When you lose your mental health

It isn’t always obvious that you are in crisis. From inside a mental health crisis, what you are doing and feeling may well make perfect sense. Lockdown may make people more vulnerable to suffering the consequences of not knowing you are in trouble,  so I thought I’d talk about a few things to watch for, in yourself, and anyone you’re interacting with.

Paranoia is a likely consequence of poor mental health. It’s a form of anxiety, and right now it will be made worse by lack of contact with people who can offer alternatives, plus the vast array of conspiracy theories out there. If you are in a country whose government is handling the pandemic badly and people are dying because of that, then some amount of paranoia may be appropriate and reasonable. When it takes over your entire thought process, then you are in trouble, but this is hard to spot from the inside.

Catastrophising is another common consequence of failing mental health. You focus on the worst possible outcomes and start to see them as likely, or inevitable. Again this may seem wholly realistic. If you’re starting to feel like lockdown will never end, that you and everyone you have ever loved is bound to die, then you are catastrophising. It is a persuasive line of thought, but that doesn’t make it a definite truth.

Overwhelming futility – this one comes from depression, but it can pair up easily with paranoia and catastrophising. It feels like there is no point doing anything. At the extreme end, there seems to be no point getting out of bed, or eating. This is likely to turn up with, and be reinforced by overwhelming feels of exhaustion and leadenness.

The best solution I have found when dealing with this in better times, was to have people you can trust to hear you, not make you feel ridiculous and help you get things back in proportion. However, there is no knowing right now who else might be driven around the bend by what they are experiencing. If we dig in with these experiences together, we can amplify them for each other. It’s difficult to keep things in proportion when the world is such a mess. It’s hard to be certain that any kind of hope or optimism is rational at all. But in terms of surviving and being able to function, some kind of hope is essential. Hope as a deliberately chosen path, despite all the evidence that does not support it, might be the most insane and most healthy thing you can go for right now.

The other thing to always consider with failing mental health, is to focus on the practical and physical things. Look after your body, eat good food, rest, get exercise, get some sun if you can and some tree time. It gives your mind something productive to focus on and you can make a difference to yourself and those around you with a focus on bodily wellbeing. Focus on surviving and staying able to function. Hopefully there is a far side to all this where healing will be possible and we can rebuild ourselves. Human minds are fragile and damage easily, but are also resilient and can recover.

Struggling with mental health

I wrote this in the middle of the night recently, crying, unable to sleep, overwhelmed with panic and despair. The first version went up on Facebook. I’m mostly trying to out a brave face onto my online presence – easy to hide behind a screen. But, I doubt I’m the only one feeling this way and I think it needs talking about.

TW – Suicide issues.

Like a lot of people, I was suffering from anxiety and depression before the virus. There has never been much help available for us, and now there will be less.

Many of us have lost key things that were keeping us going. We may express hurt over that online – the loss of the gym, the dance class, the pub time, the live music – we may not be being super selfish when we express distress. We may be talking about the things that helped us stay alive. Depression also kills people. Knocking people back for expressing distress or difficult, really doesn’t help.

It’s really hard for me, reading people saying ‘stay in’ and ‘don’t see anyone’ with a clear message that anything other than total isolation makes you a terrible person. I’m really struggling with feeling like a terrible person, I expect I’m not alone. I don’t do much going out at the moment, and I’m being careful and have been for weeks. But I’m also not sleeping, and crying a lot, and terrified of being trapped in this flat and what that would do to my already poor mental health.

Tom has some serious anxiety issues and for him, being trapped in a building is deeply problematic.

So maybe don’t share the memes about how all you have to do is sit on the couch, it isn’t that hard. For some of us, isolation could well be a death sentence.

And yes, lots of anxiety about how selfish I am in not wanting to end up suicidal. I’ve been through periods of wanting to kill myself before now, I’m fighting not to go back there. I’m seeing people online hoping the virus will take them quickly because they’ve already lost the will to live. I see the same thoughts creeping in with me. ‘Selfish’ can be something of a trigger term for me and again I suspect I’m not alone. I think people who kill themselves often do so because they think its the best thing they can do for the people around them. What else is there, if the things you do to try and stay alive are deemed selfish?

I know many of you are new to massive anxiety, and you just want everyone else to be more sensible so you and your loved ones are safe. Of course you want that. But some of us were only ever holding on by our fingertips, and now things are worse. Please, when you go online to vent your fear, consider how it might sound to someone who is having a mental breakdown. Someone – for example – for whom going outside for a run, or a walk is the one tool they have left to manage their failing mental health.

