Category: Anxiety

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!

Exercise
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.

Hypnosis

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

Asylum

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.

How to cope with anxiety

Learn how to cope with your anxiety
Learn how to cope with your anxiety — Image from Unsplash

I’d like to thank Andrea for letting me guest post How to cope with anxiety on her blog Lifeallday last week. And now I’ll share it with you.

Does your mouth go dry and your your stomach do somersaults at the thought of an interview or a difficult conversation? Maybe you feel nauseous, your heart pounds, and you can’t catch your breath? You might recognise these feelings?

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Everyone has feelings of anxiety at some point in their life. For example, you may feel anxious about sitting an exam or a job interview. During times like these, feeling anxious can be perfectly normal but some people find it harder to control their anxieties. Their anxiety is more constant and can often affect all areas of their daily lives.

Anxiety lets us know when we might be in danger, at risk or under threat — like a car hurtling towards you at 60 mph. You get a shock, but you manage to jump out of the way — quickly!  However, anxiety disorders occur when our fears and perceptions of danger are greater than they need to be.

This next brief section comes from the NHS website, and is about one specific condition called generalised anxiety disorder (GAD). GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.

Symptoms of anxiety

Recognise the symptoms of anxiety
Recognise the symptoms of anxiety

GAD can cause both psychological and physical symptoms. These might also occur in all other anxiety disorders but for brevity, we’ll just talk about GAD. These symptoms vary from person to person, but can include:

  • feeling restless or worried
  • having lots of negative thoughts, feeling guilty, angry, or shame
  • having trouble concentrating or sleeping
  • dizziness or heart palpitations
  • feeling like you’re having a heart attack – if you suspect it’s a heart attack, seek urgent help
  • Loss of humour, confidence
  • sweating, sticky palms
  • shaking
  • fidgeting or pacing
  • feeling faint, dizzy or nauseous
  • feeling like you can’t breathe, choking
  • irritability or angry
  • fingers or toes tingling (this happens when the blood runs from your extremities to your heart and muscles, where it’s needed to prepare for fight or flight

What causes anxiety disorder?

Does imbalance of brain chemicals cause anxiety?
Does imbalance of brain chemicals cause anxiety? — Image from Pixabay

The jury’s out on this one. The exact cause is not fully understood, tho’ it’s likely that a combination of several factors play a role. Research has suggested that these may include:

  • over-activity in areas of the brain involved in emotions and behaviour
  • an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood
  • hereditary – you’re more likely to develop an anxiety disorder if you have a close blood relative with the condition
  • having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying, and so on
  • a painful long-term health condition, such as arthritis or Multiple Sclerosis
  • having a history of drug or alcohol abuse

However, many people develop anxiety disorders for no apparent reason.

Who is affected by anxiety?

Absolutely anyone. Anxiety doesn’t care who you are, how old, how smart or what colour you are. You might’ve noticed someone constantly drumming their fingers annoyingly or nervously tapping their foot? Maybe you’ve seen that irritating CEO who constantly fidgets during meetings or spits out the nails she’s chewed on for the last half hour? Have a heart next time you see these behaviours — think, they might be feeling really anxious.

Anxiety in me

I’ve experienced mental health problems, including anxiety and I know how terrifying it can feel. The dread when going to watch my sons’ swimming galas because of the steep seating area! I hated all those stairs looking over the pool and had a terrible fear of tumbling down them all. I’d be shaky and my heart would be pounding in my ears. It was the same in the cinema with those damn stairs, and in the dark!

Tube stations soon became a problem too; the further down the escalator went, the more anxious I got. I’d feel like I couldn’t breathe, my mouth was dry, my heart was bursting, and I imagined falling down all the stairs or stumbling blindly onto the train tack.

Vicious circle of stress and anxiety

See, the thing with an anxiety disorder is that once it starts, you get anxious about being anxious. You only have to think about, let’s say, upcoming exams, and your anxiety levels shoot through the roof. And then it becomes a vicious circle of thoughts, feelings, behaviours.

You might think “I’m dreading these exams,” and you begin to feel anxious, afraid, or even angry, so you might choose to go out on a date instead of studying (behaviour). After this, you might think “I’m so stupid, I won’t pass them anyway,” and feel sad, alone, angry and so on.

It becomes a vicious cycle of worry, anxiety, fear, anger at self, inability to cope, avoidance, withdrawal — you get the picture.

Anxiety in men close to home

Men get anious too
Men get anxious too — Image from Unsplash

My two now-adult sons have experienced anxiety and a few panic attacks in the past. They’re both black belts in Karate, they’re club swimmers, they surf, attend the gym, and play football each week. So, although they’re both geeky in a science-type way, they’re not weedy or wussie; nor do they come across as lads who’d have anxiety.

