Author: Millie :)

A young person trying to make the tiniest difference in the world, and finding my voice
Posted in Advocacy, autism, Mental Health, neurodiversity

Misogyny and The Psychiatric Complex

Posted on by Millie :)

I think nowadays more and more people are aware that sexism connects with and is compounded by other factors such as racism, economic insecurity, homophobia etc. However few people are aware of the links between misogyny and the psychiatric complex. I’d go a step further and say a majority of people are reluctant to examine or criticise the psychiatric complex at all. However this ignorance is harming the most vulnerable among us at their lowest points, and threatens to affect all of us should we experience a mental health issue (as an estimated 1 in 4 people will every year). So let’s have a brief look at the relationship between misogyny and the psychiatric complex:

Throughout history psychiatry has been used majorly to uphold societal values. As such the history of psychiatry is entrenched with sexism. The most obvious example of this was the epidemic treatment of ‘hysteria’ in women. Hysteria has been described from the second millennium BC, but it was not until Freud – a man – that it was officially considered an exclusively female disease, though it’s important to note women were disproportionately institutionalised for hysteria for hundreds of years before this. It may surprise you to know that it was not until the DSM-3 (the DSM is the leading book used for the classification and diagnosis of mental disorders) that ‘hysterical neurosis’ was deleted. 

The treatment of hysteria can be very generally described as using natural remedies to calm the nervous system until the renaissance period, notably the end of the 16th century. This is also notably where it became considered much more of a ‘female’ disease’. Around this time hysterical women would be treated by a physician interesting their fingers into genital organs to try and produce an orgasm and semen production (which raises serious questions about consent and abuse in the history of psychiatry which still pervade to this day. Some people considered suffering women to be witches or possessed with demons around this time also. For doctors at the time the uterus was their explanation for hysteria in women – claiming it caused them to be psychologically and physiologically inferior.

During the 16th century physicians and philosophers such as Thomas Sydenham, Rene Decartes, and Ambroise Pare started to recognise that hysteria was connected to the brain and other organs also, not just the uterus, but the idea of a uterine, female disease continued. For example, Joseph Raulin in the 1700s suggested hysteria was due to the fumes of big cities, so in theory it could affect both sexes but women were just weaker. 

Perhaps the most famous outbreak of hysteria is the Salem witch trials in 1692. Marion Starkey related it to more contemporary events after WW2 with the theory that classic hysteria was actually a reaction to social conflict and restriction, such as the puritanism in Salem. Note she’s the first woman mentioned. Much evidence would support that mental illness and the classification of it is intrinsically tied to the pressures of the world we live in, notably under hyper capitalist values nowadays, so I would not think it too much of a stretch to think that women during these times under such enormous pressure to conform would present symptoms of hysteria. But they were labelled as mad – their individual character was named as the problem, not as a symptom of a societal issue. And they were labelled mad by men. 

This general hypothesis of hysteria, especially during this period, seems to make sense in the majority of cases when you consider that women could be committed to mental institutions – which were comparable to jails at the time and arguably still are – by their male relatives simply for not conforming to the standards expected of them. The inhumane conditions in many of these asylums are well documented, and I personally think some treatments could be considered comparable to torture. As Angela Davis so eloquently put it: ‘Studies indicating that women have been even more likely to end up in mental facilities than men suggest that while jails and prisons have been dominant institutions for the control of men, mental institutions have served a similar purpose for women. That is, deviant men have been constructed as criminal, while deviant women have been constructed as insane.’

While psychiatry may have changed – yes, in some ways for the better and in some ways just more palatable to a modern society – its roots cannot be ignored as they are the foundation upon which modern psychiatry is directly built and this harm still exists. Let’s have a look at the current day now, through the lens of BPD diagnosis, aka Borderline Personality Disorder. 

Women are disproportionately diagnosed with BPD. There’s a 3:1 female to male ratio in the diagnosis of BPD which is quite pronounced for a mental disorder, and has led to speculation about its cause by professionals. However critics of the diagnosis have gone as far to say it is the modern day version of hysteria – a label extremely loaded with stigma that judges the emotional reactions of women. Think even of the title ‘personality disorder’ – the name itself suggests it is solely an individual issue, a defect of their character, not linked to anything in the outside world.

I write on mental health from a place of personal experience, and I will admit that because of this I am biased in how I view mental illness. There appears to be some research that genetics plays a factor in BPD for example, which would be an individual trait. However I believe it is essential that we also look at how the world as it is is unsuitable for people with that genetic component. Can we answer the question of whether that genetic and neurobiological component would present in the way it does if that individual was not subjected to trauma and systemic pressure? Perhaps not in full. But there is ample evidence that sociocultural factors affect mental illness, and that seems to be so often ignored. 

A sociocultural factor could explain why more women are diagnosed with BPD, as they often experience more pressures in the world to conform, and are more likely to be the victims of violence and assault that contributes to trauma in BPD. However the stigma surrounding BPD stemming from its symptoms may explain this too. Hypersexuality for example is a trait of BPD; being sexual as a woman is still less acceptable than being sexual as a man, so for example a woman’s behaviour may be labelled as hypersexual while for a man it’s just seen as a strong expression of his sexuality, or perhaps not even noticed at all. Likewise anger is also a symptom of BPD, and we are much faster to label women as problematic for expressing anger than we are men. So the social misogyny impacts when we start to consider a person’s behaviour as more than just odd, more than just problematic, but actually disordered. 

It would be unjust to write this article without drawing attention to the disparity in mental health care between races. Like aforementioned, psychiatry and misogyny are intrinsically linked with other social justice issues. If we ignore this intersectionality we are ignoring the full picture. For example, Black women are more likely to struggle with mental health issues, less likely to get treatment, more likely to be misdiagnosed, and more likely to be sectioned (an example of the criminalisation of mental illness, but that’s a story for another day). In fact detention rates under the Mental Health act during 2017/2018 were four times higher for people in the ‘Black’ or ‘Black British’ groups than those in the ‘White’ group, and 29% of Black/ Black British women experienced a common mental disorder in the past week, higher than for White British women or Other White women. Clearly we can see the link between the pressures and pain of racism to the experience of mental illness in Black women, and their subsequent further incarceration and abuse in the mental health industry. Likewise we can see a mirror image effect in the LGBTQ+ population – almost half of trans people (46 per cent) have thought about taking their own life in the last year, 31 per cent of LGB people who aren’t trans said the same. This is not a stand alone issue.

Another example of misogyny in the psychiatric complex is the recognition of neurodiversity in women and trans people. Early autism research was based on white boys from middle class backgrounds. Outdated tests, and a lack of understanding of how autism presents in other races and genders in the general population still result in late diagnosis or misdiagnosis of women and trans people everywhere. And here seems to be a good time to put all of this information into context – the misogyny in the psychiatric complex damages and ends lives. Whether from the trauma of institutionalisation from stigmatised diagnoses, or the pain of leading a life without understanding or accommodations, individuals and communities suffer every day. As a late diagnosed autistic myself I can attest to how painful it is to grow up being bullied, misunderstood, and confused without any path forward. I can’t imagine how different my life might have been if I had known I was autistic and had the resources to help me and my family as I navigated a world not built for me. And I had it easy! 

Yet if we take a look at neurodiversity through the lens of knowledge that gender is a construct, we can see clearly how much the pressures of the world to conform to gender norms affect people. I was taught to be a girl, while autistic. So the way my autistic brain processed that (for lack of a better phrase) was to make me mask so heavily I couldn’t see myself through it all. This is common in those who identify in genders other than male. The world taught me to be a woman and because I learnt to do it, in a system that ignores neurodiverse women, I had no idea how my brain worked. I had no idea who I was, and I was in pain. And to add a little history again, a major leader in the foundation of autism research was Hans Asperger – a man with well associated ties to the eugenics programme of the nazis. Asperger’s and autism aren’t different, but Asperger’s was used to basically say they were more intelligent, and therefore more worthy to society. These messed up roots run deep in all directions. 

