Tag: mental health recovery

Posted in Advocacy, autism, Mental Health, neurodiversity, Personal Growth, sobriety, therapy

Hurt by Psychiatry

Posted on by Millie :)

Content warning: ED, psychiatric abuse, suicidal ideation, any mental health topic really

I want to write a really strong and defiant letter. I want to write some crazy, proud, creative theatre piece. I want to write something truly hopeful. And while I do have hope, and I do have gratitude – because it is essential to my survival – I also have a lot of pain. And anger. I can talk openly about so many traumas and just general shitty things that have happened in my life. But the one I’ve never been able to write about, never even been able to get through a conversation about without screaming and crying, is the pain endured under the psychiatric complex. Because they were meant to help me. Time and time and time again I have gone looking for help and time and time and time again I have been turned away with only more hurt. I know help is a brave word. I’m not afraid to say it. But I am afraid that when I say it no one will listen. This is my story of a journey through the mental health system. 

Just a disclaimer, because as a writer on mental health I feel it is my responsibility – if you are in a bad place and looking for professional help, please do not use this as your excuse not to. I do know some people have been greatly helped by the mental health system, and you could be too. This is not intended to invalidate anyone’s good experiences, but rather to say that all of us deserve to have those good experiences. This is simply my story as someone who feels they have slipped through the cracks. If you feel this may affect you negatively I implore you to take the decision not to read any further. 

I first asked for help from the mental health system when I was 12 years old. I was experiencing mood swings and distress that were really bothering me – maybe just normal teenage things, maybe not, but the point is it doesn’t matter. They were bothering me. Anyone who wants help, even just to navigate daily life, should be given it. I was assigned a counsellor from the early intervention team. I didn’t like them, so I asked to change. I was discharged from the service – I took that as a message that if I had an opinion on my care, my care would be withdrawn from me. 

My first contact with CAHMS (child and adolescent mental health services) was due to an eating disorder at 14. My life was being ruled by it – I had complete meltdowns when I couldn’t exercise, was hyper fixated on food all the time, was weak and angry and alone; I was really hurting. They weighed me. They told me I wasn’t a low enough weight. I took that to mean I wasn’t sick enough. Without any regard for how I felt, or how food was ruling my life; without anyone trying to find out anything about my experience they denied me the help I so desperately needed. Suggested possibly a meal plan – with no support to implement it or formulate it. If a teacher hadn’t sat with me at lunch every single day for a year and coached me through it because she’d been there too, I don’t know how I would’ve gotten through it. 

I severely relapsed with my eating behaviours twice more, and I still struggle with some thought patterns and triggers to this day (though I am in a much better place, largely due to recovery in other areas giving me the tools to transfer). But I never felt like I really recovered from it, or had the support I needed. Even 9 months ago that teacher would still notice when my old behaviours around food crept in – even before I did – and help me to recognise and head them off. I am immensely grateful for that… but it wasn’t her job. It was never her job to be the main guidance and support in eating disorder recovery. 

CAHMS did offer me six sessions of group therapy. This was to deal with my overwhelming anxiety – much of it around socialising – and deep depression. They didn’t see it as deep depression. It was. It was really, really dark. I stopped going to any lessons and lost all sense of self and hope. But yeah, six sessions would be enough apparently (obviously not). I freaked out at the thought of group therapy, it was entirely unsuitable for me. Once again I received the message in response that if I had an opinion on my care, I wouldn’t get any care. They wanted to discharge me right then, but my wonderful mum stuck up for me so they offered me three – I repeat THREE – CBT sessions. They were not useful. I was put on a years long waiting list for an autism assessment. I was offered no more support. I continued to struggle. 

My mum’s determination to get me the help I deserved was incredible, and probably the only reason I got any support at all. (My mum is probably reading this, so thanks mum). She found a charity that was amazing in supporting us through my teen years, and funded me to see a private psychiatrist – this would not have been possible without them. However I wouldn’t say that was particularly helpful either. That psychiatrist did diagnose me with autism (side note – the assessment for autism really needs to be changed), anxiety and depression. I am eternally grateful for my autism diagnosis – it truly did change my life knowing I was autistic. But it changed my life because I went away and learnt about it, as did my family. The psychiatrist did not formulate a treatment plan for any of this, or provide any further support. Some medication that didn’t work was all she offered. 

In this time I also saw a few therapists – I didn’t like them, one of them didn’t like me and kinda dumped me. All of them were privately paid for. The subpar care I received was paid for privately – can you imagine how much worse it would have been if we hadn’t been able to afford it?

I know this is all a lot of information, but stick with me here. This journey is important to understand because it is something so so many people face. I slipped through the cracks of this system – even with the privilege of being a white, cisgendered woman. I had it reasonably easy. 

