A Life Lived Vividly Series: ‘I Thought The Voices Were Normal’ Realising I Had Psychosis

A Life Lived Vividly

I suffer from bipolar disorder, well known for it’s symptoms of mania and depression. What many people don’t realise is that some sufferers also experience psychosis. These could include delusions, auditory, visual and tactile hallucinations. For me, I hear voices. This happens during periods of extreme moods, so when I’m manic or severely depressed. I may hear voices that are comforting or spur on my mania. Sometimes the voices are just a jumble. When I’m depressed, it becomes disturbing. Voices will scream and shout at me, or sneer vindictive threats. You can read my journal entry My Hearing Voices Journal

When I was younger, I thought having someone talk to me in my head was normal. Then, as I grew older, I knew something wasn’t right. I was denial for years. Something like this couldn’t;t happen to me. It just didn’t seem fair. It wasn’t until I stumbled upon an article that explained the symptoms that I began to truly accept this wasn’t right. I sat reading, with tears welling up as the realisation dawned on me; I was experiencing psychosis. I cried for a long time. The idea of telling anyone I had psychosis terrified me. What if they were afraid of me? What if they thought I was dangerous? My fear of being labelled as ‘mad’ or ‘insane’ stopped me from being honest with the people closest to me. I didn’t want to lose friends or have family treat me any differently.

Even as a sufferer my view of psychosis had been skewed by pop culture representations. You were a disturbed, dangerous individual that didn’t fit into society if you heard voices. It couldn’t be further from the truth in my case. I was just an ordinary woman; I was in a long term relationship, I worked, I went out with friends. Yet I felt stigmatised before I even reached out to anybody. I stayed silent for years, only telling my psychiatrist after a year of treatment.

I eventually opened up to my partner. It was an awkward conversation, with many pauses and silences as I struggled to explain myself. Although he initially found it difficult to understand, he was supportive and caring. He could see how upset I was becoming and how much of an internal ordeal I had been through keeping this bottled up inside. He knew all I needed from him was a hug and to hear him say ‘I love you.’ Later, I told my family and they excepted it with an ease I wasn’t expecting. I’ve begun to be open about my experiences on social media and the outpouring of support from friends has been incredible. I am truly lucky to have such open minded family and friends.

I know there and people out there who don’t understand some that are scared of psychosis. If these people opened themselves up and had a genuine discussion with someone like me they wouldn’t be afraid. Psychosis doesn’t equal dangerous . I’ve met people who believe it’s edgy and cool, or use it as a fashion statement. It’s none of those things and isn’t something you should ever wish on yourself. It is debilitating, bewildering and terribly frightening, but with support it can be tackled.

 

What Does ‘Recovery’ Mean?

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The word recovery means very different things to different people. The word is problematic and can ultimately be damaging. When people talk about recovery it marginalises those that can’t.

Some people use the word to describe the process and not an actual milestone. Some see it as having a positive outlook, that they see as a form of recovery. Others actually mean being in a stable place and free from mental illness. ‘Clinical recovery’ is a term many mental health professionals use to describe someone who no longer presents symptoms of their mental illness. I think many people think of this when we hear the word recovery and this is my main problem with it.

I prefer to say manage rather than recover.

Managing to me signals acceptance. That the person has come to the point where they’re no longer in denial. They’re now willing to find a way to manage the condition they’re faced with. This isn’t a phenomenon categorised just for mental illness, but for many physical health problems. Managing diabetes and other long term illnesses comes with similar challenges.

Ultimately it’s about building something new for myself. 

I can’t go back to who I was before. I don’t recognise that person. For a start, she was a young teenager and without mental illness and its impact I would be an entirely different person. Would I even want to be that person? I have no idea.

