Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts

Wednesday, 7 September 2011

Broken System, not Broken People?

Thanks to Michael for sending us this excellent guest blog;

When the esteemed people at The Broken of Britain Blog kindly invited me to write a guest blog for them, I did something typical of a person who suffers from anxiety and depression: that is, I instantly compiled a mental list of the reasons why I was unqualified or unable to write a blog.  What made me change my mind was reading some of the other contributors to this blog and others like it and reminding myself that many people have the same exact reactions when faced with something new or difficult.  Reading the other blogs also reminded me how many people there are out there who I share things in common with and whose lives have intersected in some way with my own- the people who find themselves isolated or alienated or restricted or flattened by ill health or all of the above.  My personal experience lies in five years of mental ill health and so it is this issue that I will focus on.

Mental illness does not happen in isolation.  There are well-worn figures about 1 in 4 people suffering from a mental disorder in the UK in their lifetime or that the World Health Organization predicts depression will be second only to heart disease as the most widespread illness in the developed world.  But mental illness is not just statistics on a page or distant “others,” far removed from regular human activity.  It is all too human.  It’s dependent on how we order our own individual worlds and how we relate to other human beings.  We evolved as a social species, it was partly our ability to co-operate within small group structures that helped us to outlast other early humans and enabled us to endure the unimaginably difficult circumstances that faced hunter-gatherer tribes for thousands of years before the development of agriculture.  

Psychiatrist, Neurobiologist and author Paul Keedwell explains in his book, How Sadness Survived: The Evolutionary Basis of Depression,
‘The biology of our brains was shaped over a period of six million years, and for over 99.5 per cent of this time Homo Sapiens lived in small groups of hunter-gatherers.  Compared to this period of evolution the past few millennia or so of human civilisation- dating from the beginning of the Bronze Age- are a drop in the ocean.  Advanced civilisation- the organisation of subject peoples within a large society, with armies and division of labour- has only been possible because of the relatively recent development of agriculture and animal husbandry.  Biology takes a long time to catch up with changes in environment.  Our brain mechanisms, although malleable and adaptable to cultural changes, have limits to their capability set by our ancestral heritage.’  

Keedwell goes on to say: ‘We may be witnessing an epidemic of insecurely attached, psychologically vulnerable individuals in modern urban society.  As the extended family has been replaced by a smaller more mobile one, balanced homes have been replaced by broken ones, rearing parents have become working ones, young parents have become more stressed and isolated; and we may have failed to rear our children effectively.  Furthermore, we may have started to chase the wrong goals, or goals which are out of reach.  We have exposed ourselves to ever-increasing work and social demands while turning our backs on mutual interdependence.  In the west we have gained much more personal freedom and material wealth, but at a cost.’   

We are not built to go it alone- I know this from my own experience of an isolating episode of depression.  My family have been my loyal tribe and taken care of me.  However, my inability to engage in wider society or reconnect with the friends I used to know has left a scarring void in my life that feels as unnatural as it does paradoxically instinctive for an introspective depressive.  This is crucial: mental illness is not just a burden for the individuals or their families that suffer, it is reflective of the society we have built and the effect that it can have on us.  The social breakdown, health and wealth inequality, binge culture and the Three Cs- Consumerism, Competition and Celebrity Culture- that we see in our cities and towns and on our televisions all affect our mental health.  Social mobility had stalled and is now in reverse.  A working-class ethnic minority kid going on to become Prime Minister is about as likely as any single sperm connecting with the coveted egg- it will happen against the odds eventually, as it did with Obama, but that doesn’t mean the system is fair.  These damaging phenomena are a monument to the unfettered market that has ruled our lives for three decades and has captured the leadership of all three major political parties.

It is widely acknowledged that the policy of ‘Care in the Community,’ which has been pursued for the last thirty years, represents progress to a more humane approach compared to the large Victorian asylums.  These imposing buildings were conceived of more as quarantines where the uncomfortable truth of “madness,” an ever-present throughout human history, was sealed off as an act of segregation.  This is a rare instance where the Thatcher government should be given the credit they deserve for a progressive reform.

However, despite this change in focus and political language (which suggests a more inclusive approach to caring for the large numbers of mental health “Service Users”) the reality is still oftentimes one of isolation, stigma and neglect if not outright abuse, either within NHS services or in wider society.  By accepting that sufferers of mental illness are a part and not apart from society, we must now accept that aspects of our society are contributing factors to our dire problems with our mental health.