In February 2020 I had what I now recognise to be my first (and most intense) mixed episode. I cannot even put this experience into words but essentially it was all the darkness of depression with all the heightened energy and irritability of mania at the same time. I felt reality slipping away from me and I have never been in such intense distress. Two teachers stayed with me at school hours after school ended to try and keep me safe. They eventually helped me calm down, but I later found out they were so concerned they were about to call an ambulance or the police, as the crisis line wasn’t helping. I went to the GP during this episode begging for help. She prescribed me valium to calm me down, but when I begged her for more support I remember her chastising me for being so emotional because she had other patients waiting. I took that as a message that I still wasn’t sick enough; still wasn’t important enough. 

In March 2020 the private psychiatrist diagnosed me with cyclothymia. We had to pay extra for an emergency appointment. She decided I was now too complicated to be under her care and needed more support so referred me back into the NHS. They did not follow up on her recommendation for more support. By the time they saw me I was a bit calmer so apparently that meant I didn’t need help. In her eyes I was too bad, in their eyes I wasn’t bad enough. So I was left with nothing. This was the trend that would continue for the next three years. 

In September 2020 I wound up in A&E. I was broken and desperate. When the CAHMS crisis person finally arrived she acted annoyed about me being there, annoyed she had to be there, uncaring. She essentially asked ‘if things are so bad then why haven’t you killed yourself yet?’ and sent me home with no support. They didn’t follow up on any support because I calmed down a bit after, so I was no longer considered in crisis when they finally did get in contact (even though they hadn’t helped me when I was in crisis) and because I was drinking at the time. Just so we are all clear – if a young person is drinking as heavily as I was, that is exactly the time they need support. I went to my first AA meeting after I left the hospital that day. And excuse my french but thank fuck I did. I have no idea if I would still be alive otherwise. And having connected with others who have been subjected to inpatient treatment, I am incredibly grateful I did not have to bear that extra trauma. This is how bad the surface level service is – it’s even worse inside. 

After I got sober in July 2021 I was still struggling. I finally got to see a psychiatrist on the NHS in October 2021 because of my mum’s insistent fighting for me. When he asked me what I wanted from the meeting, he chastised my response. He was unclear. He shouted at me, and revoked what I thought I had been diagnosed with in a letter. I was meant to see him again in 10 weeks and he cancelled. I got discharged from CAHMS without them ever asking to talk with me about how I was doing. 

The one professional who has been a saving grace is my therapist. She is autistic herself and very flexible. But again – if I wasn’t able to fund that privately I don’t know where I would be. After my charity funding stopped when I turned 18 I had to take the sessions down to every 2 weeks, even with her sliding scale, which is significantly less helpful. Luckily I’ve also found amazing peer support, especially through AA, and spent a lot of time reflecting and doing my own work, so I’ve managed to build myself a much brighter life. But it’s been hard. And sometimes I really do need some more help – no one should have to do this alone.

I Went back to the NHS this October and had my first ever good meeting with anyone, just someone in my GP clinic. Why? He was honest. He genuinely seemed to care, but there was nothing they could offer me. He explained that as far as the system saw it, I had already been helped.

In late 2022 my mental health really started to decline again. I went back to the NHS this October and had my first ever good meeting with anyone, just someone in my GP clinic. Why? He was honest. He genuinely seemed to care, but there was nothing they could offer me. He explained that as far as the system saw it, I had already been helped. So from October I was searching for a psychiatrist who would see me. 

I was turned down by over 10 private psychiatrists for being too complex, having comorbidities, or my favourite way of putting it: ‘them not being able to offer the support I need at that time’. So I was again too bad for private and not bad enough for the NHS. One of the only people who would see me charged just under £1000 a session. Others said they would consider seeing me, but were booked up until 2024.

Finally in March 2023 – 5 months later – I got to meet with a private psychiatrist. And wow, he was amazing. We had three meetings so we could cover everything. He was kind, listened to me – really listened – and didn’t patronise. He treated me like an adult, and made it clear I would have a say in my care plan and the final report that would be sent to my doctor. I would have a say? I almost thought that wasn’t allowed. I’m still sceptical, it still doesn’t feel real. 

He diagnosed me with Bipolar type 1. Just think about that for a minute – an 18 year old has been dealing with undiagnosed bipolar 1, unsupported, emerging from 12 years old. I have no idea where I would be without the angels placed in my life along the way; without the undying support of my family and friends; without the flexibility of my school. I knew something more was going on, I knew how much pain I was in, and no one in the mental health industry was listening. I was screaming into a void and not even hearing the echoes of my own screams. (A separate issue is that we shouldn’t need labels to validate that level of human distress, which is what it is at its core, but diagnosis can be so validating. Read more about that here). 

I am not in any way saying this one experience erases all the rest. It does not. It absolutely does not. And it doesn’t not mean that psychiatry isn’t built on an oppressive, harmful foundation whose history has been hidden. It is. But it was a little hope given back to me. A relief at the very least. Before I went into that meeting I said ‘I’ll take them just not being actively mean to me’. How sad is that? What a desperately low bar. 