If you’re not seen as moving forward, you end up feeling like a failure. There is so much pressure to be better, to be able to work and socialise, to be a productive member of society. The impetus is put on recovery above helping those that it isn’t feasible for. It’s this unattainable goal that is set for us that so many with severe and enduring mental illness will fail at. Why isn’t there more support for those that need and want to manage a mental illness?  There’s this idea that we can recover if only we tried hard enough. For some of us it’s an impossibly high standard to measure up to.

I’m not here to be an inspiration. I’m not someone that’s going to miraculously be better and totally stable for the rest of my life. It’s not realistic. I can’t pretend that everything is going to be ok. I can’t pretend to be in some form of recovery, because I’m not, and I don’t think I ever will be. I’m managing bipolar and psychosis and it will also be a part of who I am.  I don’t intend to recover from bipolar and psychosis, because it’s just not an option. This is an illness that I will have for life. It’s severe and chronic and I’ve had to accept that. It’s part of my life. I can be miserable and hate the fact, or I can learn about it, start to understand it and find ways to manage it.

 

What Nobody Tells You About Mania

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As I’ve said before there is more to mania than just feeling good. It’s a complicated symptom of bipolar. When someone asks me “What’s it like to be manic?” I have to really think about it. There’s so much to it, I can’t sum it up in a couple of sentences. It goes through many stages, with different symptoms appearing, disappearing and resurfacing again.

One of the major parts of mania for me is anger. I’m not talking about irritability, like you can have with depression. What I mean is real, intense anger. My partner and I have coined the phrase ‘KatieRage’TM to describe these moments. I turn into an entirely different person, I’m completely unrecognisable.

It’s like a constant itch I can’t scratch. I can’t seem to find any relief from the anger I’m feeling.

I have a scar on my right knuckle from when I punched the wall. I hit it so hard, I left a dent in the bedroom wall. You’d think something unbelievably dramatic had happened to make me do that wouldn’t you? In reality I’d found out I didn’t get the day off work, so I couldn’t go to a party. That’s it. I get stuck in a loop of anger. One little thing will trigger it and then, I can’t move on from it. It just keeps going around and around in my head, until I found an outlet for it.

Delusional thinking can be another aspect of mania. I’ll believe I’m the most important person in the room. Actually I’ll know I’m the smartest, most valuable person on the planet. Anyone that disagrees with me is wrong. Anyone that calls me out is an idiot. Even when the right answer is staring me in the face I won’t believe it. I have to be right, because nothing else would make sense.

The anger leaks through to my delusional thinking. Because I feel that I can do no wrong, when I see people doing something differently to me, or not listening to my opinions, it makes me extremely angry. I feel like there is a tremendous pressure in my head that can only be released by me screaming, shouting, ranting and raving.

Along with delusional thinking, people with mania may also see, hear or feel things that aren’t really there. I’ll hear voices that are sometimes comforting, but mostly they drive my manic behaviours. They push me to take risks and do things I wouldn’t normally do.

Overspending. Not “Whoops I lost track of how much I spent on Saturday night” I mean serious, crippling debt. Making the choice between the gas meter and food, sort of debt. Bailiffs at the door kind of debt.

It’s a compulsion I can’t control. I know I don’t have enough money to cover my spending, but I don’t think about the consequences. Mania makes me believe that everything will sort itself out, that it doesn’t matter.

As a young person with bipolar, I was free to collect as many credit and store cards as I wanted. At one point I had four credit cards and three store cards, all spent to their credit limit. I’m still paying them off years later. I got to the point when I would regularly go beyond my overdraft limit and had literally nothing to fall back on.

Mania varies for everyone that experiences it, but for each individual it’s a complex set of symptoms. Listen to people’s experiences of mania and ask how you can support them. Whether it’s keeping an eye on significant changes to their behaviour, or their spending, small gestures can make a positive impact.

 

 

“Why Are You Walking On Eggshells?” How I Began To Recognise Manic Anger

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I saw my parents today. They came over to my flat and I made them coffee. We had a catch up and giggled at my Mum attempting to play video games.

