Tag Archives: mental health

What’s the point of raising mental health awareness?

I’m really excited to see the The Duke and Dutchess of Cambridge and The Prince of Wales heading up the Heads Together mental health campaign. Only good can come from talking more about mental health and ‘celebrity’ status can aid this.


They’ve brought together The Mix, Place2Be, Contact, Mind, CALM, Best Beginnings, Anna Freud and Young Minds so let’s hope this campaign does the business and gets everyone talking about mental health the way us Brits talk about the weather! (Maybe not, that would be weird!!)

It is great that Heads Together is the charity of the year for the London Marathon and I’m really excited everyone is wearing the #HeadsTogether headbands but will anyone know what it’s all about and why we need to get everyone talking about mental health? What are we actually going to talk about when we get started? Here’s what I want to say, I’m sure many others with mental illness would echo my words:

  1. My mental health diagnosis doesn’t mean I can’t work. Everyone has skills and experience to offer the work place, it is an employer’s duty to offer reasonable adjuastments to enable people to work despite a diagnosis. Please do not discriminate against me, I am not my illness.
  2. Just because my illness is hidden I should not be made to feel ashamed or guilty nor should I feel I have to prove or justify my illness because people assume I’m making it up.
  3. Sometimes my mind makes me behave out of character, please forgive me, don’t judge me.
  4. It’s ok to talk to me about mental health, it’s not catching, it does not make you weak. The only way we’re going to reduce stigma is if we make it a normal and natural thing to talk about.
  5. Caring for someone with a mental health diagnosis is tough, carers need support too.
  6. Mental health education in schools is vital, early diagnosis means recovery is more likely.
  7. Recovery is different for everyone. Some people need to stay on medication for life, some people need therapy on and off for life. Not everyone will be in full time paid work but striving for recovery means an illness can be managed and a meaningful life can be found.


So, however we do it and whoever does it, raising awareness of mental health issues is important and these are some key messages. We can use all the gimmicks and celebrity endorsement we like but we must remember key messages we’re trying to communicate!

How do you love someone who doesn’t love themselves?

It can be absolutely devastating to watch someone self destruct. This can be through drugs, alcohol, an eating disorder, self harm or more subtly through constant self deprecating thoughts and language. I’m not talking about someone who doesn’t like the odd characteristic in themselves but someone embroiled in these behaviours who has a deep seated hatred of themselves.

It can absolutely rip your heart out when you know someone is doing themselves harm and the way out seems painfully obvious. 

If someone is taking drugs or drinking too much, if only they would stop…

If someone is ravaged by restricting and binge eating, if only they would eat regularly…


I’ve watched close friends make the same mistakes time after time and they turn to me in desperation. I know if only they could respect themselves, they could break their destructive cycles and they’d start to see the light at the end of the tunnel. But they don’t believe they deserve respect from anyone, let alone themselves.

Watching someone in pain, at times can feel like you’re grieving. Where is the person? How do they not see themselves as you see them? Why are they in so much pain? It’s important to be honest about this grief. You have not lost them but if this is how it feels, be honest, at this moment, they may still be there in body but if their mind is not all there, they can feel missing.


I have been both the person watching on and the person being watched.

Until recently, I had no idea what it meant to even feel ok about myself. I feared that if I liked myself, I would be arrogant so I ran in the opposite direction and I hated myself. From a young teen I travelled through various self destructive behaviours always with an internal self loathing running commentary. I pushed everyone away at the same time as I cried out for their help. I would say I was incredibly hard to love.

There are no simple answers but here are a few of my thoughts.

Accept that, although the answer looks obvious to you, you are unlikely to be able to, nor is it your job to fix the person. Even if the person in pain is your son or daughter for whom you feel responsible, they are their own person, you can only advise and guide, you cannot fix. When I accept this, I find I have more space to do what I can do.

Consider what you are doing, good enough. Whatever you do, you will be showing love. People show and receive love in different ways, this may not be the time to have a deep conversation about exactly what’s right for them but if you show love through words, actions or gifts, keep going. Sometimes just being there is all that is needed or possible, just keep being there.


Make sure you get the support you need. Acknowledge that you are going through a tough time too. You might feel grief or anger, fear or shear desperation, no emotion is wrong. Give yourself some TLC or ask for it from others, there’s no point in your life veering off too!

