Improving Mental Health: the Goal of 2021

It took a global pandemic for many people to realise the necessity of taking care of their own mental health. A time of adversity led to great introspection and reevaluation of what is important. The question remains, how do we go about it?

Foster relationships

Investing time and energy into relationships, old and new, can decrease loneliness and provide a sense of social connection. This could be through texting, zoom calls or in person. The method is less important than the contact. Reaching out to people can help both you and them.

Gentle exercise

Exercise can reduce symptoms of anxiety and depression by releasing endorphins but it need not be excessive and is not for everyone (especially not people with eating disorders). Exercise can also help improve the quality of sleep. A simple walk in nature or a quick dance in your bedroom can instantly shift your mood.

Improve your sleep hygiene

No this doesn’t mean you need to have a shower and clean sheets(though both can help)! Sleep hygiene is a term referring to good sleep habits. Some tips include; going to bed at the same time each night, avoiding caffeine 4-6 hours before bed, developing a bedtime routine, a small amount of exercise and refraining from naps during the day. It can also help to make you room dark and to reserve time in bed for just sleeping.

Follow Mindfulness

Mindfulness can be as simple as paying attention to the beat of your heart, emptying your mind and centering yourself. When you evoke calmness by turning inwards, your blood pressure decreases and your heart-rate and breathing slow. You can focus on the feeling in each limb of your body, give yourself a gentle massage or focus your attention on an object or sound. If you feel your mind wandering, just refocus and don’t be disheartened.

Find a Sense of Purpose

It does not have to be something as big as a career or starting a family, purpose can be found in smaller things. Activities like art and journalling can be a great creative outlet that leave you feeling productive. Volunteering is a way to give back to society and make a difference. Caring for a pet can make you feel needed and loved. Becoming a plant mum can give you a sense of responsibility. Find what works for you.

Mental Health During Stage 4 Lockdown

This pandemic has been extremely difficult and it’s impacts are far-reaching. There’s constant anxiety about getting sick and the unknown, and it is proving to be extremely detrimental to the mental health of just about everyone.

I live in Melbourne, Australia and while we’re doing better than a lot of places, we’re two weeks into a stage four lockdown. Our whole country was put into early lockdown measures in March, this included things like; no  non-essential gatherings of more than 500 people outside or more than 100 people inside, social distancing at 1.5 metres, the slow closure of gyms, pubs and entertainment venues, and then schools went to online learning. The government was excited about ‘flattening the curve’ but turns out the restrictions were lifted too early. The prime minister said we’d be living with this virus for at least 6 months, and we’re at that point now. Numbers began rising again in Victoria and restrictions were put into place. Two weeks ago, Melbourne was put into stage four lockdown for six weeks. This is what it looks like;

• A curfew between 8pm and 5am
• Four reasons to leave home; essential shopping(1 person per household only), work (if can’t be done from home), exercise, healthcare
• Must stay within 5km of home
• Maximum of 1 hour exercise outside a day
• Mandatory face masks
• Workers must carry permits

It’s been a prolonged process and if we’d gone straight into this months ago maybe it would have been easier, but I’m struggling. I haven’t seen my friends since March. I feel isolated and alone. I can’t go grocery shopping with my mum and when the panic buying happened, I couldn’t get my ‘safe’ foods. I can’t go to the movies or eat at a restaurant. I can’t even see my therapist because telehealth is too anxiety provoking. I don’t even want to go for a walk anymore because it’s hard to breathe in fresh air through a mask.

I’m lying in bed, all day every day. My depression was bad but it’s gotten worse and my eating disorder is thriving in isolation. Last week, I went the whole week without showering. Today, I just want to disappear. Things are difficult.

I wish this was more of a positive post but it’s not. My mental health is the worst it’s been in a while and I’m fearful of what the result of that will be.

To people out there going through this, know that you are not alone. Remember that this is temporary. And reach out if you need support. We’re in this together.

Would I Cure My Mental Illness?

It’s not a secret but I suffer from a myriad of mental health issues; depression, anxiety, borderline personality disorder, and anorexia nervosa. Since a young teenager, they’ve tormented me and taken over my life. They’ve lost me friends, taken months or even years away from me and driven me to try and take my life. Considering all of this, brings the question, would I cure my mental illness? It’s not an easy decision, even though on the surface it may seem to be.

