How I Learnt to Deal With Nighttime Panic Attacks

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I wake up with an intense nausea that floods my system. Running to the bathroom I’m convinced I’m going to be sick, but I’m not. Then comes the pain. It stabs at my chest and upper back to the point I can hardly breathe. I went to bed feeling relaxed and contented, but now I’m pacing the house, my heart pounding terrified I’m having a heart attack. The reality of panic attacks is the physical pain that cuts through you in great swathes. Having a panic attack at nighttime is very different to having one during the day. At night everything feels more intense, the atmosphere changes to one that is ethereal and other worldly. People that you count on to talk you through the experience are asleep and unavailable. You feel alone and desperate and not sure if you can get through the night. I’ve learnt some techniques to help me cope over the years, that have quelled the panic attack before it becomes too difficult to manage.

Thinking Logically

I know this is a panic attack. I know it’s painful but it won’t kill me. Twice I have been taken to hospital by ambulance because of the unrelenting pain I was in. Twice I’ve spent hours having multiple tests to find what was wrong, for everything to come back clear. What I know now is that although I have found myself in a great deal of pain, it won’t turn into anything sinister. I will talk myself through the situation by repeatedly telling myself this. I have to say it with conviction, to convince myself it will be okay.

Getting Out of Bed

Lying in the dark in bed during a panic attack is the worst possible thing I could do. The pain is all the more intense as I lie there, with nothing else to distract my mind. All the worst scenarios run through my head and all I achieve is making myself more and more anxious. I force myself to get up, go into another room and turn the light on. I force myself to have a drink of water and to do something, anything, rather than staying in bed worrying.

Therapy

I had CBT (Cognitive behavioural therapy) to manage my panic attacks, and to understand why I was having them so frequently. Therapy helped me to realise that I wasn’t dealing with stressors in my life, and that my worries and anxieties were manifesting as panic attacks. I learnt to face what was causing me stress in a situation and to deal with it there and then. Panic attacks for me often occurred after a stressful event. Once my body and mind were relaxed again, like going to bed on a Friday night after a difficult week, I would wake up in the middle of the night with a panic attack. It became vital to realise when I was going through a stressful time, so when that stress had disappeared I wouldn’t end up having yet another nighttime panic attack. I was taught breathing techniques to calm myself, which I still use today

Distraction

If thinking logically doesn’t work on its own and I’m up and out of bed, I’ll try and distract my mind. It might be watching a favourite tv show, something light and entertaining that I’ve seen before. I might sketch or get out a colouring book, that keeps my hands busy and forces me to focus. I love to play video games so I might turn on the console and try and figure out that Zelda puzzle that’s been bugging me. If I occupy my mind effectively and for long enough, I won’t even realise the pain and panic has gone.

Using these techniques has cut down the amount of nighttime panic attacks I have drastically; I haven’t had a serious one in a year and a half. What I’ve leant in therapy often preempts an attack completely. Changing the way I manage stressful situations and work through them has had a significant positive impact on my life.

The Mania Hangover

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The Best Feeling Ever!

When I’m in the grips of mania, I love Bipolar. The euphoria I feel is like no other drug. The feeling is addictive and I never want it to end. The mania is unbelievably epic, like I’m living in a blockbuster movie and I’m the star. The whole universe revolves around me. Continually going through my head are thoughts that instil an enormous, gratifying confidence: ‘I’m the best at everything!’ ‘I can do anything, be anyone!’ ‘Nothing can touch me. I’m invincible!’ It’s a feeling like no other and yes, when it ends I do miss it. Because of course, like any good thing, it has to end. I talk more about mania in this post Mania is…

Here Comes The Hangover

What I hate about Bipolar, above anything else, is what I call my mania hangover. First of all, I realise I’ve spent far too much. Imagine having a big weekend when you’re suddenly buying everyone shots, but that weekend stretches on for months. Or that clothes and shoes binge you’re on when you spend an evening sat in your pyjamas on the internet, but imagine it lasting weeks. I’ve found myself in crippling debt more than once, the first time meaning I had to move back home with my parents. I felt terribly embarrassed and an absolute failure for having to go back to live with mum and dad. Luckily I had that option.

