Loneliness

There have been a few issues to make me think about how loneliness and isolation can impact on people's mental health lately.  Some are directly related to myself, others are with regards to other people, but either way it perhaps isn't surprising that managing being 'alone' can be very challenging, and either exacerbate an individual's existing mental health issues or cause problems for people who before perhaps had never experienced them.

Insert stereotypical loneliness image here

Loneliness can also be caused by mental health problems and can also be the cause of mental health problems, or indeed both - which I have experience of.

I've had an anxiety condition for 18 years, which means when I first started experiencing anxiety I was ten years old.  So back then, as explored previously on this website, I had no idea what the influencing factors were on this.  What I do know, however, is that these experiences which at the age of ten and for many years subsequently, I called 'abnormal' because I didn't know what they were, were impacting on my social quality.

I had friends - I'm fortunate to have always had a close knit small group of friends - but it was difficult to build relationships with people.  I socialised less than the average teenager, despite a longing to do so.  Then, when it got to the latter years of school, when people started experiencing alcohol and pubs, I never joined in because most of the time I was in fear.  Fear of being a fool, fear of not fitting in and often just in fear of having a panic attack at the pub or wherever.  For most of the latter years of school and University I had to put most of my efforts into managing my anxiety condition with no tools to help me, so socialising took a back seat.  I wasn't too concerned about this, but even back then I knew that a lack of socialising may impact on me in later life.  And so it proved at University - the first two years involved me running off for the earliest possible train and avoiding anything remotely outside my comfort zone.  Something I don't apologise for, because my anxiety was so severe at the time that anything would have set it off.  It's all very well for folk to say 'oh well, if you'd have felt the fear and done it anyway you may have got onto the road to recovery a lot quicker' but I dare someone to say that when they are having five panic attacks each week.

As I said, I've been lucky to have had a core group of friends for most of my life, and that includes now.  Some of them are still around and I still see them often.  But these years of debilitating anxiety has wrecked my confidence in many ways, so as most other people I know in their late 20s like myself move on and get married and have children, this remains just a pipe dream for me.  Meeting 'that special person,' which for most people just seems like something that happens naturally, for me just seems like a thing that happens to someone else.

Now, I'm quite comfortable being single, don't get me wrong.  My fear is that when all of my friends finally move away, which I have to assume that at some point they will, and are no longer in close contact, I'll be left behind still alone and rather than just being alone, I'll be lonely.  

I've actually learnt to cope with being alone.  I've actually started to enjoy it, especially in the last year, which isn't something I could have said until recently.  I've always been used to keeping myself busy; I've got no brothers or sisters, a very small family most of whom don't live particularly local and an anxiety problem which for much of my life has made socialising very hard.  So this 'keeping myself busy' isn't a problem.  What worries me is the future.  I don't believe that there is that special person waiting for everyone and that, as people keep telling me, I'll find someone eventually.  Anxiety and general personality factors have utterly destroyed my confidence when it comes to developing those sort of relationships.  Moreover, I did an analysis not too long ago (see, keeping busy) and of the 32 couples that I knew of, only two of them did not meet through work or at university or school.  Uni and school have long gone, and the chances of me meeting someone at work is very very slim, given who I work for and what I do.  

I would say that, at the moment, I'm in a comfortable situation with being alone, albeit wary of it carrying on for much longer.  I'm finally in a position in my life where I could give a long-term relationship a crack.  Only in the last couple of years or so have I been in this position; before that I was too messed up to have realistically considered it, albeit I didn't necessarily appreciate this at the time.  I suppose my message is, if you're in a relationship and you're happy, don't take it for granted for goodness sake.  They don't come easily to everyone.

I also know of elderly people who may have been in relationships but perhaps their partner died some years ago.  There are a lot of people that fall into this category who live near to my parents, in a rural suburb where people go to retire.  As they lose their partner and they become less physically able to do things for themselves, they become isolated and lonely.  This can, in the worst cases, cause serious depression for older people as they find it hard to adjust to a life predominately on their own.  Perhaps they didn't have the practice in youth that I have had / am having; they may have been with their partner for most of their life and to suddenly lose them must be a huge shock to the system.  I'm sure many of you have seen this happen to family members.  I believe this will only become a bigger problem in a future with an ageing population.

These people often rely on their community.  I know several people who's daily routine is to catch the local bus into town, not because they need anything in particular but because they enjoy seeing people on the bus and in town that they know.  It's their lifeline and their connection outside of their isolated bubble.

Eagle eyed Twitter folk amongst you will have noticed that there is a cut to a bus service in my area happening imminently, the majority of whom it will affect are people like those that I describe above.  Because the elderly have bus passes, they don't have to pay a fare and therefore both the transport operator and subsidising authority have deemed it not 'commercially viable' to run, even though it is a well-used service. I used it all the time when I used to live at my parents' and have met some great people in the process.

But for many of these elderly people, their lifeline is being cut.  I have spoken to many of them who are affected by it lately and they are physically distressed by the idea.  Suddenly their only route out of their house will be cut.  Not only will they have to pay an absurd taxi fare if they want to travel to the town centre, but they will also lose their communication with fellow bus passengers.  Without going off on another rant about how scandalous it is that this service is being lost and about the cretinous, un-compassionate morons who are making this decision, the impact on these people's mental health is my real concern.  It's been difficult enough trying to campaign against it in the last three weeks, let alone the concept of it being all in vein when it is cut this coming Saturday 5 September.

No-one seems to care about the mental health of our elderly.  It's all about physical health, which of course is important, but there are more and more isolated and lonely old people in our society due to reasons like this.  There needs to be more schemes in place to instil community spirit, which, whilst existing naturally in some places, do not exist everywhere.  Just popping over to someones house a couple of days a week for a coffee is better than nothing, and would be something for the person to look forward to.  Instead there is an increasing feeling that we're casting these people aside for the convenience of our creaking health service.

