Going beyond a pill

This post is about the subject of mental health – and health in general. It’s a subject close to my heart because I was first diagnosed with anxiety-related depression just over ten years ago.

The sad fact is that by writing the above, a future employer may take a look at it and decide that having someone who deals with the challenges of an anxiety disorder is not someone worth taking risks over. If an employer wants to take the call of excluding the one in four of us who’ll be affected by a mental health problem in our lifetime, that’s their call. I say it’s time to change mindsets

How I ended up spiralling downwards during my second and then final years at university is something that I have spent many a day, evening and counselling session trying to figure out.

The hardest part of being diagnosed was acceptance of my condition – and that there would be no ‘going back to normal’ because in part, it was ‘normal’ that got me into that state in the first place. The idea that a short course of medication would help sort things out also had to go too. Prior to that, my understanding of healthcare was something along the lines of being prescribed medication for minor illnesses, going to hospital for major surgery and being locked up in secure accommodation for mental health patients. Remember that as recently as the 1990s, the idea that children could suffer from depression and anxiety-related illnesses was not widely acknowledged. (If it was, support for children at the time would have been comprehensive, systematic and impartial.)

Things spiralled downwards at the end of my second year at university. What I thought were combinations of the onset of an asthma attack combined with a heart attack was probably the most frightening experience of those days. My flatmate at the time called an ambulance but their tests came out with nothing doing. The doctor at the emergency appointment said it was a panic attack, and after that things started to make sense as I went online to find out what panic attacks were all about. It was at that point where I moved back home from university for what was about half of that autumn term. It was at that point that I knew things had to change – big time. At the same time, there was this petrifying realisation that I could be stuck with this for the rest of my life. Why me? Why now? What will the impact be? Will I graduate? What if I do not? Will anyone employ me in the future? A million and one thoughts go through your mind in that situation.

When I returned to university for what was left of the autumn term, I found that I benefitted from having chosen modules that matched subjects that I had done in detail during my A-levels a few years previously. This made the task of ‘catching up’ much easier – to the extent that I passed the end of term assessed papers with relatively high marks (2:1’s) considering that I missed half of the term.

2002 was the year when I started taking anti-depressants. At the same time, I also made a number of significant lifestyle changes – improving diet, regular swimming, long walks out to Hove and in the countryside, and volunteering at the Brighton Peace and Environment Centre (which at the time was in the vibrant hub of Gardner Street rather than on an isolated traffic roundabout by the station). It was also a time when I started writing a story that was both inspired by the Harry Potter books, the Lord of the Rings trilogy (that was showing at the cinema at the time) and a role-playing computer game.

The story itself was judged by some people to be one of the worst pieces of literature they had ever read. Yet what they had missed was that it wasn’t supposed to be a masterpiece. The process of writing it was part of the ‘healing’ process alongside all of the other things that I was doing.

I graduated with my upper second class degree from a redbrick university in a subject considered to be respectable enough not to be called a ‘mickey mouse’ degree by the tabloid press. Yet despite this, I felt that I had joined university not in debt and not ill, and graduated in debt and with mental health problems…and couldn’t help but feel that my old university had played a significant part in the state of my mental health – not least because of its utter failure to ensure that there was sufficient suitable accommodation for students. Although this is and has been a nationwide issue for many years, it doesn’t make it any easier if you are living in accommodation which, later on the local council decides is unfit for human habitation – which is what happened with me.

When I returned to Cambridge I stumbled across the local youth charity Centre 33 – simply by noticing that there was a door open and that there were some posters that caught my attention. They were brilliant with me in terms of counsellors and counselling – to the extent that I looked forward to my evening counselling sessions. I was to reciprocate the help they gave when the BBC came knocking on two occasions (local TV and local radio) who wanted to feature the work Centre 33 did, and wanted to interview one of the service users. Finding a young person to go on telly or radio to say “I am here because I need help” was going to be no easy task, but I felt that it was important that someone gave the viewpoint from a service user, which is what I did.

My experience with the counselling services provided by the NHS were not nearly so positive – but that’s not to say the people there were bad people. Group therapy was something that I struggled with and found that the group setting and the experiences of other users had a negative impact on me rather than the opposite. This was especially the case when faced with personal criticisms or insults; I was there to sort out my mental health problems, not be slagged off by other people.

I did some cognitive behavioural therapy (CBT) shortly before I transferred down to Whitehall on the in-service Fast Stream in the civil service. It was at that point where I felt I needed to go back onto medication (I’d stayed off it for over 18 months before then) and remained on it throughout my time in London, only recently beginning the steps to come off of it.

And here is where I find myself.

The interesting thing reflecting on the past ten years, many of which (including the past five continually) have been on one sort of medication or another, is identifying some of the factors that seemed to exacerbate the symptoms, and those that seemed to alleviate them. I’ll try to list them here.

