Recent thinking on Mental Illness

Recent thinking among the boffins in mental health circles is running along the lines of everyone being mentally ill. What they are suggesting now is that we are all a potential car crash waiting to happen with regard to becoming ill. All it would take is a trigger to start it all off. Or to put it another way, apparently we're all crazy, it's just a question of degrees.

Gone are the days whereby it's a simple case of nature versus nurture. The thinking is that, as genetics and environmental influences can never be separated both can be the foundation stones for someone becoming ill, but neither on it's own may trigger it. They are just two of a myriad of factors that have to be in place in the right order to act as the catalysts to illness.

This is born out by the evidence of many case studies. Mental illness may run in your family, but rather like diabetes it can skip generations so even when there is a strong genetic element it is not a fait accompli that you or your children will ever get ill. If you've been brought up with a family member who has a permanent condition of mental illness it is more likely that your own behaviour will be shaped by those experiences to make it more likely for you to suffer illness yourself.

A person from different genetic stock  with no evidence of mental illness suddenly having to live with a severe form of mental illness in a loved one is likely to experience bouts of stress, anxiety and depression, so it's become unwise just to assume that genetics are the only factor in play when people are blood relatives.

Likewise, environment or circumstances into which we are born do not in themselves mean that we will become ill. Some people brought up in a disturbed setting can follow suit but many don't. In short there is no one answer and no one way to predict who will become ill and who won't.

Everyday potential for illness
If we have a passion or interest in anything at all, some boffins now say, then we are probably suffering from some form of Obsessive Compulsive Disorder (OCD). This includes passion for our jobs; our hobbies like sport such as keep fit, football, working out at a gym, walking, cycling etc; creative activities like art, theatre and music and even everyday interests like shopping. So long as those passions and interests remain containable we are considered well. It is when they become all consuming to the point of interfering with our ability to function in other things that adverse effects may occur.

Added to which, as human beings we are all prone to every day stresses, worries and anxieties. We might have concerns about our jobs, our health, our finances, our homes or our relationships which are all perfectly 'normal', or average. However no one can predict what events might transpire to exacerbate normal stresses, worries and anxieties into some form of illness. For example, we can not assume any of us will not experience redundancy, a house fire or becoming a victim of crime.

Given this, suddenly we come to realize that there is no such thing as immunity from mental illness and that it really does come down to a bit of a lottery as to who becomes ill and what may trigger it. You may be a person that can cope with losing a job, but are one who is more susceptible to becoming mentally ill over the breakup or loss of a loved one. Hence we can look at the statistics in a slightly different way and say that 25% of the population become mentally ill because they were unlucky in the events and circumstances that came their way and that 75% of the demographic were lucky because nothing that could have triggered illness happened during the course of their lives.

Bereavement
However bereavement is, in my opinion, a form of depression and as none of us are immune from losing a loved one, (indeed we except our parents to predecease us), we can and should expect to be pretty miserable at such a loss at some point. In that period of adjustment known as bereavement it would be unusual for people to feel like doing cartwheels and throwing a party and to continue their interests in normal life in the same way.  Even people who experience relief over an aggressor dying can experience symptoms of bereavement including guilt and shame over their relief.

80% of us can expect to experience bereavement at some point in our lives (not everyone will) and that state is a painful and distressing one often to the point of making us introspective and miserable. A mind that is distressed and/or miserable for more than a couple of weeks is considered to be a depressed one and therefore can be considered to be ill. In the light of this the stats should read that 80% will experience mental illness in some form.

It is also common for people to experience a sense of loss akin to many symptoms of bereavement when they lose partners through divorce, or lose their jobs or home. Depression is classified as a form of mental illness and one of the most common at that. Along with stress and anxiety millions of people each year go to their doctors for help with it. How is it then that stigma over mental illness still exists?

In correspondence with a psychologist in Australia I was shocked and appalled to learn that in third world countries people do not become psychotic from being left on their own while dealing with a bereavement, because in third world countries retain their sense of community and care for each other at such times. I don't know if the statement is true or not, but to me even the thought that it might be constitutes a damming indictment on the entire developed world.

