A Life Lived Vividly Series – Psychotic Doesn’t Equal Dangerous

A Life Lived Vividly

Evil

Nasty

Freak

Bitch

Jealous

Dangerous

These are all words that people relate to psychosis. We all need to stop using it as a derogatory term. So often I hear people described as psychotic when they’re being cruel, or acting unpredictably. Recently I saw someone on twitter describing an ex as a ‘psychotic nazi.’ Politicians, especially a certain orange American one are constantly being described as psychotic. It’s lazy and ignorant to use a mental illness to negatively describe someone.

Psychosis is a mental health condition that makes you feel;

Scared

Confused

Vulnerable

Alone

I have psychosis. I hear things that aren’t really there. I’m a danger to myself when I hear voices. Those living with hallucinations and delusions are some of the most vulnerable in society. Feeling detached from reality and not being sure what you’re seeing or hearing is real can be terrifying.

Once I’d just turned the lights off and got into bed. Out of nowhere, I heard a voice, as if someone was speaking right into my ear. The voice whispered in a slow, assured tone,

“I see you.” I sat straight up in bed, my heart thudding in my chest. I couldn’t move, I felt paralysed with fear. I couldn’t sleep for the rest of the night. I couldn’t calm down and kept hearing that voice whisper in my ear. Even now when someone says that phrase I’m transported back to that night and I feel deeply uncomfortable.

People with psychosis are far more likely to hurt themselves than others. According to Time To Change   

‘Over a third of the public think people with a mental health problem are likely to be violent.’

Psychosis doesn’t make you a ‘psycho’. It doesn’t make you a freak. It doesn’t mean you’re scary. It doesn’t mean you’re dangerous.

How do you think it makes those feel that have psychosis to keep hearing the word used to describe murderers and violent criminals? Hearing it in tag lines for horror films and descriptions for Halloween costumes? It hurts. It makes a tiny piece of you feel that maybe you’re actually evil and dangerous, because you’ve heard it so many times.

I’m in a place now where I understand my condition, and I’m learning to manage it. It wasn’t always this way and for me and many others like me I was terrified of opening up about my experiences for years.

Too many people mix up the meaning of psychosis with other disorders. They use the term psychopath to describe those with psychosis. They aren’t the same thing. Psychosis means a person will hear, see or feel things that aren’t really there, or a combination of these. It doesn’t mean you’re going to go hurt anyone.

We’re ill not dangerous. We deserve compassion, understanding and to be listened to without judgement. Please think about the language you use and how harmful it can be. Your words can cause more harm than you realise. They could cause someone to remain silent and not look for help that they desperately need.

The Problem With “I’m Fine!” When Really We’re Not

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We all do it. We say this even when we’re not ok. Someone casually asks,

“Hey, how are you?” and we say,

“I’m fine!” and that’s it.

Why do we do this?

To be polite. We don’t want to make the other person feel awkward or embarrassed. Sometimes it’s something people ask how you are as an ice breaker, to get a conversation moving. We believe they aren’t really expecting a detailed response, because they have an ulterior motive for talking to us.

It’s a knee jerk reaction. We say it without even thinking. We’ve said it hundreds of times before and now it’s become second nature. Even if we want to say no, I’m not fine, we’ve said it already and feel like we can’t backtrack.

We feel rushed. Life often feels like it’s rushing by, and our days feel full to the brim. It’s the same with our conversations. Everyone is in such a hurry to get to their point, to say what needs to be said, they don’t stop and take time to really talk. But most importantly, we don’t always feel like we will be listened to.

We’re conditioned to say it. Everyone reacts the same way to the same question. It’s almost seen as improper to reply in any other way. We’ve grown up hearing it. Our parents said it as we were growing up. Our friends say it. Our colleagues say it. We overhear it in public. Because we’ve heard it again and again, by so many different people, there seems like there’s no other reply to make.

All of these reasons are there for one reason only. The F word; Fear

We fear what someone will think if we’re honest. We’re worried about the reaction we’ll get. The stigma attached to feeling unwell mentally means we hide our true feelings. We’re scared that the person who asked the question will not take us seriously, will judge us, will think we’re weak, or simply not care. In that split second these thoughts circle our minds and we answer how we always do.

