Apparently people with mental health problems just need to “tell someone”

So Robin Williams has died.  Suicide.  And that’s sad as any death is.

Facebook is full of posts with his picture sharing phone numbers and websites of helplines.  Ones telling people that “suicide is a permanent solution to a temporary problem.”  And declarations that if you’re feeling down, if you have depression to make sure you tell someone.  Friend’s saying that they hope their friends feel capable of telling them.  And similar on twitter and other places.

Here’s the thing: I have a depression diagnosis and I have a lot of anxiety at times which has been recognised by medics although it’s never been given a label like GAD (generalised anxiety disorder).  It’s more than 11 years since one of my friends finally convinced me to go and see a GP about the way I felt.

I’d told someone.  I’d told her.  But she couldn’t physically make me go to the doctors and get help. She kept telling me I needed to and encouraging me to for at least six months.  I’d probably been depressed to a certain extent I had to do that myself (and unfortunately that meant things deteriorated because I didn’t go until I got scared about what might happen unless I did).

Then I went and told a GP.  It wasn’t my GP because my mine was a male and I thought a female doctor would be easier. It was a first step but it wasn’t the solution facebook seems to be suggesting it was.  Telling her wasn’t enough.  I needed her support but I also needed meds and I needed time.

That first type of antidepressants made me ill so I ended up telling most of my carers although I’d not meant to.  Several of them said “me too.” and I was shocked.  Telling people might have been easier if I’d known how common it was. I felt less alone.

I went back a few weeks later for review and I did tell my then GP because really I loved my uni GP because he also had CP and he got a lot of what I went through.  Over the years he’s been one of the few medics I’ve never had to convince that my depression isn’t caused by my CP. He’d seen me a lot in the months before for UTI and chest infections and I don’t know what else routine stuff.  And he apologised to me for missing my mental health problems.  It meant a lot to me but I wasn’t surprised and I didn’t blame him.  I’d hidden it.

And since then over the last 11 years I’ve been on and off of antidepressants.  I’ve told a lot of people about my mental health.

I’ve told friends.  Family. Doctors, counsellors, social workers. Carers and some other people too.

Sometimes it helps a lot.  Sometimes it helps a little.  Sometimes it doesn’t help.  And unfortunately sometimes it makes it worse.

I’ve had the response:

That I’m being silly

That I just need to stop taking antidepressants because they “are addictive and bad for you.”

That of course I’m depressed because I’ve got CP, what do I expect?

That things that have triggered bad times are in the past and I need to move on.

That I’m worrying about nothing

This too will pass

“you think you’ve got it bad I’ve blah blah blah” from a friend who kept telling me to tell her when things were bad.  She still does that now and she gets annoyed if she ever finds out I’ve not told her stuff.  But I’ve never, in more than 11 years since diagnosis been able to have a conversation with her about my mental health problems without it immediately being turned into something all about her.

Offering to listen and encouraging me to tell you about my problems is huge.  But I need you to actually listen.

How could you help someone in a mental health crisis:

Don’t use cliches like this too shall pass or the one I keep seeing today “suicide is a permanent solution to a temporary problem”.  Robin Williams had been undergoing treatment for various mental health conditions for over twenty years.  He had a real, serious illness not a temporary problem.  Calling it that belittles his suffering.

If someone tells you don’t try and make them tell you exactly what it is they have to be depressed or anxious about.  Mental health conditions can and do defy explanation.

Also, don’t make assumptions about causes.  I’m sure some of the counselling I’ve had would have been more effective if I’d not spent so much time trying to get it though the counsellor’s head that the fact I can’t walk had nothing to do with my mental health. The assumptions of a supposed link between my physical disability and my mental health condition make it harder in fact.

Only make offers of support that you genuinely mean.  If someone offers me the chance to talk but then tells me all of their problems rather than listening when I try to take them up on it I usually end up feeling worse because I feel alone and I’m worried about my friend.

Support takes different forms for different people.  I have issues with medication compliance.  Someone demanding to know everyday if I’d taken my meds (something one of my carers tried) didn;t help me.  But when I had a friend who was also struggling with med compliance we would tweet each other and check in every day or two sort of “I’ve managed my meds today, how’re you doing?” that really helped.

Don’t try to force a particular therapy or drug on someone.  Fluoxetine might be really great for people who have depression that worsens around their period.  I was on fluoxetine when I first started raising that issue and it didn’t help.  Sertraline did but all I kept being told from medics was “fluoxetine is good for that, perserve” until finally one switched me to sertraline for another reason.  Friends told me fluoxetine was good too.  It was good for me but it wasn’t the answer.

Just because you recovered doesn’t mean I will.  I care about how you’re doing but when I’m really struggling telling me that I only need six months of antidepressants doesn’t help.  And actually, the standard treatment isn’t six months of antidepressants.  it’s treatment until condition improves and then for another six months to ensure no relapse.

If the person in question is able to lead you in what support they need try to follow them.