The challenge has to be to eradicate the stigma to increase the chances of people feeling OK about seeking help when they need it. The stigma alone can prevent people seeking help and result in the problems escalating in their severity and becoming long-term. That said the statistics show that people rarely have more than one episode of serious illness in their lives. I wonder how many remain ill because recovery can be incomplete or prevented due to the stigma.

By being supportive of those around us, by allowing them to talk, by encouraging them to go for help early I vehemently believe we can jointly make significant inroads into reducing the severity and longevity of many forms of mental illness. To that end I feel we need to encourage people to get informed and no longer be ignorant about the subject, to deal in facts and not in assumptions because even a staunchly prejudiced person may find they could be the next person to become ill.

I don't advocate going on a crusade and turning into a raison d'etre (reason for being), but I do suggest that we become more aware and correct people in their assumptions as and when it's appropriate and when there are openings. After all there is a sharp difference between being dedicated and being obsessive. Obviously this blog is concerned with the subject, elsewhere I do other things and I recommend you do the same.

Is Depression Your God?

I was told once that depression was my God by a so-called Christian group which I didn't consider a very compassionate, nor a Christian thing to do. What I was trying to tell them at the time, (because they asked me to), was about my life in which depression has featured. (Thankfully not all Christian groups are like that one).

A couple of things worth flagging up here...
1. Depression by it's very nature is a debilitating condition. The sufferer cannot 'snap out of it'. If they could they wouldn't be depressed. As I've mentioned before, when people are depressed they tend to become totally absorbed with and consumed by negativity sometimes to the point of nothing else existing.

When people are like this, if they talk (and often they try their best never to do so), they do so because they are looking for help. Their troubles are in the present and haven't been resolved and those troubles can have a very understandable cause such as a death, job loss, stress at work or over a loved one's well-being. These are things that any of us could encounter in our lives at any point. As much as anything depressed people need to talk as part of the solution seeking process.

2. There's a sharp distinction between someone sharing something about their past and something they are still experiencing. Recalling memories of depression I see as the equivalent of another person recalling a divorce they've been through or a rotten job they've had or even recounting happy memories of a fabulous holiday. Why shouldn't someone who has been depressed pretend it hasn't happened? Why should they deny it or hide it? Is that not part of the reason why the stigma over mental illnesses prevails? How can people become less ignorant unless sufferers share what it's really like?

There is a difference of course between wearing a past trauma on your sleeve and just talking about it when it crops up as relevant to a conversation or when asked. Using it as a source of sympathetic attention to get what we want is not, in my view, what it's about. What we really need is acknowledgement for those experiences not sympathy.

When I came out of hospital I was extremely sensitive to any reference to mental illness. I started being offended by the language people used; words like "nutter", "fruitcake", "psycho", "mental" and "bonkers" all made me cringe because for the first time in my life I knew I could and (in some instances) was being seen as a sub-class of human being, one that wasn't welcome, was never going to be accepted and therefore a reject and one which these words were hurtfully being applied to.

From there I began to look for signs of stigma whereas I perhaps would have done better to look for places and people where it doesn't exist and stuck to them like glue. The maxim 'we find what we look for' really does hold true. There are instances where I have been wrong about people simply because those individuals haven't known what words to use in their efforts to try and understand.

Then again people use potentially harmful language because they are afraid of the subject, don't want to look at it in case they find they too could become ill. I use the word 'potentially' because it is up to us to not let it harm us, to let it float over our heads. "Easier said than done" I hear you cry and yes, you're right. But just as bigots are dismissive of what they don't like and are afraid of, why should not we be dismissive of what we don't like too?

I confess that on occasion I've applied words like "nutter" to myself in defiance of those who seek to look down on me. I know isn't always a popular tactic with other sufferers, but I do it to show the would-be bullies of this world that I am unafraid and to reclaim the language. As a consequence I don't care what people call me anymore. This way of fighting the stigma really has to be a personal choice of how or indeed whether we confront it head on or not. Much depends on our confidence levels and our personalities. Be true to yourselves on this is what I recommend and don't ever feel you have to follow my, or anyone else's example.

