Archive for Mental Health

Reasons to stay alive

Posted in Biographical, Mental Health with tags , , , , on September 15, 2019 by telescoper

I saw this message from author Matt Haig on Twitter last weekend and it affected me so much I couldn’t write about it at the time.

Twenty years ago, when he was in his twenties, Matt tried to take his own life. He didn’t succeed, but the attempt left him severely ill as he summarises in that tweet. He wrote about his crisis in his book Reasons To Stay Alive, from which I have borrowed the title of this post.

Why did this message affect me so much? It’s largely because the words he uses to describe his condition also exactly describe what I was like seven years ago when I was admitted to an acute ward in a psychiatric hospital. I wasn’t exactly suicidal, just so exhausted that I didn’t really care what happened next. I was however put on a kind of `suicide watch’, the reason for this being that, apparently, even while sedated, I kept trying to pull the tube out of my arm. I was being fed via a drip because I was ‘Nil by Mouth’ by virtue of uncontrollable vomiting. I guess the doctors thought I was trying to sabotage myself, but I wasn’t. Not consciously anyway. I think it was probably just irritating me. In fact I don’t remember doing it at all, but that period is very much a blur altogether. Anyway, I then found myself in physical restraints so I couldn’t move my arms to stop me doing that.

Eventually I was deemed well enough to move to a general ward and shortly after that I was discharged (with follow-up counselling and medication).

Experiences like that – which I sincerely hope none of you reading this ever have to go through – make you feel very isolated because you are lost inside your own head and body. Knowing that other people go through similar things, and not only survive but prosper, helps a lot. You feel a bit less of an outlier. Of course I’ll never appear on stage at the National Theatre, but although the intervening years haven’t exactly been plain sailing, the last seven have brought far more positives than negatives.

It’s hard to explain why Matt’s message had such a resonance. His experience was clearly far worse than mine, but when I was discharged from hospital the doctors made it very clear just how ill I had been, and that if there was any recurrence I should get help as soon as possible. As well as writing about it on this blog, I did a piece for Time to Change Wales, encouraging people to ask for help if they need it.

Anyway, this brings me to the point of this sermon. Yesterday I received this by email:

It’s from Niteline, an organisation whose volunteers offer students free confidential counselling, and it came with a suggestion (which I will follow) that I should share it with students before and after my lectures. I’m not sure how many students will read this blog, but I thought I would share it here too. If it encourages just one person who is struggling to find someone to talk to then it’s worth it.

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Health and the Season

Posted in Biographical, Cardiff, Maynooth, Mental Health with tags , , on August 10, 2019 by telescoper

After I came out as having arthritis a few months ago, I’m sure all both my readers are agog to hear news about the state of my knees. There’s only good news to report, actually. The warmer weather seems to have brought considerable respite. I have not taken any anti-inflammatory medicine for a couple of months now, and have largely dispensed with the walking stick too (at least for the time being). I still get the odd twinge, but nothing compared to what things were like during the winter.

I ended my earlier post about this with this paragraph:

One other thing worth mentioning is that this condition does seem to be highly temperature-dependent. This last week the weather suddenly turned a lot colder and the arthritis definitely got worse. Perhaps in future I could learn to use the colour of my knees as some kind of forecasting method?

Talk to anyone who suffers from arthritis and they will tell you a similar story – it gets worse in cold and/or damp weather. Talk to any medical expert, however, and they will tell you that there’s very little hard evidence about this and what evidence there is suggests that the effect is very weak. See, for example, this paper, which has the following abstract:

It is a common observation that pain and stiffness in patients known to have arthritis get worse in cold and damp weather conditions. The objective of this article is to review the available literature on this subject and to put forward an explanation for this common clinical finding. Literature search revealed twelve relevant articles including laboratory experiments and prospective questionnaire-based human studies. Various investigators have tried to study the effect of cold weather on arthritic symptoms and have suggested different theories. The effect of temperature changes localized to the joints has shown to increase stiffness at lower temperatures and decrease stiffness at higher temperatures. The effect of these changes has been found more pronounced in elderly population with arthritis and patients with advanced disease. The evidence to support this common observation is weak; however some studies have reported a trend towards worsening of pain and stiffness with falling temperature and barometric pressure in arthritic patients.