But don’t, ever just tell someone to “tell me” if you have a problem and expect that to be the answer.  It’s a first step that you can take to helping them.  Telling you is a brilliant first step for the person with mental health condition.  But living with/treating/recovering from/whatever a mental health condition is a long, long journey.  And it needs more than that first step of talking about it.

Self-Care Sunday: Thinking It Over

I’m not sure what to write about today. There have been lots of little things going on like continuing to take my meds everyday (I have approx 8 days left on iron tablets for the anaemia. That will get easier after that because those are my only three times a day med) and taking a break from my wheelchair in the middle of most days. And working on picking my battles and when to let things go and move on. But I don’t have a lot to say on the little things – in part because it feels too soon. The picking my battles thing is something I probably should blog about. Just not today. Mostly because that would defeat the object of letting things go.

I killed my wheelchair batteries off last Monday and ended up walking home incredibly slowly to ensure they didn’t die completely. The good thing about that was it meant I bumped into an acquaintance. I really, really don’t know them well and hadn’t seen them for years. It was nice to chat and they shared a piece of information with me that’s been making me think more on a subject I’d vaguely wondered about then dismissed. That could be good for me. Maybe.

Truly I’ve been thinking about a lot of different things this week. One of which is this occasional address by the awesome Tim Minchin. I should probably act on some of his points. In fact, not probably, definitely. But I must also admit to being a little disappointed it wasn’t a beat poem like Storm or a song. That would have been epic but probably would have diluted its message.

Self-Care Sunday: I Did

Just a quickie this week because Downton Abbey is on in a few and I’m trying not to watch TV and be on the iPad at the same time.

Having written last week about feeling like a failure I’ve been trying to keep that big picture in mind more. One of the things I’ve been doing is writing a list of what I’ve done/achieved each day. It’s very useful because yesterday I did very little but I’m not beating myself up about it because I know I’ve achieved a lot this week I might otherwise have overlooked.

Plus, knowing I’m going to be writing it down means I’ve eaten a proper dinner each day and taken all my meds. I’ve not achieved that for a few weeks.

I feel better this week.

Random Bullet Points of Health Related Life

♥ I still don’t have my new wheelchair cushion. I had my fitting appt at wheelchair services but that was the worlds biggest waste of time because they didn’t have it. The story is a bit more complicated then that and totally ridiculous as well as very badly handled. I made a complaint to PALS about that. It made me feel better if nothing else.

♥ I was diagnosed with anaemia about ten days ago. It was borderline but based on symptoms I’m being treated with ferrous fumarate (prescription strength iron supplements) three times a day for 8 weeks. I keep wanting to call it ferocious fumarate. Sophie said when she was anaemic and had iron pills she felt great. I’ve been feeling crap – nauseous to the extent that on Wednesday I was on my way home and I was convinced I was going to projectile vomit on the street (I’ve not been sick at all). I decided to persevere over the weekend and I’ve felt ok yesterday and today.

♥ I had my 6th UTI of this year. GP I saw this time thinks I’m getting cystitis and not full blown infections and prescribed me nitrofurantoin to keep in the house. 1 on symptoms and a litre of extra water then give it 24 hours. She also said she thought if I took 1000mg vitamin c a day I’d stop getting infections. We shall see.

♥ I’ve started trying to take better care of myself. Baby steps is the plan. At the moment that’s taking most of my meds (well, it was meant to be all but I appear to have run out of sertraline). It was also improving my sleep pattern but that’s slipped big style this weekend.

Talking, Ten Years Later

It’s that time of the month again when I mosey on over to Bea Magazine and share what I’m thinking, feeling, doing, whatever with them.

I don’t like February. There have been a lot of tough times in previous ones and there are several anniversaries now in a short time. It’s been long enough now that most of their sting has gone but still it lurks. This year I remembered the dates but it wasn’t until several days into the month when I wondered why I felt down and put it together that its often a time I struggle.

Yesterday marked 10 years since I was first diagnosed with depression. It is what it is. I can’t change it and I’m not sure I would if I could.

I’ve written a bit about that over on Bea in Talking, Ten Years Later.

Mojo

I think it’s probably obvious to many people who read this that I’ve not been myself for the last several months at least. Since April I’ve been dealing with issues which have left me very depressed and struggling with feelings of worthlessness. I’ve not done a particularly good job of dealing with that and taking care of myself, not least because my medication compliance slipped way down.

Going to the Paralympics however has made me really want my mojo back. I want to be me again. I want to get back not just to the girl who I was before all this kicked off five months ago but who I was a few years ago. Or a variant of that girl. Whoever she was. Sometimes I’m not sure I remember her correctly.

Today I made two decisions – one of which has been on the cards since May and which a couple of people been pushing me to make. That has however involved backing down from a fight I’ve invested a lot of time and effort into. But I was never going to win that. It feels wrong for a fighter like me to back down and not get resolution to such blatant (and easily solved) discrimination as that of the NHS weight loss clinic who can’t weigh a wheelchair user. It was pretty toxic for me though so dropping out of the course was necessary.