Mental illness has shaped who I am. It has taught me to be compassionate, empathetic and to not assume anything about what others have gone through. I’ve learned that everyone has their hardships even if they may not all be identical. I have become a better listener and a stronger person. I would not have thought that I could have gone through all that I have and be still standing. It has taught me that I can withstand more than I think and I have this drive to always keep trying. Mental illness has taught me not to give up, no matter how hard it gets. I believe it has made me a better person.

But what about the harmful bits? The constant torment, the anxiety, the overwhelming sadness, and suffering. Nobody would ask for that. Nobody deserves that. If I could remove the painful parts I would in a heartbeat. But the good and bad are tied together and that’s problematic.

All in all, if I had the option I don’t think I would change things. Mental illness has shaped who I am. I wouldn’t have chosen to have it but it’s made me who I am today and I like the person that I am now. Moreover, I don’t believe it’s a lifelong sentence. People recover from these things or at least learn to cope with it and go on to live long and healthy lives. I still have hope for myself.

An Intro into Acceptance and Commitment Therapy

I’m currently participating in an acceptance and commitment therapy (ACT) group and I thought I’d give you a bit of an insight into what I’ve been doing because I know some of you might have an interest.

ACT is about accepting what you can’t control, such as unwanted emotions, and choosing to behave in line with your values so that your life is enriched and meaningful. It utilises mindfulness ie. paying attention nonjudgmentally to the present moment and other techniques. It’s not about removing unwanted thoughts and emotions but instead, changing the way you respond to them.

There’s a metaphor of passengers on a bus and in ACT you keep on driving despite difficult passengers (thoughts, emotions). You don’t fight them or kick them off but keep moving forward anyway and noticing the positive passengers. You’re driving towards your values(what’s meaningful to you) and a lot of time is spent identifying what these are.

We’ve been learning about dealing with strong emotions and how we get ‘hooked’ by difficult thoughts. This is accompanied by bodily sensations, urges for action and feelings. Then there’s a choice point and this is where you can choose to act on your urge or do something else and is a point of potential intervention and where change can occur.

Some ways of acting including noticing the emotion is there, using imagery by imagining it as a shape/colour/thing, or accepting it and giving it space realising that you can continue on with this emotion present.

The Journey of My Mental Health

Early life

My story begins, as it often does, with my home life. Compared to a lot of people, I had a good childhood, my parents loved me and I was lucky. But it wasn’t perfect. Without going into too much detail, my father was abusive (primarily towards my mum but also me) and an alcoholic. I witnessed a lot of violence and was constantly scared. He had affairs behind my mums back and even had a secret child. I also was physically hit as a child by my two older brothers and the behaviour was often ignored because ‘boys will be boys’. My mother was unpredictable with her moods and you never know what will set her off, she also wasn’t the most affectionate. My parents split up when I was 11 and things got relatively better but there are ongoing issues.

High School

I’ve always been an anxious child, I can remember having difficulties with making friends when I was as young as 8. I was shy and awkward and I’ve spent my life watching the popular cliques from afar. By the time high school started, the anxiety had become debilitating. I spent the first 3 months eating lunch alone and the next 3 tagging along with the girls in my class who I didn’t even like. Over the next two years I was bullied for being ‘different’ and my self-esteem disappeared. Girls would talk about me behind my back, point at me and laugh and exclude me. I remember one occasion where I was put into a group for cooking and then on the day of the class, neither girl turned up, it turned out that they’d taken the day off on purpose because they didn’t want to work with me. That was hard to take.

Year 8 (aged 13) was the year I believe that I first started suffering from depression and an eating disorder but neither was diagnosed until I was out of high school. I was doing well in school but I felt alone and like I was always the outsider in any friendship groups. I was also really sad and I didn’t know why. One day I was in class when a friend slid a pair of scissors across her arm. Seeing a solution, I started self-harming. It was superficial and occurred rarely at first but it became a much bigger issue a few years later.

The next year I went on a leadership camp in the country for a term. It was here that I suffered my first panic attack. I was dizzy and couldn’t breathe or talk, I didn’t know what was happening and neither did the staff at the camp so they called an ambulance. I felt like such a failure and I think this experience made it harder for me to later seek help. At the camp there was a girl who was anorexic and by that time I already had an eating disorder. She was a lovely girl, but way skinnier than I was which made me feel like I was doing something wrong. Later that year I went on a school trip to Japan and I just remember picking at my food the whole time and it got to the point where I felt my teachers watching me. And it’s difficult to admit, but I liked that.

