I saw in turn. I wonder, does this even happen anymore? Recently, on moving to Eastbourne, I have registered with a new medical surgery. Since doing so, I have been having so many issues in booking an appointment and in managing to see the same GP. After posting about my frustrations on my twitter account, it seems I am not alone. Understaffing at surgeries, lack of available GP’s and the inability to see the same GP consistently, seem to be common issues.

I dread seeing a GP. Being transgender, I’m often faced with the problem of the “Trans broken arm syndrome”. This is where whatever symptom you present with, the doctor somehow magically links it to your being trans. I have lost count of how many times I have sat in a GP’s office, with a complaint which has nothing to do with my gender transition, and they then spend the entirety of my allotted ten-minute appointment time asking questions about why I am taking testosterone. They sit there, glued to their screen, brow furrowed, clearly not hearing a word I am saying. I then must explain I was assigned female at birth, I am transgender, I have undergone gender transition, blah blah blah. You would think that being medical professionals, they would be exempt from problematic responses but no. I have had more than a handful of GP’s make comments such as, “You really can’t tell,” or, “Which way are you going?” and most recently, “Oh, so originally you were a female”. By the time this humiliating exchange is over, so is my appointment. I either don’t get an accurate diagnosis or I am so demoralised I simply can’t sit there any longer.

Additionally, my mental health issues mean that I require regular monitoring from a GP. I am currently in the middle of a serious flare up of depression and anxiety, this means I often need medication reviews and fit notes for claiming benefits. My mental health history is complex and every time I see a new doctor, I must explain all of this first. Inevitably, this gets tangled up with my gender transition medical history. I again then find myself using up my ten minutes explaining my history, rather than my current presenting issue. Whilst both of these factors can, of course, impact my mental and physical health, a GP who doesn’t know me is often too quick to just assign my presenting issue to one of them, without looking deeper into the issue. These reasons are why it is so important for me to be able to see the same doctor every time, I can then get all of this over with the first time I see a new GP. From then on, appointments can be kept to the point of why I am there, and I can feel like a patient rather than a medical fascination.

I was lucky in Devon that my local GP surgery wasn’t too busy. I could get an appointment fairly easily and could see the same GP each time. This means that I managed to avoid the above issues and had great support from my regular GP. This has not been the same for my medical surgery in Eastbourne. I rarely manage to see the GP I am assigned, seeing random doctors each time I visit. This means I am back to facing the same issues again and it has been very stressful and frustrating. For the last six months, I have been seriously mentally and physically unwell. I know my mental health challenges inside out, I knew that the way my moods have been presenting are unlike any mental health flare up I have had before. I have said this every time I have visited a GP. However, I do not feel any of the GP’s I saw actually heard me. Instead, they focused on my gender transition or attributed my symptoms to my mental health issues. My anti-depressants have been increased at most visits, despite my stressing that the increases haven’t helped and that I feel that something else is going on.

A couple of months ago, on discussing a strange symptom of numbness and pins and needles in my hand, I had a breakthrough with one of the GP’s I saw. He diagnosed carpal tunnel syndrome and explained that it could be a symptom of an underlying cause. He referred me to another GP at the surgery for treatment and for blood tests. This felt like amazing progress. However, the specialist GP I was booked to see went off sick. The receptionist rang me to cancel the appointment and to tell me that there was nobody else who could do it. My name would be put on a list and I would be contacted. Unfortunately, this is when issues at my medical surgery became even worse. The problems then escalated from not being able to see the same GP, to not being able to see a GP at all.

Due to severe staff sickness issues, all bookings ahead of time were cancelled. Instead, to see a doctor, you are asked to telephone in the morning at 8am or in the afternoon at 2pm, to be seen that day. This is not as easy as it sounds. In fact, it is remarkably like the yearly race to the post to get Glastonbury Festival tickets. You constantly hit refresh and by the time you get through all the tickets have gone. I’ve even tried using two phones. I’ve spent many a morning sat with my mobile in one hand and my landline in the other. Both speakers echoing the words, “Sorry, all our receptionists are busy, please hold and we will answer as soon as we can.” This is frustrating for anyone of course, but when you are a person who relies on regular GP interaction to stay well, it is an absolute nightmare.

Over the last two months since then, I have had to fight to see a GP, to have the blood request initiated and to then have the blood test itself. Having had the test, now there was the unnecessarily complicated procedure of obtaining the results. I became so frustrated with the constant failure to get an appointment that I gave up. I am so exhausted and low all the time, waking up at 7.30 and hitting redial until finally my call is answered forty minutes later to be told, “Sorry all appointments are gone,” was just making me feel worse. I decided that things must be okay with the results. If there was anything which needed to be addressed surely, I would get a call, or my notes would say something to alert a receptionist when I called?

On a more recent and desperate visit to the medical surgery, I asked the receptionist if it was instead possible to print out my blood test results. The receptionist looked on her computer notes and said, “You need to see a doctor”. I tell you it was all I could do not to fall on the floor in a fit of hysteria! Gathering myself together I felt relief, on the request from an actual GP to see me, I expected this would by-pass the staffing issues and I’d be prioritised for an appointment. Shockingly no, the receptionist apologised and said I needed to just keep trying at 8am and 2pm.

