Merry Christmas

Wishing you love, peace and happiness

I haven’t been around much lately and I’ve just come online to wish you all the very best during the festive season.

The magic of Christmas never ends, and its greatest gift is being with my family and friends……….

Me

I hope you enjoy the festive season as much as I do and that the new year brings us all much peace and happiness. I’m not sure how much I’ll be online, typing, as I just don’t have the energy right now. But honestly, I am reading and enjoying all your blogs.

Look after yourselves and stay well. I look forward to catching up with you in the New Year 🙂

Caz

Self-care during the festive season

How to get in some self-care during the holiday season

Look after your self-care during the holiday season
Look after your self-care during the holiday season — Photo by Pexels

Most of us know how stressful and exhausting the festive season can be, and we tend to forget about our much-needed self-care.

Anecdotally, it’s known, at least by anyone who has extended family, that more stress-inducing grudges are formed during holiday seasons than at any other time of year. Old family rivalries, arguments, one-upmanship, split families and unresolved conflicts can all contribute to holiday anxiety.

Other sources of stress might be political (think Brexit or Trump) or cultural clashes caused by generational or even geographical differences, which can result in slightly tense atmospheres or even furious rows over the dinner table.

Fortunately, my family has managed to avoid any of the above and boy am I glad. I’m not sure how I’d cope. Let’s face it, we don’t need any of that, we’re already exhausted by our

extra-heavy workload prior to the festive season

Take time to relax during the holiday season -
Take time to relax during the holiday season — Photo by Pexels
  • writing lists and cards before the last post. Buying and wrapping lots of unwanted gifts – tho’ I’m told I good at getting them right.
  • planning the menu, the huge unnecessary food and drinks shop because the stores are all shut for — uh, one day! Oh, and not forgetting that Aunt Annie’s a vegan, little Guy’s gluten-free and niece Natalie is allergic to nuts.
  • planning who’ll sit where to avoid any old family feuds, tho’ I wouldn’t worry about it too much — they’ll have to pull crackers, wear silly hats, and smile — like everyone else.
  • table decorating – is huge now – you see everyone posting ‘my amazing Christmas table on Instagram and Facebook – what’s all that about? While I love my table to look festive and special, not sure my pals want to see ten photos of it – all from different angles.
  • being all things to all people at all times i.e. “Mum, while you’re out will you pick up a gift for Aunt Annie from us? Then wrap it and put a gift tag and a ribbon on it too? You’ve always got loads of that stuff.”

Phew! I’m already shattered. So, having done all the above, you’d think you’d be able to relax on the day, right?

Nope! You’ve still got the kids to get ready (remind them about their manners and “yes, you must give bearded Aunty Annie a hug) ………………..”

Right, rewind……. let’s start again. Okay, so I’m a bit late posting this as Christmas is almost upon us and most of you will have done all your cards, shopping and preparation.

What self-care is — and what it isn’t

Good self-care includes taking in a balanced diet and adequate fluids
Good self-care includes taking in a balanced diet and adequate fluids — Photo by Pexels

What is self-care?
Self-care is any activity that we do deliberately in order to take care of our mental, emotional, and physical health. Although it’s a simple concept, in theory, it’s something we very often overlook. Good self-care is key to improved mood and reduced anxiety. It’s also key to a good relationship with oneself and others. Self-care tops up our tank and keeps us fuelled.

What isn’t self-care?
It isn’t a selfish act or only about considering our needs; it’s rather about knowing what we need to do in order to take care of ourselves. Thereafter, we’re more able to take care of others too. That is, if we don’t take enough care of ourselves, how can we be in the place to give to loved ones.

How to look after your self-care during the festive season

Aromatherapy oils are great stress relievers
Aromatherapy oils are great stress relievers — Photo by Pexels

But, and it’s a big one, you still have a few weeks to get some self-care in, so that you’ll be as relaxed as everyone else on the day:

  • if you haven’t already done so, enlist some help: write down who’s doing what on Christmas and Boxing Day, and make sure the kids are involved — delegate, delegate, delegate.
  • when the going gets tough, remember the holidays are a time for family, for friendship and spending time together — so what if you accidentally throw out your stock for the gravy (like my mum did at ours one year, to her horror) – use a packet! If you burn the roasties, cut the burnt bits off and hide them with the stuffing or Brussel sprouts – no one will notice 🙂
  • enjoy some simple things like go for a walk somewhere calm and soothing —gentle activity such as a 15-minute walk helps your body to regulate its insulin production, which can be disturbed by stress.
  • try yoga, meditation or do some gentle stretches to loosen those tight muscles.
  • take time out to have a massage or even just get hubby to give you a ten-minute foot massage/shoulder rub.

For an extra boost during the festive season

Visualisation can help reduce anxiety
Visualisation can help reduce anxiety — Photo by Pexels
  • Dot your favourite aromatherapy oil around the house — lavender is great for stress. In aromatherapy, essential oils are inhaled using a diffuser, or diluted with carrier oils and applied to the skin for soothing benefits.
  • have yourself a long, luxurious bubble bath – small acts of self-care go a long way in helping us feel more positive and energised.
  • have yourself a nice hot chocolate (with or without the marshmallows) and snuggle up on the sofa/bed with a good book for a few hours.
  • listen to your favourite music and, if you’re feeling up to it, dance like no one can see you, and sing along like no one can hear you.
  • catch up with a favourite friend and have a good old belly-laugh, nothing better to get you in the mood and it’s well known that fun and laughter are great stress relievers.
  • go to the cinema, the theatre or a comedy show – sit back and relax
  • eat mood-boosting foods; a carbohydrate-rich meal can help to boost serotonin levels.
  • wind down gradually before bedtime and get plenty of sleep; set an alarm for bedtime and go to bed at the same time each night – to regulate your sleep pattern.
  • sniff some lemons (I’m not kidding) – according to researchers at Ohio State University, lemon scents instantly boost your mood.
  • and breathe – deeply – out then in, half a dozen times or so – taking just a few moments each day to practice some deep breathing exercises can decrease stress, relax your mind and body and can help you sleep better. Deep breathing is, among many other things, a relaxant, a natural painkiller, it improves digestion and it detoxifies the body.
  • Mindfulness reduces anxiety.
  • Acupuncture or hypnosis are great for anxiety and stress reduction.
  • Practice visualisation for 20-30 minutes.
  • a few minutes of gratitude.

Go on – treat yourself – try out a few of the above and let me know how you get on.

Over to you

What other stress relievers could we try (without reaching for the second bottle of Prosecco)? Any tips, please? Perhaps you’re just going to relax all by yourself during the festive period?

Me? I’m looking forward to seeing family, especially the little ones. They’re still only 5 and 3 so they’ll be excited and I can’t wait to see them opening their gifts and playing silly games with us all.

Oh, and what’s your take on gift-giving? I love it- I don’t give to receive, I just enjoy buying and giving gifts.

Not all disabilities are visible

Watch out for invisible disabilities

Does this little boy have and invisible illness?
Does this little boy have and invisible illness? Image from IDPWP

The International Day of People with Disabilities (IDPWP) theme for 2020 is “Not all disabilities are visible.” The IDPWP is held every year on the 3rd of December. I know I’m a day late but I’d like to share my experience of living with invisible disability.

This year’s theme focuses on spreading awareness and understanding of disabilities that are not immediately apparent, such as mental illness, chronic pain or fatigue, sight or hearing impairments, diabetes, brain injuries, neurological disorders, learning differences and cognitive dysfunctions, among others (IDPWP).