Your suicidal friend probably won’t tell you how they feel because that’s part of how this illness plays out. They won’t ask for help, especially not if what they need is time with another human being. You won’t know who is in trouble, most likely. Yes, isolation saves lives. Kindness also saves lives, and your depressed friends need to know that their lives matter too and that they are not failing as human beings for wanting or needing things that are difficult at the moment.

Isolation and mental health

There are reasons we use prisons as punishment and solitary confinement is considered especially harsh. Most humans are social creatures and isolation is bad for us. However, we’re faced with a pandemic that requires us to at least do some social distancing, and that for some people means as much isolation as possible in the hopes of survival. Isolation is bad for mental health, and depression also kills so there is a lot to consider here.

I’ve had a lot of firsthand experience of isolation impacting on my mental health. Living with a few other people does not reliably offset it, and it puts a lot of pressure on those people to provide emotional support. They might not be well enough resourced to do that. Isolation can feed anxiety and depression because there’s not enough to counteract it. There’s not enough positive reinforcement, counter-narrative to the distress, or distraction from it. If you have mental health problems already, being isolated with your own thoughts is hell.

If you start out mentally well and are isolated, you may be ok at first. However, you can still end up feeling unable to leave the house after a while. Boredom can slide you into depression. Apathy can take over, with loss of motivation, loss of joy in life, you do less, you feel worse, you cycle into depression.

Our minds and bodies are not separate systems. Poor mental health is poor health. It can often lead to choices that further undermine health. The things we do for short term comfort may only make our situations worse. The process is likely to be slow and it may not be obvious what’s happening if you haven’t dealt with it before.

Here are some suggestions. Having a voice and a face to communicate with helps – use online tools, use your phone, get the emotional intimacy of talking directly. If you don’t feel able to ask for help with being isolated, contact someone else and ask how they are doing. Rescuing each other often works best.  If there’s no one you can talk to, I find the radio helpful – it’s immediate, and feels more personal than television.

Think about who might be unable to communicate. Consider older relatives who aren’t tech savy. Make sure you know who of your friends is vulnerable. Who is old enough to be at extra risk? Who has underlying health conditions and may need to totally isolate? Who already suffers from anxiety? Don’t wait for them to ask for help. The nature of a mental health crisis usually makes it very hard indeed to ask for help. After all, people are dying out there, how can you approach your friends and family – who no doubt have their own problems – and ask them to give you some time because you are overwhelmingly sad? Mental health conditions are good at persuading sufferers that they are making a fuss and/or don’t deserve help anyway. Make the first move.

If you can choose

It sounds empowering – you can always choose how to think about something. Unfortunately it isn’t true, and putting that idea about can add layers of blame and shame for people who have been damaged by trauma, and by design.

Brainwashing. Conditioning. Gaslighting. These are terms for processes that are undertaken with the intention of controlling how a person thinks about things. Stockholm syndrome is a consequence of experience that impacts on how you think. When people come out of cults, they need de-programming. Depression and anxiety are illness that are fundamentally about not being able to choose your thoughts. These are all familiar terms, and yet the idea that we can all control our thoughts and choose them, all of the time, keeps doing the rounds.

The human mind can be quite fragile. It can be damaged. Your ability to think rationally can be messed with in ways it will take years to recover from. We like to focus on the people who, by dint of remarkable strength, faith, or persistence are able to resist mind-control and keep their thoughts their own. That a person can do something is not evidence that everyone can do it.

To have your mind broken is to lose yourself. You don’t know who you are anymore. You don’t know what you want or need, or how to feel. You can’t make choices, you are frozen and frightened and lost. I’ve been there. I’m a person with a lot of willpower and a decent capacity for reason, and I have had that taken from me and been obliged to re-build it from scratch. I’ve spent a lot of time not being able to control my thoughts or choose what I think and I’ve had a long, hard fight to overcome that.

I don’t have words adequate to express what it means to lose your self in this way. The experience of not being able to control thoughts – of not being safe even inside your own mind – is an awful one. For anyone who was damaged in childhood there may not even be points of reference for knowing what a functional self looks like. It is hard choosing thoughts when you don’t have a range of possible thoughts to draw on in the first place.

If you can choose what to think about a situation, then you are in a position of privilege. Either you’re not going through something that is damaging you, or you are possessed with unusual degrees of inner strength and resilience. While that’s something to celebrate, it isn’t fair or realistic to assume everyone has the same experiences and resources. Like all privilege, it remains largely invisible to the people who enjoy it.