Among the problems associated with studying such effects is the issue of how to measure `pain’ in a reliable way. It may be in the winter people are generally less upbeat about their health which may affect the way they self-report the state of their arthritis. And even if one could measure the level of pain objectively, there are obvious confounding factors: people are generally more active during the summer months, for example, which may help ease joint pain. And what aspect of the weather really matters: temperature, humidity or atmospheric pressure? These tend to be correlated in complicated ways.

All I can say is that the last couple of months have been far better for me. Whether that is because of some direct causative influence of the weather or not I can’t say.

While I am on about health and the time of year, I’ll comment on another personal matter. Seven years ago I was suffering some serious mental health problems, which resulted in me being for some time on an acute ward in a psychiatric institution. That happened in July 2012. I’ve dreaded the arrival of July every year since because it reminds me of that very bad period in my life and I worry that might bring on something similar again. This year, though, has been much better. I can’t attribute this entirely to my move here to Ireland, but the change of scene has undoubtedly contributed.

As a final comment I’ll just say that 31st July was the third anniversary of my leaving Sussex (in 2016) to return to Cardiff on a three-year part-time contract back. I was planning to take early retirement when that expired, but things seem to have turned out rather differently. Things have a habit of doing that. Then again, if life were predictable it would be very dull. Anyway, it was very nice to meet up with quite a few former colleagues from Cardiff during recent week off, including at their summer barbecue at Llandaff. It seems quite a few will be spending the next week or so marking repeat resit examinations, so let me take this opportunity to wish them all the very best!

Sleep Hygiene

Posted in Biographical, Mental Health with tags , , on March 2, 2019 by telescoper

This afternoon I remembered a discussion I had with a few friends last week about insomnia and I thought I’d comment a bit on it here. This topic has come up before, e.g. here, but I’m very happy to say that sleeplessness is not a problem I’ve had recently (apart from once or twice when I’ve had a fever, but that’s different).

When I was struggling to come to terms with insomnia, much of the advice from NHS doctors and psychiatrists concerned sleep hygiene. This does not mean having a shower before you go to bed. It’s a collection of behavioural modifications designed to ensure you get a full night’s sleep every night. Here’s an example of the sort of things:

Received wisdom is that this actually works in most cases. I am, however, bound to say that it didn’t work at all for me. During the worst of my brushes with insomnia I was considered such an intractable case that I was passed around a collection of consultants who, despite their best intentions, didn’t really help either.

Then I had an appointment with a doctor who was refreshingly honest. She said that if insomnia is a result of anxiety or depression then making strict rules about how long you should sleep and what you should do to comply with them can easily make the anxiety worse and hence perpetuate the insomnia. She went on to explain that the practice of sleeping eight hours per night is a relatively recent one. In pre-industrial societies periods of wakefulness in the middle of the night were considered quite normal. Literature from the Victorian period in England, for example, describes how in some communities people would get up in the middle of the night – and even visit their neighbours for tea – before returning home and going back to bed for their `second sleep’. There’s an article in a recent edition of the Irish Times that describes this and cites studies that appear to show that two periods of 3-4 hours each is in some sense more natural than 6-8 hours in one chunk.

So the advice given to me when all else had failed was not to attempt to impose rules on myself but simply not to get stressed if I found I woke up at 3am and couldn’t immediately get back to sleep. Get up if you want to, she said. Relax. Listen to some music. Make a cup of tea. Iron a shirt for the morning. Then go back to bed, but only when you start to feel sleepy again. I’ve done that many many times over the last few years, without feeling anxious about it, although I have to say that nowadays I more often get a solid six to seven hours.

