Friday, 4 March 2016

Mental Health Survival Tools

Silver linings - Regents Park, February 15 2016
(source: Ian Roullier)
It’s been over 18 months since I last wrote and firstly I want to say just how overwhelmed and touched I was by the reaction of my friends and family to that blog. Thanks to everyone who got in touch to offer their support, to empathise or to tell me about their own struggles with mental illness (I hope you’re all coping well at present).

Initially I was unsure about sharing something so personal so publicly but I know it was the right thing to do. I hope it helped others not to feel ashamed of their mental health problems and to open up to those around them and ultimately seek the help they needed.

Since I wrote that blog, my own situation deteriorated further, just when I thought I couldn’t get any lower, I did. However, with the help and support of my loved ones, counselling via my local mental health team, a trial I took part in at Imperial College (that’s for another blog perhaps) and the DBT course I’m currently studying (more about that below), life feels a bit more manageable, if still often not easy.

Anyway, ever since I wrote my previous blog, I’ve been meaning to write a list of all of the potential sources of help and support people suffering from mental health problems can call upon. And here it is. I hope it helps you or those close to you who are currently going through a rough patch. Bear in mind I’m not a medical professional but I hope the information below at least gets you on the right track to start getting better. If any of you think I’ve forgotten any vital information then please get in touch and I’ll update the list.

Friends and family – While you may feel completely alone and isolated and unable to speak to people about what you’re going through, speaking to others really is the first step towards getting better. Confiding in a close friend or family member about how you feel can mean you no longer have to struggle through on your own. They may not have all of the answers but opening up can lift a weight off your shoulders and the person you confide in can keep an eye on how you’re doing and perhaps even do practical things to help you out. A good friend shouldn’t judge you and there’s every chance you won't be the only person they know who’s been through a tough time. If you feel you don’t have anyone close enough to you for you to confide in, there are still many different sources of help you can call upon so please read on.

Your GP – They may be jacks of all trades and masters of none to an extent but your doctor has a range of options available to them that they can prescribe to help people with mental health issues. These include prescribing medication, referring you to a counsellor or to your local mental health team or writing you off work while you recover. If you’re anxious about going to see the doctor, take a friend or loved one with you who knows about what you’re going through and may be able to help you explain your current situation. That way you can make sure you get the type of help that’s best for you.

Samaritans – If you can’t face telling a friend or family member or going to see the doctor, are feeling suicidal or like you just can’t cope any more or just need someone to talk to, Samaritans are there 24 hours a day, 365 days a year. Just call 116 123 for free (from the UK and Republic of Ireland) or email jo@samaritans.org. More information here: http://www.samaritans.org.

Missing People – If you’re thinking of running away or have run away (or are the friend or relative of somebody who is thinking of running away or has done so) Missing People offers help and support via their free 24/7 helpline. You can call or text 116 000 or email 116000@missingpeople.org.uk. If you’re under 17 years old, the Runaway Helpline offers a similar service, also available via phone and text on 116 000 or by email at 116000@runawayhelpline.org.uk.

Medication – Medication can alleviate your symptoms enough so that you are able to get on with your day-to-day life. There are many, many different types of anti-depressants and mood stabilisers available so it may take time to find the ones that are most suitable for you but they can help you feel and function better. Your GP or psychiatrist should be able to help you find the right medication for you.

Counselling – a whole separate blog could be devoted to the various different types of counselling that are available and, again, it’s about finding out which type is best suited to you and your circumstances. Always bear in mind that if you don’t benefit from one type of counselling or from the methods of a particular counsellor, there are still many other avenues you can try instead. Personally, I was referred by my doctor for Cognitive Behavioural Therapy (CBT), which is based on uncovering your patterns of behaviour and thinking and enabling you to find other, more positive ways of behaving and thinking about yourself. It really helped me to make various breakthroughs, gain a much better understanding of why I am the way I am and to alter my approach to myself and to life. Click here for more information on CBT from the NHS.

Dialectical Behavioural Therapy (DBT) – DBT is based on CBT and has been developed to help people who experience extremely intense emotions. It has been shown to be effective for treating people who self-harm or attempt suicide/feel suicidal, use alcohol or drugs to control their emotions, have eating disorders or are emotionally unstable. DBT encourages the practice of mindfulness (more about that below), enables people to cope with extreme emotions or manage ingrained behaviours and encourages people to live a more fulfilling life that is in line with their own individual values. For more information on DBT click here.

Mental health charities – There are several mental health charities that you can turn to for help in the UK. The best known is probably Mind which offers a wealth of easy to understand and helpful information about all kinds of mental illnesses and how to go about getting help on its website. Mind also offers counselling and support locally throughout the UK and sometimes (depending on what’s available locally) you have the option to self-refer yourself to some of these services. Other mental health charities that may be able to help you get back on your feet and stay there include SANE and Together. The YoungMinds charity offers support to children and young people who are having difficulties with their mental health.

