Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

What's in your Stress Container?

I can't remember the last time I cried. I remember crying at my Mum's funeral. I'm sure I've cried since then - 18 years have passed after all!
 
I've recently told people that my tolerance is lower than it was than before I became a father a couple of months ago. Stress and disrupted sleep will do that. An NHS colleague described the last few months as being dumped on continuously. It does feel like that. There are days you are scrambling to keep near the top and other days you are peering like a Meerkat awaiting the next disaster.

 
No one is ever fully prepared for being a parent. There are quirks and phases, some last hours and others last months. There's pressure and people who know best even though it's been out of medical practice for almost 10 years.

All that being said, I wouldn't change a thing. I love my wife and I love my Son.

To any prospective parents reading this, take some time and spare capacity in your life and your mind. Be ready to ask for help and say 'No'. Be ready to do what is best for you and your clan. And when you think you have enough spare time and energy, make some more. You have a partner to support too and that had its own pressures, concerns, and rewards.

I've been so lucky to have work - so I'm not being a parent 24/7. You don't appreciate how much strain Mum is under because you are in a different mindset - stressed at work. I'm working full time in the NHS in addition to working self-employed and so recently felt very aggravated when someone suggested I do even more work - unpaid. I do quite a lot of volunteering as it is and when someone tries to take those tiny moments you have to enjoy family time, it's infuriating.

This brings me back to the feeling like I need a cry. Crying is OK. I sometimes feel like I need a good cry to let it out but for whatever reason, I can't. I've never found crying easy.

Everyone has a stress container. They are different shapes and fill at different rates. The pressures in my life and the dates in my diary are different to yours and this is reflected in the way we hold and manage our stress. This is something we discuss during the Mental Health First Aid course by MHFA England which I teach - details here. Something you find easy can fill someone else's stress container. When the bucket is full, it bulges and bursts with stress until we snap. We lash out, we snap, we cry. The expression "the straw which broke the camel's back" is great example of when something you might normally see as minor can be the event that buckles your bucket.

If you'd like to know more, then please consider becoming a mental health first aider. There are some good short courses out there for introduction, but I would strongly recommend an accredited course like the 2 Day course by St John's Ambulance or the 2 Day Online course I teach by MHFA England. Being a Mental Health First Aider helps you better support yourself, your staff and your customers in the same way a physical first aider does. It helps teach you to support and react in general everyday occurrences as well as big crisis - just as physical first aid supports you to use a plaster or to do CPR. In fact global company Deloitte published studies showing a positive case for employers investing in mental health, with an average return of £5 for every £1 spent.

Find out more about Mental Health First Aid at www.mentalhealthmatt.co.uk

No one has committed suicide in England or Wales since 1961

It may seem like the most clickbait of titles but I can assure it is 100% true. Since Summer 1961 not a single person has committed suicide. Yet in 2019 5,691 people took their own lives.

According to statistics from 2016, the United Kingdom is 109th in the World Health Organisation’s rankings of suicide figures out of 189 nations. Records from the Office for National Statistics show that between 1981 and 2019 a staggering 200,711 people ended their own lives. On average, 75% were male. [1]

Mental ill health is responsible for 72 million working days lost and costs £34.9 billion each year. [2] I’ve even spoken about my own mental health and how I survived suicide on national TV.

Given the horrible records, how can anyone claim that no one has committed suicide?
To answer that question we need to go back to the start - or as close as we can. In your mind travel back to 967 AD. Edgar the Peaceful, King of England, has been on the throne for 8 years after the last Viking King flees to the North. He’s a deeply religious fellow and works closely with Dunstan who lead the ‘10th Century Reformation’ as the Archbishop of Canterbury. Dunstan himself would later become a Saint. History records that King Edgar would take a yearly tour of his realm to ensure that his law was being upheld. History seems to remember him favourably.

