Tag: mental illness

Living With Psychosis – How Your Language Can Hurt

If you throw around the words ‘psychotic’ or ‘delusional’ to describe someone you disagree with, or roll it out when you’ve been hurt or upset – then you can’t call yourself a mental health advocate, or say that you care about mental health. There, I’ve said it.

People have said to me, “But surely delusional doesn’t just have a pathological meaning?” My answer to that is it depends on the context. I think generally people know what they’re insinuating when they call someone delusional. They know exactly what they’re doing, what they mean, and the reaction they’re trying to invoke. I have delusional thinking and I find it offensive when someone uses it as a slur. Delusional, and the word psychotic, are not synonymous with badness, which is often how they are used. The English language is huge and I don’t think it’s much of a stretch to change up your vocabulary!

The misuse use of these words is one of those things about mental illness that just doesn’t stick when you talk about it. And I’m majorly fed up with explaining it. People either don’t want to change the language they use, don’t see it’s a problem, or simply forget the point, and start using the words all over again. I see or hear the word psychotic misused pretty much everyday. It’s either on social media, in tv or film. So really, it’s EVERYWHERE. It’s exhausting to keep calling it out, or getting annoyed at a show or a movie when they use it in the wrong context.

I’ve had people say to me “C’mon, it’s not a big deal, it’s just a word!” That’s your opinion, but it’s important to listen to the opinion of people that are actually psychotic. That live with the condition/symptom and have to hear the word being used negatively every single day. Imagine you’ve been diagnosed with psychosis. The word psychotic has become a part of your life, whether you want it to or not. You know the feeling of dread when you start to hear, see or feel things that aren’t really there. You remember the extreme paranoia or delusions of grandeur that come with delusional thinking. You’re slowly learning to manage it, but it’s terrifying. It’s confusing and disorientating. It makes you feel extremely vulnerable. You feel untethered from reality and like there is no safety net to catch you. Because of all of this, you’re at a higher risk when you’re ill of being the victim of crime than the general population. Then imagine a friend has had a bad break up. They suddenly start describing their ex to you as a “psychotic nazi.” Later that day you find a show you think you’ll like and put it on the telly. The villain, the character the audience is supposed to hate, is described as psychotic. The next day, a family member rants to you about a politician. They tell you that they’re “evil, dangerous, psychotic.” And it continues like this, with people all around you casually throwing the word around – not once thinking about the impact it will have on you.

All I’m asking is to think before you speak. It all adds up. You might think it’s not a big deal when you say it, but hearing it constantly misused takes it’s toll. If you live with psychosis it warps the way you think about yourself. You start questioning, “Am I a bad person?” “Am I dangerous when I’m ill?” Because the word has been given a different meaning by the people around you and in society in general. It’s so commonly misused you start to doubt whether the way you use the word is right. It grinds you down, it makes you feel like you’re broken and people see you as dangerous.

They’re not ‘just words’ they carry venom that poisons people that are already vulnerable. It stops people from accessing care and support because they don’t want the label. It isolates people that already feel alone and misunderstood.

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 Someone with Bipolar Disorder

I’ve had a diagnosis of bipolar disorder since 2012. It’s been a rough journey and I’m still learning more about the condition, even now. My loved ones have been on the ride along with me, and we’ve had to learn together how they can best support me. I’ve put together what I believe helps – and a little about what doesn’t.

Learn their triggers and warning signs

Talking to your loved one about their triggers for an episode, and warning signs that one is about to happen, can help you help them. Triggers vary from stress, difficulty sleeping or insomnia, or a physical illness. Keep an eye out on major events happening in their life and how if they’re feeling overwhelmed it could lead to a bipolar episode. Ask them about their warning signs so you know what to watch out for. For instance for me, warning signs of a manic episode include; sleeping less, spending more, fast speech and having much more energy than usual.

Try not to become too controlling. Telling them what to do, how to look after themselves and taking over complete control of their life (such as their finances) can lead to your loved one pushing you away.

