Guest Post: Juggling - the Fine Line Between Working & Mental Health

I am so pleased to welcome +Claire Robinson-Ayres (BrizzleLass)  to my blog for the first ever guest post! 

http://brizzlelass.co.uk/

Claire writes about her experiences working alongside life-long mental illness, with an eventual diagnosis of bipolar. When I read this I am reminded of how strong, resourceful and creative many sufferers of mental illness are. Even though her health makes working extremely hard, Claire still holds on to her ambition and drive. Thank you Claire, for this inspiring story. +BrizzleLass Blog 

I first started showing signs of problems with my mental health as a young child, when I was diagnosed with depression and emotional instability at just nine years old. Being part of the mental health system was nothing new to me, and if anything it made me all the more determined to be 'normal' and to show everyone I could be successful and I did, to the detriment of my mental health.

I was diagnosed with bipolar disorder when I was 25, by which time I had forged a career in marketing within professional services, most prominently in the legal sector. I worked hard at my career while juggling my illness for several years. In the end I left professional services as it was far too stressful and worked part time in online marketing; but even that wasn't enough to stop my illness taking over, especially when a mystery physical problem appeared which took a few years for doctors to diagnose and resolve.

I was forced out of my job in 2013

After being forced out of my job in 2013 I decided to set up as self-employed and start managing my workload more effectively. I had some great contacts from my 15 years of experience. I started contacting people, and the work slowly started coming in. I managed to get enough work to keep me busy 2-3 days a week, which was just what I had hoped for.

I had a great rapport with my clients and they appreciated having someone who understood social media algorithms and could put together plans to utilise their marketing budgets effectively. I spent my time writing social media posts, blogs, rewriting blog content, sorting out SEO, and generally doing the kind of marketing I really enjoy. I made my clients happy, made them money and all was good.

Then hypomania started, I went from working 2-3 days a week to working 18-20 hours a day, seven days a week. Now for a start I didn't have near enough work for this, but I managed to do it anyway, I would sit at my kitchen table, bent over my laptop working like my life depended on it, I would just be typing away, correcting things, rewriting posts, pages, changing spreadsheets, reformatting invoices. You name it I found it to do. 

This spectacular demonstration of hypomanic obsession went on for four months, at which time I crashed into the deepest depression I've ever been in. In my entire life, through all the depressions I've ever known nothing has been like this. In the space of a week my business folded and I was bankrupt.

As if that wasn't bad enough I tried to take my life for the first of six times that year, I was at the beginning of what was to become the year from hell and it was only April! Later I joked that at least I lined my breakdown up with the financial year for HMRC!

I went from always being the person who worked, and found a way through to having no job, no business, no savings, no money. For the first time in my life I had to turn to DWP; it was the most humiliating process of my life (and bankruptcy was very humiliating)! I've been on these benefits just over a year now and to this day I hate them, I feel sad that my life reached a point where I became that sick. 

I work really hard with the team that helps with my mental health care, and I have a clear goal of being able to work again in the future. But I also need to reach a point where I am stable. This is something I have never been and it is an issue my mental health team are helping me deal with. Between medication and therapy we will get there.

I'm not good at doing the 'sick' thing though. I can't just fill my days with nothingness. I'm a born worker-bee. So I started blogging again. I now write about mental health, I'm trying to be an advocate, to speak out and encourage others to. The more people speak of their experiences honestly the less 'hidden' it will be.

I also review books: reading gives my mind peace; it calms the 'voices' I hear and regardless of whether I'm depressed or manic I get some time out. Writing is also very therapeutic to me so finding different ways to write has helped immensely.

"I also review books: reading gives my mind peace"

I have a daily to-do list, which contains all the daily basics for when I'm depressed and struggle to even get out of bed, so an achievement will be ticking off things such as: shower, eat breakfast, make lunch, clean teeth, go outside. On more normal days, the idea is to do more interesting things on the list like writing, or walking, making sure housework is done. When I'm hypomanic I need to make sure I don't go overboard and so must do no more than is on that list. For example, I have a tendency to go out for a short walk and come home 5 hours later so I will set a timer and that will tell me to turn and go home regardless of how much I want to continue!

