23/08/2016

Lived experience

I've been meaning to write about tattoos, but an assignment I'm doing on the difference between grief, sadness and depression and a lecture I went to this morning have me thinking. The idea of the lecture was to give student nurses an insight into mental illness that we may not otherwise get, a lived experience story from the point of view of a 'consumer' and that of a carer. Jayne Newling came to speak with us. She lost one son to mental illness when he took his own life and both of her other sons have lived with mental illness and now consider themselves recovered. Jane has a journalist background and wrote a book called Missing Christopher that looks brilliant. I have it and plan on reading as soon as study is over for the semester.

I'm going to cry when I read the book. I know I am because I cried during the talk today. I wasn't doing ladylike eye-dabbing, my body was vibrating with silent sobs and I was worried that snot would drip down my face coz I didn't want to disturb the room by blowing my nose. There were a lot of tears in the room so I didn't feel terrible, but it wasn't great.

Part of the reason it was so difficult for me to listen to was that I saw it from both sides. I am a mother to two boys and I'm deeply sure that my biggest role in life is to protect my boys from harm, and give them the tools to deal with the bad times when they come along. There is a history of mental illness in their family (not only me!) which increases the likelihood of them suffering from mental illness and the death of a child, is every parents worst nightmare. If you are a parent reading this there is every chance you will get a lump in your throat just reading this, let alone having someone tell you the details of their child's suicide.

Then there is the other side: I was a child with mental illness. I don't remember a time when I didn't at least toy with ideas of my own death, and by 10 (yep, ten years old) I had not just thought about taking my own life, I had a very concrete plan. I was too little to be able to have much agency, but the one lethal thing I had access too was heights. At age 10 my father was living in a 7th story apartment and I would go out on to the balcony and try and work out if I would definitely die if I jumped off. I thought I probably would but I didn't know how to get a definitive answer - if I asked someone they might see/guess my plan and remove access. I thought adults could pretty much read my mind. The time I remember getting very close to going through with it was summer, the window was open, my brother was asleep but I was awake and unhappy. I climbed from my bunk to the window and sat in the gaping window. One leg hung down inside the room and the other was hugged to my body. My head was under the level of the open window, my scrawny little bottom fit comfortably on the flat of the sill, half in and half out. I remember so clearly being desperate to end my life, believing that the world's population was already too big (remember this is around '83 and we had just come out of fears about peak oil etc) and that we could just fix that with all the people who didn't want to be alive being able to die. Euthanasia.

The big question is what stopped me, what are protective factors for a 10 year old? For me there were two things: fear of failure and preemptive guilt over the pain I would cause my mother. The horror of having to face my family after failing at suicide made me sick with anxiety (and still does) and the thought of my mother living without a child of hers was too sad (and still is).

The rest of my childhood is a dysthymic haze. There was anxiety, bullying, perfectionism, guilt, isolation and then some things that brought joy - connection to friends and family and anytime I managed a sense of self-efficacy (oh how little things have changed for me!). My next episode of serious suicidality was at 16/17, then again at 21, then 26/27 (that one was bad and lasted over a year), 28 (when I got my first diagnosis). Then things were up and down, with bouts of premenstrual dysphoric disorder until I was postnatally depressed at 33 and then depressed again at 37. By 42, last year, I ended up only feeling safe in hospital. Now I am in remission, or as the current best-practice term has it, recovery. I'm mostly happy, I deal with everyday stressors but don't really feel recovered, I feel like the meds I take and the self care I do keep me well for the moment, but if something comes along that messes with what is important for me I could get sick again. Anytime something crashes into my feelings of self-efficacy or the connection I have with those close to me, I can't promise my brain won't slide off into the crazy again.

So what is this history lesson in aid of? Jayne Newling and her son Nic strongly feel that talking about mental illness, including experiences of illness will help people get more and better help, younger, and this will save lives. Nic worked for the Black Dog Institute and has recently set up a group called the Champions. There is no way to know how much easier my life might have been if I had been diagnosed and given good help when I was a kid. Imagine if I wasn't totally terrified of telling people that I hated my life so much I wanted to end it. Maybe I did and they thought it was just a strange kid-thing? I now wish I could have told my loving and supportive parents. Admittedly, they were busy with their divorce and new lives and I didn't want to be a hassle. Yep, I was 10 and thought telling my parents I was suicidal would be an unnecessary burden for them. I don't want any other child to feel that, and I don't want any other parent to live with the guilt that my mother has lived with, since she's known how depressed I was and that she couldn't do anything to help.

In my own way, at a personal level, I have been doing the same kind of work as The Champions - sharing bits of my story and creating a community of like minded people who have lived experience or 'loved one experience' where 'R U OK' is an everyday question and where people feel safe and supported when they admit that they really are not OK  (I like to call this group my 'friends'). If I can normalize this within my own little sphere of influence then just maybe it can spread. I want to end this by thanking my near and dear ones; for coming with me, for letting me out you, for outing me and for always having my back.