Raising awareness of invisible disabilities

During the COVID-19 pandemic, isolation, disconnect, disrupted routines and diminished services have greatly impacted the lives and mental well-being of people with disabilities right around the world. Spreading awareness of invisible disabilities, as well as the potentially detrimental— and not always immediately apparent— impact on mental health is crucial as the world continues to fight against the virus. 

I live with invisible disability

What Transverse Myelitis looks and feels like

As many of you might know, almost ten years ago, I was struck down with a rare disorder – idiopathic (cause unknown) Transverse Myelitis (TM). It’s normally caused by a virus but, despite the hundreds of tests, mine wasn’t, hence the idiopathic.

TM is a rare neurological disorder, a “neuroimmunological” disease of the central nervous system. It’s an inflammation of both sides of one (or more) section of the spinal cord.

TM involves inflammatory attacks in the central nervous system which damages the insulating material covering nerve cell fibres (myelin). In short, it creates lesions on the spinal cord that interrupt the messages that the spinal cord nerves send throughout the body.

Symptoms of Transverse Myelitis

Muscle weakness in the legs can cause stumbling
Muscle weakness in the legs can cause stumbling — Image from Pixabay

The main symptoms of Transverse Myelitis are:

  • muscle weakness mainly in the legs – so I can stumble and trip and appear drunk to others. My arms are weak too and I’ve dropped the kettle, pots and pans and many cups of coffee causing severe scalding.
  • change in sensation (unusual feelings) in the lower half of the body. Mine occurs from just under my arms to my toes. It feels like a tight banding all the way down to my feet so even wearing shoes hurt. I do get odd looks wandering around in flip flops in the rain or cold.
  • numbness, and pins and needles from the torso down
  • heightened sensitivity to touch i.e. the feel of clothing on the skin might cause pain (allodynia). Even a single hair can cause me pain, like one unshaved leg stabbing the other! A light breeze blowing on my legs can be agony and a cold wind blowing on my torso feels like a hot water bottle in the area. All this can change each day and it’s never the same feeling every day.
  • heightened sensitivity to temperature i.e. extreme heat or cold. My normal body temperature is now anything from 32.3 to 35.9° (even in the sun) which is really low compared to others at approximately 37°. This causes extreme perspiration (I do not sweat buckets, rather I perspire gracefully 😂) if the temperature rises due to any activity i.e. showering or cooking.
  • losing the ability to tell the temperature of water or objects. This happens mainly on my left side but does occur on both sides. It’s really odd when I’m in the shower or the bath because different areas of my body feel different temperatures. And say when rubbing my hands together I don’t know which one is cold and which is hot. Common sense should tell me, but perhaps I’m missing that 😂 .
  • pain (nerve and muscle). The nerve pain feels like I’m burning and tingling with sharp stabbing shooting around all my nerves. And the muscle pain — well, that feels like I’ve done 12 hours in the gym. I ache all over and any movement is painful.
  • tiredness and extreme fatigue. Just showering and drying, together with brushing my teeth, or ten minutes of housework feels like I’ve done a days work already. Some days I have to lie down before I fall or faint with exhaustion and, trust me, this is no exaggeration.
  • muscle spasms and twitching muscles. The twitching in my muscles feels like that twitch you get in your eye – painless but irritating. The muscle spasms can be more painful and can make my hands and fingers contort and I can’t hold a pen or cutlery properly.
  • a general feeling of being unwell i.e. just not with it and my body feels like it doesn’t belong to me, it’s separate from my mind — that’s literally how it feels even though that common sense thingy tells me it can’t be.
  • problems with the bowel and bladder. Suffice to say I’ve had many an accident both at home and in public. And please, don’t suggest those big uncomfortable incontinence pants — it’s just not happening! I’m 59, not 89.

The unusual feelings (paraesthesia) that we experience generally starts from the spinal area where the lesions are. My lesions started at C5-6 and L5 so areas like my arms, wrists and hands are affected. Imagine a horizontal line or band drawn around the torso i.e. from just under my arms, and that’s where the unusual sensations begin – so that, for me, is all the way down! Aaarrgghhhhh!

Mental health symptoms can be invisible

Mental health symptoms can be invisible
Mental health symptoms can be invisible — Image from Pixabay

That’s TM in a nutshell. So, please try to understand how invisible illnesses can affect people, how difficult life is for them and for those around them i.e. their families and carers can have it tough too. I know mine do and sometimes I wonder how or why they put up with me. It’s not just the physical side but also the

  • mental health side like depression and/or anxiety, suicidal ideation, hallucinations due to extreme fatigue, and
  • sleepless nights
  • sadness for the loss of the life I used to l used to live, the loss of the job I loved, and the friends who just moved on — without me.
  • anger at not being able to do the things I used to and having to be cared for, cleaned up behind or helped to shower and dress
  • loss of confidence makes me upset, feel useless, worthless and sometimes hopeless
  • annoyance when people laugh if they think I’m drunk when stumbling or when people glare if we park in a disabled bay, like we don’t belong there…….

“You can’t understand someone until you’ve walked a mile in their shoes.”

Unknown

Have a little empathy and compassion and treat people with respect — always. Treat everyone you come across in the same manner. You never know what’s behind someone’s smile.

Okay, I’ve shared my experience of invisible illness……..

Over to you

ClipArt

Do you or someone you know have an invisible disability, or are you a carer? How do you cope with your disability or someone else’s? What’s been your experience with how people treat you or others with invisible illnesses? I’d love to hear your thoughts and I’m happy to answer any questions.

Poor practices within my NHS Mental Health Trust

I should have reported poor practices within my NHS Mental Health Trust to the media
I should have reported poor practices within my NHS Mental Health Trust to the media — Photo by Pexels

In my last two posts I wrote about dangerous practice on mental health units here and here. I said I should have reported the poor practices within my NHS Mental Health Trust to the media. I wish I’d had the courage to report my concerns outside the Trust — but the bullies stopped me!

The RCN says “Knowing if a situation should be raised as a concern can be difficult. Ask yourself whether it has caused harm or distress, or, if you let it continue, is it likely to result in harm or distress?

And the Nursing and Midwifery Council (NMC) Code is also clear: “you must act without delay if you believe there is a risk to patient safety or public protection.

All Trusts must have policies in place for such things as ‘Raising concerns’ or ‘Whistleblowing’ and they must state how they will support you through the process. While our Trust did have this policy, the processes were never followed through and my concerns weren’t dealt with appropriately.

Disturbingly, I had several concerns dismissed after going through the correct channels. And after verbally reporting many incidents of poor practice by my manager, I was sent to mediation with him. We were to be seen by a Consultant Psychologist (Sue) for ten one hour sessions to “sort out our differences.”

Staff mediation in my NHS Mental Health Trust

Staff mediation in the NHS Mental Health Trust
Staff mediation in the NHS Mental Health Trust — Image by Pexels

I should have walked out after the first session but I was intrigued to see where this mediation process would go. I could see the look of horror (she tried to hide it) on Sue’s face as I recounted how Perry had given out unauthorised antipsychotics.

She coughed almost embarrassed and asked him to reflect on the situation, sharing how he would do things differently the next time.

I would have laughed out loud if it wasn’t so serious. And this is how mediation continued.

Sue also raised her eyebrows at me when Perry told her I let a junior co-worker (Mal) live in my home for a short period of time. I explained how nurses and health care workers are known to flat-share and that there are no regulations to the contrary.

