Blog Posts

2020 Ends In Hospital

I am going into hospital later today.

And I am aching to get there, straining towards the moment I close the door to my hospital room on a world I am the wrong shape for right now.

How did I get here this time?

Fourteen days ago I had a regular appointment with my psychiatrist. Just a Bipolar 1 Disorder monthly maintenance appointment. I was completely asymptomatic.

Thirteen days ago I left for our beach holiday and forgot to pack my swim wear. Subtle. I mean that could happen to anyone. Right? But by the following morning I was symptomatic alright. My short term memory and concentration were dissolving like sugar cubes in boiling water.

A buzzing pressure behind my eyes radiated up my forehead. I knew from bitter experience, if I did nothing, soon that buzzing could make me second guess what was real or not.

That was symptomatic enough to page my psychiatrist on a Saturday morning. It’s only the second time I’ve paged him out of hours in 14 years. He called back in under three minutes.

Over the last nearly two weeks, the first of which I stayed at the beach, he telephone consulted with me every second day, adjusting medications, a little more of this, a little more often of that. I slipped from my bed gratefully into the ocean, timing the most sedating medications for times when I’d be in bed not the ocean. I seemed a little better, maybe? But then not.

Back home we continued every second day phone consults, adjustments. This is by far not the sickest I have ever been (although psychosis and catatonic depression requiring ECT to reverse, do set a very low bar)

So why would I want to go into hospital, rather than continue treatment at home?

Here’s why:

The surface of my brain feels as though it is covered in papercuts and being surrounded by people and noise is like having lemon juice dribbled over the cuts.

Trying to hold in the irritability of being around people and noise (including my close family) is like being intensely nauseous with someone threatening to punish you if you vomit.

One of the parameters I use to assess how close I am to needing to go into hospital is ‘the sandwich test’. Think about the amount of concentration and short term memory it takes to make a sandwich – nothing fancy, just two slices of bread, some butter and one topping. For most healthy, able bodied, able brained adults, this is not a challenging task.

Right now – I can still make a sandwich, but it’s a challenge. I am making a decision, based on past experiences, not to wait with hospitalisation until challenge becomes an impossibility.

As for the seasonal timing – Christmas and New Years celebrations? I am veteran enough in the management of this illness to know it has no knowledge of nor respect for holidays and anniversaries. I could list my tenth and fifteenth wedding anniversaries as times spent in hospital, a longed for trip to Paris cancelled because of recent hospitalisation, and that would be the beginning of a list so long I’ve forgotten most of it. These times are just human constructs. If it swallows them I don’t dwell on them.

Instead I celebrate the unscathed special occasions extra hard, to make up for the times there is nothing.

The final reason for going into hospital now, is because I can access this level of care. I am fortunate to have the option of going into a private psychiatric hospital when I am sick. The standard of hospital care I will receive will be excellent. It will far exceed anything the public psychiatric hospital system has to offer.

I loathe getting sick enough to need hospital support. But perhaps even more than this I loathe the hypocrisy of someone with my privilege not utilising that support because of some misguided stigmatising ideas about what it means to be a patient in a psychiatric hospital.

I am profoundly grateful I can afford care in a good private psychiatric hospital. And part of my own recovery, once I’ve stabilised medically, is to remember there are many people living with this illness, and other severe mental illnesses, who are learning to live with them with far less support and privilege than I have. When my recovery feels hard I focus on this:

If I access the supports I am fortunate to have, I am more likely to be around for long enough to help raise awareness of the inequality between our private and public mental health hospital systems, and work towards our public mental health hospital system actually supporting some of our most vulnerable when they need it most.

If you are new to Thought Food and would like to know a little bit about who I am when I am well, you may like to check out:

Who Am I ?

Radio And Podcast Interviews

Rewards For Reports: Entitled or Deserved?

I had an interesting conversation with one of my children this morning.

They opened with this:

‘Why don’t you give me something to celebrate my report card?’

 They paused briefly before elaborating: ‘It’s just that my friends who also got good marks are all talking about the presents their parents gave them for it, and they ask me what I got and I have to tell them I just got a pat on the back and a “well done”.’

Where to begin? Maybe with a little context:

For their entire school careers (so far) I have placed no pressure on my children to achieve academically and almost no importance on the marks they get. Providing they are not falling so far behind that they need additional support, and they are doing their best – I am not invested in the outcome. The only two report parameters I care about are their effort and their behaviour.

So far neither of my children have needed additional learning support. This is something I am grateful for, don’t take for granted, and I definitely don’t take any credit for.