Finally, after a couple more weeks of trying, I managed to see a GP last Friday. It was another one I hadn’t seen before. Luckily, I did not find myself having to explain my entire medical history, likely because my medical issue was at last clear. The GP informed me that I have hypothyroidism, an underactive thyroid. Alongside this, I also have low vitamin D and high cholesterol which are apparently side effects of Hypothyroidism. An underactive thyroid causes a myriad of symptoms, two of which are extreme fatigue and depression. This could very well explain why my low mood has been so bad for the last six months and why I’ve felt so utterly exhausted.

This is the reason why it is vital that those of us with complex medical issues assert ourselves. It is all too easy in a ten-minute snapshot, especially with an unfamiliar GP whose focus is on our past rather than the present, to miss an important health concern. I am aware that the NHS is under a ton of strain and there is a general lack of NHS GP’s.  However, there must be a solution to this in the meantime. GP’s do most certainly need more training around healthcare for transgender individuals . I also think this is the same for patients who have mental health diagnosis, as the same problem exists of seeing the condition rather than the patient. It may also help to develop new guidelines for people with conditions that require constant monitoring, to be prioritised and to have an allocated doctor so that there is consistency in diagnosis and treatment. In the meantime, those of us with unusual or complex medical histories, need to be persistent with our GP surgeries. We must make sure we strongly advocate for ourselves to be seen and heard so that we can get the treatment we need to stay well.

Day 7 of #365daysofselfcare

This Blog is part of the #365daysofselfcare challenge

IMG_20180506_232842_244It’s been a funny old day today. Woke at 7.30 so l could take my first thyroid medication. Fell back to sleep and woke at 10.30. Had every intention of going to the seafront for the Magnificent Motors event which started at 11, but l was just so exhausted it took me until 12.30 to actually make it out of bed. I decided to at least give it a try and headed to the seafront.

However, my mood was so low and anxiety so high that the crowds were too much. Did a quick walk through and then decided the best act of self-care for me today, was to just allow myself to come home. Once back indoors, I put my feet up, watched snooker and did a bit of colouring. Sometimes it’s ok to give in, do something else and not beat yourself up about it.

Day 5 of #365daysofselfcare

This Blog is part of the #365daysofselfcare challenge 

IMG_20180504_213822_229Today’s act of self-care, was to persevere with my local GP to be seen by a doctor, after weeks of trying and having no luck.

I am so glad I persisted as it turns out that my blood tests show l have an under-active thyroid! This could explain why my depression and anxiety has become so severe over the last six months and explain to crippling fatigue I’ve been experiencing.

I’m also low on vitamin D  and my cholesterol is high. Apparently this also all linked to hypothyroidism.  It additionally explains the carpal tunnel syndrome too!

I am of course not happy to know l have hypothyroidism, but I am happy to at last have a reason for feeling so terrible. I am very hopeful that the new medications will get me feeling back to normal soon. Thank goodness l managed to see a doctor!

After  a very eventful day, I am cow curling up in bed, watching Starwars, and then having an early night

The late bloomer. “It’s never too late to be who you might have been.”

InspirationalQuotes3.pngOne of the hardest things for me in recovery from addiction and mental health challenges, and in going through gender transition, is the deep grief felt at the wasted time.

I began my recovery from alcoholism at the age of 37.  Finally, with the help of Alcoholics Anonymous, I saw clearly how drinking had not served me well at all. I drank since the age of 13, this had stopped me pursuing a career, building a life, making proper relationships and even growing up.  It felt like I had slept my life away. In suddenly seeing how wonderful life could be, I wished so much that I hadn’t waited so long to get sober. If I had addressed it earlier my mental health issues wouldn’t have got as bad as they did. I would have realised I was transgender a lot earlier and I would have had many more years to enjoy this beautiful planet and to make something of my life.

Waking up at the age of 37 has made me a late bloomer in every aspect of my life. It is only now, in being sober, that I am able to return to study and make a career for myself. It’s only now, having learnt to identify and sit with the various emotions I feel rather than drinking on them, that I can develop healthy platonic and romantic relationships. Because I have also gone through gender transition, this adds additional new aspects to my life that most folk deal with when they are young.  I have had to rebuild my identity, discover who I am as a man, get to know my new body and discover my sexuality. I am 44 years old now and only just starting out in life. I am a pubescent boy in a man’s body!

With so much being still so new, there is so much I yet need to learn and whilst I am not old by any means, neither am I young. There is so much joy in this newfound life but also so much sadness at wishing this life could have started years ago. Of course, I realise that had things been different, then I wouldn’t be the person I am today. I have skills and qualities, only gained precisely because of the path my life has taken, but still, the grief needs to be acknowledged. It is both valid and understandable. Accepting the loss of time means that I can transform it into a determination to make the most of the time I have now.