  1. Having a secure place to live. The collective failure of the political establishment to deal with the UK’s housing crises – and I use the plural deliberately – is nothing short of a scandal. This is because of the impact unstable living arrangements can have on people’s lives.
  2. Debt. The spectre of that death cloud hung over me for far too long. The impact that this had on my mental health – both in terms of ‘am I ever going to pay this damn thing off?’ and the fear of losing my job & being in serious financial trouble had devastating impacts on my ability to perform to to the peak of my ability as money worries were always in the background.
  3. Having family and a stable group of close friends around. When you’re suffering from mental health problems, it takes a huge amount of patience from people to stick by you. Combining moving around fairly regularly meant that holding down that stable group of friends that live close by (i.e. that you could call up and go out for a drink with) was going to be more than difficult. I also made more than my fair share of mistakes, bad choices and misjudgements.
  4. Having something to do during the day. You could say that daytime TV is rubbish for a reason – to get people out of their houses. In a sense this is one of my biggest challenges at the moment. For the first time many years I’m not compelled to get out of bed by anything – which is one of the reasons why I’ve been more proactive than perhaps in times gone by. I know what getting up regularly in the afternoon feels like and it’s not good. Having a sense of purpose – a sense of contributing something to wider society played a key role in my choice of applying to become a civil servant.
  5. Exercise. The challenge for me was finding a form of exercise that I could keep up. I tried lots of things over the years – swimming, cycling, dancing, the gym, city boot camps and all (bar gyms – I’m not a gym creature) have had some levels of success. The challenge I’m facing at the moment is shifting several years worth of “commuting tyres” which is easier said than done.
  6. Diet. It goes without saying that keeping control of what you eat – types of food, quantities and times of day are all factors and have been with me. I was drinking far too much caffeine during my commuting days. Yet I felt I could not function with a three hour commuting round trip and a full-time job without something to wake me up.
  7. Having activities outside of work and something that taxes your brain when at work. There’s a big assumption in this heading – the assumption is that a person is in work. In this day and age that can no longer be taken as a given. In previous jobs both in my days as a junior civil servant and as a shelf-stacker or temp worker, the sense of frustration was enraging…

…so enraging that at times it led to despondency and despair. I would stop off at an internet cafe after a late shift at work sometimes, just to send and receive emails. (Remember that this was in the days before social media really took off.) I remember thinking “I am so much better than this!” – in terms of feeling that I had so much more to contribute, but someone or something was stopping me from doing so.

There were also times in the white-hot heat of a high profile policy posting in Whitehall where I felt that I was burnt out and wanted a break from it all to deal with my mental health issues once and for all…but felt both the weight of expectations (of being a fast streamer) and the sheer privilege of being in the role I was in, that I could not afford that option.

Taking a voluntary exit from the civil service dealt with two problems. The first was that it got me out of the unhealthy lifestyle of commuting too and from London every day for a job that was going to become far more stressful as everyone started fighting for their livelihoods in the cuts process. The second was that the redundancy payment cleared up all of my outstanding debts – and removed a massive millstone that had hung around my neck for the past decade.

I may be out of work in the traditional sense, but have chosen to make use of the ‘career break’ as productively as I can – not least in coming off long term medication. I’ve been able to take the diet and exercise challenges head on – though I really need to up the ‘exercise’ to start really burning those commuter tyres! It’s also a chance to be creative and practical about things too. As Puffles started becoming well known in twitter world, I noticed that some of the people I was meeting were confusing me with Puffles the baby dragon fairy. (If you go down to some parts of the country people do call me “Puffles” – hence the idea of commissioning a bespoke cuddly toy.

This term (but for this term only), I’m also able to spend much of my day exploring new activities, courses and skills at leisure. Part of the healing process for all my childhood issues was making up for some of the things as a child I always wanted to do…by doing them as an adult. These have included playing in an orchestra again, dancing, experimenting with both art and DIY, and branching out in terms of what I do using computers.

My point in this stupendously long blogpost? Recovery from mental health illnesses takes more than just a few pills. It requires a much more comprehensive look at a person’s life and lifestyle – and a very personalised approach to treatment and recovery. It would be nice for example if public service providers under the watchful eye of skilled and empowered caseworkers (whether GPs or otherwise) could deal with the issues of medication, diet and exercise for example – where the NHS could subsidise people’s attendance at exercise classes as part of a health improvement programme, or work with colleges to help people learn how to cook healthier meals.

Those of us who have had more fortunate lives may scoff at those last two suggestions. But remember that there are lots of us who want to improve our lives and our health who for whatever reason have no idea where to start. I got lucky with Centre 33 because I walked through an open door. Some people don’t know where those doors are. Showing them where those doors are, are part of the solution, just as is making sure that those doors are open too.



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18 Responses to Going beyond a pill

  1. Mary says:

    Useful post, and helpful ideas. Guess Ive had similar but different experiences. Its hard! So totally right a world which is so difficult for so many now with cuts, housing problems debut, is made even harder if you also have other battles to fight with yourself and your mind. Would like to condem those in the con-dem government who are happily going about the business of making it even worse. Surely they are the really sick ones.

  2. Dan says:

    We should chat about this sometime.