Over here in the UK positive action is being taken to fight the stigma in a campaign called Time to Change http://www.time-to-change.org.uk/. It is currently trying to encourage sufferers of mental illness of whatever kind to speak out about their experiences. It's an attempt to give us an opportunity to have our say, to give us a voice. People will always have the choice of whether or not they make assumptions or deal in facts, on whether they remain ignorant or get informed. The campaign also highlights many of the unfairnesses that are prevalent in mainstream society concerning how sufferers are regarded and responded to.

Yep, I've signed up to it, but... I think it important to remember that mental illness is only one aspect of our experiences and who we are. Undoubtedly it has been an influential part of the development of our characters, but it is not the only factor nor the sum total of our existence. From my own experience of working with MIND I am constantly reminded of how normal, average, sensible, considerate and compassionate people can be even when ill.

To become well we capitalize on what is working ok while acknowledging what's not. To only focus on what isn't working in my opinion only serves to perpetuate and escalate the problem. Yes, we need to address whatever it is that makes us unwell, but by also looking at what is still fine, what we enjoy and like we soon come to realize that the illness is not all consuming and nor is it an absolute of who we are. As with everything there needs to be a balance for us to reach our goal of wellness.

Sadly a perception remains that if we talk about our illness then we are ill and that depression is our God. The truth is that by not talking we jeopardize our chances of recovery and part of that process includes integrating back into mainstream society.

Folks, I'm glad to say not everyone is prejudiced so look out for them. Their numbers are growing because of campaigns like Time to Change, and at long last it's happening - people are gradually beginning to twig that we wholeheartedly deserve our place in the world too and that our bouts of illness are just that and nothing to be ashamed of.

The Perils of Success

There is a particular reason why I've chosen to write what follows. I'm petrified but also excited about the possibility of my achieving something I've longed to do. Petrified for fear of what it may lead to if I'm successful and excited because of that longing to achieve. Of course all my efforts may come to nothing too.

It probably sounds bizarre to many but I fear success because I fear being put on a pedestal; for others to have too high an expectation of me. It stems from people in my past expecting me to have a magic wand to cure their ills or to carry them to a brighter future. Quite simply I can not do that. No one can.

If we look at the world of celebrity as an example of what can happen, one of the first things that occurs to me is how many get into difficulties due to the expectations of their followers and fans. People latch on to them because they want the recipe for success.

The celebrity has become famous for something they have done or do, but it is only one element; one facet of their being. Many end up having breakdowns, turning to drugs, alcohol or with maladaptive behavioural problems because relationships can get seen as things to avoid instead of embrace. They start thinking of others only wanting contact with them to help with finances, help them with their career etc with nothing in return.

While I would like acknowledgement for some task I've performed well, I never want to be worshipped for it.

Expectations can soon turn to demands of "MORE MORE MORE" which can lead to pressure, stress and burnout if the person feels they need their own 'me time'. Just because a singer comes up with one great song, does it follow that they MUST always do as well with others?

When we think of the world of business the same scenario can emerge. In essence the successful person has to feel at ease with what they are doing and strike a balance between the source of success and their sources of stability which include relationships, hobbies and all things that are separate from that one talent, skill, or aptitude that has given rise to that success. People need to rest from their good works and need to ensure there is that balance.

It can be a very fuzzy fine line between dedication and obsession, between welcome adulation and disturbing and distressing demands imposed on by ourselves or by others. Without a balance there is a risk of people crashing or plummeting; of abandonment of the the very things that in the beginning made them happy and made them successful. It isn't something that is unique to the world of the famous either; doctors, managers, scientists, engineers; people from all walks of life can be susceptible to this pitfall.

How often have we seen the media berate a person for their work or behaviour deteriorating when the demands of the public and the media have not been continually met or satisfied? They root for them on the way up but are often scathing and feel betrayed if they ever disappoint. It's not a fair or nice thing to do to anyone. So yes, I fear excesses of success.

