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.

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My Mental Health Toolbox

PWC keynote image

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?

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What a mental illness can teach you about your mental health

jony-ariadi-197568-unsplash Photo by Jony Ariadi on Unsplash
Photo by Jony Ariadi on Unsplash

Here’s a paradox: My mental health improved after I developed a mental illness. When I am not symptomatic (which is a lot of the time) my mental health is fantastic. It is possibly better than that of many people who don’t live with a mental illness. Here’s why:

Mental illness can teach you a lot about mental health, because it confronts you with the choice to change the way you approach your life.

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Accepted: Crumbs To Canary Wharf

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It started on the paper bag that the breakfast toast came in. First, I shook out the crumbs to give me an even writing surface. I had no other paper. I was inside the SCU (Special Care Unit), in a psychiatric hospital in August 2006, emerging from my first psychotic episode. And as the medication slowed my boiling brain, a miniscule part of me, took in my environment and thought:

‘I am one step away from a padded cell. Unbelievable. But while I am here, I will record as much as I can, because not many people experience this.’

So, I made my words tiny to fit as much detail as I could onto the toast bag.

Over a year later I wrote an account of my psychotic episode based on that bag and some diary entries. My supervisor for my Master of Arts in Writing Editing and Publishing read it.

‘This is really good writing. You should consider expanding it into a memoir.’

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Lies Of Omission: What You’re Never Told

Psycho Killer Shatters Young Family!’

Thoughts?

I had an interview with a PhD student from Melbourne Uni last week. It was for a study into what can be done to improve media reporting around severe mental illness (SMI) to reduce stigma. The media is largely responsible for the way people like me are perceived by the general public. So, I was delighted to contribute to this study.

Our trusted news sources are slickly practiced at generating gory headlines that draw eyeballs to them like magnets. If SMI is thought to contribute to a crime, it is either ignored or thrown into the story as a cold, hard after thought. Something that can’t be changed and is barely acknowledged as an illness.

The main characters in these horrific accounts may have an undiagnosed, poorly managed, or unmanaged SMI, but the journalist in the by-line doesn’t dig deep enough to expose the reasons for this:

Society does not care about or for us in the same way they do for others with serious, chronic, intermittent potentially fatal illnesses.

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My Mental Illness Makes Me A Better Parent

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I am giving my eight-week-old son a bath. One hand supports his head and neck, the other gently moves a wash cloth over his delicate skin. He kicks his legs, rippling the shallow water. His dark eyes stare up at me. Pools of trust. I make a minute adjustment to my hand supporting his neck. His head slips under the water, for less than a second before I instinctively lift him up. He splutters briefly and is fine. But I am not.

I hit the call button next to the baby bath and a nurse pops her head in:

‘Are you ok?’

‘No.’

I hand her my baby. Nausea clamps my stomach and works its way up my throat. Black mist hovers in my peripheral vision and I sink to the ground. I put my head between my knees, as red-hot malignant words shoot through me:

‘Did I just try to drown my baby?’

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Lessons For A Control Freak

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Image courtesy of Flow Magazine

I have a somewhat unhealthy relationship with control. I rely on having it a little too much. Throw me an unexpected traffic jam, and I’ll feel no more or less anxious than the next person. However, when control goes AWOL from the bigger areas of my life my stress levels sky rocket.

I have been seeing my psychologist for years now. Some visits neither of us have to work hard to tweak things. But whenever there’s a larger life issue I’m struggling with, my distress almost always comes down to my lack of control over an undesirable situation. For me one of the worst-case scenarios are sleep deprivation  combined with the stress of a sick child. The reason this combination is so triggering is that it is kryptonite to my defences against a bipolar episode. (Sleep deprivation especially accompanied by stress is a major risk factor for developing manic and psychotic episodes)

This said, I firmly believe the universe sometimes sits back stroking its chin and assesses where I’m at. And then as though giving me a cosmic performance review, it points out areas for improvement, and gives me the opportunities to practice the life skills I lack. Clearly, I still need a lot of practice accepting a lack of control, because I have been sent the following homework:

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#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:

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Media-Made Monsters

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Day six

(Confronting Content Ahead)

I don’t dwell on what might have happened had I been sent home on day five after my daughter was born. But whenever the news throws up sensational stories reporting murder, infanticide, or suicide, and there is even a slim possibility the perpetrator might have been psychotic – then I think about it. Because that could have been me.

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Making Sense Of It

 

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How do you learn to live with the difficult truths of your life? The ones you can’t just step over and leave behind?

Confirmation of my Bipolar 1 diagnosis was one of those truths for me. For several years after my first episodes of illness, we didn’t know whether we were dealing with Postnatal Psychosis or Bipolar Disorder. In my mind one was transient, the other a life sentence. Each time I’d press my psychiatrist for a definitive diagnosis he’d say:

‘We’ll have to wait three to five years to see if you have another episode.’

This answer frustrated me immensely. I wanted to put the whole experience of being mentally ill behind me.

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