It is likely that time after time someone in self-destruct mode will push you away, this can feel like a personal attack but try not to see it that way. Give them time and space (this will show them love) but do go back and let them know you’re still there for them.

As hard as it is, almost impossible at times, remember that the person you love is in there somewhere. No matter how hard they try to push you away, no matter how much they hate themselves, no matter how destructively they are behaving, they are the same person underneath.


People do not behave destructively for no reason, they are not deliberately trying to cause you pain. Most people in this position have not been shown the love or emotional care they need, for this they will need professional help. If at all possible, they need someone to remember who they are beyond the destructive behaviour and love them for who they are. You do not have to condone or even accept what they’re doing, just love the person underneath.

Healing can and does occur.

Surviving a festival with a mental illness

I’ve come away, for the first time, to Spring Harvest (a Christian festival/conference) with my husband. I’m very fortunate, at the moment, to be mentally well but I’m always aware of how much my mental illness impacted my life, either stopping me enjoying things, or stopping me doing things altogether.

I’m not suggesting anyone will be able to strike out to the next festival mid crisis but when on the road to recovery, we need things to challenge us and this might be just the thing…I hope this blog will help someone think they could cope with coming away to Spring Harvest (or similar) even if they are still struggling. A Christian festival is fantastic place to find support, friendship and fellowship with people who could draw you closer to the ultimate healer.
I just have a few pointers on how to ensure you get the most out of it even when times are hard.

  1. Be prepared – If anxiety is a problem, predicting that every disaster that will happen will come as second nature but a few simple plans can reduce fears. Ensure you have confirmation emails ready and/or wrist bands etc. Ask people who’ve been before how to prepare/what to pack etc, phone or email the organisers, explain you’re concerns, they’ll be more than happy to help, they’ll want to put your mind at ease. 
  2. Pack something comforting – whether your favourite food, a teddy, a cosy jumper or your iPad, have something with you that reminds you of home and you can call on to if your having a wobble.
  3. Go with someone you know well – talk to them about any apprehension and ask them to watch out for signs you’re not coping. Let them know they do not necessarily need to look after you, as you can look after yourself but if they’re there for support, it’ll help.
  4. Don’t try and do everything – when you’re faced with a programme packed full of events it can be easy to feel overwhelmed and think you’ll miss out if you don’t go to everything and pack your time but the reality is, you cannot do everything and you’re there to enjoy yourself, you won’t if you’re dashing around! Take time to look at the planner, mark what you want to do so you don’t forget, then just do it.
  5. If you’ve come in a group you don’t have to do everything with them – being in a group can be reassuring so take advantage of that! But it can also be exhausting so make sure you do the things you want to do, on your own, or just with 1 friend. Be aware of what your character needs, when recovering from depression a good balance of time with people and time alone is important. 
  6. Make sure you have food plans – mental instability plus lack of physical energy is not a good combination, make sure you have plans for regular meals. This can be tricky and depends on the exact nature of the festival. At Spring Harvest, there is a great choice of self catering, buying meals on site or a half board dining package. If you have an eating disorder, self catering is often best but recovering I have found half board really helps as it’s helped me break unhelpful disordered habits (such as sticking to salads etc). 
  7. Plan relaxation time – if the weather’s nice, go for a walk or find a safe place and just spend some time sitting reading or having some “down time”. Don’t worry about missing out, what’s the point of sitting in a seminar if you’re not really listening or listening to a band if you’re mind’s elsewhere?! Take time to recharge.
  8. Make sure you take all you treatment – if you need medication, a week before you’re due to go, make sure you have enough so you have time to put a repeat prescription in. If you have therapeutic techniques you need to practice or worksheets you need to fill in, make sure you set aside time. You may be going on holiday but recovery is a full time occupation!
  9. Have a back up plan – make sure, if things get too much, you have a plan for what you will do, will you stay in the chalet? Want a friend to stay with you? Or will you need to have a way of getting home? Often, if we have a “get out plan” we don’t need it, just having it there is all the reassurance we need. 
  10. Remember why you’re there – if you’re struggling at a Christian festival, focus on God or ask for prayer; people willing to lend an ear or a hand in fellowship will not be in short supply! At a secular festival, focus on the music, remember loving music is part of what makes you you, mental illness does not have to define you.