Next, the realisation of my actions set in. I start to see with clarity and I realise I’ve done things that I’ll regret for years to come. I cheated on my ex, whilst I was away traveling in Japan. When I was feeling stable again the memory rushed toward me and I felt dizzy and sick over what I had done. It was completely out of character, and I was remembering it through a haze, as if I had been drunk. I see how much stress I put family and friends through with my unpredictable, sometimes rageful emotions. I’ve made family and friends cry with vicious words that cut them to pieces. I’ve done so many embarrassing, ugly things I regret over the years I can’t fit them into one blog post.

From constantly being full of energy and unable to sleep, now I’ve become emotionally and physically exhausted. I’ve been running on empty for weeks and not even noticed. All I want to do is to become a hermit, hide from the world in bed and eat junk food.

Hello Depression

Then, inevitably depression sets in. I hate the depression, and it’s usually part of the whole mania hangover. The juxtaposition between the mania and depression is ridiculous. I’ve heard the description of ‘it’s like living on a rollercoaster’ but it’s too simplistic a description. Rollercoasters for me are fun, and the lows of acute depression are far from fairground ride fun and games. Depression, just like mania, takes complete hold of you, and won’t let go. I can no longer function like the average person. I stop going outside, I have to force myself to shower and brush my teeth. Everything is an unbelievable effort.

My Hangover Cures

Ultimately, I would not want to be manic in the first place! To do this I check The Warning Signs of a Manic Episode that I have identified over the years. Even though at times it can be a tempting prospect to go back to that feeling of constant elation, it’s not worth the adverse effects. Taking my medication is the surest way to stop this from happening. If I do find myself with a mania hangover, I take the time to look after myself. I’ll take some time away from work and socialising. I’ll keep an eye on my mood and check for the warning signs of depression.

Childhood Grief

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I met Vicky when we were in Reception class, at just four years old. I remember walking up to her and saying innocently,

“Do you want to be my friend?” We became inseparable. We did everything together in and out of school. I was the tomboy who hated wearing dresses and pulled ugly faces in photos. Vicky was bubbly, full of fun and the one always in pretty dresses. We lived a five minute walk away from each other so we were always at one another’s house, playing after school or having sleepovers at the weekends. People say that we have the same laugh, we spent so much time together growing up.

Our Mum’s became close friends. Vicky’s Mum, Tracy, I instantly liked. She was lively and loud, and had a thick Geordie accent. It became our little tradition that I would have dinner with them every Tuesday. The ice cream van always came down their road, and Tracy would always treat us to a fab lolly. I was mischievous as a child, and was always pushing Vicky to do things we weren’t allowed to do. We would jump on the bed together singing along to our favourite music. Tracy would charge into the room and shout,

“Stop bloody jumping on the bed you two!” Every time she told me off I could see a twinkle in her eye that she didn’t really mind, and secretly loved seeing her daughter and best friend having fun. I felt I could talk to Tracy and would tell her about what was worrying me and I trusted her advice. I began to see her as my second Mum, someone who loved and cared about me. She was ambitious, and began a University course, which showed me it was never too late to better yourself.

When Vicky and I were Ten years old, Tracy suddenly collapsed one evening at home. They couldn’t wake her up and she was rushed to hospital. There, Vicky, her Dad and younger brother were told that she had had a brain aneurysm. She had been put on a ventilator, but they were told she would never wake up. She was only thirty eight. My Mum didn’t want me to see her in the hospital, but to think of her how she was. I remember my Mum coming home from the hospital in tears and telling me it was like she was just sleeping. Neither Vicky or I had lost anyone before. It felt impossible to get my head around that I would never see Tracy again and that Vicky didn’t have a Mum anymore. As I get older, I’m now in my early thirties, I realise just how young thirty eight is. She still had so much life to live and it’s so cruel that is was cut short in that way.

The funeral was gut wrenching. The room was full and we were all fighting back tears or sobbing. Everyone was in a state of shock and disbelief. It took place a week after Tracy had died, and I hadn’t seen Vicky until before it happened. I sat in tears, watching her cry, wanting to run up to her and hug her tightly and never let go. At the wake I went up to her and asked her if she was ok, not knowing what else to say. Her response was simply,

“I’m fine.” She ran off to play with her cousins. I was so confused. She was running around the garden and laughing. I went to my parents and told them what had happened. They told me Vicky was dealing with it in her own way and wasn’t ready to let go of her Mum and grieve yet.

