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.

Marvellous Medicine? What is Private Hospital Care for Depression like?My Week.

It’s the end of my week off, hospital done and back to work next week.

Tomorrow I’ll be writing another #dayinthelifeMH post, and adding it to others’ contributions, but in this post I’m reflecting on my experience of taking time out for my depression (as I knew I needed to), seeking treatment for it, and going back to normality (whatever that means – I guess work and living) afterwards.

"Okay, I need help, time to take the mask off for a while and deal with this."

My experience of hospital is of private treatment for mental health patients with a variety of conditions, and it’s private because I am incredibly fortunate to be able to work for a company which provides, as a benefit, private health insurance. I can’t talk about public healthcare for mental health as I’ve never had it (see previous post for more details). What my private mental health coverage means is I have a psychiatrist and a one-to-one therapist I see, and in-patient or day-patient treatment which I can also make use of – depending on the severity of my depression at a given point, and also a fair amount of paper work which my psychiatrist, therapist, key worker (another therapist with whom I make appropriate treatment plans) and others complete to make the case to the insurance company that I should get approval for the treatment we believe I need.

Thanks very much, I'll take all that money from you right now...I need treatment

I knew that I’d be struggling after last weekend and a variety of external matters contributing to my worsening depression, so I took the step to see my psychiatrist beforehand and ask for the paper work to be submitted requesting day care at hospital for a couple of weeks (because it’s always easier to ask for more upfront than go back and ask for more later). Luckily my case was accepted and covered by my insurer. It’s not possible for me to pay for it privately, even on what I know is a really good salary. It’s just too expensive – something like £500-700/day, which, to be honest, if I were well I’d far rather splash out on a new pair of gorgeous Louboutin shoes as a massive extravagance (and a one off, not 5 pairs in a week, although if I ever win the lottery…).

Shoes fit for any Superheroine

The fact is that I might be able to pay for just one day of care at this amount, but I just wouldn't be able to pay for more, without going into debt. Money worries have always been a contributing factor to my anxiety and depression; when teaching I couldn't afford to feed myself without using my credit card (on £17K/year with London rents and prices) and I longed for a day when I would be able to pay my bills and eat, and socialise, without getting further and further into debt. Now that time has come, I feel physically sick at the thought of going back to that place. I cannot go back there. It would certainly worsen my health – probably both physically and mentally, as I know they’re connected (and I describe below).

When Depression Debbie comes calling, she's packs a punch.

Anyway, to hospital. My experience of private day care (as opposed to inpatient care, where I would stay in hospital) is to travel to hospital from home and to attend a number of groups every day which aim to educate and support people like me going through a difficult period of mental illness, whether that be depression, anxiety, PTSD, bipolar, borderline personality disorder. I attend groups which my keyworker and I determine will best suit my needs.

Time for support group. Let's share our troubles and support one another.

The first group of the day is support group, where I and other day patients sit in a confidential environment to share how we are feeling, what issues we’re struggling with that day and what we think we will do about them. We have to go around the room to introduce ourselves and ‘check in’ with our state of mind and feelings. This is helpful since many people are ‘new’ to the group each day. This really all comes down to insurance – if you’re covered for a particular day you turn up that day but not on days when you’re not covered. In the last week I met at least twenty people I had never seen before (and a couple I already knew). We are all taking what we can get. The people I met varied every day, so there’s always something new to talk about.

Time to fight our illnesses together. Pow!

In the hospital environment, the support group is guided by a therapist – in our case the therapy manager – and this helps us to dig a bit deeper with the problems that we’re overcoming, whether our illnesses have been triggered by a family matter, work, other pressures or a mixture of all of these. I love support groups because I don’t have to take notes or apply particular therapeutic techniques, but sharing with others is a kind of release, and hearing and participating in group discussions about issues often help me to unpick some of my own personal struggles and find that I am not alone or that I have new options I had not previously recognised.

Hello Demon Difficulties. Please go away.