His laws were recorded in Ecclesiastical history in the Charters of Abingdon Abbey – given his positive connections to the Church and that generally only ‘men of the cloth’ were literate we can imagine why. It was a law in 967 – which I’ve been unable to directly find without a paywall – that King Edgar is perhaps the first to make “self murder” a crime. His law made is clear that anyone who died from suicide would forfeit their estate and lands to the feudal lord which made suicide a felony.

Perhaps it was just a way to make money? A few hundred years later Thomas Aquinas, later a Saint himself, would document his views as scholar and an authority on religion. He felt that the Christian God had created humanity in his image as a gift and therefore killing that gift would be a little bit insulting. The commandments state that “Thou Shalt Not Kill” and so suicide would be a literal breach of the law handed down by god. [3]

It is fascinating how religion and law have become so entwined. This isn’t unique to English history either. The oldest appears to date to 1937 BC in Egypt a tale was being told where a man considering suicide is having a conversation with his soul who fears that suicide will leave the soul lost where “goodness is rejected everywhere”. [4]

With so many cultures and religions angered by the concept, it became enshrined in law on an almost universal scale. In England and Wales it was the Church who had this commandment in their law book which overtime became Common Law. Over the Centuries this has appeared in different ways. Churches would reject burials and certain rites for those who have taken their own lives. In Medieval England, tales of secret midnight secret burials, sometimes at crossroads partly due to the stigma around how the person died. This stigma of shame, embarrassment and humiliation stirred throughout history with many people being refused burial rites following suicide into the 20th Century.

With secret funerals and stigma, entire family members would vanish from history becoming unspoken gaps. Some people felt embarrassed of their familial connection whilst others truly believe that suicide was a sign of demonic possession. The concept of a burial at crossroads seem to stem from the idea that the passing traffic would somehow prevent those evil spirits rising from the grave. [5]

The fear of mental health and suicide is evident whenever you hear the world “asylum” something the horror film industry used inadvertently perpetuating more stigma. In 1914 there were over 100,000 patients in around 120 mental health institutions. The nearest to my home is St Bernard’s Hospital which was previously known as the Middlesex County Lunatic Asylum. Much of it still exists albeit as NHS offices and part of Ealing General Hospital. Like many Asylums, the buildings strike fear looking more like prison than welcoming treatment facility. When you look at facilities like these, leeching fear and discrimination into the community, they seem to mirror the historic feelings towards mental health. It is easy to understand why self-murder was a punitive offence. [5]

Records show that even in the early 1700s, a coroner’s inquest would rule around 90% of suicides finding the victim guilty of felo de se – committing a felony against themselves; suicide. The punishment would be complete forfeit to the Crown. However as the century passed, beliefs moved away from evil spirits towards more medical explanations. Juries ruled the suicides as non compos mentis which meant there was no criminal offence and would allow a simple Christian burial, often at night. [6]

First published in 1759, Adam Smith’s The Theory of Moral Sentiments questions and documents the turning opinion of the times: "If your situation is upon the whole disagreeable... walk forth by all  means. But walk forth without repining; without murmuring or complaining. Walk forth calm, contented, rejoicing, returning thanks to the Gods, who from their infinite bounty, have opened the safe and quiet harbour of death, at all times ready to receive us from the stormy ocean of human life… "
By 1800 over 97% of suicides were ruled in this non-criminal way, acknowledging the person’s long term struggle with what we would call mental health and this continued into the 1900s. [7]

Following the Criminal Justice Act in 1948, probation rather than imprisonment became the norm. There were exceptions. Edward French plead guilty to attempted suicide in 1955 and was sentenced to two years imprisonment because the evidence showed he made a serious sane attempt to end his life. The data for those trying to take their life, attempted suicide, is rather patchy prior to the 1960s. "One reason why so many suicidal attempts fail to reach the ears of the English Police is that it is against medical ethics for a physician to report them" Glanville Williams said. In the years 1952 to 1956 over 1800 people were sentenced to a probation order while 194 were imprisoned. The total number of people convicted of an attempted suicide during this period was 2,922. [7] How many others escaped ‘justice’?

