What happens in a mental health rehabilitation ward – a genuine insight

One night shift in a mental health rehabilitation ward

Here’s what happens on a night shift in a mental health rehabilitation ward; or at least within the Trust I worked for.

I was working a bank shift which means I am on the Trust’s bank of staff who are available to cover shifts on the various wards if they don’t have enough staff. Because I was a student I could only work as a nursing assistant (N/A).

In comes Ayo with her big bag and her big blanket, tutting as always before slumping down into a chair, moaning, “Oh Lord, I don’t need this, I worked an early bank shift on Jasmin (ward).”

Working a night shift and then a late shift is not standard practice. Long hours, fatigue, and lack of rest breaks or time to recuperate between shifts are associated with an increased risk of errors. However, it’s very difficult for Ward Managers to keep track of, if staff members do extra bank shifts on another ward, which many of them do. Is it any wonder they’re tired and burnt out when they’re working three to four bank shifts a week elsewhere?

What happens in a mental health rehabilitation unit during handover

Mental health rehabilitation handover
Mental health rehabilitation handover — Pexels

Lisa arrived just in time, as Clare was about to start the handover at nine pm. “Mandy’s not coping with the titration of her Diazepam and continues to scream at medication time. Sasha remains bright in mood and went out with her nurse to buy new underwear today. She asked when Nancy was working next……..” and this made me smile as I’d taken a shine to her too.

“Elsa messed herself today — again, and her clothes were found on the shower floor.” Clare briefly covered all patients on the unit and said her goodbyes. That left Lisa, Ayo, and me working as a support worker.

Ayo was coordinating this shift but before she could even allocate patients and any tasks Mandy was banging on the office door. “I need my medication. I need my medication……” and as I went to speak to her Ayo cried out “No. Let her wait. Everyone have to wait.”

“Ayo, I just want to let her know that she will get her medication soon. It’s not nice that she’s crying and upset. I ………..”

“No!” thundered Ayo and she kissed her teeth, after which she allocated four patients to me, including Mandy and Elsa. As much as I loved working with all the patients, cos they each brought their own joys with them, I noted how I was always given the more difficult patients to work with. Unfortunately, lots of staff on various wards did this but, by rights, being qualified they ought to have taken these patients.

Lisa would be doing medication this night and I was to prepare supper of toast and hot chocolate; no coffee or tea because patients weren’t allowed caffeine before bedtime.

Supper time on this rehab ward

Mandy was given medication first before tottering through to the kitchen, wringing her hands and muttering to herself. “Hello, Nancy. It’s nice to see you again. I’ve had my medication but they’ve cut it down and I can’t cope Nancy. Honest, I can’t. Can I have three slices of toast nurse and will you cut it into quarters for me?” before shuffling over to the large table. I took her hot chocolate over as she was trembling and I could see her ending up with half a cup if she was to carry it.

Edward was next at the counter and he too shuffled away happily with his toast and jam and cup of chocolate. At only forty years old Edward could have passed for fifty-plus as he was always unshaven, his face was weatherbeaten and his grey hair had receded.

Edward had a diagnosis of schizophrenia and since he was seventeen he heard many voices and saw people who were not visible to others. Unless you saw him at mealtimes, you wouldn’t know he was there; he was so quiet. I had to seek him out each week for games night and he came along willingly, as he was actually really good at Scrabble and we both enjoyed the challenge.

What happens at Bedtime

With medication and supper over I went to check on my four allocated patients. All bar Edward were in their rooms and in various states of undress. Mandy wore a long floral flannelette nightgown and ancient slippers and I watched as she carefully folded the clothes she’s just taken off into neat piles. Her room was spotless if not a little cluttered as she collected china teapots of all sizes. and colours. “Night, night nurse. Will you close my door for me?”

Sasha was in bed and snoring lightly. Elsa was struggling with her bra straps so I offered to help. “Fuck off me, you. I don’t need you.” she spat and turned her back on me. “Go on, fuck off.” Then she gave me another of her toothless grins. I think she just liked to test the nurses’ responses. She always made me smile and I told her I’d be back in five to see she was okay.

I did go back because if you say you will, then you must. So many patients are left waiting when nurses tell them they’ll come back and don’t. I think it’s cruel. That just left Edward. He was watching a film in the shared living room, chuckling away to himself. I wasn’t sure if he was laughing at the television or the voices he heard but he looked happy enough.

Staff lacking common sense

Just when I was going to join Edward for a while, Ayo called “Bedtime Edward.” and switched the lights out. I said “He’s watching this film, let him see the end. It’s over in twenty minutes.”

“It’s eleven o’clock and it time for bed. Come, Edward. Come now.” Totally ignoring me, she watched as Edward struggled to get out of the chair and shuffle over to the door.

Once everyone was in bed Lisa checked all the downstairs doors and windows then returned to the office. I asked why Ayo wouldn’t let Edward finish watching the film. “Eleven o’clock lights out,” she mumbled, and at least had the good grace to look a little embarrassed.

Unbelievable. We all have very different body clocks and bedtimes, and had Edward been at home, he would have watched the end of his film before going to bed. I was going to make sure that I documented this in Edwards’s notes and flag it up at the next team meeting.

Staff bedtime too

Staff bedtime on mental health rehabilitation ward — Pexels image

It was eerily quiet, pitch black, and unnerving as I went to the kitchen to get drinks for myself and Lisa. On my way back to the office, all I could see in the living area was a pair of eyes peering out at me from underneath a blanket.

I whispered “Hello,” but got no response. I crept forward so as not to startle what I thought was a patient but Ayo shrieked “My Lord. Girl, what you doing? You frightened the life out of me.” There she was, feet up with her slippers lying on the floor, curled up on the sofa. “I havin’ my break. Go. Foolish girl,” and she kissed her teeth.

Off I went with the drinks, shaking my head, stunned. I asked Lisa whether this was normal practice, for staff to sleep while on duty and was told that we each get two hours break but Ayo just sleeps all night. “So that would leave one of us on the floor?” I inquired. If both Ayo and Lisa were on a break that would leave me, an N/A, to be responsible for the unit. “Yes, that’s what we do. It’s okay, Ayo always sleeps” she smiled.

“I’m sorry Lisa but I don’t feel comfortable with that. I’m working as an N/A and I’m not qualified if there’s any emergency.”

Staff ignoring poor practice

“Nancy, she’s done it for years. Even our manager knows,” said Lisa sighing and shrugging her shoulders. However, that night neither she nor I had a sleeping break. We both sat in the office, Lisa looking at holidays online and me reading through my patients’ notes. I really enjoyed finding out more about the patients and while it was quiet I could help update their care plans, number the pages in their files, and generally complete paperwork that’s often difficult to do during a busy shift.

The time went quickly and I was so immersed I didn’t hear Ayo coming into the office. However, I heard her loud yawning and watched as she stretched upwards before dropping herself into the spare chair next to me. I caught a whiff of her stale morning breath and body odour! Offering to make us drinks allowed me to make a swift exit and by the time I’d returned, Ayo had wheeled her chair to another desk.

Six fifty-five and the morning staff were starting to arrive. “Nancy, Lisa, you go on the floor, I do handover.” Which is normal for the coordinating nurse to stay in the office to give the handover, while the rest were outside attending to patients. However, I couldn’t help but wonder how a nurse who’d slept all night and hadn’t asked her colleagues about the shift’s events could possibly give an adequate handover. Again, I asked Lisa who tutted and said “Nancy, you’re just a student. It really won’t do you any good to keep questioning your colleagues’ practices now. They won’t thank you and you’ll fall out.”

Nurses ignoring health & safety

“I don’t want to fall out with them but as I’m a student, working as a nursing assistant surely I have an opinion? And I don’t think it’s safe for patients or staff if others are not doing their job.”

“Nancy, it’s just how it is, how it’s been for years and you can’t change it.”

The Nursing & Midwifery Council’s (NMC) Code of Conduct 2015, sets out professional standards of practice and behaviour for nurses, midwives, and nursing associates. Point 3.4 states: act as an advocate for the vulnerable, challenging poor practice and discriminatory attitudes and behaviour relating to their care. Both Ayo and Lisa had completely ignored all the rules!

Would you be able to highlight where they’d gone wrong? Would you have reported them?

I would later talk this through with the unit Manager.

Note to self: “Folks who never do any more than they get paid for, never get paid for any more than they do”― Elbert Hubbard

Feel better after reading my tips for dealing with anxiety

My tips for dealing with anxiety

Maybe this lady needs some tips for dealing with anxiety.
To feel better she may need some tips for dealing with anxiety — Photo from Pexels

Are you dealing with anxiety and need some useful tips? I lived and worked with anxiety for many years and you might find my tips come in handy.