Some family and friends were shocked, like “Wow, I didn’t think they’d have mental health problems.” But younger lads in the family or friends were encouraged by this and sought support themselves. Some went into talking therapy and they’ve all said they’re so glad they did.

So, what I’m really saying here guys is, it doesn’t mean you’re a weak person, anyone can experience anxiety. It doesn’t care where you’re from, what class, faith, creed, race, gender you belong to or what job you do.

As you might already know, anxiety and depression are closely linked so, if you have one, you’re more likely to be experiencing the other. You might also find that some form of agoraphobia, a fear of doing certain things, or going to certain places quite often occurs with anxiety.

How is anxiety disorder treated?

Anxiety disorders can have a significant effect on your daily life, but several different treatments are available that can ease your symptoms. These include:

  • psychological therapies – you can get psychological therapies like cognitive behavioural therapy (CBT) on the NHS; you do not need a referral from a GP and you can refer yourself for psychological therapy service in your area
  • medicine – such as a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs)
  • lifestyle changes

With treatment, many people are able to control their anxiety levels and lead normal lives. But some treatments may need to be continued for a long time and there may be periods when your symptoms worsen.

Self-help for generalised anxiety disorder (GAD)

There are also many evidence-based activities you can do yourself to help reduce your anxiety, such as:

Lavendar is known to ease anxiety
Lavender is known to ease anxiety
  • see some Tips to help with your anxiety and panic attacks here
  • attending a self-help course in person, or online
  • use muscle relaxation techniques. Try it now. Let your shoulders slump down from your ears, wiggle your neck side to side, unclench your jaw and give it a little wiggle. Uncross your legs and unclench your fists, lay your palms and fingers gently on your thighs and remind yourself that your body cannot be relaxed and tense at the same time. You can practice this on the bus, at work, at home, practically anywhere. Just make sure you do it regularly throughout the day and this will help to calm you down when you most need it.
  • put a few drops of lavender (known to ease anxiety) on a tissue, exhale long and slow through your mouth then slowly breathe the scent in through your nose.
  • try mindfulness or other forms of meditation.
  • exercise regularly or do something fun with family, friends or your partner.
  • go for a long walk, get in touch with nature.
  • try to stop smoking.
  • cut down on the amount of alcohol and caffeine you drink.
  • try some of the free mental health apps and tools online.
  • adjust your lifestyle to make it less busy, hectic, and rushed.
  • Learn how to set boundaries and to say ‘NO’.
  • take part in activities that give you pleasure, make you feel competent, or give you a chance to take a break from other, more stressful activities.

Over to you

ClipArt

Of course, the above lists are not all-inclusive, and you’ll find loads more information online, in blogs, and so on. What do you think about anxiety, the effects and impact it has on our daily lives? Perhaps you have some tips you could share? I look forward to your thoughts and comments, and of course, I’ll answer any questions.

10 Myths and facts about mental illness

You’ve heard the myths, now here are some facts about mental illness

Coloured image of bald young man kneeling on the beach with a noose beside him
Mental illness won’t affect me

Have you ever read that people with schizophrenia are violent, dangerous or unpredictable? Heard someone say that mental illness is all in your head? Or that only certain people get a mental illness? As a former mental health ward manager in one of London’s busiest mental health settings, I’ve heard many myths about mental illness. Here are my top 10 mental illness myths, together with the facts