Being alone and experiencing loneliness are two totally different things.  I'm in the former category at the moment - most of the time - and can generally these days enjoy being in my own company. But how long this will last as society whizzes by me at 100mph is anyone's guess.  

For now, I keep busy(!!) by trying to help these poor people get their bus service back.  It isn't too much to ask.  I even (almost accidentally, I hasten to add) got snapped in the local paper this week, and before you ask, yes I am the tall, younger looking one in the background, and not the man with the walker.

Best wishes
Al

We are destroying one key method of mental health therapy - and we don't care

Hi all

I apologise in advance if this blog turns into a political rant.  There is a risk of this, as I am combining two passions of mine into one blog; not just that of mental health issues but also the sorry decline of our beautiful green spaces.  I am also writing this at a time when my job, which isn't to do with ecology or the rural environment per-se but rather is focused on environmental sustainability which is still closely related, is probably at it's most vulnerable in terms of security than it ever has been.  And there is no other explanation than to blame our new elected Government for this.  

Cannock Chase - if anyone cares

So I promise I will try my best not to rant at them, but to keep the ranting to the human race as a whole, which is also to blame.  I also appreciate that many of you reading this will disagree with some, if not all, of my perspectives here, but frankly what is a blog for if not sometimes to give an opinion?

Combating mental health conditions is a huge challenge - I imagine everyone reading this blog will empathise with that viewpoint.  I have been with anxiety (trying to avoid the term 'suffered from' these days!) for around eighteen years now, and yet my recent immersion into the social media world and through writing this blog, I've learnt that I have still been quite lucky compared to what some others have gone through from a mental health perspective.  Hospitalisation, decimation, destruction and sometimes worse.  

Consequently trying to 'fix' mental health 'problems' provides therapists, individuals and families with a myriad of dilemmas, some of which will work, some of which won't.  But one simple method that mental health therapists and charities alike both state helps people with mental health conditions is that of getting outside, 'being with nature,' and exercise.  Outdoorsy stuff, basically.  Being able to access green space can allow you to exercise without having the pressure of people being everywhere, without having the noise or air pollution, and we all know that physical exercise and staying fit can generate mental health benefits.  This could be through walking, running, cycling or anything of the like.

Green space can also generate peace, as can our incredible rural areas that we are blessed with in the UK.  The landscape can benefit our creationism, channel our thoughts into creative arts, can allow us to take ourselves away from the stresses of reality and again, provide physical health benefits.  All of these will help to combat mental health problems.  

Our biggest mental health charity, Mind, has even set up an Ecotherapy programme, which connects people with nature, that relies on the preservation of our rural heartlands or our urban green spaces.  

In summary, green spaces and rural environments have huge benefits for mental health and physical health.  They are also home to our wonderful array of creatures and species.  Green spaces have multiple other benefits as well, such as reducing the urban heat island effect in large cities and trees can also help to alleviate flooding, and not least provide us with a hugely critical resource - oxygen.

And yet we, as a human race, have absolutely no regard for our precious natural environment whatsoever.  We destroy it at a rate of knots, willy nilly.  'Oh look at that spectacular view,' as we discard a piece of litter on the floor, or burn another bonfire or remove another tree for the sake of landscaping the garden.  We spit in the face of the beauty of our environment because as a group we're lazy and disrespectful people and don't appreciate what's right in front of us.  I'm the same, and yet I feel that I'm generally a conscious person.  Do I go round and pick up every piece of litter I see when I'm out walking? No. I'm just another person spoiling this land that we have been blessed with.

OK, so rant number one.  

The problem is, no-one can change the attitude of our collective existence, so the last thing we need is further destruction of our natural environment on a bigger scale (mostly ignited by the Government).  And yet what are we doing? 

- We're building a brand new high speed railway system (HS2), that conveniently destroys acres of woodland, farmland and other areas rich in biodiversity.  All, in my opinion, for the sake of a plaything for the rich that happens to cost billions of pounds at a time when everyone's jobs are at risk - apart from people who are involved in constructing HS2, of course.  I'm against HS2 for all sorts of reasons, but those that are against it seem to be against it purely for economic reasons.  Yes so am I, but have we thought about the environmental damage?  No.  Does anyone care?  Probably not.  Not least, from a mental health perspective, what must the poor people living in HS2's proposed path be going through at the moment?

- Then of course, there's roads.  Yes roads are congested - ironically because our public transport system is appalling.  People love new roads.  Because of course, they won't damage any natural environment at all.  Not much(!)  Does anyone care?  No, because we can travel somewhere 10 minutes faster than we could before.  

- Now, I don't know how much green space would be destroyed if a third runway is built at Heathrow, but it's probably more than I care to wish for.  What if there are people living there with a mental health condition who use the potential green space for clearing their heads?  I'm hypothesise, but you get my point.  Not least what damage a third runway would do from a pollution perspective (yes, planes do pollute on a massive scale.  So do diggers, chemicals and construction techniques used in building a new runway).  

- We need thousands of new homes.  This point will make most of you think I've gone, well, mental I suppose.  But do we care where we build these new houses? No. I catch the train everyday and go past acres of land that is rotten and already destroyed by our previous developments. Are we thinking of building there?  No, let's build on the green space, shall we?  I know we need more housing, I'm not disputing that.  What I'm disputing is the lack of care over where we build them.  

- Did you know that we can now build mobile phone masts wherever we bloody well like?  Sod the quality of the land and whether they destroy it.  The thing is, people will favour mobile phone masts in remote, rural locations because a) they won't be visually intrusive upon where we live and b) these are the sorts of areas where you currently get poor mobile phone signal.  And let's face it, we all need a good signal don't we?  Let's get a life, first.

- Then of course, there's the new phenomena that is known as fracking.  Now, fracking basically involves building huge great big tanks and generation stations, as well as digging huge holes into the ground and fiddling with the geology - which, by the way, is one key element that provides us with our majestic natural environment - until we get something out of it which puts your light on.  By the way, it may cause minor earthquakes.  But it's okay, because most fracking sites will be on previously habitat-rich land so said earthquakes, or pollution caused by the fracking process, or construction traffic, won't affect too many people.  It'll just destroy somewhere in the middle of nowhere.  