The likelihood is you (like most of us) have experienced anxiety in your life; perhaps before a driving test, an exam, or another important life event.

Experiencing some anxiety is normal, but if it’s so strong that it interferes with your being able to carry out your normal day-to-day activities, it’s considered to be an anxiety disorder.

Anxiety disorders are very common. The prevalence of anxiety disorders across the world varies from 2.5 to 7 percent by country.

Globally an estimated 284 million people experienced an anxiety disorder in 2017, making it the most prevalent mental health disorder. Around 63 percent (179 million) were female, relative to 105 million males.

When is anxiety a mental health disorder?

Some anxiety is necessary — it helps us react to stresses or potential threats, by quickening our reflexes and focusing our attention i.e. if a lorry’s hurtling towards you you’re able to jump out of the way. The anxiety usually settles once the stressful situation has passed. 

Is anxiety a mental health disorder
Anxiety is a mental health disorder — Photo from Pexels

Anxiety can become a mental health problem if it impacts your ability to live your life as fully as you want to. For example, it may be a problem if:

  • your feelings of anxiety are very strong or last for a long time
  • your fears or worries are out of proportion to the situation
  • you avoid situations that might cause you to feel anxious
  • your worries feel very distressing or are hard to control
  • you regularly experience symptoms of anxiety, which could include panic attacks
  • you find it hard to go about your everyday life or do things you enjoy.

If your symptoms fit a particular set of medical criteria then you might be diagnosed with a particular anxiety disorder. But it’s also possible to experience problems with anxiety without having a specific diagnosis.

What anxiety feels like

What anxiety feels like
What anxiety feels like — Image – 7cups.com

I experienced most of the common physical symptoms of anxiety: muscle tension, headaches, backaches, a clenched jaw, feeling keyed up, restless, and “on edge”, as well as difficulty concentrating.

These symptoms are a side effect of our body’s attempts to protect us; blood moves around our body and brain, into our large muscles, like our arms, legs, back, and neck, to get us ready to ”fight” or to “flee.”

“Have you ever had that feeling you get when the roller coaster is about to thunder 100 feet down and for a split second you think you’re going to fall out?

But as you reach the bottom that feeling passes……………..

Imagine that feeling being stuck there, forever. Your chest is thumping, you’re struggling to breathe and your mouth is so dry……. that fear and sense of dread never leaving you……….”

You’ll have your own set of jumbled thoughts and feelings if you experience anxiety; not everyone feels it in the same way. But I know it feels rotten anyway!

Fortunately (hmmm?), I no longer have internal sensation from below my underarms down to my feet because of MS. It helps that I have no physical sensation of anxiety because that’s what led to the automatic negative thoughts that fed my anxiety………

What actually happens in anxiety

stressed woman covering her face with her hands
Need some top tips for dealing with anxiety — Photo Pexels.com

There are 3 parts to an anxiety problem: anxious thoughts, the emotion of anxiety itself, and anxious behaviours:

(1) Negative thoughts i.e. “I’ll fail all my exams”, “I’m always going to have panic attacks”, “I shouldn’t have shouted at the kids this morning, I’m such a bad mum/dad” or “I’ll get thrown out of my home cos I can’t pay the rent” etc.

(2) Negative physical feelings i.e. stomach-churning, heart palpitating, sweating, dry mouth, shaking, nausea, vomiting. Negative emotional feelings i.e. sadness, fear, disgust, shame.

(4) Negative behaviour i.e. stealing your friend’s anxiety medication, isolating yourself, turning to alcohol or illicit drugs.

So, let’s clarify, the 3 parts of anxiety are thoughtsfeelings (physical and emotional) and behaviours. You might think your anxiety appears from nowhere, but — it starts with any one of the 3 parts and snowballs from there.

Model of anxiety based on Beck’s cognitive triad model (Beck, 1976).
Model of anxiety based on Beck’s cognitive triad model (Beck, 1976).

If your negative interpretations of situations aren’t challenged, the patterns of thoughts, feelings, and behaviours can be repeated as part of a debilitating and unpleasant cycle. It starts as small as a snowball, rolling down the slopes, then it gathers momentum, gets bigger………. and before you know it — you’re starting to panic.

My top tips for dealing with anxiety

Become your own relaxation expert
Become your own relaxation expert — Image from Pixabay

Not every tip will work for every person. What helps you might be different to the coping skills I’ve used. But, whatever our various methods, we need to be able to deal with our own anxiety.

The very first thing you must do is breathe………… very slowly, out through your mouth as much as you can. Then slowly, in through your nose as far as you can and feel young lungs fill right up. Very slowly out thro’ your mouth, then in thro’ your nose………. and do this say 5-6 times.

I won’t bore you with the scientific reason that this does work but you can read it here. However, just know that it will have a physical effect on the mind; deep breathing helps to relax a major nerve that runs from the diaphragm to the brain, sending a message to the entire body to let go and loosen up.

So, the instant your anxiety begins — do the above breathing exercise. This will slow your heart rate and give you time to calm down. You can do this anywhere; at the bus stop, in a staff meeting, and nobody has to notice.

Relax your body by first unclenching your jaw, go on….. give it a little wiggle. Let your shoulders drop down from your ears. Uncurl your clenched fists and lay your palms lightly on your thighs. Uncross your legs and let your feet rest lightly on the floor.

So, relax your body and breathe slowly out thro’ your nose……… When your body is relaxed it will send messages to your mind letting it know you are relaxed, and your mind will follow suit. Remember, your body cannot be tense if it is relaxed, and vice versa.

Become an expert on relaxation techniques

Become an expert on relaxation techniques
Become an expert on relaxation techniques

and practice them often so that you’ll be able to use them immediately you start to become anxious. Some people say “Yeah, I’ve all tried that but it doesn’t work!”

Trying anything once will not make you an expert. It takes practice, practice, and more practice! You wouldn’t be driving on the motorway if you just had one driving lesson, would you?

Relaxation can take many forms i.e. Mindfulness, yoga, visualisation, meditation, light exercise or stretching, or listening to restful music. You don’t need special yoga mats, candles, cushions etc, but they might help you feel more comfortable. Like the breathing exercise, these techniques will have a relaxing physical effect on your mind.

If you’re out in public find somewhere safe and comfortable to sit until you’ve calmed down. If you can or want to, sip a cool drink — don’t gulp or you might find yourself (like me) choking. Breathe, and go through your relaxation techniques.

If you can, talk to someone you trust and let them know you feel anxious. They’ll be able to reassure you that you’re safe and it’s normal to feel anxious under the circumstances i.e. going for a job interview, a driving test, or preparing for a presentation.

Seek out professional help as soon as possible — your workplace or school/university might provide this free of charge. A therapist will be able to support you in finding coping skills that will help relieve anxiety.

Over to you


If you’re anything like me, you’ll have tried most things before settling on what works best for you. Acupuncture was great for my panic attacks but I still had to learn effective coping techniques as I didn’t have my acupuncturist in my pocket. What works for you? Can you share any tried and tested tips?

How to pace yourself if you have a chronic illness

Chronic illness and the need to pace yourself

Learning how to pace yourself if you have a chronic illness
Learning how to pace yourself if you have a chronic illness — Image by Pixabay

In my previous post The need to pace yourself if you have a chronic illness we looked at:

  • Why, if we don’t learn to pace ourselves, we’ll crash and burn
  • Types of chronic illness; both mental and physical
  • Where we might be going wrong
  • Chronic illness and the Spoon Theory and
  • The Push-crash Cycle

Moving on to understanding HOW we can pace ourselves

My youngest son is a Physiotherapist and, since I started this post last Monday and have been unable to finish it, we’ve talked a lot about understanding our limits.

He reminded me that pushing myself means more pain, yet avoiding any activity at all will also lead to more pain. He explained how pacing myself will help me to stay active, and how I’ll be able to get the things I love doing (or need to do) done with minimal pain.

We looked at how using the paced approach will give me a way to break down everyday activities and exercise into smaller bits; it means doing little bits often, and then resting.

He’s suggested 10 minutes of rest after 10-15 minutes of activity to get my heart rate back down. I’ll still be able to get things done, albeit a little more slowly, but this way I’m neither overdoing nor underdoing. I’ll be stopping the push-crash cycle that can take me days to recover.

Essentially, I’ll be using a Spoon (unit of energy) and then getting one back during my resting period, so I don’t crash before I even get to noon! Because I love visualisation I’m able to see my spoonful of energy going down with any activity, and back up after resting.