  1. Mental illness won’t affect me. FACT – Mental illnesses are surprisingly common; they don’t discriminate and can affect anyone. In fact, I think most of us know someone who has a mental health problem.Approximately 1 in 4 people in the UK will experience a mental health problem each year. In England, 1 in 6 people report experiencing a common mental health problem, such as anxiety and depression, in any given week, mind.org.uk.
  2. People with mental illness are just weak. FACT: Mental health disorders are not a personal choice, nor are they caused by personal weakness. Mental illness might occur due to a combination of genetic, biological, psychological, or social factors. Research has shown genetic and biological factors are associated with schizophrenia, depression, and alcoholism. Social influences, such as loss of a loved one or a job, can also contribute to the development of various disorders.
  3. You can tell when someone has a mental illness. FACT: Many people think you can see when someone has a mental illness — maybe they think that a mentally ill person looks different, acts crazy, or always comes across as depressed or anxious. This is not true. Anyone can have a mental illness, even if they look completely normal, seem happy, or have a lot of money, a great job and a big house, redbookmag.com
  4. People don’t recover from mental illnesses. FACT: Recovery is absolutely possible in some mental illnesses. As yet, there is no cure for mental illness, but there is recovery. Recovering from mental illness includes not only getting better, but achieving a meaningful and satisfying life. Indeed, lots of people with mental health problems still work, have families and lead fulfilling lives. Being told that you have a mental illness is not the end of the world. With help and support, people can recover and achieve their life’s ambitions.
  5. People with a mental illness can’t tolerate the stress of work. FACT: With one in four people affected by mental illness, you probably work with someone with a mental health problem. Many people can and do work with mental illness, such as depression or anxiety, with little impact on productivity. However, like any illness, there are times when the person isn’t able to work due to the severity of the condition. FACT: According to MentalHealth.gov people with a mental health illness are just as productive as other employees. Employers who’ve hired people with a mental illness report good punctuality, attendance, and motivation, good work, and on par with or better than other employees.
  6. People with schizophrenia are violent. FACT: Mainstream media has been guilty of regularly portraying people with mental illness as violent. In truth, this is rarely the case. People with a mental illness are much more likely to be the victim of violence. While research has shown there is an increased risk of violence in those living with paranoid schizophrenia and anti-social personality disorder, in general, mental health sufferers are more at risk of being attacked or harming themselves. Official statistics consistently show that most violent crimes and homicides are committed by people who don’t have mental health problems.
  7. People with a mental illness are lazy and should just snap out of it. FACT: This is certainly not true and there are lots of reasons why some people might look lazy. Many people with a mental illness experience fatigue and lethargy as part of their illness or from side effects of their medication. This is not laziness. People can’t just snap out of a mental illness if they try hard enough, and many often need help to get better. This help might include medication, counselling and support from their care team, carers, family and friends and their workplace.
  8. People with mental illness rely on medication. FACT: Medication can be used on a short-term basis, especially for depression and anxiety, but for other mental illnesses, medication is used long-term. Mental illness is not like a physical illness because it can’t always be treated with one single medication. Often, a group of medications is needed for someone with a mental health disorder i.e. antipsychotics and antidepressants together with antiemetic medication to treat the side effects of antipsychotics.
  9. Mental illness is “all in your head. It’s not a real medical problem.“ FACT: There’s still a common belief that someone with anxiety can “just calm down” or someone with depression can “snap out of it, if they try”, like they can pick how and when to have an episode come or go. That’s simply not true. There are psychological and real physical symptoms. Someone who has depression may see changes in appetite, libido and sleep pattern and someone with anxiety might feel breathless, have palpitations and feel nauseous or dizzy. Someone with schizophrenia might be lethargic with low motivation due negative symptoms or side effects of medication.
  10. Asking someone about suicidal thoughts and feelings will make them do it. FACT: If someone says they are thinking about suicide, it can be very distressing. You might not know what to do to help, whether to be concerned or your talking about it will make the situation worse. However, asking about suicidal thoughts or feelings won’t push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal feelings, Mayoclinic.org.
Coloured image of white female lying on the floor with tablets all around her
Just ask someone “Are you having thoughts of suicide?”

Unfortunately these myths about mental illness often contribute to the stigma and discrimination that many people still face. It’s so important that we challenge these myths so we can understand the real facts around a mental illness.

If you’ve had any of the feeling or thoughts as described above, please find someone to talk to. You can always talk to your GP in confidence, or look up your local branch of the Samaritans. Many people experience mental illness and you don’t have to suffer alone.

Over to you

Big red question mark with white character man leaning against it.
Clipart.com

Have you ever had to, or how would you challenge a friend or family member about these myths? Would you feel comfortable about calling people out, or would you just ignore them? If you have questions about any of the above, I’m happy to answer, and I’m always willing to offer support and information.

How to stay emotionally healthy over Christmas

Dissolve.com

Christmas is a time for getting together and celebrating with family and friends. However, it can also be a very difficult time. Lots of us feel under pressure during the festive period – to have the perfect Christmas, to buy the perfect gifts that our children and friends want, to please all our families. A lack of money, time or energy, credit card bills and the pressure of giving gifts might also contribute to stress during the holiday season.

If you begin to feel overwhelmed by problems, Christmas can turn from being a season of joy into a time of panic, loneliness, depression, anxiety and dread.

Anecdotally, it’s known, at least by anyone who has extended family, that more grudges are formed at Christmas than at any other time of year; old family rivalries, arguments, one-upmanship and even fights about your sister’s spoilt kids tend to rear their ugly heads. Split families and unresolved conflicts may also contribute to Christmas anxiety. Other sources of stress might be political (think Brexit) or cultural clashes caused by generational or even geographical differences, which result in tense atmospheres or furious rows over the dinner table.