The second has only been a consideration for a week or so but I’m pretty excited by it. I know it’s possible and that the majority of the logistics involved in it are easy for me. There is however a small bit logistics wise that should be doable but I need to try to be sure given some of the issues I’ve had with my powerchair and public transport. Actually, that should probably be a separate part of the “getting my mojo back” plan now I think of it.

I also ordered prescriptions for the majority of my meds (I didn’t order pain meds) so I can try to get back into a better routine of taking them. Mostly I need to be taking them at more sensible times so they’re working when I’m awake rather than swallowing them immediately before bed and sleeping through most of the benefit.

It’s a start.

>December Goals

>Take my meds every day (seriously my med compliance has been absolutely atrocious lately. And no suprise, my mood is appalling as a result. Surprisingly my spasticity hasn’t gone as crazy as it used to with not meds).

Continue my one better choice a day plan I’ve been working on.

Finish some damn knitting.  (honestly I don’t think I’ve finished a single knitting project this year :-O)

No more ridiculous chocolate binges (I ate a totally ridiculous amount today and don’t know how I wasn’t sick).

15 mins on the house each day.

Catch up on book reviews

Exercise a couple of times a week.

>Goals for the week

>It’s been a bit of a crap week and I’ve been feeling down at times, missing my meds and feeling a bit ill on and off. I do think there’s been a bit of a virus going around as a couple of other local people have complained of nausea too.

Anyway although I’m slowly pulling it back together now and have an actual proper achievement to show for today – I went back to a very badly stalled project and have got it moving again. I thought it would be good to set a few goals.

1. Take my sertraline daily.
2. Take my baclofen at least once a day (will worry about consistently taking the second dose next week, getting some in is a better goal now)
3. Work on the above mentioned project daily.
4. 1 hour total in the standing frame.
5. Watch The Lord of The Rings
6. Send emails I’ve been procrastinating about

>In Which I Am Apprehensive About An Upcoming Appointment

>I’m back at the hospital tomorrow. Only I don’t really know what for.  I rang them on Monday about various things and the receptionist referred to my appt as being at X time with the physio.  But I was under the impression that my appt was 15 minutes later than that and in the clinic with a consultant (although I believe this clinic has physios and consultants working together, I was under the impression I was going as they need me to see the consultant).

At the end of the day none of it really matter but… I was already a bit apprehensive about the appointment due to some of the stuff that’s going to be discussed (which could mean big changes for me which are never easy) and now I have what ifs going round and round in my head.  I’m told by they physio the new meds they might want to give me are sedating. Reading on the Scope website suggests one of the possible treatments is painful to administer – and I don’t know for definite but based on stuff that was said I think they might want to do it then and there if they think I’m a candidate.  And something that was discussed when I saw the physio is a treatment I swore I’d never have but am now thinking I’ll try if they suggest it.

And then there’s the fact that the transport people despite having picked me up two weeks ago from here had a question about where I should be picked up from. Here.  Or my parents old house which I moved out of 10, nearly 11 years ago, they moved out of 7 or 8 years ago and at which I never had hospital transport.  And which isn’t my most recent previous address by a long shot.  And how did they get the answer to that question? By ringing my parents and speaking to my Dad.  So much for confidentiality.

So basically I’ve just turned into a big ball of stress and it’s not fun.  Nor is depression which makes these things so much worse.

I do know it’ll all turn out all right in the end but… I wish I could skip to the end like fast forwarding through a DVD!

>Meds and Such Like

>I think it’s safe to say that at the very least I need to go and chat to my GP about my depression.  I’m much better than I was when my antidepressant was changed to Sertraline but I’m still struggling a lot at times.  That said I don’t necessarily think I need it tweaking again but I’m not sure and I need to keep an eye on these things.

And when I went to the physio she was talking about the possibility of changing my muscle relaxants.  Either an increase of my baclofen or taking something else (which said could be instead of or in addition to the baclofen).  I’m back there on Thursday to chat these things through.  That was quite interesting though because I’d not heard of one of the mentioned meds being used for spasticity and I know of loads of people who take it.  And she also queried whether I was taking anti-depressants for depression or spasticity as apparently some anti-depressants can be used for spasiticity as they relax you.  I’d never heard that before but it’s an idea I’m quite interested in.  If I don’t come back without a drastic increase in my baclofen or an extra prescription I’ll be very surprised.

The physio has also referred me back to wheelchair services as she says I either need this chair adapting or a new one as it’s totally unsuitable and she thinks part of the cause of my pain.  Wheelchair Services however are saying I have to go back on the waiting list which has an average wait of 18 weeks.

She also advised me to go back to social services and asked to be reassessed for care needs, specifically for help with socks and shoes.  I’ve not done that yet.

A few other things were mentioned as possibilities so I came back with lots to think about which is part of the reason I’ve been so quiet on this blog.

Oh and she told me I should be leaving my wheelchair in a different position (equivalent to where it would be for a lateral/slide board transfer) when I’m standing and transferring.  Getting the hang of that is not proving easy at the moment!