You might have another way of seeing your spoon? And you might find the above information given by a Physiotherapist useful too.

What you can do to pace yourself

Rest and Relaxation — Image by Unsplash

I’ll use my 10 minutes of rest to do some mindfulness, stretching or more visualisation, after which I feel rested and relaxed.

Watching t.v. or reading a book, or even writing down the chores I’ve remembered is a no-no! That doesn’t help (me).

And that’s where I was going wrong. I understand now that I need to switch off completely; give my thinking brain a rest! However, if you find reading or watching a film restful, then you can continue to use your rest period that way.

Ways you can get back some of the energy you’ve used to minimize symptoms and improve your quality of life:
  • Organisation is key in pacing, and it helps me feel grounded. Being disorganised can create chaos for me.
  • List all your tasks, chores, appointments, and exercise routine (daily/weekly) then separate them into has to be done and can-wait til…………….
  • Delegate where possible — is there someone else that can do the task?
  • Be mindful of each task as you’re completing it, that way you’re focusing on that one thing alone and not leaping to the next task.
  • Self-care — and this doesn’t have to mean bubble baths and candles, but take that relaxing bubble bath anyway. Just simple things like remembering to brush your teeth and enjoying that lovely clean taste will slow down the pace.
  • Be mindful when you’re eating. Turn the t.v. or music off. Chew your food and enjoy the different tastes and textures.
  • Do some breathing exercises, mindfulness or visualisation. You’ll also find heaps of these exercises on the internet ad Youtube.
  • Play your favourite track and really listen to it, enjoy the music and the lyrics; while you take time to breathe.
  • Spend some time with nature; whether it’s in your own garden or out in a local park. World Mental Health Week (10th – 16th May) has now passed but their theme 2021 was Spending time with nature. The Mental Health Foundation wrote “Research showed going for walks outside was one of our top coping strategies and 45% of us reported being in green spaces had been vital for our mental health.

‘There is something to be wondered at in all of Nature’


More you can do to improve your quality of life

blooming cherry tree with white flowers
Being amongst nature is relaxing — Image by Pexels
  • Go for a walk round one of your favourite parks, by the river or the coast; just amble and listen out for the birds, and take a look at the flowers and greenery.
  • You might enjoy cooking or baking — it’s something I love but I still have to be mindful of the stress it can create, so I’ll rest as my pots simmer.
  • Call or visit a supportive friend, the one who wants nothing more from you than a warm chat — not Auntie Joannie who constantly whines, saps your energy and always asks favours of you.
  • Do some stretching out on your sofa, bed or floor, and breathe…….
  • Spend time with a pet — in or outdoors.
  • Read a lighthearted book, blog, or magazine; not something that gets you wound up or takes any energy.
  • Do some form of exercise, whether it’s indoors or out. Exercise is well known to be an antidote to depression and many other mental health disorders.

You’ll have your own list of tasks or chores and various ways of relaxing; having some downtime. But you must remember to rest after each activity!

Over to you


Are you organised and manage to get through your to-do list? Or are you chaotic like me (the old me), dashing from one thing to another, pushing then burn? Do you manage to get some rest during your busy day or do you just soldier on?

Do you have any tips for others? I’d love to hear your thoughts and I’m happy to answer any questions.


Why We Need Awareness On Workspace Bullying

A collaborative post on Why we need Awareness on Workspace Bullying

Bullying - This is why we need Awareness on Workspace Abuse
Bullying — This is Why we need Awareness on Workspace Abuse — Image by Pixabay

Kally of Middle Me kindly allowed me to reblog her post on Why We Need Awareness on Workspace Abuse. It’s a subject close to my heart and I’m really happy to be sharing this article with you. Thank you Kally.

I’ve also written about Workplace Bullies and Stand up to Workplace Bullies if you’d like to read more on the topic.

Kally writes:

More Awareness on Workspace Abuse is needed
More awareness on Workspace Abuse is needed — Image by Coolsmart.com

I choose to share this topic because it is very dear to me. In fact, I have friends who are going through workplace abuse. Many of them are trying to either find a new job or trying to report to their HR.

Workplace abuse is a serious matter! However, it was hardly in the spotlight until the Harvey Weinstein scandal in Hollywood. Even that still feels somewhat unreal to us because well, it’s Hollywood where make-believe magic comes alive.

Enjoy my piece of contribution and if you’d like to read others’ too, here’s the link: Awareness – Skilled Helpers Collaborative

In recent years, there is a growing movement that is advocating for the elimination of workspace abuse. Cases, where employees were abused by their fellow employees, have been increasing in recent years. Some cases are so severe that it has caused companies to be under scrutiny.

While there is some action by companies to stop it, it’s clear that it’s a culture that continues to persist. But why is it happening despite calls for it to end? What can be done to make it an issue that companies must react to immediately?

Bullying in the Workplace is a Taboo HR Subject

Workspace Awareness is often taboo — Image by Unsplash

A major reason why workspace abuse persists is that it’s a subject HR wants to avoid tackling at all costs. There can be many reasons why this is the case. It could be because of the “power” held by those involved, especially those who bully the victim.

If the bully has an important position in the company, HR will have a nightmare trying to replace them. Directors will pressure them into laying off the issue. It’s also possible that some HR teams or the company do not have a clear policy on workspace abuse.

Awareness means more people can self-protect

Whichever the reason may be as to why HR doesn’t want to tackle any bullying claims in the workplace, it’s important that employees take a stand against it. Some victims do not report their situation because they are not aware of the company’s anti-workspace abuse policies.

By building awareness, these people will be able to protect themselves and find support if needed. It will also open discussions on how others can help protect those who are victimised without fearing possible retaliation from those who abuse or bully others.

Train colleagues and managers to detect signs of bullying

One should also launch or request training for everyone to participate. There are special training courses to combat workplace abuse, and they include ways on how to identify workspace abuse as it happens, how to stop it and how to resolve it.

Some training courses may even help people discover what behaviours should be avoided to prevent bullying and empower others to report bullying cases without fear.

Allow abuse to be anonymously reported

Some victims of bullying and workplace abuse don’t want to report their situation because they fear that they will be ostracized for speaking out, which can lead to further abuse.

Others don’t want to report because the ones who are bullying them are more powerful than them. Those who see bullying do not report because the bullies may turn against them and transform them into victims. Some may not want to get involved at all and ignore what they see before them.

In this case, it is important to have communication and support systems that will allow these victims to report abuse situations. Ask your company to set up a hotline that anyone can dial to speak about abuse cases or get help if they feel they are being targeted.

If that is not possible, look for organisations who can provide assistance and list down their contact details so everyone in the workplace can get help. Surveys can also help employees raise their concerns regarding bullying, especially when they see someone being bullied or experiencing it.

HR and Managers to take reports of abuse seriously

If companies want workspace abuse to end, HR and managers should change their stance regarding the issue and take each report seriously. HR officers and managers are keen to get everyone working productively to keep the company growing.

However, if workers are not happy because of the toxic and abusive work environment, productivity will decrease and result in unhappy workers. If it continues unresolved, the company may lose the precious talents they need to get the company to flourish.

If you are the HR officer or the team leader, listen to the discussions in the workplace and try to get to know everyone’s position. You can sit down with them, hear out their concerns and find a solution that everyone can agree on. You should also be a model for the rest of the employees to emulate, especially when dealing and working with others.

Openly discuss the effects of workplace abuse on individuals

Finally, workspace abuse is very serious and can have lasting impacts on its victims. When it comes to their health, victims of workspace abuse can experience anxiety, high-stress levels, panic attacks and even ulcers. Some may even show a loss of energy and high blood pressure, which can lead to serious health complications in the future.

With their physical and mental health declining due to abuse, they will slowly lose their motivation to work and find it hard to focus because all they think about is how to get away from their bullies. Some may even feel isolated or trapped in their situation, further affecting their mindset.

Have regular talks to discuss the effects of workplace abuse with the entire team. You can invite an expert to speak about these impacts so that employees who may have been victimized by abusers can ask questions.

If you can’t do these talks, have resources available for everyone to read and discuss with each other. Remember to be sensitive when discussing these issues and don’t judge others if you see them react to the topic being addressed.

If we want our workspace to stay productive and welcoming for all, we must do our part in ensuring that no one will be subjected to abuse. Whether you are a regular employee or a team leader, it is crucial that you step in and lead the initiative to fight against it.

As more and more people become aware of the impacts of workplace abuse, there will definitely be changes in the workplace that will improve it for the better.

Over to you

ClipArt.com Images

I hope you found this post interesting. Have you been bullied, abused or harassed at work? Did you do anything about it and (whether you answered yes or no) can you tell us about it? Kally and I look forward to reading your comments and answering any questions.