Let’s face it, you’re already exhausted by your extra-heavy workload:

  • shopping for cards (particularly the special ones for mum and dad or sister etc), wrapping paper, crackers and presents (a few extra for surprise guests or someone you’d forgotten about altogether)
  • getting your tree down from the loft or buying a new one; making sure the lights work – before you put them on the tree, decorating it and tying tinsel everywhere
  • writing out cards in time for the last post and, if you’re like me, filling them with sparkling stars and glitter, which drives my family and friends nuts. Ha, they’ll miss me when I’m gone
  • perfectly wrapping presents with matching tags, ribbons and bows (unwrapping one without tearing it to throw in the aforementioned sprinkles that I’d forgotten)
  • planning the menu, shopping for the huge amounts of food (because the shops are closed – for one day) and loads of champagne – oh, and don’t forget Uncle Cedric only drinks Stout – do they still sell this stuff?
  • planning who’ll sit where – to avoid the old family feuds – I wouldn’t worry about it cos there’s always someone who’s not happy anyway!
  • table decorating – at Christmas is huge now – you see everyone posting their amazing table on Instagram and Facebook – what’s all that about?
  • being all things to all people

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

Nope! You’ve still got Christmas breakfast to cook………………..

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

Etsy.com
  • if you haven’t already done so, enlist some help: write down who’s doing what and make sure the kids are involved – delegate, delegate, delegate
  • when the going gets tough, remember Christmas is a time for family, for friendship and spending time together – so what if you’ve forgotten the stuffing (tho I know my hubby would be desperately disappointed) or batteries for the kids’ most wanted gifts (they’ll have to join in the annual game of Monopoly)
  • 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
  • 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, 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 is a great stress reliever
  • 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.

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

What other stress relievers could we try (without reaching for the second bottle of Prosecco)? Any tips, please?

Dipng.com

Fake mental health patients

Some of you might want to crucify me for mentioning ‘fake’ patients but hold on. Wait until you’ve finished reading this post.

Pauline

Gettyimages.com

I was still in my six month preceptorship period when Pauline was admitted to Lavender Ward, an acute inpatient mental health ward. She was neat and tidy, her hair and nails were spotless, she appeared cheerful and engaged easily with the other patients while waiting to be assessed. However, during her admission assessment she relayed that she had been living on the streets, she was paranoid, depressed, anxious and suicidal – she’d actually been seen by passers bye running across a main road several times, without looking out for traffic, according to the paramedics who brought her in.

Pauline was articulate, she maintained good eye contact with me and smiled appropriately during the assessment. She said she had no family at all and had lost her friends since becoming ‘mad’ and homeless – though she couldn’t remember for how long. Pauline reported that she slept well although she had paranoid dreams, which didn’t wake her. The paranoia she described was that someone was after her and wanted to kill her but she couldn’t be clear about when this happened or who it was that wanted to kill her.

Once seen and admitted by a nurse, the patient’s baseline observations are taken i.e. blood pressure, temperature, pulse, respirations, height, weight etc. All of which were stable. After this, the patient would be seen by the ward doctor, normally an SHO, a junior doctor who is on their six month rotation and has little psychiatric knowledge.

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We had a tall, handsome and smarmy (oops, I mean polite) young chap, Dr Wellar, who looked down his nose whenever a nurse approached him. This was only his second week on the ward and I did tell him one day, “these nurses know way more than you do, and you ought to treat them with the respect they deserve.” That marked my card with him, I’m afraid.

Dr Smarmy stood to greet Pauline and, shaking her hand, he invited her to sit in ‘his’ office for a chat. She was in heaven, all smiles and giggling like a teenager. So I wasn’t sure why, when they’d finished her assessment, he announced to the team that she needs to be on close obs (There’s lots of circumstances where patients may require one to one nursing i.e. the patient is acutely physically unwell and/or requires frequent observations, the patient is acutely mentally ill and/or at immediate risk of serious self harm/suicide etc).

Depending on the level of risk, one to one nursing can be carried out by either a qualified nurse or a nursing assistant. Pauline was classed as high risk of suicide so needed to be observed by a qualified nurse 24/7, which includes when the patient goes to the loo. This takes one person from the staff numbers i.e. reducing the amount of staff by one. If you are nursing one to one, you cannot be expected to care for your five patients on top of this. Sometimes, the Trust allowed us to have an extra member of staff, more often a nursing assistant, to keep costs down.

As I’d done Pauline’s initial assessment, I was allocated as her 1:1 nurse so I spent the rest of that morning’s shift with her. We chatted about the weather, her dog and how she was worried about him – she didn’t know where he was. Pauline’s mum works “oh, I mean worked” as a teacher but she couldn’t remember the name of the school. I just kept the conversation light and said how proud she must have been of her mum etc. But something just didn’t sit right with me and I passed all this onto the afternoon shift.