Let them share their experiences with you

If you can offer your support and listen free of judgement, your loved one with bipolar disorder will trust you more and will be more likely to open up if they’re struggling in the future. Listening and having empathy for someone’s situation doesn’t mean you have to totally get it. You don’t have to have been through the same thing in order to be supportive. Listening attentively can be a powerful tool.

Learn more about bipolar disorder

It shouldn’t be up to your loved one to answer every single question you have. From my own experience, it can be incredibly draining explaining every little detail about how bipolar impacts my life. If you can show you’re committed to learning more, it will show you respect love and support them. A great place to start is Bipolar UK who have tons of information about the illness. They also run support groups in the community and have an ecommunity on their website.

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.

Help them 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 mania/depression ends. 

When they’re manic, 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.

Talk through their behaviour

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.

Don’t panic! Some symptoms (like psychosis) can be scary and daunting to deal with. Try to stay calm and follow this advice.

if you’re worried about a loved one, make sure you seek help. This could be through their GP, psychiatrist or community mental health team. You’re able to attend appointments with them, which can help in a number of ways; you can offer support, you may have insights into their behaviour they do not, they may have trouble remembering what’s been said and you can help them make decisions about their care, or advocate on their behalf.

Lastly, it’s ok to find it difficult! It’s ok to be angry with them if they’re offensive and rude during a manic episode. It’s ok to be upset and frustrated when they’re depressed. Make sure you take care of yourself, so you’re in a better place to support them.

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.

Stop Romanticising Mental Illness

Mental illness should never be something to aspire to. Making it seem cute, romantic, or beautiful distorts what it actually is; scary, lonely and ugly.

When I see someone in the public eye talk about how an illness is beautiful, or whatever other positive word they want to use, it cultivates the idea that mental illness is romantic; that it’s a quirk, and something that makes you special and unique. At a time when many people are struggling, or having setbacks with the management of mental illness, it devalues the struggle of people living with mental illness. How are people who live with mental illness meant to be taken seriously when people keep romanticising it? There is so much awareness trying to be raised for mental illness, important campaigns, and all this does is undo all of that.

I’ve had to deal with this many times. I remember being at a party, where a group I didn’t know too well, were discussing a friend, who believed she had bipolar disorder. They were making fun of her, and throwing around comments like, “Everyone has something these days” and “Yeah, bipolar is is just the fashionable ‘in’ thing to have.” and another, “People just want to be different, and bipolar makes you look quirky.” There were nods of agreement. The very idea makes my blood boil. I decided it was time to speak up, and educate them. I said, 

“I have Bipolar. It took 12 years for me to be diagnosed. It’s not fashionable, in fact it’s terrifying and debilitating.” 

I went onto to tell them about the blog I wrote about Bipolar, and recommend some websites and books that they should take a look at. There’s still a long way to go in educating people about Bipolar. People are quick to judge and repeat stigmatising myths they’ve heard. Not everyone is confident enough to call people out. It makes my heart race when I do. This compounds the problem, when people’s views go unchallenged. If you can point people in the right direction to mental health campaigns and charities, it can make a big difference to their point of view.

To me, Bipolar will never be fashionable. It’s a life long severe mental illness that takes determination to live with and even more work and drive to find stability. People seem to hold onto the idea that bipolar can make you more interesting; that others will see you as edgy and vibrant, or brooding and mysterious. It’s harmful to those who are suffering and trying to reach or maintain stability. 

If you can look at your journey and take some positivity from it, that’s great. it’s important to understand and learn from our experiences. There is a line though, and romanticising an illness will never be ok. It’s damaging to people that struggle everyday. Language is a powerful tool, and we need to think about how we describe mental illness; will it cause someone to relapse if I say this? Will my words make someone feel like they’re not trying hard enough? That’s the crux of it; saying mental illness is fashionable, beautiful, a quirky, cute trait to aspire to, tells people that have a negative, brutal, unrelentingly bad experience that if only they tried harder, then they could see it that way too. Mental illness just doesn’t work that way. How about praising people for getting through each day, for still being here? How about being there and listening to a friend who’s struggling? How about actively being part of the change in perceptions of mental illness? That’s something we should all aspire to.