If you haven’t already seen Kally’s MiddleMe, you might want to drop by. It’s a goldmine of current information about almost anything from how to apply for jobs to relationship advice.

Chronic illness and the need to pace yourself

Do you know why you need to pace yourself

How to slow down and get off the wheel
How to slow down and get off the wheel — Image by Pixabay

Do you know why you need to pace yourself if you have a chronic illness? The truth is, if you don’t, you’ll eventually crash and burn!

Chronic illness is pretty far-reaching in its effects, touching every aspect of our lives. It affects whether or not we can work, our mental state, our relationships and friendships, our income, our hopes and wishes, together with our sense of self.

Even after having a chronic illness for 10 years, I’ve only just realised today that I need to pace myself. I’ve pushed myself too hard too often and it’s having an adverse effect both physically and mentally.

I feel like I’m perpetually on a hamster wheel, going round and round but not getting any one thing done — completely. Or I feel like I’m juggling twenty balls all at once. And at some point, they’ll all just hit the floor.

Ergo, I do nothing! So here’s the rub ……. I swing from doing a million things at once to doing nothing, nada, zilch!

Physical disability can slow you down

How to slow down when you need to get things done
How to slow down when you need to get things done

I have Transverse Myelitis (TM), a physical disability with too many symptoms to talk about all at once, let’s just say that apart from

  • Inflammatory Pain: An abnormal inflammation caused by an inappropriate response by the body’s immune system…..
  • Neuropathic Pain: Pain caused by nerve irritation. …
  • Functional Pain: Pain without obvious origin, but can cause pain……. i.e. arthritis …………

I’m also prone to chronic fatigue and doing any task for more than ten minutes can knock me out. The following symptoms also occur:

  • I start to perspire (ladies don’t sweat) profusely
  • my pulse races
  • my vision is impaired, it’s like a fog
  • the blood rushes from my head, my lips, hands and feet go white
  • I can’t catch my breath and it feels like I’m having a panic attack — but I’m not panicking. These are just some of the symptoms I get with TM.

Mental illness can slow you down

At times I also experience:

Sleep deprivation can lead to hallucinations
Sleep deprivation can lead to hallucinations — Photo by pexels.com

It’s definitely true for me that some days are worse than others, and I’ve had to learn to manage it all; be aware of triggers and symptoms.

It isn’t always easy, and I’m not sure if people who’ve never had a mental illness know how hard it is to maintain the equilibrium.

Where we might be going wrong

The need to pace yourself if you have a chronic illness  ---
The need to pace yourself if you have a chronic illness — Freepik image

If you’re anything like me you still think like an able-bodied person, or you still feel like your only 40 when in reality you’re nearing 60. Your day might go something like mine:

  • in the kitchen, making cake pops for our grandchildren……doing dishes and need to put wet dishcloths in the washing basket in the bathroom……..
  • wipe hubby’s toothpaste from the mirror……….pick up the wet towel, now perspiring, go to the hall cupboard to get more toilet rolls because no one else ever replaces them ……..
  • Breathe….. rinse a clean flannel under the cold tap and wrap around neck to cool down…….. see the soap dish needs cleaning, the shower cubicle……. oh, so do the taps………… slump to the bathroom floor for 10 minutes.
  • On the way back to the kitchen note the duvet needs plumped up and the bedroom window needs opening……… In my haste, I’ve trodden on the shoes hubby leaves lying around. I lose my balance, bash my face on a door frame. It will bruise. Need to lie down….. on the already plumped up duvet.
  • While resting I remember I need to ……. I can’t breathe…….
  • Next, I walk towards……………… swoon……….come round on the floor, the sofa, or the bed…….. and hubby’s tugging at me……. he thinks I’m dead!

All this rushing around, pretending I’m fit and can still do everything at breakneck speed, has lead to many accidents.

I’ve got massive bumps, bruises, blisters and scars from dropping boiling hot coffee all over my lap and nether regions (Oh the shame at the hospital). Or from (unwittingly) kneeling in oven cleaning liquid, and constantly bashing myself as I race to get a million things done………

Chronic illness and the Spoon theory

Spoon Theory and mental illness
Spoon Theory and chronic illness — Tumblr image

You might have heard of the Spoon Theory by Christine Miserandino. She came up with this when one of her friends asked her what it really felt like to be sick.

It’s a helpful analogy of what it’s truly like to live with chronic illness or disability. The theory:

  • effectively explains to others how your energy levels are limited when you have a chronic illness – using spoons!
  • originally came about for physical illness but it also translates well to mental health and can be adapted accordingly.
  • describes the energy needed each day, and the pain everyday tasks cause for someone with a chronic illness.
  • explains that while it might not be physically evident that someone you love is struggling with anxiety, depression, or stress, their body and their energy levels are being severely impacted. We need much more energy to i.e. attend to our hygiene needs than someone who doesn’t have a chronic illness.
  • started out with 10 spoons; each one equating to a unit of energy.

It might take a healthy person just 1 spoon to get up and ready for work, leaving 9 spoons (units of energy) to use throughout their day. But for someone like me, it took 1 spoon each to get out of bed, 1 to shower, 1 for my teeth, another to get dry and one to get dressed……. I’ve used all of my 10 spoons, I’m out of energy! And I haven’t even got out of the front door yet!

Pace yourself if you have a chronic illness – the theory

Push-crash cycle

Having a chronic illness can often feel like we’re living on a roller coaster. We swing between intense symptoms and rest, in a frustrating cycle of push and crash.

I believe the Push-crash cycle originates from the founder of the Chronic Fatigue Syndrome (CFS) Self Help forum. However, I think it’s helpful to use for any Chronic illness. And rather than reinvent the wheel, I’ll use excerpts of his to explain the cycle:

“People who use this way of living with a chronic condition find themselves caught in a frustrating loop, swinging between overactivity and forced rest.

When their symptoms are low, they push to get as much done as they can, the overexertion triggers an increase in symptoms, which in turn leads to forced rest or a crash.

Resting is usually successful in reducing symptoms, but then, feeling frustrated at all they didn’t accomplish while resting, they plunge into another round of overactivity to catch up.”

Bruce Campbell, PhD, creator and Executive Director of the ME/CFS and Fibromyalgia Self-Help Program

So basically, when you find yourself feeling overwhelmed, frazzled or that you’re racing from one thing to another, learning how to slow down is maybe just what you need.

Understanding how we can pace ourselves

How to pace yourself — Image by Pixabay

We know that marathon runners don’t run as hard as they can the whole way. They set a steady mile-eating pace early on, saving their energy reserves for the end of the race. You can do the same — as long as you take regular breaks. 

We’ll discover what we can do to pace ourselves in my next post 🙂

“When you intentionally slow down your days and your life, it helps you become more present and mindful in your days. And even better, when you’re not struggling just to keep up, life can be a lot more enjoyable!”

Melissa at Simple Lionheart Life

Over to you

Image from Clipart

Do you find yourself overwhelmed, exhausted, or wornout by your daily activities, whether it’s at work or at home, with or without a chronic illness? Are you finding it difficult to pace yourself, or do you even know how to? If you do, you might have some tips for the rest of us?

I look forward to reading your comments and I’m happy to answer in questions. In the meantime, take five minutes out…………. and breathe.


Yay! Just got a Blogger Recognition Award

I love this Blogger Recognition Award

A big fat thank you to Jess at Beyond the front cover for nominating me for the Blogger Recognition Award, Yay! If you haven’t been over to visit Jess and her blog before please give it a go. She loves books and reading, and she does great book reviews!

Because Jess has a toddler on her hands now, I’m guessing she doesn’t get a whole load of time to blog as much. However, I love her book reviews and monthly roundup where she keeps us up-to-date and talks about all things close to her.

While I write about all things Mental Health, which can be quite distressing at times, it’s a breath of fresh air reading blogs like Jess’s Beyond the front cover.

If you know my blog, you’ll know how much I love the Blogger Awards. They give us an opportunity to nominate our fellow bloggers and hopefully put their blogs in the spotlight, encouraging you to drop by and say hello.

The Blogger Recognition Award Rules
Thank for for the Blogger Recognition Award Jess — Photo by Pexels.com
  • Thank the blogger that nominated you and give a link to their site
  • Do a post to show your award
  • Give a summary of how your blog started
  • Give two pieces of advice for any new bloggers
  • Select up to 15 other bloggers for this award
  • Let each nominee know you’ve nominated them and give a link to your post
Give a summary of how your blog started

It took me years to actually start writing a blog. I had so many thoughts about what to write constantly whizzing around my brain, so I started writing them down.

