ourhappynotes – Our Happy Notes

Non-Canonical Autistic Characters

Posted on March 24, 2023March 24, 2023 by Millie :)

Ok so this is actually a list of characters that I have decided are autistic/ neurodiverse – not actual canonically autistic characters. In fact the only media representation of a canonically autistic character I have ever seen is Sam in Atypical – and I really struggled with this series. The only book I’ve read with an autistic character is The Curious Incident of a Dog in the Nighttime. To this day I have never – I repeat, NEVER – read a book or come across a media representation of a canonically autistic character who is female or gender diverse. Ever. I only realised that two days ago while thinking about this post and it made me really sad. In many ways I feel the media is moving forwards, and I do not feel I lack autistic representation in my life because I have had the privilege to be able to actively seek that out online. But to have never come across an autistic girl in the media I consume? I’ve heard there is an autistic character in Heartstopper so I will have to give that a watch soon. I’ve realised how much I want to consume content with autistic characters, so for the first time I think I’m going to actively seek that out.

But anyway, what’s the point of this? What’s the point of calling characters autistic? Well, in part for fun. This is simply my opinion and not a critical analysis of any of these characters. But also for representation, in a non-direct way. Resonating with fictional characters and relating to the world through them is a huge part of my neurodiverse experience, so if I can see myself in them a little more by calling them autistic, it’s really comforting. And finally also to raise a little awareness of an ongoing trend of creating autistically coded characters (characters with clear neurodiverse traits) without calling them autistic. It lends itself to another ongoing trend where people love the quirky characters on screen or in books – they even seem to worship them – but in real life people with the same traits are bullied and left behind. Recognising that I, as an autistic person, resonate with neurodiverse traits of characters begs two questions: 1 – Why aren’t characters called autistic? Perhaps because people are afraid to relate too closely to neurodiversity, it threatens them; 2 – Why do we celebrate difference in fiction but create intolerance to it in reality?

With that being said, here are some character I (and other autistics) have decided are autistic:

Sheldon Cooper – The Big Bang Theory and Young Sheldon

The fact that the creators refused to admit Sheldon is autistic (like literally entirely based on autistic traits and stereotypes) is a source of great frustration – though it may be because they wouldn’t be able to make fun of him in the same way if he was autistic. But nonetheless, I really love seeing some of my traits on a big screen, especially in Young Sheldon, which at times seems to mirror my own childhood experiences exactly. Though it should be noted that autism is so much more complex and varied than the representation of Sheldon (and other similar characters like in Rainman).

Some of his autistic traits include:

Sensory sensitivity (sound, taste, smell)
Different speech and intonation patterns
Love of routine
Difficulty dealing with change
Lacking social skills
Hyperfixations and special interests
The list is literally endless

Wednesday Addams – Wednesday

I mean the character of Wednesday is overall very neurodiverse, but the recent representation in Wednesday on Netflix was really relatable for a lot of autistic people.

Some autistic traits include:

Monotone speech
Less facial expressions
Different way of moving (the iconic dance scene)
Sensory sensitivities (allergic to colour)
Bluntness
Difficulty interpreting others emotions – ‘It’s not my fault I can’t interpret your emotional morse code’
Strong sense of justice

Matilda – Matilda

I have always been obsessed with Matilda, and that’s probably at the core of why I see her as a neurodiverse character. I think I’ve read the book more than any other book (including in Spanish) and I’ve seen the musical more than any other show. I love it. As a kid I would spend hours staring at objects trying to get them to move with my mind, and I feel as though I’ve had my own ‘Miss Honey(s)’ in my life too.