The glaring void across the political and media debate is some recognition that the complex and multi-layered causes of mental illness can no longer be attributed solely to the individual.  It cannot just be their burden for a dysfunctional family life or some innate weakness.  We must instead acknowledge that a significant factor leading to our higher levels of mental disorders compared to other wealthy nations is the scarring and widening inequalities that are an inevitable consequence of our “brand” of capitalism.  Equally damaging is the widespread ideal in our society that we must all fret and compete over varying states of perfection which are invariably unattainable (or undesirable) chimeras, be they the perfect house, car, job, appearance or status.  The economist Tim Jackson writes in his book, Prosperity without Growth, ‘We are persuaded to spend money we don’t have, on things we don’t need, to create impressions that won’t last, on people we don’t care about.’

The public realm and, in my opinion, the public good have been systematically dismantled and undermined by a cross-party consensus of government economic policy.  The neoliberal mantra of ‘private: good, public: bad’ has ring-fenced large swathes of the economy as beyond regulation.  If the supreme aim of every country is to create an amenable environment in which to do business then the wellbeing of the citizens of those countries can never be more than an afterthought.  This leaves us with government measures in health, crime, education, immigration and environmental policy being largely a thankless task of trying to clean up a mess predominantly wrought by an economic system that fosters inequality, promotes greed and narcissism and propagates that all human meaning resides in the relentless pursuit of material wealth.  I prefer the argument for helping people to lead healthy and meaningful lives but even those with the reductive and wholly economic view of human affairs must deduce that it costs much more to deal with the effects of these problems than it would to begin to tackle them at root. What kind of mixed message do we send to children when the Health Secretary meets with fast food corporations to draw up policy and the England Football Team are sponsored by Mars chocolate bars?  And how will we explain to our grandchildren why we have a national carbon footprint three times the size of our country’s foot?  It is time that politicians were honest that their own ideological dogma is the straitjacket preventing real change from breaking through instead of conducting debates on the margins over minutiae.

Exhaustive research by eminent epidemiologists Kate Pickett and Richard Wilkinson for their fantastic book, The Spirit Level, reveals that more individualistic and unequal societies have higher rates of mental illness as well as crime and prison rates, overall health, gender inequality and social mobility.  They write, ‘There are big differences in the proportion of people with mental illness between countries.  In Germany, Italy, Japan and Spain, fewer than 1 in 10 had been mentally ill within the previous year; in Australia Canada, New Zealand and the UK the numbers are more than 1 in 5; and in the USA more than 1 in 4.’  These rates correlate accurately with how wide the gap is between rich and poor in the countries named.  Their contention is that mental illness is closely related to status and more particularly status anxiety within society and therefore more unequal and callous countries leave more people marginalised, more ‘losers.’  

Such high levels of mental illness mean that it is no longer an issue that can be brushed under the carpet.  Is there anything else which affects 1 in 4 people and touches nearly everyone’s lives which is so ignored or misunderstood by politics or media?  I think that those are the kinds of ratios which demand that we as a culture begin to re-examine our attitudes and language towards the concept of madness or insanity.

  The fact that there is a cross-party consensus over draconian welfare cuts shows us how politically acceptable it is to attack the most vulnerable and voiceless.  When a company like Atos Origin is allowed to undertake its outrageous assessments of the physically and mentally disabled with impunity it shows a culture that has lost its compassion, its humanity and its priorities.  

Sufferers of mental and physical disabilities can be forgiven for believing that whoever we vote for, we always lose as the choice is between three shades of the same ideological dogma.  This is why websites like The Broken of Britain are so important, so that a group of people who have been consistently ignored and discriminated against can join together, exchange stories and speak as one.

