Hiding Behind A Smile

What do these photos say to you? You probably see a happy, smiling young person, enjoying life. The reality is I was ill in each of these photos.

I’d either just had a diagnosis of bipolar, or was about to be diagnosed. You can’t see it, but I was all over the place mentally – either depressed or manic, it was relentless and I felt stuck in a never-ending loop. I don’t remember being stable for more than a week at a time. Mania made me confident and almost euphoric, but at the same time I was dealing with delusional thinking and spending thousands of pounds that I couldn’t really afford. Then there was the irritability and anger that made me act out and say terrible things. Crushing depression left me feeling hopeless and stuck. I was also struggling with bulimia and in no way was I taking care of myself physically. To be honest, it was a shitty time in my life. Somehow through it all, I was working full time, spent the weekends partying with friends and going to festivals and gigs. I never stopped and I was always, always, smiling.

By that point in my life I’d become an expert at pretending everything was fine, hiding behind a mask and smiling through the pain.

It’s obvious with hindsight what was about to happen; I crashed. I became deeply depressed – the worst I’d ever felt. I was suicidal and couldn’t work, couldn’t go out, could barely function enough to have a shower. It forced me to confront what I’d been going through for years and start searching for a reason why. The answer was bipolar, and that started me on a long road of learning and acceptance. It taught me I have to be honest. I couldn’t hide anymore.

It’s easy to see a smiling face and assume everything is totally ok. But it’s not enough to just assume. Someone you love could be hiding how much they’re struggling and you may never know.

So ask the difficult questions; tell them you’ve noticed signs that something isn’t quite right. Reach out to them if they suddenly become withdrawn. Listen like you’re really listening, mean it when you empathise with them and ask how you can help. The mask will slip, and how you act when it does will make a huge difference to that person.

I wish I’d been more open about how I was coping. I wish I’d told the truth back then. But here I am now, being authentic and honest. It’s never too late to stop hiding, to let people in. I’m always blown away by the support I have from family and friends. It’s not always easy for them, and we communicate our feelings to each other when mental illness makes life tough. I have lost friends but, the ones that really care will stay by your side.

How To Help A Friend With Depression

Depression is common, but it’s also common for people to freak out and not know how to support a friend. Below, I’ve listed a few ways in which you can help a friend with depression.

Listen

Listening, real, active listening, can be your superpower. Hearing what someone has told you means you can then validate their feelings, and make them feel less alone. Ask questions to get more information, rather than assuming you understand. Instead repeat back what they’ve told you in your own words, so they can see you’ve heard. Don’t make it about you and your own experiences, listen and show empathy; do this by showing your interest in what they’re telling you, through your words and body language.

Help them find support

This is easier said than done, but if you can help them get the ball rolling, by encouraging them to make that first phone call, taking them to appointments, or even advocating for them at appointments, it’s better than doing nothing. Depression can make people isolate themselves, and that includes accessing therapy and going to appointments. Check up on them and encourage them to continue with their treatment, by doing one of the above.

Offer to help practically

Practical help can be just as vital as listening. Knowing your place is a mess for instance, can make you feel guilty and worthless. They might need help shopping for groceries and essentials, or help tidying their home or room. It’s important to not take over and do absolutely everything for them. It can make them too reliant on you, or even make them feel guilty and like a burden. Try to share out the workload if you can, or offer to do something they absolutely feel they can’t face.

Don’t pressure them – but don’t exclude

When someone is depressed, they’ll be less sociable. It might feel frustrating when they’re invited out, but refuse to go. Don’t pressurise them or make them feel guilty for not going out. This doesn’t mean ignoring them completely though. You can still include them by extending an invitation. Try saying something along the lines of, ‘we’re going to the pub, you’re welcome to come if you’re feeling up to it.’ Acknowledging they’re having a difficult time, will make it easier on them if they feel they’re not ready..

Be patient

It can be a slow process for your friend to start feeling better and more like themselves. They’ll have good days when you think they’re ok, but then this could be followed by more bad days. Recovering from a bout of depression isn’t linear, and even when they’re in the middle of the storm, they might have days when they seem absolutely fine.