I do my best to make sure they get enough sleep and have a decent breakfast before school. I pay for their uniforms, books, excursions, and other school related expenses. I try to give them an emotionally healthy home to return to after each day at school. And while their academic achievements may be built on this foundation, they are very much their own.

The child who began this conversation with me this morning happens to consistently get very high marks across their report card. None of these marks, or the awards received because of them, have ever been incentivised by my husband or I.

Of course, we are proud of our children when they do well, and we tell them, but we are not about to start rewarding high marks with extravagant material possessions. Here are some of the questions I asked my child to help explain why:

‘Do you feel good about getting a fantastic report card, just for the sake of it?’

‘Do you think the most important thing about you is the marks you get?’

‘For the kids getting the fancy presents for getting good marks – do you think they might feel pressure from their parents to get those marks? ’

‘And what happens if one of those kids has a really ordinary year – for example they get sick, or they have a rough time with their friendships and feel sad, and their marks slip below excellent? How will it make those kids feel if they don’t get the good marks and the presents, because of things that are out of their control?’

‘When those kids grow up and do something really well at work and don’t get presents for it, – because that is not the way the grown up world works – will they feel let down?’

‘And say for example I did give you a fancy big present for getting great marks, would you go to school and tell everyone about it?

I got different answers for each question, but the answer to the last one was (thankfully) a resounding ‘No.’

Whether you choose to reward your kids materially for academic achievement is your decision.

I don’t, because it feels like a slippery slope. It adds pressure. I don’t believe getting top grades at school is a marker for future happiness or success in life. I place more importance on developing my children’s emotional intelligence and mental health than their academic achievements.

I want my children to know that their worth as a person has nothing to do with the marks they get at school.

Living vicariously through your children by either shoving them into the same life path as you followed or wanting them to do better than you did, or (even worse) validating your parenting through your children’s achievements, can all present as pushing them to achieve academically. The problem is these motivations revolve completely around the parents’ needs. They have nothing to do with the child.

But if you want to give your kid a Nintendo switch for their straight A report, please give it with a side of humility and sensitivity. Teach them that doing well at school – while yes it may be the result of their hard work – is not a given for all kids.

Some kids work harder than your kid ever will and will never get top marks. Other kids are not privileged enough to get the basics for good academic achievements (breakfast, a desk to study at). Still others live with a diagnosis whose symptoms make it impossible for them to win any awards.

And none of those kids need to hear yours bragging about their report rewards.

You may also like to check out:

Don’t Try This At Home: Schooling

Mental Health Parenting Truths 101

Talking About Mental Illness With Children

Veterinary Work And Bipolar Disorder: A Podcast Interview

My new little niece

Earlier this year I wrote a blog post Veterinary Work In The Time Of Covid-19: Unspoken Truths which received a lot of attention, especially in the US and resulted in me doing a couple of podcast interviews.

The second one was released recently and dives deeply into my work life before and after the onset of Bipolar 1 Disorder, and the adjustments I had to make for it to be sustainable. It hopefully goes some way towards dissolving the myth that it is impossible to function highly when living with a severe mental illness.

I was interviewed by Dr Kimberley Khodakah and you can find that episode here:

https://anchor.fm/time-to-paws/embed/episodes/Living-a-good-life-despite-everything-el0eqc/a-a3o42u4

The other veterinary podcast episode with Dr Andy Roark https://drandyroark.com/cone-of-shame-episode-30-unspoken-truths-about-covid-19/ came out in May. This one is a bit more veterinary industry oriented than Kimberley’s.

Happy listening!

If you are interested, you can find all of my radio and podcast interviews here:

Radio And Podcast Interviews

The Cost Of Canine Anxiety

Photo by sergio souza on Pexels.com

A baby or child fatally injured by a dog.

Every few months a fresh headline proclaims a new tragedy. Having worked as a vet in small animal practice for twenty years, these cases frustrate me because they are often preventable.

Pointing fingers at shell shocked, grieving parents is neither kind nor helpful. But as a society it is our responsibility to be better educated about how to integrate our canine companions into our lives more safely. This means considering our dogs’ mental health as we should the mental health of all our family members.

To further explore the subject of canine behaviour in relation to cohabiting with children I exchanged messages with my friend Leonie, also a vet who is not only passionate about treating canine behavioural issues appropriately but has also done further study in this area. And I thought I’d share some of the key points we discussed, which not all dog owners may be aware of:

By far the most common cause of canine aggression is anxiety that has been ignored or not addressed appropriately.