During the Parliamentary Debate for the Suicide Bill in July 1961, the idea of treatment over punishment was endorsed across the political spectrum. Viscount Kilmuir spoke of “medical or therapeutic” treatment while the only documented disagreement was on whether the treatment be made compulsory.

Since the 1950s Asylums, the authoritarian, crumbling and cruel scheme, transitioned into a more supportive and nurturing care in the community scheme. I should note that the care in community isn’t perfect and we are now severely under-resourced when it comes to supporting those who need inpatient or even ‘day care’ support.   

A memo from Norman Brook, a Cabinet Secretary to Harold Macmillan from 24th October 1960 notes that there were believed to be 30,000 attempted suicides each year with around 600 being prosecuted and found guilty. “It seems to be the general opinion, both in the medical profession and in the courts, that these people be better dealt with outside the criminal law – as the majority already are.”

After a handful of discussions, often unnoticed in a world occupied with the Cold War, Royal Assent was given at 6:31pm on 3rd August 1961. Within hours a Home Office memo was sent to every Chief Constable that “it will no longer be an offence to commit suicide.”

Suicide rates steadily declined between 1963 and 1975. [8] By the early 1980s, the figures are around 5,700 [1]. Rather than decreasing the value of life, decriminalising suicide decreased the stigma and the rate of suicide by starting to make care and treatment easier to access.

The reason for writing this article is twofold:
Firstly, it is an interesting bit of trivia: that no one has committed suicide since 3rd August 1961 because suicide was no longer a crime anyone could commit. However, the main point is to show and emphasise how language and our choice of words can have such a profound impact.

Whenever someone uses the phrase ‘commits suicide’, it stirs up that fear and hatred. It scares people that they will be detained in some horror film asylum for attempted self-murder rather than being the kindness, understanding and compassion they deserve and need.  To me, ‘commit suicide’ is like nails on a chalkboard.

I try to highlight to people that while they are using a common phrase, it is deeply hurtful and actually causes more harm than good. Some people prefer the phrase ‘completed suicide’ although I prefer ‘took/ended their own life’.

People with mental health issues, thinking about suicide or not, are not criminals.
Work by Mind, a leading mental health charity I am proud to be a member of, shows that people with mental health issues are three times more like to be a victim of crime than the general population. [9] An article from The Lancet in 2020 stated “People with mental illness are much more often the victims of violence rather than the perpetrators.”  It goes onto say “It is clear that cuts in mental health service expenditure in England in the past decade have led to a reduced quality of overall care”.

Whether you hear it, see it or read it – I ask you remember this article and challenge it. Just as we would not accept homophobic, racist or sexist remarks. We all need to politely challenge the discrimination and say “No, No-one commits suicide”.

 

Thank you for reading my article. Please feel free to share it and consider reading some of my other posts.
Matt Streuli is a mental health writer and Mental Health First Aid Instructor. By day, he is a Secretary in the NHS. He lives with his Wife, two cats and is expecting his first child this May.

[1] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2019registrations
[2] https://www.centreformentalhealth.org.uk/publications/mental-health-work-business-costs-ten-years
[3] https://ethicsofsuicide.lib.utah.edu/selections/thomas-aquinas/
[4] https://ethicsofsuicide.lib.utah.edu/category/author/egyptian-didactic-tale/
[5] Julie Mathias, “Victorian Attitudes Towards Self-Murder”, Curious Histories (blog on oldoperatingtheatre.com), November 11th, 2016.
[6] https://www.ncbi.nlm.nih.gov/books/NBK513543/
[7] https://etheses.lse.ac.uk/1573/1/U136493.pdf
[8] G. M. G. McClure, Changes in Suicide in England and Wales 1960-1997, British Journal of Psychiatry.
[9] https://www.mind.org.uk/about-us/our-policy-work/victims-of-crime/
[10] https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30002-5/fulltext




My cup doth overflow! Stress Containers at Chateau Streuli

 The last month or so has flown by. Mrs Streuli and I have moved house and thanks to a very supportive family are about to rent out our little one bed flat. In the meantime, we have some rather good news to share.


Baby Streuli will be coming to cause chaos in May 2021!

