You Matter. World Suicide Prevention Day #WSPD15, #RUOK

I think few would disagree that suicidal thoughts are in themselves very frightening. However hard we may find it to live in this complicated world of wars, births, deaths, marriages, losses gains, progress, recession and so on, suicide is not something that we often discuss, at least not among my friends. Imagine, though, a person whose world has become so unbearable that it seems a release to consider letting go of all of the things that are making life seem impossible for a different choice – a choice where none of these struggles exist anymore, and where that person will be freed from expectations and constraints of life placed on him / her by others, or, most importantly, by him/herself.

I recently spoke to a group of senior leaders at work about resilience in my definition of the term. More to come on that in another post. During my talk, I mentioned how bad things had been last year and how things still were, quite often, very very bad for me with depression and anxiety invading and dictating various aspects of my life – what was possible and impossible. I told the group that at my lowest ebb I had not been suicidal, meaning I had not made plans to kill myself or set about putting those plans into practice. What had happened to me, though, was something very damaging: I had stopped wanting to live. I awoke each day with a heavy head as I looked out of the window at a world I no longer wanted to be part of. I felt a total failure, despite the promotions, the new job, the happy marriage, the friends I had. I felt awful. I felt I was awful, and that feeling this terrible way each day was my life sentence, a sentence I wanted to give up.

Nothing if not practical, I eventually realised that the tears every day before work and the panicked feeling that I couldn’t shake no matter how much exercise I did, sleep I got, reading or other distraction techniques I employed, the feelings of absolute hopelessness, were not going away, and that I had to do something about it. I chose to see my psychiatrist and explain how I felt. He made me fill out a questionnaire to assess the severity of my depression, and as I circled ‘very frequently’ against ‘feeling of not wanting to be alive’ I started to cry and cry, realising when I saw my self-assessment on paper just how bad things really were. I was dreadfully ill. I was living not even a half-life, even though from the outside every aspect of it was going well.

And this is how to interpret...

Mind puts it like this:

Mixed feelings
You may be very clear that you want to die – or you may simply not care if you live or die. However, for most people, suicidal thoughts are confusing. As much as you want to die, you may also want a solution to your difficulties. You may want others to understand how you feel and hope that they can help. Yet, you may not feel able to talk to anyone who offers to help. Having such mixed feelings and being unsure about what to do can cause great anxiety.

The latter description is more relevant to me – I just did not care whether I lived or died. But I did want a solution and I did want others to understand.

In hospital I met many other patients who were stuck and wading through the treacly mess of depressive thoughts. Looking into the treacle to try to find meaning, but seeing only blackness. Trying to get out of the treacle, but being sucked back into its sticky, strong mass that we had not the means to counterattack.

One patient who became my friend was very silent almost the entire time that I was there. Many more were like him. I was pretty well versed in the language of therapy and (no surprises here) had always been something of a talker, but others, particularly men but not exclusively, were so immersed in the terrible depths of their illnesses, so entrapped, that their mouths and gestures were glued shut and slowed by the treacle. And even if they opened their mouths to speak, many times they had no language to say what was going on.

You may be aware that more men commit suicide than women, by which I mean that more men succeed in the attempt. It is always dangerous to make generalisations, but the rates of suicide among men are rising over the past few years, whereas for women they have stayed broadly the same.  Wikipedia says: “The rate of nonlethal suicidal behavior is 40 to 60 percent higher in women than it is in men. This is due to the fact that more women are diagnosed as depressed than men, and also that depression is correlated with suicide attempts.”

The Guardian says: “The Adult Psychiatric Morbidity in England 2007 survey found that 19% of women had considered taking their own life. For men the figure was 14%. And women aren’t simply more likely to think about suicide – they are also more likely to act on the idea. The survey found that 7% of women and 4% of men had attempted suicide at some point in their lives. But of the 5,981 deaths by suicide in the UK in 2012, more than three quarters (4,590) were males“

As I have said before, I am not a doctor and have no qualifications in this field other than the benefit of my own lived experience.

I personally believe that we need to do more to support each other – whether we are struggling or not – to prevent ourselves and others potentially struggling to the extent that life ceases to be enjoyable. Even for me, while I may (may, no proof) be genetically predisposed to depression and therefore have life’s experiences + genes to thank for my seemingly effortless propensity to become depressed through various times in my life, life can be enjoyable and often is. I am so lucky that I have people who ask me ‘Are you okay?’ and really mean it.