Dog owners need to be better educated about early canine anxiety signs, which the dog uses to communicate its discomfort. These signs include, but are not limited to: lip licking, yawning, averted gaze (often misinterpreted as submission), whale eye (when any of the white part of the eye is showing), panting, pacing, and neediness (often misinterpreted as love).

Dogs should not be punished for showing anxiety around a child. This will just increase that anxiety in future interactions and cause the dog to lose trust in their emotional advocate (the adult).

The time to get behavioural advice is when the dog shows anxiety around anyone, not just a child. Don’t wait until anxious behaviour converts to aggressive behaviour.

If anxiety and/or aggression are part of your dog’s behavioural issue, do not seek help from a dog trainer. Seek advice from a vet first.

Your vet is likely to first rule out any physical causes of anxiety and/or aggression. This usually starts with a thorough physical examination, but may also include further diagnostic tests such as blood tests or X-rays etc. Pain or feeling unwell can change even the most placid dog’s behaviour. Once a physical cause can be confidently ruled out, it can be classified as a behavioural issue. In this case a referral to a vet with a keen interest in behavioural medicine (preferably someone who has done some further study in this area) may be recommended.

If you are considering adopting a rescue dog, think very carefully about whether your family and home is going to meet all of that dog’s physical and mental health needs. Rescue animals are prone to anxiety disorders due to previous loss of attachment figures (owners). Animals are also rehomed because they have an anxiety disorder, which exacerbates it further.

Another less common cause of dogs injuring children is prey drive. This is based on instinct. It is a subconscious response that can be triggered by noise and/or movement and could cause a dog to treat a small noisy child or baby as its prey. Even some play is an inhibited form of prey drive (seek and chase during hunting), and particularly if the dog is bigger and stronger than the child this interaction could result in significant injuries to or death of the child.

Prey drive is more developed in some dogs than others. Knowing your dog well and (if their prey drive is strongly developed) keeping them away from children (and other smaller dogs) can avoid a tragic outcome.

It comes down to this:

Before you bring a dog into your family – educate yourself about dog behaviour.

If you as the adult(s) in the household make the decision to have both children and dogs in that household, then you are responsible for the physical and mental wellbeing of both. Generally speaking, neither the child nor the dog has an adult human’s judgement or emotional regulation, and depending on the age of the child they may not be capable of reading the subtle signs of canine emotional discomfort that can precede aggressive behaviour.

If you live with both dogs and children it is your responsibility to model and teach your children empathy, respect, and good behaviour towards animals, from the earliest age possible.

And the one nonnegotiable rule is:

Never leave a dog and a child under the age of 12 (or over 12 if they have not been taught how to read a dog’s body language and respond appropriately) together without the close and careful supervision of a responsible adult who can interpret the dog’s behaviour as well as they can the child’s.

And when I say never I mean not even for the length of time it takes you to go to the toilet.

If we can accept that knowing about canine behaviour is just as important a part of being a responsible dog owner as knowing about keeping your dog physically healthy, it will mean fewer children are injured by dogs, and fewer dogs will die by euthanasia for a potentially preventable behavioural issue.

With thanks to Dr Leonie Thom for contributing to this post.

Please note that a full exploration of all the causes of aggressive canine behaviour is beyond the scope of this post. The information in this post is general and not intended to replace a veterinary consultation.

You may also be interested in:

Veterinary Work In The Time Of Covid-19: Unspoken Truths

Our Vets Are Dying For Your Pets

Not So Body Positive

Mental Health Parenting Truths 101

Written for Queensland Mental Health Week 2020

At some point you will get it wrong.

It will be well intentioned. It may come from a place of not wanting to replicate your own upbringing or the mistakes you think other parents are making. And it will probably be informed by your experiences and biases.

I’ve always known this…in theory.

But the other day my fourteen-year-old daughter courteously yet clearly served my imperfections in this area up to me. This was no teenage tantrum. It wasn’t even an argument. It was simply a conversation in which I was presented with unpalatable information about myself, and then had to choose what I did with it.

It started simply:

‘Mum, can I please get TikTok? Remember I asked you about it a month ago, and you said you’d think about it.?’

‘Mmhm.’

For context – she gained Snapchat and Instagram over the last few months, to my knowledge has not abused any of her privileges, and right now appears to be in good mental health.

So, we talk about how she’d manage seeing distressing content if it popped up. I probe her with her worst-case scenario.

‘What about animal cruelty?’ I say and follow it with a graphic example.

‘I’d talk to someone about it.’ She answers calmly.

‘Who would you talk to?’

She doesn’t hesitate: ‘Well definitely not you! Probably Dad.’