Some of Matilda’s autistic traits include:

Strong sense of justice
The loudness in her head and different way of perceiving the world (‘But I wonder if inside my head/ I’m not just a bit different from some of my friends […] And when everyone shouts / Like they seem to like shouting/ The noise in my head is incredibly loud’)
Different from her peers and family
Hyperlexia (can read very well very early)
Special interests (reading)
Direct way of communicating
Sensory sensitivity – to Ms Trunchbull’s shouting and the TV for example

Hermione – Harry Potter

Mentioning Harry Potter can seem a bit of a tightrope walk nowadays, but it was a very important part of my childhood and forms part of who I am today. That being said, trans women are women – always have been, always will be. So let’s reclaim the narrative further and say that Hermione is autistic! I was so obsessed with Hermione that all the new clothes I bought at 12 were based on her costumes. She was super smart and didn’t let others put her down because of it, and as someone who was often ‘ahead’ in school this was so comforting to see. Also Luna Lovegood is 100% autistic as well and I love her.

Some autistic traits:

Strong sense of justice
Sensory sensitivity – notices details others miss
Lacks social skills (at least in first few books) and skips social niceties
Special interests and hyperfixations (intense devotion to studying)
Obsession with learning and following the rules
Hyperlexia

Phoebe – Friends

Another one of my comfort shows, I have watched Friends more times than I can count. And the more I’ve watched it, the more I’ve related to and appreciated Phoebe’s character. Watching it again after being diagnosed was really interesting because I remember wondering for the first time about how Phoebe was showing a load of those traits I had just been asked about in my assessment. I’m not convinced she’s autistic, maybe ADHD or something else – but she is definitely neurodiverse. 100%.

Neurodiverse traits:

Doesn’t care about social niceties (will just leave or say she doesn’t want to do something)
Unique fashion sense
Sensory sensitivity (she can hear music and voices and feel spirits etc, I’m putting this under sensory sensitivity, maybe it’s an extra sense)
Special interests – guitar
Different way of communicating
Moves her hands in different ways
Wandering thoughts
Hyper empathy
Strong beliefs that don’t bend to social expectations

So there’s five there. Is that representation good enough? No, because it’s not really a representation. Is it a bit comforting to think about, personally? Yeah, it is. Can we do better? Yeah, we can. A lot. I’m not looking for a whole series about autistic experiences. But I’d like to see myself in the media occasionally, because there’s a lot of autistic people here in the world. Just for already autistically coded characters to maybe have a moment of recognition on screen, a single mention of it, would be huge. If I – a privileged, white, verbal, cis autistic woman – haven’t seen myself represented yet, how long will it be before we start seeing the Black autistics, non-verbal autistics, physically disabled autistics represented? It might seem like a little thing if you have seen yourself on screen and in books all your life, but it can have such a huge impact. I remember crying the first time I read a book with a gay woman. It meant I wasn’t alone. I enjoy a lot of the media I consume, because I can relate to lots of different people with lots of different experiences, and I can enjoy media I don’t directly relate to. So why are people so afraid to relate to us once in a while instead?

Thanks for reading! Sending all my love and support today xxx

Happy Notes, Managing Mental Health, Personal Growth, positivity

Gratitude Practice

Posted on March 21, 2023 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:

My natural instinct when searching for something to help me was to practise gratitude
Practising gratitude had an immediate effect
Despite not wanting to do many things, I wanted to continue to practise gratitude
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:

It improves empathy and reduces aggression
It helps improve sleep
It boosts self confidence
It strengthens relationships with family, friends, and romantic partners
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

Advocacy, Mental Health

Psychiatry and LGBTQ+ Rights

Posted on March 3, 2023March 1, 2023 by Millie :)

Psychiatry has throughout its history and still is very much linked with control and upholding societal standards. The view many people have is that at its core, even though it may be failing, the mental health system exists to help us be happier. And while it’s true there may be individuals in the system who wish this, the very structure is built around an idea of societal norm, and returning people to acceptable states of being and productivity. Part of that history of western psychiatry has been its link to LGBTQ+ rights – or more specifically the denial of such rights and the pathologisation of the community as mentally ill. So here is a very brief overview of some of that history today.