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On my next shift, I was allocated to Pauline, 1:1, as apparently she liked me and we’d built up a good rapport. Again we chatted amiably about her past – what she could remember of it – she said her depression was affecting her memory. Obviously I had to accompany her while she showered and went to the loo, but to give her some privacy and to maintain her dignity, I averted my eyes temporarily. However, she was inappropriate at times, dropping her towel, not able to find her knickers, could I pass her the toilet paper or her wet wipes – almost anything to keep my attention.

Let me tell you something now; it’s no fun being in a bathroom when someone else has to poop and it’s worse still when you have to get close enough to pass the toilet paper.

Towards the end of one shift, she told me how sad she was that I’d be off over the weekend as she really enjoyed out chats. At the end of my shift she really invaded my personal space when she threw her arms around me and planted a great big kiss on each cheek “Adios. Au revoir. Bye my angel nurse. I will miss you.” I kid you not.

I’d really enjoyed my days off but still looked forward to getting back to work. On my return, as I walked through the front door to the ward, I was almost past the Dr’s office when Smarmy called me in, “Can’t you even get one thing right? You only had to look after one person – how hard can it be?” he demanded and shook his head at me disdainfully. “Pauline said you left her in the shower for nearly 20 minutes and she tried to kill herself.” I shook my head back at him, I smiled and assured him that this was simply not true.

He continued berating and belittling me until he took a breath and I simply responded that I was off to see our Ward Manager. She believed and trusted me that it simply wasn’t true. He’d been ‘had’ but obviously this was the story he was re-telling the whole multi-disciplinary team, making me look incompetent. However, he took in what the ward manager said to him and conceded he might be wrong.

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In the meantime, I felt like I’d been punched in the stomach. I was hurt by Pauline’s tale; I thought we’d formed a good professional bond. One of our senior nurses said not to worry, don’t take it personally and reflect on this; trust me, you will learn from it.

I had to work with Pauline a few more shifts and just kept up the banter but didn’t mention the ‘incident’ and nor did she. Had I been a bit more experienced I would have discussed it with her but right at that moment, I didn’t want to upset her – there was something going on for her? and I was still trying to work her out.

After a week, we had a phone call from her mother, asking if we had a Josephine on the ward. Yes, it turns out this is something Pauline does now and again. She frequents hospitals seeking admission because she said ‘she gets a bed and fed’. In the meantime, she saves up her benefit money while she’s in whatever hospital. Some might say that this is a mental illness in itself?

Ronnie

This young lad had been admitted voluntarily after he went to A&E saying he was paranoid and hearing voices. He was amiable and loved chatting with fellow patients and the staff. He could be heard asking other patients why they were in hospital and was interested in hearing about their symptoms. After a few days staff could see that he wasn’t displaying any symptoms of anxiety, paranoia or hearing voices and had hinted as much to Ronnie.

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Late one night shift, we watched as he paced the long corridor outside the nursing office. He had his head cocked to one side, looking up towards the heavens’, and was saying out loud “Sorry. Say that again. I can’t hear you.” He gave the odd sideways glance towards the office to see if anyone was watching him and continued, “Don’t say that. I’m scared. You’re scaring me.”

Me and Billy, my favourite nurse, found this rather comical and went to sit outside to observe Ronnie and start a conversation with him. Billy asked “What are the voices saying to you Ronnie?” and Ronnie cocked his head to one side, looked upwards again and asked “What are you saying? Ah, ok, hold on.” and in all seriousness, he turned to Billy and said “They’re saying they don’t like you. They don’t want me to talk to you.”

I could barely keep a straight face as I probed a little further, “Okay, tell me Ronnie, how many voices are there?” He did the cocked head thing and the upward glance then cupped his ear, as though he was listening, then counting on his spare hand he looked at me and whispered, “two – and they said they like you.”

We continued in this vein for around fifteen minutes before Billy and I just laughed out loud. Ronnie’s utterances were becoming more ludicrous by the minute and Billy said as much to him, “Hey, soft lad. You look bloody stupid. You’re not hearing voices are you?” Ronnie knew the game was up and pleaded with us not to tell the doctors, “Anyway, they can’t send me home, I don’t have anywhere to go. They’ll have to find me a flat, won’t they?”

Emergency Treatment Team

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I worked with the Emergency Team for a while. This was where people would come during daytime hours to be assessed and we, as nurses, would decide whether to admit someone or to refer them to another service i.e. home treatment team (HTT).