However, diagnoses aren’t all great. In fact they can be downright damaging in themselves. As mentioned, a BPD diagnosis is highly stigmatised, and disproportionate in women. Having a diagnosis of any mental health issue or neurodiversity can lead to people’s experience being invalidated. If you’re labelled as mad, how can you ever convince someone you are sane? For one it can be very hard to get out of hospital and escape that system if you are committed, and extremely hard to report any abuses taking place there as they often do because concerns can simply be brushed aside as delusional, symptomatic. Any legitimate problems in interpersonal relationships can be labelled as a symptom. Any very real feeling is simply boiled down to a mental illness. Women – already more likely to experience violence – see their diagnosis weaponised against them when they try to report violence; and people with a mental illness are significantly more likely than the general population to experience violence!

The sexism in society and psychiatry doesn’t just adversely affect women and trans people though. It also affects men who are significantly less likely to come forward if experiencing a mental health issue. In 2021 men were three times more likely to commit suicide than women. And much of this can be traced to the stigma of men expressing emotions in fear of being seen as weak (translate: as fear of being seen as expressing a feminine trait). Everyone, including men, are being harmed by the systems men built. 

And yes, the modern psychiatric complex was built by men. Built on the foundations of male researchers at a time when women were denied an education, and continuing to be led by men. I’ll end on a story about how the DSM – that book used to diagnose mental illness – was created. The DSM-III was the version of the DSM that formulated how we see and diagnose disorders nowadays. It included innovations such as explicit diagnostic criteria and multidimensional diagnostic systems. But the formulation of it was hardly clear or scientific. Robert Spitzer was appointed editor of the DSM 3 and by his own admission the editorial meetings over six years between 1974-1980 were chaotic. New Yorker’s journalist Alex Spiegel reported that the psychiatrists invited would yell over each other, and the loudest voice tended to win out, while no one took minutes. People would yell out names of new diagnoses and possible checklists for symptoms, and if the cacophony in the room seemed to agree it would be typed out, set in stone. The diagnoses in that book still have very real implications for very real people nowadays, and diagnoses are removed and added in each edition following. It’s not an exact science; it doesn’t centre the lived experience of people.

If you take nothing else from reading this article I hope you remember this – sexism is systematic; it affects all of us in all aspects of our lives. But our distress, our joy, our love and our pain? That’s not just symptomatic of a system, that’s symptomatic of being human. 

Sources:

Posted in autism, neurodiversity

Neurodiversity Dictionary

Posted on by Millie :)

Here’s a quick breakdown of some terms commonly seen when talking about neurodiversity. I use many of these in my writing so want to make sure everyone understands, and also by understanding this language we can help build a world more accesible to neurodiverse people. If you have any questions about these or any other terms let me know in the comments below!

Neurodivergent

Neurodivergence means that someone’s brain learns, processes, and/or behaves differently from what is considered the norm. Autism and ADHD are most commonly associated with being neurodivergent, but the term also encompasses many other conditions and ways of braining (so to speak) such as: OCD, Dyslexia, Dyspraxia, Bipolar, Dyscalculia, Down Syndrome, epilepsy, and other chronic mental health conditions. 

Neurotypical

Neurotypical describes someone who’s brain tends to function in the way that is considered the norm, more aligned to how the world is set up. This can be seen abbreviated to NT. 

Allistic

Allistic means not autistic. It doesn’t necessarily mean someone is neurotypical, it just means that they’re not autistic. 

Functioning Labels

Some people use terms such as ‘high-functioning/ low-functioning’ to describe the presentation of neurodivergent people, especially autistic people. However many neurodivergent people don’t like the use of these labels at all. This is because high-functioning essentially means ‘more able to act neurotypical’ and erases the very real challenges in their lives, and challenges from being able to present more neurotypical when they are not! Meanwhile ‘low-functioning’ tends to write people off as having less value or ability to do anything because they don’t conform to neurotypical standards. There are many more issues with these labels, but all to say that these labels fail to encompass the experience of neurodivergent people and puts them in boxes – unless a neurodivergent person tells you it’s ok to use these labels specifically to describe them, it’s best to avoid them. 

Stimming

Stimming stands for self-stimulatory behaviour. It involves the repetition of some kind of movement, sound or behaviour to regulate a person’s nervous system. While all people may stim sometimes, it is a common trait in neurodivergent people – especially those with autism or ADHD – to stim regularly, although some people may have been trained or forced not to stim which can be very damaging. Examples may be flapping hands, bouncing their legs, humming – the list goes on and on. Unless the behaviour is immediately dangerous to the person you should never try to stop them (and even if it is, proceed with caution and sensitivity). 

Nonverbal

Nonverbal means a person does not speak. You may hear the term ‘nonverbal autistic’ or ‘non speaking autistic’. Being nonverbal does not mean a person is less worthy or less able to communicate, nor does it mean anything about their intelligence or personality; it simply means they don’t speak – and it is important that they are provided the resources to express their own experience, needs, and access education. It’s also very important within the autistic community that we uplift and listen to nonverbal autistic voices – especially POC nonverbal voices – as they are often the most ostracised. Here are three pages on Instagram you can have a look at:

  • @ galaxibrain
  • @ fidgets.and.fries
  • @ nigh.functioning.autism

Ableism

Ableism refers to the system, and as a part of that the individual actions and words, that discriminate against disabled people (many neurodiverse people are disabled, which is not a bad word). Ableism is often not understood or recognised and it is intrinsically linked with racism, homophobia, transphobia, sexism, and economic inequality. It affects the life of disabled people everyday. 

Masking

Masking means a neurodivergent person is covering up their traits. Many people learn to do this to be accepted easier, and may not even know they are doing it, and it can lead to serious burnout. Sometimes people are forced to mask in situations for their own safety.

Sensory Seeking/ Sensory Avoidant

These terms can refer to specific behaviour or the whole experience of an individual. For example someone may describe themselves as ‘sensory seeking’ meaning that they often act in a way that looks for more sensory input to regulate their nervous system and how they are feeling. This would mean they are under sensitive to input like noise, texture etc. Meanwhile someone who was sensory avoidant would be extra sensitive to sensory input, so they would look to lower how much sensory input they had. People may not even realise this is what they are doing. Some people may be sensory seeking at times and sensory avoidant at others – it’s not always the same. 

Sensory Overload

Sensory overload is when your five senses take in more information than your brain can process at that time. This can set off a fight, flight or freeze reaction which can feel really scary and like a crisis to the individual, especially if they don’t understand what’s going on. It can present in lots of different ways. The difference between sensory overload and an anxiety or panic attack is that sensory overload will usually subside/ lessen when sensory input is decreased. 

Tics

Tics commonly occur alongside lots of neurodivergent conditions. They are involuntary sounds or movements and the person cannot stop these from happening. 

Echolalia

Echolalia is the meaningless repetition of something someone has just said. Autistic people, those with Tourette’s or developmental/ neurological conditions can often have echolalia. 

ABA

ABA stands for applied behaviour analysis. It’s a therapy that many autistic people, especially children, are subjected to to try and modify their behaviour so it is seen as safer or more acceptable. The problem is it often teaches autistic kids to mask and many people have come out later in life to speak out against the trauma they experienced from ABA. There is a lot of pushback from the autistic community on this kind of therapy being used, but the conversation is complicated as many parents of autistic kids often have no other choices when worried about their child’s safety or where their children will go everyday. This is not a field of great knowledge for me so once again I would refer you to research autistic viewpoints if you’d like to know more about ABA (fidget.and.fries on Instagram ein particular has a downloadable file of all their extensive writings on ABA).