The other groups are harder. This week I attended a schema group, which educates us as to our core needs as “newborns”, and how our core needs (whether met, overly met or not met) lead us to ‘maladaptive’ coping strategies – i.e. things that we do to compensate for whatever our upbringing and childhood environment was like. For me there’s a lot to learn about the way that I behave now as an adult which links back to being bullied as a child and feeling isolated. It is fascinating and useful, but it is also very hard to think back to those times where I was in so much pain and had no means of understanding or coping with the situations into which I was placed. You can make friends at hospital - because you may bond with others. It's a matter of choice, though, because if you do make friends you often talk more and more about your and their struggles, making the experience more intense and potentially tougher.

Memory Lane. Tough as nails and stronger than steel. And ever growing.

Other groups look at cognitive behavioural techniques (conscious recognition and rational working through) for anxiety, depression, and other important areas like anger management and assertiveness. Practising recognising our negative feelings and the ways that we automatically respond to them, and hearing how to apply different thinking patterns to try to retrain ourselves is what we do in this group.

I can see you, negative thoughts. I'm ready to fight.

For example, if I text a friend and don’t receive a text back, the lonely and isolated, bullied child in me might apply an automatic response, linked to our old ‘fight or flight’ mechanism. I don’t receive a reply = I’m somehow in danger of getting hurt here; = My friend doesn’t like me anymore; = I’ve done something wrong… and so I start to become anxious because of these worries and start becoming  depressed as I wrack my brain for potential incidents in the past where my behaviour might have caused the person to dislike me. (The first – worry – leads to a build-up in anxiety, as the physical symptoms like a racing heart, feeling sick, feeling dizzy may strike in addition to the ‘cognitions’ or thoughts that I described above leading to the feelings – shame, guilt, fear, etc. The second – rumination – leads to increased depression and may include some of the physical symptoms above, but also add sluggishness, a feeling that one is hopeless, a failure (more shame, more guilt, anger at self and others, fear of never getting better.)

In this case, 'A' is very much for 'Anxiety'

When I read the above and tell you that attending these groups leaves me feeling exhausted, I hope that you are not surprised. It’s quite hard for me (and I think it’s hard for others) to acknowledge in the first place that I need help of this level. Unfortunately the part where I get help is far from easy, as I look to past events and their effect on my feelings and depression, and I have to recognise them and confront them in order to start working through those feelings and events to feel better.

I went through this on Tuesday, Wednesday and Thursday, always attending the support group first thing, and following this with other groups. By the end of each day I am drained and sad, probably sadder than I was when I arrived, because it is hard to go through things from the past. However, the alternative – not to go through those things – not to challenge my past and my negative thinking – not to address the deep depression that is overwhelming me – is not to live. And since I choose to live, I choose to get help, even though it’s hard and afterwards I curl up in my bed under the duvet, with pillows all around me, and I tune out with Netflix or my Kindle, or with a radio programme, and perhaps go to sleep for a while.

Support group. Where we share and sometimes laugh together. 

It's good to know I'm not alone.

I took Friday as my last day before returning to work. I didn't go to hospital because I wanted some time to do more tuning out and re-acquaint myself with the land of the living, thinking a bit about work, doing some food shopping, posting some parcels, paying bills and so on. I also spent a good deal of time cleaning (which is surprisingly therapeutic as a physical activity that allows me tune out) and resting in bed with a book. It's also just good not to think about myself in such a focused way - not to work on myself anymore. It's a relief to stop that and necessary in order to dip into a week of treatment and then return to work immediately. For me, Friday was the opportunity to start back into life and lead into the weekend with rest, and with those sad, terrible thoughts not exactly put away, but left for a while to get some air and be revisited in a smaller way at a later date.

And time for sleep while that works away...

I now feel like I’m ready to work again, and I feel rested, and heard. On Tuesday I felt hopeless; on Wednesday more so; on Thursday tired by the whole thing, and on Friday relieved to be away from all that difficulty, but able to recognise its value. I could see the sun and smile quietly at it. I could walk and appreciate the wind (and drizzle!) on my face and be in the world without anger or self-hatred. It’s a step forward. I will keep stepping forward. 

Time to step forward.  And put my head band and shield back on. Obviously.

Help, I Need Somebody, Help, Not Just Anybody...Or Any Drug...I Just Need Help...

I've said it before and I am sure I’ll say it again, after I say it here: recognising that you need help when you have depression, and trying to understand to what extent you need help, is incredibly hard.