‘Why not me?’ I ask,

‘You and your mental health stuff – you’d blow it all out of proportion, take me to a psychiatrist, have me medicated and force me into years of therapy.’

I did ask.

And while she is wrong about the imagined consequences of telling me she saw some distressing social media content, she is right about something else.

I am hypersensitised, filled with knowledge of the very worst mental illness has to offer. And not just my own. Every time I go into hospital, I share that space with others who are going through their own worsts.

When I see young inpatients often only four or five years older than my eldest child with bandaged wrists or cutting scars, bolts of fear shoot through me. Fear that one day my children could hurt like that.

Every time after my Bipolar 1 Disorder has put me through hell I am frozen by the threat that I will have given this illness to my children. I know that (beyond not introducing significant trauma to their lives and warning them of the dangers of drugs that can trigger the genetic component of this illness) there is nothing I can do to outparent it. But I still try.

After I got sick I was determined my children would grow up in a family that was open about mental illness. There would be no shame and no stigma. They would know from a young age where I was going when I went into hospital and why.

The knowledge that sometimes mental illness sprouts in childhood and adolescence is heavy and made heavier by the fact that sometimes it is fertilised (even in the absence of major trauma) by parents unwittingly invalidating their children’s’ feelings or experiences.

I never wanted to be that parent. And I am not. But I may have made the opposite mistake.

 By unintentionally force feeding my children my concerns around mental health, could it cause them to turn away from the very tools that could help them should they run into a mental health crisis?

Mental health is stitched into the fabric of our family’s conversations partly due to my lived experience, but also because of what I do. My children have never known a time when I haven’t been a vocal mental health advocate. I write about it. I talk about it frequently – sometimes quite publicly.  

And if I dig deep into my motivation for wanting to change the way mental illness is perceived and treated, my children are at the core of it. That motivation is as simple as it is unrealistic:

I want to fix our mental health system so that it can help rather than harm my children should they ever experience mental illness.

I am loathe to admit it but yes sometimes all my motivation, knowledge and focus, can morph into hypervigilance, ready to pounce on the very whisper of something not being right with my children’s thought patterns.  And in my futile efforts to protect them from my worst nightmares, at times I probably veer dangerously close to pathologizing their emotions, which can be as damaging as not acknowledging them at all.  

I do this reflexively even as I know that parenting out of the fear of what could happen is even worse than living your own life ruled by fear.

And yet, deep down I know that if either of my children get sick it won’t be my fault or TikTok’s. If that happens, hopefully their father’s less informed love will be the perfect counterweight to remind me that while my knowledge might be useful in some situations, at other times applying the full weight of it can be like attempting to kill a fly with a sledgehammer. Ineffective and potentially damaging.

Post scripts:

It was a yes to TikTok.

While I am deeply grateful that right now neither of my children require psychiatric care, my advocacy work will continue, because it is grim out there. I caught up with a friend recently whose child does need a child psychiatrist urgently. The waiting time to get an appointment with a private child psychiatrist is currently twelve months.

Or there’s the public hospital Emergency Room if symptoms become life threatening while you wait…

Published with full permission from the fourteen year old who also helpfully pointed out I’d misspelt TikTok in the previous draft.

You may also like to check out:

Talking About Mental Illness With Children

As Mothers Of Sons

As Mothers Of Daughters

Is YouTube Rotting Our Brains?

On Uncertainty

Written for QLD Mental Health Week 2020

How does uncertainty make you feel?

I ask because uncertainty is having a moment right now. It galloped in with the Covid-19 pandemic, and the further we get into it the more it seems to be digging itself into our awareness.

I used to be deeply uncomfortable with the pebble of uncertainty in the shoe of my life. I liked to know what was ahead. It gave me a (false) sense of control and the misguided belief that just because I couldn’t see uncertainty in my life, it didn’t exist. I deluded myself for decades that when there were no clouds on the horizon, the course of my life was somehow more certain than if I could see trouble ahead.

Then all the certainty in my life was put through a paper shredder within five days of my first baby’s birth.

I got my new baby experience with a side of florid postnatal psychosis severe enough to warrant admission to the locked Special Care Unit of a psychiatric hospital. My sense of certainty and control over my life went down the toilet.

After I’d recovered from this psychotic episode I felt entitled to some certainty. I wanted to know this nightmare was over. And I wanted a guarantee it would never happen again.

So when my psychiatrist mentioned ‘a possible underlying Bipolar Disorder’ and that it would ‘take three to five years to know for sure’, the inside of my head threw a combination of a tantrum and a pity party.