We moved on to how well I’ve been coping recently. They told me they were so happy to see me stable and well. Then they told me what they didn’t miss about me being ill. The mania and what it often leads to; anger. They don’t hold back my Mum and Dad. They tell me how it is. Although, it’s been a long road to get to this point.

My family and partner used to creep around me when I was manic. They didn’t want to say anything that would make me lose my temper and really, just about everything did.

I used to be fully aware that everyone around me was scared to call me out on my behaviour. The problem when I’m manic is that I’m delusional and believe that whatever I do and say is right and justified. No one can tell me otherwise. Knowing they were too worried to say anything to me riled me up even more. It made me feel like a freak, someone that needed fixing and I hated that idea.

I’ve learnt to recognise it. Here’s how:

One of the main ways I’ve done it is making sure my family and friends call me out on my behaviour. I don’t mean confront me, or make negative statements. They tell me my anger or behaviour isn’t normal for me (normal for me, because there’s no such thing as normal) and I should take a step back and think about how my actions are hurting others.

The problem with this is when I’m manic I can’t be reasoned with. Everyone is wrong. There’s nothing wrong with me. I can’t see through my behaviour. There’s no voice telling me to stop or behave. No usual voice of reason we all have that says,

“Should you really do/say that?”

I’ve learnt to rely on my partner and family to be that voice of reason.

When I’m in the midst of bipolar anger there’s no point telling me to calm down. Or to explain anything really, it just doesn’t get through to me. So I ask people to tell me when I’m more stable how out of control I was. Then I’m in the mindset to say I’m sorry and reflect.

They know I need help at those points. I won’t realise it, but my loved ones do. A support system is so important to have. They keep me grounded in reality when otherwise my world would unravel.

Writing Is My Therapy

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Writing has always been an important part of my life. I remember filling notebook after notebook with reams of ideas and stories as a kid. Writing was my escape. As I got older I continued to write and it became a release from the depression that had suddenly manifested into my life. I even decided to go to University to study creative writing.

As an adult, I’ve had many struggles with mental illness. The symptoms of bipolar ran my life and my attempts to control the highs and lows were in vain.

I began to write, but this time, it began as a journal. I’d never kept a diary before. I just started to write, and soon everything was laid out. How much I’d been struggling, how guilty, helpless and ashamed I felt. it helped me immensely. I felt a release to see all these thoughts that I’d bottled up committed to paper.

Writing became my own private therapy.

I’ve had therapy, CBT (Cognitive Behavioural Therapy) a couple of times. The first time round it really helped. I went to the sessions to help me deal with panic attacks. I learnt some important techniques and a new way of thinking about the experience. I use them to help me deal with nighttime panic attacks . The panic attacks subsided afterwards, and now I very rarely have one, maybe only once a year.

My second experience of CBT was not so positive. It wasn’t long after I’d been diagnosed with bipolar disorder. I was offered group therapy and wanting to know more about the condition, and share experiences with others, I said yes. The course didn’t help. It was basic, and didn’t teach me anything new about the condition. There was never any time to share our experiences. I still felt alone.

I continued to write, but now I wanted to share what I’d written. I started a blog, this blog. Although now I don’t always write about my personal experiences, writing still helps me.

It gives me focus and a sense of purpose when I’m depressed. It helps me to stay calm and concentrate when I’m manic. It drowns out the voices and helps me process the experience when I’m psychotic.

I’m not in therapy at moment. A lack of therapeutic styles on offer from the NHS means I’d have to seek private therapy. I can’t afford to do that, so my option is talking therapies; that didn’t go well last time

So for now writing will have to be my therapy. I’m sort of ok with that. I’m annoyed that I can’t access actual therapy, but at least I’ve found something in my life that helps me.