Manager propositioned junior staff

Manager propositioned and bullied junior staff
Manager propositioned and bullied junior staff — Image by Pexels

But Perry wouldn’t let up. He continued along the lines that it showed favouritism and that I was splitting the team….. Oh dear! He’s digging a deep hole…..

I explained how Mal had been propositioned by Perry many times and was afraid because Perry was using blackmail to get him to engage in a relationship with him. Perry was threatening to tell the team about our Mal’s confidences that he’d shared when he was an in-patient on Perry’s previous ward.

I continued with how Mal didn’t feel comfortable living in his own home because Perry was near-stalking and bullying him. Sue’s eyes were on sticks, and it was clear she wasn’t sure what to say.

During each mediation session, I was enabled to share all my concerns about Perry under Sue’s inquisitive and watchful eye. He’d put me in this damn situation, and now it was payback. I admit, I enjoyed watching him squirm and redden as I explained each incident of his poor practice.

The only good thing I know is that she would have discussed how wrong it all was with the Director who I’d complaint to. But I still wonder, why didn’t our Director or this Senior Psychologist deal with my concerns appropriately? They ought to have thrown the book at Perry. The guy was a maniac and they were allowing his behaviours to continue.

Senior nurse sleeping with junior staff

At almost the end of our penultimate session Perry chose to disclose a concern of his. He puffed out his chest, grinning like he’d just won the lottery and stuttering with excitement said to me “Kwami (another junior coworker) said that you and him were sleeping together. It’s not good as it shows favouritism within the team.”

“Okay, well I’ll sleep with all of them shall I?” I thought, and almost laughed, “Will that even it out?”

More raised eyebrows as Sue turned to me and said “I know this must be difficult for you and I can sense some incongruence. You’re smiling but I’m sure you’re angry. I’m sorry but this is the end of the session, can you hold onto this until next week?”

“I am angry but yes, I’ll hold it ’til next week.” I smiled as I stood and left, not before noticing Perry’s excited nod and grin at Sue. We both returned to the ward, Perry obviously pleased with himself, and I happily got on with the day.

Oh, I’m angry

Nursing colleagues having dinner
Nursing colleagues having dinner — Image by Pexels

Later that evening I invited Kwami round for supper with me, my partner, my parents, and my two adult sons. Over dinner I asked him “Did you ever, even in jest, tell Perry that you and I were sleeping together? Even if you said it in fun, just tell me.” Everyone almost choked on their dinners and stared wide eyed at Kwami.

“No way! Why would I say something like that? You’re all like family to me, you’ve fed me, invited me to family parties. No, I did not say it. Ever!” Again, later in the kitchen and alone, I said I wouldn’t be angry if he told me the truth, but just to tell me. “No. I give you my word.”

Next mediation session I sailed in happily and Sue started “Look, I know we had to end the last session at an awkward moment and that you must have been angry. How do you feel now?”

“Oh, I’m angry…….” I nodded.

“Yes, I’m sure you’re very angry with Kwami,” Sue appeased, and Perry sat there arms folded, all chuffed with himself.

“I am angry, my partner, my parents, and my sons are angry too. But not with Kwami,” I replied, turning towards Perry, “It’s you we’re all angry with. Kwami said no such thing to you. What is wrong with you?” I told him about the open conversation I’d had with Kwami…….

He reddened ‘cos he knew he’d been caught out and he spluttered….. “Well, it wasn’t Kwami, it…. it was someone else that told me and I’m not going to name any more names……” I knew all I had to do was wait………

Time for a formal written complaint

Mental Health Ward Manager raging
Mental Health Ward Manager raging — Bigstock.com

Then, as expected, he showed his true colours — raging, “Anyway, mediation. is. private. and. personal. between. us. It’s not supposed to leave this room. You shouldn’t have told anyone else what’s been talked about.”

Sue tried and tried to stop him as he yelled and counted on his fingers – 1) How I had no right talking about this, 2) how he’s putting in a complaint about me breaching confidentiality rules, and 3) having me moved to another ward…….

I just shook my head, stood and told Sue I wouldn’t be returning for the final session as there was obviously no point. I smiled, relieved that it was all over, and returned to the ward to call the Director.

This time I was putting in a formal written complaint about Perry’s behaviour and about every single incident of poor practice. I’m glad I had everything neatly filed away, safe — at home.

Over to you

ClipArt

I’m really interested to hear your thoughts on the situation. Would you put in a written complaint? I’ll let you know what happened in my next post. In the meantime, I hope you’re all staying safe, happy and well under the current restrictions.

While I’ll never actually be physically well, I feel relatively stable mentally and all’s good at this end. Had a sneaky visit (with masks) to watch our gorgeous grandchildren in the park this weekend. What a treat.

Dangerous practice on mental health units ignored

Dangerous Practice and ‘whistleblowing’

Dangerous practice on mental health units ignored. Whistleblowing
Who wants to whistleblow? Image by Freepik.com

Dangerous practice on our mental health unit was ignored on more than one hundred occasion. And that was just the incidents I knew about.

Take Perry, my former dangerous ward manager, from my previous post. He’d been working with a patient (Craig) who had schizophrenia and was struggling with telling his parents he was gay. Craig regularly told staff he was feeling lonely and really anxious, and we all knew how vulnerable he was. So what did Perry (our manager and Craig’s nurse) do?

After noticing that Craig had missed counselling twice a senior nurse, Mal called to see if he was okay. Craig said didn’t feel so good but he didn’t feel comfortable coming to the ward any more and asked to meet him elsewhere.

When Mal returned to the ward he informed the team that Craig had been on holiday with a member of staff but he didn’t want to say who. This member of staff had tried to engage him in some sort of relationship but Craig hadn’t been interested. There was a falling out after this and Craig reported spending the last three nights wandering the streets, afraid to return to the hotel.

It wasn’t difficult to put 2 and 2 together as Perry had returned to work a darker shade of pink than normal and his hair a paler shade of ginger.

Mal was the same grade as me so he should have been the person to speak with Perry or someone more senior but he refused to. So, now the whole team knew — yet nobody felt comfortable raising or reporting the incident.

Raising concerns

Choose to look away
Choose to look away

All NHS trusts and primary care organisations in England must have a raising concerns policy. This policy will include the type of concern you can raise, how you can raise it, who you can raise it with, and your organisation’s commitment to supporting you through the process.

Unfortunately, despite all the available policies, there was a culture of ignoring or dismissing concerns within our unit. And much of the time managers turned a blind eye. I know! I’d previously relayed concerns to my managers or modern matrons who chose to look away when:

  • I mentioned one nurse’s regular drug errors and was told “Oh, look, she’s been here for years and that’s just the way way she does things sometimes.” Right, that makes it okay then?
  • a male member of staff helped a patient back into bed one night after she’d fallen out, but didn’t call the doctor to assess the patient. In the morning, it was clear that the lady had actually broken her arm, and she’d been left in pain all night. When I mentioned it to our manager he shrugged his shoulders “she’ll live.”
  • another manager would allow staff on night duty to sleep for 2-3 hours but I was instructed to “ignore it, he’s the manager and if it’s okay with him……” Really? Until there’s an serious untoward incident (SUI) or fatal accident.
  • or when I told of my manager giving out whole boxes of unsubscribed medication, his boss (a Modern Matron) asked me “are you trying to get him sacked so you can have his job?”
  • and when I eventually had to inform a senior Director of the above, he huffed “Look, now you’ve involved Daisy, the modern matron, it gets difficult….. Just leave it with me.”
  • Eventually, during a counselling session (organised by the Director) between me and my manager, the therapist asked me “Why does all this bother you?”