Doh! I’d forgotten that I had 10 + years of diaries from my mental health nursing days tucked away somewhere.

Most of the time I don’t use the diaries though, as I have enough to write about — what with me becoming physically disabled and medically retired from the job I loved. Still, the diaries will come in handy when I run out of words 😉

I just started my blog with the Home and About Me pages, people actually read them, liked and commented on them. Whoop Whoop!

Two pieces of advice for any new bloggers
Brainstorm all your ideas for your new blog — Image from Pexels.com

You might have lots of ideas for a new blog and if so, you might need to brainstorm to cut your list down.

However, in the end, write about what you love and know as it’s much easier and will show readers your enthusiasm and passion for your topic. They’ll feed off this and want to come back for more.

Read other blogs in your niche, check out what’s current in your field and just start writing. Don’t be like me, and wait almost 10 years!

Now for my nominees for the Blogger Recognition Award
Award nomination — Image from Pexels.com

I usually select new bloggers who’ve recently come to my attention, but this time I think I’ll switch it up a bit and pick a couple of blogs that I’ve been following (and thoroughly enjoying) for a while. My choices are:

Life All Day: Live like a pro

Fights MS daily


Prisoner by no crime of my own

The tiny couch: wellness for all

There’s no obligation to take part of course, but I look forward to reading your answers if you do! Thank you for reading,

Over to you


What advice would you give to readers about starting a new blog? Some of you have been blogging for a while now — has your niche or blog evolved in unexpected ways? I look forward to your comments and I’m happy to answer any questions.

Until the next time…Caz x

Have you been feeling “blah”, down, or sluggish lately?

A name for the “Blah” we’ve all been feeling is Languishing

A name for the Blah we've been feeling is Languishing
A name for the Blah we’ve been feeling is Languishing — Photo by Unsplash

A recent article in the New York Times (about the Blah we’ve all been feeling during the pandemic being called Languishing) has flooded the internet.

Have you or someone you know been feeling Blah during the pandemic? I suppose I have, and I know many in my family and friends circle have been feeling the same way.

We just didn’t know what it was called or that there was actually a word for the way we were all feeling. Now I do know, it makes sense; kind of.

So, what is this Blah or languishing we’ve been feeling?

In Psychology withering is like languishing; feeling Blah!
In Psychology withering is like languishing ; feeling Blah — Photo by Pexels

Thesaurus.com and Merriam-Webster’s Dictionary suggest the following:

  • withering
  • fading
  • flagging
  • snivelling
  • droopy
  • listless
  • tired
  • sluggish……………

Mind you, I won’t be calling myself snivelling, droopy or withering any time soon. In fact, I’m not sure I’d use any of those descriptions, other than listless or tired perhaps, and fatigued — yes, that’s how I feel. Languishing tho’? I always associated that word with luxury, like languishing in the bath or on a beach? Okay, maybe not.

The author of “A name for Blah is languishing” writes

A name for the Blah we've been feeling is Languishing
Text by Mentalhealth360 —Image by Freepik

In psychology, we think about mental health on a spectrum from depression to flourishing. Flourishing is the peak of well-being where you have a strong sense of meaning, mastery and mattering to others. Depression is the valley of ill-being and you feel despondent, drained and worthless.

“Languishing is the neglected middle child of mental health. It can dull your motivation and focus — and it may be the dominant emotion of 2021.”

Adam Grant, professor of management and psychology at the University of Pennsylvania

It’s the void between depression and flourishing — the absence of well-being. You don’t have symptoms of mental illness, but you’re not the picture of mental health either.

You’re not functioning at full capacity. Languishing dulls your motivation, disrupts your ability to focus, and triples the odds that you’ll cut back on work. It appears to be more common than major depression — and in some ways, it may be a bigger risk factor for mental illness.

Languishing, like depression, is associated with significant psychosocial impairment in terms of perceived emotional health, limitations of activities of daily living, and workdays lost or cutback.

Changes post-Coronavirus

Languishing at her laptop
Languishing at her laptop — Photo by Pexels

Since the start of Coronavirus, remote working and reliance on technology with no face to face contact have become increasingly common practice in workplaces around the world.

Coronavirus has had a huge impact on the way work environments have changed, and I dare say we’ll see further negative changes before it’s over. I imagine either reduced hours and/or more job loss post-Covid, meaning reduced income and more stress for some.

While I feel for anyone in this situation, unfortunately, there isn’t much we can do about these enforced changes. However, what we can do is look after ourselves mentally and physically, and look out for our loved ones, and be supportive where possible.

Be kind and show compassion to both yourself and others, and let’s all give ourselves the care and attention we’d give to them.

“If my thoughts or feelings were being expressed by a loved one or a friend, what advice would I give them?”


How to spot signs of languishing

Lack of excitement? — Photo by Pexels

While not as severe and not its own mental health disorder, languishing could be one of the first warning signs of depression. Things to look out for, in yourself or others, and sooner rather than later, might be:

  • Lack of motivation to i.e. exercise, work or complete household tasks
  • Lack of interest in things that previously mattered
  • Poor concentration i.e lose the plot of a story or t.v. programme
  • Lack of excitement about the future
  • Being stuck in a monotonous routine
  • Not functioning at your fullest
  • Indifference
  • Loss of purpose

The spectrum of languishing to flourishing

From languishing to flourishing
From languishing to flourishing — Photo by Pexels

Research identified 6 core components of psychological wellbeing that influence where someone falls on the spectrum (Keyes, 2002). How might you help yourself and others move from languishing towards flourishing in these areas?

  1. Self-acceptance – liking most things about ourselves. If not, and this is important, jot down some of the things you like about yourself, and keep writing ’til you run out of words. Seeing the words can have a positive effect on your mental well-being.
  2. Positive relationships with others – forming and maintaining warm, supportive, and trusting relationships with others. Think about those close to you and what you mean to each other.
  3. Personal growth – seeing ourselves as becoming better people. Most of us strive to become better people. I love it when hubby tells people “she makes me want to be a better person!” It makes me feel good about me; that I’ve made a difference, even to one person.
  4. Purpose in life – having a sense of direction or meaning in life. This one often gets to me, ‘cos when I was medically retired from the job I loved I felt I’d lost my purpose in life. However, blogging about, and as an advocate for all things mental health from both personal and professional experience helps.
  5. Environmental mastery – feeling able to shape the world around us (at least to some extent) to meet our needs. If you live in a small space like me, you might have a few plants that you water and tend to. Or you may be lucky enough to have a garden and grow flowers, fruit or veg, and plants, and be able to sit out in the sun. While these are small ideas, lots of people flourish when gardening or when they feel the sun on their skin.
  6. Autonomy – believing that we’re reasonably in control of what happens to us (i.e. rather than others, fate, or luck being totally in charge). Again, this one was difficult for me — but I’m back on track.

Don’t worry, to be considered flourishing, we don’t need to be highly rated in all areas of life at once.

Speak up

Understanding and identifying languishing can help us all shift this focus and have a conversation — sooner rather than later. That way people are supported back to positive mental health sooner and more efficiently.

If you or a loved one feels stuck and you’re not sure how to move forward, you might want to seek professional help, so contact your GP in the first instance.

Over to you

Have you been feeling Blah lately? What’re your thoughts about languishing? I look forward to reading your comments and answering any questions.


I live with chronic pain and depression

Do you live with chronic pain and depression?

Chronic pain and depression commonly coexist
Chronic pain and depression commonly coexistimage from Unsplash

If you’re living with chronic pain and depression, welcome aboard, you’re not alone. I’ve lived with both since a diagnosis of Transverse Myelitis (TM) since 2011.

Did you know that

  • around 20% of people worldwide are affected by chronic pain
  • chronic pain and depression commonly coexist
  • one study showed that 60.8 % of people with chronic pain are likely to have severe depression too
  • chronic pain accounts for 15% to 20% of visits to GP’s
  • depression is the third most common reason for consultation with a GP and the most common mood complaint
  • any pain that carries on for more than 12 weeks is classed as chronic

Dr Norman Kufakwaro, Consultant in Pain Medicine & Neuromodulation in the UK, says… Depression can be triggered or precipitated by chronic pain. As a result, individuals with chronic pain are at high risk of long-lasting emotional disturbances characterised by persistent low mood and anxiety.

Getting personal

Multiple Sclerosis and Transverse Myelitis causes chronic pain and can lead to depression
Multiple Sclerosis and Transverse Myelitis causes chronic pain and can lead to depression

I’ve lived with chronic pain and depressive episodes for 10 years now. I say episodes because while I’m always in terrible pain I’m not permanently depressed.