- All of this probably won't lead anyone to be surprised that species in our country are in decline.  So much so, we're considering re-wilding (see the link for definition).  But it leads me to ask the same question as I did before... does anyone really care?  What's the one species not in decline? Humans. And pigeons, but they live on food that people litter parks with.

I think one of the many stories of things that sums it up for me was when a friend and I were out walking on our nearby Cannock Chase AONB one day to find a rich, pretentious woman who lives in a village on its outskirts spraying Jeyes Fluid onto her hedge to stop the deer from eating it.  Not only would that potentially kill the deer, the irony was she was also killing her hedge.  But no doubt, she lives there because she loves the beautiful surroundings and wildlife that Cannock Chase provides.  Think about this for minute.

When it comes to the environment, we are disgustingly selfish and hypocritical.  Most of us adore our rural landscape and use green spaces more than we probably even appreciate.  We complain if our local green space is destroyed by development or by idiots kicking up flowers or dropping litter.  And yet as a nation, we turn a blind eye to the railway building, the road constructing and the house erecting on other area's wild landscapes if it doesn't directly affect us.  Then, of course, there's the collective damage we appear to be doing to our climate, which seems to be becoming ever more volatile.  I don't need a scientist to tell me that the weather is doing increasingly weird things.  What happens if it becomes so erratic that nature can't cope?  All in the name of our selfish, materialistic and over-consumptive lifestyles.  Well I hope everyone is happy.

OK so this has, unsurprisingly, turned into a rant.  But don't come crying to me when your local green area has been damaged or destroyed.  The impact on our mental health could be catastrophic if there is no 'green' escape from the reality - the chaotic world we live in, or at least, the chaos that our mental health condition conjures up for us on a daily basis.  Green spaces are a vital tool in mental health recovery, but our blasé attitude to our natural environment will render this more and more difficult in future.  We're all to blame.  And yet most of us will dismiss this blog as nothing more than a tirade from a crazy man.  The irony is, this isn't far from the truth.

Nothing like some light reading on a weekend afternoon, hey?

Best wishes
Al

Zzzzzzzzz....

Hi all

I have always had an interesting relationship with sleep.  Needless to say, by 'interesting' I don't mean particularly positive and also needless to say, a lot of the reasons I have had said an 'interesting' relationship is due to anxiety.

Cats don't have this problem

When I was at school in particular, I used to get frequent panic attacks.  The vast majority of these, probably 90% or more, happened not long after I'd gone to bed and it is hardly surprising that they kept me awake for a long time after the worst of it had past.  Couple this with the fact that I've always been an early riser, for as long as I remember, you get a total of not too many hours sleep.  I think what made me fall asleep in the end during a night of panic was sheer exhaustion. So overall, whilst lack of sleep didn't seem to cause a problem for many other people whilst I was at school, it was certainly an issue for me; albeit overshadowed by the more severe symptoms of anxiety (not just panic attacks, but health anxiety, food issues, confidence etc etc).

Today, despite the overall removal of panic attacks from my life, I still have an interesting experience with sleeping.  Interesting meaning the same thing as before, to clarify.  Take last night as an example.

> I went to bed at 23:30.  This is quite a bit later than normal, but then it was a weekend night so I didn't have to get up in the morning.

> Went to sleep quite quickly, but woke up not long after unsure as to whether I'd gone to sleep or not.

> Stirred for a while, not properly asleep, I would guess until about 01:00

> Woke at 05:00 almost exactly.  I got pissed off, because although waking at 05:00 is normal for me, when I don't have to get up AND when I went to bed later than normal, it was very annoying.  Of course, getting pissed off about being awake is not helpful (see later points).

> Vaguely drifted off briefly sometime between 06:30 and 07:15 and got up not too much after that.

As a consequence of all this, it was difficult to determine exactly how many hours of sleep I'd got, although I wager somewhere around five hours.  I would say that this is slightly lower than average for me; I usually wake up at 05:00 or thereabouts, but go to bed around 22:15 on a work night (and on any weekend night where I'm not doing anything worth staying up for).  

I've learnt to tolerate about six to six and a half hours of fairly unbroken sleep a night. That isn't bad you might say, but when it's rare that you get more than that it's not brilliant.  The fact that I often struggle to stay awake between about 13:00 and 17:00 on any given afternoon is a clear indication of the fact it isn't enough.  I'm 28 years old, not 78.  

But nevertheless, if I get six to six and a half hours sleep, I'm tolerantly satisfied.  Seven hours is a bonus.  Anything more is a once a year event.  Unusually, I went out with friends for my birthday two weeks ago and didn't go to bed until 03:00. I still woke up at 07:00.

So why is this?  Well first and foremost, I've had problems in the past with the following anxiety-fuelled mind loop:

I notice I can't sleep >>> I start drifting off to sleep >>> My mind notices I've started drifting off to sleep and in noticing I wake up again >>> I get annoyed and frustrated >>> I can't sleep >>> I start drifting off to sleep >>> and go again.

Sometimes this happens as a one off; in these cases, it takes me hours and hours trying to get to sleep, getting more and more frustrated about not sleeping, until eventually I get to sleep at something like 04:30.  And then wake up at 6.  There have been a smattering of one hour nights in the past.  On one occasion, after I first moved into my first (hole of a) shared house in 2012, this happened to varying extents for months on end, and it was starting to affect me severely by the end.  Fortunately I managed to arrest the problem just as it started becoming quite a serious issue.

I blame anxiety and my small OCD (Pure-O, Weird-O, whatever you want to call it) traits for this as well; I've had mind loops on numerous occasions with things in the past, and this is one example.  All, of course, are part of the overall anxiety / mental health package.