I’m still scared. He has instructed my GP to refer me back to secondary care teams in the NHS, which I still – like always – hope might offer some help. But the main thing offered seems to be medication, which I have some serious and valid concerns about. But I am terrified of raising these concerns or asking about alternatives for fear that a) I will be labelled as disordered and my new diagnosis weaponised against me or b) I will be labelled as non-compliant/ not wanting help enough, and sent away again. I wish I didn’t want help from them, and maybe one day I’ll be able to find a path that avoids dealing with the mental health system altogether. But I’m not there yet. Nor should I have to avoid it. It should be an inclusive, varied, accessible service. It should have community and individualised care. It should have alternative treatments and input from patients. It should see the human condition as a spectrum. But it doesn’t. And being mentally ill makes me scared that if I voice any of this, I will not be taken seriously. How can anyone ever prove that they are sane?

I deserve better. Everyone deserves better; we deserve to know that no matter what we’re going through there will be appropriate support for us. But it’s not there. And this broken system is quite literally killing people. We can’t just say fund the system either, the system needs to change. I need it to change, we all need it to change. 

I think I’m sharing this because the younger version of me wanted desperately to read it from someone else. So the core message is that you are not alone. You are not alone in the hurt psychiatry has caused you. You are allowed to be angry about it, and distrusting of it. You are allowed to choose your own care and your own path – even if others don’t understand it! (And that applies to all paths – mental illness should not be policed). Your pain is valid, completely valid, and I see you. I see you.

Sending love and support to you all today xx

Posted in Happy Notes, Managing Mental Health, Personal Growth, positivity

Gratitude Practice

Posted on by Millie :)

How often do you take time to stop and appreciate life? Even when it feels like everything’s going wrong? It’s not a test, I just want to encourage you to honestly consider how often you purposefully notice the good in the world. How often do you pause? You might be the kind of person that never does this, or the kind that laughs it off as some more mindfulness nonsense (I know that word can get on my nerves sometimes). Or maybe you try but it’s too difficult, or you feel like you aren’t present enough, aren’t appreciating things enough, so you might as well not try because you’re not getting it right. Maybe sometimes you do this a lot and other times not at all. 

Personally I make a list at the end of every single day with things I’m grateful for. And some days I really deeply feel that gratitude – somewhere indescribable in my core. And other days I’m more like going through the motions. But I make this list every day, and I have for the last 617 days – since I started addiction recovery. I guess that’s kind of been helpful for motivating me to continue with the gratitude practice because I do kind of see it as a life or death thing personally – I either do the things that keep me sober or my life takes a serious turn for the worse. However, that’s not the only reason I do it; I’ve genuinely come to love what practising gratitude in specific (such a small thing) does in my everyday life. And looking back on my mental health journey I’ve realised it became an instinct for me to practise gratitude very early on – though I didn’t realise that’s what I was doing. And that’s interesting. 

When I started to recover from my first full-blown, 9 months long, very-not-good depressive episode, I started this little practice for myself. Every day I recorded: 3 good things I noticed in the world that day, 2 good things I did that day, and 1 good thing someone else did for me that day. They could be as small as I ate some food, or got out of bed (which are not always small feats at all), or someone said hello back, the colours of the leaves are changing on the trees etc. Sometimes they were much bigger than that of course, but actually the best emotional rewards came out of finding those tiny little things to list every day, especially on the days it felt like there wasn’t anything good in the world. I realise now I had created for myself a sort of gratitude practice. 

This came about because at one of my very lowest points, in a desperate attempt to help myself (I was essentially in a headspace of ‘this has got to work or there is no hope left’) I came up with the idea to write two lists. First I wrote a list of all the good things in the world – with the caveat that I didn’t have to think they were good at the time – because nothing seemed good at the time – I just had to have thought they were good/ fun/ not utterly miserable at some point in time. The second list was all the things I would never get to do if I wasn’t around anymore. And something incredible happened while I was writing those lists. Half way through writing the first list I started to realise I wasn’t just remembering things that used to feel good, I was actually starting to feel a faint sense of happiness about these things in the present. Half way through writing the second list I realised I wasn’t listing things I would never get to do, I was listing things I wanted to do in the future. I could actually, faintly, see a future and feel joy. 

It’s interesting to me looking back for several reasons:

  1. My natural instinct when searching for something to help me was to practise gratitude
  2. Practising gratitude had an immediate effect 
  3. Despite not wanting to do many things, I wanted to continue to practise gratitude 
  4. Practising gratitude consistently actually started to change my perspectives on the world and allowed me to be able to take a step back when things got tough again. It essentially created and trained a little voice in my head that no matter how bad things got was there whispering that it would be ok, that not everything was awful

My instincts for survival and healing are fascinating to me because as someone who slipped through cracks of the mental health system, I find them a practically spiritual thing that came to me in depths of hurt. Of course that might not be the way you look at it, and gratitude has been proven in multiple studies to be a powerful tool, but for me the fact that I automatically reached for gratitude suggests that there must be powerful forces of ‘good’ and love in the universe. 