Monday, 8 November 2010

Rohan's Story*

Never before have I been so aware of myself, my strengths, happiness and many faults, as I was this morning on Sunday 10 October, World Mental Health Day 2010.
World Mental Health Day
There are so many misconceptions and myths surrounding mental health and depression, and they add a stigma which so often perpetuates the issues, and actively instil fear in those that might otherwise seek help.
For those who consistently tell society that sufferers can just ‘snap out of it with willpower’, I have nothing but contempt and pity, for as they have judged others so too will they be judged.
Depression and mental illness is not just ‘in the head’, as some would claim, but is a very real illness with potentially devastating consequences.
Women are more likely to suffer from depression than men, 1 in 4 women will require treatment for depression at some time, compared to 1 in 10 men. Men are far more likely to commit suicide, this may be because men are more reluctant to seek help for depression or it may be due to other factors including substance misuse, unemployment and social isolation
I cannot speak from a medical perspective, but can certainly do so as an individual who suffered from depression for the best part of ten years, a period which could and should have been a fraction of that, had I sought the assistance available to me.
Before I continue, I must emphasise that there is no blame to any of the circumstances surrounding my symptoms, but only on myself for being too proud and stubborn to either recognise or, more pointedly deal with them.
At the age of eighteen, I had had opportunities beyond what many would consider as reasonable. My parents did not have much, but had made every sacrifice to give me a first-class education and to nurture my sporting talents, particularly in cricket.
Two years later, I had become a man, far before I was ready to assume such responsibility. There were several underlying circumstances, not least the divorce of my parents, but most pertinently that in not dealing properly with that, I had turned to the bottle and turned my back on cricket altogether.
Don’t get me wrong, I was never an alcoholic that needed his first drink at 7am, but I was often to be found at the Student Union bar from lunchtime, often not to leave until the dying embers of the evening. Believe me when I say that is NO life for a young man just out of his teens.
The spin-off was that I ostracised and hid away from true friends because they are the ones who would tell the truth and would try and get me to seek help. We surround ourselves with ‘yes men’, none of whom truly care enough to disagree with us.
Denial turns to frustration, which turns to anger, out of which eventually emanates self-loathing. At this point, life no longer holds any type of value.
Life, at most points, was the same as that of anyone else, but an ‘episode’ was seldom distant. It is very difficult to describe the emotions and the constant shifts. It was almost as if there was no middle-ground, just moments of extreme happiness intertwined with dangerous lows, best described on a site that I discovered today:-
These destructive patterns of thinking seem to be connected to a “switch” in the mind of a person who struggles with depression. Certain “triggers” seem to “trip” the switch, causing a flood of hopeless and self-loathing thoughts, which then ignites the embers of depression into full-fledged flames.
Triggers can be anything that trips the switch, such as being criticized, having an argument with a spouse, losing a job, flunking a test, making a mistake, becoming ill, being denied a promotion, feeling rejected, raising a difficult child, having a bad day, experiencing a loss or disappointment, having a financial setback, and so on.
~ Source: Serenity Online
During this long period, there were times when the switch would not be tripped for over a year, but I always knew that it might not be far away. I lost a lot of friends during that period, and am eternally grateful to those who have stood, and continue to stand by me.
It was Saturday 14 January, 2006, the day on which I started to live again. I woke up that morning in St Mary’s Hospital, Manchester, at the age of 31, as a man with a past before he had even begun to explore his future.
By that point in my life, I had taken two major overdoses, and shamefully managed to acquire myself a single record, the type which is not available in HMV.
I know that I would not be here today, but for the intervention of Danielle, my late fiancée, and one of my closest friends Sally. Unanimously that morning, I was told that I was on my own and would have to face up to my problems. Dani simply said that as much as she loved me, she had to walk away. Maybe, it was tough love, either way it was indubitably my saving grace.
I moved back to Birmingham that weekend, leaving behind a life strewn with unpaid debts and bills, broken friendships, lies, anger and self-disgust. How on earth could I expect Dani to love me, when I was incapable even of liking myself.
Of course, there was one person, who had always loved me, despite the traumas to which I had subjected her, and that was my mother. She took me back in at that point, and I vowed to myself that the time for change had come.
I was fortunate to encounter a man whom I only knew for 6 months, but who had a dramatic impact on my life. My counsellor, who has sadly passed away, was the most positive influence on me, never reneging on the promise that he made not to be a comfort blanket. Instead he challenged me to start believing in and getting the best out of myself.
Make no mistake, this was not an easy process as baggage, for so long unattended, was carefully opened and constructively packed away into the past. It was a journey of self-discovery which has made me the person that I am today.
If there is a sole vindication of the positive changes in my life, it is that Dani took me back into her life, and that we were engaged to be married prior to her untimely loss last November. In many respects, it makes her loss all the more tragic.
However, any fears that I would find myself slipping towards any type of depression were confined to those around me, certainly never entering my psyche. I am a very different human being now, to the one which terrorised myself over a long period of time.
I am not too proud to talk about my problems – if this was the case, you would not be reading this. I am not afraid to deal with the challenges that life brings, and I cherish the gifts that we are given every day. I am surrounded by a fabulous group of friends and family who are not afraid to tell me the truth, and moreover, I am unafraid to listen.
It is because of where I have been, that I have absolutely no fear in where I am going. If I said that there were no regrets, it would be an untruth, but they are few and far between. My biggest regret is that I did not have the strength and wherewithal to deal with my depression before it had such a damaging impact on my life and on those around me.
HelpingHands
For this alone, I implore you all to be more accepting of mental illness and depression, and not to attach a stigma to it. As an illness, it can have fatal consequences, and yet with the right support, it truly can be cured permanently. Whether you are reading this as someone who has or is suffering, or know someone that has, please do something positive to change it.
Mental illness is not just ‘in the mind’ but can have physiological and physical impacts, so we owe it to ourselves and those around us to do everything we can to raise awareness of it, and erase the ignorant myths and conceptions around it.
From a person who could not bare to look himself in the mirror, I am now a man full of life, hope, appreciation, and a better awareness of the feelings of those around me. In those moments of reflection and melancholy of all that has transpired, I simply remind myself of all the gifts I have had, and remind myself of the words of the Prophet Isaiah:-
“Fear not, for I have redeemed you, I have summoned you by name; you are mine. When you pass through the waters, I will be with you; and when you pass through the rivers, they will not sweep over you. When you walk through the fire, you will not be burned”
However, you do not have to be spiritual to seek help, for it is available for all who choose to take it.
I have today written about things that have not been previously spoken outside my very closest circles. I dedicate this post to Danielle Antonia Price, my best friend and late fiancée, and to Pedros Kypridemos, an incredible man and counsellor. You both believed in me, and although you are not with me today, I feel you looking down on me and shining a light on me at every moment.