Should we dismiss concerns

Drug errors must be documented
Drug errors must be documented

Look, we all make mistakes and I’ve made many. I made a drug error once but I noticed quickly and let my mentor know immediately. I followed the 5 rights of medication administration before completing my documentation and an incident form.

I’d given the patient the right medication but at lunchtime rather than in the evening. It was a minor mistake, in this instance, and easily rectified.

However, the above incidents were neither mistakes nor minor errors. Some would be classed as critical incidents or SUI’s and could have been fatal.

I was starting to think I was going mad. I couldn’t be the only one who had concerns about the above behaviours? Why did nobody want to deal with it? It seemed the further up I went, the more they tried to dismiss any concerns.

I mean we all knew who was sleeping with who on the unit, literally. Yes, some colleagues did have clandestine meetings in various offices on the wards. And, of course, some were married — to other people i.e. someone in or outside the unit. Where these people were having relations with their lovers colleagues, it made it difficult for them to address any concerns appropriately.

So, what should I do? Ignore it, don’t pass concerns on, and dismiss them as some sort of eccentric nursing foibles? Should I just allow vulnerable patients to be taken advantage of?

Shut me up already!

This nurse cares

It was horrible. All I wanted was just to do my job. I didn’t want to have to deal with senior nurse’s poor practice or other people’s bloody extra-marital affairs.

These damn situations were making me anxious because I couldn’t ignore them and just couldn’t shut up. I wish I could have. But I loved working with patients and I cared about them and what happens to them. Why would I ignore poor practice?

It was wrong. So wrong. And it was unfair to expect me to turn a blind eye! It was unethical, immoral, unprofessional and not just poor but dreadful practice. Every time I witnessed bad practice, I completed electronic incident forms as soon as possible after the act, and before I was told not to. That way, at least there was a record of everything.

Understand when and how to escalate a concern

NMC The code
NMC The Code

NHS Employers say “If you are unable to raise your concern within your organisation, or your employer has failed to adhere to policy requirements, or the issue you wish to raise is so serious that there is a wider risk to patient or public safety, you may need to escalate your concerns to a prescribed body.”

It goes on to say “Prescribed bodies do not have the power to investigate individual concerns but can hold organisations to account in meeting their legal responsibilities to address concerns appropriately.”

Heaven forbid I went down that route?

It’s not how it should be, but can you imagine if I’d escalated my concerns outside of the Trust? I wish I’d had the courage to report it to the newspapers — now there’s another post – honestly, it’s just reminded me of an incident!

Over to you

Clipart

I’d be really interested to know what you think about any of the above incidents and how you might have dealt with them. Trust me though, it’s not as easy as the policies make it out to be. Would you want to be that person at work?

Dangerous Mental Health Ward Manager

What it’s like working with a dangerous mental health ward manager

Dangerous Mental Health Ward Manager
Dangerous Mental Health Ward Manager — Image by Unsplash

I recently found out that one of my old Managers was transferred to yet another hospital within the same Trust. Yay! He’s finally been demoted again.

Why he wasn’t dismissed and why the heck it’s taken so long to demote him, I don’t know.

Well, I suppose I do and I’ll come to that, but first let me tell you about a few of his other misdemeanours.

Some years back a patient came onto the ward with what appeared to be Extrapyramidal Side Effects (EPS), which can include:

  • tremor
  • slurred speech
  • uncontrollable grimacing
  • akathisia; a sense of restlessness and intense need to move. To relieve this feeling, you need to stay in motion, pacing
  • dystonia; muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures
  • anxiety and/or distress and, in some people there’s the
  • Oculogyric crises; acute dystonia characterized by spasmodic movement of the eyeball(s), usually upward, and each spasm lasts from seconds to hours. It’s not usually life-threatening but it can be very distressing to the patient and family (and staff).

These symptoms are primarily associated with either improper dosing of or unusual reactions to neuroleptic (antipsychotic) medications. The EPS tends to occur with the older type of antipsychotics and I witnessed many of these disturbing side effects over the years. I’ve also experienced dystonia with my physical illness and therefore know how painful it is.

Dispensing non-prescribed medication

Antipsychotics are prescribed by doctors
Antipsychotics are prescribed by doctors — Image by Unsplash

The aforementioned patient (Craig) appeared to be experiencing akathisia and acute dystonia and came to tell me that Perry (my manager) had given him a box of 30 antipsychotic tablets the previous night.

  • Risk factors for acute dystonia are young age and male gender, history of substance abuse, hence the side effects in Craig!

He needed side effect medication like — now! Hmmm, his meds chart was blank. I couldn’t give him anything. I had to contact the on-call SHO to prescribe Procyclidine — to counter the side effects of the illicit antipsychotic drugs given by my errant boss.

Craig happily admitted he’d taken two over the agreed dose (with alcohol and lots of cannabis) because he couldn’t sleep. But now he was pacing, edgy, grimacing, anxious and agitated, so he asked for Procyclidine. It’s used to treat symptoms of Parkinson’s disease or involuntary movements due to the side effects of certain antipsychotics.

Nursing Code of Conduct

“As nurses, we can advise on, dispense or administer medicines within the limits of our training and competence, the law, our guidance and other relevant policies, guidance and regulations.”

Nursing & Midwifery Council’s Code of conduct, 2018

In accordance with the Royal College of Nursing (RCN) Code, nurses must adhere to the five “rights” of medication administration. This includes right patient, right drug, right time, right route, and right dose. These rights are critical for nurses.

Within each Mental Health NHS Trust, there are medication processes in place to limit errors, along with an audit trail and clinical documentation.

However, Perry chose to prescribe and dispense a whole month’s worth of antipsychotic medication, without seeking advice from the on-call doctor! Furthermore, there was no clinical documentation anywhere and there was no message to communicate this information to staff on the next shift.

As nurses, we must ensure that our colleagues are working within the scope of their experience and capabilities, particularly when prescribing medication. And as Perry wasn’t a nurse prescriber, he should never have prescribed meds for Craig! So

What was I to do?

Mental health ward morning nursing handover
Mental health ward morning nursing handover

It was busy on the ward the following day and I thought I’d give Perry a chance to ‘hand over’ the above information to staff. However, there was no mention of it during our one hour morning handover. I didn’t want to call Perry out in front of the team. So, I waited until the next day.

I didn’t sleep too well that night and my stomach was turning at the thought of how a meeting with Perry would go.

Duh! I knew exactly! When I mentioned the meds he’d given to Craig, his face turned puce, his eyes bulged and he snorted with rage. “How dare you question me?”

I explained that as a fairly new nurse and recently promoted charge nurse, I had a duty of care……. “The NMC’s Code states…………………”

“Don’t you quote all that crap to me. If a patient’s in need, then we give them meds,” he ranted. “I made a rational and informed decision.”

“You know we’re not qualified t…………” I tried, to no avail. I said that all he had to do was to explain to Craig’s Consultant, document the transaction in Craig’s notes and complete an incident form. At this point I willing to view it as oversight, something we can learn from and move on. But

Professional jealousy

Mental Health Ward Manager --- professional jealousy
Mental Health Ward Manager — professional jealousy —Image by Pexels

I knew Perry wasn’t fond of me, he made that quite clear from the start — completely ignoring me, in front of the team and patients. His predecessor had promoted me from another ward in Perry’s absence, and he was absolutely furious.