So, if you’ve been to a festival before or you’re considering one for the first time, be bold. Put your mental illness, where it belongs, on one side. There are many to choose from. Spring Harvest have kicked off the 17:21 campaign, a scroll is visiting 22 festivals celebrating what unites us as Christians, including:

Give it a go!

What is happiness?

It’s International Day of Happiness but what does that mean? Do we all have to be happy all day? Can we force happiness? How do we know when we’re truly happy? Is superficial happiness good enough?

Having suffered from severe depression I’m well versed with measuring that, rating each symptom depending on how serious it feels or how often you feel like that over a given period of time. So, recovery is measured by a lack of symptoms but a lack of depression does not mean you are happy.

Happiness can be thought of as an emotion, most people can say at any given moment whether they are happy or not. But being happy overall is slightly different. Words such as content or satisfied may be more important to consider.

So, how do we measure happiness?

Positive Psychology researchers use 3 measures:

  • Positive affect (mood and emotions)
  • Negative affect
  • Satisfaction with life

As with measuring symptoms of a mental illness, so, we can subjectively measure positive and negative mood and emotions. The Positive and Negative Affect Scale is a good example of how we can measure our mood and emotions. It can be used in the moment or over there past week.


Measuring our satisfaction with life is very interesting and full of variables. Things may include:

  • Have you achieved goals?
  • Do you have friends? Do you measure strength and depth of friendship or number of friends?
  • Can you trust the people who influence your life to have your happiness as a priority?
  • Does money factor? For some people this would be quantity, for others, having enough would be an important factor.
  • Have you had children? Are they happy? Do they need to be achieving to feel you’ve achieved?
  • How healthy are you? Have you recovered from an illness? Do you manage chronic illnesses well? What impact does illness have on your overall life?
  • How are the people you care about? Are they happy?
  • What personality traits are important? Are you kind, generous and warm-hearted? Are assertiveness, ambition and gregariousness important characteristics? Is it important that other people notice these characteristics in you?
  • Is a lack of greed or selfishness more important than positive characteristics?
  • Is it ok to put yourself first? If so, how much? How often?
  • Do you have enough time with the people you like, doing the things you enjoy?
  • When things aren’t going so well, do you feel able to change it?
  • How in control of your life do you feel? Do you have self-belief?
  • DOes a belief in a higher power impact you positively or negatively?
  • How much importance do you place on what other people think of you?
  • Is your work life balance how you want it?
  • Is what you do worthwhile?
  • ARe little things more important than the big things? Or vice versa?


Different people will leave different levels of importance on each of these and may consider other things play a bigger part in general happiness and well-being.

It is perfectly possible to be satisfied and content, even if things are not objectively “going well” as our higher functioning is able to see coping with adversity as a positive.

The government considered happiness so important in 2010 they asked the office of national statistics to survey the country’s happiness. Discussing how the survey would work, they found happiness was intangible but well-being is more easily measured. They asked 4 questions:

  1. Overall, how satisfied are you with your life nowadays?
  2. Overall, to what extent do you feel the things you do in your life are worthwhile?
  3. Overall, how happy did you feel yesterday?
  4. Overall, how anxious did you feel yesterday?

Recent findings (up to Sept 2016) include:

  • Life satisfaction, worthwhile and happiness have been steadily increasing since 2012 to October 2014, since then, they’ve plateaued.
  • Anxiety was steadily decreasing to October 2014, since then it has been increasing.

Should we strive for happiness?


In my experience, I think this quote puts it perfectly. Striving for something intangible is fruitless, you will never know when you’ve achieved it. This does not mean, sit around doing nothing and happiness will arrive. Knowing what makes you happy is important, striving to achieve goals and thinking and behaving positively will all help.

I also believe we need to have times of unhappiness in order to recognise and appreciate the times of happiness. I do not strive to be unhappy, angry, anxious or frustrated but in experiencing these things, I enjoy the relief, joy and happiness all the more having been through tougher times.