Around this time I started feeling suicidal and then not soon after, I lost a classmate to suicide. That was awful and I still wish it had been me. In year 10 was when the depression became more of an issue. I began crying and just laying my head on my desk in class. I wanted someone to notice how much pain I was in. That pain was nothing compared to what the next two years would bring. I had also begun questioning my sexuality but I pushed the thoughts aside and pretended that they didn’t exist. When I joined an LGBT group and began speaking at assemblies, I was bullied for that too.

In my final year, I was suicidal and had anxiety attacks every day, I had begun purging a few years earlier but now it spiraled out of control. I lost weight and felt happier, then I’d gain it all back and feel worse. My camp and formal were some of my low points, one I was surviving off of air and the other I couldn’t keep any food down. I almost fainted at my formal too. I hated myself and felt like I wasn’t good enough. I wanted to be perfect but perfect doesn’t exist. I was a mess. Self-harming became my release and the only way I knew how to keep myself alive. I just felt like my grades weren’t good enough, I wasn’t smart enough, just not enough. I tried so hard to seek help but I was unable to. I was getting detentions for missing class, being punished for being ill. I tried to speak to the coordinators and counsellor but was never able to. I came close with one teacher who generally cared and wanted to know why I was struggling but I didn’t know myself. Here is when I attempted suicide for the first time, though I never told anyone.

University

I got into my dream university course and struggled through the first year. The work was extremely difficult, I was isolated and still sick. I had panic attacks every day. Near the end of the year, I finally spoke up and got help (read about that here), where I started seeing a youth mental health service. They were amazing.

I was diagnosed with depression, anxiety (general and social), anorexia and traits of bpd. I started seeing a counsellor and eventually began taking medication. Telling my family was hard. They had no idea I was struggling and it still hurts today knowing that they were so oblivious.

The Downward Spiral

At 18, I was admitted to an adult psych ward for the first time. I had gone to an appointment and they felt I wasn’t safe. It was awful. There was little help and it was such a scary and isolating experience. Most patients were in their 40s-50s and suffering from some form of psychosis. It wasn’t the right place for me.

A month later, I overdosed for the first time. I was found unconscious and taken to hospital via ambulance where I was admitted to a cardiac ward. They gave me narcan which I reacted badly to; hallucinating and being restrained. This began the cycle of suicide attempts and admissions. Between my first two overdoses, there was maybe a 6-month break but then I was admitted again and again. Sometimes months in between, sometimes days. Suicidal thoughts. Attempts. Some being quite severe.

Around this time, my brother got into hard drugs. He was violent, unpredictable and home wasn’t a safe place. I can’t share much without invading his privacy but I can say it was an extremely difficult time.

At 19/20, I had my first admission to an eating disorder ward(11 weeks in total with 4 being in either medical or normal psych) and things started looking up. I did okay for a while. Returned to uni and was doing well. But then the self-harming started again and I was needing stitches frequently. That same year, 5 months after the first ed admission, I was admitted again. This time, I didn’t want to be there and the force-feeding was something I struggled with immensely. My ed had been helping with my depression and now that had stopped. I ended up being kicked out for frequent suicide attempts and transferred to psych HDU for a few days which was awful. Just awful. I was on a community treatment order for a while.

A month later, I had my worst suicide attempt. I ended up in ICU on a ventilator. Unfortunately, the attempts didn’t stop there either. I’ve had so many that I couldn’t count and not all overdoses either. It’s escalated to worse things that I don’t feel comfortable speaking about.

A year and a half ago now, I was transferred to the adult public mental health system (from the youth one). This was hard. There’s no therapy and the doctors are nowhere near as compassionate or knowledgable. The level of care just isn’t the same.

I’ve since had two private admissions and they’ve been somewhat helpful. I’ve started different meds, been through group therapy and received TMS. Basically been treated like a normal human being.

Today

Sitting here today, aged 22, things still aren’t good. I’m struggling. I’m about to graduate university, finally, and should be looking forward to my future but I don’t want one. I’m tired and don’t want to be here anymore. Every day is a battle and I feel like my mind is winning. The darkness is all consuming and I don’t know what to do anymore. I feel like I’ve tried everything

Where to from here? Who knows.

