CW: Mental Health, Mental Illnesses, Bipolar Affective Disorder, Anxiety, Stress, Suicide
TW: Suicide, anxiety, panic attacks, NHS, mental illnesses, stress, trauma, self-harm, eating disorders, emotional/mental/sexual abuse.
Whenever I attempt to be open and honest about my mental illnesses, I am often confronted with either “oh, that’s so brave” or “oh, how do you cope with that?” Fact is, there’s nothing brave about being honest on a stigmatised topic, that’s kind of the problem.
But depending on your illness, it shouldn’t be that hard to cope with. I am fortunate to be a fairly high-functioning person with regards to my mental illnesses. I can socialise for the most part and stay stable within part-time or free-lance employment. However, what isn’t easy to deal with, what I can’t cope with, is the NHS. The NHS and how they treat their patients with mental health issues.
Looking back, I’ve suffered with anxiety since childhood, not just being nervous or simply a shy kid, but genuine cold-sweat, irrational anxiety; since I was a toddler. This progressed, as I entered adolescence, into depression with anxiety and intersects with my experience of mental, emotional and sexual abuse. The Mental Health Foundation also highlights that socio-economic background and sexual orientation provides a big spike in the variation and severity of mental illnesses that can affect an individual, the only element positively helping me is not being subject to racism – which again, if you’re black or brown, adds another layer to possible mental health complications. Winner winner, chicken dinner.
The NHS has come under attack and scrutiny in recent years and how effective it is with treating the ever-rising tide of mental health issues it faces. Not surprisingly, so have the Tories. But I’m going to try and keep this politically neutral as no government has done fantastic on this, to date.
So, here is my break down of experiences with the NHS to mark my three-year adventure into trying to get help:
I have my first major mental breakdown after almost a decade of self-medicating with class-As and alcohol and have my first experience with severe suicidal thoughts.
I spend almost a month in bed after moving back to my Mum’s and then two months starving myself (and going to the gym twice a day, every day). I’m not on top form.
GP refers me to local trusts and charities which could offer me counselling or CBT (cognitive behavioural therapy). I opt the CBT. Not because it appealed to me, it didn’t, but because I was told that waiting for counselling would take 3 months, and even then, it wasn’t guaranteed.
It looked like this: a one week wait for a phone assessment (read: interrogation) a one month wait to be given an appoint and then a further 6-8 weeks until that appointment.
This would be a common theme for the next 3 years, a continual loop of 3month waits.
So, I got my appointment for June, a date I couldn’t make as I had a pre-planned holiday. These dates are non-negotiable. You get given them and you must take them. If you don’t, you get them taken away and you have to apply again. I opted for the latter as I wasn’t prepared to have my life disrupted any further.
Same process, new incompetence. I wasn’t issued my appointment (via mail) after my assessment due to ‘missing’ my June appointment, even though I had called up and cancelled. They didn’t attempt to contact me in this time to clarify or double check, I was just left ‘double booked’ and ignored. I lost my patience and decided to call it quits with the NHS for a while.
Second year at University, first year of exams. Anyone with a mental illness will testify that higher education is one of the most gruelling experiences, I watched my mental health slip through my fingers. So, to make sure I got through my exams – I was off to the GP.
After a year of reflection and attempting self-help by staying away from drugs, cutting out toxic relationships and keeping drinking to the minimum, I had been doing a lot of research. I fitted the symptoms of bipolar pretty well, I also kept in mind that my Dad was diagnosed with bipolar a few years before and there are allegedly genetic links. Yay.
Explaining this to Dr. Middle-Class snobbery, I was told quite point-blankly that I would know if I was bipolar, that I would be a violent mess, foaming at the mouth and be a nightmare to all around me. Oh, great, Doc. Guess I’m fine then. I got put on an anti-depressant called Citalopram.
I spent three months on the meds. I sank into a depression which on one particular day felt like I was going to die, I had physically lost my body and the will to live, all I felt were ripples of raw emotion and pain emanating from my chest. I hallucinated killing myself. But it passed. And I carried on, because I was in a new stage of what I considered normality.
Returning to a new doctor to be referred again for counselling. Only this time, I would miss my future August appointment because of a job interview. I needed money, but the NHS mental health team are non-negotiable, so they made it that I had to choose to be financially stable over mentally stable. Thanks.
I asked for anti-depressants again (as although they were horrible, they allowed me to study for more than 2 hours at a time) and I was also offered Valium to help with anxiety-attacks.
I lasted until a week or two before my first exam where I had what they call a ‘contradictory’ episode whilst taking a combination of anti-depressants and a sedative, which meant I spent 15minutes on the top deck of the 53 bus, slowly running down the old Kent road like cold treacle, where I sat on my hands in fear, as I couldn’t stop picturing killing myself.
Little did I know that people who are bipolar, like that Doctor had denied me, should not take anti-depressants. Anti-depressants exacerbate your highs and lows to make you even higher or even lower.
I went to be referred again, another three month wait.