My solution
I am human, and therefore will err, will disappoint, will say 'enough, no more', will do things which are good for me and walk away from anything that I am uncomfortable with or find potentially harmful. Most of all I will reject ever being hoisted onto a pedestal as I see it as one of the loneliest places to be placed. I refuse to go there, but will continue to do what gives me pleasure for as long as it does so; welcome acknowledgement if it pleases others but never let it control or govern my life. We all have a choice in how much or how little we push ourselves or let others do so. We have a choice in how we respond to that too.

In a conversation this week I explained that if ever I was asked for my autograph I'd be tempted to say "what's wrong with yours?" We all have the potential for success, but it's wise to temper it with our most basic needs as human beings and never let go of that.

Sorry if this posting is a bit cryptic in places but I have decided not to reveal my personal dilemma yet because I'm simply not ready to in any detail.

Visions of opportunity

Vision Boards
Recently I produced a Vision Board for what I'd like to achieve artistically. The areas I excluded were writing and creative workshops. I like to write novels and plays and I'd like to deliver all manner of creative workshops all of which I've started but I've a long way to go. In the meantime I need the balance of regular work to be able to do these things so that I can afford materials for the materials for artworks but still have the time to do them. Striking a balance between work and private interests is important.

So I'm currently working on to producing a Vision Board for the broader picture of where I want to be in the future to include what sort of home, the type of social life and personal relationships I'd like to develop and the sort of career I want to aim for etc. Vision Boards are a way to focus our ideas, dreams and ambitions.

Rather like the Mindmaps we can scribble our thoughts down to help give us focus, the only difference is that they tend to involve gather pictures as a visual reference. The concept behind both is for them to bring to the front our our minds what is of most importance to our well-being. Vision Boards though, are specifically a starting point for what we ultimately want to achieve. By sticking them on a wall we can then set about devising the journey that could take us there. There is nothing to stop us deleting one target and replacing it with another at any point, and most will evolve that way as and when different things interest and inspire us.

So now we have the end goals on the wall to remind us of where we want to go, it becomes a question of how to achieve it. Quite simply for 99% of the population it involves taking things one step of the time. Vision Boards can become a means by which we assess the merit of taking something on e.g. if I was a person interested in a career involving cars I could sit down a list of the possible jobs that were connected with cars. The list might look like this:

• Mechanic
• Car Designer
• HGV driver
• Sales Rep
• JCB, Forklift or cherry picker operative
• Tank mechanic
• Racing driver
• Toy maker
• Administrator or Manager
• Photographer etc.

Determining on where my interest in cars is would help me to decide where to start and it would help me to aim for roles which provided the next opportunity toward that ultimate goal. This may alter due to the experience I gain. Then I'd look at the skills and experience I have and which I have enjoyed using the most and compare the two lists noting where the gaps are so that I could look for courses and experiences to fill them.

For each area of my life I would do the same. It's slightly trickier when it comes to a place to live or close relationships, but even there the exercise highlights what to be looking out for.

Aspirations are important to have as it provides us with a direction to head in. They need to be tempered with reality though as to where we are now and what opportunities are about, but without them I believe we are all in danger of stagnation and depression.

Finding Opportunities
In a training course I went on last year I tried out a new game to highlight opportunities to help increase people's motivation for finding them. I took a balloon and the idea was for the group to keep it from touching the ground and to see how long they could keep it up in the air. We counted the number of touches before it fell to the ground - 56!

The second time I said the balloon represented 'opportunity'. Like the balloon, opportunity doesn't stay in the same place, we can miss it, we can let it burst or fall. The score was 79 this time! For the second game though I told one person they could only touch the balloon if it came their way and they were not to move from the spot they were standing on. I told another person they could only touch the balloon if it was above shoulder height. Understandably they didn't get to touch the balloon nearly so often as the others in the group.

Both these people represented limiting the our possibilities. By only looking at possibilities of becoming a racing driver I would be missing other opportunities of working with cars; opportunities that could later lead to my becoming a racing driver. I would be preventing realizing my own dreams.

The point being, we need to move in the right circles to increase the chances of the right opportunities coming our way, we need to keep our eyes and options open to all possibilities if we are to stand a chance of fulfilling our dreams.

Good luck in achieving your goals and keep your eyes open as there are possibilities out there.