Dealing with night terrors

Anxiety when it comes in the night can be particularly hard to deal with. It may be less troubling than anxiety at times when we’re more visible, but it is also harder to manage. The tired mind isn’t as easy to control. When you’re awake, it is easier to try and reason with your own panicking mind. When awake, strategies can be deployed – be that breathing techniques, or visualisations, or just leaving the building.

In the middle of the night, in your bed attire, with everyone else asleep, or perhaps alone, it is difficult to fight your way out of panic. Waking into panic is especially hard because you get no conscious warning and there is no time to deploy tools or even brace yourself.

If it happens rarely, it’s a hard thing to prepare for as well. If it comes round more often, it pays to develop a plan when you can think about it properly. Decide what you might be going to do – because when you’re sweating with night terrors and barely awake, you’ll have trouble coming up with anything useful.

I find it helps to move. If you just lie there with nothing to distract you, it is easier for the terrors to keep chewing on you. Moving your body can help ground you and if the terror is vague, just the action of getting up and drinking some water can help push it away.

If that’s not enough, I go for distraction. The internet is a great blessing to me at these times, and there’s often a friend or two from some other part of the world online in the wee small hours. Random chats have rescued me on many occasions. I find things to read. If I’m more awake, I might go for a book. There’s no point trying to reason with my brain if I’m tired, but distraction often works.

I give myself an hour. If I can’t get it under control in that time frame, I wake my chap up. I don’t like waking people up, but if the panic is too intense for me to cope with on my own, this is the better call. Sometimes a calm, sane person who can talk you down makes all the difference. In the night, my fears can be incredibly irrational, and I can know they are irrational and still not be able to challenge them. I latch onto small problems and wake up convinced that they are perilous and disastrous and it’s hard getting out of that by myself.

That said, anxiety isn’t utterly irrational even when the focus of it is ridiculous. It troubles me how CBT and other ‘cures’ start from the assumption that you have nothing to fear and need to stop being silly. Anxiety exists either because of something historical that still haunts you, or something contemporary that threatens you, or both. Taking it seriously and trying to put it into perspective is more productive than dismissing it. If the superficial anxiety seems ridiculous, it could be because something else is underlying it. It can also be hormonal, and I know much of what I’m experiencing relates to the menopause. This too is an entirely real experience that needs taking seriously, even if it is manifesting as irrational panic. It seems to come from excess stress in my waking life, even if the rest of the time I feel like I’m on top of it.

If we lived in a kinder culture, with gentler working practices, this would all be so much easier to deal with. The sleepless night would not lead to the terrible day, and that in turn would give us less to fear.

Dealing with fear – some advice

For many people who already feel marginalised, the current political situation is causing a great deal of fear. I’ve lived with anxiety for some years now and I’ve learned a lot about what helps and what doesn’t. This post is primarily for people encountering someone else’s fear and wondering what would be helpful.

Just because you aren’t afraid of something doesn’t mean it is unreasonable for someone else to fear it. They will have reasons. Dismissing the fear doesn’t reduce it for the other person or help them at all. Taking them seriously will mean they feel validated and supported, which will help a bit, and in the meantime, you can learn how things impact on them.

You may want to offer comfort. The trouble is that when someone is deep in a state of fear, attempts to jolly them along, or make light of it don’t help. It just feels like being ignored and dismissed. Ask yourself if you want to make them feel better, or if you want them to seem better so that you could be more comfortable yourself. That’s not an easy thing to look at, but, it makes a lot of odds if you can. You may be trying to protect yourself by not wanting to take seriously the things they fear. This is understandable, but likely it won’t be helpful.

Many people are afraid not simply of what will come, but of what’s already happening. This is important stuff to hear. It is often not speculative fear, it is coming from a place of things being awful already and being afraid simply of it carrying on, not changing. Whether we’re talking about lack of mental health provision, climate change, poverty, lack of jobs, cost of housing, work insecurity, pressures on the NHS, (or medical costs if you’re somewhere that’s an issue) social breakdown, racism, threats to minority groups – these things are all happening. It’s not irrational to fear they may get worse, but there’s plenty enough to fear in just keeping the current levels.

If you are better resourced than average, you may feel more secure and more insulated. You may be confident that you have the skills, intelligence, education and opportunities to keep you and those you care about safe. That’s nice for you. But, most of us are in reality only a paycheck or two from disaster at any time. Most of us could be put on our knees by the misfortune of a serious setback. It may be more in your interests to stand in solidarity with people who have been unlucky and to sympathise with their fears.