Stay in touch

Don’t let a friendship drift because they have depression! Staying in touch can make all the difference to them, especially during a time when other people might pull away, because they don’t know how to deal with it.

Learn about depression

One of the best gifts you can give a friend is simply learning more about depression. This doesn’t mean showering them with advice and ‘have you tried?!’ it’s reading up about what it’s really like, the signs and symptoms and what kind of support is out there. If you know the signs and symptoms, you will be more aware if they or someone else in your life becomes depressed. You can also share with them any information you’ve found on support groups etc.

Take care of yourself

Make sure to take time for you. Practise your own self care, and set boundaries around how much help you can provide, such as how much time you can spend on the phone talking to your friend.

And remember, this is still your friend. They haven’t suddenly changed into a stranger. You can still treat them and talk to them how you would at any other time.

How To Sensitively Talk To Someone Having Suicidal Thoughts

It can feel incredibly tough to talk to someone who is experiencing suicidal thoughts, but it’s so important to have these conversations. We often worry about making the situation worse if we talk about it, but actually, we could just end up alienating that person by not talking about it. Language is a powerful tool, and the way we use it can have a huge impact on someone’s life. It’s important to use language sensitively when talking to someone about suicidal thoughts.

Suicide and having suicidal thoughts is often stigmatised. People are often afraid to talk about it, but that’s the best way to remove the stigma.

I have felt suicidal in the past, and the people around me have been scared and confused as to what they can do and how they should help. It doesn’t have to be complicated. I’ve spoken to close family and friends about how to talk to me when I might be suicidal, and I wanted to share here what helps me.

Active Listening

You don’t have to be an expert to talk to someone experiencing suicidal feelings. Active listening is a good place to start. It’s all about giving the person space to talk, without interruption. When it’s your turn to listen, don’t spend the time planning what to say next. You can’t rehearse and listen at the same time. Think only about what the other person is saying. Don’t jump in with advice, instead listen and really hear what they’re saying about their feelings and emotions. Be nonjudgemental – because only they know the thoughts and feelings and you can only find out what they are by listening. Wait for them to pause, before asking questions, and those questions should be just to clarify what’s been said. So really you could call it being a sensitive listener.

Choose Your Words Carefully

Using the correct terms around suicide shows you’re compassionate and understanding. If you use the word ‘commit’ you’re suggesting it’s a crime. Suicide in the UK hasn’t been illegal since 1961. If someone has heard you using this term, they might be less willing to open up about their thoughts when they’re struggling. Instead use terms such as ‘died by suicide’ or ‘took their own life.’ Showing you’ve changed your language shows you’re willing to be there and listen.

Don’t Avoid The Subject

You don’t have to give advice when someone opens up to you, so don’t be afraid of talking to someone about suicide. You can point them in the direction of help – whether that’s helpline numbers, their mental health team, or calling the emergency number. You can help them by taking them to an appointment, or to A&E, if it’s an emergency. We often worry talking will trigger someone into doing something drastic, but having a listening ear and someone to talk to maybe just what they need.

Show you care by showing empathy. Empathy is about even if you’ve never experienced what they’re going through, you can appreciate the way they feel. Try not to share your own experiences, instead, ask them questions that give them the opportunity to be honest. It’ll encourage them to think about their thoughts and feelings in a way they never have before.

Remember – not to speculate about suicide you may have read about in the news, especially if it’s about the method. This can be triggering for people that may be struggling with difficult, intrusive thoughts.

If you are in crisis and are concerned for your own, or someone else’s safety, call 999 or go to A&E

Samaritans – 116 123 or email jo@samaritans.org. The Samaritans are available 24/7 and are completely anonymous.

How to help someone before and during a manic episode

Make a Plan. Before an episode of mania starts, make a plan together. First off, they’ll be more receptive to your ideas. They’ll be more in control and be able to look objectively at previous episodes of mania. Decide together what will help them, and what support and help they want when they are seriously ill. Write down your decisions, and keep them in a safe place for when you need them.