I wake up most days and sort of mentally poke at myself: “How do you feel today?” “What’s you mood?” “Do you feel depressed?” “Do you feel okay?” “How do you feel about the day ahead?” “What’s your anxiety level?” As I lie there for those first couple of minutes after waking there are usually two different general responses to this: either I feel totally anxious and un-rested after (another) eight hours or more of nightmares, usually connected to the traumas I've recently experienced, or experienced in the past, or I feel okay. 

For two minutes. And then after those two minutes are up, I get to know exactly how I feel, really. My heart can start to sink; my stomach can curdle and recoil inside me with fear or unrest; my head can feel empty or too full, or both. My limbs feel sluggish and exhausted. My heart might start to race and I might start to feel sick at the thought of the day ahead, even if it’s just thinking about having a shower or eating breakfast.

If only it were that simple!

Mondays are the hardest because there are five whole days to get through before the weekend. And it’s not even as if I like the weekend, or find it easier to cope with. Sometimes the thought of seeing friends and putting on makeup and a happy (or vaguely happy) (or just not crying my eyes out and scaring everyone!) is too much to take, and the anxiety that I experience at the thought of this is almost enough for me not to go.

But as always, with all of the above, in 99% of cases I make myself go through with it. I know that I’m supposed to be brave and I’m supposed to get on with things, using all of the cognitive behavioural strategies that I've learned to support myself with. And I have my medication too (even though the anti depressants make my legs shake so badly that even with a sedative I can find it hard to sleep because they won’t stop moving).

Today I’m at hospital about to get help because I realised a couple of weeks ago that I was struggling again and that issues I was facing were escalating and bringing out the worst (or the best, if I look at this from the perspective of my fabulous type A personality) in me. I am going to go to groups that will help me look at my anxiety and depression and try to reinforce all those practical strategies I know I can apply when times are tough.

The day begins with group support, where we all have to name the emotions that we are feeling. Today I feel sad, angry – both at being here and needing to be here - and at the external issues that have helped bring me here again. We all speak our feelings. Usually it’s hard for some people because depression can leave you totally numb, so that the ability to experience any feeling seems untouchable, and incomprehensible. To be able to feel – it’s some cloudy far away concept – it doesn't mean anything.

Sometimes hope feels just like 'tomorrow'...something that never comes.

The best thing about support group is that it’s a free flowing conversation about our struggles, rather than a strategic almost-lecture on how to make ourselves or keep ourselves well. The rest of the day is much more tiring because of the things we need to learn – ways to control our anger, anxieties, how to adopt healthier coping strategies, how to use drama or music to articulate our difficulties.

I don’t know how I’ll feel at the end of the day, but I suspect I’ll feel very, very tired. Being ill is hard; getting the treatment is draining, and instead of the beautiful picture or essay or solved maths puzzle one might take home after a hard day’s work at school, I go home with the raw feelings unearthed by a day of delving into my past difficulties and disappointments, my demons and tormentors alive and well and brought into my consciousness from which ever compartment in my brain’s filing system I had buried them away.

But I have to go to hospital. I have to get help. The alternative is to stop living at all, or to continue with all the terrible symptoms of depression that make me want to stop living. So I go. I’m lucky to have the treatment and support. And I've recognised that I need help. So here I am. I'm getting help. It's another first step.

M'aidez on May Day - Getting Help

I've been meaning to write about the rest of my Japanese adventures, and they will come. This week has been interesting, though, for a number of other reasons, as I've returned to a semblance of normality with the working week, weekend and so on. And with those normalities come some of the 'normal' feelings of depression and anxiety that at times I feel that I want to run away from and at times just bury myself in the sand (i.e. the duvets) and hide from the world.

Saying this out loud has taken me a long time. But I've got there.

I may have mentioned this before, but a lot of people who have not previously been diagnosed with depression don't recognise the symptoms, in their infancy, for what they are. A change in appetite, a few bad nights' sleep and a lack of interest in doing things might slip by unnoticed for a while. Added to this the fact that many people who suffer from depression (and I would include myself in this 'many') are people who push themselves fairly far towards (and sometimes past) their own limits to 'succeed' in whatever way they can, whether it's at work, with a partner or in social situations.