Fast forward a few years and I found myself in addiction recovery, where practising gratitude daily is a foundation of healing. That’s where I realised that what I had done those years before in creating those lists was practising gratitude. So I started doing it again, listing things I am grateful for every day, and in fact sharing them with others – another very healing exercise. Being grateful doesn’t mean we ignore the hurt and wrongdoing in the world, nor does it mean we have to settle for the way our lives are currently. But it does allow us a stable basis to build from; a calm to return to. And it really increases how wonderful the bright things in life feel!

From a scientific standpoint gratitude has been proven to yield many benefits. Here are just five:

  1. It improves empathy and reduces aggression 
  2. It helps improve sleep 
  3. It boosts self confidence 
  4. It strengthens relationships with family, friends, and romantic partners 
  5. It aids the immune system 

Personally it grounds me, makes me feel connected to the wider world, helps me feel more peaceful and content, and takes me out of my thoughts. 

I encourage everyone to try practising gratitude daily for a few weeks, and see how it affects you. If a few weeks seems like too much, then just start with today. The very simple way to practise gratitude is to simply ask yourself the question: What am I grateful for? Allow any thoughts, images and feelings to arise, and try not to judge them. It might help to take a deep breath and sit somewhere quiet – or it might help to have something to entertain your hands like a fidget toy, depending on how your brain works (it’s stuff that gets said a lot, I know, but it is actually helpful). 

Here are some questions to ask and ways to record your gratitude practice:

  • You could try writing out a list of 10 things you’re grateful for; that’s what I do most often
  • You could do a mind map 
  • Illustrate some things you’re grateful for 
  • Make a moodboard on pinterest or from magazine clippings 
  • Ask, what is a kind thing someone else has done for me today? What are the kindest things people have ever done for me?
  • What brings me joy? What used to bring me joy as a child?
  • What makes me smile? 
  • What are the three most important items to me?
  • Who are influential people in my life?
  • The possibilities are limitless 

I really hope you enjoyed reading this blog and that you give some gratitude practice a go! Best thing is it’s not a new skill, it’s something you’ve likely felt many times throughout your life – all we’re doing is tapping into an emotional tool with intentionality. Let me know your experiences in the comments below!

Sending love and support to you all today xxx

Sources and further reading:

https://greatergood.berkeley.edu/article/item/how_gratitude_changes_you_and_your_brain

https://www.forbes.com/sites/amymorin/2014/11/23/7-scientifically-proven-benefits-of-gratitude-that-will-motivate-you-to-give-thanks-year-round/?sh=118cb73e183c

https://research.com/education/scientific-benefits-of-gratitude

Posted in Advocacy, Managing Mental Health, Mental Health

Reframing Healing

Posted on by Millie :)

We receive a lot of messages, consciously and subconsciously, about what healing is. I have my own opinions, some of which will be evident in this post, but I think one of the most important things to keep in mind is what does healing mean to you? There may be limitations to our ideas of a dream life, because we don’t live in a vacuum, but only you get to decide what your healing actually means and looks like. Unfortunately it’s something that is quite overlooked in a lot of mental health spaces, and we’re not often encouraged to really define it for ourselves. But that doesn’t mean we can’t. 

Personally, an important part in redefining healing for myself has been understanding what I’ve been taught about healing. A lot of what I’ve learnt is to see ‘getting better’ as this hyper-individualistic thing. We’re told that ‘getting better’ is about becoming a productive member of society again, going back to work full time, having more output, and living up to the expectations placed on us. A lot of therapy is often about this idea – it’s about mitigating the factors that get in the way of productivity rather than fostering genuine happiness. The idea of compliance and non-compliance in the mental health system is a huge part of reinforcing this and getting in the way of anyone who needs to stop and question whether this striving for efficiency under societal norms is actually what they need. 

We don’t live in a vacuum, so I think it’s only logical to suggest that we don’t heal in a vacuum either. And yes it is possible to have personal peace without those around you experiencing the same, but that’s not to say our healing is entirely individual. We are connected; we are even a part of nature. When bears hibernate or trees shed their leaves we don’t look at them and say they should be doing more, they should be doing better; we understand that they are in a season of their life. Yet we so often fail to extend this same understanding and grace to ourselves. We are a part of nature too, and so we are connected to those around us and every part of the world around us. It is only logical to think we should lean into this connection and these seasons to find peace. So I would say healing is community. Healing is working together. Not in order to fix or mend one broken individual, but to recognise what in our living, breathing system of life contributed to their pain in the first place, and to heal all of us. I’ve found that when I am held by a community, only then am I able to find my own inner peace. 

We also seem to see healing as this end destination – we arrive at ‘healed’ and then we continue there as before… until maybe we need to be healed again. But I don’t see it like this. Healing is an ongoing, every day process for me. Just like I see myself as a continually ‘recovering’ alcoholic, I also see myself as a continually ‘healing’ person. Partly because there are new challenges to life every day; partly because I have chronic mental illness; and partly because I see healing in a larger sense too, one of societal healing. That can be hard to conceive sometimes, or to not get wrapped up in. But I see it as a source of hope rather than a drain of hope. A source of power. That healing, as an ongoing, everyday practice, also means trying to help others and be connected with their struggles. Trying to learn how we can all work together to do better, to build better infrastructure, to break the chains and patterns of the past, to move forwards.