We had so many ‘fake’ patients asserting their mental illness rights, looking for admission so we could find them a home with a garden. Or they needed housing application forms completed, saying that they had a mental illness, which they hoped would put them near the top of the the already groaning housing list or benefit forms so they could access Disability Living Allowance.

Many reported being depressed but when asked to explain, some would say they’ve got a bad back and needed a ground floor flat as the stairs were difficult. Or excruciating headaches due to noisy, antisocial neighbours and it’s driving them mad so they need to move. As though getting a new home would somehow magic away their pain and depression. While I appreciate that decent housing is beneficial to everyone, admission to a mental health ward is not. Furthermore, housing lists are stretched to their limits and London now requires around 66,000 new homes a year to provide enough homes for current and future Londoners.

Given that our hospital served the local population which was approximately 52% non white-British, we had patients from nearly every country and many of them needed interpreters. When they mentioned housing or benefit forms, I always asked them via the interpreter “Do you know where you are right now?” and “Do you know this is a mental health emergency department?” And often told them “This is not a housing services.” or “This is not a benefit office.” before signposting them to the appropriate services

The thing is, we had thousands of patients with chronic mental illnesses who desperately needed our support and mental health intervention or treatment. Moreover, Mental Health is like the Cinderella service of the NHS and we don’t get lots of money so what little we do get is needed for ‘real’ patients.

Do you think I was harsh in turning patients away?

Spoiler – find out what happens on Mental Rehabilitation Wards

Early shift

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As I parked up my first morning, even above Slade’s Noddy Holder screaming “It’s Chriiiiiistmass”, I could hear a female screeching “Medication. I want my medication. Where’s my medication? I need my medication.” The poor neighbours either side of the building must have been well p’d off. It was six forty-five, pitch black outside and the streets were eerily quiet — other than the high pitched screeching coming from the Mental Health Rehab Unit piercing the air.

Someone in the office by the front door pressed a button to let me in and I was greeted by this tiny little lady who grabbed both my hands and panted “Help me. Help me please. I need my medication. You’re new. Are you an Agency Nurse?” Will you help me? Please?”

I spoke calmly but firmly, “Listen to me, I can’t help you right now…” I was trying to placate her enough so that she could hear me and take in what I was saying. At the same time I was trying to get her to take a breath as she was panicking and was as white as a sheet. I really felt for her.

“Please, please. I’m begging you,” she continued to screech, now in my face, as I tried to disentangle myself from the tight grip she had on my wrists. The office door opened and a nurse yelled “Cindy, stop it, leave her alone. Cindy!” I’d now managed to get myself free but Cindy had grabbed the nurse and was pulling on her cardigan, all the while screeching “You’re a bitch. You’re a fucking bitch! Get my medication you fucking black bitch.”

The nurse eventually pushed me into the office and she followed, turning to slam the door in Cindy’s face with a kiss of her teeth “Oh Lordy Lord. That Cindy. She will be the death of me. I am Ayo. Who are you?”

I breathed a sigh of relief and introduced myself as the Student Nurse. “I don’t know. See how it is here. I pray to God for her sins,” humphed Ayo. “Hmmm. Take a seat. Ah! Here come the staff.” and I turned to see two females and one male puffing away outside, the ciggie smoke belching through the office window. “Tsk, Tut. I don’t know. Smokers, heh!” moaned Ayo as she reached to slam the offending window shut.

Seven o’clock on the dot the three members of staff traipsed in, throwing their coats on top of a filing cabinet. Lisa was first to introduce herself as the RMN, the shift coordinator and my supervisor, and said “That’s Lorna, she’s a qualified (RMN) and that’s Graham the NA (Nursing Assistant).” Where’s the fourth member of staff? I thought to myself.

Morning handover

“Okay.” started Ayo, above Cindy’s screeching. “The lady herself. Cindy, she slept and now she has been shouting before six thirty. Lord help me! Everybody still in bed. Only Sasha, she awakes all night but she stay in her room. Somebody needs to clear her room. I saw the mouse there.” My feet moved on their own, up off the floor as I sat on a desk, and I shuddered involuntarily when I was looking around for the said mouse.

Ayo continued and ended with “Moses needs to see a Doctor and his toenails need to be cut. It’s in the diary for this morning. Now I’m going home. Goodbye!” She pulled off her slippers and put them in her bag then huffed and puffed as she bent down to put her shoes on. She grabbed a large woollen blanket and shuffled out of the door.

Lisa went through the diary, handed out tasks to the other two and said she was doing medication and that I should shadow her. Lorna went off to wake up the other nine patients that lived in the ten bedded unit and Graham wandered off to the kitchen to prepare for breakfast.