Being such a late bloomer may well mean that I can’t do a lot of the things I wish I could. However, I can find other ways to fulfil those dreams, simply by adapting them. For example, I’ve recently accepted that I must shelve my plans to be a therapist. I have too much healing of my own to do first. The motivation underlying that career choice lay in my passion to help people, to make a difference to the world and to people lives.  Instead of giving up that dream, I can search for new ways to fulfil it. Moving instead into writing as a career, using my psychology studies and my personal experiences, mean that I still get to follow my passion and in fact may even make more of a difference by following this new path.

“It’s never too late to be who you might have been”.  It may just mean you need to adapt the way you go about achieving it.

 

World Mental Health Day 2017

This year’s World Mental Health Day has the theme ‘in the workplace’. I am not in paid employment at the moment but I feel this theme is still very relevant to me.

I have had mental health issues since as far back as I can remember. My official diagnosis started in 1993 when l was sectioned after a suicide attempt.  At that time I was diagnosed with depression and anxiety. Not that l needed a label to tell me this but this label allowed me access to the mental health system, support and various modalities of treatment

In the years since then, my mental health became steadily worse. Unfortunately, the main way I dealt with my depression and anxiety was to numb it with food restriction, alcohol and drugs. Doing this also allowed me to keep working. If I was numb then l could blot out the anxiety and exhaustion that being around people caused and cope with the sickening feeling of nameless dread I experienced on a daily basis.

Not surprisingly, living life like this was not manageable and soon, not only was l caught using cannabis and being drunk at work, but also being numb just was not masking the low mood and anxiety like it used to. I then moved from being, in the loosest possible term, a ‘functioning person with mental health issues’ to being completely non-functioning. My anxiety was at astronomical levels, to the point where I was constantly rocking and l had picked up self-harming as another futile coping tool.

No longer functioning, my life began to shut down. My University faculty department suggested I take some time out of my University degree studies which I wasn’t managing at all. I approached my local GP for some support and was officially signed off from work. Later that year, I was admitted to a full time 18-month non-residential treatment at a therapeutic community in which I stayed for 23 months including assessment phase. There I was diagnosed with various personality disorders, to add to my already existing diagnosis

Although the therapeutic community addressed my drinking and using, it wasn’t enough to stop me completely. For the entire time, except the last month of therapy, I was free from using cannabis but I was still drinking alcohol. The communities approach to alcohol misuse was to use controlled drinking methods rather than abstinence and this allowed me to continue to drink and lie about the amount I was drinking. Once I finished the 18-month program in the April of 2010, l went out for a drink to celebrate and that party lasted 4 months.

Waking from a particularly wild night in early August 2010, for some reason I found myself for the first time really wanting off of the hamster wheel of it all. A series of chance events led me into the rooms of Alcoholics Anonymous where for the first time I was able to admit I was an alcoholic, stop drinking one day at a time and begin to take responsibility for my recovery and my life.  Not only am l now 7 years clean and sober but l am also managing my various mental health issues in healthy ways and am able to move forward in my life, despite them often making things more challenging

And this is where I return to how this year’s World Mental Health Days theme applies to me. I am still unable to return to paid work, although l am so much better than l was l am still unable to stay consistently well enough to withdraw from benefits into paid employment. On top of my mental health issues, I am also undergoing gender transition which currently involves a lot of medical treatment and surgery recovery. This in turn has an impact on my mental health and l have to be so careful to make sure I’m being balanced and taking care of myself. If l don’t stay self-aware and vigilant about my recovery and my mental health, I risk relapse and if that happens l could lose all. mental health progress I have made.

The worry and shame of being on benefits affects me every single day. I live in dread of the constant reassessment forms and medical assessments which are done by people who have never met me and make an assumption based on a small snapshot of my life. It’s an exhausting and humiliating process that you never get a break from for more than a few months at a time and always negatively effects my mental health.  As anyone with mental health issues knows, the benefit system, including the back to work team, are not clued up about how having long standing mental health diagnosis effects trying to find and keep employment. This means that many people with mental health issues fall into two categories. The first are those forced back into work due to inadequate mental health assessments deeming them fit for work by the benefits team. The second are those who are awarded benefit and then get stuck on it because they are too scared to move forward into work for fear that if they do and they find it negatively effects their mental health, they will then lose their benefits.

I am trying to develop a career for myself that allows me the flexibility I need to make my own income. I’m not lazy, l don’t want to be on sickness benefits, l am hard working, and driven but the current general pattern of work that employers ask for just do not suit my mental health needs. I need to be able to evaluate where i am on a daily basis and set my own hours according to my level of mental well being. I need to be able to simplify things when times are tough or take time off when my mental health is feeling too fragile. I have to put my mental health first or nothing else is possible. The way we work in our society does not allow for this flexibility in employment.

Surely there must be a better way. Can the benefit system and employers work together to provide a system whereby a person with long standing re occurring mental health issues, can be supported into work with flexible hours and the option to withdraw at times where their mental health is too severe without losing their money? This would be so fantastic and would also help in recovery as the self-esteem generated from managing to be productive and achieve something is so good for one’s mental health. Additionally, knowing that in times of need, some down time can be taken without fearing looking money, would also remove the shame or worry of having mental health issues and encourage better self-management. Until something like this is created, those attempting to make the transition from benefits to work will be failed by the system time and time again causing a cycle of constant relapse, shame and stigma.