 

What It’s Like To Have A Mixed Episode Of Bipolar

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A couple of weeks ago I had what’s called a mixed episode of bipolar disorder. What this means is that I was experiencing mania (the highs) and depression in very short succession, to the point that I felt both at the same time. In this post I wanted to write an account of what it felt like at the time, to hopefully shed some light on this difficult to understand symptom of bipolar.

I’m sitting at a table outside a restaurant, waiting to be served. I’m with my husband who is attempting to start a conversation. The air is warm and the sun is out and canal boats are drifting along the canal next to where we’re sitting. It should be an idyllic setting, leaving me feeling happy and contented, but I’m not. My head is abuzz with uncontrollable thoughts. The world around me feels very surreal right now, like I’m seeing it through a kaleidoscope. The images keep flicking backwards and forwards, never staying still. I’m restless and on edge, my whole body feels on high alert. Everything and everyone is irritating me. The chair I’m sitting on is way too uncomfortable. My husband is talking and right now I can’t stand his voice. The laughter from the table behind us is grating on me and I feel like screaming until my throat is hoarse,

“SHUT THE FUCK UP!”

My head is full of pressure, it literally hurts from all the thoughts racing in my mind. It feels like my head is going to explode. I can feel my hands and body trembling. It feels like I’m on the edge of a cliff  with a safety net below. I know I need to jump and if I do they’ll be a release from the ceaseless, building pressure. I can’t make myself jump. It’s like my legs are stuck and I can’t move forward.

Now, suddenly, I have an overwhelming feeling of dread. It feels like all the energy has been drained from my body and I feel utterly useless and completely broken. The pressure in my head is still there, and my mind is still racing away. The thoughts are negative and intrusive, telling me I’m worthless,  pathetic and don’t deserve to live. Ten minutes later our food has arrived and I can’t stop talking. My head is full of thoughts, mostly gibberish that I can’t decipher. I’m laughing but I feel like crying at the same time. I don’t like this feeling. I feel like I’m losing grip on who I am and the world around me. i can’t concentrate because I’m trying so hard to grip hold of some type of stability.

I feel like I’m at a crossroads and which ever way I go something terrible is going to happen, but I don’t know what. I maybe at the crossroads but some other force beyond my power is going to choose the direction I turn. Will it be mania? Or depression? Its a terrifying feeling to have seemingly no control over your own mind.

This had been going on all weekend and now it was Monday and I was mentally exhausted. We went home and I cried on the sofa, not knowing what to do with myself, as my body and mind continued to hum along with a relentless energy.

The mixed episode broke, eventually, but not to my relief. I found myself severely depressed, a depression I’m still trying to ride out. I hope my story helps others going through these experiences and shows people what it’s really like when someone says they’re in a mixed episode. if you want to help someone, listen and above all be patient with them.

 

The Problem With The Term ‘Mental Health’

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I’ve lost my connection to the term ‘Mental Health.’ It means different things to different people, and that’s a problem. I consider myself a mental health blogger, but I’m thinking of changing that. To be honest I’m a mental illness blogger. I’ll explain why.

For some people, myself included, mental health equals mental illness. It’s a term we use to write about our illnesses, to explain and engage with others about what we go through day to day. For others, mental health covers everything to do with the way we think and act. People proclaim,

“We all have mental health!” Which is true, and I have no problem with people discussing their individual experiences. My problem is that vital voices are being drowned out. ‘Mental Health’ has become this huge umbrella of different meanings. The ideas that are more accessible and easier to digest for the general public will undoubtedly receive more attention.

It feels that mental health is becoming more and more synonymous with wellbeing, mindfulness and self care. Again, all great if you struggle occasionally with the stresses of life or have mild mental illness. It’s not for everyone and it certainly isn’t a magic cure. I’m growing more and more concerned that these subjects will shift the idea of what mental illness is, and trivialise it. I don’t need to read anymore articles about mindfulness, I get it, I know what it’s about. I don’t want people to start preaching to me about how if I practised self care and had a hot bubble bath with some aromatherapy candles, I could break out of a manic episode. No, what would do that is a review of my medication and the support of my psychiatrist.

