I have never been so grateful to smell cat shit in my life.
But let’s add some context for that sentence.
A few weeks ago, I went out for a friend’s birthday dinner in a small, busy restaurant. Indoors, noisy. There was a lot of leaning in and speaking loudly to hear and be heard. Within a couple of hours, tongue bitten from sitting across from someone who told me they didn’t believe Covid vaccinations had been sufficiently tested for safety, I was ready for home.
Three days later tiny terrorists held me hostage in my room. I was tethered to my bed by sticky tissues and vicious spike proteins digging in to my respiratory tract. Sick, but not my usual sort of sick. I cancelled plans for the week ahead as Covid leapt through the family. And I marvelled at how easy it felt compared to cancelling things for a Bipolar hospital admission. In 2023 everyone can relate to Covid cancellations.
Prior to contracting Covid, the things I was most concerned about, should I be infected, were likely to be things of no concern to most people. I am grateful I don’t live with any type of immunocompromise or chronic respiratory condition. Neither does anyone in my family. And yet I have continued to wear a mask to the shops without caring what people think.
Because I am vulnerable to collateral Covid damage.
Anything that potentially interferes with my sleep or ability to exercise increases my risk of a Bipolar episode. Covid does both. Then there is long Covid. The stress of living with this nasty reality would skyrocket my risk of multiple Bipolar episodes. And then there is losing my senses of taste and smell. As someone who begins to feel depressed if these senses diminish with a cold, the prospect of potentially losing them long term or permanently was horrifying.
I imagine everyone values their senses differently. When it comes to reasons to breathe, I am someone for whom smelling is as important as oxygenation. I don’t mean I am someone who just appreciates nice perfume and the smell of freshly ground coffee – although I do.
I am also someone who knows the smell of my husband’s sternal notch, the dip between his collar bones at the base of his throat. It is an olfactory hug, a smell I could pick out of a line-up of other sternal notches.
I know the softest fur behind my kittens’ ears smells of butter and air. The smell of garlic sizzling in olive oil or a chocolate cake just ready to be taken out of the oven are pure dopamine hits for me.
So, when Covid blindfolded my sense of smell on day five, and in doing so kidnapped one of my greatest sources of joy and information, I panicked…enough to google how long this was likely to last. It can be as little as five days…but sometimes this black out lasts for 6-12 months or is permanent.
This loss of smell was not like the kind I’ve experienced with a head cold. It wasn’t associated with nasal congestion. My nose was clear and breathing air in a world apparently devoid of all scents and odours. I realised quickly that aside from the discombobulation and depression of living with no nose, there were practical difficulties. Sniffing potentially spoilt milk – nothing. Toast burning to charcoal – nothing. A rotting potato decomposing in a black pool of noxious liquid at the back of the potato storage drawer – totally undetected.
Without smell to accompany it, my sense of taste was reduced to only being able to differentiate sweet from salty foods.
I began to bargain in my head. Which of my other senses would I give up in exchange for my sense of smell? Impossible. I don’t want to lose any of my senses.
Thankfully, for me, the blindfold loosened within ten days. I began to smell around the edges of the world again. Strong smells returned intermittently and then faded away again. The fading times lessened. I discovered the foul stench of the decomposing potato that had been reverse air freshening the kitchen for at least a week. Cat shit re-entered my nasal vocabulary. And with time so have the subtleties of air and butter on kitten fur,
As for the Bipolar risk factors that accompany my visit from Covid, I’ll have to wait and see. The last couple of months have carried other stressors with them too. From experience, my Bipolar episodes tend to sit back patiently while the risk factors peak and the stress unfolds, and then set in as a special treat once things settle down.
So I am moving carefully through the world with my fingers crossed, while I enjoy being back in the world of the smelling.
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.
I am not home schooling my children at the moment.
That implies a level of competence that far exceeds my attempts to provide a bit of supervision while they do what could pass for some form of schoolwork.
In fact, what I am doing could no more be called ‘home schooling’ than calling what my children’s teacher does when they are at school, ‘veterinary surgery’.
The new educational arrangements have made me ask myself this over the last week:
Are there any professions (apart from teachers) who are being asked to convey how to do their whole job to the general public in a very short time, using only online resources? I can’t think of any.
Yet suddenly teachers are expected to translate their university degree and years of practical experience into a format that parents with no training or experience in education can apply to their unwitting children at home.
And there will be some parents who will anticipate the same results as when their kids are being taught at school by the teacher.
I accepted a long time ago that I have no interest in the intricacies of how my children’s education is delivered. And I am not expecting to suddenly become enthusiastic about it, just because external circumstances have changed.