When I got sick again after three years, after seven years, and after nine years and my diagnosis of Bipolar 1 Disorder was confirmed, I still felt entitled. Entitled because: ‘hadn’t I suffered enough yet?’ Entitled to not have to tiptoe through my life with everything clenched, waiting for the next time this thing pounced.

I have only recently acquired some degree of acceptance of the uncertainty this illness introduced into my life. I didn’t enjoy the last two episodes in 2018 and early 2020, but I also didn’t waste energy resisting them. In the same way I no longer spend any of my resources anxiously wondering when it will happen next and how bad it will be, because without wanting to sound nauseatingly Zen, the truth is: It will be what it will be when it will be.

Uncertainty exists in everyone’s life every day. But instead of it floating along in the background, right now it is constantly being rammed down our throats. It’s like having a nasty little gremlin on your shoulder whispering over and over again:

‘You do realise bad things could happen to you at any minute’, when the true risk of something bad happening to you is probably not that different to pre-Covid times.

For our mental health to survive this pandemic we have to learn to live with uncertainty, because the end of it is nowhere in sight. And just like my psychiatrist couldn’t give me any certainty when I first got sick, the smartest scientists in the world aren’t able to accurately answer this question about Covid-19: Will it ever be over, and if so when?

Uncertainty is an uninvited, kicking, snoring bedfellow. So how do we get comfortable with it?

First we tease out what about this situation we can control and what we can’t. For example, we can’t control the flow of information that feeds our uncertainties rushing over us every day, but we can control how much of it we absorb.

And once we’ve done what is in our control to help ourselves, we have to try and unclench from the need to know what is going to happen next. We need to stop trying to know and plan for a future that is like a spiderweb in a storm. Here’s what I mean:

During one of my admissions to hospital I sat staring out of the window of my room feeling as though there was no point in doing the work to rebuild myself because my future was too uncertain, my illness could tear me apart again anytime.

Over a couple of days of intermittent staring I noticed a spider in its web just outside my window. Every night it stormed. Rain, wind, a couple of times hail tore chunks out of the web, at times almost destroying it.

That spider showed me the way out of my tangled thoughts, by not only rebuilding every time after its pristine web was wrecked, but doing so in the face of the risk of the same thing happening again, whether the next day or in a year.

The sword of an uncertain future has hung over every single one of us since the day we were born. Nothing has changed there. It is just up to us whether we choose to battle with uncertainty and lose, or whether we accept that being alive will always mean living with uncertainty, pandemic or no pandemic.

You may also like to check out:

Lessons For A Control Freak

The Other Curve Being Flattened

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

Tokenism In Mental Health Awareness

Tokenism In Mental Health Awareness

Written for QLD Mental Health Week 2020

Saturday 10th October is World Mental Health Day and I feel a little conflicted about highlighting it. There are a lot of positives to having dedicated days or weeks to draw our attention to mental health. But I also believe we need to approach these awareness days with a little caution. It’s too easy to post or repost something related to the topic, tick the box of doing good and move on with our days.

Ironically these tokenistic efforts are becoming more common as awareness around mental ill health grows, especially when we don’t have to move beyond the comfort of our keyboards to feel as though we are achieving change. Of course it is good that there is more awareness, tolerance and marginally less stigma surrounding mental ill health than there was fifty or even twenty years ago. But we have to make sure we don’t replace the old insensitivities with their more modern counterparts.

I have written about my dislike of RUOK day before RUOK Day: Full Disclosure and this year I heard another perspective that reenforced my reasons for disliking this day. When I am well, my psychiatrist appointments usually consist of me requesting scripts for any medications I am running low on, a brief check in with how I’m going and then we chat about the state of the world, my advocacy work, his psychiatry work. This year one of my appointments happened to fall around RUOK day and we talked about the pros and cons of this day. I expressed my opinion and my psychiatrist referenced one of his patients coming in on RUOK day in distress because they were bombarded by people they knew asking them if they were ok. People they didn’t hear from for the rest of the year. People who were probably well intentioned, but using them as the token mentally ill person in their lives, to tick the box of having asked: RUOK?

Awareness around mental ill health should not be confined to one day or one week of the year. Episodes of mental illness flare unpredictably and feel as though they will never end. This feeling is fed by the fact that no one can tell you when it will end. There are good days and worse days. There are days when the risk of it turning into a terminal illness skyrockets. Someone may have a spectacularly good day on RUOK day, a calm and uneventful mental health week, but be suicidal sometime in April or on Christmas day, when it is all too easy to be under the impression that we showed our support for those among us living with mental illness back in mental health week, and Christmas day is busy and by April we are into Caesarean awareness month and IBS awareness month.

