My Sliding Doors Encounter With Our Public Mental Health System

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Have you ever had a moment when your answer to a question determined whether your life imploded?

I have.

It came five days into parenthood. I was lying on the floor in my maternity hospital room crying because I was trying to outrun a jaguar chasing me towards a cliff. Things were starting to go very wrong in my brain.

In the following months, when my mind warped and writhed in the grip of psychosis and later catatonic depression, and when what started out as postnatal psychosis turned out to be a first episode of bipolar 1 disorder, I could not imagine things being worse.

But they could have been.

Continue reading “My Sliding Doors Encounter With Our Public Mental Health System”

Visiting Someone In A Psychiatric Hospital?

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2010 My daughter visiting her little brother and I in the mother/baby unit of the psychiatric hospital

‘My daughter never visits me in hospital. She doesn’t like this place.’

An elderly woman told me this in a private psychiatric hospital several years ago.  Sadness dripped from her words.

The thought of visiting someone in a psychiatric hospital (especially for the first time) can leave people feeling: Awkward. Uncomfortable. Fearful. Repulsed. Guilty. Ashamed. Misinformed. Unsure. To name a few.

What do you say and do if that’s you?

Continue reading “Visiting Someone In A Psychiatric Hospital?”

My Mental Health Toolbox

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This week I had the pleasure of giving a keynote address for one of the departments at PWC (Price Waterhouse Coopers). As part of this I ran through some of the things I have found helpful to help me monitor and manage my mental health.

I got some really positive feedback after the presentation and requests for the list of things that help me with my mental health. So I thought I’d share that list as a post here:

EARLY WARNING SIGNS AND INSIGHT:

In this context insight is the ability to identify early signs of mental ill health in yourself. This is much more challenging than it sounds, because signs of mental illness can masquerade as normal feelings and emotions.

For example – irritability and sadness are part of the normal spectrum of human emotions, but if they are overwhelming and persistent and interfere with normal functioning, they can also be symptoms of depression.

It can take time to identify their intensity or persistence as abnormal. The other challenge is that when we are well, we can often think our way out of sadness or irritability. But when they become symptoms that is impossible.

Someone affected by symptoms of a mental illness can no more think their way out of them than someone with a nasty case of gastro can think themselves out of their vomiting and diarrhoea.

But whereas vomiting and diarrhoea are obvious signs of illness (both to the person experiencing them and everyone around them) it takes insight to recognise when symptoms of mental illness emerge.

For me early warning signs can be an inability to sleep even with a lot of medication, intense irritability, and poor short-term memory and concentration.

Early warning signs are different for everyone. By learning what ours are we can be proactive about seeking help rather than waiting for symptoms to worsen.

For further reading on an example of insight into a depressive episode you can go to: Razor Blades In Mud: Laziness Or Depression?

Continue reading “My Mental Health Toolbox”

Who Holds You When You’re Broken?

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I’ve been told the first time we met I was shuffling slowly up and down a blue carpeted corridor. Slumped body. Empty eyes. I barely registered being asked how I was with a slowly exhaled

‘Not so good.’ before moving on with my pram.

I say ‘I’ve been told’, because I don’t remember our first meeting or the following weeks. I was sicker than I’d ever been. Not many people would have repeatedly made friendly conversation with someone as unresponsive as I was.

She did. At a time when she wasn’t well herself.

When I finally re-emerged after several months of illness, I was delighted to find I had a new friend. A friend I never would have met in my geographical or professional circles. A friend who, like me, had spent the early months of first-time motherhood in a psychiatric hospital instead of at home.

Continue reading “Who Holds You When You’re Broken?”

2018 – The Year I:

Thought about homelessness, after I witnessed displaced people with cardboard placards to explain their belongings smudging the busy and important streets of Sydney in the first days of the new year. My emotional barometer flicked between pity, sadness, relief, and settled on horror because this could still be me one day. The Right To A Home

Went to work. After twenty years the neural pathways for running a consultation competently and compassionately, for reading who I am in a room with, and being a shock absorber for their anxieties and concerns, are so well-worn they are almost automatic. Contrary to popular belief (and this photo), we spend much less time playing with puppies and kittens, than we do using our communication skills to explain, empathise, and advise our way to the best outcome for our patients via their owners.20170619_130857

Felt it come for me. In February, over two days. My sanity stepped into quicksand. Mania swallowed me. I called into work sick. I said goodbye to my family. I went into hospital. Battened down my hatches and prepared for the usual long stay. Only to be pleasantly surprised. Four weeks in hospital. That’s short for me.