So what does healing mean to you? Does healing mean connection? Does healing mean going back to the life you had before? Or is that just the easiest life to imagine? Does healing mean productivity, or does it mean inner happiness and peace? What do you need to see that realised? Is healing individual, or collective, or aided by the collective? Is healing a destination or a journey? 

I’m not saying there’s one right way to redefine healing. It is personal in how it manifests in our lives, but the very fact that so many out there are healing and recovering shows that while it is personal, it is not individual. And I think the mental health system needs to recognise that too. 

Sending all of my love and support to you today xxx

Posted in Mental Health, Personal Growth

Letter To A Younger Me

Posted on by Millie :)

Hey sweetie, 

I’m writing you this letter because you’ve been on my mind a lot lately. And the thing is, I know you won’t actually read it, you can’t, I can’t actually travel back and give it to you. So there’s no real point in me giving you advice; any advice I do write is, I suppose, more of a reminder for me now – born from the gifts you gave me just by keeping going. Yeah, this letter isn’t really for you. It’s for me now, or us now. To heal a little bit and reflect in a way that doesn’t consume us back to where you are. If that makes any sense? 

I want to comfort you. I want to hug you, hold you tight, and whisper ‘I’ve got you’. Which is something to remember when you feel like the worst person ever, because eventually we’re able to look back and show ourselves compassion. I know it hurts. And I know you feel really lonely, I know. 

I think I’m writing this to you at about age 13, maybe just turned 14. Right as all the mental health stuff really took off, and before you’d gone through enough of it to have any perspective on it. It was all new and you had no reason to think it wouldn’t last forever. But, hey, spoiler alert – it doesn’t last forever. I won’t lie to you, it does get worse. And then maybe worse again. And again. But there’s this magic process you haven’t come across yet, where even though in some ways it gets worse, it never feels quite as bad as that very first time. Because you’re growing and learning and after you survive it once you always know, deep down inside of you, that you’re going to survive it again. And you’re going to learn all these little skills – and big skills! – that help you get through. You’re going to be ok. Maybe not always, but you are going to be ok. 

I would say please don’t drink, but if you’re 13/14 it’s already too late for that. So I’ll say this instead: you know how you always knew, from when you were really little, that you didn’t want to drink? And you were adamant that you never would, and you always thought if you did it wouldn’t end well, but you didn’t know why? Well, that was your gut instinct, and it was a good one. Learn to listen to your gut – it very rarely serves you wrong. So I know you’ve already had a drink, and done some other things, and I know it feels really great right now. I also know I can’t change what happened (or is going to happen, from your perspective). So I’ll say enjoy it while you can. Enjoy it while it’s fun and have those memories that we treasure. The world is a confusing place; it’s a paradox and time is a funny thing – things can be both good and bad. But listen, when it gets too much, know there is hope. Know that this isn’t going to be forever, and you are going to be ok again, I promise. I promise you the madness it’s going to cause is not going to rule your whole life. And I promise you that one day you’ll actually be grateful for it, strange as that may seem. 

But that’s a few years away yet anyhow. For now it might be more relevant to say that food isn’t the enemy and that you are allowed to take up space. You are allowed to exist and feel and show that you feel. I know right now a lot of your time is taken up thinking about food, and actually you don’t even think that’s a problem yet. Well, you’ll figure it out. There’s a lot of cycles and waves in this life, and you’re gonna ride every one of them out. And you’re not going to do it alone. 

In a few months you’re going to meet this amazing person – she’s a bit crazy. I’d like to say thank you for trusting your gut instinct that first day you met her; the one that says ‘this person gets me’. She does. She’s going to help you. And that’s also going to unleash a whole load of other sh*t in your head because once you open the floodgates of emotion, it’s hard to close them. But you’re not going to be alone. Lean into the people who help you, even when it feels uncomfortable and you’re ashamed to do it, because one day you’re going to be able to show them it was worth it. You are going to meet like-minded, supportive people, and make true deep friendships. Loneliness isn’t going to go away completely, I doubt it ever does, but slowly you’re going to learn to make connections and redefine what that means for you. It’s a process we’re still going through – and we’ve come to appreciate it’s actually kind of a wonderful thing that learning is lifelong. You never stop growing. 

I want you to know that I forgive you. I forgive you. All the unforgivable things that make you think there’s no point, the whirlwind of self-destructive hate that spirals out to others – I forgive you for all of it. You are doing the best you can. And one day you’re going to be able to do better. And in 5,10,15 years you’ll be able to do better again! So I not only forgive you, but I thank you for trying so damn hard to keep going when it all seems impossible. 