The hardest thing for me about feeling so dreadful was the loneliness of it. And I talked about it as it was happening to my husband and my doctor, and still I felt alone. What must it be like to be someone who is experiencing these terrifying thoughts that a world without them in it would be a better reality than one with them?

We cannot move mountains to end all suicides today. But we can do little things to connect ourselves to one another and seek to invite connection from others, so that people feel that they are not alone, and that someone – a lot of someones, in fact – cares for them. We can ask each other how we are, not as a throw away ‘hello’ platitude, but as a real question expecting (and accepting) a real answer.

We can ask about each other’s lives and share something of our own, so that we make connections with each other. We can smile at the person we meet out running and wish them a good morning. That might be the only time that person sees a smile or hears that all day. Simple steps like these can be very powerful. And at the end of the day, we can say thank you to our work colleagues for what they have done for us. We can ask them what their evening or weekend plans are, and listen and share our own. We can thank our friends or partners for helping with dinner (whether ordering Domino’s or cooking a three course meal, whatever!).

By connecting ourselves with others and by sharing things about ourselves, especially if we are not having a good day and we feel we can say it aloud, we are inviting others to do the same. So when I next ask you how you are, or how things are, or if I ask, “Are you okay?” I promise: I really want to know the answer.

Thirty Five Candles. Celebrating, Not My Life, But Being Alive

Yes, THAT many candles

A year ago to the day I decided it might be a good idea for me to go into hospital for a while, because of my depression. I realised that my ability to cope with the day-to-day had become severely impaired, and that I had been more stressed than ecstatic to have my friends over to ‘celebrate’ my birthday (which is today, by the way.)

Me last year

The worst symptoms of my depression and anxiety were in full flow: I was trying to do everything possible to make everyone at my party have a good time. It had been a miserable failure of a plan, since the bouncy castle I’d organised for the fun of it and trip to the park with friends and their children all had to be called off on account of rain (just like most sports days I remember) and I was rushing around our flat instead, frantically getting drinks, food, conversations going and feeling my heart beat quicken and quicken in my chest.

Enough. Time to talk. Time to act. Time for the truth.

The final straw was when I had a wobbly moment with a good friend I thought I had offended. To a people pleaser like me, to please is the goal (a short term goal, because I believe I’m only as good as my next act of goodwill towards others) and to displease is catastrophe, causing internal combustion.

Ugh. Hate displeasing people. 

So, the next day, sitting on the sofa and tidying after the night of many drinks, laughter, conversation and lovely people, I quietly called the hospital where I see my psychiatrist and enquired about in patient care for the first time. I wasn’t a suicide risk, and I knew from past experience that my mental illness was not (is not, has never been) bad enough for me to be admitted under the NHS. I learned that there are usually beds available at the hospital. I learned I needed to speak to my insurer. I

learned that I could arrange the whole thing with relative ease. (Thank goodness. I was not well enough to do anything difficult.)

It was the first step towards admitting to myself that my depression (and anxiety, which I hadn’t even realised I had, despite running around like a headless chicken and running (literally) myself into a skinny nervous wreck of a person) had become so debilitating that work was becoming impossible, and social gatherings also a major challenge.

It’s pretty bad when you see your best friends around you and you feel utterly disconnected from them, and from the world you’re living in. Yes, I was smiling and laughing and passing around drinks, making conversations happen and passing the canapés, but all at top speed, almost as if to slow down and drink in how I genuinely felt would be as calamitous as a car smashing into me at top speed, obliterating my whole being into the mess of blood and cells and harmful thoughts that I was subconsciously aware were what made up ‘me’ at the time.

I didn’t know anyone who had ever been in hospital for mental illness, except a distant cousin’s mother of my mother, years ago, when that sort of condition meant a long term stay in the type of institution that can rarely be found anymore. I made that phone call to hospital because, practical as always, I wanted to know what my options were. I realised I couldn’t go on. It’s not ‘just the way life is’ to cry at spilled milk, spilled anything in fact, all the time, or at a lost book, a broken pencil, at the thought of getting off the sofa and walking to Marks and Spencer just across the road. It’s not normal, i.e. healthy, to dread going to work and to cry every morning about it because of the untouchable contractors who are ignoring you or bullying you with snide comments and belittling at every opportunity (well, it would be normal to dread going to work, but I would certainly say to anyone, don’t put up with it if it’s happening). I am a planner, I am practical, I am resourceful even in the face of damnable, draining and dreadful depression, and I suddenly realised that perhaps there was an option not to feel so terrible every day; not to wake up and wish that I had actually not woken up at all.

