I spent part of the summer in airy historic churches listening to choir performances. The combination of uplifting voices and sunlight through stained glass windows was heady and romantic. I hope to join a choir in time for Christmas carols. I’m in no way a professional signer. Not even a confident amateur. I’m a hopeful novice with a yearning to be part of something greater and more musical than my single modest voice.
I spent 12 months staring up at the Post Office tower. It’s on the door step of the University of Westminster where I studied for my masters in psychology. At lunch times, away from the stress of the course and difficulty of trying to work myself out, I’d sit in a leafy square close to the foot of the tower and gaze up wondering.
I’d imagine the view, a rich skyline of glass and trees, brick and concrete, towers and spires and domes. London is glorious from on high. A pretty green marble dense with history and striking modernity, like the Shard, St Paul’s, Big Ben and the amazing London Eye. Visualizing all of that and more whilst dining on my sandwiches stilled my anxieties for a moment.
When all else fails, cake making is the only option i.e. therapeutic baking at the Thursday Club. Decadent flapjacks are my favorite.
Being engrossed or buried in complex detail is something I’m fond of doing. I’m spellbound by colouring books, I get lost in embroidery and I sink deep in the silence of my meditation.
However, there are times when I’m consumed by persistent repetitive thoughts and rumination which is not helpful. It tends to drive me a bit bonkers, like a mouse stuck in a wheel with no way out. Horrible thought. And yet, being lost in the weeds of my mind is not always a bad thing, especially when I’m daydreaming.
Recently I’ve been visualizing myself being safely curled up in the cotton wool puff of a dandelion. Peaceful.
New growth in my kitchen. Mint. I don’t have a garden so growing herbs is my way of nurturing my own patch of mother earth. Let me know your recipe for fresh ginger lemonade. I’m thinking: sparkling water, lemon juice, grated ginger, mint and crushed ice.
Things have changed. I had a relapse in July and I’m currently recovering. Mostly I’m lost in DIY, photography, creating collages and writing – my diary, short stories and other projects. Long story about what triggered the relapse. That’s not really my focus. Right now, I’m in love. It’s bewildering. His bright eyes fixed on me, up close, and from a distance thousands of miles of away. Dream.
Gardening on Tuesday
Pots of lavender are being planted around the borders, and the vegetable beds have been richly watered. Pumpkin, sweetcorn, chilli peppers, garlic, tomatoes, herbs, berries… There’s plenty of growth in the glistening soil. A handful of residents are dedicated to the cause while others look on, intrigued. It’s hot and humid, so after taking snaps I sit with the onlookers and merge in with their quiet.
Under section 3 of the mental health act, medication is compulsory in hospital. If you refuse to take it, you’re pinned down and injected by force. When I was first admitted to hospital in west London, I was given olanzapine, an antipsychotic but I didn’t like the side effects: confusion, blurred vision, memory loss. It felt like I was trapped in a woolly fog.
Eventually I refused to take it, and the response was to give me a forced injection of aripiprazole, another antipsychotic (pictured). I found the discarded packaging when I woke up, dazed and disorientated. I don’t remember how long I was knocked out for, and at the time the drug meant nothing to me, and none of the ward staff bothered to explain.
I refused medication twice after that. It was a personal campaign. I kept pushing for talking therapy but that option wasn’t available for reasons that were never made clear to me. Instead, I was taken off the consistently refused olanzapine, and placed on a depot injection, a painful jab I would receive every two weeks. The jab was an antipsychotic, zuclopenthixol decanoate and it left me feeling like a plank of wood floating out into nowhere. I couldn’t smile or express any kind of emotion. Up, down, sorrow, joy. None of it was there. The light was switched off. Everything about the animated me was surpressed, and I couldn’t get to grips with myself. I was locked in a hazy fog and completely disconnected from everything and everyone around me.
Home Treatment Team
I had four depot injections in hospital, and the recommendation was that I remain on those painful jabs for up to a year. No chance. Out of hospital (Oct. 2013), I could refuse medication. Under care of the Home Treatment Team, I had two further jabs at a reduced dose. After that I said no to the depot. Being lost in a chemical haze wasn’t the right treatment for me.
I described my symptoms to Dr LV, a psychiatrist from the Home Treatment Team. I was a plank of wood and I had other side effects: memory loss, blurred vision, trembling, lack of concentration. I felt dislocated, like I’d lost the vital, creative part of myself. I wanted to come off the depot, and I wanted talking therapy. Dr LV was sympathetic. She said not taking the depot would risk a relapse, but if I really didn’t like the depot there were alternatives. She would look into talking therapy for me, possibly CBT, and she prescribed Procyclidine which she said would ease some of my symptoms. It did, for a week or two. But I didn’t want an escalation in the number of drugs I was taking, so I stopped Procyclidine at same time that I said no to the depot. (Dec. 2013).
I wanted to start the New Year medication free, but it wasn’t easy. I sunk into a black hole for most of December, and by the end of January I couldn’t sleep, and I was having desperate mood swings and panic attacks. I knew I was in trouble when close friends were buying bags of shopping for me, and when my little brother pretty much ordered me to get help.