I’d initially thought he might be happy to use my Human Resource Management skills? I’d hoped he’d share his knowledge and skills with me. Ha!! Anything I could do, he could do better; which would’ve been excellent — if only he’d actually showed me. Rather than tell me.

Anyhow, he obviously resented that I’d questioned his actions so told me to leave it at that. He wasn’t going to do anything. “End of!” he nearly spat as he tried to shoooooo me out of his office with a sweeping flourish and a conniving grin.

Not so quick Perry, “Look, I’ll leave it a few days to give you the chance to complete the necessary paperwork — and — job done,” I smiled as I left. “I can’t unknow this situation, Perry.”

Modern Matron to the rescue

Must be me then — Photo by Pexels

The thing is, Craig had quite happily told me, the rest of the team and all the other patients that Perry had given him “unauthorised meds.” This could all go terribly wrong! As we knew about this incident, the team was in fact colluding with Perry to keep it quiet. And that alone is a disciplinary!

Moreover, imagine if Craig’s dystonia had occurred at home — without the Procyclidine? He’d be in agony and would probably have taken himself to A&E via ambulance, where everyone would’ve found out that he’d been given unauthorised antipsychotics.

Long story short, Perry refused to complete any documentation and I said I’d have to speak with his Manager, a Modern Matron. She asked me in front of Perry what was my agenda here? Was I after his job because it seemed like I was trying to get him sacked!

Oh, my word! All I’d wanted was for Perry to deal with the situation himself. Full stop. However, Matron loved all her boys, something known to everyone on the unit, and was covering Perry’s back. No problem. I no longer had to carry this indiscretion around, but it p’d me off as I was made to look like the baddie.

What next?

Vulnerable mental health patient
Vulnerable mental health patient — Photo by Pexels

So — what was I to do when Perry flirted with his male patients — in full view of the team and other patients? Or when he regularly gave them money for cigarettes, and cannabis or alcohol. And what about the fact that he took a male patient on holiday, and started a fight with a colleague on a night out, and ……..

Whoa! Let’s back up a bit!

He took a patient to Portugal for a week? He kept that quiet. But surely he knew how patients talked to other patients, and to staff? So now we all knew he’d taken a vulnerable patient, who’d just come out, on holiday!

I asked the team what we should do — collectively, believing they would feel the same outrage? “Hmmm, I don’t like grassing him up.” and “Maybe we should just leave it – this time?” wasn’t very helpful.

It got even worse. Well, Perry’s erratic behaviour did.

Over to you

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Do you want to take a guess at what Perry does next? What do you think about the situation i.e. morally, professionally, ethically? Have you ever worked with someone like Perry? I’d love to hear from you.

Living with pain and hallucinations

Why living with pain and hallucinations feels like torture

Living with pain and psychosis. Transverse Myelitis is an invisible disorder but that doesn't stop it from hurting all the same
Transverse Myelitis is an invisible disorder, and I’m always in pain.

I can’t sleep I’m exhausted, and living with this pain, sleeplessness and hallucinations feels like torture. It makes me wish I wasn’t here. But in reality, if someone took away the pain and the spiteful voices, of course, I wouldn’t want to be dead.

I honestly don’t want to be dead! I just want to share my experience of living with both physical and mental illness, together with suicidal thoughts.

While I’ve been physically unwell and unable to sleep this past week, all I’ve been able to do is think. Unfortunately, it hasn’t been all positive thoughts either. See, when I’m in pain and exhausted, I feel angry and it’s difficult to think lovely whoopy doo positive thoughts.

Yes, you heard that from me. I don’t always have the energy, motivation or wherewithal to use my CBT toolbox to self-therapise. And while I’ve been painstakingly practising my breathing, mindfulness, and self-hypnosis, the pain and sleeplessness deny me any normality.

I can’t think normally so I don’t know where the negative thoughts stop and the auditory hallucinations begin, and vice versa.

I’m unable to read anything vaguely mental-health, trauma, psychologically or emotionally-related when all this is going on. Doing so distorts my mind even further and makes me wonder whether I’m going mad. It’s as though if I read anything related, maybe I’ll catch that too — like you can catch a cold?

No, it doesn’t make much sense to me either.

Night terrors

Night terrors and psychosis
Night terrors — Image from Astrotalk

As with most things, it always seems a little easier during daylight hours. But then all I’m able to do is overthink, trying to process what’s been happening, or did it even happen?

I knew when I landed with a thump on the floor of my bedroom in the early hours this morning that I must have dozed off at some point. See, when I do sleep, I get these awful night terrors where I’m being harmed in strange ways. I’m trying to scream but can’t because I’m cotton-mouthed.

I know I lash out in my sleep because of the many broken water glasses by the side of the bed or the sofa. When I’m in the nightmare, it’s like being locked in in my head and not being able to get out. It feels like a horror movie on fast forward, rewind, fast forward…….

When I’m woken I’m told I’ve been screaming and crying and kicking out. Then I’m exhausted but can’t get back to sleep because I’m afraid I’ll return to that place, that trauma!

Restless leg syndrome

Restless leg syndrome can cause sleeplessness and depression
Chronic restless leg syndrome can cause sleeplessness and depression

On top of the TM I also experience restless leg syndrome (RLS). I used to get this occasionally but now, perhaps because of the TM, it’s a regular occurrence. The main symptom of RLS is an overwhelming urge to move your legs and

  • it can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs.
  • the sensation is often worse in the evening or at night. Occasionally, the arms are affected, too.
  • RLS is also associated with involuntary jerking of the legs and arms, known as periodic limb movements in sleep (PLMS).
  • Some people have symptoms of restless legs syndrome occasionally, while others have them every day — me!
  • the symptoms can vary from mild to severe. In severe cases, restless legs syndrome can be very distressing and disrupt a person’s daily activities.
  • in the majority of cases, there’s no obvious cause of restless legs syndrome. This is known as idiopathic or primary restless legs syndrome.

Restless body and unspent climax

Restless legs and body feels like fireworks going off inside me
Restless body feels like fireworks going off inside me

What happens with RLS is that the tingly sensation starts slowly, creeping and crawling up through your legs and feet. It builds and builds until it erupts in a burst of firey tingling. Which lasts for about 10 seconds. Then it stops, suddenly! Give it 20-30 seconds, and here it comes again, building and erupting, and the massive firey tingle!

Think how fireworks hiss and fizz, then explode and bangggg! And imagine that inside your legs and feet.

Sadly, I get whole restless body too and unlike the RLS, it doesn’t crawl slowly, erupt and bang. It crawls, tingles, and tingles and it just stays there tingling and tingling, and it’s excruciating! I can only liken it to being ready to climax! And staying right there! On the verge! But, there is no end! It’s damn unbearable? And it’s not pleasant! Aaarrgghhh!

Sorry about the graphic explanation. I did think about explaining how a sneeze builds and builds then erupts, then you get respite — until the next one. But that doesn’t even touch the sides! Let’s go back to the fireworks hissing and fizzing, and continuing to fizz … and fizz ….. And imagine that inside your whole body, for hours on end.

Trust me, I’ve tried all the tips and tricks to alleviate my restless body, even the bar of soap under my sheet. I’ve tried cannabis oil but can’t seem to get the dose right. Too little and it doesn’t work, too much and I get the paranoia — which, on top of everything else, I need like a hole in the head.