We need voices that talk about bipolar, psychosis, personality disorders and schizophrenia. Voices that have the right platform and are listened to, because these aren’t easy subjects to open up about. It feels terrifying to begin, the real fear of being judged and ridiculed, stigmatised for something you have very little control over. By using the term mental health, these important discussions are being lumped in with articles about adult colouring books and how to meditate. Self help articles in my opinion should not be compared with articles educating about severe mental illness. There is a vast difference in the two.

As an example I recently had a conversation with a friend of a friend. He asked about blogging and I replied that I was a mental health blogger. He instantly started talking to me about how he is sometimes anxious whilst travelling and how he’s managed it through thinking positively. That’s great and I was genuinely pleased for him. When I started talking about what I blog about and how I’ve recently started a series about psychosis I could see his eyes widen. He quickly changed the subject. This is the problem. Anything beyond being anxious on the train was too much for him to handle. By his response, that was what he was expecting and it was because I used the term ‘mental health.’ If I’d said I wrote about mental illness, I think his expectations would have been different.

We need conversations about the underfunding of mental health services in the NHS and to create that link to the general public of why so many people are struggling and ending their lives. We need conversations about how those with severe mental illness are not all dangerous, but are more likely to be the victims of crime. We need conversations about how poverty, housing, being an ethnic minority or part of the LGBT community can have a negative impact on mental health.

Maybe it’s time for a new term, or a shift in how people use them. If you’re writing about general well being, say that. If you’re writing about mental illness, then say that too. Don’t jumble up the two, it’s causing more harm than good.

A Life Lived Vividly Series – The Voices Are My Friends; Mania And Psychosis

A Life Lived Vividly

 

Not everyone realizes that some sufferers of Bipolar Disorder also have psychotic symptoms. These could include delusions, auditory and visual hallucinations. For me, I hear voices. This happens during periods of extreme moods, so when I’m manic or severely depressed. 

During mania, the voices can be comforting. I have many ideas racing through my head during a manic phase, and the voices I hear add to the jumble. They give me ideas and fill me with confidence that then elevates my mood further. I often speak out loud to them and they reply very audibly, as if they were in the room with me. I remember instances when I’d been in my bedroom alone and I would run downstairs extremely excited, like I had just spoken to a friend on the telephone who I hadn’t seen for a while. I’ve had conversations with people where I’ve become distracted or ‘zoned out’ because there is a voice speaking to me. Sometimes I might make a joke that no one understands but myself and the voices, or laughed out loud for seemingly no reason. Over the years the voices have become my friends and I think I would miss them if they were gone. If my mood becomes very elevated I know they will be there and I look forward to hearing them.

When I’m severely depressed I have heard screaming and shouting in my head. It’s often incoherent with a few words and sentences scattered about and all of it incredibly loud. The loudness of it all makes it an extremely intense experience, like being at the cinema with the sound booming all around you. Sometimes if feels directed at me and at other times the shouting feels intrusive, like somebody is ranting and raving at nothing or no one in particular. The worst part of this is not knowing how long it will go on for, and knowing I can’t escape it. It often happens when I’m in bed and can’t sleep, but it has happened during the day too. I’m sat or lying in the dark when the screaming starts. The screaming is constant and then there is a voice shouting “Everyone hates you”, “You’re worthless”. It frightens me immensely. I’ve found myself covering my ears to escape the noise. I’ve curled into a ball and cried on the floor or in bed as the screaming continues. Very occasionally, I hear tapping. It usually happens when I’m extremely irritable, which can happen when I’m depressed or manic. 

When I was younger I thought having someone who talked to me in my head was normal. I know people have conversations out loud to think through a problem, but the difference is they know exactly what the next sentence is going to be. As I’ve got older I’ve realised that my experiences are not the same. Now I find it embarrassing and I don’t like discussing it with anyone.