Self-diagnosis

Self-diagnosis is a term often seen with autistic and ADHDers. It means that they have not chosen to or been able to pursue an official diagnosis from a ‘professional’, but that they recognise themselves to be neurodivergent. Many people do not have equal access to professional diagnosis – and the diagnostic system itself is very outdated – so they have to self-diagnose. It’s important they are respected and listened to regardless. Some people may also choose not to pursue an official diagnosis because they are worried about the repercussions of this. 

Person-first language vs identity-first language

Identity first language puts the condition of a person first – for example ‘autistic person’. Person first language puts the person first – for example ‘person with autism’. They’re are arguments for both. Some people see person first language as emphasising the fullness of a person without defining them by their condition, while identity first language can be seen as recognising how the condition is an intrinsic part of a person and not something to be ashamed of. A large part of the autistic community in specific is in favour of identity first language, however it will always come down to personal preference, and each person’s preference should be honoured when referring to them specifically.

Posted in Mental Health, Personal Growth, sobriety

Teenage Alcoholic’s Sober Story

Posted on by Millie :)

Trigger Warning: mentions of specific drinks, alcoholism, eating disorder

I’m an alcoholic. To be more specific, I’m a teenage alcoholic. I got sober 15 days before my 17th birthday and so I have never had a legal drink. I find that entertaining to think about, but it’s also a block to my recovery sometimes. How can I say I’m an alcoholic (which is vital for me to accept in order to recover) if I’m so young? 

While getting sober at any age and for any reason has huge challenges – that may vary and cannot be compared – getting sober young comes with a unique set of difficulties. One of the very first struggles is that it seems no one else in recovery is your age; it feels like there are no teenage addicts and alcoholics out there. So it can be a very isolating experience. Especially when the rest of your life stretching out ahead of you seems so long to go without a drink. So I thought today I’d share a little of my story of getting sober young to show everyone that we exist! And we’re thriving.

Before I dive in I will be honest and say I was very apprehensive to post this. I’m used to being open, and sharing my other mental health battles to some extent, but this is scary to post. Much scarier than anything else. And I think much of that is to do with stigma – fear that if someone reads this they might not want to know me, might not want to hire me etc. But I have decided to post it anyway because that’s exactly why it should be posted. So often fear keeps people quiet about important experiences that need to be shared and understood. I don’t want another teenager out there to feel alone like I did. I don’t want people to be afraid they won’t be able to move forward in life because of something in their past. So this is my story, and I’m not ashamed of it. I wouldn’t be the person I am today and the person I’m going to be in the future without it. If it can help just one person, then it’s worth it.

I ‘only’ drank heavily the way I did for a year and a half/ two years, but looking back I can see I was different in how I drank from the very first time I had a drink at 13 years old. Everyone else was fine to stop the next day, to stop that evening, but for me it finally made being in a group something that felt easy, and I wanted to drink again right away. I always took it further than others or was more excited about it than everyone else when the opportunity to drink arose. 

I did stop drinking for a period of a few months, but only because I was struggling with an eating disorder, and the calories in drink scared me shitless. In a strange way I feel very grateful for that, because I don’t know what my path would have been if I had been drinking at that time. You can’t exactly buy other substances at the corner store, so I was saved from that spiralling off in a way; alcohol became my drug of choice. 

In the space of two weeks I went from drinking a can of gin and tonic every night to a bottle of vodka every evening, and within a few months I was drinking in the morning and had to start changing my routines to fit around when I would be able to drink. I don’t remember once going to the cinema or visiting my grandma when I was drinking – it would have been impossible. I’ve heard a lot of people talking about how this transition from low amounts of alcohol to day drinking took years, decades even. And that used to make me feel very alienated; it played into the idea that this was just a phase for me. But now I see it like I took the exact same path, I just did a speed run of it.

This began in the months before the covid lockdown and carried on through the return to schools and socialising. I won’t go into the details of what I did, because some of it’s personal and also I don’t think it really matters overall. Because every alcoholic has a different path, different consequences and patterns of drinking. But the one thing we do have in common is once we start we can’t stop. So what I will talk about is my feelings, how it felt to be like that. 

Some people may say I was a high functioning addict, and I suppose in a way I was. I could drink a huge amount and still be able to hold a conversation or even write coursework graded A*. My blackouts were very very rarely passing out or waking up somewhere I didn’t recognise – they were walking blackouts. Whole weeks have gone missing from my memory and it’s only now that small moments are returning to me; it’s a very strange experience. Terrifying really. So yeah, in a way I was high functioning – but being a functioning alcoholic is like saying you’re painting a house with a toothbrush. Yes you can do it, but nowhere near as well as you could. 

I was also the star student. And I’d already had to grapple with my identity as the perfect A* student when I stopped being able to go to all my lessons a few years prior. But when I was drinking it was like losing this part of my identity entirely. I had to leave (was asked to leave) school 3 times in year 12. I became the total opposite of everything I thought I was; I lost myself and I used the disappointment to fuel my drinking more. Nowadays I choose to try and see the light in what I went through and put others through, so in a way I’m grateful for having to deconstruct my perfect student persona, because now I see more of the parts that make me who I am. 

Although there are many many ways to recover, I use AA (alcoholics anonymous, a worldwide peer support group) as the foundation of my recovery. I went to my first AA meeting on 28th September the year before I got sober, and though it would take me another 10 months for me to stop drinking, I continued going to AA. Because really I knew I needed to be there. And that’s the thing – just because I knew I was an alcoholic and would later want to stop drinking, doesn’t mean I could just stop. It wasn’t that simple. But AA being there throughout, welcoming me when I felt like nothing, and slowly helping me build up whatever it was that allowed me to stop, was invaluable.

I hurt the people closest to me, people I could never have dreamed of hurting. I lost touch with reality and who I was. I lost a view of the future. All there was every day was the planning and expedition to get drink. It was the only thing that shut my head up. And the second it started wearing off, or the search showed up empty, the panic and hurt and self loathing and anger would all start to creep in again. It was like I wanted total oblivion. 

Some of it looking back is truly laughable to me – the ridiculous extent of the lies, convincing myself that one piece of chewing gum would cover the smell. And the best of all – hiding bottles all over the town, not just my house or the school, the town. And not just one town – 3 towns! You have to be able to laugh at the ridiculousness to survive I think. It also does no good to tell myself it was all awful, because I did have some good days while I was drinking. Several good days. And if I try to convince myself it was all awful it’s easier for me to forget what it was really like long term, and I run the risk of relapsing. I had some wonderful times and great fun, but overall it was so crushingly painful, even if I didn’t realise the full extent at the time. 

I was always trying to escape, trying to distract. But in doing so I was throwing away all the love and brightness in my life too. I didn’t even realise how sick I was physically! All the time there was something wrong with me, and not always something small. I didn’t get hangovers, but I was always in pain in some way. 

I swung between wanting to stop drinking more than anything in the world and deciding it was pointless to try. It was never really that I wanted to keep living like that but rather that I couldn’t conceive living any other way. I came up with several schemes to help me stop that are ridiculous in hindsight – split the same amount into more than one bottle, change the mixer, listen to a particular song before drinking again etc. None of them worked. There were so many more logical times to stop drinking than when I did: times when I hurt worse and hurt others worse. But I couldn’t. And that’s the thing – an alcoholic can’t simply put the drink down, and if they do by some miracle manage it they can’t sustain life without dealing with the emotional symptoms beneath. 