In the following months we dealt with our grief in very different ways. Vicky wouldn’t talk about it to me for months, whereas all I wanted to do was talk. She became quiet and withdrawn. I felt like I was losing my best friend, but knew I had to stand by her. We walked home from school together everyday and on one afternoon, out of the blue, she started talking to me about her Mum. She told me how angry she was and how it was the doctors fault. Tracy had had heart palpitations in the weeks before and Vicky was convinced the doctor should have seen something else was wrong. I knew, as my Mum had told me, there would have been nothing for a doctor to find until it happened, but I couldn’t tell Vicky that. All I could do was listen and let her vent.

Grief made us grow up. We weren’t innocent ten year olds any longer. But it made our bond grow stronger. We realised that grief wasn’t a short term emotion, but that it lingered and caught you out when you weren’t expecting it. Vicky became quieter, but her bubbly side would surface every now and again. She tended to bottle up how she was feeling and only express herself to me when she was deeply upset. I became fiercely protective of Vicky, and when she was bullied in secondary school for ‘not being sad enough about her Mum’ I would lash out.

Vicky and I are still best friends, so that’s twenty seven years of friendship. As much as I have been there for her, she has supported me just as much through my mental health problems. I still think about Tracy all the time. To lose someone so close to you at such a young age you never really get over. In my own way I still celebrate her life by telling people about her. About her big, bold personality and caring nature. I’ll never forget.

 

 

My Hearing Voices Journal

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Last week I had an episode of psychosis, where I suffered from auditory hallucinations, or hearing sounds and voices. To help me through it, I journalled the experience in a notebook. Some parts are written during the episode, and some are written directly afterwards. It helped me make sense of what I was hearing and to ground me in reality and to help me deal with the shock when it had stopped.

“I think I’ve found the worst combination ever of physical and mental illness. Migraine, room spinning and doubting my sanity as I hear voices whilst sat in bed. I’m feeling very vulnerable and scared. I’ve felt physically ill all day today. We went out for a meal with friends but had to cut it short because I thought I was going to pass out or fall over from being so dizzy. This week has been an emotional rollercoaster with my moods all over the place. I’ve been ecstatically happy and hyperactive, busy working away on new projects. In a startling contrast I’ve felt hopeless, useless and deeply lost.

Now I’m home, and sat in bed. The noises have started. I can hear creaking. It sounds like it’s coming from the bed, but I’m not moving. It won’t stop. I’ve turned on my laptop and found the easiest, light hearted programme I can find, Friends. It reminds me of my childhood, before the voices started. I remember when it was first aired on a Friday night and I was allowed to stay up and watch it. If I can focus on this maybe the voices will leave me alone.

It isn’t working. Now the creaking has turned into banging on the bedroom window. The banging is urgent, fast and incredibly loud as if a fist is pounding on the window. The blinds are closed and I’m paranoid now that the banging is real and someone is playing a joke on me. Should I get up and check? I really should. I’ve been to open the blinds and there was nothing there. It’s windy outside, and all I could see were the bushes and trees swaying. The unpredictable and forcible wind today is mirroring my state of mind. The banging is making me really uncomfortable. I’ll turn the volume up on the laptop to try and drown out the noise. It’s not working, Fuck. What is my mind trying to tell me? How can I rationalise this or tell it to stop?

It’s suddenly stopped, thank fuck for that. I can breathe again. The cat has leapt up on the bed and has curled up next to me. It’s like she knows something is wrong. Stroking her and listening to her gentle purr is calming me down. I’ve just realised it’s getting dark outside and I’m sitting in the bedroom with no lights on. But I don’t want to get up because right now sitting here I’m not hearing anything scary or confusing. I don’t want to jinx it.

Now it’s dark and I’m still sitting in the bedroom, still too afraid to get up and turn the lights on. I can hear footsteps coming into the room, it must be my husband. I hear the bed creak as he sits down on it next to me. He says to me “Do you want any carrots? I think we need some more carrots for next week.” I’m confused. Why is he talking about carrots? I respond, “Yeah ok, I’ll put carrots on the shopping list next week.” I hear him get up and walk out the room. I’m not sure if that conversation was real. It was weird and random and now I feel really muddled and confused. I’ve turned the light on now so I could write this down.