I do care about my children’s education. But my role and the teacher’s role in providing that education are clearly defined and there is little overlap.
I view these as my roles:
To love my children unconditionally and make sure they know it. To set clear boundaries for them. I am privileged to be able to afford to feed them, clothe them, and buy their educational resources. To do my best to allow them a good night’s sleep in a room free of devices, during the school term. To offer them a decent breakfast and a packed lunch, or at least the ingredients to make them. To offer them support in completing homework or schoolwork set by their teacher.
And to make myself available for communication with their teachers at any time.
I regard teachers with awe for the job they do. I know from friends who are teachers the high levels of empathy, patience, resilience, and emotional intelligence, among many other skills, they draw on to do their work well.
I also respect my children’s teachers enough not to encroach on the territory of their expertise.
When I attend parent teacher interviews, I only tend to ask four questions:
‘Does my child seem mostly happy and engaged? Is their behaviour appropriate? Are there any areas they are falling behind in? And, Is there anything else you would like me to know?’
Do you know what I never ask about?
The curriculum. Because I trust the teacher to know it inside out.
I feel for the parents who ask in depth questions related to the curriculum during parent/teacher information sessions, because right now they may struggle with the concept that they can’t single handedly provide their child’s school education at home, no matter how much they research the curriculum.
From an epidemiology point of view, at the time of writing, I believe the best place for my children is at home. But at the same time, my care factor for the quality of my children’s academic education ranks way below how much I care for not only my mental health, but the collective mental health of my family.
I acknowledge that while the two cares might not be mutually exclusive for many households, in mine – they don’t always sit well together. I may be biased by my own life experience, but that experience tells me this:
If my children fall behind in the curriculum, I am confident they will eventually catch back up to where they each normally sit. And they won’t be alone in that experience.
Yet if I tried to deliver the full curriculum to my children at home, I would transfuse the stress of my unsuccessful attempts into them. Over time, their mental health would suffer. Mine might suffer to the point of me having to be hospitalised again.
It would make as much sense as my children’s teachers attempting to perform surgery on their dog with only my online instructions to guide them through.
So, the alternative of my children having to work harder to catch up when this is over feels fairly benign. And this doesn’t mean they are doing nothing now. It just means I don’t hold myself to the unattainable standard of replicating my children’s in school educational experience at home.
And I could be way off here, but I imagine whenever I eventually return my children to their formal school based education – their teachers may prefer those children with their mental health relatively intact and their academic knowledge lagging, rather than the other way around.
(Additional note: The veterinary surgery analogies were drawn from my experience of working as a small animal vet.)
Long before Covid-19 arrived, vets and vet nurses were quiet, hard workers who didn’t complain about less than ideal working conditions. And, possibly unbeknownst to most of the pet owning public, for many veterinary staff, challenging working conditions were the norm.
Since this crisis hit, these essential workers are not getting much opportunity or airtime to communicate the difficulties they currently face at work.
The advent of the Covid-19 pandemic has put the challenges of veterinary work on steroids.
I know a bit about what it takes to work in this industry.
I fell in love with veterinary work at fifteen, when I started volunteering at a local vet clinic. I wiped down tables, cleaned cages, and held animals. Then I started work as a casual junior vet nurse on Saturday mornings.
I committed the second half of my teenage years to the tunnel visioned hard work it took to get into veterinary science at university.
I worked as a small animal vet for twenty years, in many different practices in Australia and the UK. Working conditions ranged from excellent to atrocious.
Thanks to my experiences, I know this:
Vets don’t talk about their work stresses outside their own tightly knit vet circles. Some of us don’t even confide our struggles to our colleagues. We talk about our cases in detail for hours, but many of us still cringe at opening up about the state of our mental health.
Our clients get our kindness, our compassion our sympathy our skills our knowledge, our communication skills. But they never see our vulnerability. They don’t understand how high our risk of burn out (borne of caring too much and being overworked and undervalued) is.
They don’t see that when we walk through the door of the clinic our rostered working hours become irrelevant because we give ourselves over completely to everyone else who walks through that door after us.
Our clients don’t feel our pain when we lose yet another amazing member of our profession to its sky-high suicide rates.
I am currently taking a break from veterinary work while I concentrate on writing and mental health advocacy work. But I have many vet friends who are out there working and hurting.
I have spent the last couple of weeks collecting descriptions of work life from some of my (currently working) veterinary friends and contacts, because I believe that for the veterinary profession to survive this pandemic with its collective mental health relatively intact, the pet owning public needs to know about the difficulties its workers face at this time.
