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

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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. 

 

A Life Lived Vividly Series – I Can Do Anything! Delusional Thinking And Me

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I live with bipolar disorder, but also have symptoms of psychosis, which includes delusional thinking. I describe what delusions are in the post A Life Lived Vividly Series – What Is Psychosis?

When I’m manic I experience delusions. I think I can do anything. I have what’s called delusions of grandeur, where I believe I’m better than everyone else. I will think that I can do no wrong, that I’m always the smartest person in the room. Actually it’s more than that. I’ll truly believe that only I have all the answers, that I’m the smartest person that ever existed. This type of thinking causes me to react to people irrationally and often aggressively.

“How dare they think they’re better than me!” I will say to myself.

“How can they possibly question me when I have all the answers!”

“Everyone around me is ignorant and stupid. They should all listen to me.”

This isn’t arrogance, or an inflated ego. I don’t believe these things about myself most of the time. In fact, I’m pretty insecure. I’ve written an example of this type of thinking in the post A Story of Self Sabotage

What mania makes me is incredibly confident. Sometimes this confidence turns into delusion. I believe that everything I am creating is like gold dust, and must be seen and shared. I have written reams and reams of notes of ideas for a book, at the time believing them to be the best ideas I’ve ever had. When I look back on them at a later time all I see is scribbled nonsense, a stream of consciousness, misspelled and a jumble of words. It’s like the pages of these notebooks are a reflection of my manic mind. My mind is constantly darting from one idea to another, and never finishing my original point. My mind is distracted by the smallest spark of an idea, and every thought that comes to mind grips my attention. I show everyone what I’ve been working on, with a pride that verges on narcissism. 

Other times when I’m manic, the delusions I encounter put me in danger. A recurring belief is that I can stop traffic. I believe that if I step into a road, every car, bus and lorry will immediately stop and I can walk safely across. I also think that even if this power  becomes faulty in some way, I will not be hurt. I don’t believe there is some greater power watching over me, but instead that I’m so important that I have become invincible. I live in Reading, a busy town with it’s fair share of traffic, so you can imagine the danger I have put myself through. I’ve had many near misses as I’ve walked along busy roads and have stepped out with no fear and no thought for the repercussions. I’ve been run over twice, and had a near miss with a double decker bus. On both occasions of being knocked over, I was extremely lucky not to be seriously hurt and came away with just a few cuts and bruises. Unfortunately, not being hurt on both occasions fuelled my belief that I was invincible.

Everyone experiences delusions in a different way, and no two experiences are the same.  I have learnt to recognise when I’m beginning to show signs of mania, that I’ve written about in the post The Warning Signs of a Manic Episode

Even though I can recognise what’s happening, I’m not always able to stop it and I still have episodes of mania that can lead to me experiencing delusions. Luckily I have a supportive husband and family that can keep a close eye on me and stop me from putting myself in dangerous situations.

Any questions about delusions or want to share your own experience? Then comment below!

Don’t let the Worry of Being Ill Ruin A Holiday

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Living with mental illness is tricky. It’s a sneaky bastard that creeps up on you when you least expect it. Often when we relax, mental illness barges its way into our lives and tries to take over. A prime example of this is when we go on holiday. We can’t always be 100% sure we will be well when we plan and book a holiday, it’s a risk anyone with mental illness takes. We can plan meticulously but still have a mental health crises. Or like me, forget something vital to staying mentally well.

Last year my husband and I went on holiday to Devon. It started off well, with us going to the beach and going for long walks in the woods around where we were staying. We’d relaxed and spent long evenings drinking, chatting and enjoying each others company. Three days in, I started feeling strange. I felt rundown, almost like I was coming down with the flu. I realised I’d run out of medication. Not only that, but it dawned on me I hadn’t taken medication at all since we’d been in Devon.

Shit, shit, shit was my initial reaction. The damage had already been done, and I knew by the time I’d organised emergency meds the holiday would be pretty much over. I had the shakes, a temperature, I felt nauseous constantly and felt dizzy and exhausted. I spent the rest of our trip in bed or under a blanket on the sofa, far too ill to do anything else. I felt incredibly guilty, like I’d let down my partner and ruined our time away together. It was our only holiday away, our only week just us together and supposed to be a week where we could totally relax.

This was when it all went wrong, and I let my anxieties about not enjoying my holiday ruin it for me. I have coped better, I’ve planned better and I was annoyed at myself. Being mentally unwell on holiday doesn’t mean it’s totally ruined. If you plan well and go in with a realistic outlook, you can still have a great time.

A few years ago we went to Croatia for a week away. We were staying near Dubrovnik, on a tiny island called Kolocep. I had been struggling with a persistent depressive mood leading up to the holiday. I was nervous, on edge. What if i was too ill to do anything I’d planned? Before leaving, I told myself so what if I’m ill? I’m there ultimately to relax. If I have a difficult day there’s nothing wrong with taking a break from our plans. I hadn’t scheduled to go somewhere or activities every single day. There were days when I wanted to just lay on the beach or sit by the pool and read. Trips could be moved. Personally I like to plan a trip myself, rather than be led by a tour guide. This gives me the freedom to see how I feel each morning and decide what we’re going to do there and then.

It ended up being one of the most memorable holidays I’ve ever been on. I didn’t allow the expectation that I must be on top form and enjoying myself every single minute of every day ruin my time away. I was depressed, but I still managed to explore the old city of Dubrovnik, go kayaking and discover hidden coves around the islands. I accepted the fact that I would have bad days, and there were a couple of afternoons when I went back to my room and went to bed or simply just sat and had much needed time alone. I didn’t feel guilty for doing. Most importantly, it didn’t ruin my holiday.