Oh yay, hear comes the shouting. I close my eyes and try and focus my mind. All I can hear is “Fuck! Fuck!” “Get the fuck out!” Can’t take this anymore. I’m getting up. I realise I’m trembling and I feel as if I’ve been shaken roughly by someone much stronger than me. I sit down next to my husband on the sofa. I ask him, “Did you come in the bedroom earlier?” He replies “No, I’ve been in here the whole time, why?” I can’t be bothered to explain what’s been happening. I’m still feeling overwhelmed by voices. I’m asking him about his game. He’s playing Elite. I love how passionate he is about this game and the idea of space travel. I make myself listen to him intently, and the shouting starts to fade.

The problem with hearing voices is the paranoia afterwards. Is that banging from outside or in my head? Is that whispering in the background of the tv show I’m watching or in my mind? Unknown noises set my teeth on edge. I’m jumpy, full of panic with the fear it will start again.

At least I’m talking about it.”

Still More To Do To Tackle Mental Health Stigma

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For mental illness sufferers, an underfunded NHS, discrimination against benefit claimants and a negative tone from the media is still creating a society that misunderstand and stigmatise.

A lack of funding for mental health and parity of esteem in the NHS reinforces the view that mental illnesses aren’t as important or as serious as physical ailments. It gives the impression that there is a quick fix, with a few sessions of therapy and some medication it will disappear the problem. Many people wait months, even years, to see a therapist with the NHS. The dreadful reality is that for some it comes too late. For complex conditions, the right medication or combination doesn’t always work the first time. It can take patience to find the right medication.

The High Court ruling that changes to PIP (Personal Independence Payments) were ‘blatantly discriminatory’ against people with mental health problems proves the Government aren’t committing to their pledge to end stigma and discrimination. PIP is a benefit for those with disabilities, and that includes mental illness. Anyone with disabilities can apply, if they’re in employment or not. It’s designed to cover the extra costs that come with having a disability. A person applying may not be able to cook a meal for themselves for instance, and need someone to do this for them. People with mental illness often find leaving the house to be an insurmountable task and need support to do so. This is the aspect of PIP (the mobility section) that the government decided to change last year. People who were unable to travel independently on the grounds of psychological distress were not entitled to the enhanced mobility rate of the benefit.

The almost constant barrage of negative views in the media against benefit claimants strengthens public opinion that those with long term, severe mental illnesses are in fact lazy work dodgers. Dare to go on a message board on any well known news website and the vitriol against those with mental illness is clear to see. People proclaim, “There were never this many people with mental health problems when I was young!” To that, there has been a rise in people seeking out help and support in recent years. The ‘chin up’ and ‘keep going no matter what’ British attitude has kept people silent and unwilling to find help for decades. This attitude has ruined and cost lives that could have been saved. Severe mental illnesses such as Bipolar Disorder, are not as common as people believe. Only 2% of the UK population have been diagnosed.

Much of the ‘awareness raising’ centres around depression and anxiety. It’s time to move forward and introduce the general public to illnesses that are extremely damaging and life changing. Personality disorders, Bipolar, Psychosis, Schizophrenia, and PTSD deserve more positive attention. For many people, as soon as the term ‘mental health’ is brought up, what comes to mind is depression and anxiety. In no way am I trying to say that depression and anxiety aren’t important, they can be crippling and severe. The problem here is that so much emphasis is put on these conditions, but we must be speaking up about all mental health issues. There are conditions out there that are seen as less palatable and not as relatable. The general public can relate to depression and anxiety as they are more common and chances are, they themselves or someone they’re close to has suffered from these conditions. It’s easy to forget about a disorder when you have no real life experience of it. These less talked about conditions are also more stigmatised. With a personality disorder you’re seen as manipulative and attention seeking, with psychosis you’re seen as crazy and could snap and murder someone at any moment. Continuing to not pay these conditions any attention leaves sufferers feeling incredibly isolated and alone. We need to raise awareness of all conditions under the mental illness umbrella. Ignoring conditions because the conversation is harder to start will only further alienate sufferers. Allow people to share their story. Their experiences are valid and important.