Friday, 29 October 2010

Rebecca's Story

Six years ago I suffered a breakdown and was diagnosed with depression
and social phobia (also known as social anxiety disorder). I was 17.
The most work I'd ever done was in the village corner shop - a few
hours every week for a whopping £3 an hour, and of course I never had
to pay tax or NI contributions because I was so young.

When I turned 18 I went quickly and rather trivally onto Incapacity
Benefit. I remember going to have a quite hideous interview in a
really unwelcoming building - at the time I was pretty much housebound
and only because I was driven there by my mum was I actually able to
go. Still, I got the benefits and received them until I went to
university a year later. Because of the benefits I was able to get
some private CBT (Cognitive Behavioural Therapy) which helped me to
overcome my daily panic attacks: but I was far from better; the
treatment I'd had was a temporary solution to a problem that ran much
deeper than just my panic.

University went by, and I racked up around £25,000 of debt along with
most other students. I ended up oweing my parents a good few thousand
pounds that they refuse to allow me to even try and pay back. Because
I was a student, I couldn't receive benefits, even though my health
deteriorated to the point of being placed on suicide watch and under
the care of a psychiatrist. It's possible that I could have been able
to get some disability allowance from my university, but I was never
offered it and wasn't in a state to be thinking about going through
what would have undoubtedly been a long investigation into some help
that wouldn't come to much.

When I left university, and finally started to get some proper
treatment from the NHS, I applied for the new form of incapacity
benefit
- ESA. Because it was three years since I'd been on Incapacity
Benefit, I wasn't eligible to go straight back on that and had to go
through the rigmarole of applying again. So I did the form over the
phone with a very helpful woman who was patient with me when I got
upset telling her why I couldn't work. I started receiving benefits
and a couple of months later I was summoned to Croydon for a work
capability assessment. My therapist told me that it would be fine;
there's so much evidence of my ill health (from both the hospital and
my GP) that it would be nigh on impossible for ATOS to turn me down.

Oh, how wrong she was.