Strained relationships

Living with pain and psychosis strains relationships
Living with pain and psychosis strains relationships — Image from Pxfuel

The TM pain, exhaustion, sleeplessness, nasty negative voices, the night terrors and symptoms of RLS have most definitely strained my relationship with hubby (who’s not around this week to wake me from the night terrors).

There’s no way for anyone to understand how or why someone just can’t relax in bed, with or without a partner. How can anyone understand why a person has to keep pacing, moving, fidgeting, punching their legs and arms. For me, the worst is when it reaches my neck and face too. Imagine peeps — this is all night, or until I finally doze — only to be woken by more of the intense physical tingling.

The following day is absolute hell; being fatigued and unable even to shower and dress on my own in the mornings. Brushing my teeth and scraping my hair back is often as far as it gets with my daily self-care. How attractive is that 😉 Let alone trying to do five minutes of tidying up or cooking a meal without almost passing out.

Heck, I wouldn’t want to put up with someone like me in a relationship. I admit — I don’t have the patience. For mental health yes, because I understand it. But a partner being in constant pain, unable to do things for themselves…….. hmmm?

Over to you

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Well, that’s a week in my life. What’s your average week like? In what ways do you suffer or experience pain? Can you tell us about it? I look forward to any comments, any tips and I’m happy to answer questions.

Holidays are not ALWAYS happy

Unhappy holiday?

Holidays are not always happy!
Happy holidays? — Photo by Pexels

“Anyone that knows me, knows just how much I love happy holidays, and particularly Christmas, always! Give me all the hustle and bustle, the mulled wine and the Bailey’s hot chocolate at Winter Wonderland in Hyde Park. I’d never really thought about anyone not enjoying it. So, I’m delighted to have read and be able to share this post from Valerie @ The tiny couch. It’s about her take on holidays — and it’s certainly made me think”

Me

I’ve only recently come across Valerie’s blog where she writes about self help, psychoeducation, or tips and tricks for overcoming obstacles. Her blog The Tiny Couch promotes inclusion, equality, mental health awareness, ending stigmas associated with diagnoses, and helping you master your own universe. Why not pop on over to say hi.

Guest post about unhappy holidays by Valerie Rice

The Holiday season is upon us. Well, according to stores it has been forced on us since before we could trick-or-treat, and before you start screaming “Merry Christmas!” At every passer-by, I think we should have a chat. Not everyone finds joy in the holiday season.

Yes, for you it may be filled with snowy days of nostalgia and warmth, curled up by a fire with hot cocoa and joyous memories. But for many others it is a dark tunnel of fear, loneliness, suicidal ideation, and pain.

Every twinkling light that fills you with dewy eyed joy is a reminder for others of some hidden horror life has thrown their way. If this is difficult to wrap your head around, please allow me to explain.

Dysfunctional family

Yes, your family may be what you call “dysfunctional” because Aunt Maude drinks too much and Uncle Frank tells inappropriate jokes at dinner. Hell, you probably even have more than one political opinion you have to dance around once the wine starts flowing.

Oh, my! This is normal, folks. An ACTUAL dysfunctional family is where:

  • Aunt Maude secretly beats the children with a cheese grater until they bleed. Mother looks the other way because she is drunk, and at least they are quiet.
  • Uncle Frank slips into the children’s bedrooms at night to tickle the little boys’ and girls’ until they beg him to stop, but nobody cares because “it’s all in good fun.”
  • The dissenting political opinion is more than a dinner argument; it results in one parent beating the other bloody, taking the kids away, and never letting them see the other.

Catch my drift? So with all the pressure to be with family around the holidays, is it any wonder that people who have dysfunctional families are feeling a bit…unhappy?

Let’s get real now

Okay, real talk: Miserable, isolated, alone, and severely depressed. Not to mention traumatized by surfacing recollections of holidays past (Dayton, 2016).

Then there are those who, having mastered the art of avoiding these triggers, are now feeling the complex mixture of relief, guilt, and estrangement that comes with being bombarded by social pressure to go home because it is, after all, the holidays.

This is not even a rare occurrence. Remember when I said mental illness is prevalent in society? Do you remember the number? 1 in 4.

Neurodiversity

You hear me talk about this one a LOT. This is because my darling son and nephew-son have Autism Spectrum Disorder and not one single child of mine is neurotypical. All four of them have special needs.

We do NOT like holidays. Why? Well, they screw up our regularly scheduled program, and with special needs, daily life is key. No, we do NOT want an extended break from school. We do NOT like sudden changes to our menu, crazy decorations everywhere, people in our faces, random packages appearing, the tension of expectation and so on.

We REALLY hate the inexplicable contradiction of religious proselytizing and commercialism. It drives those of us with logical wired brains up the wall. And kids on the spectrum are highly logical, emotionally unstable, schedule driven bombs. So the appearance of religious paraphernalia, Santa Claus, scented decoration, and so on in mid october is not only confusing, but it is overstimulating.

We now have to avoid any stores with decorations. So all of them. And any people on the march in the imaginary war on christmas. So we go nowhere. Why? These people think they are doing good. How very egocentric of them.

Well, because not only have you turned our entire universe into a cinnamon and pine drenched stink bomb, but the constant shouting for months is a burden to the overabundance of neurons in their brains (Jasmin et al, 2019).

So for us, October through December is a clusterfu*k of hellish avoidance and meltdowns as we try to keep life on track despite society’s insistence to disrupt our well ordered lives.

Seasonal vulnerability

Yes, this is a real thing. Many people, more than you would think, are negatively affected by increasing darkness, cold weather, and the changing seasons, especially those with mood disorders (Dell’Osso et al, 2014).

What does this mean? It means that individuals with certain brain chemical imbalances are affected by the shortening days and become increasingly suicidal.

Even if they do not present with active disorders for the rest of the year, the imbalance in their brains is triggered around the holidays and causes seasonal depression, which means they can’t, no matter how much you smile, enjoy the holidays.

Individuals who are prone to eating disorders and PTSD are more affected than others, primarily because they are sensitive to what we call circadian rhythms (light fluctuations). Our bodies are naturally tuned to our environment.

This is why we have a whole subfield of psychology called environmental psychology, to help improve the wellness of people especially in urban areas and indoor environments. Sometimes, you are just SAD. Sorry guys, you can’t think or smile your way out of Seasonal Affective Disorder.

What you can do if you hate holidays too

I believe I made it abundantly clear that I despise the holiday season which, for some reason (money) takes up 25% of the year. So what do you do? A few things, actually.

  • Let’s start with your priorities. Prioritize yourSELF above everything else. I want you to take a deep breath and repeat after me: Self care is not selfish.  Good.
  • Now I want you to try a few mindfulness exercises. I know, I know, the last place you want to be is here right now. But it is much better than getting stuck in past trauma, so click here.
  • Another thing you can do is get a light box. Artificial sunlight will help you feel better in the darkness of winter, try for 5,000 to 10,000 lumens every morning (Shaffer, 2019).
  • What my doctor recommends for my entire family every year is vitamin D supplements. I’m not usually a supplement type of girl, but I trust my physician. I also live in the mountains and in the middle latitudes, so we do not get enough vitamin D. Aim for 600-1,000 IU daily, or talk to your doctor.
  • A simple blood test can tell if you are deficient.
  • Find a support group. Of any type. Hell, join a book club. Just make connections with other people to keep from being isolated. Of course, if you end up with a book about some damn holiday theme, you should leave.