Lost my job. I do every time I get sick.

Opened new neural pathways by setting up a website, which enabled me to write and publish this blog. My technological ineptitude is boundless, so the existence of Thought Food is a minor miracle.

Supported three men. All stepping through the sticky tar of depression at some point this year. All blindsided by the ferocious nature of this beast. All strong, kind, intelligent, undeserving.

Exercised most days. Ate green vegetable omelets for breakfast some days and Nutella on toast with mug loads of coffee on others. #NotFitspo

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Welcomed Clarence, our baby Stimsons python into the family. He is the lowest maintenance pet I have encountered. Gentle, inquisitive, and only needs to be fed every seven to ten days.

Continued to receive rejection after rejection of the manuscript for my memoir from publishers via one of the best literary agents in the country. Each one stings. Each one frustrates. According to publishers’ feedback the quality of the writing is great, but it’s not commercial enough. In other words: No one wants to read about psychosis if you haven’t killed someone in the throes of it or at the very least been picked up wandering the streets nude and ranting.

Began considering self-publishing the manuscript for my memoir.

Climbed back into some weekend work.

Heard my mother’s voice tell me my father had nearly died after a massive heart attack. Seeing him on day two after triple bypass surgery, comatose, tubes and wires snaking in and out of him, and the comforting blips and beeps and numbers flashing on familiar screens was easier than seeing him on day four, awake, in agony with each movement. He survived. My Father’s Heart Broke

Applied for, was accepted into, and completed the SANE Peer Ambassador training program. The glow of being in a room with others who went through hell, survived, and are now well enough to use that experience for good, still warms me. And I finally feel I’m not advocating on my own anymore. The Chosen Ones

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Gathered friends for dinners and lunches to enable my love of cooking, baking, great food and wine, and conversation…so much conversation.

 

 

 

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Became familiar with the inside of an ambulance courtesy of seven night time trips to hospital in ten days. My son developed partial seizures lasting up to ninety minutes each. Relief flooded me when his MRI scan was clear (of brain tumours) and he was diagnosed with benign rolandic epilepsy (infinitely more manageable). Lessons For A Control Freak

Clung to small wins amongst the manuscript rejections. Three posts published on Mamamia, one on SANE, and a submission for Dr Mark Cross’s book on anxiety accepted.

https://www.mamamia.com.au/mental-illness-language/

https://www.mamamia.com.au/symptoms-of-postnatal-psychosis/

https://www.mamamia.com.au/signs-of-depression/

Narrowly avoided a second hospital admission in October. I pounced on the onset of a depressive episode with an emergency psychiatrist appointment, a medication adjustment and slashed away all commitments except exercise for several weeks. Razor Blades In Mud: Laziness Or Depression?

Became a spokes person for the Australian Genetics of Bipolar Disorder Study, and suggested edits to make the language in the main study survey more consistent and less stigmatising. Most of my edits were approved and included less than twenty-four hours before the study launched. A clip of some of my participation and how to participate in the study can be found here:

https://www.geneticsofbipolar.org.au/hear-from-study-participants-alex-anita/

Attended my first ever non-veterinary conference: ‘Empowering online advocates’ and came away feeling much more hopeful than the trip to Sydney in January had left me. #HealtheVoicesAU

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Discovered the joy of camping, absolutely enabled and enhanced by beautiful friends who supplied (and set up) most of the gear.

Resigned from veterinary work. Ostensibly to stop straddling several worlds and free up more time and energy for writing, mental health advocacy, and my children. That is all true. But I am also bone crushingly tired of the cycle. Work, get sick, lose employment because the nature of my illness means I can’t give a date when I’ll be well enough to return, and I can be sick for months. Then I clamber my way back into a demanding profession you can only inhabit when you are functioning at 100% of your capability. I expend time, energy, and money to do enough CPD (continuing professional development) to keep my registration up to date…only to lose it all again the next time I get sick. The plan is two years off. Then see where I’m at.

Received a handwritten Christmas card and instant scratchie from my pharmacist… one of my six medications alone costs $30/week. Treatment

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Reminded you to end the year saying no when your gut tells you to, and being kind to yourself when you feel like doing the opposite.

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Razor Blades In Mud: Laziness Or Depression?