04/08/2016

More on gardening and emotional distress

I am a bit anxious at the moment and my mood has been a bit up and down with normal triggers of uni stress and relationship stress. This means I've been trying extra-hard to fit bits of self-care into the busyness of my days. For exercise I have been trying to walk to the station rather than driving (a solid 15+ minute up-hill walk which is fine if it's not raining and I don't have too much to carry), I've been spending time around people who make me feel safe and good (hi Clare!) to feel socially connected, I've been careful with my alcohol consumption and sleep habits (apart from the very early wake-ups that I have minimal control over. I don't mind it on days I have to leave early, but it can be irritating on weekends). Keeping things around me reasonably neat and tidy can help with the anxiety but one of the most important things for me personally is a sense of self-efficacy. It's a common thing for depressed and anxious people to have difficulty with, both noticing the stuff they do manage to do, and building up the motivation to get things done. There are all sorts of 'tricks' to focusing on this stuff - from things as simple as writing a specially tailored to-do list (there were times when my list had nothing more than 'shower, eat lunch, pick kids up from school' so I could manage to get everything done) and to make the things you get done small and/or enjoyable. Getting a tangible result is another trick - if you manage to do the dishes you can really NOTICE.

You can see where this is going right? Gardening. It ticks so many boxes! Doing some weeding creates order out of chaos and channels bad feelings into a positive result (although on a bad day I once had to apologize through my tears to every weed as I pulled it out. For real. I think I went and did something with the compost that day). There is also a tangible result - a nice garden is a lovely place to be and it can get that way, slowly, without too much money, just a whole lot of time and hard work. On a good day when I weed the lawn every dandelion I remove is another dandelion that won't set seed. I acknowledge I'm taking tiny steps, but they are steps in a forward direction. Today I was smirking to myself, thinking that if the garden is a metaphor for my mental state then a therapist is the horticulturalist/tree lopper/lawn mowing guy who I pay to help me sort my shit out.

I've hardly done anything in the garden for the last year (after about three years of lots of time and effort) and it just feels great to be getting my hands dirty again, so apologies for hurriedly written posts the overstretched analogies.

02/08/2016

To plant a garden is to believe in tomorrow

"To plant a garden is to believe in tomorrow" is allegedly a quote by Audrey Hepburn. It sounds twee to me, even when I imagine it in her voice, but there is a really interesting current of truth running through it. I was weeding the other day and realised that if there was one thing I would recommend to anyone with what are coyly titled 'mental health challenges' it would be gardening.

I feel dealing with mental health challenges might be an area where I have something to add. I have always been interested in mood, thinking and feeling. I am studying mental health nursing at the moment, I have close friends and family who suffer from mental illnesses, varying in both type and severity and I have what gets termed 'lived experience' as well (if I were a therapist I would interrupt to ask me why I needed to justify myself. This is my blog, I shouldn't feel the need to recite credentials and yet.... Why?)

Anyhow, there are a bunch of things that are commonly agreed to promote good mental health, with the potential to aid in managing mental illness and promoting recovery

  • Adequate exercise
  • Appropriate sleep
  • Diet - plenty of fibre, not too much sugar or saturated fat
  • Avoiding alcohol and recreational drugs
  • Medication as prescribed
  • A sense of connection
  • A sense of self-efficacy
  • Mindfulness/meditation

And I actually think that gardening helps with every single one of these. Exercise is obvious to anyone who has ever been in a garden but sleep is more interesting. I know when I was very depressed sometimes I could get myself into the garden in the morning. Morning sunlight is thought to assist with regulating mood and daylight, again, especially morning light, helps to regulate circadian rhythms. If you find it hard to wake up in the day and impossible to sleep all night (common in situations of emotional distress) daylight can help, which means gardening can help, because gardening is a reason to be out in the daylight.
When you are gardening, grow veggies. If you can't grow veggies then grow herbs. It just might help you eat if that is difficult for you and if eating is too easy then having dirty fingers/grubby gloves means it's easier to pause. It's also easier to concentrate on the goodness of your food, rather than getting caught up in it's emotional value if you cook fresh food with herbs you grow yourself.
Gardening is never going to knock out your substance abuse habit or convince you to take the meds that cut your highs and lows and make you feel flat. Spending time in 'nature' is well known to increase feelings of connectedness and gardening is no different. It can increase feelings of self-efficacy too. Self-efficacy was one of the most important things when I was really depressed and anxious. I felt I couldn't DO anything, particularly anything that made a positive difference. Having seeds germinate, protecting a seedling from snails or staking a tomato plant was an observable thing, and I did it. It mattered to the plants.
Like exercise, mindfulness and meditation are a part of gardening. Weeding requires a type of mindful concentration but allows for meditative states. My lovely wise mother tells me that all the biggest decisions of her life were made while weeding. I tell my kids that it's a bit like playing the type of repetitive puzzle games that I play - I play them compulsively when I'm falling apart.

I could probably provide scholarly references for all of that but what I can't back up, but know in my bones, is that gardening helps. When my life is spinning wildly out of control, I can work methodically to get the clovers out of the lawn. When study stress is threatening to take over my life I joke to my uni friends about procrastigardening, Weeding is a relatively healthy and functional way to channel compulsivity, a manic episode could see trees pruned, lawns mowed, and who knows what built while depression might see nothing worse than more weeds than normal. This is starting to read like an impassioned plea for more community gardens and for employee flexi time for gardening but I actually think those things would enable us to handle our stressful lives a bit better.

So this thinking all came about when I was gardening the other day. I was actually marveling at how things are growing, even in the depths of winter, and pondering the wonderfulness of my terrific friends. My friends (you know who you are) are the people who would help me hide the bodies - both metaphorically and also possibly literally. I was thinking about how they pop up like four leaf clovers, lucky, rare and precious. I pick four leaf clovers when I find them, and feel smug and lucky, a similar feeling I have about my wonderful support network. As I was thinking these nice but somewhat self-congratulatory thoughts I came across a FIVE LEAF CLOVER. Never seen that one before!

This slightly chewed, odd, mutant miracle is for D.