In conclusion

The holidays are a time of resentment, fear, stress, and joy. For some ridiculous reason our society likes to jam Christmas deep down our throats, whether we celebrate it or not (46%of Americans actually celebrate it), and then get offended if we gag.

Look, you don’t have to do anything you don’t want to. I feel terrible for those of us who have to deal with this out of control season. Winter is dark and cold, the constant reminder of trauma is cruel, and it isn’t going to get better until at least March.

So ignore those jerks with jingle bells, and do NOT feel obligated to respond in kind when someone says “Merry Christmas” in a defensive and overly chipper way. This is YOUR life and YOU get to control it. Focus on you and take care.

As always, over to you

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Okay, over to you. What’s your thoughts on the holiday season? I’m guessing there’s a mix of lovers and haters and I’d love hear why you love or hate it. If you dislike it because of all the stress, you might like my Managing good mental health during the holiday season? In the meantime, Valerie and I look forward to your comments and we’re happy to answer any questions.

Caz 🙂

References

Dayton, T. (2016). There’s No Place Like Home: How Unresolved Familial Trauma Can Emerge Around the Holidays. Counselor: The Magazine for Addiction Professionals, 17(6), 10–12.

Dell’Osso, L., Massimetti, G., Conversano, C., Bertelloni, C. A., Carta, M. G., Ricca, V., & Carmassi, C. (2014). Alterations in circadian/seasonal rhythms and vegetative functions are related to suicidality in DSM-5 PTSD. BMC Psychiatry, 14, 352. https://doi.org/10.1186/s12888-014-0352-2

Jasmin, K., Gotts, S. J., Xu, Y., Liu, S., Riddell, C. D., Ingeholm, J. E., Kenworthy, L., Wallace, G. L., Braun, A. R., & Martin, A. (2019). Overt social interaction and resting state in young adult males with autism: core and contextual neural features. Brain : A Journal of Neurology, 142(3), 808–822. https://doi.org/10.1093/brain/awz003

Shaffer, D. K. (2019). A healthy, whole holiday season: Cultivate wellness this year. Alive: Canada’s Natural Health & Wellness Magazine, 446, 35–37

Ups and downs of mental illness in men

The ups and downs of mental illness in men captured in film

Happy Sad Man — Docu-film by Genevieve Bailey

Jane from Jane James Consultancy has given me permission to share her post about this docufilm which charts the ups and downs of mental illness in men.

I haven’t seen the film yet but I’ve contacted the filmmaker to see how I can view it here in the UK. You already know how much this film appeals to me, given my background. But I also want to highlight and raise awareness of mental illness and men.

Moreover, I’d like to encourage conversations with men around how they see mental illness, and look at ways we can all help.

Most of us know how difficult it is to get men to open up or to talk about their mental health. Perhaps it’s a film we can all watch with our hubbies/partners or share it with other men you know? Get the conversation going……………………..

A brief synopsis

HAPPY SAD MAN gives unforgettable voice to the complex emotional landscapes we can all traverse. Touching, funny and tender, this must-see documentary is set to shine a light on and change the dialogue around masculinity and mental health today. Exploring hopes, anxieties, joy and darkness the raw vulnerability of these stories will inspire you to hold some of the men in your life that bit closer.

Over to Jane and her post

Happy sad man David showing the ups and downs of mental illness
Happy sad man — David

I came across this film on Eventbrite. A two part event from Australia.

Genevive is a film maker from Bondi Beach, Australia who has spent years making this documentary. If follows a group of five men – all ages and backgrounds in their journey through the ups and downs of mental ill health and their strength in finding ways to make a difference to others.

I’ve been interested in mental ill health and wellbeing for many years and seen diverse projects/films/discussions trying to capture the stigma and loneliness felt by those living with mental ill health – none touched this film.

Ivan is an outreach worker
Ivan is an outreach worker

The sensitivity, respect and inclusion Genevieve showed, John, Jake, Grant, David, Ivan, Dave and their families/friends conveyed the real range of emotions felt. The passage of time from the 50s/60s to today hasn’t demolished the stigma mental ill health causes. Still a taboo subject.

It’s always struck me – where does this stigma come from? We aren’t born with it. If we’ve learned it, we can surely unlearn it? Why does the mind scare us so much that we feel unable to say ‘hey, how are you feeling? I’m really concerned about you’….. The mind is just part of the body. We wouldn’t fear asking ‘how’s you leg? healed ok?’.

Happy sad man

Raising awareness of Mental illness on Bondi Beach
Happy sad man — Grant, A keen surfer who has bipolar — Bondi Beach raising awareness

tells the story of a group of men. An emotional awakening of understanding on how these men feel on their rollacoaster journeys. Little gems are littered throughout the films.

Grant’s synergy of living with mental ill health is like a recipe. You have to balance everything. Using fluorescent colours to start a conversation on Bondi Beach about mental health every Friday morning at 6.30am.

Flouro Friday is now on 200 beaches across 40 countries. Using bright clothes and surfing to spark a conversation. Can we adapt this idea to fit the communities we live in?

David’s wet dog perfume was another highlight. His goal wasn’t to make money but to get people smiling and talking.

Jake from docufilm Happy Sad Man --- portrayal of men and mental illness
Jake from docufilm Happy Sad Man — portrayal of men and mental illness

Jake’s journey from film maker to war photographer was stark. Even in such dire circumstances he was able to teach children in Syria, Aleppo etc to skateboard and do the things that kids everywhere do. He also taught them how to make films on their mobiles to capture the environment they live in the the futility of war.

The overall message of hope was uplifting.

There is still time today to register on Eventbrite to watch this outstanding documentary and join the live Q&A session tomorrow.

John says he's an old hippy and he has a  mental illness
John says he’s an old hippy and he has a mental illness

You can follow Genevieve Bailey at:

You can find out more about the film here. And, like I said, I’ve sent messages to Genevieve to find out how I can view the film here in the UK. I’ll let you know how I get on, whether I get to watch the film and what I think of it.

Over to you

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Have you any thoughts on this docufilm? Have you seen it? If not, is it something you’d watch — and share? I’m really interested to hear what you think and I look forward to any comments. Tho’ not sure I could answer any questions — until I’ve seen it 😉

How to manage panic attacks

Find out how to manage panic attacks

Knowing how to manage panic attacks helps
Knowing how to manage panic attacks helps

This was initially a guest post on Happiness between tails and I’m now sharing it with you. As someone who’s experienced and had to manage severe panic attacks, I understand just how frightening and debilitating they are.

I never want to experience another one and if this is you too, let’s look at how to prevent them.

First tho’, in order to overcome panic attacks, you’ll need to understand what they are. We’ve all had feelings of anxiety – it’s our body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come.

For example, you may feel anxious about a job interview. During times like this, feeling anxious can be perfectly normal, but some people find it harder to control their anxieties.The most severe form of anxiety can trigger panic attacks.

What is a panic attack or panic disorder?

Panic attacks might follow stressful life events
Panic attacks might follow stressful life events – Image Pixabay

We have panic attacks and panic disorder; one episode is a panic attack, which might occur following a stressful life event i.e death of someone close.

Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. You experience regular and subsequent attacks. It’s a common yet very misunderstood illness and lots of people with this disorder won’t ever seek help due to fear and stigma.

The attacks can occur often and at any time, seemingly for no apparent reason. It feels like a sudden, unexpected rush of intense fear and anxiety along with a flood of frightening thoughts and physical sensations – so, panic attacks are not merely psychological.