 

 

Why I Got Private Health Insurance

From the ages of 18-21, I was managed solely by the public mental health system. However, for the last year and a half, I’ve also had health insurance. It wasn’t something I ever thought I’d get, mainly because I didn’t think I could afford it and honestly I can’t. I rely on my mum to pay for it. But if I didn’t have it, I don’t think I’d be alive today. Here’s why;

From the ages of 18-20 I was involved with a youth mental health program called Orygen. The age range is 16-25 but they only see you for a maximum of 2 years because the demand is so high. Basically, they’re a world-leading youth mental health program specialised in conditions such as BPD and psychosis. I was involved in the BPD program and received cognitive analytic therapy. They were amazing because they provide both case management and therapy, group programs as well as access to a youth inpatient ward and psychiatrists. They’re also world leaders for research. For those two years, things were good.

After that, I was referred to the public adult mental health system and that’s where things went downhill. The service provides case management but no therapy. They have psychiatrists but for me, they seemed to always be rotating. In a 6 month period I saw 4 different ones. My case managers were amazing but I suffered due to the lack of therapy. For a while I was also involved in a youth program called Headspace, but the multiple appointments got too much. It’s worth mentioning that I’m also involved in an eating disorder service too.

The real stigma though, resided in the hospital system. I’ve presented to emergency countless times due to suicidal thoughts and attempts. What became apparent to me was the way they viewed me as ‘just another BPD patient’, despite me being diagnosed with multiple other conditions, and showed the misconceptions they held about the illness.

It got to the point that I would only be admitted to psych units for very short periods of time, in fact my treatment plan states that I should only be admitted for 24-48 hours. Well let me tell you, that’s not enough. Going from 2 week admissions in the youth system to 24 hour ones, was very difficult. That’s keeping in mind that public psych wards are AWFUL. You’re pretty much left on your own the whole time with nothing to do and it’s the last place I’d want to be, but in times of crisis they can keep you safe. They saw/see my attempts as attention seeking and don’t believe I truly want to die. I remember one time where I was admitted and was crying and begging for them to help and not discharge me because I wasn’t safe, well they did. The next day I ended up in ICU and was eventually transferred to psych where I stayed for, you guessed it, less than 48 hours. It became apparent that they weren’t going to help me.

For reference, below is a photo of a room in a public psych ward.

Compared to a private ward;

That’s why I got health insurance. It doesn’t cover outpatient treatment, merely inpatient but it’s been good so far. I’ve had two admissions to a youth program; one for 3 weeks, another for 4.5. There are many differences in the systems; in private you get your own tv, the food is cooked by a chef, you can bring in your laptop, the other patients are less severe, there are psychologists and group programs and generally it’s a much more pleasant experience. The biggest thing for me though was that they don’t appear to discriminate based on diagnosis. They didn’t care that I had BPD, in fact they changed the diagnosis to BPD traits, and were probably motivated more by money but hey if that means I get treated like a human then I’m not complaining. I was also able to undergo TMS (transcranial magnetic stimulation), and while it didn’t work I’m glad I had the opportunity. They also listened to me about my medication and I was finally put on the right ones.

Food in public;

Food in private;

 I haven’t self-harmed or attempted suicide since my first admission to private, last year, and that goes to show that patients with BPD can do well in hospital settings. It’s not us that are the broken ones, but the system.

 

But you don’t look depressed

I don’t know what image the word ‘depression’ conjures in people’s minds but I can guarantee it’s not the smiling and chirpy university student. The reality is, no one can read minds, and it’s impossible to know what’s going on for someone unless you ask them.

I’ve been told by health professionals, that I don’t look depressed or that I’m doing better than what I’m saying I am. But unfortunately, they’re judgements are usually based on what is visible and not what isn’t. not usually the case. I may look happy and be smiling but really, inside I am struggling with feelings of despair and worthlessness. Struggling with the feeling that I don’t deserve to live. Sometimes this facade may be on purpose but that’s not always the case.

Regardless, I want you to know when I’m struggling. Whether I try to hide it or not, I want you to know because in that comes a sense of validation. The knowledge that while this may be in my head, it is still real. What I’m feeling is real even if it is not obvious.

 

 

 

 

 

 

 

 

 

 

The inner battle of taking my medication

These pills, these tiny little pills. Especially this one. this single white pill.

It seems so simple, so easy. Follow the instructions on the packet. Yet, my experience with it is so far from easy. Me and this pill, we have a complicated relationship.
This white tablet in my hand, you see, is an antidepressant. And it’s not just any antidepressant, it’s my antidepressant. Prescribed by my doctor because she believes it helps me, but I have so much trouble taking it.