Focus on triggers. You could look at their work commitments and any other projects they have and offer your own opinion on them. It may be you feel they’ve taken on too much, which could lead to stress and burnout, that could then lead to an episode. Be calm and gentle with the suggestion, so they don’t feel you’re being overly protective or critical.

Stick to healthy routines. Again to keep them healthy, and during an episode, you could help them stick to a routine. Making sure they have regular meals and a sleep routine will either help to keep them well, or be in a healthier place when the hypomania/mania ends.

Join in with their activities. During an episode you could do things together with them. If they are being creative, join in. It shows you’re interested in what they are up to, and means you can make boundaries on how long they spend on the activity. Again, don’t force them to stop, but remind them of other things they need to do that day, or that they need to eat, sleep and look after themselves.

Help with finances. You might have to manage their money when unwell. This can be organised beforehand. Doing things such as putting a site blocker on their phone or computer – that only you know the password to. It’ll stop them from spending money on websites you know they use often. You may need to take their cards from them, and have access to their bank account. If they need money for something, they will then have to ask you. It might feel like you’re infantilising them, but believe me, they will appreciate it when they are stable.

Sometimes when someone is very ill, their behaviour can be challenging. It’s difficult to understand and to deal with. Often when someone is manic/ hypomanic, they can be very disinhibited. Their behaviour could be embarrassing for you. It might be strange and they act oddly around you and others. It could even be upsetting or aggressive. It’s important that you talk about this, and don’t let it fester. It probably isn’t the best time to talk to them right there and then, because in a manic or hypomanic state they might not listen to reason. Actually, they almost definitely won’t. They won’t be able to see your point of view. So, its best to wait until they’re stable. Write down what you want to tell them, so you don’t forget what it was they said or did. Writing it down can help you cope with your own feelings, without reaching boiling point. Calmly discuss their behaviour, and how their words or actions made you feel. Try not to judge or be overly critical. Remember that they were ill at the time, and would not have been aware of how much they upset or concerned you. Tell them how their actions and words made you feel. Don’t accuse them of acting in a certain way or generalise; instead turn it around and explain how you felt at the time.

When someone is manic, they might lash out at the people closest to them. You’re allowed to be upset if they’re pushing you away or upsetting you. Remember why they’re acting that way; they are ill and dealing with difficult moods and emotions. When things start getting too difficult, it’s ok to take time out. If you’re worried what will happen if you need some time away, then talk to friends and family to help out. It could also help to talk to other people in a similar situation.

Ideas To Help Someone With Psychosis

I’ve listed on the blog before about what not to say to someone with psychosis, and although that’s important, I realised I didn’t go into much detail about what helps. As I’ve mentioned before, psychosis covers experiences from hearing, seeing, or feeling things that aren’t really there, and delusions. Delusional thinking causes us to believe grandiose ideas about ourselves, or may make us paranoid and secretive. Here’s a list of 6 things you can do to help.

Be gentle and calm. It’s easy to get frustrated with someone when what they’re saying doesn’t make any sense. You might feel like calling them out and confronting them. Don’t. What they’re experiencing is very real to them at that moment. Challenging their beliefs could easily push them away – if they’re paranoid it could even fuel the delusion.

Listen and try to understand. Listen to what they say and stay calm. You don’t have to agree with what they’re saying. Don’t encourage a delusion as this can make things worse. Ask them what would help, and if you’re struggling to understand educate yourself a little more about what psychosis is.

Focus on their feelings. It’s important to talk about how someone is feeling rather than the experience they are having. If they’re feeling stressed or worried, this could be the reason for why they are having an episode of psychosis. Making them feel safe and secure can help guide them through the experience.

Show them respect. Don’t be critical of what they’re going through or over protective. You might feel that you know better, and telling them what to do will help. However, it often creates a divide. You can respect their wishes to an extent. For instance, if they want to be supported in the home, rather than in hospital you should respect that, unless they become a danger to themselves or others.