I don’t want people to feel guilty for saying “I’m fine.” I don’t want mentally unwell people to feel the weight of having to change their behaviour. It’s up to both sides to change the course of the conversation.

Asking how someone is isn’t a simple question. No one is just ‘fine.’ So we shouldn’t expect that answer and should answer that question honestly and openly. I’ve spoken on the blog about self honesty before, which is part of what we need to do to be honest with others.

“Actually I’m not ok.”

“Honestly I’m struggling at the moment.”

“Life’s tough right now.”

When you’re asking how someone is, really mean it. Sit down with them, over a drink or a meal so they feel that you’re present in the conversation. Build up to it. Don’t just blurt out “How are you?” If you’ve noticed a change in them recently start with that.

“I’ve noticed you’ve been quieter recently”

“I’ve been a bit worried about you”

“I thought it would be good to have a catch up.”

Time To Change are running a simple yet powerful campaign encouraging people to ask twice. Asking someone how they are and if they respond with they’re ok, ask them again. It shows you actually want to have a meaningful conversation with them. You’re not rushing them, you’re not waiting for your turn to speak.

Have that conversation, be honest and frank about how you’re feeling. For both sides it will make a difference.

 

 

 

 

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.

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.

Talking About Mental Health Is Vital, But It’s Not Enough

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I often find myself saying,

“Talking about mental health is so important.” and “Just be open and honest and you’ll feel so much better!” I have done so many times on this blog.

But in my heart, I know it’s not enough. So many of us are being let down again and again. Services are spread thin and desperately underfunded. Recent reports that young people are being denied care until they’re at crisis point, and receiving little to no help unless they have attempted suicide, is disgraceful.

We do need to talk about mental health. Talking can save lives, but our friends and family are not experts. There is only so much that they can do to help and often unfortunately, it’s not enough. It puts a strain on our relationships which can further the isolation and hopelessness of our situation. I’m lucky enough to have a supportive family and group of friends. I do what I’ve been told helps; to talk. I’ve been talking and reaching out for years, but it’s not always enough.

I’ve sought professional help when I’ve contemplated suicide. I was given a number for the crisis team if ever I needed them. I was told they were available 24 hours a day and would help. I’ve had very different experiences to what I was told I would have. After the phone call I wished I’d never picked up the phone. Firstly, I was given the wrong extension number, and then when I finally got through to speak to someone they simply said,

“Carry on taking your medication and you’ll start to feel better soon.” I talk more about this in the post My Experiences of Mental Health Crises Care

GP’s need more training to identify severe mental illnesses and provide the correct referrals. I like many others with bipolar were misdiagnosed countless times, and it took 12 years for me to be diagnosed. Therapy needs to be far more accessible and not just a one size fits all solution on the NHS. Talking therapies is not always provided by a trained psychologist. In my experience it was a counsellor, who had been trained in basic techniques in order to provide talking therapies. It wasn’t enough and he wasn’t prepared to deal with the symptoms I was displaying. Specialist, long term therapy is still out of reach for many. The price tag attached is as if it’s marketed as a luxury rather than a necessity for those with severe mental illness.

Mental health has had budget increases, but they’re far smaller than budgets for physical health. It’s been five years since the government pledged to create “parity of esteem” between NHS mental and physical health services. People are suffering and we demand better. We need to recognise the role of poverty and discrimination in determining access to formal mental health services. We need to address the reasons why so many people from ethnic minorities, the LGBT+ community and those with disabilities suffer from mental ill health. There are still disgustingly long waiting lists. Having an assessment due in eighteen months when you’re suicidal is not only callous, but negligent. Still we’re seeing mental health services strained to their limits. Still people are told,

“You’re not ill enough” and “Come back when you’ve attempted suicide” Change is desperately needed right now.

In the end investment, not rhetoric, is needed to save lives.

 

When Speaking About Mental Health, Language Matters

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Why does language matter? What is the difference between describing someone as ‘Is Bipolar’ or ‘Has Bipolar’?

Firstly, language is a powerful tool of expression. We tell stories with language and these stories conjure up images and ideas in the listener. We can impact the way people think or perceive the world around them with the language we use. Language can change people’s opinions of others and more importantly when it comes to mental health, themselves.