For someone that struggles daily with a debilitating mental illness, it can feel overwhelming to be faced with such adversity. To deal with a severe illness and to know that there is blatant discrimination embedded into society is exhausting and infuriating. It takes a great deal of strength to keep going everyday knowing this. Having a mental illness, being aware of this and speaking out doesn’t equal weakness, in fact it shows how strong you are.

Relationships and Bipolar

 

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Relationships are difficult for everyone, but they can be even tougher when you have a mental illness. Each relationship I had before my diagnosis of bipolar suffered as partners found it difficult to be around me; they never knew which Katie they were going to be greeted with.

I didn’t have a serious relationship until I was twenty. I met someone on a night out and we instantly clicked. At first it was fun and we both looked forward to seeing one another. We went out for meals and nights out dancing together. We went on trips away to places like the Cotswolds. We were happy, but it didn’t last. She told me she could no longer cope with my unpredictable moods. She had enjoyed spending time with me she said, and could look past the bursts of anger and paranoia I had often displayed. But that now I had changed. I was no longer fun to be around and it was bringing her down. She had wanted an easy going relationship, but had realised now that I was too intense, too high maintenance.

I quickly found another partner, and we formed a bond online. It was a long distance relationship, with her in Manchester and me in Reading. We made it work and I admired her sense of humour and vibrant personality. Suddenly though, to me, she expressed an exasperation over my constant talking, my fits of rage, and my lack of concentration or planning that was needed to see her. My inability to listen to her concerns about my behaviour didn’t help, and she felt it was best to just be friends.

After two failed relationships in a row, that both ended because of my behaviour, I began to see my personality as flawed. I felt I was doomed to short term relationships, that sputtered out when they realised just how difficult I was to be around.

Then I met Jimi. We met online, then chatting occasionally on the phone when we decided to meet in person. We ended up having two dates in one day.  We bonded over our love of all things nerdy, and our similar tastes in music and literature. Our personalities were very different, but it worked. He was a calming influence on me and taught me to be more patient. I taught him to have more confidence in himself and to be less socially awkward. He has stuck by me through some of the most difficult times in my life. When I had a breakdown and had to leave my dream job. When I was diagnosed with bipolar disorder. When I’ve been manic and unpredictable and angry. When I’ve been suicidal. He has taken it all in his stride and remained his compassionate, caring self.

We’ve now been together for eight and a half years and two and a half years ago we married. My Dad summed him up in his speech when he called Jimi “a true gentle man.”  I’m proud to say he his my husband.

It is possible to have a healthy, long term relationship with someone when you have a mental illness. I am proof of that. It’s not easy, but never settle for someone that doesn’t understand your illness. You deserve to be loved and cared for.

Taking Medication For Your Mental Illness Doesn’t Equal Weakness

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Every evening at 10pm, my husband’s phone starts to beep. It’s a daily alarm to remind me to take my medication. I go to the kitchen drawer where the tablets are kept, and rustling around (because it’s our lets shove everything we don’t know where to keep in this drawer, drawer) I’ll find them. I’ll take the 100mg Lamotrigine, 50mg Aripiprazole and 50mg Sertraline. They’re a combination of a mood stabiliser, an antipsychotic and an anti depressant. Taking medication is a part of my night time routine, as much as washing my face and brushing my teeth. I never hesitate to put them in my mouth and swallow them with a gulp of water.

These tiny pills keep me stable. They allow me to function and get up in the morning. They counter the negative thoughts that lead me to feeling desperately depressed and suicidal. They stop any manic episode from emerging and causing me to become a whirlwind of self destructive hyperactivity. They silence the cruel and vicious voices in my head when I’m depressed, or the delusions that make me believe I can do anything when I’m manic. With all that in mind, why would I not take them? Why would I choose to be poorly? I’ve learnt that I can’t live without medication, otherwise bipolar completely overruns my life. It sweeps in like a high tide, submerging my true self, and the low tide never arrives. It controls my life, and I’m resolute that I’ll never knowingly let that happen again.

It’s not a weakness, or a flaw in my character to take medication. I’m not naive, I haven’t blindly allowed a doctor to prescribe them. It took a long time to come to terms with the fact I needed medication to survive. Long discussions with my psychiatrist allowed me to make informed decisions about what approach I wanted to pursue with my treatment. I didn’t settle for meds that left me with debilitating side effects. I tried a number of meds and combinations of them to find what worked for me. It was a long process but ultimately more than worth the time and effort.