First appointment with a psychiatrist. Within an hour they had me diagnosed with bipolar affective disorder (bipolar 2), which is the less severe version. Bipolar lite, you could say. I had a brief discussion over what medications I’d like to try, definitely not an anti-depressant, a mood-stabiliser, quetiapine, and I was on my merry way.
I was told I’d have a follow up appointment soon.
What I wasn’t told was when that follow up appointment would be or whether I’d be taking a higher dosage at some point. All medication has an ‘affective dose’ which in theory means there’s a minimum amount you need to take for maximum effectiveness. My new med was 250mg a day, I was on 10% of that. It was also noted, via hundreds of online resources, that the lower the dosage the more chance of side effects and at a higher severity. Here we go again.
My follow up appoint was to be in 3 months. See that funny little pattern again? The pattern where they think it’s ok to leave people with a quite serious fucking life-long mental illness for 3 months at a time, without contact. But wait! The letter also stated I could call up at any time, phew!
I called up every day for two weeks. I left messages. Dictated emails to receptionists. Begged for the psychiatrist to be disturbed on break or anything. Nothing. This might seem a bit intense, but the side effects effectively made me sleep for 15-17 hours out of the day. I couldn’t keep it up.
I decided to go to the surgery and wait until the doctor became physically available. Now, although I could see them in the hallways and they knew I was there, they did not come and see me. Not even for a minute. I was being avoided.
Five weeks had passed since my initial diagnosis, five weeks I had to plan a gradual increase of my medication to move out of the side-effects, I had gotten myself up to 250mg and although I couldn’t stay awake past 9pm, was unable to have a life outside of my room and the meds lowered my heart rate at night to the point of stopping, I was of ‘stable mood’ – *rolls eyes*.
I wrote a lengthy complaint to the governing body on malpractice which I received several replies to, all with diplomatic apologies only to reiterate what I thought were my grievances back to me. Pointless.
On my third and final visit with the mental health team I waited almost two hours until they could squeeze me in for 15mins. I got a half-hearted apology that the doctor’s health was poor over the course of these last few weeks and when I contested that there were other people that should have been able to help me, or a backup plan, they put their hands up and said the practice was poorly run and needed to do better.
We agreed on a final dosage of medicine, as I was running out and I tried to go into some detail about my struggles but was told that I was looking great, doing great and now discharged from the mental health team. I just had no idea how quickly one can be of sound mental health! It was a miracle!
I had another mental break down and appealed to be seen again by my local mental health team. I was told I’d have to go through the three-month loop again. Did I? Did I fuck.
I am now paying for private counselling at almost £40 an hour, once a week. I’m incredibly lucky to have the finance for this at the time, especially considering it’s almost half the price of others out there.
After 7 months of being sedated I decide to wean myself off of my medication as I was depressed and incapable of living a life that I would define as normality.
I have since moved boroughs, from Greenwich to Lewisham and contacted my GP to ask what the services are like in the area. I put a tiny bit of hope in perhaps getting NHS counselling, as financial strain sets in.
I am referred to something called the IAPTS, which is the local mental health team.
I book another appointment and my GP asks if they have been in contact, they have not. I am told to apply online and call them.
They don’t answer the call and do not email me the questionnaire their website says they would.
I see another GP who refers me again and makes me feel incredibly uncomfortable by requesting that my private therapist writes a report on me to send to them. I meekly agree and speak to my therapist who says this is not normal practice.
I am currently poorer than ever in the last 9 months and attempting to seek private psychiatric help to further expand my diagnosis. I am stable now I have come off of my meds and am resolute in the direction I need to take in looking after myself.
Whether it’s a combination of austerity and poor governmental policy that’s taking place here, it’s relatively easy to surmise that we as a society have a poor cultural relationship with mental health and mental illness. If any at all.
42% of GPs say they haven’t had any relevant mental health training. This is leading to people, like myself, to be left in the hands of practitioners who could potentially kill them.
Our only option within the three-month waiting period is to go private or to go to the local A&E to see their ‘crisis’ team, a team which will only deal with you if you’re suicidal or a threat to yourself and others around you. What that realistically means is that you’ll be sectioned or detained until no longer a threat.
There is absolutely no duty of care on any spectrum of the NHS. Long waiting times and inexperienced staff are causing people serious mental harm and pushing people away from even attempting to seek treatment.
It is estimated that over £26 billion is lost each year due to poor mental health and mental illness, either as limited productivity, absence or sick leave.
And although the Discrimination Act of 2010 can protect us by classifying our illnesses as disabilities, the stigma attached to mental health means that people will not mention it in interviews, on applications or when it arises due to fear of dismissal, lack of understanding or empathy.
Mental illness is a minefield and anyone who has had to go through the NHS knows full well that just the process of being referred alone, is enough to trigger an episode or a breakdown.
With the local elections coming up, have a think about whether you’ll participate or not. Think hard about if you were to break your leg tomorrow, would you receive prompt treatment? But what about if your mental health deteriorated, or someone that you cared for, could you say the same?
We need to support those that are pushing for change in our mental health services and also support those that we know around us suffering with the consequences of a mental illness.
Mental health and mental illnesses do not discriminate. It could be you one day.