But first, why is this important? Well, the history and injustice of psychiatry is really important to understand because the way the system operates now is directly built on this, so we’re still seeing discrimination of all kinds. We can’t just fund a harmful system, we have to review it, build alternatives etc etc. If we do not understand this history we cannot engage in meaningfully informed conversations about what the future of mental health care might look like, because we risk making the same mistakes by perpetuating the system.

So here’s some fast facts about psychiatry and gay rights:

The World Health Organisation (WHO) didn’t declassify being gay as a mental illness until 1992.
They didn’t declassify being transgender as a mental illness until 2019.
Between 1935 – 74 chemical and electrical experiments were done on gay men in psychiatric hospitals to try to change their sexuality in a process known as ‘aversion therapy’. Some men were made to do this to avoid going to jail for engaging in homosexual activity. Conversion therapy is still a practice in many places today, an ongoing demonstration of this abuse and trauma inflicted upon LGBTQ people.
Being gay was also criminalised, as well as being classed as a mental illness, until 1973. This is a clear example of the direct link between psychiatry and criminalization. Under these laws over 100,000 men were convicted in the 20th century. One such example is Alan Turing who was forced to endure hormone ‘therapy’ to ‘cure’ him, or go to jail. He chose the former and was chemically castrated – as were many other men. It was not until 2017 that the UK offered pardons to the thousands of gay men convicted of abolished sexual offences, simply because of their sexuality.
Gender dysphoria and incongruence (for example) are still used to pathologise being trans – meaning they are terms that label being trans as some kind of individual mental defect, and means transgender people have to jump through hoops before they can access gender affirming care
1 in 7 LGBT people avoid treatment for fear of discrimination nowadays

The joint stigma surrounding mentally ill people and LGBTQ+ people means that they are seen as people to be feared, shunned, or fixed by many. And much of that stems from this history listed above. It is true that LGBTQ+ people are more likely to experience mental illness:

52% experienced depression in the last year
One in eight LGBT people aged 18-24 said they’ve attempted to take their own life in the last year
One in six LGBT people said they drank alcohol almost every day over the last year.
Almost half of trans people said they have thought about taking their own life

These statistics are unsurprising when we consider the intersectional nature of mental illness. It’s not something that exists in a vacuum, and although it may be experienced by an individual it is not an individual flaw. Economic insecurity, discrimination, exclusion, lack of support, homelessness, addiction – these all compound mental distress, understandably, and LGBTQ+ people are likely to suffer more with all of the above. But treatment often focuses only on the individual symptoms, and fails to address the bigger picture, which leaves LGBTQ+ people at even more of a disadvantage. And that’s without even considering the discrimination, homophobia and transphobia within mental health care, which puts an unreasonable expectation on LGBTQ+ people to trust the providers of their care when they haven’t been proven to be safe:

One in eight LGBT people (13 per cent) have experienced some form of unequal treatment from healthcare staff because they’re LGBT.
Almost one in four LGBT people (23 per cent) have witnessed discriminatory or negative remarks against LGBT people by healthcare staff. In the last year alone, six per cent of LGBT people – including 20 percent of trans people – have witnessed these remarks.
One in twenty LGBT people (five per cent) have been pressured to question or change their sexual orientation when accessing healthcare services.
One in five LGBT people (19 per cent) aren’t out to any healthcare professional about their sexual orientation when seeking general medical care. This number rises to 40 per cent of bi men and 29 percent of bi women

I think at the very least, LGBTQ+ people should be able to choose mental health care with professionals that reflect their lived experience, but this is so often not an option and as a result they are unable to engage with their care, and may even be blamed for it. But the history of LGBTQ rights is full of stories of community care and community love, and for a community that has good reason to be distrustful of authority figures, perhaps the key lies in modelling peer support and community care on the rich love of LGBT history. I don’t know all the answers; I have opinions, but I do not feel confident enough to say I definitely know what’s right. I do however know it’s time to move forwards and forge a new future. We’re going to get things wrong still, it’s inevitable, but maybe if we’re a bit more aware and intentional about mitigating harm, we can see a brighter tomorrow for mental health care, and the LGBTQ+ community.