I was given an ultimatum from school a week before my last drink. This wasn’t what made me stop, but it did however allow me to see, even slightly, a future without alcohol. Or rather refuelled my want for that. And this happened to coincide with me being in the headspace I was; truly tired of it. My rock bottom didn’t coincide with events in my life or chaos of my creation. My rock bottom was when I realised I had completely lost myself. 

It was a serendipitous concurrence. My last drink was nothing spectacular or awful. It was just my last. And I knew it when I woke up the following day. I felt it. The relief, the lifted weight. And I can’t explain that. It was not a renewal of will power, it wasn’t a specific motivation. It was a miracle (if you possibly believe it). I was done, I was free. Within days I started to see my life return in colour around me, though it would take months for the fog to truly lift in my brain and trust to be regained. To this day I dream about it and wake up thinking about it (one major sign my relationship with alcohol is not normal). 

My journey – which is not the same as everyone else’s – included a remarkably easy first few months. I was free from cravings and the opportunities that came to me were amazing. I got to go back to school, continue rehearsals and deepen friendships. But in a way I was white knuckling it. I sprinted forward like I was making up for lost time and in later months I would have to grapple with how hard I had fought to get where I was. For me though I wouldn’t have had it any other way. The cravings emerge still in full force, as do life’s challenges, but now I have a fighting chance. And I have so much love and support around me.

Stopping drinking was the bravest decision I ever made. I got my future back. I got my friends and family back. I got my dignity back. And I got so much more than I could ever have dreamed of. No it’s not easy; some days it’s a real fight. But I’d rather fight this fight and grow than shrink myself back to what I was. And do you know how great it is to remember all the fun I have?? Being sober means I get to honour what I actually enjoy doing. 

I made a list the very first day I got sober of all the things I wanted to achieve through sobriety. It had things like do my A-levels, get into drama school, gain my family’s trust back, feel more physically healthy and more and more. I’ve done every single thing on that list. In a year. Every single one. That is beyond my wildest dreams. With the words ‘I am proud of you’ my list was complete and the second I heard them I burst out in tears. My path is not what I expected, even with all the things I hoped to achieve completed, life is always unexpected. It’s different from how I imagined, and I’ve had to deal with some real upheavals sober. It’s not always fun, but it’s always worth it. If I can grow that much in just one year of sobriety, I cannot wait to discover what else lies on the horizon. 

If you’re a young person struggling, know that you’re not alone. I’ve found young groups of alcoholics and addicts too now, and it was such a breath of fresh air the first time I went to one! It reaffirmed that I was not too young, I was not being dramatic. I was being very very brave, and so were all these other amazing people. You can get better and there is a future waiting for you. 

So much love and support to you all today xx

Posted in Advocacy, Happy Notes, Mental Health, Personal Growth

OHN Hopes for 2023 (and beyond!)

Posted on by Millie :)

I struggle with the idea of New Year’s resolutions. After all, New Year’s Day is simply just another day. The sun will continue to rise and there will always be new tomorrows; new opportunities for change and growth – in fact it happens every day. However I do realise that years are markers of points in our lives and our developments, so I wanted to share some hopes and aims for this space in the coming year and beyond! In the interest of transparency, I don’t have a clear plan on how to achieve everything on this list. But I’m working on it. Just like I’m working on learning more and listening to more voices on mental health and its intersections every day. My hopes will change, my perspectives will change. And I am so glad to have all of you along for the ride. 

Thank you all so much for your support of this space and mental health advocacy in 2022. 

If you would like to be more directly involved with Our Happy Notes – whether on the blog, instagram, or something else! – please do reach out. I would love to hear from you! You can fill out the contact form on this website or email ourhappynotes@gmail.com 

So without further ado, here are the hopes for Our Happy Notes in 2023:

1. More tangible actions 

2. More pressures on governments and organisations 

3. Consistent blog posting

4. Regularly get back to how it started – distributing happy notes!

5. Create connections

Posted in Advocacy, Mental Health

Actions to Support Mental Health Nationwide

Posted on by Millie :)

Here are some tangible actions you can take to support mental health in your community and nationwide, but there are so many more! Follow this blog to get notified of new posts and ideas in the future.  

Write to your MP

Imagine if everyone in the U.K. wrote to their MP in the morning demanding more mental health support. While it’s unlikely that will happen, small actions over time DO add up – it’s worth a shot. When writing to your MP make sure to mention mental health system reform, not just more funding. Writing and protesting other issues such as the cost of living crisis also supports mental health, as it is not a stand alone issue! 

Join the Young Voice Network at Mind

If you are aged 11-24 in the U.K. join this network! They constantly send through information and opportunities for young people to get involved and shape the direction of Mind and the mental health support for young people in a meaningful way. 

Protest

If you’re able to – protest. We don’t hear a lot about protests for mental health system change and support. But that doesn’t mean it doesn’t happen. CPA in London held several last year for example. And the protests and shows of solidarity for other issues such as Black Lives Matter and fair pay are all interlinked with mental health support too of course! If you want you could even set up your own protest or vigil. 

Promote mental health support at your school or work

Mental health support starts at an everyday level, and we can build communities of support. Have a look at the support available at your work or school, even your local community, and join meetings, boards, unions etc to demand better mental health support be available to fill the gaps. Suggest support groups in community centres, accommodations and counselling available at work – the sky’s the limit, and you are not powerless. Of course do not risk your own security to do this, but often a gentle conversation can be enough to plant the seed and get the ball rolling. 

Reach out to friends

Simply reaching out, offering a listening ear, and being non judgemental can make such a huge difference. If someone has been isolated for a while, welcome them back without criticism. Send a letter or a funny picture that reminded you of them. Just reach out. 

Educate yourself

Educate yourself on the intersectionality of mental health and the issues in our mental health systems today. Have a look at new ways of looking at mental illness and support. And always approach with an open mind. I would recommend always making sure you are listening to survivor stories too, not just psychiatrists or professionals. Because people living with mental illness are the expert on what it’s actually like to live with a mental illness. Being better educated can empower you to make changes in your life and community and to raise your voice. I’ll be posting more resources on this soon. 

Drop off some goodies at an inpatient ward

Being in inpatient mental health treatment can be a terrifying, traumatising, and lonely experience. Drop off some cookies and notes of encouragement if you can (nothing that poses a ligature or safety risk). Letting the people inside know they are not alone and that there is a world out here rooting for them with love is so so so important. 

Talk about it

Talk about mental health with your family and friends. Talk about how you are feeling, talk about the stigma, talk using the terms you are learning. And talk about the system and what you think of it. All change starts with a conversation. 

I know how hard it is to know where to start making a change when it comes to mental health. It can feel like we’re not allowed to question the narrative or talk about certain things. But there are actions that can be taken on a personal level and beyond. 

This is only part 1 – follow for more!

Posted in Managing Mental Health, Mental Health, Personal Growth, therapy

Types of Therapy

Posted on by Millie :)

Let’s start today’s post by busting some myths about therapy – scroll down to find out more about all the different kinds of therapy out there! (Spoiler alert – there’s lots of them!)

Myth: Therapy is only for people with a mental illness

Truth: While therapy can definitely help people facing mental illness, it can also be really helpful for anyone by providing a space to express and explore emotions and situations 

Myth: There is only one kind of therapy 

Truth: There are lots of different kinds of therapy that address different experiences, work better for different people, and approach therapy from a different angle. If you haven’t found what’s right for you yet, it doesn’t mean it isn’t out there! 

Myth: Therapy is only in person 

Truth: Some therapists provide online or telephone support instead or in addition to in person therapy! 