Medication

With our coffee, Lisa and I went to the medication room, we were met with Cindy who was still gulping in great lumps of air, wringing her hands and saying “Thank you Lisa.” and “Thank you nurse.” to me. Yes, I could get quite used to being called Nurse.

“Right Cindy. You know we start titrating down your Diazepam today.”

“No, please Lisa. Not today. I can’t cope. I can’t cope!” Cindy screamed.

“Nought point five milligrams Mandy. You won’t even notice it.” Lisa tutted and turned to me. “She’s been on thirty milligrams three times a day for years and you can see it doesn’t reduce her anxiety. So we’re going to try titrating down while she’s in Rehab.” Cindy lived in a one bedroom flat and had apparently relapsed over a period of six months prior to admission to an acute ward. Once stabilised she was transferred to rehab.

Cindy had generalised anxiety disorder (GAD) which is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. 

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue. Titration looked like it would go on forever, reducing her Diazepam by nought point five mg three times a day. However, Cindy eventually accepted the reduced dose and greedily swallowed down all her medication, followed by gulps of water, then scurried off to the dining room.

Breakfast

We continued until each patient had had their medication then joined everyone for breakfast in the dining room because, on rehab, we were encouraged to eat with the patients each mealtime. Lisa waffled something about nurses having a responsibility to role model table manners and eating with the patients was supposed to encourage healthy eating. I wasn’t sure that this was an evidence-based intervention but I went along with it anyway.

Coffee and toast with jam was just what I needed but as I sat to eat I was immediately struck by an offensive odour. One older lady to my left had obviously not washed or brushed her teeth, yet there was another disgusting smell.

Graham screwed his nose up and said “She’s just sat there and shit herself and carried on eating!” to nobody in particular. “That’s Elsa.” he whispered with an Aberdonian accent. “She normally goes to the toilet but she uses her clothes to wipe herself and then hides them down the back of the toilets, eh Elsa?” he now boomed. “Elsa, say hello to Nancy, she’s our new student.” Elsa’s face was buried in the huge breakfast she was picking up with her teeth. She raised her head and gave me a toothless grin.

None of the staff got up to help Elsa so I offered, but Graham told me “No. Wait til after breakfast!” And this is rehab? I wondered — does it really work?

Around the table, there was belching, farting and one young chap was trying to snort back the snot that was threatening to hit his top lip. He eventually gave up and wiped a huge glob on the sleeve of his t-shirt leaving a silvery snail-like trail.

Coffee finished and my toast in the bin, I helped clear the table and took my time in the kitchen. I was hoping someone would deal with Elsa, as I was already feeling queasy. Fortunately, she’d gone by the time it took me to do the dishes but she’d left wet poop dribbling down the chair legs. Gloves and apron on and ten minutes later the chair was scrubbed and left outside in the back garden to dry.

Activities of daily living

To the bedrooms on the first floor now where I tried encouraging patients to wash and dress before attending any appointments or activities. Oh my word! I’d knocked and opened the door to Sasha’s room and was aghast at the cereal boxes piled as high as the ceiling. At a guess I’d say there must have been over two hundred boxes and the only other floor space was filled by her bed and two or three black sacks.

“Get out of my room.” stormed Sasha as she pushed me and slammed the door. I stood for a few seconds, stunned, then knocked and called out “I’m a student nurse Sasha. Is there anything I can do? Would you like me to help you clean your room.”

“Get lost.” Sasha muttered. I went to find Lisa and asked what I could do to help Sasha. “Not a lot,” Lisa laughed. “Her room’s been like that forever. She won’t let us in.” That can’t be right. Surely we have a duty of care? I went to the office to look through Sasha’s file and her painstakingly completed but outdated care plans to see if I could find ways to engage her.

I read that she was single, had no children and had been in care since the age of eleven when her mother couldn’t cope with her chaotic behaviour. She was thirty one and was diagnosed with Schizophrenia at eighteen. Sasha heard voices and was often heard talking back to them when alone in her bedroom. Apparently Sasha had no insight and didn’t believe she had a mental health problem. She’d been on the unit for six months and was awaiting housing but it was proving difficult to find a place that would meet her needs.

I decided then that I’d be really firm with Sasha right from the start, telling her that we have a duty of care to ensure that her environment is habitable. If she wouldn’t clean it herself, then we would have to do it! It annoyed me that staff had let her live like this for months. Even if Sasha had refused to let them clean it, surely the staff could have come up with a plan between them.

It was exhausting and often thankless, but I worked hard with Sasha for the next twelve weeks, updating her care plans and engaging her in meaningful activities; things that would both interest and help her rather drum banging or painting by numbers. I appreciate that one of her care plans previously stated ‘Engage Sasha in activities.’ But, while these particular activities may help with dexterity and fine finger/hand movement, I wasn’t sure they would support her development. It was clear that certain staff had intermittently tried to push Sasha into any activities and wrote in her notes ‘Declined to attend.’ I wondered why!