If I could actually give this letter to you, the one thing I would probably most like to say is that you’re autistic. Surprise! You’re going to find out in about two years and it’s going to make a whole lot of sense and it’s going to change your life. It’s going to be a catalyst in helping you to understand yourself and learn to exist in this world. Because you’re not broken, you’re living in a world that wasn’t built for you. So when in a few months the whole world comes crashing in around you and you can’t be the perfect A* student you built your identity around (don’t worry, it’s actually a blessing to get to rebuild your sense of self and be able to do other things), know that you are allowed to express your needs. You are allowed to be tired and burnt out and unable to carry on at that level without support or understanding. You are allowed to take up space – I’ve said it once, I’ll say it again. 

Ok, what else would you like to know? We’re still obsessed with Carrie Fisher. You were right, we do have a developing mood disorder. Also anxiety, a lot of it. Oh! You’re going to act! You’re going to see your dreams becoming reality and it’s going to feel even better after all this hurt because you’ll understand how precious it really is. You’re actually quite funny, and it wouldn’t hurt you to trust that you can lean into your comedy every now and then. You write a lot, including a lot of poetry (we like poetry now). You went around Europe on your own for 2 months at 17, just like we’d always dreamed! You run a mental health space, have been on a podcast, won an award. We’re still gay. So yeah, you’re ok. You’re not perfect, no one is, so it’s ok to stop chasing that idea of perfection. And you don’t need to do crazy, harmful things to gain other people’s approval and affection. Laughter is the key to making it through rough times – you have to be able to find life funny. Oh and also – not everyone can hear colour?? We were 15 by the time we realised that! 

I love you, always, through all of it. You’ve got this, even when it feels like you don’t. And I’ll be waiting right here for you in a few years, 

Love, 

You.

Glowing fluorescent blue triangles in a pattern
Posted in Advocacy, Mental Health, therapy

Issues with IAPT

Posted on by Millie :)

Disclaimer: Before I dive into the issues with IAPT I just want to clarify that this blog is in no way intended to discredit anyone’s positive experience with IAPT or discourage anyone from using the service. IAPT could still be a piece in the puzzle of helping you find the right support. I am purely highlighting issues that some people face because everyone deserves to have a positive experience of mental health care – if the mental health system can’t adapt to different needs, then it needs to change. This post is about raising awareness of the gaps within that system, and the plaster solution that IAPT has become. Because we all deserve better – it could be you or any of your loved ones needing a more comprehensive, long term and personal care plan. And I would hope that the door was always wide open for you to receive the support you need.

With that said, let me give you an introduction to what IAPT is. IAPT stands for Improving Access to Psychological Therapies. If you are an adult and go to the doctor with a mental health concern, you are likely to be referred to this service as one of the first ports of call. It was rolled out in 2006 and there are now around 220 IAPT services in the UK. It offers patients a limited number (usually 6, up to 12) of sessions with a counsellor using CBT – Cognitive Behaviour Therapy. And it’s true that rolling out this service greatly reduced the 8-12 month waiting time for psychological therapy in 2005, which is great, but that doesn’t mean it provides a greater level of care. 

So let’s look at the information I’ve just noted. CBT focuses on changing thought patterns and behaviours of individuals – which by definition is not suitable for anyone who’s mental health is being impacted by the situation they are in. It’s true that CBT skills can be incredibly useful in helping us cope with day to day life, giving us the tools to reframe our experience so it becomes bearable and our thoughts less consuming. But that doesn’t mean it’s perfect by any means, nor suitable for everyone. For example many autistic people have likened the approach of CBT to gaslighting; it just isn’t suitable for application with neurodiverse thought patterns in many. For many others too it simply doesn’t provide the all round support they need – the therapy sessions are not designed to hold space for the person, explore route causes that will continue to be present, or brainstorm ways to change the situation they are in. It can provide people with a quick fix to a singular problem, but lacks a long term approach. 

However, it’s the only framework offered with IAPT, already excluding many from the help they need. Especially because if someone goes through with IAPT treatment they may be seen as already having support and having to face longer waiting times; likewise if they refuse to continue this raises the issue of non-compliance. Non-compliance is a complicated label used in the mental health system sometimes that essentially labels patients as unwilling to try and help themselves and makes it harder for them to access support, simply because the support they refused was not suitable or accessible to them. This is a systematic issue of not providing individualised care, but instead it is labelled as a personal fault and the burden is borne by the individual. 

Even for the people CBT framework does suit, the IAPT programme offers such limited sessions that it’s arguable how much long term support and healing they actually offer. 6 sessions is simply not enough in my eyes. What about the people with more complex issues? The people that learn slower? The people that need time to build a secure relationship with a therapist before they feel confident to start working with them? They are all being left behind by the existing IAPT service. 