My life hasn't quite turned out how I planned: I thought I would be a company director by now. But that wasn't meant to be. Instead I've discovered I'm immensely creative. Words come to me when I start writing and I'm using that gift to raise awareness. I will go back to work but what I will do exactly I don't know.

I do know that I won't let Bipolar beat me!

Please do come and follow me at my blog BrizzleLass.co.uk, on Twitter @BrizzleLass, or on Facebook see BrizzleLass Blog.

R-E-S-P-E-C-T Let's Talk About Mental Health - Comfortably

I cannot believe it has only been five days since I wrote my manic Monday post. I am feeling distinctly odd after three consecutive nights of very little sleep at all, trouble even with getting to sleep, as well as my old favourite - trouble staying asleep - which is my biggest problem.

I expect attending the judging panel for @womenoffuture (Women of the Future awards) this morning did not induce additional drowsiness! I was so excited to have the opportunity to talk about mental health and the need to end the stigma around this widely experienced and more widely misunderstood category of illnesses. I also felt tremendously grateful to be in a position to speak about it: mental health for me is one of our most critical health issues in this country and globally.

It continues to become more and more apparent that mental illness does not discriminate. Speaking today to the judges I remarked upon this. There is not one group of people I can think of - whether we think about gender, age, ethnicity, sexual orientation, nationality, lifestyle, or life, in fact - where mental illness is not present. We may have 1 in 4 people with a mental illness in the UK, but that means that so very many more people are affected by their connections to those 1 in 4. Let's think of the mothers and fathers, the wives and husbands, the children, friends, work colleagues, medical professionals and strangers who are interacting every day with those 1 in 4. We are living in a world of tremendous pressure and challenge. I would be very surprised if many people at all were completely free of connection to someone with a mental illness (themselves or others).

The paradox is that while mental illness is everywhere, silence about it is also everywhere more often than not. We still do not talk about mental health comfortably. I try to, with my known background in this area serving as an "easy chair" to slide into for this discussion, but others who are speaking of their illnesses or struggles for the first time cannot gauge the reaction of others as there are so few precedents; cannot guarantee that when they take that huge step, that leap, risking so much, while so ill, to be honest about a part of them that is unwell and needs support, that they will get that support. They might not even receive acknowledgement, let alone respect and help.

The judges asked me what I would do if I won - what I thought needed to happen - to improve things. For me, it isn't about providing support mechanisms in the work place or better NHS care (although both of these things are absolutely critical and the latter is in dire need of help, with so many people excluded from care as they do not qualify for treatment based on basic statistics. For example, did you know that if you had an eating disorder and presented with a BMI of 17.1 (i.e. .9 points below the lowest 'healthy' weight for a height of about 5'5") that you would be turned away from A&E (the ER) and asked to return when your BMI had dropped further. You would not be deemed sick enough to receive care. "Please lose more weight." = "Please get sicker, and then maybe we can help you.") 

This is what I said needed to happen, and what my focus for the next three years will be: "We need to make it normal for people to talk about their mental health." 

Why did I say this? 

Imagine if you had a very unpleasant spot on your face. You can use concealer to hide it, sure, but at the end of the day, you're very aware of a throbbing, red, sore, mass on your face that you know you'd far rather would disappear, and you're pretty sure everyone has noticed. But if you tell people about it, you're more likely to get empathy and shared stories (and recommendations of nuclear strength Clearasil), as well as perhaps the odd puerile cry of "That's gross" than have people fall silent, look down, say "Oh," and nothing more. Say nothing. Walk away.

Imagine if you could walk into the office, and on the second (or third) round of 'How are you?'s (because we know that the first is a saying hello, and the second might be a reflex action from the first) that you could say, "I'm feeling quite anxious today, so I didn't sleep that well" or "I'm feeling quite unwell mentally. I think I need to take it a bit easy today to try to prevent things getting worse." The latter statement makes perfect sense to me: you're not feeling well, and you've got to work / go to school / attend your child's school play / go and run errands. Therefore you see how you can reduce your 'to-do' list for the day so that hopefully those sniffles or early symptoms don't turn into flu (or, worse, man flu. Hor.ror.). And so your sick feeling isn't exacerbated by excessive travel. 