I have good and bad days and often my depression is reactive. I’m not good if I’m feeling overloaded, weighed down by tasks or too much is expected of me.

Where before I could multitask now I can only do one thing at a time, and complete only one major task per day.

A major task might be attending to my hygiene and even then, I feel faint after showering. Another might be trying to blow dry my hair, getting dressed, attending an appointment, going to the local shops or cooking a family meal (which I truly enjoy).

Unfortunately, it’s all I can cope with before I become utterly fatigued and unable to manage anything more. I like to think I do all this quietly, and without too much fuss, just taking myself off somewhere quiet to rest and recover.

Unlike my other half!! “Ow,ow, ouch, ooh,ah,ow, ow, owwwwwww, flippin’ ow!”

Other people’s pain

Man with chronic back pain
Chronic back pain — Photo by Pexels.com

Now, I know pain in its many forms. Did I mention that I’ve lived with it for 10 years? Yes, well can someone tell hubby that! Please?! The poor love currently has a bad back.

Now, it’s clear to anyone, even with their eyes covered, that he’s in pain, (“Ooh, ow, ouch, oooooh…….. Aaah, help me. No, don’t move me. ……….”) and I feel for him. I really do.

But why the heck does he have to make so much bloody noise? Neighbours in a one-mile vicinity must imagine I’m killing him. Or perhaps that’s just wishful thinking — on their part, not mine 😉

I get it, I do, honestly. Pain hurts! But just take a damn tablet for crying out loud, until you get to see an osteopath or your GP. Make an appointment or just shut. the. hell. up! Okay, rant over, and back to those who live with chronic pain (quietly) and associated depression.

Supporting someone with a chronic illness

I just took a short break from this post to read that of a fellow blogger, also named Caz, at Invisibly Me. She’s written about supporting a loved one with a chronic illness — way better than I could, and you might want to read it. Just click on her logo. There’s no point in re-inventing the wheel, right!

New chronic pain symptoms

Missed appointments cost the NHS  millions of pounds each year
Missed appointments cost the NHS millions of pounds each year — image from Unsplash

After recently moaning to my GP about what appears to be many new chronic symptoms, she organised an appointment with my neuro team. Said GP wasn’t happy that I’d apparently missed a follow-up appointment in February with my usual team.

Since I’d received my appointment letter about a year ago, was it any wonder I forgot! However, it turned out to be a stroke of luck for me.

I got to see a new Consultant, Dr Marta, who specialises in neuromuscular disorders such as my own Multiple Sclerosis (MS), and appeared to actually give a damn.

She suggested we start at the beginning and she took a full medical history then asked about these new symptoms. She then conducted a few physical tests and asked lots of questions before she explained what would happen next.

Whoop, whoop! If I could have skipped (I can’t) out of her office, I would’ve. I felt listened to and heard for the first time in years. If you’ve ever had to visit the medical profession for long periods of time, you might understand how some of them make you feel like you’re wasting their time!

Biopsychosocial approach to pain management

Image by Monica Noy

Dr Marta used what’s known as the Biopsychosocial approach which addresses pain (health) from multiple angles: physical, psychological, and emotional. The biopsychosocial (BPS) model was originally described in 1977 by George Engel, a professor of psychiatry at the University of Rochester. 

It uses what scientists know to be true about the connection between the brain and physical pain signals in order to change these signals over time. Quite honestly, I’m not sure.

It’s said that when it comes to recurring pain, the brain, nervous system, and body have locked into a painful cycle. The biopsychosocial approach educates pain sufferers on the patterns and habits that might be reinforcing the painful cycle and the powerful new patterns and habits that can break it. Hmmm!

The biopsychosocial approach has allegedly helped millions of people get rid of the real, physical pain in their bodies. The jury’s out on that one. But I’ll give it all a go.

Pain Management referrals

I’ve been referred to

Restless leg syndrome can cause sleeplessness and depression
Chronic restless leg syndrome can cause sleeplessness and depression
  • A two-hour Pain management class, which I’ve already attended and, no disrespect to the three medical professionals (Occupational Therapist and two 15-year-old Physiotherapists?), but it’s all stuff I knew already.
  • Pain psychologist for Cognitive Behavioural Therapy to find coping skills for dealing with the pain. On top of the MS pain, I also have Restless Leg Syndrome (RLS) and restless body syndrome (yes, it’s a syndrome) and I’ve tried absolutely everything to manage this kind of pain, without success. Here’s hoping.
  • Dr Marta also requested another full MRI dye contrast to rule out any further attacks or changes since 2011. Some MRI scans involve having an injection of contrast dye. This makes certain tissues and blood vessels show up more clearly and in greater detail. Sometimes the contrast dye can cause side effects, such as: feeling or being sick. Oh, just great!
  • Full bloods; 11 vials taken that day; to find any disease that may have caused the constant all over body pain.

Addiction to pain medication?

Am I addicted to pain medication?
Am I addicted to Tramadol — Photo by Pexel.com

Dr Marta suggested that long-term use of Tramadol can cause this all over body pain which p’d off me quite a bit because, as I told her, I only take half the amount prescribed, and I cannot move in the mornings without it. She recommended that I stop the Tramadol

I was even more p’d off ‘cos hubby agreed with Dr Marta as that’s what happened to him when he used tramadol??? and — it’s addictive! Duh! He only used it for a month or so, and very little of it!

So — I tried going without Tramadol for the last three days. OMG! The pain was sheer torture! I could barely walk, bend, stand, sit, lie down or get comfortable. Can you imagine not one, but two people in excruciating pain, in the same room!

Last night I had to give in and take, not the two prescribed, just one Tramadol. Fortunately, I have a telephone appointment with the Pain Psychologist next week where I can have a chat, and look at other more effective ways to cope with the pain 😕

As many of you know, I was a Mental Health Nurse, Ward Manager, CBT Practitioner, and Mental Health First Aid (England) Trainer, so I have a relatively large toolbox of coping skills and different approaches to managing depression.

Furthermore, before my nursing career, I studied hypnosis, various forms of massage, mindfulness and visualisation…………………. so I’m aware of which self-help techniques either work for me (or don’t).

I’ve tried most things, including cannabis, which just makes me paranoid — yuk!. I’m finding it almost impossible to self-therapise (treat one’s self), so wish me luck with my upcoming therapies.

Over to you


Do you or someone you love live with chronic pain and/or depression? Can you relate? What coping skills do you use? Do they work?

I look forward to your comments and/or tips, and I’m happy to answer any questions.


What happens in a Community Mental Health Team

What is a Community Mental Health Team (CMHT)?

Community Mental Health Teams are multi-disciplinary
Community Mental Health Teams are made up of multi-disciplinary professionals

Have you ever wondered what happens in a Community Mental Health Team (CMHT)? Let’s take a look.

They were developed in the UK to deliver Care in the Community in the late 1980s. This was a British policy of deinstitutionalisation; treating and caring for physically and mentally disabled people in their homes rather than in institutions. 

A GP might refer an out-patient, but in-patients are generally allocated to a CMHT prior to hospital discharge. These CMHTs are made up of various multi-disciplinary professionals such as:

  • Community Psychiatric Nurses (CPNs) and unqualified support staff
  • Social workers and Approved Social Workers (ASWs); social workers who’ve undergone specific training in mental health law; the Mental Health Act 1983. This then enables them to carry out Mental Health Act assessments with other professionals.
  • Consultant Psychiatrists, Senior Registrar and/or Senior House Officers (SHOs) who are Doctors undergoing their six months training in a particular area of medicine. In this case, Psychiatry.

Once referred to the CMHT, an assessment would be completed to build up an accurate picture of a person’s needs. The patient might get help from either one or two of the above professionals, depending on their needs.

My first placement at a Community Mental Health Team

How a basement CMHT might look
How a basement CMHT might look — Image by Washingtonpost.com

As a Mental Health Nurse student, I was allocated to Alan, a CPN who would be my supervisor during this placement. I arrived early so I had a coffee and introduced myself to a few of the team while waiting for Alan.

It was eight fifty-five and the team’s overall mood matched the weather that stormy Monday morning. Had they not been sitting at desks, behind the flexy-plastic window, I might have thought they were patients with depression — just staring blankly into oblivion.

I smiled as the front door opened and an older gentleman walked in. He was wearing a tatty tweed jacket, a moth-eaten jumper and a shirt so old, the collar was frayed. His creased trousers looked as though they’d had an argument with his ankles and his black plastic slip-on shoes squeaked as he walked.