There isn’t much that can be done to alleviate fear right now because there truly is a lot out there to be afraid of. What we can do is take each other seriously and show each other care and respect. We can have different anxieties and priorities and still be on the same side – wanting things to be better and more hopeful than they are.

Unspeakable loneliness

How can you speak of it when it implies criticism of everyone you love? How can you say ‘I am lonely’ if you have a partner, or friends, or family, or all of those? But you can have people in your life and be lonely, and I think it needs talking about.

In any given 24 hour period, Tom and I spend something close to 24 hours together, waking and sleeping. We work at the same table. But, we work alone, usually in silence, each engaged with whatever we’re doing. Working in the same space isn’t time spent together, and it took us a while to learn that.

We both suffer from depression and anxiety. This means there are times when both of us need someone with the energy and ideas to break through our numbness and take us somewhere else. When we’re both ill, we can’t actually do that for each other. It is also a lot to ask that it falls only to your partner to wade in and rescue you when you have been kidnapped by the monsters in your head.

Depression and anxiety both, in their own ways, make it hard to ask for help. If you are feeling gloomy and worthless, how can you ask someone you like to spend time with that? How can you show up socially without a mask firmly in place to spare others? And if you socialise while masked, you will feel incredibly lonely. If anxiety is gnawing at you, then the fear of how anyone will respond to you making it visible is also going to be part of the mix.

Mental illness means you can be in a room full of people and totally unable to connect to them. It can mean you won’t let anyone see you as you are, and you experience the profound loneliness of being related to as you are not. It can mean being unable to go out at all, unable to speak, unable to reach out. So you may have hordes of lovely friends and just not know how to approach them when depression has its teeth around your throat. You probably don’t want to put them through seeing you like this. Maybe you don’t want to sabotage your own dignity by letting people see you when you are broken.

There are many potential causes of loneliness – and for many people isolation is central. But, a person can appear not to be isolated, and still be feeling really cut off. It may be very difficult to hear about loneliness from someone you think should feel close to you, but if anyone does talk to you about it, this is a sign of tremendous trust. Try not to be cross with them over how you might feel, because if they’ve come to you it’s likely because they think you are one of the few people who might not hate them for feeling as they do.

Down Days – Further

Yesterday I posted a review of Down Days by Craig Hallam. I read the book a little ahead of that and have had time to think about it beyond the reviewing process. It’s taken me some interesting places. I’ve only had dealings with the medical profession in the last decade about depression, and only in that time frame have I used the term confidently with regards to myself. I didn’t get much help, which played into my anxieties about how I make a fuss and over-react.

Reading Craig’s book, several things struck me. That he’s talking about down days, with some longer patches of being mired in depression. One of the blocks for me, to taking my mental health seriously is that I’ve always been able to keep going, to get out of bed, to push through and do whatever was important. So I’d been taking that to mean that in the grand scheme of things, I probably wasn’t suffering that much. I don’t have down days. I rarely have days where depression isn’t with me – perhaps only as a low level hum in the background, but definitely almost always there.

I’d not really treated that as meaningful.

Craig talks really well about living with depression, that it is something he’s going to have to manage for the longer term, not something he might ever be truly free from. I realised I’d been holding the belief that I should be able to fix this. If I try harder, make better choices, do the right things… that it is a failing on my part and something I ought to fix. Reading Down Days made me consider that perhaps this isn’t the size of it, and that I might treat myself more kindly if I put those beliefs down. And also that treating myself kindly might be more helpful than pushing for a fix.

When was I not depressed? Thinking about the symptoms, it goes right back for me. When was I not anxious? And when did I ever feel like my discomfort, my fear and my distress actually mattered? Even since I started trying to sort myself out and acknowledging that there’s a problem, I’ve not thought about it in terms of being entitled to feel better than this. I’ve thought about it as being less of a nuisance. And that’s probably not helping. In the background noise remains the fear that I’m making a fuss, being unreasonable, and if I act like any of this matters, it would be fair to tell me off and put more pressure on me.

For the last ten years or so, it’s been about trying harder. Being more mentally disciplined and controlling my thoughts. Risk assessing my anxiety to stop myself taking it seriously. It came as a bit of a shock to me to consider that being kinder to myself might be the key thing to being more mentally well. That maybe it would be ok to be kinder to me. That this would not make me a horrible, selfish awful person. That I might be entitled to be passably comfortable, not deserving to drown in misery. These are big thoughts, it’s going to take a while to adjust to them.