Sources:

Glowing fluorescent blue triangles in a pattern

Advocacy, Mental Health, therapy

Issues with IAPT

Posted on February 24, 2023February 23, 2023 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:

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
Sign up to Mind’s newsletter to find out about their campaigns for better mental health care
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
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’

Happy Notes, Notes, Personal Growth

22:47, A Poem

Posted on February 20, 2023 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.

Happy Notes, Managing Mental Health, positivity

100 Good Things in The World

Posted on January 30, 2023January 30, 2023 by Millie :)

I’ve made a previous post on reasons to stay alive, which you can read here, but I wanted to create another list of good things in the world. It’s like a list of reasons to live, but also a list of reasons to be grateful (a very important practice in my life), and a list of reminders to see the little good things in life when things get rough or stressful. Use this list to find a moment of pause in your day to connect with some peace, and let yourself connect with the goodness in this world. There’s a lot of issues and sadness, and we can’t ignore that, but sometimes we do need a moment to escape the pressure.

Potatoes – they can be cooked in so many different ways!
The smell of the air after it’s rained
Crunchy leaves
Handwritten letters
Listening to the sound of the sea in seashells
Chameleons – they literally change colour, that’s insane!
The amazing activists and advocates trying to create a better world for us full of hope
The internet. It’s really quite incredible if you stop to think about it
Video calls allowing us to see each other and connect from afar
Really soft fluffy blankets
All the different kinds of music and how all of us can find different pieces beautiful
Board games
Deck of cards – how many different games and tricks you can do, and how they’re unlikely to ever be in the same order!
Snow under your feet
Sledding down a hill
Laughing until your belly hurts
Hats.
The northern lights – they’re like magic!
How many different languages exist
The top of ice cream before anyone takes a scoop
Really cold water on a hot day
A cat’s purring
Bluetooth
The smell of old books
The smell of new books
The smell of freshly mown grass
The smell of freshly baked bread
Pretty sparklers and fairy lights
The Fibonacci sequence
Those random acts of kindness from a stranger that brighten a day – like letting you go first in line, offering a tissue, holding a door
Dogs little paws and toe beans
Bubbles
How many different flowers there are!
The miracle of ecosystems in nature
The feeling of floating in the sea
Building sandcastles
Clouds at sunset when the light illuminates them
Hugs
The amazing scientific advancements being made every day
Shooting stars
Book clubs (or any kind of community club, it’s so lovely to get together over a shared love and interest)
Amateur dramatic theatre – it’s totally about doing what you love together, no other reason!
Magnets (just so fun to play with and the science is actually very cool)
Charity shops and thrift stores
People sharing their knowledge and encouragement on the internet
Pillow fights
Water fights (why stop doing the things you loved as a kid just because you’ve gotten older)
Electricity
Beautiful trees
Daisies close up at night like they’re going to sleep
Sunflowers turn to face the sun
The colours of leaves changing in autumn
Teddy bears
The infinity of imagination
Community gardens
People being brave enough to live their truth and share their stories every day even though it may be dangerous or stigmatised
Libraries (they offer the gift of reading to so many more people)
The word ‘serendipity’
Public transport linking us easier
Funky hair dyes (and the amazing things people do with them)
Fidget toys and logic puzzles
Hilarious movies we can bond over and laugh at
Free education (hopefully one day equal and free education will be available to all)
Poetry that reflects our own experiences and feelings
Funny animal videos
Free guided meditation videos
Peer support groups
Smiles
So much art and creativity in so many different forms that connects us, reflects and shapes culture, and inspires
Calculators you can type rude words on
AAC communication devices allowing nonverbal people to communicate easier
Medical and emotional assistance animals
Hot chocolate (or your other favourite warm drink)
Colour changing lights, they are so cool
Written letters
Messages of kindness from strangers posted online or scrawled in public everyday
Blue tac
Glasses and hearing aids – imagine what it was like before we had them!
Apps for so many different things, making knowledge and the world more accessible for many
Woodland walks
Friendships
Love is all around us in so many different forms
Dad jokes
People donate blood to save others every day
Audiobooks making reading more accessible
Picnics
Pizza – circle shape, in a square box, cut into triangles
Alcohol-free alternatives
Fluffy socks
Showing gratitude
Bird song in the morning
Finding a penny on the ground
Running through sprinklers
Feeling of popping bubble wrap
Hearing a song you used to love and had forgotten about \
Seeing an old friend for the first time in a while and picking up like you only saw them yesterday
When you have a really cool dream and you can remember it when you wake up
Eating breakfast food at night or dinner food in the morning
That cosy feeling when it’s rainy outside but you’re warm inside
There’s always more tomorrows