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(Contains Confronting Content)

The amnesia of good mental health is powerful. When I’m well I struggle to conjure up what a depressive episode feels like. I can’t remember not being able to think my way out of it. I can even understand how easy it could be (without the experience of this insidious symptom) to dismiss those who suffer it as weak or lazy. This inaccurate, hurtful labeling occurs when people fail to understand the fundamental differences between a psychological challenge and a psychiatric symptom.

Continue reading “Razor Blades In Mud: Laziness Or Depression?”

My 2018 World Mental Health Day

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How was your World Mental Health Day? Mine happened to be pretty shit.

It doesn’t really matter, because mental illness doesn’t respect particular days, especially those deemed meaningful by human beings. I’ve spent enough birthdays, Christmases, and anniversaries in hospital with a mental illness to lend weight to this theory.

Paying homage to mental health (ours or others) on a designated day seems like a nice idea on the surface, but I’m not convinced it does a lot. I suspect it makes people who don’t suffer a mental illness feel good if they remember it or mark it. But is this just another version of tokenism? Does it really make any difference to the lives of people living with mental illness every day of the year?

A very smart woman who ran the SANE Peer Ambassador training workshops I attended recently made the excellent point that we don’t have World Physical Health Day.

And that is because every single day is World Physical Health Day. It would be far better to reach a point in history where caring for ourselves and being sympathetic towards those around us with mental illness is as matter of fact as caring for our physical health. We shouldn’t need World Mental Health Day.

Here’s what today looked like for me:

10 am

‘You look flat’

There is only one person I trust to make this assessment, and it’s the one who spoke to me. My psychiatrist. He and I have known each other and worked together for just over twelve years now. And I have trusted him with my life many times.

For the last four days I have felt flat. It started with a sluggish Sunday. But everyone has those. Right? I am exhausted. That’s ok, understandable. It’s been a stressful couple of months. However, in the space of those few days ‘I’m exhausted’ morphed into: ‘I am exhausted by life.’

I have been on this runaway train often enough to know that feeling exhausted by life is the last stop before suicidal ideations set in. And that is where it turns into not ok. By yesterday, when I made the appointment with my psychiatrist, I was feeling worthless. Black thoughts crept in and crowded out the positive, the motivated, the real me.

Thankfully I have the insight to recognise these feelings and thoughts as imposters. These are symptoms of depression setting in. They have been waiting in the wings for their moment. My Bipolar Disorder is here to collect, on all the stress and sleep deprivation I had no say over in the last few months.

In the past I went to war against these thoughts and feelings. So naïve to think I could somehow out think or out feel them. Such a rookie error. As is waiting to see how it will all play out. That tends to land me in hospital for months at a time. So, after four sluggish days, feeling flat, off, down, irritable, and with my memory and concentration beginning to fray I walked into my psychiatrist’s consulting room this morning. That’s when he proclaimed, before asking me a single question, that I looked flat. And I felt relieved, because I knew I’d been right to come.

I listed my symptoms. He looked at my chart. Then, reminiscent of a pilot attempting to correct a plane out of a nose dive, he said:

‘Let’s increase the Lexapro by 10mg and halve your Lithium dose until your mood comes back up. As soon as your mood lifts, go straight back onto the full dose of Lithium. And keep your appointment for next Friday.’

‘Good. Let’s try that.’

Then we speak of the heavy truth between us:

‘And if I crash before then….’

‘Then you will call me and come into hospital.’

Neither of us want that. Neither of us want the months in hospital possibly having ECT, because I’ve become catatonic. Yet we both know it’s still a possibility.

So, in honour of World Mental Health Day 2018 – here are my thoughts on what will get me well again:

Insight. Communication. Early intervention with a medication adjustment. Fingers crossed. And luck…so much fucking luck…

Making Sense Of It

Treatment

What Does Someone With A Mental Illness Look Like?

Sick Not Selfish

Wedding Breakfast Spoiled

Lessons For A Control Freak

 

As Mothers Of Sons

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(Confronting Content Ahead)

A young man in the inner circle of one of my work colleagues died earlier this year. I didn’t know him, have few details, but the devastation written on my work mate’s face said it all. And the details I do know are telling:

He suffered from depression.

But he was going really well.

And then he died…unexpectedly…by suicide.

Tragically, the unexpected element in this scenario is such a common postscript to male suicide it could almost be described as a hallmark. A third of all deaths in young men are due to suicide. As the mother of a son this statistic makes me want to stick my fingers in my ears and hide behind these words:

‘That would never happen to us.’