But I wouldn't say that this is a chronic problem, yet I often still sleep poorly and wake up early.  Why?  The other reasons are less unusual.  Firstly, environmental factors play an important role; they fuelled the 2012 example I gave above.  This time of year is a nightmare for me.  Who decided that it should get light at 03:30?  I can live with it getting dark at 22:30 because I'm only usually just going to bed.  But as soon as it gets so light I wake up.  You've heard the expression 'out like a light.'  I'm up with the light.  I'm like a bird (wasn't that a song?)

Then there is the heat of course.  I dislike the heat for numerous reasons, but sleeping is probably the biggest reason I don't like it.  You can put a thick blanket on, or thick PJs, or switch the heating on when it's cold.  But what can you do bar strip when it's hot?  Unless you are privileged enough to have air con, not a lot.

Then there is noise.  Noise wakes me up - OK, so no news there, but the problem I have is when a noise wakes me up, I then can't get back to sleep again.  I stay awake expecting to hear it again.  Noises have caused me to wake up and have a panic attack in the past, particularly if I don't know what the noise was.  The last few weeks in my recent shared house generated problems of this nature.

The other thing that keeps me awake is, of course, other things 'on my mind.'  When people without an anxiety condition say 'I've got a lot on mind,' I fail to have a huge amount of sympathy.  Anxious people always have a lot on their mind, most of it irrational, most of it absurd, but all of it seeming perfectly feasible - even more so at night, when you're in a slight slumber and when you have nothing to do to take your mind off it.  So what sort of thoughts keep me awake?  They could be genuine worries, of course, but they could be utter trash, the sort that by day wouldn't seem like an issue - unless you thought about it too much, then you'd get anxious again.

Solutions? 

So what have been my solutions, or perhaps more accurately small steps, to help combat this constant life of zombified nonsense?  Few and far between, for you see, when I am lying there having one of those nights where I struggle to sleep at all, I don't get up and read or do something to potentially take my mind off it - no, I lie there getting more and more irritated about not sleeping, leading, of course, to a lower likelihood of falling asleep.

That said, I have done some basic things, such as:

- Keep my room as cold as possible.  I need to get a TRV (control for my radiator) fitted in my bedroom in my new house so that, in winter, I can put my radiator off but keep the rest of them on if required.  I'm happy if my room temperature is 15-18 degrees.  I can sleep in the cold, I can't sleep when I'm too hot.  Hence - recently has been very unpleasant.  It was 26 in my room on Wednesday evening last week, and at my parents house due to various unfortunate circumstances I once recorded 31 degrees in my bedroom there.  I started to baste myself in my own sweat to stay cool (OK I didn't, but there's some imagery that won't leave you for a while).  

- Wear ear plugs.  These have been a life-saver.  I have to shove them in quite far to make a significant difference, but they do keep out most noises, including normal traffic noise, birds and other noises.  Bassy noises they struggle with, but overall a high recommendation.  Just don't shove them in too far (I couldn't get one out one morning for 20 minutes; there was blood and all sorts - I just about managed to retrieve it in the end, but the anxiety that was produced outweighed the impact of the ear plugs... anyway, there's another image to take your mind off the sweaty one).  Ear plugs may feel uncomfortable at first but you get used to them.  Wash them often and buy a large pack of them from Boots.

- Wear an eye mask - also known as a glorified blindfold.  This does help in light rooms at light times of year - the biggest problem with it is that it makes my face sweat when it's hot, so I can't wear it at the moment as it wakes me up anyway.  And of course, when is it at it's hottest?  When it's light in the early hours.  So it only has limited effectiveness, but it can be useful when it's cool and light.

- Put blackout blinds / curtains up.  Again, effect is limited but worthwhile.  At my new house, I have cream blinds in every room.  They look good, but are as useful for keeping out light as a bladeless lawnmower would be for cutting the grass.  So I purchased a cheap black blind from Wilkos that sticks to the top of the window and pulls down.  You can also get a proper job done and get lined curtains.  The problem with any of these is that the light still gets through the edges of the blinds, so again the effect is limited - but better than nothing.

- Block clocks.  What do I mean by this?  I used to have a red digital display clock that, as soon as woke up, meant I could see the time.  This isn't helpful, because again when it read something like 02:37, I used to get frustrated that it wasn't four hours later, and thus this kept me awake.  So now I've got rid of any clocks you can see without at least pushing a button.  A television box I've recently bought for my new room had such a clock, which I've since stuck a sticker over the top of so you can't see it!  Again, the effect of this is only limited, because you have a reasonable idea of the time by the light levels.  I love the odd morning at this time of year when it's still quite dark so you assume it's 4am, only to find the weather is crap making it look earlier when it's actually 6am!  Little things in the world of anxious sleep...

Note that the above solutions are all helping to combat the more environmental factors. Some of the CBT techniques I learnt for my general anxiety condition have helped a little towards other psychological sleep issues, but overall my tackling of what my mind thinks about at night and how I deal with lack of sleep is still not good.  As stupid as this sounds, but I'd tolerate not sleeping a great deal a lot more if only I could deal with it better... There may be other things I could try as well, like drinking chamomile tea before bed.

Talking of drinking, worryingly drinking alcohol before bed is the only thing that (so far) has guaranteed me to go to sleep quite quickly.  It doesn't necessarily prevent me from waking up early (or feeling well), but as a solution to falling asleep... well... 

Sleep is a major inconvenience for me.  Granted, it's better than being an almost guaranteed panic attacked-fuelled experience like it was years ago, but even still today, it often causes me more exhaustion than being awake does... go figure.  I'd certainly be interested if anyone reading this has found a good solution to sleeping well (that doesn't involve meds, or a hammer).

So, when the next person that says to me on the day the clocks go back 'ooh, an extra hour in bed,' forgive me if I punch them in the face.

Best wishes
Al

The Talking Therapy Run Down

Hi all

Apologies it has been a while.  As my last blog detailed, I have recently moved into my new house and this, along with the usual, has occupied a lot of my time recently.  Apparently it's important to insure your life and buy plates.