Since I only observe one or two of the list of ten steps to sleep hygiene given above I must be a dirty sleeper, but I much prefer that than being trapped into a cycle of insomnia and anxiety. My advice is sleep the way you can, and don’t worry if it’s not what others think should be the norm.

Come to think of it, that goes for many other things in life.

P.S. If they want us academics to obey rule number 2, why do seminars always go on for an hour?

P. P. S. Anxiety isn’t always the reason for lack of sleep. Sometimes it’s this:

It’s Mental Health Awareness Week Again

Posted in Mental Health with tags , , on May 14, 2018 by telescoper

image

This year the focus is on stress. Research has shown that two thirds of us experience a mental health problem in our lifetimes, and stress is a key factor in this. By tackling stress, we can go a long way to tackle mental health problems such as anxiety and depression, and, in some instances, self-harm and suicide.

For further information about how we can tackle stress and help improve our mental health see the Mental Health Awareness Week website.

Farewell to Whitchurch..

Posted in Biographical, Mental Health with tags , , on May 4, 2016 by telescoper

One of the things that happened over the Bank Holiday Weekend was the closure of Whitchurch Hospital on April 30th 2016. I read about this here, from which source I also took the photograph below:

Whitchurch-Hospital-2

Whitchurch Hospital was built in 1908 and was originally known as Cardiff City Asylum. After over a hundred years of providing care for the mentally ill – including soldiers treated for shell shock in two world wars – the remaining patients have now been transferred to a brand new psychiatric care unit at Llandough.

It was strange reading about the closure of Whitchurch Hospital. Having spent more time myself there than I wish I had, including an extended period an acute ward, I never thought I would feel nostalgic about the place. Quite apart from the fact that it looked like something out of a Gothic novel, it was in dire need of refurbishment and modernisation. Looking back, however, I have the greatest admiration for the staff who worked there and deep gratitude for the patience and kindness they showed me while I was there.

The first extended period I spent in a psychiatric institution, back in the 1980s, was in Hellingly Hospital in Sussex. That place also had something of the Hammer House of Horror about it. I was completely terrified from the moment I arrived there to the moment I was discharged and don’t feel any nostalgia for it at all.  When I recently looked at what it is like now – derelict and decaying – it gave me more than a shudder.

 

Mental Health at Work – to Declare or not to Declare?

Posted in Biographical, Mental Health with tags , on April 19, 2015 by telescoper

I couldn’t resist a comment on a recent article in the Times Higher  (written in response to an earlier piece expressing an opposite view). The question addressed by these articles is whether a member of University staff should be open about mental health issues or not. The latest comes down firmly on “no” side. Although I understand the argument, I disagree very strongly with this conclusion.

In fact I’ve taken this a bit further than just disclosing my problems to my employer; I’ve even blogged about them, both here and elsewhere. I also stood up in the University of Sussex Senate about two years ago and spoke about them there. That latter episode was in response to the attempts by some members of Senate to play down the extent of the violence and intimidation associated with a protest on campus that erupted into a full-scale riot on March 2013, accompanied by theft, vandalism and arson. Since violence is the root cause of my longstanding troubles I was incensed by the casual attitude some academics displayed about something that should never be tolerated. I don’t know whether my intervention had any effect on the discussion but I felt I had to make my point. It still troubles me, in fact, that the culprits have still not been brought to justice, and that some of them undoubtedly remain at large on campus even today.

Anyway, two full years have passed since then and I have received nothing but supportive comments from colleagues both in the School and among senior managers in the University.

When I applied for my current job at Sussex, it was just after I’d recovered from a serious breakdown. When I was offered the position, paperwork arrived that included a form on which to declare any health issues (including mental health). I have moved around several times in my career and have never made a declaration on such a form before, but this time I felt that I should especially because I was still taking medication then. I did wonder whether I might be declared unfit to take up a job that promised to have a fair share of stress associated with it. In the end, though, what happened was that I was put in touch with the Occupational Health department who offered their services if there was anything they could do to help. All these discussions were confidential.