I’ve always prescribed to the idea that those living with long term mental illnesses are strong. We manage to live through our struggles everyday and emerge stronger than we were, whether we realise it or not. Part of our strength comes from admitting we need help. It takes someone of a firm and resolute character to come to the realisation that their mental health is having a marked effect on their life. To take medication when there is still shame and stigma surrounding it proves we can withstand the negativity.

Of course, the choice is there for us. I fully support and understand when someone doesn’t want to take medication. Therapy and lifestyle changes is enough for some. What I disagree with is being shamed or not seen as being as strong as these individuals. I am. Every evening when I take those tablets I’m not seeing them as a sign of weakness. I haven’t failed. With them I’ve achieved so much and become a healthier version of myself.

 

How to Help Someone When They’re Hearing Voices

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I have bipolar disorder and along with this psychosis. This means I hear voices that aren’t really there. Sometimes the voices are comforting, and urge me on to try new things and motivate me. At other times they can be malicious and terrifying, criticising me and goading me to hurt myself.  I talk about my experiences in the post Doubting Myself – Hearing Voices and in this post Hearing Voices During A Manic Episode I also describe how I was in denial for many years in this post ‘I thought the voices were normal.’ Realising I had Psychosis To learn more, check out MIND Their website is full of information about hearing voices and psychosis in general.

So how can you help me and others like me when we are hearing voices? 

It might seem daunting, but there are simple things you can do to help someone when they’re struggling with voices. Sometimes all I need is for someone to just to sit and be with me. If I don’t know you I’m not expecting you to have a full on conversation with me. I just need someone there so I’m not feeling alone. When you hear voices you feel out of touch with reality. It is an intense and genuinely scary experience. You’re not always sure what’s real and what isn’t. It creates a surge of fear and anxiety. So to counter this having someone sit with me helps to ground me. It’s a really simple act that can make a huge difference. Helping someone doesn’t have to be complicated. You don’t need to fix them or make the voices stop.

Don’t panic.

If I said to you I’m struggling with hearing voices, don’t visibly panic. If you’re panicking, it will make me panic, and I’m already struggling with the anxiety of what is going on in my head. I’ve told people before when I’ve been hearing voices, and I can almost see the gears going into overdrive in their head. Like I’ve already said, you don’t need all the answers. If you’re worrying about what you can do; ask. It’s far more helpful for someone to ask me what they can do – rather than sitting panicking and stressing out.

What can you say to help?

Talk to me about anything. Talk to me about the surroundings. Tell me your life story. Tell me how your day is going. Tell me what you’re up to tonight. Anything. It can be as mundane or as interesting as you’d like. It can be the first thing that pops into your head. Treat me normally, and if you know me treat me as you usually would.  I want to be distracted from the voices. Distraction is key. Put yourself in my shoes and think how you would like to be treated.

What do I do to help myself?

When I’m low and the voices are vicious and scaring me, what I try to do is rationalise it in my head. I think yes it’s scary, but I know what it is. The experience feels very real but it can’t do anything to me, the voices can’t hurt me. It’s like if someone was having a panic attack. They’re not going to die. In the same way I know nothing bad is going to happen to me.

Often I hear voices at home, when I’m alone. I will try and have a conversation with someone – I’ll call a friend and ask them to talk to me. Again it’s all about distraction. If no one is available I’ll do something creative. Painting, drawing and writing all help to ground me and distract from what I’m hearing.

Painting ‘Bear Repeat’ by Anne Wilson

Breaking the Silence

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Too many people with mental illness are silent. Silent with friends and family, Silent at work. Silent from their doctors, silent with themselves. Breaking that silence can feel like the hardest thing in the world.

We worry about what others will think of us, and that they will judge us. Maybe they’ll think we’re attention seeking, exaggerating, or crazy. What if they recoil from us or decide they can’t deal with it. We worry breaking the silence will make work life difficult, or even cost us our job. Maybe our doctor won’t believe us, or won’t have any answers. We worry that being truly honest with ourselves will mean we will have to face the reality of our illness. All of this circles our minds and paralyses us from taking action to help ourselves and to reach out for help and support.

It all comes down to stigma and discrimination. It is such a huge issue for people with mental illness. We fear the repercussions of breaking our silence. If we start talking and sharing collectively, we can hold each other up and give ourselves the confidence to use our voices.