Myth: All therapists are the same, it doesn’t matter who the therapist is

Truth: The individual therapist and your relationship with them is extremely important and can vary hugely – it took me a long time to find the right person for me 

Myth: Going to therapy is something you should hide 

Truth: there’s nothing shameful about going to therapy 

Myth: Therapy is accessible to everyone 

Truth: Currently therapy is not equally accessible to everyone, and this needs to change. It can depend on location, financial situation and identity (for example) as to how accessible it is. However the NHS, charities, insurances and local initiatives do offer certain kinds of therapy and support so it’s definitely worth looking into what’s available to you! 

Now here’s an introduction to the kinds of therapy available. If one sounds appealing to you, or like it would be a good fit for you or a loved one, I would encourage you to do some more research on it and have a look to see who is available to deliver that kind of therapy in your area. 

CBT 

CBT stands for cognitive behavioural therapy and is one of the most popular/ available therapies out there – for example the IAPT services in England (Improving Access to Psychological Therapies) only offer CBT. It’s based on the idea that thoughts, emotions and physical sensations are linked and that negative thoughts lead to negative cycles. It centres around  learning to break these thought patterns in practical ways, so is therefore more focused on changing the way you’re feeling in the present or with behaviours in a particular situation rather than a deep dive into past experiences, for example. 

Many people find CBT to be of great help, but for some people it just doesn’t click. If you are neurodivergent and thinking of trying CBT I would definitely recommend trying to find a neuro-inclusive CBT service, as from personal experience the typical delivery of CBT is much more focused on a neurotypical thought pattern – however that is only my opinion! 

The great thing about CBT’s popularity is that the structured skills it provides to deal with thought patterns, along with its basic concepts are now widely available for free. So if therapy isn’t viable/ comfortable for you at the moment then you can still learn some skills to implement. My personal favourite app to learn CBT skills is called Woebot. It’s laid out in an easy to explore and pleasing format, and you learn the skills from a cute little robot therapist. Definitely worth a look if you’re thinking of learning some more about CBT. 

DBT

This next acronym stands for dialectical behaviour therapy. It’s based on CBT, but it’s specially adapted for people who feel emotions very intensely. Personally I liked this therapy more than DBT not because I am someone who experiences intense emotions (which I definitely am) but because of the way it was structured. It just made more sense to me personally. 

DBT is often used to treat personality disorders and was originally developed for borderline personality disorder (a somewhat controversial condition), and has had success helping mood disorders, self harm, and suicidal ideation. It works in a way like CBT to break negative cycles and make positive changes, but also focuses on accepting who you are at the same time. A DBT therapy programme can be more intensive and involve group sessions also, however individual therapists using DBT skills can also be found. 

Counselling

Counselling is often seen as less ‘deep’ than therapy, but this isn’t necessarily the case. For some people (me included) the idea of counselling – talking with a therapist about an issue or your ongoing life, rather than focusing on specific structured skills  – is really beneficial. With this kind of support though I think it’s perhaps even more important that you are comfortable talking to the counsellor, particularly if it is longer term, as your relationship with them is central to the strength of the conversations. 

Many people also see counselling as a more short term therapy, but to me this is counterintuitive. Finding a therapist to build a long term, ongoing conversation with gives us a space to express our feelings about our daily lives and mitigate problems before they arise. Unfortunately ongoing therapy is rarely available through the NHS currently, but I hope to see that change soon! 

Many therapists will be able to provide either counselling or more focused therapy, so it’s worth asking for a mixture of sessions/ approaches if you think that might work for you. 

EMDR

EMDR stands for eye movement desensitisation and reprocessing. It is designed to help alleviate and process the distress caused by past traumatic memories and experiences, and is quite different from the other therapies mentioned already. During the therapy the patient will briefly revisit the traumatic memory in a sequential (and guided) way whilst also focusing on external stimuli. This external stimuli is often the therapist directing the patients eye movements laterally, but could also include other variations such as hand tapping and audio input. It’s thought that this allows accessing the traumatic memory network in a way that kickstarts further processing and new positive associations. It allows for total processing, relearning, better present memories and more by activating your natural healing process and removing blocks. The process is highly structured and includes evaluation for readiness for EMDR, exploration and explanation of current symptoms, and making sure you have several tools to handle emotional stress. EMDR was initially designed to help patients with PTSD, many from army settings, but is now helpful for a variety of people with different symptoms and experiences. If this sounds like it could be helpful for you I would definitely recommend researching this incredible form of therapy further!

Psychodynamic Therapy 

This kind of therapy is derived from psychoanalysis and the theories of Freud. It focuses on helping you understand how your current feelings and behaviour are shaped by your past experiences, along with your unconscious mind and impulses. It could be said that this kind of therapy focuses more on interpretation and the perspective of the client than a singular ‘problem’ like in CBT. Like all therapy the relationship with the therapist is very important, but this is one of the therapies where it is even more pronounced as it may involve discussing childhood memories, relationship with parents, etc. Psychodynamic therapy may even be what comes to mind when you first think of therapy! It’s less structured than DBT or EMDR for example, and many therapists will allow for free association in sessions (discussing whatever comes to mind). Some therapists may also combine this approach with others, so it’s worth having a look at what’s offered. 

Interpersonal Therapy

As the name might suggest, interpersonal therapy focuses on a patient’s relationships with those around them. It looks to improve relationships in their life to alleviate symptoms, because a central idea in interpersonal therapy is that psychological problems can be understood as a response to current everyday difficulties in relationships with other people. It is structured; time limited; focuses on the present; aims to improve interpersonal communication, functioning, and social support. If you are struggling with interpersonal relationships in general or specifically with family (for example) and you feel this is causing difficulties, then interpersonal therapy might be a good idea to help!

Gestalt Therapy 

This is another kind of therapy that focuses on a client’s present life rather than past experiences, so will be more effective or relevant to some than others. It also revolves around taking responsibility rather than placing blame. Like psychodynamic therapy it involves the idea of perception – exploring how a person understands the world around them, and the context of their whole life. It operates on a basis that rather than purposefully digging up past experiences, as a client becomes more self aware they will start to overcome existing blocks. It is a less structured form of therapy. 

Art/ Drama/ Music/ Animal Therapy 

Ok I’ve lumped these all together because they essentially include a common theme of using a creative medium or a way of connection to work through difficulties. Art therapy involves expressing emotions and ideas through art for example, and animal therapy involves spending time around animals which can be very calming and help with empathy etc. Different therapists using another medium in therapy may have different approaches. For some it may just be about letting the patient self-direct and spend time engaging with music, animals etc. Others may still use structured approaches or conversational exploration in conjunction with mediums as an extra tool for expression, learning, or helping a client relax so that therapy is more accessible. Talking to a therapist to ask about their individual approach before starting is a good idea. 

There are even more types of therapy than the ones mentioned above, and many things to think about when choosing a therapist or kind of therapy. Unfortunately therapy, or different kinds of therapy, are also not equally available. If you can please consider donating to local funds to support others on their healing journey, and write to your MP to demand change in the system. If you found this post informative or helpful please also follow this blog to support any work and get notified of future posts. Let me know if you have any questions in the comments below

Have a great day!

Sources: 

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

Sedated: How modern capitalism created our mental health crisis, by James Davies 

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/types-of-talking-therapies/

https://www.emdr.com/what-is-emdr/

https://www.bacp.co.uk/about-therapy/types-of-therapy/eye-movement-desensitisation-and-reprocessing-emdr/

https://www.bacp.co.uk/about-therapy/types-of-therapy/psychodynamic-therapy/

https://positivepsychology.com/psychodynamic-therapy/

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/interpersonal-psychotherapyhttps://www.verywellmind.com/what-is-gestalt-therapy-4584583#:~:text=Gestalt%20therapy%20is%20a%20form,considering%20the%20challenges%20they%20face.