During the w/c 27 January, I emailed an SOS to my care coordinator. She’s part of the Recovery Team for my local area. I had only met her a couple of times before Christmas, and I wasn’t sure how she would handle my crisis. The last thing I wanted to do was go back to hospital. Thankfully she said hospital was a last resort, and she booked me in to see the team psychiatrist, Dr PH.
At the meeting with Dr PH I was willing to give medication a try. I was thinking that I might have dumped the depot too quickly or that maybe I was in some form of denial, so I listened to what Dr PH had to say. She knew I was non-compliant with medication and she let me know that talking therapy was being arranged. She explained different types of medication: anitpsychotics, antidepressants, mood stabilisers, sedatives… and she listed the side effects of the drugs she was proposing for me: chlorpromazine (antipsychotic), sertraline (antidepressant), and sodium valproate (mood stabiliser).
Only chlorpromazine was new to me. My little brother is on sodium valproate, and a friend of mine was on sertraline for a while and said it had worked for her. I collected the drugs from the hospital pharmacy and tried them straight away. February was a quiet month.
Right to refuse
I dumped sodium valproate because it gave me persistent stomach gripes. Sertraline went the same way, but I stayed on chlorpromazine for a month. It had a calming effect on my panic attacks and mood swings. But I wasn’t keen on the drowsiness and the feeling that I was living in slow motion, so after a while I took fewer tablets, and then I stopped taking them altogether. The crisis was over but the darkness remained.
I’m not stubbornly against medication, it just doesn’t work for me on a daily, ongoing basis. And there’s no way I’m sampling different types until I find “the right one for me”. There is no right one because they all come with side effects. Other treatments work better for me: art therapy, CBT, mindfulness.
Positive psychology has also helped, and so has my new job. I’m a mental health support worker responsible for some very vulnerable clients. I have to oversee their medication and also dispense it which threw up some awkward emotions for me. Thankfully the clients have the right to refuse their medication, and I get to advocate on their behalf, pushing for medication reviews, changes in dosages, and the cessation of drug treatment. It’s very empowering and lights up the dark no end.
“When historians of the future write about healthcare in the twenty-first century, they will remark upon one of the more curious aspects of our healthcare system – the way we separate physical and mental health.” Ed Mitchell, NHS England
Your physical health gets plenty of investment: cutting edge cancer research, high profile campaigns like 5-a day, and how to spot the signs of a stroke, state of the art hospital wards, accessible community clinics, media pressure to reduce waiting times…
Your mental health gets zero investment by comparison, and much less in the way of public affection. Media stories are usually about hard pressed services unable to cope with demand, and violent patients who’ve been mismanaged by community by care. History has played a hand in the low view of mental heath. People with mental health problems have been a long-running source of public ridicule, and a fear factor locked away in asylums. Skip to the modern day and the fear factor still prevails: fall ill with a busted appendix or a broken leg and you’re rushed to A&E. Suffer a manic episode or a mental breakdown and you’re often rushed to the nearest police cell.
Things are meant to be changing, largely due to the rising cost of mental health problems to the NHS. “No health without mental” and “No decision about us without us” are stepping stones towards a new world order, a position where the profile and importance of mental health is raised, patients have a discernible voice, and mental health services get the same kind of government backing and investment as physical health services. Policy makers have been drafting plans for the last couple of years, and “Parity of Esteem” adds to the agenda by seeking to value mental health equally with physical health. But it will take a long while before the NHS drags itself into the holistic way of thinking. Says NHS England, “We tend to view physical and mental health treatment in separate silos.”
From a holistic point of view there should be no separation or distinction between the two. A person’s mental health is just as important as their physical health, so the services provided for both should be joined-up, easy to access, and automatically attached to voluntary and social services. Roll-on the day when I can have my CBT appointment at my GP surgery as standard, meet my care coordinator there, and have a mental health check as easily as I have flu jab.
Babies / Tracy Raver
23 June. Monday’s cook club had lasagne and creamy courgettes on the menu. RB and JS were in charge, the two clients who produced last week’s haddock chowder. Their stint in the house one kitchen was busy. They had two other residents on the production line, a member of staff overseeing the action, and me in the background taking snaps.
The talk was mostly about the World Cup and England’s early demise. No one was excited about the final match with Costa Rica. When the lasagne goes into the oven, the kitchen crew join others in the garden and kick a football around. Only RB hangs back, washing up and checking the oven time on his courgette dish.
I don’t yet know his case history, and for the moment, I’m not concerned. He’s an affable guy who lives in one of the independent apartments. He remembers me from last week and I show him my snaps. He likes the idea of blogging and lets me know he starts a computing course in a short while. We chat about him sharing recipes with the other residents, and I suggest he start a blog for the Monday cook club. “Yeah maybe,” he says while he checks the oven clock and decides to go out for a cigarette.
As I watch him go, I’m not sure if I’ve skipped ahead by several steps. After all, I didn’t ask him about his computing skills and how confident he might be at the keyboard. I’ll leave that till next week. For now I’m content with storing the visual data.