Why is it, then, that we so rarely hear people say anything about their mental health? Why is 'presenteeism' (which is where people show up to work with a mental illness (or any other kind of illness) but pretend that they're fine when really they are not and probably shouldn't be at work) so prevalent in our world? Why do you so rarely hear people say that they are off sick "because of depression", rather than because of a cold, flu (man flu!), food poisoning, tonsilitis, etc? 

I think the answer is, because hardly anyone says that. Still.

People don't say "I'm feeling depressed today" / "I'm feeling manic today and can't concentrate" / "I need to sleep today because my anxiety kept me up all night". People don't say it, so people aren't used to hearing it spoken of. And so people assume they can't say it themselves. They assume it's not an acceptable statement to make, and not a "good enough" reason to be absent from work.

We do - desperately- need to help people get the support that they need, but if they can't talk about it in the first place the likely outcome is that they won't seek help. They won't feel it's important/ a valid illness. And before that, they will not feel they can even mention it. 

We know that men struggle more than women to even voice struggles with stress, anxiety, depression and so on. And not talking about this can be - literally - deadly. The number one cause of death among men aged 20-34 is suicide. And this could so often have been prevented by better comfort levels for saying: "I feel very anxious." "I need help." "I am not okay." 

Gender / other factors aside, the bottom line is that people really feel they cannot talk about their struggles with mental health (even with stress). They feel ashamed, weak, less than. Like they mean nothing. 

This is so wrong. We all matter and we all deserve respect, courtesy, kindness and care - for ourselves and others. If we could change this situation and make talking about our mental health as easy as discussing a nasty spot or, say, a broken arm, shingles, or flu, this would mean that our serious and debilitating illnesses would not be worsened by the massive shame we would associate with having them. I personally have berated myself, hated myself, shamed myself and been disgusted with myself for being ill with depression. Why? Why is my illness so shameful? 

It isn't.

If I had not been so ashamed I firmly believe I would never have become so ill. I know that because being honest with my team is the same as making me feel instantly lighter. I haven't had to pretend I'm fine when I'm not, which in the past twenty years at school, university, in my jobs to date, I have done, and which has made me feel more ill: not just sick, but sickened by myself, by my sickness.

So that is where I would start. With more conversations until mental health conversations are "normal". Until people feel they can say, "Today I'm depressed." "Today I'm anxious." "I need help please." "I need to take a day or two off." And I can't wait to get that conversation going again any chance I get, and definitely at the Women of the Future summit in October. In the meantime, let's talk about mental illness and mental health. We all have mental health. Let's make it easier to make time to talk about it. Please help by starting your own conversations.

Short Post - Shortlisted for Women of the Future Award 2015

It is such an honour to be shortlisted for a Women of the Future award - thank you

I'm surprised, delighted and somewhat speechless and overwhelmed to announce that I've been shortlisted for a Women of the Future award in the category for Community Spirits. Congratulations to all the other women who are shortlisted with me and for the amazing work that they do.

You can read the full nomination listings here

This comes a few days after it was announced that I am also now named as 1/30 Inspirational City Women Champions of Diversity by Brummell magazine.

You can read all the 30 listed women's profiles here

Being recognised by both of these organisations / publications is a tremendous honour. A year ago I still wasn't being fully open about my mental health because I was terribly afraid of the stigma I might receive from others, as I had experienced in the past. I still see that stigma and experience it both personally and through the accounts others share with me. But now I talk about it. I won't accept it. I speak out and up and will keep speaking until this stops.

I support @mindcharity and @timetochange 

as a media volunteer, a campaigner, a runner and more.

Please read more about the work of these two amazing charities here: 

Mind and Time to Change

This stigma has to end. Mental illness is a killer and not being able to talk about it makes it worse. If you can start a conversation in your work place, your family, with your friends or with someone on the bus where we talk about being more accepting, understanding and kind to each other, whatever our differences are, whatever illness or disability we may have, we can make this conversation part of a bigger national and international discussion where we can highlight the dreadful stigma around mental illness and  - together - end it once and for all. I represent a person who is living with a mental illness but I am living with it. I am not a psycho, a nutter, a mental case, a head case. I am not a #headclutcher. I have an illness and I need respect for that. And then I need respect to get on with my life as I choose to. And one of the things I choose is to speak up for others suffering with mental illness (and stigma) who do not feel they want to or are able to speak for themselves.