Here are some of the (summarised, paraphrased, and quoted) insights these vets generously shared with me:
On Covid-19 Regulations:
Some aspects of veterinary work make social distancing between staff impossible. For example, it is not feasible for a nurse giving a wriggly, excited puppy a cuddle and a vet looking in its ears with an otoscope, to be 1.5 metres apart.
Some of the protocols necessary to minimise the risk of Covid-19 transmission, such as contactless consultations (where the owner waits outside the clinic in their car, the pet is transported inside by a nurse in PPE, the vet examines the pet and then phones the owner to discuss further diagnostics or treatment), severely hamper efficiency and slow everything down.
Vets are used to working as efficiently as possible:
‘Normally I would type the history while the owner is in the consult and do an exam in between taking notes. Now I can only do one of these things at a time.’
Contactless consultations also limit a vet’s ability to read their client’s body language during the consultation, which can interfere with effective communication between vet and client.
Pets can be more anxious when separated from their owners. This may mean it takes longer to perform a physical exam, or it may be impossible to do as thoroughly as the vet would like.
Covid-19 level cleaning recommended between consults is more labour intensive and takes longer than usual.
On Finances
Downsizing or closure of a practice due to further restrictions or a Covid-19 infection will have negative effects on the practice’s financial stability very quickly.
‘The nature of small to medium sized veterinary practices even in normal times is to run with incredible efficiency, but still on very low margins. They cannot sustain even mild to moderate downturns. They will not survive and jobs will be lost long before the drop of 30% revenue occurs required to be eligible for the Job Keeper Payment.’
Locum vets are particularly vulnerable to job loss now. As practices work to minimise the risk of a Covid-19 infection in their permanent staff, many locum vets are having their shifts cancelled, and are facing the financial difficulties and mental health challenges that come with job loss.
Vets are also more aware than ever of the financial constraints facing many of their clients.
‘It is super sad when you see a client who wants to do everything for their pet, but they have lost their job and can’t afford it. It breaks my heart. I am doing a surgery at a 25% discount tomorrow. The client didn’t ask for it, but I feel so sad for them.’
‘I feel even more conscious of the usual dilemma we have in vet practice of having to mix financial discussions with emotive ones as most people are understandably a lot more stretched financially right now. But veterinary practices are also under a lot more financial stress and if our invoices are not paid, there won’t be a vet for clients to take their animal to.’
And now more than ever vets are at risk of being on the receiving end of their clients’ financial frustrations.
‘I’ve already been abused in the car park once this week and I am preparing myself for a lot more of that to come as the stress is almost palpable in the air.’
On Mental Health
Vets often hold themselves to a very high standard. Under sub optimal working conditions that pressure will increase stress levels further.
‘Veterinary practice is already an emotionally draining vocation with highs and lows every day. Our staff feel responsible for their patients and care for our clients. And it goes against the grain to just drop our standards of care because of what’s going on. So, we are not going to start cutting corners.’
Many clinics have split their staff into two or more teams to reduce the chance of the whole clinic having to close if one staff member contracts Covid-19. This means vets and nurses may be working under short staffed conditions and even longer hours than usual:
‘The phones are ringing constantly. We hang up and pick up the next one. I am answering dozens of phone calls daily as a vet, as well as being my own anaesthetist, recovery nurse, and doing the usual vet things. And right now none of us have regular access to our stress relieving hobbies.’
Splitting staff into teams at work usually also means no contact between teams outside of work.
‘There were genuinely tears after the last ‘normal’ shift as people realised they may not see some of their friends for weeks, months even.’
Before Covid-19 brought added work stressors with it, vets were already at a high risk for mental ill health. This knowledge weighs heavily on many of us:
‘I’m concerned that abuse of controlled substances will increase and don’t even want to think about the suicide issue the veterinary industry already faces.’
To Clients
Vets appreciate the many clients who are doing the things that make their work less stressful, such as practicing social distancing, being patient when things take longer than normal, and assessing what might constitute an essential phone call.
For example, now is not the time to phone your vet clinic for a lengthy discussion about which breed of cat you should get.
‘If the public can show extra understanding towards vets and vet nurses that will only be a good thing. We are not the only profession under strain but the pressures we are under are very real. Everything is taking longer so people need to be patient.’
‘We place a lot of blind faith in the honesty of strangers at the moment…I feel angry when I hear of my colleagues having got to the end of a consult only to have a client mention that they just came back from a cruise a week ago.’