When we say someone ‘is’ their mental health diagnosis people immediately jump to their preconceived notion of the illness. They see what their experience of it is; what they have heard and seen in the media. It causes us to stereotype without really realising that’s what we’re doing. When someone says to me I ‘am’ bipolar it makes me feel that this diagnosis defines me. That my personality and the essence of what makes me who I am has been dwindled down to a mental illness. All that I am is bipolar, and this is all anyone ever sees. It impacts my self esteem in a significant way. It is limiting and dehumanising. It takes away our individuality to be spoken about in this way. Although I believe labels are important and a tool to receive treatment and provides answers to behaviours, being seen as just a label can be damaging.

When you say that someone ‘has’ a mental illness it has a completely different impact. I feel like I can be seen as a person and individual. It shows to me that the person understands mental illness and how it affects me. They understand that I might be struggling and need support.

There is still a huge discrepency between how we use language for physical and mental illness. Whereas physical illness sufferers are seen as fighters, those with mental illnesses are seen as weak. If you have a physical illness you’re often seen as blameless, it’s ‘just one of those things.’ With mental illness you’re seen as a failure and ‘you could be doing more to help yourself.’ Mental illnesses are biological, we have a genetic susceptibility and they are often coupled with environmental factors. It isn’t a weakness or failure on our part, but the misuse of language continues to contribute to the stigma.

It’s important that we use language delicately and with care when discussing mental illness. Think about how much impact your words have and how they can shape a person’s self worth.

 

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.

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.

 

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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Mental Illness and The Sometimes I Can, Sometimes I Can’t, High/Low Functioning Distinction

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The first time I heard the terms ‘high functioning’ and ‘low functioning’ was when I first applied for benefits a few years ago. This is the idea that although you have a disability, such as a mental illness, you’re either able or not able to look after yourself and live your daily life. I had never looked at my illness in this way before. My illness fluctuates weekly, sometimes even daily, and this has a direct effect on what my capabilities are. I can’t predict when I’m going to be low functioning, as much as anyone doesn’t know when they are going to have an accident and break their leg. The ESA and PIP system is based on a misunderstanding of what it means to be disabled. This callous lack of an attempt to understand is costing lives. The major problem here is how people are distinguished between high functioning and low functioning. The reality is for many disabled people, functioning changes across different days and across different activities.

I have bipolar. Some days I am high functioning. I can write, go out and see friends, cook, look after myself and do all the things that I want to be able to do. On other days I am low functioning. I may be manic where I’m angry and irrational, acting impulsively and a danger to myself. I may be depressed and unable to get out of bed, unable to get dressed, and suicidal. At all of these times I am ill, even if I seem as high functioning.

Another problem with the distinction between high/low functioning is everyone has areas of life they function better in. Some are more academic, some are more creative, others are better at socialising. It’s the same for people with mental health problems. Some people have a job, but their home life suffers. They can’t go out and socialise or clean the house. Other people might find socialising easy and not stressful but find employment too much to handle and exhausting.

Right now, I can’t work. The stress related to it and the physical and mental exertion triggers me into a manic or depressive episode. This has been the case for years. I tried to carry on working but the toll it took on my mental health left me repeatedly off sick and left me unable to do anything apart from work and sleep.  On the other hand I can socialise without any problems. I have never found going out with my partner for a drink or seeing friends as stressful. People will see me on a night out and have no idea that I have a a serious mental illness.

Disabilities take their toll, but it manifests in so many ways. Functioning varies across time, situations and people. There is no low functioning or high functioning, there is simply people. People who are struggling everyday to live with and manage mental illness. Having to distinguish this at a PIP or ESA assessment is deeply frustrating and is often misunderstood by the assessor. They only see that you are capable of cooking a meal for yourself, or taking a journey on public transport on your own. They don’t take into account that these ‘good’ days can be few and far between. Months can go by before you feel well enough to complete simple tasks that people take for granted.

It’s not just the benefits system that uses this against the disabled. Many workplaces and individuals also only see what you can do, and not what’s realistic. I have to manage my mental illness, and that means I often have to say no. No I can’t work eight shifts in a row, no I can’t meet up this weekend. It can cause a strain on relationships and adds to the stress already related to being ill.

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