I have been caught out a couple of times; I was on a train with my partner when I answered a question out loud. He said to me looking confused “Who are you talking to?” I remember turning red and saying “Oh sorry, I thought you asked me a question.” and left it at that. I also felt that if I told anyone about the screaming and shouting they would think I was disturbed and crazy. I’ve tried a few times to reach out to people but I can never seem to articulate exactly how it feels, or even to admit to the problem. I find writing and blogging to be therapeutic and it’s an easier way to explain how I feel. 

At the moment I am taking Lamotrigine a mood stabilizer, and Aripiprazole, an anti psychotic. They have helped balance my moods, giving me stability. It’s not perfect, and I still have manic and depressed phases where I sometimes hear voices. I’m learning more about how to deal with these episodes, such as trying to rationalise what is happening and ignoring it when I feel able to.

Managing Bipolar Disorder can be daunting at first, but there are many tools you can utilise:

  • Find support as soon as possible.  At appointments with your Doctor, try to be confident and assertive, to ensure you receive the support you need. This can be incredibly difficult when you’re ill, so take a family member or close friend with you who understands your illness. 
  • If you have psychotic symptoms, it’s important to be able to stabilize your moods. When stable, the symptoms should subside. 
  • Become an expert on your illness. The more you know, the more you will understand and find solutions to combat Bipolar. 
  • Find a Bipolar support group near you, or online. Hearing other people’s experiences and struggles, and how they have overcome them can be inspiring and informative. They are often a great resource to find advice. 

 

My Hearing Voices Journal Entry 2

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Yesterday I had a an episode of psychosis. It came in the form of auditory hallucinations, as it does with me. I’ve journaled my experiences before in the post My Hearing Voices Journal and felt as I sat in bed last night trying to sleep, but too anxious to do so, it was time to journal my feelings once again. It started as I finished my shift at work. I could hear a murmuring coming from all around me. These are my initial thoughts on the experience.

Hearing murmurs is something I experience often with psychosis. It’s frustrating more than anything. It’s like sitting in a busy restaurant or bar. As I’m a people watcher and yes, very nosy, I like to listen to snippets of people’s conversations. I find it fascinating listening to how people interact with one another. These murmurs are like not quite catching the conversation of the people at the table next to you. even with your best efforts to strain to hear what is being said. All you can hear is a low murmur.

It’s a constant background noise, like the hiss of an untuned radio, but I can’t turn it off or find another station. I’m stuck with the same incessant, nonsense sounds. The noise/murmuring follows me; it doesn’t dissipate if I move. That’s how I know it isn’t real,  that it isn’t coming from an outside source, but from inside my own mind. Trying to ‘turn off’ the noise makes me feel like I’m losing my mind. I’ll try to convince myself it isn’t a hallucination, pacing back and forth with more and more urgency looking for the source of the sounds. I begin to talk to myself, to firstly come up with a logical conclusion and secondly to calm down. It doesn’t work and I can feel the frustration rising. Why is this happening to me? Is it too much to ask for to just be normal, whatever that is. The noise after an hour or so, disappears, without my noticing. I’d grown accustomed to it and over the years during an episode I’ve learnt to carry on as normal when I’m out in public as much as I can.

Now it’s gone I feel on edge. I know I’ll feel this way for the next few days. What if a more sinister voice presents itself? What if it happens when I’m alone and there’s no one to comfort me and help me through it?