For those of you that don't know about the assessment, here's how it
works: you have an interview with a health professional. It doesn't,
actually, have to be a qualified GP: or even someone who is actually
qualified to identify your illness. It's just someone employed by the
private healthcare corporation to tick boxes. To "pass" the test, i.e.
be judged unfit to work, you have to score 15 points. I scored 0. On
the day, I had three panic attacks; one of them right before entering
for the interview. I was in floods of tears during the interview,
couldn't lift my head up, and was shaking. The woman who interviewed
me was rude, impatient and harsh in her questioning.

Thanks to the help of my local branch of Mind, I now have a benefits
advisor who is helping me with my appeal and tribunal process. Amongs
the help he has given, he gave me a copy of the work capability
assessment for mental, cognitive and intellectual functions. He and I
went through this and discovered that I should in fact have scored
well over the 15 points required. These questions include such
statements as:

"Normal activities, for example, visiting new places or engaging in
social contact, are precluded for the majority of the time due to
overwhelming fear or anxiety" - that scores you 9 points.

"Is frequently unable to get to a specified place with which the
claimant is familiar without being accompanied by another person" -
that scores you 6 points.

"The claimant misinterprets verbal or non-verbal communication to the
extent of causing herself or himself significant distress on a
frequent basis" - this scores you 6 points...and by now, you get the
picture.

I appealed twice and eventually went up for a tribunal in March. They
have a target of seeing you for tribunal within 16-18 weeks: clearly,
it is far beyond that now. Not only have I continued to receive only
£50 a week, on multiple occasions - despite me managing to put in
regular sick notes - they have refused to pay me either on a seemingly
trivial basis or one that they did not make me aware of. For example,
I changed address; they refused to pay me for 6 weeks until I had
proof of address and a new sick note bearing my new address. In this
time I had to borrow money from my parents to avoid being thrown out
of my newly-awarded temporary
housing from the council, because it had meant that my housing benefit
application was declined.

I now receive full housing and council tax benefit (which will of
course change under the Condems' new plans, as I am only 23). However
my application for DLA was turned down on the basis that I failed my
ESA work capability assessment. For something that is meant to be
separate to ESA, this is pretty disgusting. With that money I could
offset the £10-£15 I have to spend on travel every week.

I have had to subsist on £50 a week - including whilst homeless - for
over a year now. That barely leaves me anything to eat, once I have
paid my utility bills, my phone and internet bills that allow me
contact with the outside world and my support network on those days
that I can't leave the flat, my transport bills which are high because
I have to go to hospital twice a week and cannot drive.

This, of course, is just the numbers. This is before we even get to
the stress and anxiety that my struggle with the DWP, with the
tribunals service, with the council has caused me. Not only do I
constantly worry about money, but I am dogged by one single repeating
thought: "Maybe I'm not ill after all. Maybe I am just lazy, benefit
scrounging scum. I've never made a NI contribution in my life. I don't
deserve this. I'm leeching off people who are better than me because
they get off their arses."

I shouldn't have to feel these things about myself. I shouldn't have
to struggle on and try desperately to scrabble together food. It
shouldn't make me burst into tears when, like this week, my boyfriend
doesn't just bring over dinner for the two of us, but enough food for
me for a week. I shouldn't be sacrificing my health, and more
importantly my chances at getting better, because I can't afford to
reach out to the support networks that I so badly need.

Yet, I do. And the reason that I've written all of this up is that I
know for certain that I am not the only one, and I want other people
to know that too; because if you're not the only one then chances are
you're not making it all up, you're not lying to yourself, and just
because your disability isn't immediately visible doesn't mean that it
isn't there every moment of every day.

Sunday, 24 October 2010

Zellieh's Story

Please be warned, this story contains possible triggers for suicidal behaviour but Zelliah wants their story to be published. Thank you for your bravery.

Keith and Margaret's Story

My Husband Keith, is 64 years old, and had worked since he was 15 years old. He has suffered with mental health problems for over 20 years, but had managed to work despite this until he suffered a very bad Break Down 5 years ago. At that time he was diagnosed with Bipolar Disorder, and I cared for him through a very difficult 6 months, while also caring for my Mum who had Cancer and who died 5 years ago next week. We did not claim Benefits during this period as he was salaried and his salary continued throughout that period. His company agreed that he could return to work part time at first, and gradually increasing to full time. Again, we did not claim benefits, and subsidised his loss of earnings with our savings.