Read more here about @Rethink_ and this statistic

I hope you will join me and have a conversation about this today, tomorrow, or someday soon. #MentalHealthMatters. We all have it, and we need to look after it. Our own and others'.

Thank you for supporting my blog where I will continue to share my story and perspectives on what mental illness is really like. And thank you to @womenoffuture and @BrummellMag for recognising me. I am overwhelmed, delighted and inspired. I hope it will help to bring more people into the conversations we need to have about #MentalIllness and the actions we need to take to change how we care for mentally ill people - the millions within our country struggling and surviving (or not surviving) - better.

Thank you.

Just Another Manic Monday: Lists of Then and Now to Fight My Anxiety and Depression

At the weekend I planned to write a piece on authenticity. As a business woman I am exploring what this means. We all have our work personas, and our others. One of the most interesting things I've read is that we can change - we won't stay the same and shouldn't expect other people to either. It's part of our evolution. That's why we do performance development and change management. Because we need to change. However, one thing that isn't going to change is my list making...(see below!)

I don't believe we have to show everything to be 'authentic', but at the same time, being able to be honest about the part of me that has depression and anxiety.

Today I'm feeling really unwell, so this is what I can do. I'm hoping to write more on authenticity - especially in business. For now, here is a blog about how I've made changes to try and combat Monday morning anxiety.

Five years ago, if you asked me what Sunday night looked like, I'd say this:

Just to avoid misinterpretation, no, dear reader, I am not George Clooney.

1. I would pack my suitcase for the week ahead, make a note of all the things I needed to remember to do (that I hadn't remembered to make a note of on Friday)
2. I'd look forward to a cold, crisp glass of sherry and a delicious Sunday dinner.
3. I knew I probably wouldn't sleep well because I'd be thinking of all the activities ahead of me (which despite taking careful note of, were whirring around my little head like a carousel whirring and blurring at 100 MPH).
4. I'd be aware of the earlier-than-normal time I needed to wake up to ensure I got the train to wherever work was taking me, and this would mean my sleep would be broken - I'd wake up half a dozen times to watch the clock, even though I would have set an alarm.
5. I might have dreams about work - often - and I might think of new things to add to that to do list. All in all, I'd have a fairly rough start to the week, which I'd treat with a bottle of diet coke (or two), a fair breakfast bought at the station and a blurry Monday trying to get through various meetings whilst not falling asleep or seeming manic because of the amount of caffeine I'd consumed to make Monday working even a possibility.

Overcaffeinated? Yep.

What has changed? It's Monday morning.  I woke up feeling horrific, but now I know that I can employ various things to try to ease this and help me get through the day.

I feel terribly anxious after a nightmare-filled broken night of sleep where I dreamed of a wider to-do list including both life things (like trying to sell the house, tidy the flat, clean, and a long list of work activities). This means that I'm feeling physically sick, with bile present in my chest and rising in my throat.

There is nothing I can do about that, or my bad dreams if I've practised healthy behaviours before bed. Here are my best behaviours. I try to do these every day.

1. I go to bed in time to be awake for a decent amount of time getting comfortable in bed and 'finishing' the day in my head. 
2. I drink water with my tablets and only drink water (and plenty of it) after bed and beforehand. I don't drink any caffeine at all but I used to not drink any after 2pm
3. I read something that is not too challenging and not upsetting before bed on my Kindle, on the lowest possible light setting that I can manage during the dark. I find that looking at my ipad or iphone before bed can disturb my brain with the backlighting and make it harder for me to get to sleep.
4. I put on a programme to listen to before sleep which my brain will focus on (meaning not on the 1000 alternatives possible) and this concentration relaxes my brain and usually is the magic silver bullet to make me go the f*** to sleep.

You can buy this excellent book here.