I think it is very important that staff do declare problems with depression or other mental health issues. That’s the only way to be sure of getting the support you need. It’s also important for your colleagues to be able to put arrangements in place if you need to take some time off. On top of all that, employers need to learn how widespread such problems can be so they can try to deal with any factors that might exacerbate existing conditions, such as work-related stress.

Going back to the article in the Times Higher, though. I should say that I can understand the author’s reluctance. It took me twenty-five years so I am hardly in a position to criticise anyone! I was particularly struck by this section:

To disguise my illness, I try my best to be the very opposite of what depressed people are. I become the funniest, the smiliest and the most supportive colleague at work. At times, the performance succeeds and I feel a fleeting sense of being invincible. However, this feeling quickly dissipates and I am left feeling utterly alone, dark and lost. A colleague once said to me that she thought I was the most positive person she had ever met and that everyone enjoyed working with me. I couldn’t say anything to her in that moment. But if I was to speak my truth, it would have been to tell her that I was probably the darkest and saddest of her colleagues. That darkness frightens the hell out of me – so I keep it to myself.

That will ring very true to anyone who is living with mental illness; it becomes part of who you are, and it does mean that you find somethings very difficult or impossible that other people take for granted, no matter how effective your medication is. Putting on a brave face is just one way to avoid dealing with it, but it’s just a form of denial. Another common avoidance strategy is to make up fake excuses for absence from events that fill you with dread. I’ve done that a number of times over the years and although it provides short-term relief, it leaves you with a sense of shame at your own dishonesty that is damaging in the long run to your sense of self-worth and will only serve to give you a reputation for unreliability. The darkness can indeed be frightening but it does not follow that you should keep it to yourself. You should share it – not necessarily with friends and colleagues, who may not know how to help – but with compassionate and highly trained professional counsellors who really can help. It will also help your institution provide more and better assistance.

This is not to say that there isn’t a downside to being open about mental health issues. Now that my own genie is not only out of the bottle but all over the internet I do wonder what the future holds in store for my career beyond my current position. Then again I’m not at all sure what I want to happen. Only time will tell.

Reasons to be committed: mental illness in the 19th century

Posted in History, Mental Health with tags , , on April 11, 2015 by telescoper

I came across this on Twitter yesterday as I travelled back to Brighton from the RAS Club. It’s an official record of the reasons stated for patients being admitted to the Trans-Allegheny Lunatic Asylum located in Weston, West Virginia in the USA. Formerly known as the Weston State Hospital, this facility was constructed between 1858 and 1881. The first phase of the original hospital, designed to house 250 people, was opened to patients in 1864 but its population expanded to a peak in the 1950s with about 2400 patients in overcrowded and generally poor conditions. It was closed as a hospital in 1994 but remains open as a kind of museum. Like most such institutions it was founded with good intentions and was designed with long rambling wings arranged in a staggered formation, assuring that the patients received an abundance of sunlight and fresh air. Just as was the case with similar institutions in the United Kingdom, however, the lack of effective treatment for the mentally ill led to it becoming more a place of incarceration than therapy and no doubt many troublesome individuals were committed there simply to keep them out of the way.

Anyway, here is the list:

Lunatic Asylum

When I first saw this I didn’t know whether to laugh or cry. The mind boggles, for example, at a diagnosis of “masturbation and tobacco”, or was that the treatment? Among the baffling entries, however, you can see a clear thread of misogyny and considerable evidence of the traumatising effect of the American Civil War, not only on combatants but also on grief-stricken relatives of the fallen. It was on April 9th 1865, almost exactly 150 years ago, that Robert E. Lee surrendered the 28,000 troops of the Confederate Army to Ulysses S. Grant, thereby ending the American Civil War so it is not surprising so many entries refer to “The War”.

Psychiatric hospitals are no longer called “lunatic asylums”, and the approach to the mentally ill is no longer simply to lock them away out of sight, but despite the progress that has been made they remain far from happy places even if you’re only there voluntarily and for a short time. You can take my word for that.