I can’t tell if it helps me or not and taking it is difficult because it means I’m actively doing something to help myself. A lot of the time I don’t feel like I deserve help and I don’t know if I want to get better. Why? Because this is safe and familiar and anything different is scary. I don’t know how to live without mental illness. Feeling better terrifies me because who will I be if I am not who I am now?

For some reason, I can take sleeping pills and vitamins but antidepressants scare me. It’s because they affect your brain chemistry and your brain chemistry is makes you who you are. I am still the same person if I take this or not though and I need to keep reminding myself that. Taking this does not mean I am weak or will magically be cured. All it means is that I am taking it. Maybe it will help or maybe it won’t but regardless, I am still me.

I wish it was easier to do this. I wish my brain could see it as a solution or medicine but it’s hard to see it that way when results aren’t immediate and when it’s your brain that’s sick.I’m scared of feeling better but I’m also scared I’m going to feel like this forever.

I am starting these again because I have to, deep down I know I have to. I need medication and that’s okay. I wish there was a sign pointing to the one that is the right one; the solution of all solutions. But I’m learning that it’s not that simple.

Please work little pill, I need you to work, even if sometimes I don’t want you to.

You’re not beyond help

I know what it’s like to feel like the world would be better off without you. To have gone through medication after medication, sit through unproductive therapy sessions and to experience life through hospital walls. To feel like nobody can help you. I know how much it hurts to see how your suffering is affecting other people. I get it. I do I’ve sat and cried and begged for everything to stop because the pain was so unbearable that death felt like the only way out. But I’m here to tell you that there is no such thing as being beyond help.

You may feel like you are not worthy or that you’re too much trouble, but none of that is true. You’re not too much trouble and there are people out there who care and want to help. It’s okay if you haven’t achieved everything you want to. There’s still time. There’s still time.

The worst day with you here is better than the best day without you. I get that this may not feel true. I understand it might be hard to believe, but you make the world a better place just by existing. You are worthy of life and worthy of help. No matter how hopeless the future seems, you are worth the fight. Please don’t give up because you are worth it.

You are not beyond help. I haven’t given up on you and you shouldn’t either. Hold on. Please, please, please keep holding on. One day this pain will all be worth it. You are not alone in your suffering.

You are not alone.

On being a mentally ill psych student

It takes a certain type of person to be attracted to helping others.

I don’t believe people can be drawn to the psychology field without at least a small part of them wanting to make a difference. Like teaching or nursing, this isn’t a profession that you go into for the money. If it were purely for financial gain or prestige then there would be more surgeons and lawyers. That’s not to say that people who enter those fields don’t do so because they want to help people, but rather that the wages associated with psychology don’t necessarily equate to the required effort and education.

It is no secret that like attracts like and when questioning the reasoning behind your desire to help people, lines can be blurred. Some people believe that the only reason anyone studies mental illness is so that they can fix themselves but I don’t believe this is true. Yes ,it can be helpful to understand why you are the way you are and how you become the person that you did but it’s also difficult.

It can be discerning to listen to ignorant comments from other students and even some lecturers who don’t understand because they’ve never experienced what you have. It’s hard not to want to stand up in a rage and yell because what they’re saying is wrong. It’s hard having to sit through explanations of your own symptoms and even discover ones you didn’t know you had. But some say that’s the nature of studying psychology. It’s a science that can be immediately applied to every day life and people will relate to certain things whether they are mentally ill or not.

It can also be triggering and confusing. You start to question your own upbringing and wonder whether your illness’ are valid since you don’t fit ‘x’ criteria. But having a good understanding of yourself is crucial to  becoming a good psychologist and can only help you, help others.

The important thing here is to acknowledge that you can’t fix yourself. If you are struggling with your own issues the best thing you can do is seek professional support and the sooner the better. To be a good clinical psychologist  you don’t need to be mental illness free (especially as many illness are lifelong) but it is essential that they are managed. Mental illness is treatable and you would be a hypocrite and highly unprofessional if you were to treat patients without dealing with your own issues.

Please don’t be afraid of your own history impeding your ability to become a good mental health professional. With lived experience comes great empathy and unique insight that not all possess. You know what it is like to be ill and to seek treatment. You’ve been on the other side of the system and have some understanding of what is and isn’t helpful. It is not necessary to have suffered to become a good health professional but it can be used to your advantage and the skills you learn while studying psychology can be applied to many different fields.

Yes, I am mentally ill and studying psychology but no, I will not let that stop me from becoming a great psychologist and you shouldn’t either.