What you should know about panic disorder

Panic attack symptoms are similar to some physical illnesses
Panic attack symptoms are similar to some physical illnesses
  • Many of the symptoms of panic attack are similar to some physical illnesses i.e. heart attack or over-active thyroid. See your GP to rule these out.
  • It’s a chronic condition and can lead to changes in behaviour, like avoiding situations or events.
  • People dread the onset of another attack, and the fear of having one is just as debilitating as the attacks themselves.
  • Panic disorder knows no boundaries as it affects people of all socio-economic groups and races. It’s more common in women than men. It can also affect children and the elderly.
  • Although the exact causes are unclear, panic disorders can run in families.
  • While many attacks are be triggered by stressful life events, they can also occur ‘out of the blue’.
  • Be aware – anti- malaria medication, cold and flu medications, appetite suppressants and even too much caffeine can trigger panic attacks in some people.

If you experience panic attacks, you might then begin to avoid events or situations because you’re afraid of another attack. However, avoidance can create a cycle of living in “fear of the fear”, which only adds to your sense of panic. This can cause you to have more panic attacks, leading to diagnosis of panic disorder

What are the symptoms of panic attacks?

Panic attack can feel like a heart attack
Panic attack can feel like a heart attack – see your GP

If we encounter a situation that threatens our safety, we’ll experience a series of reactions known as the ‘fight or flight’ response – triggered by the release of chemicals that prepare your body to either stay and deal with a threat or to flee to safety.

During a panic attack, we’ll experience similar symptoms, even when there’s no real threat involved. A panic attack might happen in response to situations that others find harmless. Symptoms include physical and physiological symptoms:

  • Racing heartbeat, palpitations
  • Dizziness, light-headedness, or nausea
  • Difficulty breathing, like you can’t get enough air
  • Dry mouth and unable to swallow – if you do need fluids, just take smalls sips to avoid choking
  • Shaking, trembling
  • Sweating and hot flushes or sudden chills
  • Sudden need to go to the toilet, the body needs to lighten to fight or flee
  • Numbness or tingling sensations, initially in your fingers and toes
  • Your face, feet and hands might go white (as with the tingling, this is the blood leaving your extremities to rush to where it’s needed most i.e. heart and muscles)
  • Chest pains – you might think you’re having a heart attack – one way to tell is – if your fingers and toes are tingling, you’re more likely to be having a panic attack. However, if you’re afraid call the emergency services to check

You might experience negative thoughts

tender redhead woman with finger on lips
Embarrassed by panic attack — Image by Pexels
  • I’m so embarrassed, everyone can see me panicking
  • I feel like I’m dying or I’m having a heart attack.
  • I can’t cope with this!
  • I’m so stupid, I’m never going to get rid of this feeling.

and feelings of:

  • You’re going mad or crazy.
  • Being out of physical or emotional control.
  • Unreality/detachment from yourself or your surroundings.
  • Heightened sound and visual awareness, and hypervigilance (for flight or flee you need to hear and see clearly and be vigilant).

A panic attack generally lasts between 4 – 20 minutes, although it often feels a lot longer. However, they have been known to last an hour. I had them one after another, and all night for around three months and it felt like torture. It’s no wonder I became psychotic!

How to manage panic attacks

Practice breathing through your panic attack
Practice breathing through your panic attack — Photo by Pexels
  • Breathe as slowly and deeply as possible, exhaling firstly through your mouth – slowly for a count of 8-10 seconds, then in through your nose slowly and so on.
  • Some people use a paper bag to cover their nose and mouth, and breathe in an out. This is known to work but it’s not something I’d teach because you’re not always going to have access to a paper bag.
  • Recognise that this is a panic attack and tell yourself that it will pass, because it will.
  • Use muscle relaxation techniques – try slumping your shoulders, letting them drop down from your ears, give your jaw a little wiggle then let it relax, uncross your legs, unclench your fists and lay the palms of your hands lightly on your thighs (remind yourself that your body cannot be relaxed and tense at the same time).
  • Try to get to a quiet space and sit down if necessary and continue with the breathing.
  • If you’re at work or outside, ask for help, I know this might feel a little embarrassing, but do ask if you need to.
  • Count backwards slowly from 100 or
  • Look around for 5 things that you can see and name them out loud i.e. “I can see a red truck,” etc. You can go onto things you can hear, smell, taste, or touch in the same way – until the panic subsides. This technique will help you stay in the present and grounded by using your five senses.
  • Put a few drops of lavender (known to ease anxiety) on a tissue, exhale then breathe it in slowly.
  • Call emergency services if the symptoms continue or get worse, or if you’re afraid it might be something else i.e. heart attack.

How to manage someone else’s panic attacks

How to manage someone else's panic attacks
How to manage someone else’s panic attacks — Photo by Pixabay on Pexels
  • Ask the person if they’ve had a panic attack before, and what they think might help or has helped them in the past.
  • Encourage them (or tell them quite firmly if they’re confused and unable to follow directions) to breathe (as above). Do this with them if necessary, as often they think they can’t breathe and won’t be able to do this alone.
  • Follow the above steps and call emergency services if necessary.

Self-help to combat panic attacks

Notice the tension in your body
Notice the tension in your body — Photo by Pexels
  • Listen (regularly) to free mental wellbeing audio guides online. These will help prepare you so that you can manage your panic attacks as you need to.
  • Search and download relaxation and mindfulness apps or online community apps.
  • Learn other skills like visualisation to help you relax and practice them often.
  • Notice when your body is tense i.e. when your shoulders are up round your ears or your fists are clenched and let them relax. When your body is constantly tensed up, it’s effectively telling your brain you’re on alert, tensed and ready to fight or flee.
  • Ask your close friends or family members to support you by gently pointing out when you’re all hunched up and tense. Even better, perhaps they’ll give you a light head massage, or lightly rub your arms and hands in a soothing way.
  • Practice the breathing exercises often so that you’ll be able to use them easily when needed. Honestly, practice this all day, every day — it’s a great feeling and you’ll have it ready to use when you need it.
  • Try mixing lavender oil with other aromatherapy oils like geranium or camomille to produce your own stress reliever.

I really can’t stress enough the need to practice the coping techniques. You know you wouldn’t be able to drive say on a motorway after having just one lesson. It takes practice!

Treatment for Panic attacks

Talking therapy for panic attacks
Talking therapy for panic attacks — Photo by Pexels

Treatment aims to reduce the number of panic attacks you have and ease your symptoms:

  • Psychological (talking) therapies and medicine are the main treatments for panic disorder
  • Depending on your symptoms, you may need either of these treatments, or a combination of both

When to get help

See your GP to rule out other causes
See your GP to rule out other causes — Photo by Pexels
  • If you’re having suicidal thoughts, please seek professional help. Or talk to someone close.
  • See a GP if you’ve been experiencing symptoms of panic disorder. Regardless of how long you’ve had the symptoms, if panic attacks are interfering with your life, work, or relationships you should seek professional help.
  • Although panic disorder is a medical condition in its own right, there can sometimes be a physical reason for your symptoms – and treating it can bring the anxious feelings to an end. See your GP to rule out any other causes and don’t self-diagnose.

Over to you

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Have you ever had panic attacks, or do you know someone who has? Do you have other coping techniques that might help readers? Do you think you’d be able to support someone having a panic attack now? I look forward to your comments as always and I’m happy to answer any questions.