But I know enough to know that sticking one’s head in the sand just adds to the risk. Unfortunately, there will always be a percentage of unpreventable suicides, but even reducing the statistics would be some comfort. So how do we do that?

Maybe a starting point is to recognise the emotional differences between girls and boys, and how we react to those differences. I haven’t researched this scientifically, and every family is different – but here’s what I’ve noticed in mine:

My daughter and I talk a lot. Ad nauseum. I know her emotional barometer almost as well as my own. My son is easy-going, unless he’s tired and/or hangry. He demonstrates his affection physically with a hug or wanting a tickle. Whereas his sister demonstrates it by saying: ‘I love you’.

A lot of my son’s verbal output revolves around Pokemon Go and food. Because of this it can be easy to dismiss what is going on in his head as uncomplicated. I do it sometimes. Life gets busy and he seems ok. But it’s a mistake, because when I give him the right time and space he shows me he has plenty of other thoughts, and that his worries and fears are often no different to his sister’s, but the way he processes them is.

Without wanting to stereotype, or discount individual personality differences, my perception is that while our daughters often wear their emotions on the outside, our sons’ emotional barometers are internal organs. Sometimes we have no idea where they are at until the pressure is at exploding point. In little boys that might be a meltdown, or a quiet sadness. It might be something that can be soothed with a cuddle and a casual chat about what’s bothering them.

But what about bigger boys? As tweens, teens, and young men they don’t sit on their mum’s lap and cry when their thoughts don’t make sense. They tend to stay quiet. Sometimes too quiet.

There are no simple solutions. But we can start by teaching our little boys how to communicate emotional pain long before they grow into young men. And if they do give us hints that all is not right in their world we should take serious notice. Just because they might not express their emotions as noisily as their sisters doesn’t mean our response to their distress should be any less urgent.

While we work towards getting better public mental health services, there are things we can do for our boys and young men. We have to educate them about the link between substance abuse and mental illness, particularly if there is a history of mental illness in the family. And if our young man has a mental illness with depressive or delusional symptoms we must learn to sit with the following discomfort:

Talking about suicide, is much safer than silence.

We need to eradicate stigma! Suicidality is so often a symptom of a mental illness. Stigma blocks the dissemination of information about how such illness can be successfully managed. Parents must understand that it doesn’t matter how much you love and support your child, if that child is sick – whether it’s cancer or a mental illness – you do not have the professional knowledge, skills, or resources to save that child on your own.

Private Health insurance often gives you better choices, but if that’s not an option there are places to go for help. For 12-25 year olds Headspace https://headspace.org.au/  is a good starting point. Your GP can provide psychology and psychiatry referrals. But perhaps one of the most important things you can do for your son (or any other young man in your life) is to be vigilant in the face of his silence.

The image accompanying this post is a favourite of my son. He’s less than a week old. Three generations of hands cradle him – my mother’s, mine, and my daughter’s.

Things have changed since it was taken. These days my son can hold up his own head, but he still needs his family to show him how to open up, not shut down when he’s feeling vulnerable. We need to show him every, single day that we support his emotional health, and that even when he is much taller, hairier, and physically stronger than us, we will continue to have his back.

Talking About Mental Illness With Children

Wedding Breakfast Spoiled

Suicide Watch

#NotFitspo

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Mirror message at the gym

ON GOOD DAYS WORK OUT

ON BAD DAYS WORK OUT

HARDER !

At the risk of incurring the wrath of the fitness industry: I don’t agree.

My first thought when I saw and snapped this image was: ‘YES – so true.’

But then I stopped to think about how this statement applies to me and my exercise habits. I realised it was simplistic at best, and dangerous at worst. Here’s why:

Continue reading “#NotFitspo”

The Support Crew

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(Confronting content ahead)

One evening about eight years ago:

I pretend to share dinner with my husband on our deck. The air between us is loaded with the conversation we are about to have. I drag my eyes from my untouched food up in his direction and ask:

‘Why can’t you just let me go? Haven’t I suffered enough?’

He explodes:

‘How can you be so selfish? I’d be explaining to our children why you left us for the rest of my life.’

The tiny bit of energy I have left coalesces into a red-hot ball of anger

‘Don’t you dare call me selfish after everything I have been through. Ever! I wouldn’t be leaving you. I’d be doing you all a favour.’

Continue reading “The Support Crew”

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