‘Thankfully 99% of our clients are understanding and adhering to protocols without complaint, but I don’t think they quite understand how hard everything is for us right now.’
Shortages
‘The shortage of equipment is tricky – no hand sanitiser, limited paper towels and gloves. It makes it hard to follow the guidelines to use hand sanitiser between every patient. Some human medications we use are in short supply, which will be hard to explain to clients when their pet’s medication needs to be stopped suddenly.’
‘We have also been asked to supply a list of things we can donate if needed – such as ventilators, propofol, midazolam, and surgical gowns and gloves.’
What is getting us through?
Now more than ever, humour, teamwork and appreciative clients balance out the challenges of veterinary work.
‘On the positive side of things, I work with a group of amazing humans and the way we all have each other’s backs has definitely shone even more so in recent times.’
‘On the upside we have always been good at the ‘make do and mend’ mentality. Also, we were born for this – we just need to pretend every person is a parvo puppy!’
(Parvovirus is a highly infectious, potentially fatal viral infection, most common in puppies, and requires full isolation nursing.)
‘Our team are amazing and have chosen to pull together with a plan to fight and minimise risks to client and staff safety, mitigate risk to the business and work toward sustainability.’
‘We have had wonderful support from our clients and community who have commended us for our initiatives during this pandemic to ensure both human and animal welfare,’
To conclude I will reach for words one of my close vet friends passed on to me. Even though upper management of veterinary practices, can be notoriously out of touch with the needs of its veterinary workers, this directive from the upper management of my friend’s practice encapsulates perfectly what I would want all vets working through this pandemic to hold close to each day, and what I would want all veterinary clients to be aware of and respect:
‘Throughout our career, veterinarians have always put our patients first, then our clients, then ourselves. In this pandemic, we must put our safety and the safety of our nurses and support staff first.’
As a result of this post creating some interest in the US, I was invited as a guest on a couple of US veterinary podcasts, the first of which you can access below. The second, with Dr Kimberley Khodakhah, can be accessed in the Media section of the site.
Mental health extremes in our house. Where does everyone at your place sit? By the end of this post you might have a better idea.
The Covid pandemic feels as though it has equalised our collective mental health. Or if not equalised, then it has certainly ‘flattened’ the mental health curve.
Most people who live with a mental illness have at some point experienced unpleasant times with no fixed end point, over which they have little control. And now the rest of the world is being forced to experience this too.
I imagine everyone’s mental experience of this pandemic differs based on their mental health history (among other factors). But it’s fair to say that right now most, if not all, of us are experiencing some form of mental discomfort.
On the surface, those who live with mental illness appear to be most vulnerable to this. But, this demographic may not be as at risk as we think.
As someone who lives with a severe mental illness but is currently relatively asymptomatic, I feel surprisingly resilient…for now.
Having previously lived through the rock-solid horror of psychosis, the inevitable Covid anxiety that flits through my brain now feels relatively easy to manage. I have an arsenal of finely honed tools to combat it. All that Cognitive Behavioural Therapy, the Acceptance and Commitment Therapy, and individual sessions with my psychologist are coming in handy.
I am also familiar with having my freedom restricted at times. When I am on fifteen-minute observations in hospital, I can’t go outside. At my sickest I have been too unwell for visitors. It doesn’t mean I like it, but I have at least previously encountered similar conditions to the ones I am living with now.
But what about everyone else?
Many people had been living with mild to moderate undiagnosed or poorly managed anxiety and/or depression for several months or years before Covid hit. I am particularly concerned for this group.
They don’t have solid medical and social support systems in place yet. The all-encompassing Covid generated stress is the perfect trigger for worsening symptoms. And accessing good mental health care quickly and efficiently may become even harder than it usually is.
Depression and anxiety symptoms can make the sufferer feel isolated even if they are closely surrounded by loved ones. Social distancing – so essential to manage virus transmission – will exacerbate symptoms of mental ill health in this group.
Then there are the people who have never lived with mental ill health.
They may never have experienced racing thoughts, heart palpitations, chest pain, irritability, distractibility, gastrointestinal signs such as nausea, vomiting and diarrhoea due to anxiety, a low mood, insomnia, incessant worry, or any other mental and physical symptoms that can arise due to stress and/or mental ill health.
These people may not know why they are experiencing symptoms or have the psychological skills to put them in perspective. So, they will suffer more than they need to.
But there is good news in the quagmire of black headlines we are sucked into daily.
We can use our own mental health histories to help ourselves and others in this crisis.