None of this is surprising when we look at the roots of how the IAPT service came to be. In 2005 Lord Layard – an economist by trade addressing the economic costs incurred due to mental health crisis – and David Clark – a professor of psychology championing CBT – pitched their idea for IAPT to a board room full of government officials. They pitched it through the economic benefits that providing a cheap service that got people back to work could reap, easing the £12 billion cost of depression each year. Though I understand why so often proposals have to be pitched through an economic lens rather than a moral or social one, I do think it’s very sad. And I think in many ways shows why this system isn’t working. We’re approaching the issue of the mental health crisis wrong if we’re approaching it from a perspective of getting people back to work. Mental health doesn’t exist in a vacuum and is deeply intertwined with all aspects of society which we cannot simply ignore addressing when looking to help mental health. Furthermore, healing is not actually about productivity – this is considering healing through the eyes of someone else looking in on a life trying to define quantifiable proof of them getting better in a way that is palatable to society. Healing is internal and personal; our current mental health system does not recognise or allow space for this in our society. 

Nonetheless IAPT was heralded as an astounding success in the mental health sector worldwide for its quick rollout and wide reach. But in 2010 Dr Micheal Scott – a clinical psychologist at the University of Manchester – began to question the success of IAPT when assessing its patients. He was hearing many stories of patients with bad experiences of the programme who found it useless, dropped out, or pretended to be better to make it end quicker. He decided he needed to look further at how the effectiveness of IAPT therapy was being assessed in order to discover if it was really as great as it was claimed to be. 

The first thing of interest he discovered was that IAPT was responsible for collecting all the data on its own performance – there were no external reviews or assessments taking place. I think many of us will know that this is a bad scientific practice for collecting and understanding data – there should always be peer reviews. So he conducted an assessment to discover the true recovery rates. 

He began by reviewing the cases of 65 people. I’ll admit that’s not a lot, but stick with me here. Scott used various procedures for a robust review including in-depth interviews, diagnostic assessments, and evaluating medical records. His results showed that no matter the condition, only 16% could be considered as recovering. This is woefully below the 46% reported by IAPT themselves – and with good reason. IAPT’s method of assessing recovery rates only included those that completed treatment with them and neglected to count the half of patients who dropped out of treatment. The fact that half of patients drop out of treatment at all is a huge indicator that the programme is failing anyway, but the correct way to conduct research would be to include them in the data. By omitting them IAPT are artificially increasing their recovery rate. I would also add here that even their self-proclaimed 46% could be much higher with proper individualised, socio-culturally aware treatment plans. 

Scott’s admittedly small study isn’t the only one either. The University of Chester’s larger study found a 23% recovery rate, still much lower than IAPT’s claim. And that’s before even considering what IAPT deems recovery to mean. I’ve already explained that IAPT was built around the idea of getting people back to work, and so it’s unsurprising that the programme focuses on getting people back to what are viewed as functioning members of society rather than personally happy with their healing journey. 

This is seen reflected in how IAPT reviews patients progress. At the start of the therapy questionnaires are conducted that rate how depressed or anxious you are, and then again at the end of the therapy. If at the end of the therapy you score lower you are considered to have improved. If you scored just above the clinical threshold for depression at the start of the therapy (let’s say the threshold is 10 and you scored 11) and by the end of the therapy you score just below (let’s say 9) then you are considered recovered by IAPT. But in reality you’ve only dropped 2 points and are likely still experiencing emotional complications in your life! They’re now just not considered inconvenient enough to others to be clinically notable, but that doesn’t mean they aren’t hugely significant to you. You might not feel ‘recovered’ at all. And the scale is really sensitive anyway – you can move around 5-7 points simply by sleeping and concentrating a little better. 

Furthermore , IAPT doesn’t even conduct a control group meaning there’s no way to know if the 23% ‘recovering’ would have improved slightly without IAPT at all. In fact a recent meta-analysis (meaning examination of lots of data from different individual studies) showed that a total 23% of people suffering with depression spontaneously overcame their symptoms within three months without receiving any treatment. Which aligns with the 23% recovering from IAPT exactly, suggesting that the service is totally irrelevant. Yet it is often the only service offered to those struggling, many of whom will continue to struggle unsupported. Real lives are in the balance, and the system is trying to stick a plaster over the issue that doesn’t even work. 

This doesn’t even begin to touch on the deep issues for workers within the IAPT services, who are struggling hugely themselves and being crushed under a culture of form filling and goal hitting heralded above actually providing support. An ex-IAPT lead said, in an interview with James Davies: “To hit the waiting list targets we’d offer people some minor intervention but it was not what they really needed – it was what we could offer to get higher results”. And there lies the problem in a nutshell – people are not being offered the help they so desperately need. And how could they in a system that values goals, productivity and economy above people’s lives? How could they in a system that is built on societal expectations, harm, and conformity? How could they in a system that isn’t working to face the deep intersectional issues of the day? How could they in a system that is underfunded and in desperate need of reform? 

I recognise that criticising the mental health system is a complicated thing to do, because it’s where we hope to find help. But the reality is that it falls short. I do have hope it can improve; I have hope in our communities and our efforts to see better care. And I do know that despite a failing system people can recover – by their own standards – and live bright lives. But I know too it shouldn’t be so hard to get support, for anyone. 