There was never a sofa.

Anyway, I thought I'd forego writing about my experience in dealing with anxiety and the aforementioned house move, and how anxiety has fared with recent pressured social events that I have been involved in.  I will say, overall, these have been a success albeit laden with a few sticky patches.  This is progress, though, as said sticky patches would once have been unidentifiable amongst the myriad of total stickiness that I would have had to endure.  

Instead, I thought I would blog about my experiences with talking therapy that has helped me try and keep my anxiety in check, and, ultimately, that has helped me to be able to function more adequately in life than before.  There has been a lot of talk, both virtually and verbally, recently about the effectiveness of therapy so I thought I would contribute, for what it's worth.  I appreciate that there is information on all of this already laced within this website, but hopefully putting all into one blog will be useful.

Therapy No.1: NHS, referred to by GP
Year: 1997
Age: 10
Status: Year 6, final year or primary school

Obviously, so far back, I had no idea what was wrong with me or what the therapy was all about.  My parents went to the doctor's who must have referred me to the NHS therapist.  This came about after I had my first ever panic attack whilst on holiday in Devon.  I also remember fearing death at this time and repeatedly asking God (as someone who isn't religious) that I didn't want to die.  Whether there was anything else to trigger my parent's taking me to this appointment I don't know.  But basically this therapy came about as a result of the first time in my life when it was clear that anxiety was going to dominate my youth (albeit I didn't know that then).

There were only two therapy sessions.  One at the start so that the therapist could make both me and my mum cry in order to try and ascertain what the problem was, and a second one several weeks later to review progress.  I must have had to carry out exercises in between; all I remember about this was drawing circles, the size of which indicated how anxious (whether that was the term he used I don't know) I was feeling.  Given how long ago this was, I can't remember how much success this therapy had; although given I've spent the following 18 years dealing with anxiety, one could make a reasonable assumption.  

Key lesson learnt: I was always destined for an anxiety-filled life to have had therapy at such an early age...

Accessibility: I can't remember how long it took before making the appointment and getting seen.  I don't think it was long, as perhaps children are prioritised?

No. sessions: 2

Cost: Free

Success: 4/10 - may have helped alleviate the immediate issues but no effect long-term.


Therapy No.2: University counselling service, self-referred
Year: 2006
Age: 19
Status: Second year of University

I should mention that refraining from accessing therapy during my entire high school career sounds positive, but I know for a fact that I should have obtained help on more than one occasion during this time.  Call it inexperience, feeling weak, uncertainty or whatever, but for some reason even at my lowest times during high school - and there were many - I never took this option. 

And as it happened, this self-referral in 2006 only occurred out of desperation. At the time, not only was I experiencing well-established panic attacks, but my mind had decided to loop things that I couldn't get out of my head.  I thought, to use a term not conducive to helping remove mental health stigma, that I was going mad.  

Anyway, I won't dwell much on this.  I had only one session, which frankly is all I expected, and my condition was put down to stress.  I knew it wasn't - but you have to remember I was desperate.  At the time I'd have seen a trained chimp.  What I didn't know back in 2006, of course, was that I needed CBT and not a counsellor giving me relaxation techniques.  

Key lesson learnt: Therapists at Universities certainly have their place (especially to deal with issues such as exam stress) but aren't necessarily trained in therapy for advanced conditions.

Accessibility: Outstanding - I went to book an appointment and was seen within 20 minutes!

No. sessions: 1

Cost: Free

Success: 2/10 - chocolate and fireguard springs to mind, but to be fair on them they could only do their best and probably weren't used to someone like me knocking on their door.  


Therapy No.3: NHS, referred to by GP
Year: 2007
Age: 20
Status: Third year of University

At the same time as accessing the above therapy, I booked in to see the GP to obtain another course of therapy on the NHS.  Now, we are in really troubled times at the moment with regards our NHS system, so to have a go at it seems wrong, somehow.  But I can't lie - the service and the therapy I experienced here was nothing short of useless.  For a start, it took 13 months - I'll repeat that - 13 months from being referred from my GP to getting an appointment.  By which time, the reason I had booked into therapy in the first place was less of a concern.  Third year of University was one of the better times for me, so seeing a therapist during this time wasn't as relevant.  OK, so I still had anxiety, but I was in dreamland compared to 6-12 months prior.  

You could argue, therefore, that judging the quality of the therapy in light of this is unfair, but it is the healthcare system's fault that I had to wait that long in the first place. So, here goes.  The therapist was the same person I saw with my parents back in 1997.  I realised after not too long that I didn't really like him as a person; he came across as very unsympathetic and unhelpful, which is not what you need in a therapy session.

Secondly, what I needed was CBT, not counselling.  Now, I couldn't influence this at the time because I still didn't know that's what I needed, but the fact I got counselling shows two things: (1) that the GP didn't properly understand what mental health conditions require what therapy to treat them and (2) that, in my town, there was only one therapist - a counsellor - available to see on the NHS.  Hence the absurd delay.  

I was also limited to a certain number of sessions, again unsurprisingly.  So what I was a victim of here is an over-stretched service and a therapist who, quite frankly, I didn't get on with.  Consequently, the lasting impact was less than negligible.  

Key lesson learnt: The NHS needs / needed (as maybe it has improved in recent years?) a radical overhaul in mental health therapy provision.

Accessibility: Shocking. 13 months from referral to appointment.

No. sessions: 7

Cost: Free

Success: 1/10 - no lasting impact.


Therapy No.4: Private CBT, self-referred
Year: 2010
Age: 22-23
Status: Couple of years into my first main job.

I would argue that this was my biggest wake-up call, therapy wise.  By this time, I had researched into CBT and discovered that it was this that I needed.  I was specifically seeking therapy at this juncture to deal with my problems with eating out, although of course what I didn't know then is that this was just a manifestation of a chronic underlying anxiety condition.  Just because panic attacks were less, I thought my only problem was with eating out.  What I didn't twig was that eating out was the only thing I did at this time that really generated panic disorder.  Something, I would reasonably argue, ought to have been picked up by the so-called CBT therapist that I saw.