Here’s how:
If you live with mental illness and are currently symptomatic, your sole focus must be to do what you can to get well. I know from my experience I am of no help to anyone if I am symptomatic. It’s a cliché but one that applies here:
‘Put your own oxygen mask on before you help anyone else with theirs’.
Firstly, contact the medical professionals you would usually consult when you are symptomatic – whether that’s your psychiatrist, psychologist, GP, community health workers, or psychiatric hospital.
Limit your exposure to the news to once a day – if that. If you have family or friends who can reliably update you on the essential news only, do that. Immersing yourself in the details, is of no practical value, and it can make you feel worse.
Use the same tools you would usually use to distract yourself when you are living through an episode of illness. Eat regularly and well. Don’t consume alcohol or recreational drugs. And move your body in some way, even if it’s small, every single day.
If you live with mental illness and are currently asymptomatic be vigilant but not obsessed. Just because this time is stressful, doesn’t mean developing an episode of illness is inevitable.
Your oxygen mask will consist of continuing to take medication (if you take it), keeping your regular appointments with your psychologist, psychiatrist or GP where possible, eating regularly and well, exercising most days, avoiding or minimising alcohol consumption, and practising whatever psychological skills (for example Cognitive Behavioural Therapy) that you have learnt over the course of your illness.
Be aware of any news developments that have practical ramifications for you, but don’t marinate in the news. Once you have done all this and whatever else you need to stay well – consider this:
You can offer support to those who are struggling mentally, those who have never experienced symptoms of mental ill health. Reassurance that their symptoms are survivable with the right care, could mean a lot to someone who is new to these issues.
That said – only do this if you have the mental energy to spare – otherwise just look after yourself.
To those who sense they may have been living with anxiety or depression for a while and it is worsening: All the suggestions with regards to eating well and exercise apply. Don’t self-medicate with alcohol or other recreational drugs. It will make things worse. Getting the right help is also crucial.
I am acutely aware that accessing good mental health care is a challenge in this country even when we are not mid crisis, but some excellent online resources to start with are: Lifeline, Beyond Blue, and SANE (Links at the bottom of this post)
To all the people who have never lived with mental illness: Distraction, exercise, eating well, and maintaining social connections via technology are a good start. Don’t self medicate with alcohol or recreational drugs. If you are still experiencing symptoms related to anxiety or depression (as listed above) then the online resources at the bottom of this post may be useful, or make an appointment with your GP as a starting point.
And one more thing…
Once you have done what you need to help yourself – take stock of how this situation is making you feel. And then imagine feeling like this for much longer periods of time than this pandemic will last.
Imagine feeling like this but the pandemic didn’t exist and people around you made you feel as though your symptoms weren’t real.
Then translate your feelings into compassion. And when you feel like yourself again (and you will), extend some sympathy and support to those whose mental illness lasts a lifetime.
And to everyone: We can use our individual experiences of mental health and ill health to support each other through this strange new world and into a kinder future.
So look at who you are sharing your living space with at the moment and consider starting a conversation about where on the spectrum of mental health and illness you and your housemates or family sit. Then think about how you could help each other psychologically.
My own household is one of extremes (regarding the adults). I live with severe mental illness, currently asymptomatic. My husband has never experienced mental illness.
So, when he expressed frustration a couple of days ago about his attention span feeling like that of a gold fish, I said:
‘Yes, I know it sucks feeling like that. But it will be ok.’
And I gave him a hug – something which I believe (at the time of writing) is still acceptable and safe to do in a household in which no one is symptomatic or has returned a positive Covid test.
Disclaimer:
This post is based only on my own experience and anecdotal evidence.
For professional mental health advice please contact your psychiatrist, GP, or for more mental health and ill health information check out the following links, all three of which are currently set up to deal with questions about Covid related mental health issues:
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.
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:
I recently removed the key to the dangerous drugs safe in the veterinary practice I’ve just resigned from, from my key ring to return it. And as I did so, I thought:
‘I wonder if my suicidal ideations will change now?’
I’ll come back to that.
I also recalled how often I’d heard the following over the last twenty years in practice:
‘My son/daughter/nephew wants to be a vet when they grow up.’
Always uttered under the impression that veterinary work is a dream job. But the dream can morph into a nightmare. There is currently a shortage of vets (in part) because our burn out and suicide rates are sky-high.
So why, after dedicating years to entering this prized profession, do many vets want out?
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.
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
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
Gathered friends for dinners and lunches to enable my love of cooking, baking, great food and wine, and conversation…so much conversation.
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.
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:
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
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
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.
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…
Thought Food 