Before this turns into a rant about the state of mental health care in the UK, I’m going to give a brief overview of my experiences and where I am at the moment, as well as looking at one of the books that started my journey into looking seriously at my wellbeing.
I see my mental health issues as being quite situational, so most of my problems stem from how I react to things rather than feelings that come out of nowhere. I don’t feel like I’ve had any formal diagnosis and a lot of the help I’ve been offered seems to be more to do with what is fashionable and cheap. At the moment that has meant a recent movement from CBT to Mindfulness. In terms of managing my mental health, both of these seem like good options for me.
I went to my first counselling appointment as a teenager, in reaction to a difficult period where I felt there was something wrong with me, but left with the therapist telling me that I was “okay” and didn’t need to come. This was at a point where I actually was a lot better, but looking back, my teenage years at secondary school are probably the most likely time I would label as having suffered from clinical depression, though I never got that label.
The next time I looked for counselling was at university. They offered person-centred therapy and I finished it, but didn’t find it any more helpful than talking to a friend. I realised that it was the constant going out and binge drinking that is accepted as such a normal rites of passage at university, which was causing me problems. Again, this was a situational thing, but also chemical. Alcohol is obviously a depressant. But more than that, as an introvert, going out so much was exhausting and unnatural for me, and it resulted in a physical illness so bad it could have developed into what the doctor termed “leukaemia and other nasties”. For me, my mental and physical health are intrinsically linked.
Anyway, I don’t think the way we drink in the UK is normal, and although my behaviour was much like any other university student, I wanted to reach a position where I felt I didn’t need to binge drink. Lying in bed all day was something I should do (and still should do more), but without the horrible feelings that come with being hungover. I decided to go to alcohol counselling. The sessions were helpful and interesting, but it is still something I struggle with if given the chance to drink into the early hours. More helpful has been getting a job and focusing more on my career. I do like the odd night of dancing, but generally I prefer pubs and restaurants.
It was this focus on my career though, that has meant for the last three-four years since graduating from my MA I have been working so hard that I’m risking burn-out again. People have different tolerance levels, but for me working 35 hours a week, travelling 3 hours a day to and from work (often standing in rush hour), and on top of that trying to work a second job that encompasses many roles within it – writer, performer, event organiser, workshop facilitator, editor – is impossible to keep up for much longer. For the last couple of years I have been trying to find a way to make this work better, and although I feel I’ve have anxiety from a very early age, I’m now at a stage where assessments have shown that I have GAD (Generalised Anxiety Disorder). It feels slightly more official than a doctor at university saying it sounds like I have cyclothymia, but in both cases I’m highly functional with it, so the only problem is how I feel inside rather than anything else.
I was recommended the book ‘Feeling Good: The New Mood Therapy’ by David D. Burns. What I found most eye-opening and helpful about this book was the list of cognitive distortions. I was guilty of so many. There are many different techniques and suggestions that are in-line with CBT. I’m not always very good at actively doing these things, but I do find it useful to have these exercises at hand. Burns also makes the point that having therapy alongside medication is much better than just using medication alone. Its guide to anti-depressants made me feel lucky that my problems are mostly mild-moderate, as there are so many side-effects and so many different types, the trial-and-error you have to go through to get the right medication is a battle in itself.
During the time of reading this, I also got some CBT phone-calls, because the journey to my “local” psychological service was too difficult and stressful to get to. Sometimes with CBT it feels like you understand the logic of what you’re doing, but it has very little impact on the very real feelings associated with these thoughts. Maybe this is because the cognitive distortions are so embedded, but at times I felt like I was lying to myself and the therapist when the percentage I gave linked to a particular thought. Initially they had offered me to join a group Mindfulness session, which provoked lots of negative emotions, feeling like I wasn’t getting what I asked for, and just being offered it because it was cheap and fashionable. That said, I have come to see how Mindfulness is what I need, but it’s actually setting aside the time to do it that I find difficult.
My partner is a visual artist, so over Christmas, and beyond, I’ve been able to take some time to colour-in, which I’ve found to be a good exercise. I’m into all that return-to-childhood type stuff, so though I know it’s become a bit of a cliché, I think it’s good for people like me who like to be constantly doing things, as it’s an activity that keeps you occupied, but means you can relax your mind and zone-out a bit too. Meanwhile, I’ve also started some CBT sessions as part of a research project comparing CBT to a particular drug. I’ve found this quite interesting, and more useful than the phone calls. This isn’t just because it’s face-to-face, but because there is more of the B (behavioural). I’ve been set small steps to try to deal with uncertainties better – a massive problem for me, being quite the control-freak! Some of the stuff that has come out of it has been really eye-opening and I feel like I’m discovering things about myself, like how I actually have a lot of positive associations with worrying, such as it being a sign for care (inherited that one from my parents).
One of my tasks for this weekend is to leave some time for “unstructured activities”. I always set myself too many things to do, so even when I intend to do this, or to do more relaxing activities, the time gets eaten up and I always end up sacrificing it. As it’s homework, it should hopefully push me to actually do it. I’m also doing something extreme to help with the pattern I’ve got into with over-stretching myself with work etc. I’ve handed in my notice at work! But this post is quite long enough, so I’ll save that for another time…