Put a crisis plan in place. A crisis plan involves deciding on treatment options and hospital visits. You can also put together an informal plan with your loved one, where you set boundaries. By this I mean, what you can and can’t deal with when they’re in crisis. It’s helpful to be honest and have a plan in place before a crisis hits.

Look after yourself. It can be challenging, upsetting, and sometimes distressing looking after someone going through psychosis. It’s important to take care of your own wellbeing and health during these times.

This isn’t an exhaustive list, only what I would find helpful and how I’d like to be treated when experiencing psychosis. Ultimately, everyone who goes through psychosis has a different experience of it and their needs will not look the same as mine. This is why it’s vital you talk to that person to get an understanding of their unique experiences, before they become ill.

To all the people that pulled me through a mental health crisis

Through the years I’ve had many mental health crises. I’ve been on the brink of ending it all, of no longer wanting to fight, of no longer wanting to exist. Although I owe the NHS a great deal, they’ve also let me down when I’ve been at my most desperate. But there are people in my life who have been there, every time. It hasn’t always been easy for people to support me. I’ve upset family and friends during mania, and been rude and irritable when depressed. They’ve supported me without hesitation and I want to thank them.

To my husband, and his calming, caring persona. Never have I met someone with such unending patience and compassion. You’ve pulled me through in moments when I’ve felt like my whole universe was shrinking away into nothing. You’ve been a solid, grounding presence for the past 10 years. You’ve taught me so much about myself and I adore you for your kindness, geekiness and general silliness.

To my Mum, and her profoundly caring nature. For always being there when I need her most. For learning and educating herself about Bipolar and psychosis. For her understanding that I can’t always be ‘fixed’ but that she can help in her own practical way.

To my Dad, and his unwavering support of me. For showing me I’m stronger than I believe. For showing me I am resilient, intelligent and passionate. For showing me that family are the people that care for you and support you unconditionally.

To my brothers’ and their matter of fact attitude to mental illness. They always seem to just get it. I don’t feel the need to explain myself. I don’t feel judged by them. They see it for what it is; an illness I can’t control.

To all my family, for letting me talk when I need to. For accepting me. For listening without judgement or fear. For detaching mental illness from who I really am.

To my friends who accept me for who I am. That haven’t distanced themselves after I was diagnosed. That have stuck by me, and offer support when I struggle, and celebrate when I achieve.

To my online friends who notice when I’m quiet. Who notice when I’m having a difficult time. Who are there to talk to when I need support.

To everyone that reached in to support me, rather than waiting for me to reach out. Thank you. You’ve saved me from myself countless times.

I’m Writing A Book!

Yep, the secret is out! I’ve been offered a publishing contract with Jessica Kingsley Publishers to write a book about bipolar disorder.

The book is going to be a practical guide to bipolar disorder. I’ll offer tips and advice on how to navigate daily life and how to manage symptoms. All of this will be alongside my own experiences of living with the condition!

Now I need to just write the bloody thing! You can send me coffee to fuel me whilst I’m busy working on the manuscript over Xmas and into 2020!

And it all started here, on this blog. I’m truly grateful for each and every one of you that takes the time to read my posts. I’ve thought about giving up writing about mental health, and bipolar in particular numerous times, but the support I have online is incredible and has kept me going, so thank you!

It’s made me reflective and as we head into a new decade, I couldn’t think of a better end to this one. In 2010 I was a mess. I was constantly manic or depressed, there was never any respite from the chaos in my mind. It left me exhausted and physically ill. In mid 2012 I had a breakdown and came close to losing everything. I lost my job, and somehow my partner Jimi stuck with me, supported and cared for me, even though I was terrified he would leave.

Then I was diagnosed with bipolar type 1, but believe me, that wasn’t the end of what became the most gruelling, challenging decade. I was out of work for years, and I had to redefine who I was as a person. My career had been my life, it was me. I went on benefits, and was in a constant state of worry over my finances. I had to find a new way of living my life, a healthier way. It took years before I found medication that worked for me. A combination that didn’t have awful side effects.