Survey reveals referral rates need to improve

As part of Eating Disorders Awareness Week, Beat, the UK’s leading eating disorders charity, asked nearly 1700 people, (1420 of which had an eating disorder, the others knew someone close to them with an eating disorder) about their experience with GPs.

I took part in this survey to get my voice heard and it seems many people feel the same way I do…

The survey revealed that half of sufferers rated their experience as “poor” or “very poor”. Of people who would have benefitted from immediate psychological support 3 in 10 were not referred to specialised services.

More than half of the sufferers felt their GP didn’t understand them and only one third (34%) thought their doctor knew how to help them.

Only 20% of patients came away from their appointment with information about eating disorders and services that could help them.

It will have taken many of these people months if not years to have reached the point of asking for help, the courage to make the appointment, get through the door and start talking about their problem would have taken such courage, to be turned away with nothing is very worrying.



Why is early referral so important? Simple – recovery rates improve.

Anorexia has the highest mortality rate of all mental illnesses and currently, of those who live, many remain chronically ill. The sooner someone is referred for specialist support the higher their chances of full recovery.

It is important to work out why these vital referrals aren’t happening…

I do not want to come across as GP bashing, there is no way that some of the most caring people in our society are deliberately denying people the support and treatment they need. Andrew Radford, Beat’s Chief executive believes medical students, hoping to become GPs, need more training. I went to medical school, the shear volumes of information you need to absorb is vast. Maybe it’s not just about “recognising the signs and symptoms” as Mr Radford put it, maybe there’s more to it.

When I went to the GP as a 15 year old, I was not referred. I was not given any information. I did not receive the help I needed. It was hard enough just getting through the door but there is no way of turning back the clock to find out why. Maybe I didn’t explain myself well enough? Maybe there should be more eduction in schools so I was more equipped when I went to my GP?

My experience was 20 years ago but the Beat survey reveals this is still happening today. Is it the “old school” doctors who aren’t keeping up to date with training? Do newer GPs need more training? Are GPs/secondary services using out-dated/overly stringent criteria as referral criteria e.g. BMI? Is there an inaccurately held belief that if you refer someone there’ll develop an eating disorder where there wasn’t one? Are GPs so overworked, although they know the signs and symptoms to looks out for, they miss them? Do they think, “if it’s that serious they’ll come back”? Do patients go with too many problems and the GPs are distracted by other issues they consider more important? Do doctors not have enough times to refer people? Are doctors unaware of what secondary care is available? Do GPs think the secondary care is inappropriate/unhelpful? Is the mental health stigma still getting in the way?

We really need to get to the bottom of what is going wrong in the consultations where people are not getting what they need.

Perhaps some positive news is that once some of the sufferers swapped GPs (as nearly 1 in 6 did) they reported receiving the help they needed. When I approached a GP in my 20s I’m very glad to say I’ve had much better support. By this time I was a lot sicker, my GP had to persuade me to access the secondary and then tertiary services, she was excellent. Since then, I’ve moved a couple of times and each time, I’ve had a mixed experience with GPs. It’s been very difficult to find what I need but each time, with some perseverance I’ve found a GP with the right skills and experience to support me. Maybe I am a tricky/difficult patient but I’m definitely not alone with these feelings as the Beat research reveals.


Somehow we need to make sure that every single one of the 725,000 people in the U.K. affected by an eating disorder gets the support and treatment they need to recover.

Please share your thoughts in the comments section below.

For more information:

Independent.co.uk

Full results of Beat survey

Confessions from a disordered mind

So, it’s eating disorder awareness week again and I fear, yet again, I will be “preaching to the converted”… not that I preach (I hope) but I fear my blog only reaches those people who already know about mental illness, those who are already interested, those who suffer themselves or who care for someone who is or has been mentally ill. People reading this do not really need their awareness raising, so…what’s the point?!

I’ve challenged myself to go a bit deeper this year. Maybe my audience are aware of mental illness, even aware of eating disorders and anorexia. But how many of you actually know what it’s like to be stuck on the treadmill of starvation where you beat yourself up because you wonder if you’ve chosen to be ill but when you try eating an apple, a voice tells you “if you don’t cut it into 36 pieces, you’ll put on 6 stone”?