Advocacy, Mental Health

‘Bedlam’s’ True Horror History

Posted on August 6, 2022August 6, 2022 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

Advocacy, Managing Mental Health, Mental Health, Personal Growth

Journey Through Panic Attacks

Posted on July 3, 2022 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

Advocacy, Mental Health

Over Pathologisation of Mental Health

Posted on June 10, 2022 by Millie :)

We hear a lot nowadays about removing the stigma from mental illness, and that is incredibly important. After all, we all have mental health. But I also I think it’s essential while advocating in mental health spaces that we not only call for destigmatisation, but we also question the systems; call out the injustices of the systems meant to care for us. We must question whether medicalisation of mental health really helps us. Would it be necessary if our society wasn’t structured the way it is in the west? Does it further the link between mental illness and criminalisation? Because destigmatising mental distress isn’t only recognising that it exists, it’s asking why it exists, is the language we use to describe mental illness helpful, what does healing really mean, and how are we failing to learn the lessons from our madness? So here are some of my musings on the over pathologisation of mental health:

It individualises our pain without individualising our care – that is to say it tells us we are broken, it is our individual chemistry that is flawed, and we are to blame, yet also not putting us at the forefront of understanding our pain and choosing how we heal. It tells us we are too sick to know what’s really good for us, or that we don’t know ourselves well enough. It doesn’t allow us to learn who we are and what’s really at the root of our pain; doesn’t encourage us to put it into a sociopolitical context, and the context of what has informed our life. Doesn’t allow us to heal with others.

There is no community. No value given to peer support, to healing with others who are experiencing the same things or similar things or completely different things, but feel safe to heal with. Doesn’t encourage the connections that are vital to long term healing and alternative methods of care. If you want proof that peer support methods of healing work, look at AA – it revolutionised care for alcoholics. What was a death sentence became an opportunity for hope and healing.

Our pain is shunned and labelled, pathologised. Instead of learning to embrace the madness as part of who we are, we learn shame which in turn births more pain. Instead of learning to see mental distress as a natural human reaction, however difficult, we learn to be afraid of it. Language that could be used to free us is instead weaponised against us to strip us of our wholeness and our identity through clinical rotes.

But it doesn’t have to be that way. I don’t have all the answers. I listen to psychiatric abolitionists and I think, yeah, they have the answer. I listen to amazing healers in other cultures outside of the west and am filled with inspiration and hope. Then I look back at the world as it is and wonder if we don’t need to adapt our goals to be a little more realistic within the current frame of society here in the UK. I don’t have the answer nor a clear label for my ideology surrounding this all. But I do have hope. And I do know things are already changing.

We don’t have to wait to build communities. We don’t have to wait to create new ways of healing. We don’t have to wait to find hope.

You can also find a version of this post on my Instagram @our.happy.notes

Managing Mental Health, Mental Health, positivity

Identity in Mental Illness

Posted on June 3, 2022June 3, 2022 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.