Being superwoman isn't possible, and the kryptonite that gets me every time is depression coming back to remind me that I need to balance what I can do with what's realistic for my health.

There have been many posts and articles this week elsewhere which have sparked my interest in writing about my own situation again. This week is a pinnacle in my long road of depressive episodes as I can feel myself getting worse and worse towards next week when I have a planned hospital recovery period in the calendar for the whole of next week, and know that I will benefit hugely from some rest, some structured help, and just by being around other people who are freely talking about their struggles in a safe environment where there is no potential for shame, stigma, or having to pretend to be something that one is not.

I've now stopped pretending, but I still expect people to dislike me a lot of the time,

 and am a work in progress towards accepting myself

The fact is that when we can recognise the symptoms sooner we can stop the depression getting so terrible that we need to take many weeks off and have years of recovery ahead. It's hard to spot the signs and do something about them when you're feeling absolutely dreadful, but if you can do anything towards this it's a real bonus.

I've stopped pretending now - to a large extent: as difficult as I find it to accept myself to be myself, the real myself and not the garrulous 'great pretender' for whom everything is joyous, funny and to be made into a grand joke,, but I am trying to be just me whether it's me not having a great day or something else.

Sometimes plugging in or distracting is the safest way to get through to tomorrow

Here's a comment I wrote just now for a piece published recently in the Guardian:

Quoted from article: "People suffering from long-term conditions, such as mental health problems, will spend most of their time outside of NHS and social care settings."

[My comment]: I first realised I was depressed aged 20 when I sat in my university room, crying and crying but pushing my fist into my mouth or my head into the pillow, hoping my roommate couldn't hear and hoping that she could.

Fifteen years later I understand I was depressed and anxious as a young child, with the dreadful dread in my stomach, aged three or four.

My help has rarely come from the NHS; I'm not 'bad enough' or 'Ill enough' to qualify for anything more than a gp appointment. So I saw a (private) Ed Psych when I couldn't go to school anymore; I saw a wonderful (private) counsellor who helped me get back to university and complete my degree; I took pills from the NHS when I couldn't get (afford) help elsewhere. I had therapy again (privately) which was terrible and didn't help. And last year I was in hospital (privately) because I didn't want to live but - again - I wasn't ill enough for NHS help of the kind I needed. And now my GP remains supportive but my major support comes from (private) medical care. This weekend and next week I'll get some more of this kind of help to keep me going, to not take the worst step. Thank you to my brain for just about enabling me to study, work and pay for my life in private mental health care.

Thank you to all of those charities mentioned above. Although I have not benefited from you directly my knowledge of others who can't afford care privately need you now more than ever. You are amazing and I pledge to continue to support Mind and Time to Change and others as much as I can. Because not everyone is as lucky as me and can afford this care or have it covered by private medical care. And for goodness sake, we're still working hard to get it recognised as with equal rights to those with non-mental health conditions. It's already so hard. Let's help each other. And by the way, #GE2015 candidates, I'd gladly pay extra tax to support the NHS to be able to survive and serve us all - mental health and other patients - better. Just give me a call. @volette or via my blog Laptop on Tour.

Thank you Guardian for publishing this piece. I believe the third sector is critical for helping those in need struggling with all the debilitating effects of many mental illnesses. Thank you.

There's a third element that supports recovery that is not mentioned here, and I think is truly, critically important, and that is the support that comes from one's friends and family. I owe a huge debt of gratitude to my friends and family for their unswerving support for me through all the difficult times that I've experienced. I continue to need them (and this is challenging, as I ask myself, "When (soon surely) will people become sick of my sickness and my need for support?" I don't know the answer but I hope it lasts a bit longer than my illness does...and in return I hope that I try to be a good friend when I can, and answer texts or send them, make phone calls or meet up when I'm well enough, and when not that I'm accepted to do that. I hope so. 

I find these positive statements hard to hear, but I'm glad some one is saying them.