Anorexia isn’t about choosing not to eat or just liking healthy eating. It isn’t sexy or glamorous. It isn’t about losing a bit of weight, being a moody teenager, being awkward or deliberately deceitful. It’s a serious mental disorder where your every waking moment is driven by a desire to lose weight and your nightmares are dominated by fear of fat. The interlinking of thoughts, emotions and behaviours and your interpretations of these is incredibly strong, it can feel impossible to break the automatic cycle.


The voice (I later called Ana) was with me 24/7, in bed, at the supermarket, while with friends, when I was alone, she never left me alone. I thought she was my friend as she gave me hints and tips to achieve my goal. She persuaded me to make trips to a supermarket that was further away because they sold products lower in fat and sugar. She kept me going when I slowed through exhaustion while out running, she made me run faster, harder, further. She helped me say no when I was tempted by cakes and biscuits. She made me walk instead of use the car, even when the weather was cold and wet. She gave me a buzz when I lost weight but didn’t let up, she made me strive for the next target.

With anorexia I was devious and deceptive. I’m ashamed of some of the things I did. This is common. My focus became losing weight, my aim was to consume as few calories as possible and use up as many as possible. Continuing with a vaguely normal life became difficult, impossible at times. I’d pour milk into a bowl to pretend I’d eaten cereal. I’d say I wasn’t hungry when my stomach was in knots. When offered food, I’d say I’d already eaten when the truth was I’d not eaten for days. On one hand I hated wasting food, on the other, I’d throw food away. I hated lying but if I was to achieve my goal I had to. Unfortunately, the more weight I lost, the more I had to hide. I also self harmed, I had to hide this as well.


Why was I so determined? I felt out of control of my body (during puberty) and of my emotions. I’m a highly sensitive introvert who felt like I didn’t fit in the world. I thought my food intake and losing weight was the only thing I could contol. As with any other coping mechanism we use to make ourselves feel better/happier (smoking, shopping, drinking alcohol) there comes a point where they stop helping and start becaming a problem in themselves.

The more weight I lost, the better I felt about my body, I got a pleasure, I felt a a sense of achievement. But each time I achieved my goal, I had to set a lower goal weight. The lower my goal weight, the harder it was to achieve. The harder I had to work at my eating disorder (yes, it’s hard work) the more unhappy I was. Anorexia is full of contradictions.

There came a point when I realised my goals for life weren’t compatible – I did not have enough physical or emotional energy to be the person I wanted to be and to continue losing weight. I had to decide which I wanted more. Unfortunately, it’s not as simple as just choosing to recover.


When trying to recover the juxtaposition of desperately wanting to get better with desperately wanting to continue losing weight (because you know you feel better lighter and feel worse heavier) is an impossible battle. It didn’t make sense to enter into a recovery programme, signing up to gaining weight, knowing this would make me unhappy. I was unhappy with my life dominated by thoughts of avoiding food, avoiding social situations involving food and constantly trying to use up excess calories, I knew I would be unhappy gaining weight and feeling excess fat on my body. This is a very difficult experience to explain.

As I wrestled with recovery, there were so many reasons to fight to get better but anorexia is powerful. I needed people around me with a lot of patience. Recovery is never a smooth journey and there were many hurdles and many set backs but it is possible.

When I tried talking about the voice I heard I was asked to give it a name (a well established therapeutic technique) but I insisted on calling it Frances because I knew rationally it was me… it felt like someone else but I knew this wasn’t actually possible. In an odd way, my insight was working against me.

Once I gave in and called her Ana, it became easier. Instead of blaming myself, feeling angry at myself, beating myself up etc…I started aiming all my anger and frustration at Ana and started fighting against my illnesses instead of against myself.


Is life plain sailing now I’m recovered? No, of course not! But, although I may never love my body, it is what it is and I make my own decisions now, I’m not dictated to by disorered thinking.

Back on medication – have I failed?

Some of you will know, this time last year I was gradually coming off my psychiatric medication. I’d been on medication most of my adult life, I was still in therapy but I felt it was the right time to give it a go. If you’ve been on medication a long time it can be hard to tell if you still need it. The only way to be sure is to try coming off them in a controlled way and see if symptoms return. I did this, I came off everything very gradually, keeping a careful track of how I was feeling and what thoughts I was having. Soon after, my therapy came to an end and all seemed to be going well.