 So what can we do to be meaningfully aware of the impact mental ill health has on those of us who live with it, and what can we do to support them for more than a day or a week of the year?

Everyone who lives with mental illness is different and everyone’s experience is different even if they live with the same diagnosis. So, I don’t speak for everyone.

For me – I don’t need to be asked how I am. I have enough insight into my Bipolar 1 Disorder to know when I need to seek help. I am fortunate to have good support systems in place, so I don’t tend to feel lonely or isolated.

For me it is all about the language people use. Hearing or seeing stigmatising language either in the media, on social media, or spoken, punches me in the gut. When I am confronted with words like nuts, crazy, lunatic, psycho, mental institution, – the list is long – it belittles me. It strips away the facts of my life, my healthy functional relationships, my personality, my university degrees, my profession, my interests, my sense of humour and it reduces me to a hellish caricature of who the misinformed masses believe someone mentally ill is.

So, think about how you write and speak around me. If you hear or see someone else perpetuating stigmatising language around mental illness, call it out. Do so politely, but raise awareness of it. I do it as often as I can, but I also get tired of being told to shut up, get over it, or that I am overreacting.

Perhaps the most helpful thing you can do for someone in your life who lives with mental ill health is not to automatically ask them how they are, but to ask them what you can do to make them feel valued and supported all year round. They may answer: ‘Ask me how I am’ in which case you are doing it meaningfully and mindfully, not because it is a certain day of the year.

All that said, Happy World Mental Health Day everyone. In honour of it also being Queensland Mental Health Week from 10th-18th Oct I am aiming to drop a few additional posts in Thought Food this week.

Look after yourselves and each other!

You may also like to check out:

RUOK Day: Full Disclosure

Mind Your Language Katy Perry

Don’t Call Conspiracy Theorists Crazy

Don’t Call Conspiracy Theorists Crazy

If I were to call out language that stigmatises mental illness every time I came across it on social media, I’d be posting about it every couple of days. But no matter how called for I may feel it is, I don’t want to douse my readers in a bitter diatribe that often. I also enjoy a break from being told to shut up or get over it by people who don’t agree with my assessment of stigmatising language. So I’ve let it go for a while.

But I came across the following facebook post recently, which hit a nerve and left it throbbing for long enough to drive me to the keyboard:

Thoughts?

Now, I don’t like the word lunatic – but that is the least of the problems with this post. And as much as I’d like to agree with the sentiment, I have to ask:

What does this post imply about those of us who live with severe mental illness?

It equates us with people who believe and propagate fake news. The most pejorative label for people who don’t believe in climate change, the author of that snippet could come up with was to portray them as mentally ill.

Anti vaxxers, people who don’t believe in Covid 19, or who don’t believe in climate change don’t  have those beliefs because they are mentally ill. They believe them because they are poorly informed and possibly brainwashed.

So, let’s not conflate pathological delusions experienced as a symptom of mental illness with people who are just misinformed and who refuse to delve into some scientific research.

I live with Bipolar 1 Disorder, and have experienced delusional thinking as a symptom of this illness. I not only believe in climate change, I am very concerned about it. I believe the overwhelming benefits of vaccination outweigh the few risks. Covid 19? Of course it exists. Donald Trump? Ten of my posts wouldn’t be long enough to list the reasons he has to go.

And yet when I jump onto social media I am bombarded with posts that tell me that the best way to insult  the people who believe the opposite of the truth is to call them mentally ill, and thereby imply that if you live with mental illness you are in the same category as people who can be brainwashed.

Delusions caused by mental illness are completely different to the overconsumption of, and belief in, fake news. By labelling all of the people who don’t believe in scientific proof as mentally ill you insult and dismiss the many people who live with mental illness and who are critical thinkers who do believe in scientific evidence.

I can only speak from my experience of delusional thinking, but here’s what I know:

Delusional thinking isn’t a contagious false belief system you are indoctrinated with. True delusional thinking as a symptom of mental illness is completely involuntary. You don’t choose to experience it. It sweeps in on the coat tails of an illness that fundamentally changes how you interpret the truth.

For me, delusions are accompanied by mania which at its worst tilts into psychosis. The inside of my head feels as though I am riding a rollercoaster that’s on fire. I don’t sleep. The first time it happened, I tried to convince everyone of the truth to my malignant belief system. And in my experience true delusions due to mental illness resolve with antipsychotic medications.

The chances are your average antivaxxer or climate change conspiracy theorist will not change their beliefs if you dose them with antipsychotic medications.