I don't think it matters whether it's a friend or a family member (or indeed a partner) who is your go-to person when struggling. I hope that everyone can have someone, and if not someone in their personal or professional lives, then I find all the more reason to support the vital charities mentioned in the Guardian piece and many more who do so much. I am an advocate for supporting one another, and for feeling free and able to go in search of that support without fear of judgment or censure. With that said, I wish you all a healthy weekend ahead, and hope that if you need help you can find it from your friends, your support networks, third sector organisations or medical professionals. After all, we all need a little help sometimes, and we can share in the mutual support of others and ourselves by working together. Take care. x

With a little help..this can be true.

You're Not Alone...with Depression...Keep Fighting

In response to the many news articles on the recent tragedy of the Germanwings plane crash I considered writing something today about my views on the way that press coverage of this awful event has set back progress towards developing better understanding of depression.

However, I find that in this New Statesman article, Stephanie Boland (@stephanieboland) says what I want to say, and picks out the same nuanced stigmatising language from (for one) the Daily Mail's coverage of the crash. I would like to recommend that everyone read this article for an analysis of journalistic styles, and how inappropriate these are at times.(In case you're wondering, I was actually incredulous at the massively inappropriate and misleading use of the word 'Incredibly' in the Mail's article, like Boland, and I also took great exception to the word 'heinous' being used to describe what appears to be a completely fictionalised version of a statement of ambition that the co-pilot Andreas Lubitz made to his then girlfriend, a few years ago.

What really stands out for me from reading all the press coverage of how lonely it is to be depressed. I feel this especially when people make assumptions about what you can and cannot do based on your diagnosis of 'depression' without understanding more about how each person's symptoms manifest themselves and how severe they suffer, how often they present with symptoms, how this affects their life etc.

I have felt like this. But there's more to it...

I only started talking openly about having depression last year because of behaviour from others that I - rightly or wrongly - have perceived to be negative perceptions of me. I experienced various occurences where I felt there was a question as to my ability to perform work in a quality way, to be able to continue to function at a normal or above normal level, linked specifically to the fact that I was in therapy or that I had previously suffered with depression or was suffering from a low episode where my depression was worse than normal.

Spiralling negative thought focus is one of my worst symptoms,

worsened when I shame myself again and again for every wrong I've ever committed

I found that when I was ill with depression it was particularly exhausting to function because of my self-imposed rule that I must at all costs conceal it. Trying to live each day and say 'I'm fine' when actually I was anything but greatly aggravated my condition: I was not only unwell, but I had shamed myself and felt shamed by others into hiding what I believe to be a condition that many others suffer from, and that is nothing at all to be ashamed about.

What's more, while having depression over the last twenty years, I made it through school (just), got into Oxford university, managed to achieve a 2:1 degree, then was accepted onto the TeachFirst programme and taught hundreds of pupils aged 11-16 at two outer London comprehensive schools over three years. I then left teaching to become a management consultant at one of the largest and competitive firms in the market. I developed sufficient business acumen to be promoted there - twice - and to be accepted as a transfer candidate with sponsored visa to live and work in New York. I moved back and gained my current job with another large and prestigious consultancy firm.

Me, 2005, punting on the Cherwell in Oxford.

I was suffering from depression when this was taken

The year I got into teaching I was still grieving for a dear friend lost a year before, my father had cancer and I suffered from depression as a result. I had also moved to London only a year before and was in a new relationship. All this was made more challenging by the fact that I was working extremely long hours to become a teacher in a learning curve I can only describe as 0-60 in 10 seconds. The children I taught were at times very hard work: most were keen to succeed but reluctant to learn! I had six weeks of training (combining some practical and some theoretical elements in a crash course) and then started on an almost-full teaching timetable.

Most children were very easily distracted and many had all kinds of special educational needs ranging from dyslexia, non-verbal autism, other levels of autism / aspergers, having ADHD (either diagnosed or non-diagnosed), suffering from trauma, coming from abusive homes, coming from foster care, coming from many different other countries and not speaking English. I could go on and on.

Bristol 2006.

I was on medication to treat depression and sleep problems at the time.

It was wonderful and awful in equal measures on many days but even though the stress of that work helped me develop terrible psoriasis all over my head and brought on worse symptoms of depression I still managed to do the job and qualified with the highest possible grade as a teacher, and was awarded a 1(the highest assessment) during our Ofsted inspection when I was teaching year 8 (the WORST year 8 in the school's history) Romeo and Juliet. I spent weekends planning lessons which would (I hoped) engage the individual needs of every child. I produced many new resources and worked with other amazing teachers to try to grow into a teacher who would give the children the success they wanted. The majority were able to improve their English (I taught English) in spades and for GCSE students achieve the Cs or above they were looking for.