Still, his gappy-toothed smile was welcoming. He stuck out his hand, pushed open the inner door with his backside and introduced himself as Javid, a Social Worker.

I explained who I was and he took me down to what looked like a fusty old storeroom. He pointed out his desk, Alan’s desk and the one opposite that I could use, and off he went.

Student Nurse Practice Based Assessments

I went through my Practice Based Assessments (PBAs) to see which ones I might be able to meet — sooner rather than later. Students have a list of evidence-based tasks, to be carried out during placements, which are assessed for competency by their supervisor. This was a lengthy process so I always liked to get a head start and not leave the PBAs right until the end of placements.

While idly thumbing through a patient file, I happened to look up and saw a rickety old bike being chained to the railings outside. I watched from the basement window as a pair of green wellies marched up to the front door. The wellies stomped about a bit before thundering down towards the basement.

The office door crashed open and there stood Alan! He pulled himself up to his full six-foot-plus, puffed out his chest and glared at me. “What on earth do you think you’re doing?” a broad Glaswegian accent rasped. Think Billy Connolly!

“Javid said I could look through……..”

“Is Javid your supervisor? No, he’s not. I am. Javid is an ASW and you. are. a. mental. health. student. Are you not?” He turned on his heels saying “I’ll get a coffee and see you when I come back!”

And this was how Alan continued over the next few weeks; barking orders at me and ignoring any questions, or feeding me wee snippets about his patients.

Depot injections by Community Mental Health Team

Intramuscular depot injection administered by Community Mental Health Team
Intramuscular depot injection administered by Community Mental Health Team

I was surprised one morning when Alan told me I was to run the weekly Depot Clinic under his supervision. This is where patients come every 1-4 weeks to have antipsychotic medication via intramuscular injection.

Some patients prefer this as they tend to forget or refuse to take their daily tablets. Other patients must have medication by injection under a Section of the Mental Health Act 1983. If a patient is known to be non-compliant with medication, Depot injections are often recommended during Multi-disciplinary team (MDT) meetings.

“You know how to administer injections, I presume?” snapped Alan. And without waiting for an answer, “don’t forget to check which side they had their last injection. I’ll countersign the medication charts when you’ve done.” I’d observed several injections during my in-patient placement but I’d never actually administered one. I told Alan and all he did was nod; indicating me to just get on with it.

My first patient was due in soon so I checked her medication chart and spotted the small letter ‘L’ underneath the signature box. I gathered this meant that their last injection was on the left buttock so this time it would be on the right. Injections sites were alternated to stop the buildup of scar tissue on one side.

Administering my first depot injection

Preparing depot injection
Preparing depot injection — image by Pixabay

Sally, a 36-year-old female, appeared sullen and I wasn’t sure I’d be able to engage her in idle chit-chat before stabbing her with the needle.

However, she chatted amiably about me being a new student and asked whether I liked football. The needle was out — and I told her I was an Arsenal fan. “Blinding. Me too. But I ain’t never been to a game.”

I did take her along to a match some years later, but that’s another tale. Anyway, there I was, scribbling my signature on her medication chart when she turned her head to me and chirped “Come on, ‘urry up mate!”

“All done Sally.” Ha! I’d given my first real injection and she didn’t even notice. Her eyebrows shot up then I got a wink and a smile of approval as she buckled up her jeans.

“You’re alright you are. She can come ‘ere again Alan.” She gave me a knowing look and glared at him as she left the clinic. Not a word from him, just another of his withering looks as I passed him the chart to countersign.

My first Community Mental Health home visit

Community Mental Health Teams work with patients in their own homes
Community Mental Health Teams work with patients in their own homes — Image by Pexels

A month passed and Alan continued to arrive late every day. One morning, Javid asked if I’d like to go out and visit some of his patients with him, and I jumped at the chance.

We arrived at Anne’s house to see her in the front garden barefoot and wearing a flimsy but colourful kaftan. She twirled around on the grass, head back and arms outstretched as she sang. Julie Andrews popped into my head and I fondly remember Anne whenever I hear “The Sound of Music”.

Anne grinned when she saw Javid and waved him in with a dramatic curtsey, then called the children in for lunch. Four skinny under-twelves trooped into the living room and hungrily snatched up huge doorstep sandwiches.

The kids danced, skipped and jumped all over the two mismatched sofas as they munched. They sang silly songs and clapped loudly, dropping crumbs everywhere. Their likeness to the much-loved Von Trapp family didn’t go unnoticed.

They were clean, wearing all manner of clothing; some too big and some too small, all barefoot, but they looked happy and were both well-spoken and well-mannered.

Bipolar disorder

Bipolar disorder and mood swings
Bipolar disorder and mood swings — Image by Crazyhead comics

Anne had a diagnosis of Bipolar disorder which used to be known as manic-depression. Someone with Bipolar has episodes of mania (feeling very high and overactive) and periods of depression (feeling very low and lethargic).

Unlike simple mood swings, each extreme episode (high or low) of bipolar disorder can last for several weeks, or even longer. Bipolar disorder is treated with mood stabilisers such as Lithium or Valproate, which were all originally made for treating epilepsy.

Community Mental Health Assessment

Javid asked Anne if it was okay for me to complete a mental health assessment, done by observation and direct questioning, assessing things like:

  • mood, behaviour and appearance
  • thought-form for speed and coherence
  • thought content for delusions, suicide, homicidal or violent thoughts, obsessions and perception
  • cognition for orientation to time, place and person, attention and concentration

Finally, I assessed her insight to gauge whether Anne knew her incessant chatter, thought disorder and her behaviour wasn’t normal, given the weather and both her and the children’s appearance. However, she didn’t believe she was currently unwell “This is nothing.” she chirped. “You’ve seen me worse Javid.”

Javid smiled, then we stood to bid our goodbyes, and I couldn’t help but giggle when Anne and the children burst into song “So long, farewell, Auf Wiedersehen, adieu. Adieu, adieu. To you and you and you.”

Sitting in his car, Javid talked me through the visit and agreed that yes, he had seen Anne worse. “Really?” I asked. He nodded and chortled. However, he said he’d check to see if there was a bed so that he could plan a voluntary hospital admission over the next few days.

Javid said that Anne would use all kinds of delaying tactics but would eventually agree to voluntary admission. “She knows she has a chronic (long-term) diagnosis and she’s well known to services. She’s aware that if she doesn’t go voluntarily, she’d be admitted under Section 3 of the MHA 1983”. This means patients can undergo coercive interventions, such as enforced medication, seclusion and restraint.

Mental Health documentation to be completed

CPNs have to complete lots of documentation
CPNs have to complete lots of documentation — image from Pexels

After a few more less-exciting home visits Javid and I returned to the CMHT around four-fifteen, just in time to complete our documentation.

Alan threw me a look of utter disdain as he snapped his briefcase shut and headed for the door. Thank God for the weekend!

Alan’s lateness carried on, his behaviour remained erratic and his lack of interest or guidance was getting me down. There were days I was in tears, despite the admin girls telling me to ignore him, and making me laugh.

Every day Alan was late I went out on visits with Javid or other staff who’d asked if I’d like to accompany them. I was gaining so much experience as some staff were supportive and fed back to me my strengths and small areas that I could build on.

My Practice Based Assessment

Most of my PBA’s had been completed I and was pleased with the evidence I’d attached. I’d made sure there were no names or numbers that could identify individual patients.

The staff I’d worked with wrote on my PBAs that I was really intuitive and empathic, that I had excellent communication skills, and had been proactive in achieving the high standards I’d set myself. Overall they said they were impressed. All I needed now was for Alan to sign them off as having been completed.

The arrogant shit refused! He hadn’t seen me complete any of the tasks listed on my PBA so he would not sign them! He couldn’t possibly! Aaarrgghh!

Over to you

But it got worse……….. I’ll do a short follow-up. But in the meantime, I’m happy to answer any questions and look forward to hearing what you think about care in the community. Does it work? Or even, just say “Hi.”

Do you need some self-help tips for mental illness

Living with mental illness and the self-help methods I tried

Having a mental illness terrified me — Image by Pixabay

Let me tell you, I know all about mental illness and self-help, both from my personal and professional experiences.

This is the 3rd in a series of “My journey through Anxiety, Depression and Psychosis.You can read Part I and Part II if you want to find out more.

Some of you will already know a bit about my journey. However, after recent personal trials and tribulations, I thought I’d revisit this post.

It reminded me how bad that period of my life was. I was able to see how far I’d come, how I got through it, and what helped. Having re-read the post I realised that no matter what life throws at me, I will never let myself become that person again. I will seek out support way before it gets to that level.