Meditation – It has been shown that daily meditation can alleviate the symptoms of both depression and anxiety. There are many ways that you can get into meditation. One way that’s open to most people is via an app like Headspace, Buddhify or Stop, Breathe and Think (which, unlike the other two, is free). I personally use Headspace which is non-religious and has many different ‘packs’ available containing meditations relating to depression, anxiety, self esteem, sleep, stress and relationships etc. There are other forms of meditation you can practice such as mantra-based meditation (whether based around devotional religious mantras or those used within (the expensive) Transcendental Meditation). If you want to get involved with a local meditation group, they are probably more widespread than you think and if you’re based in or near London, the Dhyana Centre offers a free Meditation For Beginners course that teaches you a variety of meditation techniques as a spiritual discipline. If you’re religious then praying is similar in some ways to meditation and has also been shown to relieve depression and anxiety.

Mindfulness – Closely related to certain types of meditation (Headspace for example), mindfulness is a technique that enables people to live more in the moment. Rather than being buried in an avalanche of worries about the past and fears about the future, mindfulness encourages you to be focused more on the present. This is achieved via exercises based on the senses; eating a raisin mindfully for example – examining the way it looks, feels, smells, tastes etc – or mindfully scanning the body from head to foot and observing the thoughts and feelings that arise rather than reacting to them. As with meditation, you will probably be able to find a local mindfulness group that you can join (this may help for starters: http://bemindful.co.uk/learn-mindfulness/). The Mental Health Foundation offers an online mindfulness course, which is free to start (and at the time of writing costs £60 to complete).

Other apps – Aside from the meditation apps above, one really useful app I've come across is Mindfit. This simple but effective app allows you to log your positive experiences, contains various relaxation and mindfulness exercises and helps you to identify issues you want to overcome and gives you the tools to overcome them.

Lea Valley Park, February 11 2016
(source: Ian Roullier)
Exercise and food – A study by Stanford University has shown that going for a walk in nature can lead to a lower risk of depression. Being surrounded by scenery and greenery can calm and relax you as well as keep you fit. Any form of exercise, whether it’s walking, joining a gym class or going for a swim, can make you feel better and make you ‘the right kind of tired’ (i.e. physically tired so you’re able to sleep soundly rather than mentally exhausted and strung out by your overactive mind). That said, I realise one common aspect of depression and other forms of mental illness can be the urge to stay indoors and shut yourself away from everything and everyone. If you can’t bring yourself to go out in public, sit in your garden or do some gardening. If you don’t have access to a garden of your own or a friend's, try to do some exercise at home whether that’s buying a yoga DVD and doing that in front of the TV, running on the spot or up and down the stairs, doing star jumps or push ups or anything else you can think of – it all helps. What you put into your body can also have a huge effect on your mood and mental wellbeing. When you feel low it’s easy to eat lots of junk food and takeaways or to skip meals. But eating regular meals with plenty of fruit and veg isn’t just good for your body, it’s also good for your head. Oily fish is also good ‘brain food’ as it's rich in omega-3 fatty acids, which aid brain function and development. 

Being kind to yourself – This may sound alien to you if you suffer from low self esteem and are feeling at your worst but being kind to yourself is vital for your recovery. This can take a lot of willpower and self-awareness at times but try to treat yourself as you would a good friend. We often treat ourselves like our own worst enemies but if you can try to treat yourself with compassion, empathy and a bit of understanding and love then it will really help. This can involve catching yourself when you’re thinking negative thoughts about yourself and countering the negativity with some positive thoughts or words. You could also try treating yourself (however worthy or unworthy you feel of it at the time) to a massage, a book, some tickets to an event, a haircut, a walk, a day off or anything else you think you would enjoy and benefit from.

State help – On the one hand, regular work can help you maintain a routine and create a feeling of self worth as well as giving you regular contact with other people, perhaps preventing you from feeling isolated. On the other hand, if you are forced to take some time out because you simply can’t cope, that is no reason to feel worthless or ashamed. If the doctor writes you off work and you are not well enough to return, you can receive a certain level of financial assistance from the government for a short period to help you get back on your feet. While our perception of people on benefits has been moulded in an overly negative way in recent years by TV programmes like Benefits Street and Big Benefits Handout (where claiming benefits is made out purely to be a lazy scrounger’s career choice), you should not feel ashamed or be made to feel ashamed of being mentally ill. If that means you are unable to work for a period of time while you get the help and strength you need to get back on your feet, state benefits such as Employment and State Allowance (ESA) can provide you with a lifeline. More information from the government can be found here or you can get advice from your local Citizens Advice Bureau.

Helpful books – There are a multitude of self-help and inspirational books out there and what strikes a chord for one person may not work for another but here are a few recommendations of books that have helped me. (I’m a bit apprehensive of publishers’ inflated claims of ‘lifelong happiness’ and ‘spiritual enlightenment’ but please look beyond that as there’s useful and helpful information within these books!)
Stop Thinking, Start Living by Richard Carlson – offers practical advice on how you can learn to approach your thoughts and feelings in a different way.
The Power Of Now by Eckhart Tolle – a mindfulness handbook in many ways with a spiritual thread running through it. Really helped me to live more in the present.
Breaking Down Is Waking Up by Dr Russell Razzaque – I’ve only recently read this one. Razzaque’s approach is unique as he draws parallels between certain spiritual states and the states experienced by the seriously mentally ill people that he has treated through his extensive work as an NHS psychiatrist. He looks into how practicing mindfulness could be key to the sustained recovery of people with even severe mental health problems. A really interesting read.
The Art Of Happiness by The Dalai Lama – A conversation between psychiatrist Howard Cutler and the Dalai Lama that explores the ways in which we can all live a happier and more content existence.

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