In a couple of weeks, I’m heading off to Cape Verde, for some much needed relaxation. This time I’m going with a much more positive frame of mind.

 

 

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.

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.

 

Is Stress A Trigger For Mental Illness?

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For me, the answer is yes. However, it’s not the cause of my mental illness but a trigger for an episode of bipolar mania or depression. It’s usually coupled with other triggers such as; a lack of sleep, drinking alcohol, or not taking medication.

I’ve been through many occasions where stress has had an impact on my mental illness. When the pressures of work have become too much, I find myself spiralling. The most likely repercussion is an episode of mania. The stress will disappear and I will become a whirlwind of energy and activity. Misdirected this energy can lead to reckless behaviour and I’ll find myself in dangerous situations. Mania also leads to obsession. Either with my work, with colleagues I dislike, or on projects in my personal life. I talk about one example in detail in the post Unhealthy Obsession

Often I don’t realise I’m stressed until I start showing signs of mania and then at that point I don’t care that stress has caused me to feel so euphoric. Of course with bipolar, being so hyperactive and full of relentless energy, I have to come down sooner or later. I talk about this feeling in the post The Mania Hangover . Then the stress I’m under really hits me, as I fall into a depressive state. There have been many times when for whatever reason I am already manic or depressed when a stressful situation pops into my life. Depending on the type of episode I’m experiencing, my reactions and ways of coping will differ dramatically.

Although stress can make us feel ill, a mental health condition has to already be there, whether it’s known to you or not, to trigger a mental illness. We all go through times of stress where we feel run down, lacking energy and generally feel overwhelmed by life. If you’re susceptible to depression or anxiety, the stresses of life can definitely trigger these. I find with bipolar disorder, which I continually live with, stress exacerbates the condition. I’ve learnt that I have to manage the stressors in my life and face up to the causes. Whether that be my job, a relationship, or money worries I need to assess the impact they are having to my stress levels, and ultimately my mental health.

Workplaces in particular need to work with individuals to create an environment that eases daily pressures. Society needs to be more compassionate and provide aid to those struggling for money and living in poverty. I grew up in a household where both my parents worked, yet we struggled financially. I know firsthand as a child and then as an adult how much stress is caused every month when bills are overdue and you have no way of paying them.

If you go through stressful situations but don’t have a mental illness that’s great! But don’t judge those that do. It doesn’t make the person weak or less resilient because stress triggers their mental illness. In times of extreme stress those with mental illnesses suffer; it’s unavoidable.

 

How to Approach Your Doctor If You Think You May Have Bipolar Disorder

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Bipolar disorder takes a notoriously long time to diagnose, on average ten years in fact. Add to this that people with bipolar disorder are misdiagnosed three times on average, it can feel to many like a hard slog to finally receive a diagnosis. This happened to me, where it took twelve years to be diagnosed and I was misdiagnosed with depression several times. I don’t want to see anyone else go through this unnecessarily, so I’ve listed below what you can do before and during meeting with a GP.

Keep a Mood Diary

This is the number one thing I wish I’d done before seeing my GP. Keeping a mood diary for a few months, will give them a picture of how much you are struggling and the stark contrast in your moods. It can be difficult to explain how much your moods are impacting your life and keeping a diary of them is a definitive way to show them this. You may be thinking three months is a long time to wait before seeing a doctor, but believe me three months is better than waiting another three years or longer for a diagnosis. Entires don’t have to be long, you can make bullet points explaining you mood that day. Bullet points will make it easier for the doctor to read through.

Ask For a Double Appointment

Most doctor’s surgeries will have the option of making a double appointment. These are reserved for people with more than one ailment to discuss, or those with more complex needs. An average appointment is only ten minutes and can go by in a flash if you’re feeling mentally unwell and struggling to explain yourself. You may feel rushed and forget what you wanted to say and giving a clear picture of your moods is a vital step in receiving a diagnosis.

Write Down What You want to Say

As I’ve already said, feeling mentally unwell can make us forgetful and/or anxious, stopping us from explaining ourselves fully. You can’t show a doctor a mental illness; unfortunately we can only rely on what we say. Write down what you’re going to tell your doctor before the appointment. It will make it clearer in your mind what you need to explain and highlight important points. Take it with you and refer to it if you can’t remember what exactly you were going to say. If you’re feeling extremely anxious or upset and feel you can’t speak clearly enough, give your notes for the doctor to read themselves.

Take Someone With You

Taking a partner, family member or close friend will take the pressure off you during the appointment. Someone that knows you well and what you’re struggling with, not only provides you with much needed support, but can corroborate your symptoms. A doctor will be more likely to take your concerns seriously if someone with you is agreeing that they have witnessed your extreme moods and unusual behaviours. Their insights may provide information that you can’t, such as how your moods and behaviours are affecting those around you.

Be Assertive

This is a difficult one, but something I feel is important. You know how you’re feeling and how your symptoms are affecting you and you need to make this clear. Often those with bipolar disorder before they are diagnosed are misdiagnosed by doctors with depression and anxiety. In a short appointment a doctor may assess you as having depression as it’s the most obvious answer and much more common. If you feel something else is happening, and you’re struggling with manic, psychotic or other symptoms, you need to tell the doctor. Being assertive doesn’t mean you have to be aggressive or confrontational, only making your points confidently and articulately.

A good doctor will take the time to speak to you, and check your medical history. Your medical history may highlight patterns of earlier mental illness that link to signs of bipolar disorder. If your GP agrees with you this will lead to a referral for a psychiatric assessment. The assessment will be much more in depth with a psychiatrist and will give you a clear answer as to whether you have bipolar disorder or not.

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.