I say 'so-called' CBT therapist, because I didn't actually obtain CBT.  Although I had ascertained CBT was what I thought I needed, I still didn't know exactly what it was about, so at the time I just got in with it, albeit with a bit of confusion.  I know it wasn't CBT now, because this therapy was all about the therapist trying to find out why I had this eating issue and spent the majority of each session talking about my family history and how this could have caused it.  No. No. No.  This is not CBT.  This was counselling in some form or another.  There was also one session dedicated to relaxation techniques.  I'd heard enough dolphin noises by this stage.

The final thing to emphasise is that, although this was private therapy, it was still limited to only a few sessions.  In this sense, it was no different to the NHS and frankly, the quality of the therapy was no better either.  

Key lesson learnt: Private therapy isn't always the answer!

Accessibility: Good; I was seen within a couple of weeks from making first contact.

No. sessions: 8 - limited to this number.  

Cost: £60 first session £30 thereafter; a total of £270

Success: 1/10 - no lasting impact; I still had problems with eating out, the one thing I was hoping to resolve.


Therapy No.5: Private CBT, self-referred via Anxiety UK
Year: 2011-12
Age: 23-25
Status: Well into my first job, moved out of home for first time towards the end of treatment

And so finally, a tale of good news.  This call for help was as a result of that particular event that took place on a train back from Cornwall, when I had a panic attack for 14 hours non-stop.  Subsequently I could barely leave the house and my anxiety levels had hit a new level that I didn't think were possible.  I knew action had to be taken otherwise I was in serious trouble.

Having had no previous success locally, privately or via the NHS, I was in a bit of a quandary about who I should turn to.  Thanks to Google, I stumbled across Anxiety UK, a charity dedicated to providing help for people with anxiety.  I called their helpline to arrange an appointment with a therapist via webcam, because there wasn't a therapist available in my town.  It was impossible for me to travel any distance at this time, so webcam therapy was my only option - but that fact that it was offered in the first place was a revelation.  

Within two weeks I had my first appointment with a therapist who happened to be based 262 miles away.  She was an NHS therapist part-time and a therapist working privately on behalf of Anxiety UK the rest of the time.  She only had a few non-NHS patients at one time, of which I was one.  And lo and behold, ladies and gents, I was getting CBT.  I was obtaining the help I needed, not just to help deal with the current situation but the whole underlying anxiety condition that I'd had for 13 years.  The focus was on how to deal with the situation as it was in the present, not about why I got to that point in the first place.  This did get discussed later on, but only when I was a little more stable and we were able to get more into the meat of the condition as a whole.  

There was also less pressure to improve, because sessions were unlimited; i.e., you got what you could afford to pay for.  And finally, I must say that the therapist was outstanding.  She listened, advised, and shared her own experiences - as she too had experienced mental health conditions over the years.  We got on almost as friends by the end, and I could not speak highly enough of her manner and intelligence on almost all issues that I had to raise.

Key lesson learnt: Try going via the charity route.  Enough said.

Accessibility: Good; I was seen within a couple of weeks from making first contact.

No. sessions: 50; unlimited depending on requirements.    

Cost: £20 per session; £1,000 overall.  The best £1,000 I have ever spent.  

Success: 9/10 - I will always have anxiety, but this extensive therapy has helped me manage the condition so much better than I ever thought I could.  It's more rational, I can keep it under control more and I have tools in place to help me in the more challenging times.  I set up this blog just after the therapy had concluded which says something in itself.


There you have it folks.  My aim here is to share my experiences, raise awareness of these and to suggest things to look out for if you are looking to access talking therapy.  

My final message is this.  It appears from mine - and others - experiences in obtaining the therapy you need to deal with a long-term anxiety problem, that paying for someone's services is the only answer.  What do people who can't afford such therapy do?  The fact that good quality therapy may only be accessible to those who can afford it is absolutely abhorrent and a shocking indictment of mental healthcare provision in this country.  This is a sweeping generalisation of course, but I'm purely going on my experience.  There will be excellent NHS therapists out there - and as I've documented above, poor private ones - but nevertheless, my point still stands.

I will conclude by mentioning that this website was three years old on 15 June. Still going strong. Well, still going anyway.  I hope I can keep it up, if nothing else so I can add my two-penny's worth into the 'trying to help raise awareness of anxiety' sphere.  

Best wishes
Al

Moving on... again

For those of you unfortunate enough to follow me on Twitter, you may have noticed that some of my recent posts have been about me recently buying a house.  It's one of those annoying things that modern day life, i.e. social media, allows you to do.  I don't particularly like the idea, as sharing with people that you've bought a house can be seen as boastful and arrogant - if you didn't want the attention why would you post something like this?

My new house is slightly smaller than this...

After all, I'm sure we all know that reading other people's posts that seem to suggest that their lives are wholesome and ticking along beautifully can cause depression for many people who perhaps are not going through a good time.  However in my case, I've only shared this with Twitter followers (people I don't know with a theme in common - i.e. experiencing mental health issues, tackling stigma and/or professionals in mental health care), as opposed to Facebook (people I do know).  If I was to post it on Facebook, or even tell friends about it, I feel like it becomes a big issue - which of course I don't want it to be, as this will put more pressure on me that it works out.

So why share it at all?  Largely because I'm so amazed that I've actually got to a point in my life that I've actually been able to buy a house that I feel the need to express it.  Amazed, not so much in terms of me being able to actually afford to get onto the property ladder, but more because I'm actually in a mental state conducive enough to making buying a house possible.

I first set up this website nearly three years ago.  Back then, I was on the road to recovery from a serious anxiety incident, and indeed, a lifetime of chronic anxiety.  Not long before the inception of The Anxiety Tracker, I could hardly leave the house - my parents' house, that is - let alone move out.  By the time I set up this site I was living in my first shared house (which I'm still amazed I came through without any major setbacks).  But because it wasn't the best experience of my life I moved back home again.  Then, in September 2013, I moved into another shared house, which has turned out to be a much better experience, overall.