Managing Sleep

I know a ton of us, especially right now when we’re under lockdown, are struggling to get a good night’s kip. How can a lack of sleep affect us? I’ll also look at some tips and advice that have helped me along the way.

Why is sleep so important?

Sleep refreshes us, it keeps us going. But when you live with Bipolar disorder, or any mental health condition really, a lack of sleep can have a major impact. Sleep disturbance is very common if you live with bipolar disorder. Disrupted sleep is a symptom of mania, but it an also lead to manic and hypomanic episodes. Studies have shown that 25 – 65% of people with bipolar, who had a manic episode, had experienced sleep disruption before the episode.

Breaking down the different types of sleep disturbances

Insomnia – is having problems getting to sleep, and staying asleep, or not sleeping enough. It’s a common problem for many people with mental health problems. Hypomania and mania often lead to insomnia.

Hypersomnia – This is the total opposite of insomnia. Over sleeping affects one third of people with bipolar disorder. It often happens during periods depression, where all we want to do is sleep.

Irregular sleep-wake schedule – This is when your sleep routine goes out the window. The irregular cycle can interfere with treatment.

My own experience

I struggle with insomnia, a lot. It’s incredibly frustrating, and to top it off, for me it often leads to mania. If my sleep is disrupted for more then three days in a row (say, I get 2-3 hours a night) I can become very ill, very quickly. Not sleeping is a major trigger I’ve realised over the years and I have to keep an eye on it, and try my best to get a good night’s sleep. I’m also the type of person that when I’m depressed, I feel absolutely knackered all the time. All I want to do is sleep, and even when I get a good 8 hours, I still feel exhausted.

So what have I learnt to help me sleep?

Get some exercise – Honestly knackering yourself out can help knock you out for the night. Tiring out your body through exercise lifts your mood – and helps you sleep. It doesn’t always mean going for a run, or doing aerobics at home. Sometimes I just have a dance party in my lounge – why not! Just don’t exercise a few hours before bed, because it’s too energising and will keep you up. I realise not everyone can exercise all the time when you live with mental illness. Even a gentle walk is better than nothing.

Avoid screen time – Blue screen is baaaad for sleep. Try to stay away from the television, your phone, computer or laptop, at least an hour before you go to bed. Instead, start your bedtime routine. Read a book, even make a plan for the following day.

Routine – When I was first diagnosed with bipolar disorder, my psychologist wouldn’t stop banging on about sleep hygiene. What this means is having a solid evening routine you stick to. It helps your mind relate certain tasks and sensory experiences to preparing for sleep. Wahing your face, brushing your teeth, moisturising your body are all a great start. Try incorporating calming hobbies and interests into your routine, such as reading a book in bed or in a quiet corner of the room you sleep in. Make sure you go to bed at a regular time at night, and wake up the same time every morning. I tend to have a ‘night off’ from my routine once a week on a Saturday night, but go straight back to it the next day.

Reflect and Plan – Keep a journal and write down what you’ve done that day. It can help you sort through your thoughts and focus on something that might be worrying you, instead of those worries popping up when you’re already in bed, trying to sleep. Writing is cathartic, and can help you understand your anxieties, and work through them. Listing on paper what you have to do tomorrow, can stop you fixating on those plans when you’re laying in bed.

Avoid naps – If you can, or keep them short if you need one. I love a good nap, but I know if I nap in the afternoon or evening, I won’t sleep at night!

Keep your bedroom for sleeping – Limit watching television, or working on your laptop. Try keeping a tidy bedroom that feels relaxing to be in.

Avoid alcohol and caffeine

Get up– It might seem counter intuitive, but if you can’t sleep (say after 30 minutes) get out of bed and try doing something relaxing. Otherwise it’s frustrating to stay in bed worrying why you can’t sleep. Even if you’ve been up during the night, try to get up at your regular time.

I hope some of these tips help you to get a better night’s sleep. If you’re really struggling to sleep, go and see your GP or psychiatrist, who might be able to give you additional support and further treatment.

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.