More about Down Days here – https://www.inspired-quill.com/product/down-days/

Down Days – a review

This isn’t a self help book or any kind of technical book about depression and anxiety. It is however, a very readable and useful sort of book.

Craig Hallam is best known for his fiction – which has gothic and steampunk flavours in the mix. He’s a splendid chap. I’m reviewing this book because it has considerable merit, and I like Craig a lot. Reviewing a book about depression and anxiety written by someone who suffers, and being someone who suffers, I have some idea what a brain can do in these scenarios… Craig is lovely, and his book is thoughtful and insightful and some people are going to find it incredibly helpful. (But I can almost hear the voice in Craig’s head trying to explain why I probably hated it, and him…)

If you suffer from depression and anxiety and feel alone in this, reading Down Days might just help ease that a bit. It’s not just you. There’s much to be said for a friendly, understanding voice, and Craig is that.

It is, I have noticed repeatedly, a lot easier to think about other people’s problems. We’re likely to be kinder to other people. I rate your chances of reading about Craig’s experiences and feeling clear that the things that live in his head are horrible, unfair things that need treating kindly. Even when you’re telling yourself that the near-identical things living in your own head are perfectly sensible and justified. Sometimes, what we can feel for other people opens a door to being able to see ourselves differently.

Perhaps the most useful aspect of this book is the scope for giving it to someone else. Talking about mental illness is really hard. Explaining what it’s like is very difficult. I’m a words person, and on a good day I can have a crack at describing it. On a bad day I can barely string sentences together and I don’t talk about what’s happening. Not everyone has good days. Even on the good days, you might not have any words. What Craig has written is a very readable, unthreatening sort of book about depression and anxiety from the inside. So, if there’s a person whose understanding would make a lot of odds to you, but to whom you cannot explain things, this book could be the perfect answer. It would be a way of starting a conversation without having to do the talking, and a way of helping someone else understand without having to dig into the things you least want to have to think about.

One of the things I think reliably breaks people down is not knowing how to treat ourselves kindly. Many of us did not get here alone, and may be kept here by what’s happening in our lives. After a while, you can start to feel like you don’t deserve kindness – that’s very much part of the condition. It persuades you that this is all you are worth, that no one could care, that if they do, you don’t deserve it and that you are at best, a waste of space. This book is kind. This book will be kind to you, and it will show you things that might help you be a bit kinder to yourself, and not have that be a frightening thing.

You can buy this book other places online, but buying direct from the publisher’s blog is also a thing, so here’s the link – https://www.inspired-quill.com/product/down-days/

Druid community and anxiety

Yesterday was full of interesting challenges and unexpected opportunities. I spent the day at Druid Camp in the Forest of Dean. I missed the previous 2 years, because there had been a lot of painful drama – accusations that I had bullied someone, that led to said victim trying to get me removed from the field, prohibited from being a speaker there and fired from my day job. I had evidence of what had actually happened, and was not fired from my day job, but it was a scary and stressful time. It was also deeply emotionally loaded for me because I feel very strongly about taking bullying accusations seriously.

So, back to Druid Camp I went, but only for one day because I didn’t know how that was going to work out. I felt welcomed and supported. There was no residual stress or drama. I did a talk and it got all the sorts of responses I had hoped for, especially getting other Pagans thinking about the transition towns movement. I sat as a model (entirely clothed) for some of Tom’s life drawing class, and I spent some intense time with a number of people I am deeply fond of.

Sometimes, the only way to deal with fear is to try again. It’s hard to see what’s a reasonable response and what’s out of date, and what never was that big a deal in the first place, without testing things. Testing things is scary. But, without that, nothing can change. Fear wins. There are issues of picking your fights and assessing what information you have – not all anxiety inducing things will turn out to be fine if you go back and give them a second chance. If something was genuinely wrong and hasn’t changed, it will be as scary as it was before.

If there are reasons to think things have changed, going back can be the best way of dealing with fear. Having support also makes worlds of difference. I know I could not have done this on my own. I had considerable support for making the journey and people around me I would trust with my life. I knew I had a number of very good friends who would be on site, and that helped. They were my incentive for having another go. The organisers were supportive and encouraging – particularly Bish and Fleur who went to some lengths to reassure me, and make things as easy for me as possible. This all gives me space to consider what I might do next year.

The measure of a community is not what it does when everything is fine. The measure of whether a group of people even are a community comes when something is difficult, or broken, or on fire. How people treat each other when there are problems says a lot more about who we are to each other than anything else. It is a very big deal to me to feel safe and welcome.