I’d eventually learned more about Sasha, along with the other patients on the unit, and had managed to form a professional bond with each of them. As I got to know them better, often by engaging them in friendly banter, I was better informed about their likes and dislikes. It was easy to see they weren’t interested in particular activities and that they had their own ideas about how to spend their time.

Mark liked football so I’d have a kickabout with him in the gardens – he was quite good – so encouraged him to attend the local leisure centre where he could access different types of exercise and look out for a local football team to join.

Jenny loved knitting so we bought her knitting needles, a few patterns for baby clothes (that she requested), and some wool. She wasn’t great, dropping more than a few stitches, but that wasn’t the point. She enjoyed it. Other staff who could knit helped her unpick and start again. Eventually, with the help of staff, she started her own small weekly knitting group on the unit.

We also got a group of patients to go swimming once a week, with a member of the team. We also went to the local pub once a week so that some of the young lads could have half a pint and a game of pool. They’d never felt comfortable going into a pub previously, because they were worried about what other people thought. We quite often did get some odd looks but as a rule, the regulars were great – helping the lads with their game and showing them trick shots.

At the end of my placement I loved seeing Sasha and the others laughing, smiling, engaging and growing in self-confidence and once again, I was sad to leave.

I would later bump into some these patients in various settings i.e. in the community or on the wards and I was either saddened by their relapse or delighted by their continued improvement.

Note to self: “Public service must be more than doing a job efficiently and honestly. It must be a complete dedication to the people and to the nation.” Margaret Chase Smith.

Studying to become a mental health nurse

Within weeks of starting Uni, I learned just how stupid some people are! How many lacked personal insight, and had no idea of personal space or people skills. I studied my fellow students as they shoved their way through the doors and jumped queues to get the seats at the front of lectures or lessons.

Now, I know I was really skinny but trying to get two people through the narrow single doorways at Uni was nigh on impossible and, if they thought I wanted to bring attention to myself by sitting anywhere within a ten-foot radius of any lecturer, they were sadly mistaken. Those lardy arses who bulldozed past me, snorting, kissing their teeth, or tutting were welcome to their prime seats.

Having only recently recovered from a lengthy psychotic episode, I still felt really shy, nervous even, and constantly prayed to someone who’d help me stave off the ever-impending anxiety attacks. I’d sit somewhere in the middle of the halls and quickly avert my eyes or pretend I was taking notes if I caught a whiff of a question coming my way from the attending lecturer.

I was so busy monitoring my pulse and breathing, I probably missed half the lectures anyway.  Still, most of the lecturers appeared to be reading straight from books, which meant I could catch up by going through the same book or reading any handouts during breaks or at home.

What I hadn’t bargained for was the seminars and classes, which normally lasted between one or two hours and, where we were expected to work in smaller groups, normally around eighteen to twenty students. We’d be further split up to around 2-4 people, to discuss some topic or other, then complete a written task before presenting our understanding back to the group

Or, because of the sweet packet rustlers, the stupid questions and other disruptors, we often had to complete the task at home then feedback to the larger group. Oh, my word! If I’d known that I would have to stand up. In front of everyone. And speak? I would never have applied for the course.

No way was I making an absolute arse of myself. I practised for hours in front of a full-length mirror at home, where I’d present my findings calmly and with a flourish, maintaining good eye contact and waving my hands theatrically. Cracked it; I could do this.

Huh! For all that, the first time I presented to the class, I dropped the acetates I was relying on to distract my peers as I spoke. Taking in huge gulps of air as I bent down to retrieve said slides, I could feel the heat rising up my neck and hear my heartbeat pulsating in my ears. Then I swayed and felt dizzy, increasing my anxiety tenfold. ‘Please do not let me have a panic attack’! Though not sure who I was asking. By now, I could see my heart leaping out beneath my clothes like Jim Carrey’s character in The Mask and felt sure everyone else could see it.

It felt like an age as I raised my head and saw my well-meaning contemporaries smiling, encouraging me, willing me to get over the finishing line, so I began. With trembling hands, a fake smile and what felt like a massive boulder in my stomach, I managed to stutter my way through my presentation and answer some easy questions.

There was no theatrical waving and no calm, just relief when it was over and I was able to watch my peers presenting. Not sure I should be glad but, I could see I wasn’t the only anxious student in the room. Those following me muttered, mumbled, lacked eye contact, had hives creeping up from their chest and for some, their presentation wasn’t even relevant.

Note to self: “Today I will not stress over things I can’t control.”

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