So, If you read the post above and shrugged your shoulders or like several of my facebook friends gave it a like, let me rewrite it for you and see if you change your mind. Here goes:

‘If you believe all of (sic) world’s scientists got together to fake 7000 climate studies as part of (sic) elaborate hoax, you are not conservative you are a cancer patient. We have to stop treating people brainwashed by right-wing propaganda as political actors and start treating them on an oncology ward.’

Uncomfortable yet? You should be because the implication that people who live with cancer are idiots, is as ridiculous as it is insulting.

So why is it ok to equate my serious mental illness and the fact that I have at times spent months in a psychiatric hospital to me being an ignorant conspiracy theorist?

You may also be interested in checking out:

Mind Your Language Katy Perry

You Don’t Die Of ‘Mental Health’: Why Wording Matters

Insight: The Essential Ingredient

One morning, a few years ago my heart thudded against the tight metal bands strapped around it. Adrenalin ping ponged through my system. I was out on a run, and the air hummed with a kind of malevolent electricity. I sensed something terrible was about to happen. And it did. I was heading down the hill when I saw them. Severed limbs, pale and bloated – tossed carelessly in the gutter.

My breath lurched in and out of me as I stood and stared in horror. Should I call the police?

Then insight broke through and with it a reality more terrifying than the severed limbs. I didn’t need the police. The limbs were sandbags. I sprinted inside, hit the call button next to my bed and clenched my eyes shut while I waited for a nurse.

When he popped his head in the door, I opened my eyes and said:

‘Can you please page my doctor. I’m starting to have visual hallucinations and delusional thoughts.’

He went and, having paged my psychiatrist, returned very quickly with a cupful of antipsychotic medication. I gulped it down and waited for the jumbled sharpness inside my head to soften and slow.

If this had been my first experience of psychosis I may have been terrorised by the severed limbs (and worse) for longer. I may have tried to tell other people about what lay in the gutter at the bottom of the hill. But it wasn’t my first experience.

I had admitted myself to hospital several days before with precursor symptoms. Speeding thoughts, pathological irritability, non existent concentration and short term memory. I was in hospital waiting, the potential for psychosis hovering darkly over me. So, when it descended I knew what was happening. And that insight got me treatment quickly and saved me from the embarrassment of a family member, nurse or doctor having to convince me I was delusional.

Developing insight usually requires multiple episodes of illness and hard, proactive, psychological work. You have to dig around inside yourself to learn what are normal feelings and behaviours for you and which ones herald the onset of illness. The hard work of gaining insight is even more challenging for anyone who hasn’t had access to effective early management of their illness.

And no one ever has insight into their first episode of illness because that first episode hijacks you. It catapults you from being someone who could always trust the contents of your head to those contents not only being unreliable versions of the truth, but sometimes your worst enemy.

And unlike experiencing symptoms of a physical illness you can’t just lie back and expect others to know you are sick. If you are vomiting or have a nasty cough your suffering is obvious to everyone. You don’t need insight to tell your family or your doctor about what is going on with you in order to get the help you need.

With a mental illness, painful symptoms are often expressed as behaviours. They can mercilessly present you to the world as:

 negative, unmotivated, slow, shuttered, insecure, nervous, scattered, indecisive, irritable, unfocussed, unintelligible, uninhibited, nonsensical, lost, delusional, racing, jittery, and more.

In part insight means learning to recognise that what can feel like personal failings are just symptoms of an illness. You have to internalise this before you can translate what is going on with you for the people around you.

But regardless of how someone manages their mental illness, they won’t do so successfully in the long term without insight. Or they will rely heavily on others to tell them when to seek help.

 I absolutely loathe anyone else speaking for me in any area of my life, but particularly when it comes to my Bipolar Disorder. So, doing the work to gain the insight was and continues to be non negotiable for me.

My psychiatrist and I now communicate very efficiently. He doesn’t waste time asking about how my family think I’m going because he knows he will get the most accurate answer directly from me. I can recognise and name the symptoms I’ve gotten to know so well over the last 14 years.

I am practiced at translating overwhelming feelings into symptoms. For example, I know now that when my life feels as though I am running through chest high water with concrete boots on that is depressive symptoms setting in, and if I ignore them, the water will continue to rise.

My symptoms will always affect me, and they will always hurt when they flare into life. But recognising and naming them shrinks the overwhelming into the manageable. Insight has built a safety barrier between me and this illness. It ensures I can see that even though I may live with its symptoms, those symptoms have nothing to do with who I am.

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Vulnerability And The Exploitation Of Kanye West

Razor Blades In Mud: Laziness Or Depression?.