Having done these last night, I'm feeling just as tired as I would have been five years ago, and have a list in front of me that I'm crossing things off from. A list is helpful to me for these reasons:

1. It helps me to realise that it's unlikely I've forgotten something, and stops my mind from racing around trying to repeat the things I have to do the next day / in general again and again. 
2. When I cross things off (even if it's just writing an email) I feel like I'm making progress and it makes me feel more in control. (And yes, I am one of those people who even puts things already achieved onto that list...it's good to remember that you've achieved something already!)
3. I can build on it throughout the week and decide to allocate some of the items to other later days depending on how my health is.

On the other hand, I didn't have anything to drink on Sunday night (or at any time on Sunday in fact); I didn't have a suitcase to pack because currently I don't have to work on client work away from home, because of the project types I'm working on. I didn't eat a Sunday roast.

I went to bed at around 6-7pm because I wasn't feeling at all well. I also now have a host of drugs to try to help my depression and anxiety and the medication that I take to allow me to take that medication, that is, to help with side effects of insomnia, restless leg syndrome and, yes, anxiety.

What else do I do to make myself feel better? There are quite a few things that I know can work (even though they don't always). Here is a view of what I do to try to combat anxiety and depression and allow myself to work and get through the week ahead. Let's start with work things:

1. I decide to work from home (or I give myself the option to do this). I know this is not possible for everyone, and I feel that my current employer KPMG is absolutely essential to allowing me to do look after myself when I'm feeling really unwell. For some of the #selfcare activities I'll need to do, working from home for me is - today and on many other days - the difference between being able to work and having to take the day off sick. I'd much rather work if possible, especially because I enjoy my work and work is a welcome distraction from feelings of depression and the ruminating / worrying voices in my head, so, for me, this is the best possible outcome.
2. I make the list (hahaha, now you know I make lists!) (see above) both for work and for my non-work activities. It's really important to me that I set up my teams for success and that I set myself up for success (in spite of mental illness) by making a plan which I can put in place to support everyone I work with through the week, and enable me to be useful, work effectively, and not hold people or projects back (which would make me feel worse).
3. I am open with my colleagues about how I'm feeling. Today, for example, I can't take phone call after phone call as the constant contact might increase my anxiety levels, so I've made some calls and rescheduled others for tomorrow, ensuring we still make progress but not to the detriment of my health.
4. I arrange some critical meetings face to face for tomorrow, so that I can prepare for useful meetings on one day, in a reasonable (2/3 day) space of time to give me breaks to sit alone, quietly and have food and water between these. I need breaks to enable me to keep going.
5. I use technology (which is my business anyway!) to help myself to stay connected with colleagues and support them: Skype for Business (which allows desktop sharing and collaboration on group calls between India, USA...the world). I can review many of my fab team's work products through our online document storage options and lots more. It's good for my mental health if I can stay in touch with everyone - stay connected - and feel a part of my team even if I'm not well enough to go into the office.

And on the non-work front, here are the things that I have done (and do) to try to help myself feel as well as I can:

1. I get up and go for a run. My energy levels are better in the morning and if I manage to complete a run then, that's the best chance I'll be able to do exercise because after a day of work I'll be shattered.
2. I don't drink caffeine of any kind except very, very rarely (I've had 6 diet cokes this year). Caffeine can have an impact on my medication and make me high / then low after the post-caffeine crash. It's a mood altering drug so I'm avoiding it to try to give my medication the best change of working. This might mean I am more tired than normal in the day, so if I am shattered, I build in breaks (as above). 
3. I make myself (or buy) juice from breakfast (beetroot, carrot, apple and ginger). More from the Mayo clinic on anti-anxiety nutrition guidelines here. 
4. I drink plenty of water all the time. It's great that I don't like coffee, tea etc. but I do miss diet coke. I love the no added sugar fizzy drinks from Marks and Spencer and I certainly am not a perfect diet person - it's just some things I can do, but I'm not a paragon of nutritional virtue - far from it.
5. I eat nutritious food, but also nice food. Crisps are a non-negotiable. I also can't give up bread. I. Love. Bread. And I will eat cookies too. Refined sugar might not be the best thing, but it tastes nice.

It's only 12.03 and I've got a lot more hours to get through. So here goes. But I hope for anyone reading this and wondering how they're going to get through the next few hours. Me too.