The steps on from there have been mostly documented in my posts over the last nine months or so. I have morphed into someone who not only accepts her depression as something acute and (currently) looking like it may be with me forever, despite best efforts to relieve the symptoms through medication, rest and cognitive behavioural therapy. I have also, in the last year, spoken out about it, and with every conversation (and I don’t have that many, I’m not one of those people who, when asked “How are you?” gives you a twenty minute account of the minutiae of having depression) I have felt a little more self-accepting, which is the biggie. Everyone else has been lovely. I have been hard on myself, as I always am. Do better. Do more. Do everything. Do it now.

Okay, okay, depression, I'll do it, I'll do it. Now please sod off out of here.

I’m still that person who wants to do it all, now, to perfection. I have my manic phases where my brain goes into overdrive trying to predict every possible outcome from every upcoming conversation or exchange to ensure that I have planned my behaviour to be ‘correct’ (and, really, what the hell does that mean?). If I am on a non-sedative night my legs will shake and shuffle around with restless leg syndrome that stops me from sleeping and my brain will kick in to that mode of restlessness, endless opening and closing its many filing cabinets to pull out all the items on my various to-do lists, work to be completed, meetings to be held, weight to lose, events to organise, friends to see. It’s exhausting. It’s impossible to maintain.

Take that, Depression (and, naturally, David Bowie)

That ‘me’ can’t last, so I’ve allowed some other characteristics to enter my personality: the ability to relax (okay only sometimes, but sometimes is a lot better than never); the ability to be honest about how I’m feeling, even at the risk (in my mind) that people will judge me for it and that I may never get promoted at work because I have an acute problem complicated by a catalogue of physical injuries.

You said it Cher.

But it’s worth accepting those risks, those potential, may never happen but possibly might risks, because I can’t live without changing into the ‘me’ that is sitting here, typing this on her thirty fifth birthday. I don’t know that I’d be typing anything, doing anything, if I hadn’t taken that risk and started being honest to myself and others about the fact that I do not have an unbreakable exterior shell. In fact I’m all eggshell, to be broken again and again and again.

Just because it's an awesome song. Nothing's gonna stop us!

When I blow out my candles today (and yes, of course there will be candles, because I do love birthdays even though celebrating the fact that I’m alive seems like a bad idea to me (sometimes) because I (sometimes) wish I were not) I will sit and acknowledge the past year. I’ve said ‘Here I am’ and then jumped off a cliff into the rocky seas of honest living. It’s terrifying and tricky and hard to stay afloat, and I will keep being bashed around by depression a while longer. But I made it, and if that doesn’t deserve a hot dog with all the trimmings, Champagne and a day where I celebrate being still here at all, then I don’t know what does. Happy birthday to me. Jessica, you made it. One foot in front of the other and maybe you’ll make it to 36. 

Me this year. Well, not quite, but time to dance!

Take Good Care. Being Cared For and Caring for Myself.

Caring in practice. A friendly hug is a wonderful thing

(Image copyright Jessica Florence)

I’m off on my travels again, this time to New York for a wedding and then after a brief stopover at home, on to Poland. As I’ve mentioned before in this blog, much of what I am trying to apply against my type is to be able to recognise when I need care and take whatever steps are necessary to provide it.

Find out more and pledge to contribute to caring in your own neighbourhood, here

This week is Carers' Week, so I've been thinking a lot about this topic. I'd like to honour all of my carers, the mental health professionals. Without all of these people and my beloved husband, family and friends I might not be here today to write this. I'm grateful to all who have taught new things about how to recognise negative thought patterns and how to try to apply these skills to troublesome times where all my unhelpful skills at over thinking, rumination and comparisonitis come into play with a fervour which could win awards. The fact is, we can't survive unless we care for each other.

However, for this blog, I would like to focus on two people – one I value above all others: my husband, and one I value much less and should probably attempt to value more: myself.

I’ve nearly been with my husband for ten years, and plan to post more about the fantastic ten years we have spent together. As with all relationships, we do of course have the occasional argument, about whether he should really be touching the kitchen knives given his propensity to cut himself badly by scarcely grazing the blade, or whether it’s really necessary to buy another book to add to our currently building-foundations-endangering collection…(No.)

Mat and me. Just two hamsters taking care of each other. In pots.