While I was in teaching I took medication for depression but rarely took time off.

Most time off was related to bugs caught from germ-sharing at my schools!

After the first 7 weeks I was burnt out to use the familiar expression used by others to describe Andreas Lubitz. I went to the doctor and received antidepressant medication to help me to improve my mood, cope with work (I missed one week of work due to sickness, including but not limited to depression) and get back on track. Things did improve. I got better and life went on. I didn't miss more work for depression (I did get terrible flu and tonsilitis from schools which remain for all who are parents, students and teachers a breeding ground for all manner of lovely germs!).

2010, after running the London 10K. 

I was suffering from depression at the time.

I finally left teaching for management consulting because I wanted to make more of a difference. My ambition at the time was to lead an education charity one day. Now (8 years on) I still want to run a charity, but currently would prefer it to be one linked to mental health services, though I'm still equally passionate about education / children, so perhaps I'll find a way to do both. It would be a highly appropriate statement for me to say, as Lubitz is reported to have done, ‘One day I will do something that will change the whole system, and then all will know my name and remember it.’

Sydney, 2010, at a wedding. 

I was suffering from depression at the time.

Since joining consulting I've worked in 6 different countries in many industries to learn about how business works. I have worked long hours to produce quality work for my employers and my clients, and I've tried to build a CV that shows my passion for people, for technology and my intellectual curiosity.

2011, just after returning from 3 months working in Ghana and Ethiopia.

I was suffering from depression at the time.

 I've also mentored students through the HEAPs scheme, iMentor (in New York), have coached teachers and other professionals and have supported Mind and Time to Change as an advocate for better understanding of mental health and by being a media volunteer. I was in hospital last year with depression but took only a limited amount of time off from work, because I find work (and activity) supported by others, makes me flourish rather than flounder. I hope that my non-profit activities give value to those whom I work with - I certainly enjoy them because I love people and want to do as much as I can to help people out - it makes me happy to do this. 

Cape Cod, summer 2014.

I had just come out of hospital after suffering a severe episode of trauma-related depression

All the while, I have still had depression. I've taken different varieties of medication, I've attended and still attend CBT with a fantastic therapist who helps me try to get through tough times. I still feel like not being alive on quite a few days. I didn't particularly want to wake up on Thursday morning, just gone, for example, because - and I will not lie - depression can feel unrelenting and it is bloody knackering to keep going with your life when you're worn out from all the negative feelings that you wish would just sod off so that working, exercising, eating, seeing people, and just functioning weren't so drainingly difficult.

Sometimes the simplest activities are as hard as any other task imaginable.

They represent how hard 'living' compared to not living can be.

I am now not alone. I have friends from my support groups to hang out with. I have my beloved husband who supports me even though - I feel - it surely must get quite old when your wife greets you at the end of each day in floods of tears and can't make a decision about what she wants for dinner, despite having polished off a high quality bid and managed multiple projects and written a blog post during the day. I have my other friends who send supportive messages and put up with me being flaky when I can't always make appointments if I'm suddenly unwell. I have my family who are loving and kind. I have a lot. And at work - importantly - I have grown in the confidence to say when I'm not well and expect (and demand) that people to treat me without discrimination because I happen to suffer from depression. I speak out here. I speak out wherever I can. I believe I have the right to a life and the right to work, respect (as long as I show it to others) and fair treatment as an individual.

On days like today, when I feel 'okay' - not great, not terrible, I still hold on to my ambitions and think about the future I want to have. And I say, honestly, and with hope, ‘One day I will do something that will change the whole system, and then all will know my name and remember it.’

Just Breathe...Live.

And I really hope that I do - something positive that allows me to be the change I want to see in the world.‘One day I will do something that will change the whole system, and then all will know my name and remember it.’ And, "incredibly", I will do with depression. 

Me 2015, on medication and seeing a Cognitive Behavioural therapist to help with my depression.

Working, writing, coaching, painting. Living.