  3. Rosa says:

    Loved this. Thank you for writing it.

  4. Thank you so very much:) This is a really wonderful post. You’ve been in a difficult situation but sound as if you are making really sensible decisions and I look forward to learning how things go. But highlighting your path and the issues that need addressed for others and in general is the real value to me of this post.
    Would it be OK if this was possibly shared with medical students to help their learning in the future?
    Thank you again:)

  5. nessthehat says:

    What an excellent, thoughtful and thought provoking post. I know how difficult it can be just to think in an organised manner let alone live that way. Thanks for sharing your experience and best wishes with this new stage of your life.

  6. I agree with previous comments that “telling your story” is helpful, especially to those who may not have experience of their own. I’m just wondering if you have heard about the ‘recovery approach?’

    It’s intended to address some of the things you mentioned but also to help service users become more independent, lead a life that isn’t dominated by medication & therapy & realise hopes & dreams. If you go to any of the main MH charity web sites you will find out a lot more which is exciting & encouraging. Do contact me if you want to know more.

  7. Frances Coppola says:

    I totally agree with you about lifestyle being a major factor in mental illness. I went fairly spectacularly to pieces after my son was born and spent eight years in therapy after refusing medication. It took me that long to realise that what was really wrong was the conflicts in my marriage, my job, the demands of my family and my desire for self-fulfilment. And it wasn’t until I left therapy that I made the major changes I needed to make – ending my marriage, changing my career, and giving both my family and my singing the time and energy that they needed. As a result of those changes I’m deeply in debt, though it’s gradually getting easier (not least because the bank is now being kinder to me!) but I don’t for one minute regret the changes I made. Oh, and I recognise the work “feast or famine” too – burning out in a stressful, high pressure job, then ending up with equally stressful nothing to do and financial worries. I lived that way for years. It’s an awful way to live, but more and more it’s what we seem to end up with – either too much work or not enough. You’ve done well, though I know you’re not out of the woods yet. Hang on in there – it does get better. And thank you for writing such an honest and thoughtful post.

  8. George says:

    If society cared more about people than profit we would all benefit.

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  12. Cirisse says:

    My depression related to anxiety (needs a catchier name) started during my second year of A-levels. I hadn’t got the results I wanted and it knocked my self esteem and image of myself. It got worse as I was supposed to apply for uni – the thought of failing my exams, of being the only child (out of 9) to not go to university, to being looked down on as stupid, or disappointing my parents and teachers was all too much and I decided it was better to slowly die.

    Like yourself I didn’t find group therapy that helpfu and the judgment of others makes things worse. I’ve stopped taking my anti-depressants because I fear my GP who’s always putting me down. I’m also afraid to get a new GP (lol anxiety).

    Most of my improvement over the last year have been thanks to the support of mental health charities and, dare I say it, the job centre (My adviser is incredibly sympathetic).

    Long comment is long; just meant to say that it resonated with my MH experiences.

  13. Fabulous post, and thank you for writing it. I remember meeting a brave lady once who had set up a foundation for mental health after her son had taken his own life aged 24. She had complete conviction that medication has its place in mental health in order to get people to a level of coping at which they can start to find talking helpful and constructive, because it’s the talking that makes the long-term difference and makes it possible to reduce medication. It would save the country so much money on antidepressants and lost productivity if the government would fund talking therapies better, and act to increase awareness of services and to reduce the taboo of mental illness to eliminate the social barriers to accessing support.

  14. Alicia says:

    I strongly feel that medication is sometimes unfairly criticised, and a think a lot of that comes from people who think that, because they have felt sad, they know depression, or because they have had a mood swing, they know bipolar, or whatever.

    Of course, medication should not be seen as a cure all, and people need much more to stay in recovery, but it can often be a lifesaver.

    I think the trick is, like you did, to come off it when it is no longer needed. For some people, they will always be on medication, but for most others, they will be able to either change or gradually stop meds as the situation changes and they get nearer to recovery.

    I’m rambling now🙂

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  16. Eva Alisic says:

    Thanks for your post, that takes a lot of courage to write. It resonates, especially after seeing the TEDx Maastricht talk by Clarissa Silva, a former psychiatry patient, last week. If you’re interested, this is the link to the website and the talk: http://bit.ly/HwRwd3

    The description on the TEDx website starts with: “Sometimes good things can come from seemingly desperate situations. Clarissa Silva speaks from experience. After being committed in a mental institution, losing her job, house, social contacts and lust for life, she decided to live in a shielded environment at Pameijer. Their vision of Empowerment changed her life for good. And for the better. She learned how to give substance to life by drawing strength from within herself. Now she inspires caretakers to lead empowered lives themselves. Which has huge benefits for patients.”

  17. If you’re looking for an outdoor sport that will help shift the tyres as well as demand total concentration, can I recommend rowing or sculling to you? It’s also a sport where results come relatively quickly, and are accompanied by an immense sense of personal gratification. Look on http://www.explorerowing.org for details of local courses and clubs. Good luck with the MH issues, and thanks for being open and brave enough to share.

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