Unfortunately, my physical health in 2016 has taken a bad turn. I’ve had to see specialist after specialist as one organ system after another started going wrong. I was having numerous tests, appointments and procedures. For a time I was managing to keep positive and take it in my stride but there was only so much I could take and I started noticing symptoms of mental illness creeping back in. In an appointment with my GP I was updating her on all the hospital appointments I’d had and talking about test results etc, I was trying to hold it together but eventually the tears started falling. I then explained the other symptoms I was struggling with.

zebra

We had both been keeping an eye on my mental health as it’s common for physical health problems to take their toll on ones mental health and so at this point we discussed going back on medication. I felt disappointed about the prospect but I made the tough decision to give it a go and see if it could help. Starting on a low dose, of course, and stepping it up gradually until I felt a benefit.

woman-with-head-in-hands-e1449085629223

Initially this felt like a failure, I’d worked so hard to remain stable but I’ve managed to re-frame how I see it and I now don’t see it as a failure. In fact, noticing my symptoms and flagging up the problems earlier rather than later is an achievement for me. If the chemicals in my brain are out of balance again, surely it’s sensible to try and put this right? My old habit was to ignore it for as long as possible and hope it would sort itself out but this landed me in hospital too many times! If someone breaks their leg, you don’t expect them to walk around on it, ignoring the pain, we’d all advise them to have it x-rayed and put in plaster. It’s the same with mental illness, it’s important to find the right treatment.

Fortunately, this time, it seems we’ve spotted the signs early enough and the medication is helping.

Like all medications it’s important you’re not on them if it’s not necessary. We’ve all heard about the antibiotic crisis, over treating can have a devastating effect. It is important that anti-depressants and the like are not taken lightly without thinking about therapy and lifestyle changes as well. Also, we need to give careful consideration to any unwanted side effects. It’s also been much trickier for me this time as we’ve had to consider the interactions with all the physical health medication I’m now taking.

tablets

I do not want to be on psychiatric medication longer than necessary so when things settled down I will consider coming off them again. Unfortunately, this doesn’t look like it’s going to happen any time soon. But, I’m not going to beat myself up or apologise for putting my hand up and saying “I need some additional support just now”.

shutterstock_104302670

Fake it ’til you make it – does it work?

As a mental health recovery worker, my heart sank when I heard my colleague (who I respect a great deal) use the phrase “fake it ’til you make it” with one of her service users.

This was the worst thing someone once said to me during my recovery journey. I had spent my whole life faking it, and this was what was making me sick. Constantly trying to “fit in”, to be “normal”, meant I’d lost sight of who I really was and it made me more and more unhappy.


I’m an introvert and in a world built for extroverts I feel I constantly have to fake social confidence. When I say I’m an introvert, I mean I’m at the extreme end of the spectrum.

By no means do I want anyone to feel sorry for me. Now I know I’m an introvert and I’m ok with it, I love it! How lucky am I that I don’t NEED other people to recharge my batteries? How great is it that I can amuse myself with a ball of yarn on the sofa for hours without getting bored or needing attention from anyone?

Faking being an extrovert is exhausting. In a room full of people, where background noice makes my ear drums painfully contract and  the ridiculously high watt light bulbs just want to shut my eyes, I smile and nod along to the conversation. I try desperately to drop in some interesting or helpful remark now and again just so someone doesn’t ask me if I’m ok.

No, I’m not ok…faking having a great time when your heart is screaming “get me out of here” takes a lot of self discipline!

If introverts don’t fake it, they’re considered a “party pooper” or “billy-no-mates” or a “hermit”, these are not considered indearing qualities, they’re unfair derogatory insults. The truth is, I just like being on my own, I find peace and quiet restful and other people (except a select few) sap my limited energy. Why is this considered strange?


I felt angry that my colleague had no idea the pain my faking had caused me and I considered her comment insensitive. Add insult to injury she has to be the most extrovert person I know! In my anger I was wondering how she could possibly make such a rookie mistake. But, as I say, I respect her so I knew she meant well and I had to stop and think about what she was trying to say.