So back in April 2012, what made me go down the shared house route?  My friend, for one, who was moving back to Stafford and wanted to live with someone he knew.  But I knew that he would be away a lot (he's a musician, so goes away touring frequently) and I knew, consequently, that I would be alone quite often if we moved somewhere just the both of us.  Being alone, I knew, was the worst thing for me, because time on my own just gives my mind precious space where it can dominate me with anxious crap.  So I went down the shared house route, with the aim to meet new like minded people.

Yes, for those of you who have been down this route yourself, you'll know that I was rather naive to think this would happen.  It didn't.  The people there were, at best, weird and unclean and that is why I only ended up staying for 10 months.  I'm amazed I stuck it out for that long.  I think the fact that I came to the end of my 50 sessions of CBT about 3-4 months into this experience helped me get through it, as me and my therapist were able to talk about this and tailor coping techniques to the living situation.  That said, I jumped for joy when I moved back to my parents - but I knew it could only be temporary.

I was determined to let this fantasy of meeting new people and getting a good shared house experience be a reality.  I looked at seven different houses in my home town, most of which were similar to the one I had already moved from.  S**tholes, in summary.  But alas, just as I was giving up hope, I found a place where the landlords seemed to care about house dynamics.  When I went round to view it, I was with two other prospective tenants, almost in competition, and met the existing housemates in the communal area.  It was daunting - as I have social anxiety - but I knew that it was an opportunity I had to take.

So I did, and I'm still here today - for another two hours anyway.  I'm moving out today, into my parent's house for a week before moving into my new house hopefully next Friday.  

So what have been the positives of the shared house?

- I have met two great new people.  One sadly moved out a few months ago, but both of them have been great to live with and, although it took a while for me to open up, I became / have become very comfortable with them.  It did enrich my waning social life.

- I believe this experience - and even the first bad experience - has strengthened me mentally, in some ways.  Simple things, like fending for myself, I found difficult before.  Becoming more assertive if people do things to annoy me (this is still hard, but better).  I think the experiences have strengthened me as a person and prepared me for my next venture.

Negatives?

- I'm not sure the experience has improved my social anxiety condition.  I thought, again maybe naively, that greater exposure to forced social situation (and by 'social' in this case I mean simply cooking at the same time as someone or being in the communal area with them) would instill confidence in my social ability and improve my social skills.  Not so.  If anything, they have declined in recent months as I find opening up about certain things or meeting new people increasingly difficult.

- Little things, like messiness and people using facilities when I want to, has always got to me more than it should - and again, if anything this is worse now than ever!

- Recent times.  Two new tenants have moved in relatively recently and they dominate the house a bit.  Things are noisier, busier and I find it difficult to get space... which leads me onto...

- A change in me.  By this, I mean I feel now that I want my own space a lot more.  I want the peace and quiet, I want to be alone more, I think having now lived in a shared house for over 30 months in total, I've 'been there and done that.'

So that is why, along with practical reasons, I felt it was as good a time as any to buy.  My friend, who I have lived with for the whole of those 30 months, is renting a room from me, so he will still be around half the time.  The other half will be a test, and for me the next venture will be a balancing act between making the most of and embracing this new peace and quiet, to making sure it doesn't consume me and trigger idle, anxious thoughts.  I hope I am more prepared for this now.

So yes, it is a daunting step - I'm not quite sure what I'm feeling at the moment - but the next stage, I feel, in my chronology of trying to smash through my anxiety condition.

However, there is one thing that genuinely scares me.  At the inception of both new living experiences, and one time when I stayed at a friend's house for two weeks to look after their cat, I suffered with really bad, short-term depression.  I have never had depression for a long period of time, I'm grateful to say.  But the one thing that has triggered it is moving to a new place.  Unfamiliarity and the daunting-ness of such a big move is probably the reason, coupled of course with a vulnerability that having an anxiety condition for over 17 years can generate.  So that is what scares me about this move - I don't want to experience this again,  I hope that almost expecting it will help me manage it better; conversely, expecting it could make it more likely to happen.  I just hope the perceived magnitude of the move will not affect me too negatively.  

So I write this a week before I move into my new house.  A couple of hours before I move out of my shared house.  Another chapter is about to begin.  Sadly for you lot, I have no doubt you'll here about it here or @AnxietyTracker first...

Best wishes
Al

Election 2015: My mental health perspective

I have never cast a political vote before.  Yes I'm 27, and I've never voted before.  Does that make me ignorant to the issues of the planet?  Wrapped in my own self-centred  little world?  Stupid?  Or I just don't care?  I hope that it's none of these things.  I've only been old enough to vote in one previous general election (I was just a month shy of 18 in 2005) and a few local/council elections, but this is the first time where I feel I deserve a say in who should run our country.  I didn't know enough about the parties in 2010 to know what I was voting for (OK, so stupid then?).  And in the last local election, where I'm registered, I could sneakily cast 100,000 votes for any other party and the Tories would still get in.  So what's the point?

Please don't consider the quality of the logos when voting

However, this time, I have made a conscious effort to pay attention, to listen to what the politicians have to say, to align myself one way or the other, left or right, red or blue, or yellow, or purple, or green.  I read what I believe to be the only newspaper that is as unbiased as they come, so this has helped me form my own opinion.  I have also, following their publication last week, read key parts of each of the five party manifesto's.  Just for context, I'm based in England so can't vote SNP, Sinn Fein or Plaid Cymru etc.

Also for context, my parents live in the aforementioned Tory heartland of rural Staffordshire, which has been in Tory rule since the Dinosaur party.  My parents, as far as I know, have always voted Tory.  The only recent revelation is that Ukip are closing in a little bit on the Tory rule there, and I wouldn't be very surprised if my parents went this way too.  They think there is too much pressure on services in the UK and HS2 is proposed to crash through the golf course my dad plays at.  So make of that what you will (and you'll be right).