2019 has been a better year. I took a huge leap and started working as a freelance writer. I write about mental health, and I’m passionate and committed to my job. I’ve finally felt in control of bipolar, rather than it controlling every decision I make. Now, at the end the year, I have a book deal. I’ve come so far and I’m so proud of myself; something I find difficult to do and admit.

The me of 2010 would never have believed what I’m doing now. She was too focused on getting through the next day, the next hour. But I made it through, I fought my way through this decade.

I can’t wait to share the book with you all. For now, I’ll be typing away on the manuscript, but I’ll still be writing here on the blog when I can!

Bipolar and Credit Cards, Loans and Debt

Mania for me always leads to overspending. I’ll spend an exorbitant amount of money on useless, meaningless stuff.

Shoes, bags, clothes, collectible toys, lego figurines (yes, really), games consoles, hotel rooms – I could go on and on. I’m not a materialistic person by nature, but with mania I just can’t help myself. It’s an overwhelming compulsion.

Overspending is a common symptom of hypomania and mania. It can have a huge impact on your day to day life, especially when an episode has ended. You realise how much you’ve spent and it can lead to debt, anxiety over money and even not having enough money to cover all the bills.

At one time, during a serious and extended bout of mania, I amassed; four store cards, and three credit cards. I maxed them all out. I found myself in a mountain of debt, thousands of pounds worth. I couldn’t afford the repayments and was threatened with bailiffs. Even though I was earning a reasonable wage, I had to give up my flat. Luckily, I could move in with my parents, but was still paying rent to them and had to try and somehow reach the repayments every month.

What upsets me is how I was preyed on by companies when I was extremely vulnerable and ill. One time, I was in the town centre, when I was approached by a salesperson on the street. I was absolutely wired, full of manic energy and couldn’t stop talking. It was obvious something was wrong, that I was very unwell. They used my impulsiveness against me, and with very little convincing, got me to sign up for a credit card. I starting using it as soon as it arrived. I didn’t check the APR before signing up, which was extortionate. Impulsiveness reigns supreme when I’m manic and I’d sign up for pretty much anything if it was offered to me. Every time I was asked to sign up for a store card, I obliged.

There must be some way of prohibiting people when they’re manic from signing up for credit cards, or taking out a loan. I don’t know how this would work, but it would have saved me a huge amount of stress and worry about money. The stress alone has made me ill, and I’ve become severely depressed because of it. I still overspend when I’m manic. Although now I don’t have access to my credit cards unless I really need to use them. I’ve handed them over to my partner, because I can’t trust myself with them when I’m ill. But what if you have no partner or anyone you can trust and understand the problem? I don’t know what the solution is, but companies and banks should be ashamed at how easy it is to qualify for loans and credit cards.

Why I’m anxious about seeing a Doctor

I’ve been putting off seeing my doctor for ages.

Why?

I’m afraid. Afraid that they won’t be able to help me. That they’ll fob me off with a ‘just keep doing what you’re doing’ response. Anxious that they’ll want to change my medication. Again.

I’ve had a difficult year with medical professionals. Long story short, I was discharged whilst feeling suicidal. I made an official complaint to the hospital, and they investigated. The outcome; the psychiatrist denied his behaviour and that I agreed and was willing to be discharged. So he lied, to save himself. I was left without support from mental health services and had to fend for myself. I carried myself through that bout of depression and I’m still here. But that’s not the point. I felt let down, isolated, alone, and incredibly fearful for the future.

This year has been tough on my mental health. I decided to go full time as a freelance writer, giving up the security of a regular wage. Mental illness has kicked my arse. A few months ago I was depressed, and suffering from tactile hallucinations for the first time. I was scared, terrified of these crawling sensations on my skin. It meant I couldn’t sleep. Insomnia is painful. It seeps through your very being and leaves you hollow. I was sleeping maybe 2 -3 hours a night. For months. I tried everything I could think of before heading to the doctors. With the help of medication, I could sleep again. The hallucinations dissipated and the relief washed over me. I felt like I could breathe again.