When we began to go out many years ago it was clear to me that this was a relationship unlike any other in my previous experience. We agreed since the start of principles of sharing bills and building a partnership. We both earned a similar amount when we started to see one another and wanted to build a relationship based on equality in sharing the restaurant bills, the cinema tickets, and over time, our living space from rented accommodation to our first bought house.

True love. Except Mat didn't have to wear the hat.

Probably for the best, he would have sat on it or something.

And even in our wedding (under sufferance!) my poor love forced himself through about a billion conversations with me about how our perfect day would truly be ours. He isn’t interested in clothes or shopping of any kind so to become involved in things such as wedding planning or even buying a new pair of jeans could not be farther from his interest level. A good book (or even a mediocre one), a nice cup of tea and a lovely piece of fudge would be his preference over any shopping-related activity.

I suppose our romance was something of a whirlwind after the initial total non-start (to be explained at length in another post to celebrate our 10 years together). We moved in together after 6 months and have been firmly by one another’s side ever since.

(Don't worry, I'm the one holding the flower in case 

Mat drops it and the poor butterfly gets hurt!)

At the beginning of our relationship I had just signed up to a tough intensive teaching and leadership programme which caused me a lot of stress, fatigue and money worries, as well as all of the amazing things that I experienced while working with some of the most brilliant students and excellent teachers and leaders. After only three months of dating, I was at the GP broken with tiredness and physical as well as mental symptoms across the board, such was my extreme struggle to keep going and maintain my job, do it well, maintain my (new, London) personal life and fit in some time now and again to live my new life in London.

Mat didn’t initially seem to understand (fully, at least) that I needed to take medication to continue to be able to function, work. He said he didn’t really agree with taking medication for depression, and initially had a hard time accepting it as something that required anything more than (every depressive’s least favourite phrase) “Pulling yourself together”. It was a real struggle at the time. I myself never wanted to be on medication for my depression. I preferred to not pollute my body with medication that had no guarantee of working, was still in the process of being developed. I also hated the fact that every single one did (and still does) give me ridiculous side effects that mean I take more pills to cope with them just to be able to keep taking the depression medicine. Ridiculous!

All that, and the fact that we were in the first stages of being together, where we hadn’t known with the wisdom of hindsight, but only in the first flush of true love – that he wouldn’t leave me realising that I was a difficult case…someone with difficult, heavy, unwieldy emotional baggage connected to (at times) acute mental illness. I think it would be fair to say that Mat didn’t understand depression the way that I did, because he had never experienced it to such a long degree, with so many bursts of down periods and my inability to get myself out of bed, take an interest in seeing museums or going on walks. I am so lucky that neither of us gave up on one another. I (as insecure as I was) knew how much I loved him and wanted to keep him at all costs; but the other part of me wanted to be honest In our relationship, and I knew that It was ever going to work out between us than I needed to be honest about an illness which I expected (and have been proved right) never really goes away forever, at least not in the last two decades.

Here we are, ten years (just a few days short) and counting. My lovely Mat has now had nearly ten years of experience living with me in my highs my lows, my delights and despairs, and my sloughs of despond. Many, many, sloughs of despond. (Which you would think would be attractive and interesting given the onomatopoeia of this phrase. It’s not. At all.) Because he understands depression and anxiety – at least from my point of view – he accepts that depression is a multi-faceted and complex illness; it doesn’t mean I can't get through a full week of work, see friends, run, walk, socialise (a bit, only at the moment but still…). He can make me laugh seconds after I’ve been in tears, and I can go and have a perfectly nice afternoon only to come home and need to retire because the whole social activity or the very act of going out has left me feeling totally defeated and exhausted.

So how does it work for us? I cannot express here in a single post how much Mat does for me. He makes every effort, in every area of our lives, to try to make my (at times) unbearable life worth carrying on. He loves doing things for me, and – I guess – that when he doesn’t love doing them, when he is actually wishing I could just be better or that this whole, boring and difficult stage of our lives could be over and I could be content, reading, writing, painting…shopping even…But he does carry on. He tells me here’s there and always will be.

Well all right then. I think I can make that work.

He emails me, tweets me, messages me pretty much every day while we’re both working, or if I’m at hospital appointments, to ask how I’m doing and send me things that cheers me up. When I can’t get out of bed he comes to see me, to kiss me and hug me and tell me, as I rest in bed shutting the rest of the world out, that there will be a better day to come and that I should accept that there are bad days, but they are not all bad.