Posted in autism, Personal Growth

Guide for Autistic Travellers

Posted on by Millie :)

This summer I embarked on a two month solo trip around Europe as a female identifying autistic teenager – and it was wonderful. It was made even more wonderful by the fact that some of it was awful (I see the bad moments as adding more depth to the whole experience). So I thought that from my experience I would make a little guide to travelling for my fellow autistic people! Firstly a little disclaimer – this post is based on my experience travelling in Europe during the summer months; there may be information that does not apply to travelling at different times or different areas of the world. Also not every autistic person’s experience of the world will align with mine, so please find the information you find relevant and feel free to ignore the rest. With that being said, here’s my tips:

In London, ready to embark on the journey

Consider Your Companions

Personally, I find social interaction to be draining, especially when in unfamiliar situations. I am also pretty independent, so for me doing the majority of this trip on my own was the best option as it meant I could go at my own pace and organise my own days without having to balance that with someone else. However, I did have my moments of overwhelm and difficulties so it was really important that I had people (notably my parents and sponsor) on standby who I could call to help me in those moments. 

There is a lot to think about when travelling and a lot of new environments to deal with. It’s worth considering whether you think you will be able to handle this on your own or whether you would get more out of the experience by having someone with you to help manage this. If you do need someone, remember that is totally acceptable! It’s about getting the best experience for you. However I would recommend thinking carefully about who you bring. It needs to be someone you are comfortable being around for long periods of time and who you are comfortable expressing emotions around (as there will almost certainly be emotional moments along the way). 

If you are like me and think that you would prefer to travel alone, but also want to have some shared memories along the way, you could always invite a friend or family member to come and join you at one location. This is what I did and it worked really well. It meant I got to explore a few places with someone, but our time together was limited and we didn’t have to manage lots of travelling (and so scheduling) together. It made those experiences feel more special for me personally. 

Do whatever feels right for you – but take some time to consider this in particular as it’s one of the most impactful parts of travelling.

A la playa en Barcelona

Sensory Considerations

Something I underestimated before this trip was the variation of sensory experiences in different places. It is completely manageable, but it might have been helpful for me to be more aware of it before. Firstly, travelling in the summer months meant it was often really sunny. Before this trip I actually didn’t think I was an autistic person that was affected by light very much – but I soon realised I most definitely was (and that’s a really helpful thing to know now!). I think because I was in a new place, my sensory reactions were sometimes more sensitive, so that’s why I’m really glad I got a pair of good sunglasses before I went. I wore them everywhere and they made everything so much more pleasant. So I would recommend investing in a pair of good sunglasses (and if you wear prescription, possibly getting a back up pair) before going travelling. 

Next up is smells – different cities have different smells. This was both very surprising and not surprising at all. I got more used to it as the trip progressed but in the first few cities it was definitely on my mind a lot. If you are someone that gets affected by smells I would recommend bringing some essential oils you like to smell or even getting a nose plug of some kind for travelling as it’s a part of new cities that can’t really be avoided. 

Likewise, every city had different sounds. I had my airpods with me the whole time and had a podcast or music playing every time I was out and about to help me manage this. I actually spent a while beating myself up over this, thinking I wasn’t being ‘present’ enough simply because I couldn’t live up to the idea that in order to be present in a museum, for example, I had to stand there in silence while footsteps echoed around me. So my note here is for the autistic people who need controlled sound playing to engage with the world – that is totally ok! Whatever you need to make the most of your experience is totally ok! I also had my loop earplugs with me for when I wanted to take in some of the city noise but not be overwhelmed. This kind of earplug is really good because you can get different kinds to filter out different levels of sound to suit you. Considering bring ear defenders could also be really useful for dealing with sound. 

Next for sensory issues is a bit of an odd one – pillows. I stayed in a lot of different hotels and hostels and I can say that without a doubt the thing that varies most between them all was their pillows. I had no idea this would affect me, but it did. So if you think different kinds, shapes and heights of pillows could be weird for you, please consider bringing your own. I packed really lightly but if I had to recommend one larger thing to bring it would be a pillow; even a blow up one that you are used to the feeling of. 

Finally, consider the clothes you bring. I know personally I only really wear clothes that have a comfortable texture and feel for me. However when I was travelling I found it even more important than usual that I was wearing comfortable clothes, especially in the heat. I also found that with so much other information and choices in a day, choosing an outfit was much easier when the majority were variations of the same outfit. For example – I had four different tops that were all the same but different colours to match with four different pairs of cycling shorts that were all the same but different colours. I just found that really helpful.

In a space pod for the night!

Accommodation Choices

It’s really tempting while travelling to choose a shared room in a hostel because it’s the cheapest option, or because you feel like that’s what you should be doing for the ‘travelling experience’. This is your reminder to always, always choose what’s best for you and not what’s the easiest option or what you feel you’re meant to do. For the majority of my trip I had my own room and it was 100% the right option for me. I needed that space that I could retreat to and reflect in and not feel like I was ‘on’ all the time. I got single rooms in hotels, air b&b etc mainly because this was often a lot cheaper than getting a single room in a hostel. However if you want to also have the option of more social events and interaction then getting a single room in a hostel would be a great compromise if you’re someone like me that also needs their own space!

 I did stay in hostels for a few nights, and I’m glad to have had that experience, but I found it much more draining so I’m also glad I didn’t do it for the whole trip, and had my own room immediately afterwards. It was 100% worth the little bit of extra money to have my own room. Whatever you decide I’d just recommend you look into it carefully, read all the reviews, and be clear on what you need.

Next up on my accomodation advice is to book in advance. It might sound fun being spontaneous and just booking in when you get somewhere, but if you are travelling in summer like I was this is not only expensive but can be nerve wracking when everywhere is sold out. If you have your accommodation booked in advance it’s just one less thing you have to think about at the time, which might not seem like a big deal right now, but when you’re faced with travel tiredness and some other issue to solve, it’s a huge relief to have the basics sorted. I used booking.com’s app for nearly all my bookings so they were all in one place and easy to sort through; plus it meant I only had to get used to one interface. 

Finally, in terms of food – if you’re worried about the unpredictability of food at all then I would recommend finding places to stay that have facilities for you to make your own food. This also helps save money when you’re on a budget.

At Teufelsburg, Berlin

Where To Visit

Again, when choosing where to visit (both in terms of places and what to do in those places) don’t be swayed by what you feel you should be doing. I didn’t go to a single club or bar while travelling and I do not feel like I missed out at all, because I was happy with what I was doing. 

In terms of places I personally found Venice very overwhelming in the summer with the large volume of people in small streets. Turin on the other hand was a beautiful, small Italian city that was quiet in the summer. Look into what kind of vibe you want and what places are like at particular times of the year (I much prefer visiting Rome in the winter for example). Guide books and the many travel blogs online will often be able to give you recommendations for quieter or less busy places to visit as well if too many people are overwhelming (Teufelsburg in Berlin was truly amazing). Basically – travelling is a personal thing. Make personal choices. 

I found travel days to be the most draining, and although easier because it was planned, there was a level of getting used to each place once I arrived. If you think having to adjust to several different places in a short period would mean that you enjoyed them less, then consider staying in each place for more extended periods of time. That way you can settle in and explore each location at your own pace. 