I'm still registered there, but where I live in central Stafford, it is more even between Tory and Labour.  It changed in 2010 to Tory, and it's touch and go whether it will go back or remain.

So why I do feel compelled to vote this time?  I suppose I just want my say, and as I say I'm more knowledgeable about what I'm voting for now.  I didn't read the full manifestos of course; three more Government's will have been and gone by the time I did that.  So I researched what issues were important to me.  These included the environment and climate change (my job and my passion), the considerations of young people who I have visibly seen have been shafted in recent years, public transport and then the big issues such as immigration, housing and the NHS.  And the other main factor I specifically researched?  What each party intends to do about providing better mental health support and tackling stigma.

Now at this point I must mention this.  Another reason I didn't vote in 2010 or in local elections was because I don't believe a word politicians say.  Moreover, I worked for local Government for over five years and during this time, the majority of councillors I came across were rude and rather up themselves.  So I lacked belief that they would stick to their word and didn't particularly like the way in which they governed.  Not too much has changed my belief in recent years; but my attitude has.  Sadly, it's one of acceptance, that politicians will always break promises, fail to deliver in certain areas and often come across as up themselves.  There isn't much I can do about that, so I have to accept my cynicism and doubt and vote in the pretence that each party will do what they say.  I don't believe for one minute that they will - but if I let this get in the way I'll never vote, as, I'm guessing, won't anyone else.

This cynicism stretches to mental health.  In the nearly three years that I've been writing blogs on this site I've mentioned on numerous occasions my experiences with therapy.  I have learnt so much about other people's experiences too; from friends, from magazines such as Anxiety UK's Anxious Times or Mind's magazine and via social media.  Many have had negative experiences at the hands of the NHS, whether it be too few sessions, lack of compassion, lack of understanding, ridiculously long waiting times, or whatever.  I must emphasise that private therapy can also be like this as well.  So in my opinion, mental health provision needs a total overhaul, with easier access to quicker therapy that you can access for as long as you need.  Do I believe any Government could achieve this whether they say they can or not?  No, of course not.  But again, I have to ignore this cynicism and move on.

So, in summary, what is each party  (in alphabetical order) saying about mental health:


Conservative:

Provide significant new support for mental health, benefiting thousands of people claiming out-of-work benefits or being supported by Fit for Work.

Provide therapists in every part of the country providing treatment for those who need it.

Enforce the new access and waiting time standards for people experiencing mental ill-health, including children and young people.

Ensure that women have access to mental health support during and after pregnancy.

Proper provision of health and community based places of safety for people suffering mental health crises to stop vulnerable people being detained in police custody.


Green:

Ensure no-one waits longer than 28 days for talking therapy and those in crises have 24-hour access to help.

Eliminate places of safety for children with mental health issues by 2016.

Ensure everyone has access to a 'mental health bed' in times of need.

Implement a campaign to end mental health stigma and discrimination and support the Time to Change initiative.

Pay particular attention to mother's, ethnic minorities, ex-servicemen and children in the treatment of mental health problems.

Give priority to the physical healthcare of those with mental health problems.


Labour:

Bring together services for physical health, mental health and social care into a single system built around the individual.

All NHS staff will be trained in mental health issues.

Ensure that teachers have training so they can identify problems early and link children up with support.

Use of mindfulness to build resilience, especially for children.

Ensure that the great majority of patients can access talking therapies within 28 days,


Lib Dems:

Invest £500m to transform mental health care with waiting time standards to match those in physical health care.

Inclusion of a waiting time standard from referral of no more than six weeks for therapy for depression or anxiety and a two-week wait standard for all young people experiencing a first episode of psychosis.

Increase access to clinically and cost-effective talking therapies.

Revolutionise children’s mental health services.

End the use of police cells for people facing a mental health crisis.

Set stretching standards to improve the physical health of people with mental health problems.

Develop a campaign promoting the steps people can take to improve their own mental resilience – the wellbeing equivalent of the ‘Five a Day’ campaign.

Establish a world-leading £50m mental health research fund.

Continue to support the Time to Change programme to tackle stigma against mental health.

Ensure better training in mental health so people can identify if someone has a problem.


Ukip:

Develop a 'whole person’ approach to health and that means giving mental health parity with physical health.

Recognising there is often a link between addiction and mental illness and offering appropriate treatment where this is the case.

Provide access to specialist mental health treatment for pregnant women and mothers of children under 12 months of age.

Fighting the stigma around mental illness and supporting those seeking to get back into work.

End the postcode lottery for psychiatric liaison services in acute hospitals and A&E departments.

Provide a single point of contact for veterans experiencing mental health problem.


So there you have it.  Like with most things politically, what this summary will probably do is confuse you more rather than less, as it did for me.    

If you go by quantity alone, the Lib Dems seem committed to investing in and tackling mental health problems the most, but is this enough to get them the vote on mental health alone?  The good thing is, the issue appears in all of the party manifestos, which is progress.  It is seen as important whether you're right or left wing, which again is strong.  It would be fascinating to undertake a study (if it's not already been done) that shows what party the people who do stigmatise mental health generally vote for, or whether it's fairly random.  Similarly, who do those people that work in the mental health profession vote for?  And, most importantly, who do people who have experienced serious mental health problems vote for?  

What this blog aims to do is just get you thinking about what the parties are considering.  I'm not going to say that you should or shouldn't vote - to say the former would be hypocritical.  I believe we have a right to choose whether we vote or not, on the assumption that one doesn't normally vote if they are ignorant about what the parties stand for, as I was - and always will be, to some extent.

As for who I vote for, I genuinely haven't decided.  It will factor in the mental health policies but also other important issues of mine, as outlined earlier.  By main concern is this: it is often Government policies that cause heightened mental health issues in the first place... meaning that when we're voting, we must consider the whole package.

Best wishes
Al