In my darkest periods over my last few months I’ve stayed in bed many, many times all day. I’ve got up, showered, dressed and eaten, but just barely, from bed. I’ve cried after he has come home because I’ve been lonely and sick of myself. I’ve cried during social functions and we’ve had to beat a retreat or try to let Mat hold my hand and help me get through it. He notices. He holds my hand and looks at me without talking. He has told me again and again that he loves me and even though I find it hard to believe myself to be worthy of love quite often he persists. He seems to think I’m work it. And I am so grateful for this love which seems boundless.

I still quite believe it but I work on telling myself what he tells me, and get a little bit closer to believing in it, and recognising how amazing our life together is – despite the challenges I bring with my depression. He cooks, cleans the kitchen when I can’t, brings me flowers, buys me glasses of Prosecco and mini burgers or hot dogs because I adore them. HE truly is the most wonderful person in the word, and the fact that I spend every single day unsure of how I will feel is a massive burden on him to cope with all my mood changes, free-flowing tears without warning. (Especially in restaurants lately. Yes, I've become a restaurant crier.) And repetition of how bloody hopeless the whole thing is, and how I can’t go on (or don’t want to) and more.

Beware friends. I now do this ALL THE TIME. 

Don't say I didn't warn you when I start blubbing over the bruschetta.

Now in return I do things for Mat – because we are still very much a partnership. I’ll buy takeaway for us and take us out regularly to say thank you to him; I’ll paint and write him little cards, give him the sugary treats I know he loves (M&S ginger men and any kind of hand-made fudge are particular favourites), And I tell him that I love him but I would understand if he would leave. And he stays. It’s a miracle to me that he does.

The second topic I wanted to cover here is caring for myself (or self-care as we in the mental health area often call it). When it comes to this my ability to provide appropriate self-care for myself, for someone who has unrelenting high standards I’d say I perform pretty awfully in this respect. The fact is, that we are all responsible (as far as we can) for looking after ourselves and making sure that we can exist and survive adequately, and – if we’re lucky – happily.  

"Who me? I need to care about myself too? I totally forgot about that."

The fundamentals of what I should be doing for my self-care are to keep myself fed, clothed, clean and get enough sleep to function. Largely I manage to do these things, simple as they may appear. On terrible days I will often (now, as I become more self-accepting) call an achievement something like getting up, showering, washing and drying my hair. Those small acts on terrible days where I am drained, tearful, and devoid of hope might exhaust me, so the right thing to do for myself at that point might go to bed and rest some more – distract myself from my wretched thoughts with sleep, reading, watching Netflix box sets (particular ones…probably another post to come about what I can and can’t watch at these times).

Eat and sleep as well as you can. 

I find drinking fresh juices helps to reduce my anxieties.

If I can do it I care for myself by creating a nice space to be in – fresh bedclothes, fresh air, walks, cleaning the house (which is good exercise and good for the process of seeing things become clean and tidy when I long for order from my disordered, hectic and unrelenting mind.

There are other more complicated steps I know I have to keep practising (in both senses of the word) to take care of myself. I’ve learned (and continued to learn) to be more honest about my health on a day to day basis both with my husband, whose care and love I cherish above all else, with my work colleagues, with my mental health support professionals, and to a degree (using the assertiveness techniques I’ve learned) with everyone I meet.

For me, working towards self-care is not trying to make everyone like me (which I usually do). Not trying to make it my role to be the heart and soul of the party, exhausting myself (and probably everyone else) in the process so that everyone ‘has a good time) and I’ve clearly made an effort to be a good party attendee. It’s also about not telling myself off every second, well, second about something I’ve done that’s not been right in the past – like the time I shouted at Mat when I shouldn’t have, or the time I drank too much wine and fell asleep on the sofa at a guest’s house, drunk. If an elephant never forgets then I sure hope that particular species of pachyderm doesn’t have a propensity for depression, because my memory is never as razor sharp in its accuracy when I’m remember and flagellating myself for past wrongs. If there were awards for self-loathing and self-reproach, I feel sure I’d be a contender for the top spot.

Every day I just care for myself as best as I can, and some days I’m better at it than others. Mat helps me – every day - and I am so lucky to have him in my life in the first place, on top of which he is the most loving and giving soul to this mixed up, messy woman. And I want to care for myself because I’m working towards feeling like I deserve it – because I know I would always tell a friend or loved one that they were. You are worth caring about. You are worth caring for. You are special and even if it’s hard to see it, you have a place in this world. I will try to read this post again so I can remind myself that what I would tell others probably applies to me to. Till next time, please all take CARE. x