When you do break the silence it can be freeing and empowering. To finally share your story with someone, even if it’s just one person, can come as a huge relief. Sharing your struggles lifts a weight off your shoulders and has a positive affect that staying silent will never do. I do this here on this blog, and share my experiences of bipolar, psychosis and bulimia. I first started journalling my experiences in 2012, but only shared with family and friends. Last February, I made the decision to go further and set up this blog and to be more active about it on social media. Now I feel supported by a larger community, of people I have never even met. I have received messages from across the world of support, and others asking for advice.

In most situations, people are generally supportive. However, this isn’t always the case and we have to be prepared for this. It can be deeply hurtful when someone doesn’t understand, or refuses to make an effort to. If we feel capable, the best thing we can do is try and inform and educate. Stigma often comes from ignorance or a lack of information. We need to make sure we provide people with the right information so that they can make informed opinions. This can be from sharing your story, or from highlighting resources from charities such as MIND and Time To Change

Not everyone with mental illness feels capable of being open. We share our stories to varying degrees, and even if we tell only the one person closest to us, that we can confide in, that’s ok. We don’t all need to put ourselves ‘out there.’ We’re all different, despite our shared illnesses. Breaking the silence means talking as much or as little as you want to. It isn’t a competition and no-one should feel pressured to tell everyone they meet about their illness. Do what you can, and you’ll find it makes a difference to not only your life, but to the people you care about.

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The Warning signs of a Depressive Episode

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Depression can be sneaky and creep up on you when you least expect it. I find the warning signs can happen either all at once, quickly and anticipated, or more slowly, like the depression is stalking me. I’ve written in detail about depression in my post 101 Things No one Tells You About Severe Depression This list is not exhaustive, and the warning signs can differ from person to person.

Feeling tired all the time. I will feel exhausted and sleep will no longer feel refreshing. I can sleep during the day; something I hardly ever do when I’m stable. I will constantly feel tired and all I will want to do is to go to bed.

Irritability. The smallest annoyance will have me losing my temper. Someone eating too loudly, people walking slowly in the street, not being able to find my hairbrush are all examples that will leave me seething and ready to snap.

Lack of concentration. I love to write, read and play video games, but when depression is near, I can’t concentrate. My world feels fuzzy with blurred edges. I find my mind wandering, often to darker thoughts, or simply zoning out.

Increase/decrease in appetite. My appetite will change completely. I’ll either want to eat all the time and find food comforting, or I’ll feel nauseous at the idea of eating.

Low self esteem. I’ll start thinking less of myself. I’ll look at my body and think I’m disgusting. I’ll look at my work and think it’s awful and want to rip everything up and start over.

Socialising less I enjoy going out and socialising, so it’s blatantly obvious that something is wrong when I turn down an invitation, or don’t turn up. I’ll feel a knot in the pit of my stomach at the idea of seeing friends.

No motivation My drive and positivity will go out the window. All I want to do is curl up on the sofa and watch tv, constantly. This isn’t just an ‘off’ day, this is when my motivation will disappear completely for weeks.

No longer enjoy my favourite activities As with a lack of concentration, my hobbies that once gave me pleasure and filled me with happiness, no longer do. Every suggestion made I turn down, not able to see the fun in anything.

As I don’t always realise I’m becoming depressed, I rely on my partner and close family and friends to keep an eye out for these warning signs. I’m much better than I used to be at spotting a change in my mood toward the low side, but I still occasionally miss a change in behaviour that’s glaringly obvious. Knowing these signs has made me feel more in control of my mental illness. I can act or make a change before the depression becomes severe and I find myself in crisis. There isn’t always an answer, but knowing I’m going to be ill means I can prepare for it. I let people close to me know how I’m feeling and I talk to my GP or psychiatrist. I’ve also written about mania in my post The Warning Signs of a Manic Episode

If you’re worried that you may be depressed, please make an appointment to see your GP. Many doctors surgeries offer double appointments, of 20 minutes rather than 10, so you can have more time to explain how you’re feeling and discuss options with your doctor. I always make double appointments when I’m struggling with depression, as I find it more difficult than I normally do to express how I’m feeling, and to get my point of view across. It means you won’t feel rushed and pressured to explain everything.

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