The context of her comment was with someone who had mild depression and anxiety. They had previously been an extrovert and were disappointed and frustrated that they’d lost that part of them. My colleague was suggesting that they do the things they knew they’d previously enjoyed. The idea being if you immerse yourself in things, you know, deep down, are part of your character and enjoyable, then, fake a smile now and again, eventually the old you will emerge. My colleague was helping her service user believe in himself again. This genuinely works provided you also address the issues that led to the mental illness occurring in the first place.


Saying this to me, or any introvert, however, would just compound the issues that led to the illness developing. When this comment was said to me, it confirmed that was the failure I felt and unfortunately led me to feel that if I had to fake it for the rest of my life (since I’d been faking it all up until now and I’d never “made it” I wasn’t going to suddenly be able to make it now) there really was no point in going on.

If you tell an introvert to “fake it” to “make it” in the world, instead of building them up, you will be smashing their self esteem to smithereens. We’re already great fakers, what we really need is to be told, “it’s ok to be you”.

For an introvert, finding recovery can be a lot more subtle than for an extrovert. When depressed, the usual reaction is to hide away from the world. Extroverts needs to get out there, find people, build their energy from them. An introvert needs to be truthful about what makes them happy, it might be about treating yourself to some luxuary bath salts or lighting a candle while doing some breathing exercises. I’m not advocating introverts continuing to hide away, we all need someone in our lives, I’m just saying an introvert needs to find balance.


When searching for freedom from a mental illness, it’s about finding out who you really are. If faking being an extrovert will remind you of how fun it is, go for it. If faking being an extrovert will just remind you that you hate faking being an extrovert, please stop!

Is it a diagnosis, a label or an identity?

I’ve had a number of conversations over the years about the language used around mental illness – it’s complicated matter, made more complicated by people not knowing the power behind their words.

“I am not my illness”

I’ve had a gentleman with schizophrenia say they detest being called “schizophrenic”, explaining this by saying “you would not say someone is a cancer”. However, we are not saying he “is schizophrenia”, we would be saying he “is schizophrenic” just like we say someone “is diabetic”. However, I think what he was trying to express was that he is not his illness, he did not identify with his illness, he did not want to be labelled in this way and this is to be respected.


Even professionals use words derogatorily

If I said someone “is diabetic” I would not have any opinion or judgement on their personality or any other characteristics. However, I recently heard a paramedic say this patient “is schizophrenic” with so much power, bitterness and judgement, I could tell he was casting aspersions on this person’s character. I had presented my service users as a “56 year old gentleman with [a number of medical complaints] and schizophrenia” as information that may lead to conclusions about the current presenting complaint. While one person may be able to say someone “is schizophrenic” without any preconceived judgements, this paramedic was not one of them. Stigma in society is so strong, but it’s people who are being stigmatised that suffer, those doing the stigmatising don’t realised a subtle language change could have a powerful impact. With this small change, a person is not labelled as their illness but someone who has an illness.

“I am more than my illness”

Mental illness can have a negative impact on one’s identity. When I was diagnosed with anorexia I could have let this be my identity… i could have felt, I am not Frances anymore, “I am anorexic”. I have seen people so consumed by their illness, they may as well say “I am anorexia” – I am not a person anymore, I am an illness. But I did not want to label myself in this way, although it was true I was “anorexic” I preferred to see myself as “a person with anorexia”, then my character and personality traits could exist alongside my illness. It has been proven that assumptions about what it means to be mentally ill such as incompetence and inadequacy (commonly held) will lead to a vicious cycle of impoverished sense of self and low self esteem, ceasing to try and work or fit into society and poorer psychosocial outcomes and sustained symptom severity. (Read the full article here.) It follows that, if you identify as your illness, you identify as incompetent and inadequate, whereas if you consider yourself to have an illness, you are not your illness, you can distance yourself from these negative characteristics.

Of course, this is down to the individual and if saying “I’m bi-polar” or “I’m schizophrenic” does not impact on their ability to see themselves as separate from the illness that’s their prerogative. Or, if they want to be identified as their illness, that’s also, up to them. Perhaps I’m saying, from within a mental illness it can be very difficult to see the path to recovery, how you see yourself in relationships with your illness can be the turning point. In my opinion, recovery and turning away from being consumed by mental illness is possible for everyone (recovery may not mean cure – but that’s a subject for a different blog).

labels

When is a diagnostic label unhelpful?