My Mental Illness Makes Me A Better Parent

The ‘Breast Is Best’ Myth

Alex baby foto
Alex March 2010

Last week was breastfeeding awareness week, and the irritation I feel when I see strong pro-breastfeeding messaging flared. I usually bite my tongue and suppress my politically incorrect opinions about this emotive subject. I don’t care about how anyone chooses to feed their baby. But I do care that the ‘breast is best’ myth is still being drip fed to (especially first time) mothers like a sugary subtle poison.

Fourteen years ago I had my first baby. I lapped up all the breastfeeding propaganda from the hospital antenatal classes and my antenatal yoga classes. Because I trusted these sources.

And they didn’t exactly feed me falsehoods. But they did imply a mother who switched to formula before she had exhausted every possible option to keep breast feeding was not doing the best for her baby. Posters in the maternity hospital told me that exhaustion, blood streaming from cracked nipples and tears streaming down your face were all worthwhile prices to pay to feed your baby this liquid gold.

After going into thirty three hours of labour on two hours sleep, my daughter was delivered by caesarean. I fell asleep as I was being stitched up. The midwives wasted no time. I woke with a start, in recovery to find my baby attached to my left breast. It was so important to these midwives that my baby attached ‘immediatley’ that they didn’t even do me the courtesy of allowing me to wake up before making this most intimate of introductions.

The focus on the holy grail of establishing breastfeeding in the maternity hospital was so strong that I sat up for three hours at a time thinking I was feeding my baby, when she was comfort sucking for most of that time. It left me exhausted and my back a wall of pain from sitting in the ‘feeding chair’.

Now, if that were the worst of it, I would have probably gullibly pushed through all further discomfort to establish and continue breastfeeding. Had I succeeded, I would have probably felt proud of myself. And after being told time and time again children who are breastfeed are healthier, smarter, more empathetic, and more likely to poop rainbows, I may even have been arrogant enough  to attribute all of my daughter’s future, health, smarts, and empathy to my valiant efforts to persist with breastfeeding. (She has yet to poop out a rainbow – but I can live with that.)

But within a week of her birth, whether or not I breastfed was injected with some desperately needed perspective. She was at home with her father, contentedly guzzling formula while I was tipping my breastmilk, tainted with antipsychotics, down the sink in the Special Care Unit of a private psychiatric hospital. I had come down with postnatal psychosis and I was clinging to my life with my fingernails.

To my credit, I quickly forgave myself for ceasing my ‘breastfeeding journey’ 7 days into motherhood. And I didn’t look back. I had been too sick to ever be riddled with the guilt I saw in other mothers who had been less unwell but had also made the smart choice (for them) to stop.

But we shouldn’t need extreme circumstances to justify feeding our baby formula to anyone. Breastfeeding is a personal choice. Nothing more. Nothing less. But our society has turned it into a religion. And it’s opt out not opt in.  We are all automatically given anti formula education classes antenatally and then baptised in breastfeeding once the baby is born.

The high priests of this religion are lactation consultants and midwives who set ironclad commandments and rule with fear. The fear of harming our babies with our actions.

The pressure to breastfeed is a known contributor to and risk factor for developing perinatal mental illness. Mental illness that can leave a baby motherless if it is severe. Unlike the maternity hospital midwives, the nurses in the mother baby unit in the private psychiatric hospital I was an inpatient in don’t pressure new mothers about how to feed their babies.

But they do spend a lot of time undoing the damage done by overzealous midwives and lactation consultants who have bullied new mothers into believing they will hurt their baby if they consider formula anytime earlier than as a last resort.

For my second baby I had one breastfeeding aim: Get some colostrum into him. He went onto formula at day 7, just like my daughter. And just like my daughter, now you wouldn’t be able to pick what he was fed as a baby.

Breastfeeding is cheaper than formula feeding. It is more environmentally friendly. It is the safest and most convenient way of feeding a baby in a third world country and/or if you don’t have regular access to clean water or formula. If your baby is premature and/or has underlying health conditions for which a paediatrician has recommended breastfeeding or expressed breast milk, then – for that baby – breast is best.

But if your baby is full term, healthy, you have access to clean water and can afford to buy formula, then (beyond the first few days’ worth of colostrum) whether you choose to formula feed or breastfeed is as irrelevant to your baby’s wellbeing as the colour of your underwear while you’re doing it.

 

You may also like to check out:

World Maternal Mental Health Day: It’s Not All Postnatal Depression

Your Mental Load = Your Responsibility

Modern Martyrdom

My First Time