So here are some calls to action! What you can do to help: 

  1. Most of the information in this post comes from James Davies’ book ‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’. I would recommend that everyone read this book to educate themselves further 
  2. Sign up to Mind’s newsletter to find out about their campaigns for better mental health care 
  3. Write to your MP about the failing mental health system and demand care that is individually tailored, socio-culturally aware, and focuses on personal healing not productivity 
  4. Share this post and have conversations with people in your life about the mental health system – all change starts with a conversation 

Thank you so much for reading! Please let me know any thoughts or questions you have in the comments below. Sending so much love and support to you all today 🙂 

Sources:

https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt#:~:text=What%20is%20IAPT%3F,with%20anxiety%20disorders%20and%20depression.

‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’ by James Davies 

https://www.madinamerica.com/2022/06/uk-iapt-abject-failure/#:~:text=We%20identified%20a%20series%20of,of%20misdiagnosis%20and%20inappropriate%20treatment.

Layard, Richard (2005), ‘Mental Health: britain’s biggest social problem?’, paper presented at No. 10 strategy unit seminar on mental health, 20 January 2005 

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/

Griffith, Steve, Steen and Scott (2013), ‘Improving access to psychological therapies (IAPT) programme: setting key performance indicators in a more robust context: A new perspective’ 

Whitford, H et al, (2012), ‘Estimating remission from untreated major depression: a systematic review and meta-analysis’

Posted in Happy Notes, Notes, Personal Growth

22:47, A Poem

Posted on by Millie :)

You may or may not know this about me already, but aside from being a mental health advocate, I am also a very creative person. My biggest passion in life is theatre, and I adore all forms of creativity from writing poetry to banging pots and pans together to make a beat. I think that my passion for advocacy and my creativity go perfectly hand in hand, as does creativity and mental health recovery. So I thought today I’d try something a little different and post one of my poems that relates to my mental health journey. I only write poetry when I’m feeling an emotion intensely – whatever that may be. I find it the perfect form of writing for expressing deep and complex emotions or experiences. So here’s a little piece of my journey that I wrote about a year ago; a look into my heart. I hope you like it, please do let me know in the comments. Sending love and support to you all today!

22:47 – Letters to Friends

I have mismatched smiles 

And unsettled expressions 

I have tears that come unwarranted

-for most-

But perfectly

For me,

Though sometimes I may pretend they don’t

Till even I forget my tears are full of worth,

And most dangerous of masks 

Are the ones we do not realise we wear.

So when your breath catches

Just above the safe tide mark,

When your ears hear the words 

They want 

So your mind can steal you 

For your fears,

When everything is right, balanced in unbalanced juxtaposition, when it is perfect, 

And so then it is wrong,

And when all you yearn for is to rest,

But all you can do is run,

How then do you tell them you are grateful? 

How do you show 

When you can’t feel,

And words will do no justice, of course they won’t, because the crooked smiles and the disorganised tone of voice will give away the 

Fear? 

Is it fear? 

Or is it acceptance? That you are not, and cannot, but you belong in the silence between them.

Maybe you don’t. Maybe you can’t tell them. 

Maybe it’s enough 

That you know 

And that you be 

As you are 

Until what you are is something new,

And you can glance at what was,

Content. 

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 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 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

Posted in Managing Mental Health, Mental Health, positivity

Identity in Mental Illness

Posted on by Millie :)

As an autistic person with mental illnesses sometimes it can be hard to figure out who I am.

If you have diagnoses you might feel like you have to split up parts of yourself and your actions into boxes, like this part of you is autism and that part of you is anxiety, for example.

Or you might feel like your whole identity is your diagnoses.

Even without a diagnosis you might feel like parts of you are defined by the way you feel, split up and separate.

This can make us feel like we have to be ashamed of these parts of ourselves or like we are not really whole. It can be confusing to know who we are and find our identity in the midst of it all.

Then you add in other identity factors like sexuality, gender, and race which in many cases can complicate our mental health and understanding of ourselves even further – especially because it impacts how others see us, and this is even more prevalent for minority identities.

Rather than trying to see ourselves as a selection of different parts and separate ourselves into these parts, maybe we can start to think of it more like colours blended together and filters on the image of who we are.

Like my anxiety is red and it bleeds into my passion for theatre which is blue. They mix to create a purple in the middle, and that’s where stage fright lives. But all the colours are a part of me, blending together to make me who I am.

And my autism is a filter with a yellow tinge and that does affect how I view and interact with the whole world, but it isn’t my whole identity, nor is it separate to every other part of me. They all work together in different ways to make me who I am.

At the end of the day, you don’t have to have everything figured out about your life and who you are. No one does. It’s a journey and an ongoing process which can be really scary to think about. But it’s actually pretty amazing, all these colours that make up the rainbow of you, changing and growing each day. Remember – no one but you gets to define who you are; your identity is personal and you don’t owe it to anyone else, nor do you need to define who you are! 

But you are wonderfully unique, allowed to take up space, and your rainbow is so much more than you could ever imagine.