Finally, if you have a diagnosis and are in receipt of any official disability support (DSA, PIP etc) then take proof of this with you because loads of attractions give reduced or even free entry! I saved €70 in Barcelona in a single day so it really is worth it. You can also get someone else free with you at a lot of places! Disneyland in particular had amazing disability support for free – I got a pass that meant I could skip queues with up to 4 people and had my own place to stand for the parades. It really meant I could enjoy the day. But it’s not just big attractions like that – churches, museums, tours etc often have disability reductions.

At Prague Castle

General Advice

  • Bring a portable charger and keep it charged 
  • Have emergency cash 
  • Have a small across body bag to put valuables in 
  • Get medical insurance – GET MEDICAL INSURANCE 
  • There are shops everywhere – you can buy what you need, so don’t panic if you forget anything
  • Have key contacts and information written down, including your hotel addresses and a photocopy of your ID kept separate to the original
  • Print off a card with ‘i’m autistic’ in different languages if this makes you feel better 
  • Have more underwear than you think you need
  • Bring a water bottle and remember to stay hydrated – it’s often the basic stuff we forget first 
  • Take breaks if you need to and only do as much as you want to. You got this!! 

If you have any questions or extra tips please let me know below! Love and support to you all xx

Posted in Managing Mental Health, Mental Health, positivity

5 Books on My Mental Health Journey

Posted on by Millie :)

I’ve always loved reading, so today I wanted to share with you 5 books that have been incredibly important to me in my mental health journey as a teenager dealing with mental illness. Let me know what books have been impactful in your journey in the comments below – I would love to hear about them!

  1. The Princess Diarist by Carrie Fisher 

This book isn’t actually specific to mental illness, but it introduced me to Carrie Fisher – an incredible Bipolar disorder and addiction advocate – and that changed my life. 

When I found this book I felt very alone and unseen, but reading this was like seeing my brain laid out on a page. Someone else thought like I did, felt like I did. I’ve gone on to read all of her other books which range from entertaining to informative. And they are all hilarious. Carrie Fisher’s ability to turn a phrase is totally unique and unrivalled. 

  1. Unbearable Lightness: A Story of Loss and Gain by Portia de Rossi 

When I finally realised I had problems with food and restriction, I was struggling to wrap my head around it. This book helped me understand the severity of what was going on, and again made me feel less alone. It also helped me to understand the way I thought about food was not normal or healthy and how much it was hurting me, because I got to see it from an outside perspective.

I will warn that the details in this book are potentially very triggering and not necessarily helpful to those grappling with disordered eating, so a warning there if you are considering reading it. 

  1. Sedated: How Modern Capitalism Created Our Mental Health Crisis by James Davies 

This book was important to me as I started to be a bit more sceptical and analytical of the major narrative on mental health and the mental health system. I’ve had my fair share of unhelpful and downright damaging interactions with the psychiatric complex, and I started to question how we view, understand, and categorise mental distress, but it’s hard to find any research or information out there that even slightly criticises the accepted narrative. This book not only verbalised new ways to consider these issues but also provided evidence and further studies to explore. Of course, I don’t blindly accept everything in this book either – that would be counterproductive. But it was a huge relief to discover it and really helped me form a foundation for reimagining how we consider mental health and mental health systems within the wider social context of a capitalistic society. 

  1. 4.48 Psychosis by Sarah Kane 

This is actually a play not a book but I’ve only ever read the full script, not seen it performed, though my class did perform extracts as part of coursework, which was another interesting experience. 

In late February/ March 2020 I was experiencing my first mixed episode and it was truly overwhelming and terrifying. Sitting at my teacher’s desk in the drama studio I was scribbling something resembling poetry across several sheets of paper and one of my drama teachers caught a glimpse. They had been doing a truly incredible job of looking after me (something way above their pay grade) but I think by this point they were at a loss for what to do or how to help me process what was happening to me. 

However, upon seeing what I was writing this teacher remarked how it reminded her of Sarah Kane’s work. My teachers had a debate over whether to show me the play or not – after all it’s true it could have definitely triggered me further – but without much else to do, they gave it to me and told me to read it and come up with ideas of how it might be staged (a tactic that provided me a task to complete which was very helpful). 

I read the play and it was the first time in days that I felt anything close to calm or focused. The disorganised, brutal admissions of a mentally ill mind came to life around me and made perfect sense while the world around me seemed to make less and less sense. 

It made me feel seen in ways I had never experienced before, and also helped me realise that creativity doesn’t have to be neat nor does it have to conform to people’s sensibilities. My expression is mine alone and it can be as raw as I choose. 

I will say please use discretion if you’re going to read this and perhaps have someone on stand-by in case it affects you because it is very raw and cuts to the point of pain in a way I don’t think many of us are used to. Also I’d provide a trigger warning for pretty much everything for this one, but especially for self harm, psychiatric trauma, and suicide. 

  1. People, Places, and Things by Duncan Macmillan

Again, this is not actually a book but a play (can you tell theatre is my passion yet?) and I’ve never seen it performed. Emma – the leading lady – is my absolute dream role. 

This is basically a play about a woman’s journey through rehab and addiction into recovery, and I discovered it while still in active addiction but while I was still in denial. I related so much to her and her words; it helped me come to terms with my own addiction. And it gave me hope for recovery. 

Like 4.48 Psychosis some of the lines feel so deeply true it was almost jarring. And the innovation of the structure along with how it could be staged filled me with ideas and excitement for theatre all over again.

Posted in Advocacy, Mental Health

‘Bedlam’s’ True Horror History

Posted on by Millie :)

Today’s post is the first that looks into the history of psychiatry and ‘treatments’ for the insane, mad, mentally ill and neurodivergent, through a brief overview of the history of Bethlem. I think it’s important to share and learn about this history because it helps us to better understand the foundations and influences on psychiatry nowadays, and therefore understand the problems and potential solutions within the mental health system, including abolitionist approaches. I hope you find this little guide to be informing, let me know if you have any questions in the comments! Just a quick trigger warning for psychiatric violence and restraints.

Bethlem Royal Hospital was one of the first lunatic asylums. It’s horrifying history has inspired lots of books, movies and TV shows, most notably Bedlam.

So the real life horror in its history should be evident, otherwise why would it inspire such horror stories? Yet often we don’t stop to wonder about such histories that informed modern day psychiatry. It’s important to learn about this stuff because the legacies can still be seen nowadays in abusive, neglectful, and ineffective systems.

Bethlem was originally founded in 1247, and was linked to the Church of Bethlehem. It’s foundations are muddied and muddled – it was first used to house alms and poor people with religious ties and with the aim to make money. This monetary trend is also something we still see nowadays in many areas of life, including in the mental health system and coupled pharmaceutical industry.

It’s not known exactly when Bethlem was first used for the insane but is frequently assumed that this was from 1377. Management was through ‘keeperships’, with essentially sole control. Jumping ahead a bit, during Sleford’s keepership at the hospital (1579-1598) the buildings fell into disrepair – ‘so loathsomly filthely kept not fit for any man to come into the house’

However, living conditions didn’t exactly improve. Into the 19th century many inmates were left to sleep on straw beds and only permitted to go the toilet in their cells. Simultaneously financial exploitation by head physicians was common from the 17th century onwards – they were getting rich while the people inside suffered. In fact, in the 17th century several patients were found to be suffering from starvation, and staff practices were found to be a significant contributing factor to this. Staff practices are often a main complaint by inpatients today as well – but they are far too frequently brushed aside; once you’ve been labelled as unstable it’s incredibly difficult to reclaim your power and have your concerns legitimised.