See, I know how deep that black hole can be and, once you go down there, it’s not easy to climb your way back out! Mental illness is so hard to live with.

If you see anything of yourself or your own experiences in this post, perhaps you’ll feel relieved that you’re not alone, and you’ll seek support.

While reading my story you might gain new insight into different mental health problems, and understand how difficult it is for people who experience mental illness. Maybe you’ll recognise some of the symptoms in a friend or family member and learn how you might be able to help them.

Okay, let’s look at the self-help methods I tried for my anxiety, depression and psychosis. What worked, and what didn’t work so well.

Who said I had a mental illness?

One day I took the boys to see our GP about their asthma and after he’d seen them he sent them out to the waiting room. He turned to me and, with his hand resting lightly on my arm, said “Tell me, what’s the problem? You so thin and though you smile, I think you very sad.”

The floodgates opened and out it all tumbled; I sobbed, wiping the tears and snot on my hand as I explained how the boys’ dad had been cheating and we’d broken up around eighteen months ago.

My GP told me to take the boys home, he would make some telephone calls and I was to come back to see him in an hour. When I returned to the surgery he’d called a Psychiatric Consultant colleague who agreed to see me; like — now, at our local general hospital, and Dr Nga was going to drop me off!

Now let’s go back a bit………..

Self-help for my mental illness started here

I needed help for my mental illness --- Image by Unsplash
I needed help for my mental illness — Image by Unsplash

……….I’d been struggling desperately. I couldn’t see an end to the pain. I felt scared, worthless, hopeless, and suicidal.

That was when I had my own ‘breakdown‘………….. and that’s exactly what it felt like. Both physically and mentally, I was broken.

I had panic attacks throughout the day and particularly at night, keeping me awake.

It was torturous; twenty-four-seven, week on week and, with no end in sight, I wished I was dead!

At that time, I couldn’t talk to anyone but I knew I needed help. I was desperate so I got books from the library (pre-wi-fi) and tried to learn some self-help techniques for my anxiety, depression and psychosis. It went something like this:

Natural Self-help for your mental illness

Natural self-help for my mental illness

I tried every natural stress relief, sleep-inducing, over-the-counter remedy known to man, without effect.

As an aromatherapist, I made up bottles of stress relief oils then bathed in them and sprayed them around liberally.

However, despite all the lovely citrusy, spicy and fruity oils, all I could smell was the overwhelmingly floral lavender, reminiscent of my granny’s old underwear drawers. This didn’t work either.

Soothing massage
Massage can help relieve anxiety and depression
Massage can help relieve anxiety and depression

As a qualified massage therapist, I was aware of the benefits so I booked myself in for a few sessions. However, the first masseuse pecked at me like a small bird trying to feed itself for the first time; it was more irritating than soothing!

massage seated

The second time, I went for a seated massage which involves sitting on the chair with your upper body leaning forward, your arms on armrests and your face peeking through a hole. Looks comfortable, right?

Well, this lady (who’d attended the seated massage course with me) had me sit on a swivelling office chair! My muscles tensed more as I had to use my feet and legs to keep the chair from spinning!

running machinejpg
Exercise is known to relieve anxiety and depression

I used the local gym seven days a week, twice on Sunday; pounding the treadmill and pedalling like fury on the exercise bike.

If I couldn’t get to the gym I made up for it by jogging on the spot and running up and down our stairs.

I tried almost everything to relieve the constant anxiety and to wear myself out so I could sleep, but even the excessive exercise proved fruitless.

Hallucinations and paranoia

After three nights without sleep, I started to hear, see and feel odd things. It was strange because I heard people (I didn’t recognise the voices – but they were real) talking to me and about me; saying I was no good and I was dirty.

Suddenly I saw mice scurrying over my wooden floorboards and felt something crawling under my skin; it itched and I scratched and felt like bugs. I got up, tore off the bedsheets and put them into the washing machine on a 90-degree wash to get rid of anything that might have been crawling on them.

Worse still, that night I was wide awake, sitting curled up on my kitchen floor, and it came to me — with a thud-like a blow to my stomach — I’d killed someone!

Mental illness made me remember that I’d killed someone

I remembered it! OMG! My heart pounded and I felt the colour drain from my face as it all came flooding back.

How and where I’d buried that someone; by a huge tree outside my aunt’s flats. But I couldn’t remember who the someone was. I felt sick and tortured myself trying to figure out who it might be.

After that, whenever I saw a police car my stomach did somersaults, and I thought ‘This is it. They’ve come for me.’ I was terrified. However, there was no knock at the door.

At times I wondered if I should just hand myself in, and let them find out who I’d killed.

Mad, nuts or crazy

Devastated by relationship breakdown
Devastated by relationship breakdown

Although close friends and family were aware of my break-up with the boys’ dad and knew how devastated I was, I couldn’t tell anyone what was going through my head. I was afraid they’d think I was mad, nuts, or just plain crazy and that I should be locked away.

I certainly felt like I was going mad!

Seeing rats and the unknown ugly faces frightened me, but if I closed my eyes at least I would get some temporary relief.

However, the voices were incessant and unbearable; the constant rabble of people talking out loud about me and my inner fears. They spoke of all the bad things I’d ever done, and what should happen to people like me! They played tricks, and they were cruel.

Relaxing music

Anxiety, panic attacks, and voices kept me awake
Anxiety, panic attacks, and voices kept me awake

The voices kept me awake with their irrepressible verbal abuse. So, I bought a cd player, earplugs and a few (out there) CDs with relaxing music. The sound of water, the waves, and dolphins in the background helped me sometimes — if I really concentrated on them.

I replayed these throughout the nights but still, my heart pounded in my chest and thundered in my ears. I could barely breathe, and the panic attacks raged.

By the time I got the boys up for school, I was a wreck; I was sluggish and jittery, but I somehow managed to hide it from the boys. Even now, thankfully, they tell me how they always remember me being cheerful and smiley.

Fortunately, my part-time but demanding job at a fashion company helped abate the voices for a few hours but the anxiety, depression, and panic remained.


Can hypnosis be used as self-help for anxiety, depression or psychosis?
Can hypnosis be used as self-help for anxiety, depression or psychosis?

I even tried expensive hypnotherapy but I couldn’t relax enough to go into a trance-like state.

I bought a hypnosis video to use when the boys were in bed. After watching it many times I did eventually doze off. Then if I kept my eyes closed when I ‘came to’, I was able to climb the stairs, get into bed and sleep for a while. Sometimes it didn’t work but I was so grateful for the times it did.

Did self-help work for my mental illness?

In hindsight, and before I studied mental health for three years +, I didn’t know that what self-help methods worked for anxiety or depression most certainly didn’t work for psychosis.

“Hindsight is not only clearer than perception-in-the-moment but also unfair to those who actually lived through the moment.”

Edwin S. Shneidman


Stratheden Hospital housed patients with severe mental illness
Stratheden Hospital housed patients with severe mental illness

During my unwell years, I often remembered how, as kids, we’d all say stupid things like “The men in white coats will come to get you.” or “You’ll end up in Stratheden, (our nearest asylum)!

I recalled one day Mum said my stepdad was taking her to hospital for a short stay and I asked if I could go with them. Dad said no, and Mum said, “Aye; she’ll be fine.” So off we went and I didn’t think too much of it when we passed our local hospital — until I saw the massive sign — Stratheden Hospital.

I assumed and hoped we’d just drive past that too. But then we pulled up at the foreboding buildings and the grounds surrounded by high metal railings. I was petrified, and felt a certain shame; my mum was going into the Loonie bin. Oh my God!

From the car park, I could see people roaming around; some were stooped or walked oddly, and others made strange noises. A lady with long scraggly grey hair, wearing odd clothes, waved at me frantically and then cackled like an old witch. Not sure if it was designed to frighten me, but it did!

Mum and dad got out of the car but I wasn’t allowed to go with them so I was left sitting in the car and told not to open the doors to anyone. Ha, as if.

Back to the future

Fortunately, although I had suicidal thoughts, the Consultant Psychiatrist and the Psychology team were confident that I had no intention of killing myself. I’d said that even though I felt suicidal, I could never leave my sons with that legacy.

Hence, there was no need for admission, and three years of weekly gut-wrenching counselling followed — on and off because at times I was too afraid of the feelings it all evoked.

I hope you’ll continue to read My story, Part IV. You’ll learn about my suicide attempt and more of the hell I went through as I lived with mental illness.

Over to you

In the meantime, can you relate? Have you tried any of the self-help methods for anxiety, depression and/or psychosis? What worked or didn’t work for you? I’d be interested to hear your thoughts and I’m happy to answer any questions.

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