I’ve gone to bed, but I can’t sleep. I feel too emotional to sleep. I could burst into tears at any moment. I can feel my heart beating in my chest. Sharp pains streak across my chest, which suggests the beginning of a panic attack. All of this because I heard some murmuring. Psychosis fucks with your head in so many ways. It’s not just the actual experience, but the anxiety and the real fear that follows. I feel tense and uneasy like something or someone unknown is watching me, ready to shout and attack. I don’t like the dark. I was never afraid of the dark when I was younger, in fact I was a pretty fearless child. When you begin to hear auditory hallucinations, especially when you hear that first voice come out of nowhere in pitch darkness it is unbelievably terrifying. The fear I feel, the total vulnerability leaves me in a state of shock. Now I’m afraid of the dark. What if, just if, that voice is real this time. That there really is someone in my room whispering in my ear “I see you.” I will hear voices from what feels like all around me and for all I know they are very real. Surrounded by a wall of voices it’s easy to start to imagine what they look like. Eyes open, they start to adjust to the low light and play tricks on me. That shadow in the corner starts to form into the shape of a person, towering over where I lay.

All of this is circling my mind, so how could I possibly sleep? I know what I need to do. I need to get up out of bed and out into the light.

As I’ve made clear before in the post I’ll Keep Talking About Psychosis Whether It’s Relatable Or Not I won’t stop writing about my experiences of auditory hallucinations. It’s cathartic and journalling my experiences helps me make sense of them. If you know someone who is struggling with hearing voices, my post How to Help Someone When They’re Hearing Voices could be helpful. There’s also plenty of information out there, and I personally found MIND’s website to be full of helpful information.

Stress and Mental Illness: Are They One And The Same?

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In my previous post I discussed Is Stress A Trigger For Mental Illness? In this post I’m hoping to highlight how stress and severe mental illness are not one and the same.

We all go through periods of stress, where we feel run down, overwhelmed and generally feel like we need a reset button for life. It does have an impact on our mental health, but it isn’t a mental illness.

I have worked with colleagues that have misinterpreted my mental illness as stress, or the more important distinction that I couldn’t handle stress. Comments such as,

“Well, some of us can deal with stress better than others.” and “At least I’m here all the time unlike some people who are always signed off with stress.” Stress was a trigger for my mental illness, bipolar, and yes, I did have to take time off work because of it. It didn’t mean I couldn’t handle stress, it meant I had a severe mental illness that had not been properly diagnosed, or been provided with the proper treatment.

How we effectively deal with stress can be managed through self care techniques and adapting our work/life balance. If someone starts to show signs of mild to moderate depression or anxiety they can seek help such as CBT or other forms of therapy for a short period. Severe mental illness on the other hand, needs much greater intervention. A psychiatrist, hospital admissions, long term medication and therapy. Significant lifestyle changes such as cutting out alcohol may be not advised, but desperately needed. Can you see the difference? Stress in our lives can be managed, if we want to do so; mental illness cannot. Your lifestyle is a choice, mental illness is never chosen. I think it’s important here to highlight one glaringly obvious cause of stress; poverty. This can’t be eradicated by a simple change in lifestyle by the individual. It’s society at large that needs to work towards this. Is there a difference between the stresses of the upper and middle classes and those living in poverty? Yes, I believe there is. Are those in poverty more likely to have a severe mental illness? Again yes. According to the Mental health Foundation,

“Poverty increases the risk of mental health problems and can be both a casual factor and a consequence of mental ill health. Mental health is shaped by the wide-ranging characteristics (including inequalities) of the social, economic and physical environments in which people live.”

Many people with severe mental illnesses also fall into poverty because of being unable to work. This exacerbates already difficult to manage conditions and leaves the individual extremely vulnerable to self medicating, self harm and suicide.

When many people speak up about mental illness, often it’s from their own experiences. That’s fine, but when it’s highlighting stress and lumping it in as a mental health condition, it devalues the impact of severe mental illness. Bipolar, BPD, PTSD, Schizophrenia to name a few are long term, life altering conditions that need psychiatric intervention and expertise to assess, treat and manage. Stress is damaging, physically and mentally I’m not denying that. I feel though that there needs to be more room for conversations surrounding severe mental illness. Too much noise is made around stress, and mild to moderate mental illness. Already sufferers feel marginalised and isolated in society and need more spaces where their voices can be heard.