While it appears restraints and solitary confinement were used for the insane at Bethlem from the start (and still today!), not a lot is known about so-called ‘treatment’ in the medieval period. However from 1460 the transition to a specialist institution for the insane was mostly complete and more is known from then on. In the 1680s cold baths were introduced as a form of treatment, as were incredibly hot baths later. Patients were bled, blistered, then dosed with emetics (make you vomit) and laxatives indiscriminately during the 18th century.

Perhaps one of the most disturbing parts of Bethlem’s history is that from the 17th century onwards visitors could pay to come and gawk at patients like animals in a zoo. Can you imagine the shame and anxiety of having your distress put on show as amusement for others? How could anyone possibly heal in that environment? We can infer from this a part of the pattern of control and benefit from locking mad people away rather than a genuine care for them as individuals and a desire for them to heal.

There was even an ‘Incurables Division’ added 1725-1738; patients in here could never hope to leave. One approach was rotational therapy: a patient was put in a chair suspended from a ceiling and spun at sometimes more than 100 rotations a minute

Experimental (read: unsafe) treatments were also used on patients at Bethlem. Furthermore modern investigations have uncovered mass graves on the property, dug exclusively for those who died under care at Bethlem.

This barely scratches the surface of Bethlem’s horrifying history of abuse and exploitation. The hospital is still in use today and many patients are still voicing their pain and trauma from their time there – restraints are still used, as are forced medication, and mad voices are not respected. There’s even a museum of patient’s artwork there, and while some exalt this as them respecting the patient’s expression, I have to wonder to what degree is it a modern day version of gawking st misunderstood minds?

We may have come a long way, but there’s still a lot further needed to travel.

Sources:

https://www.huffpost.com/entry/bedlam-the-horrors-of-lon_b_9499118/amp

https://en.m.wikipedia.org/wiki/Bethlem_Royal_Hospital

Porter 2006, Whittaker 1947 

Porter 1997 

Andrews et al, 1997 

‘A view of Bethalem’ 4th December 1598, quoted in Allderidge 1979

Posted in Advocacy, Managing Mental Health, Mental Health, Personal Growth

Journey Through Panic Attacks

Posted on by Millie :)

The first time I experienced a panic attack I was 11 years old. I had come home early from school that day with a headache and some other physical symptoms I now know were anxiety, and I had gone upstairs to have a nap before dinner. My mum came to wake me up when it was time to eat, but I must have been in the wrong phase of my sleep cycle because I awoke disoriented, thinking it was the morning. We’ve all been there when we wake up not quite sure what’s going on. So I thought it was the morning, and when my mum told me it was time to eat I responded asking about breakfast. There was some confused back and forth with my mum trying to convince me it was in fact dinner time, and still the day before, and I suddenly spiralled into my first panic attack. I don’t remember a whole lot of the details while it was happening, but I do remember how terrifying it was. I remember feeling like I couldn’t breathe; I simply could not get the air into my lungs. I felt faint, and sick, I thought my legs couldn’t hold me up. I don’t know if I had the thought that can come alongside panic attacks where you think you’re going to die, but I knew something was very, very wrong; I definitely thought I was going to faint. Somehow I ended up at the bottom of the stairs, gasping for air and sipping water out of a bottle cap (I think that was the only way I could manage to do it?) as it subsided, and I can still recall the exhaustion after that first one and how foreign it felt. My mum suggested it had been a panic attack, and at that point I didn’t know what that meant. I had no idea they would become such a huge part of my life. 

I have had many panic attacks since this day. I’ve also had some anxiety attacks, which are more prolonged and less intense, and I experience sensory overload too as an autistic young person. Sometimes sensory overload meltdowns and panic attacks can be hard for me to distinguish, and sometimes they overlap or morph into the other, but it’s helpful sometimes to figure out which is which as it can aid in the recovery process both long and short term – for example in a panic attack changing my jumper probably isn’t going to help and may not even be a possibility, but with sensory overload changing the material of my clothing or my environment may help it to subside or avoid it altogether when I feel it building. This year I have felt the strongest mentally overall that I have in a very long time, but I still have panic attacks. Some months I have none; others I have many. For example in May I had seven.

 It’s important to note that while I find the label panic attacks useful, it is a pathologised word. That means there is a certain medical connotation attached to it. However panic attacks are a total overload of our nervous systems; an explosion of tension and anxiety. We cannot talk about expressions of mental distress without recognising that they are often responses to a traumatic and stressful world, whether immediate results of a specific trigger or a build up over time. For example in May I was dealing with exam stress, difficult atmospheres at home, grief for my safe place, and more time on my hands. These all contributed to my spike in panic attacks I have no doubt. Other times I may make it to the other side of a stressful event and then experience panic attacks, almost like a hangover of emotions. It’s not an individual failure, but an understandable reaction to a difficult world. You are not broken for experiencing anxiety. You are not shameful for having panic attacks. 

I am a firm believer that to appreciate life fully we need to be able to laugh, even at the bad stuff. There are certain events surrounding some of my panic attacks that I find kind of hilarious looking back on and that helps me to deal with any embarrassment or regret surrounding them I may have. For example, I have terrible stage fright (despite being an actress, ironic I know). Before the final dress rehearsal for Bugsy Malone – my first show in a proper theatre – I had a panic attack in the wings. I was crouched behind a prop box in heels I could barely walk in and my tailored sparkly dress writhing my legs in pain and sobbing without air. It was a pretty desperate moment, though the juxtaposition itself is amusing looking back. The next thing I remember is a stagehand saying into their walkie talkie ‘can someone please come and remove the fire hazard from the wings?’. I was the fire hazard because I couldn’t move myself out of the way, and I was carried back to my dressing room by my director. Talk about a diva moment. Looking back I cannot help but laugh at the absurdity of the experience. 

That particular panic attack also showed me how loving people can be. I hope that someday everyone experiencing mental health issues gets to experience the pure love and support that I did that day. I had to go on stage just after recovering to do a mic check. I was so exhausted – my bones were heavy; the exhaustion of a panic attack travels to your core and can make you feel like your body isn’t your own – so all I could do was stand centre stage. The rest of the cast sat in the audience as I weakly sang ‘My Name is Tallulah’. Half way through the song I raised my eyes and saw that they were all swaying along, waving their hands in the air; at the end of the song they stood up and cheered and called out encouragement. It was beautiful. No one judged, no one whispered or pointed. They rallied and supported me. That’s what we all deserve. 

Another amusing panic memory was when I fell on my face in the mud on a rainy day trying to escape prying eyes and instead drawing them all to me; again, it wasn’t as embarrassing or well remembered as I feared it would be. Or when my teacher gave me their scarf to wrap around me and help me feel safer and I immediately snotted into it – I got to keep that for a while rather than immediately returning it. Or the time I went to get help while having a panic attack but there was already a girl in the office having a panic attack and it became like a queue for a very strange and unwanted product.

 I’ve been alone on bathroom floors, writhed my legs, hit my chest, backed myself into literal corners to try and feel a bit safer, thought I was going to die, taken off most of my clothes because I thought my skin was going to burn, and just general cried and made weird sounds while trying to breathe. Point of all of this is – I survived. And each one has become a little easier to recover from. The worst a panic attack will do is make you pass out; it cannot kill you. Remember that – it cannot kill you. If you are having one, it is horrible and tiring and painful, but you are safe. And if you are with someone experiencing one it’s ok to remind them of that; if you can recognise what it is and call it what it is. Tell them it’s a panic attack and that they are safe. Often it helps not to try and suppress it either but rather to ride it out, let it be. Because they are not the end of the world, but they are super scary and it’s ok to recognise that too. 

I hope that maybe reading this has helped someone feel a little less alone in their experience. If you’d like a more in depth guide on how I deal with my panic attacks let me know in the comments below! Sending love and support to you all today! Xx