I’ve had other conversations with people who think we should do away with mental illness diagnoses all together as the words can have such a negative impact on the experience. It can be very confusing when some words can be used by the general population, for example feeling depressed or anxious are valid and appropriate emotions, however, clinical depression and anxiety disorder are very different experiences, in some ways a million miles away from the basic emotion. For other diagnoses there are other problems e.g. the use of derogatory terms, such as “schizo” which has been used to mean “unpredictable criminal”. Personality disorder is a confusing term, we think (as society) we understand what is meant by personality so if someone’s personality is disordered, surely, their core being is fundamentally altered/damaged? Well, no, personality disorders are extreme complex and there is much discussion about changing the label to fit the experience better. But an individual experience of different personality disorders is unique such that everyone has a different perspective on which words would be more useful.


Of course, diagnoses are an essential part of communicating. It’s helpful if a collection of symptoms has a name so that treatment can be targeted appropriately. I have also had the experience of an inaccurate diagnosis being used which then had a negative impact on the treatment I received.

Language changes, this is normal

The word spastic used to mean “muscle spasms, a common symptom of cerebral palsy” – it is now an offensive term, because of how it was used, and has fallen out of use. The media may hide behind “the dictionary definition”, but if we follow this through, we can still use the word spastic, but we don’t. The ~”dictionary definition” of “schizophrenic” is “a person with schizophrenia” or “contradictory”, e.g. “the rehearsal was schizophrenic” could mean “frantic and disjointed” but this is as it’s at odds with the definition of diagnosis. Many people still think someone with schizophrenia has a split personality or they will definitely be violent…continuing to use the word in different contexts perpetuates this misunderstanding of the illness.

Just hoping people think about what they say…

It’s not hard to change, “schizophrenic person” to “person with schizophrenia”.

Breaking down stigma is vitally important in a cruel and judgemental world. Not realising the power behind our words can have a negative impact on those affected by the illness by perpetuate societies misunderstanding, judgements and stigma. Even if you do not mean offence by the words you use it can have more of an impact than you realise.

Is it ok to be a little bit OCD?

No, it’s not ok, there’s no such thing!

I was horrified recently when I saw a young girl, hold a creased piece of paper aloft and call out “you’ve triggered my OCD”.

Would anyone call out “you’ve set off my bulimia” or “you’ve sparked off my schizoid personality disorder”? No!

So why is it ok to make fun of OCD?

It seems there’s something cute or glamorous about wanting things neat, tidy and organised. But this is not what obsessive compulsive disorder (OCD) is about…it’s a thought disorder with devastating consequences where people have uncontrollable urges to carry out meticulous actions in order to avoid perseived disaster occurring to them or their loved ones. People can need hospitalization as short term management. Long term the condition needs therapy to understand the meaning behind the symptoms and to break the compulsive behaviors.

I’m sure this young girly meant no harm by her comment but unfortunately, language like “I’m a little bit OCD” perpetuates stigma that people with serious mental health disorders could do without. If OCD (or any other disorder) is banded about in a frivolous way, full understanding of the nature and impact of the illness is missing, people think they understand but they miss the point. Misunderstanding has many consequences including discrimination and isolation.


If person A has advertised their OCD as not wanting a crease in their leaflet, how will anyone understand that person B will always be late for meeting friends because they have to perform a repetitive ritual lasting many hours before they can leave the house or they fear for the life of their children? Everyone experiences OCD differently, it’s a highly complicated and varied illness.

I’ve had anorexia and depression, at various times I’ve been more or less ill but at all points in my illness it impacted my ability to function. Yes, it can appear that some illness are on a continuum with neurotypical individuals but there is a line where you fit the criteria for diagnosis and it’s at that point, life is severely impacted. Anorexia is not losing a bit of weight, depression is not feeling a bit sad. Mental illness is complicated, sometimes not even fully understood by the individual who’s suffering.

We must stop this unhelpful language around mental illness. Talk about it, yes, if you suffer, talk about the triggers and how it impacts you but if you do not have a diagnosis, more sensitivity is needed, it is not ok to poke fun at or making light of something you don’t understand.