Despite all this, I can’t bring myself to talk about mental illness with a doctor.

I didn’t mention the hallucinations to my GP (general practitioner). I knew they would refer me to mental health services. The idea of this fills me with anxiety. The number one thought that goes through my head is,

“What if I end up with my last psychiatrist?” The same one I made an official complaint against. Surely there would be some form of animosity from them. I’d be on edge and be distrustful of their competency. So then I’d have to explain this whole story to my GP, before they referred me. I might have to wait even longer than usual to see a different psychiatrist. What if they are the only one available? What would I do? I can’t afford to go private. There are so many questions going through my head, and the process just makes my head ache, and fills me with anxiety.

I know I need to see a doctor. I’m experiencing some weird symptoms that I think might be connected to one of my medications. I don’t want to have to change meds. On the whole, they’re doing a good job. As long as I keep stress in check, they work and keep me stable. It took years to find the right combination and I’m so afraid of losing this balance I’ve achieved.

Again, I need to see a doctor. There’s no way I want insomnia to come back. I’m scared of psychosis and how it could manifest. I need to work through these feelings and book an appointment when I feel brave enough.

Tactile Hallucinations

For the past few months I haven’t been sleeping properly. It has taken over all aspects of my life. Most notably, here on my blog. I haven’t blogged for months, because I simply haven’t had the concentration span to finish a post.

I’ve been irritable and moody. My short temper is now just a very blunt fuse. Every little annoyance is blown way out of proportion. I’m exhausted all the time. I walk around in a haze not really able to focus.

I have tried everything I can think of to try and sleep. I’ve listened to everyone’s opinions and well meaning advice. I’ve stopped drinking. Cut down on caffeine. I’m exercising more. I’ve even tried meditating, which for me is unheard of. Nothing has worked.

You’re probably thinking,

“Just go to the doctor already!”

You see, I’ve been putting it off. I knew if I went I’d have to talk about the main cause of why I can’t sleep. Everyday for months, I’ve felt like something is crawling over my skin. Mostly I can ignore it during the day, I’m moving around, busy with work, or socialising. At night though the feeling is hellish. Laying in the dark everything feels more intense, more real. There’s a crawling, ticklish feeling over a toe. I slap it with the palm of my hand. A few seconds later I feel something on my leg, my arm, even my face and neck. It goes on and on for hours.

I’ve found with much of the psychotic symptoms I’ve displayed, like hearing voices, my first reaction is to deny, deny, deny. I think, there must be a mosquito in my room. Countless times I’ve got out of bed, turned the light on and scanned the room for the little bugger. I never find it. There isn’t anything to find. This week I’ve managed to face it head on and go and see my GP. I wasn’t going to mention it but the doctor very astutely recognised I was holding back the real reason I was having so much trouble sleeping. Please can we have more doctors like her, who are attentive, empathetic and make time for their patients! I need to go back and sort out a referral to see a psychiatrist, because at the moment I don’t have one. This was after I was discharged in the same appointment where I admitted having suicidal thoughts only hours earlier.

As I’m writing this I can feel a crawling sensation on my thigh. I’m wearing shorts so I can see the skin where there feels like there should be a bug. I’m looking at it and still the sensation lingers on. It’s freaky as fuck. I’m desperately wishing for it to stop now.

I worry intensely about going to bed, because I know I’ll be kept awake by these phantom insects. Every night I think to myself,

“This is the night where it stops. This is the night where I can finally sleep.”

But every night it’s the same old frustrating routine.

This is very new to me, and I’m still coming to terms with it. Even though I’ve experienced psychosis before, and I’m open about my experiences, I’ve still found myself nervously talking to my partner and family about this new symptom. I still worry how people will look at me when I explain the experience. I want to know more people that have tactile hallucinations, have discussions and learn from one another, so get in touch in the comments or message me!