The anxiety that Lockdown 2, Baby and house move all in the same short time period has been huge. At the same time, we've been working full time and I've been doing a training course to become a Mental Health First Aid Instructor. The nightmares about missing or unfinished homework have returned!

But as we head toward December, I look back at the chaos of those weeks. Is Mrs Streuli safe at work? Are we keeping ourselves safe without shutting out the world?

In MHFA (Mental Health First Aid) we talk about Stress Containers. Everyone has a different size and shaped container. What is stressful for one, might be routine for another. Working lots of a night shifts or having a rapidly changing routine is like a stress tank shrinking and bulging. 

At the bottom of your container is a tap. Sometimes that tap can get clogged and the stress keeps piling up until you explode. Other times, you have the safe coping strategies or working skills to keep your tap flowing and your stress manageable. Sometimes just talking it through with someone, like I do with Mrs Streuli, can keep that tap flowing freely. You have the power to unclog your tap. 

What useful strategies do you use? Yoga? A jog? Writing? Dancing? Film Night? 

Sometimes you can control the flow into your stress containers. Sometimes, life happens all at once.

One last thing you can do to help other people with their stress containers - is for you be safe this Christmas.





Why become a Mental Health First Aider? - Suicide Prevention Month

Making time to take care of yourself can be hard. During lockdown, it felt like life was in a loop of work, home, work, home, work, home. By the time you get home, you just want to crash in front of easy watching TV. I have the same issue with writing my blog. I feel so much better for doing this but it does take time and effort like all self care does.
 
For many parts of the world September is Suicide Prevention Month however organisations big and small come together with the WHO and the International Association for Suicide Prevention to mark 10th September as World Suicide Prevention Day.
Globally, over 800,000 suicides are reported and there are many more which either go unreported or don't fit the criteia for suicide in the death certificate of a country. As I type this the Office for National Statistics has released the latest data with headlines following the common theme of "Male Suicide at highest rate in 20 years". 
Occasionally I go back through my blog to revisit my posts. They mark how I felt and thought as different stages of my mental health journey but they also indicate how far we have come as a society. One of the posts I am most proud of, conveniently for World Suicide Prevention Day 2016, was written by one of my closest friends and her view of not only my struggles but also of her Grandfather. It is a powerful read you can find here.
Stigma was an incredible oppressive force when my mental health was at its worst. I can clearly remember how liberating being suicidal was - I could speak out because I had literally nothing to lose. It was that with the right support from friends, family and the NHS that supported my recovery - something which I'm proud my blog has recorded.Suicide can be a difficult subject to approach but once you cross the threshold with compassion and honesty, its a stigma that seem ridiculous. 
Tweet from Prof Appleby: clinician & Gov adviser on suicide
Tweet from Prof Appleby: clinician & Gov adviser on suicide

Recently, thanks to the NHS Trust I work for, I attended a two day course and qualified as a Mental Health First Aider.  Why would any employer want a Mental Health First Aider? It's another cost
In a previous post we've discussed the business case for taking the mental health battle head on. In that post we discussed how research by Soma showed the businesses that record and track mental health make up to three times of the profits compared to ignorant competitors. In that post we also discovered how every 80p of investment in prevention and support for mental health and well-being at work saves £4 in costs whether that is sickness, loss of business or, as my case showed, legal fees. In the end, I argued that with the potential saving of £9 billion per year to the UK economy, that businesses big and small couldn't afford not to invest in mental health and well being of their staff and customers. 


The course is written by MHFA England who are working with the aim that by having more and more Mental Health First Aiders in businesses and organisations that stigma can be more routinely battled and that awareness raised more often. It also hopes that earlier intervention can be made for those needing support and prevent staff, friends and family reaching crisis - like I did in 2015.
To start with I did have to confront some anxiety. Would this course be upsetting? Would it stir and prevoke feelings I don't want? Would the people there be tolerant of me? 

In hindsight, I shouldn't have worried but anxiety can be pair of concrete boots in the murky canal of life if you are unable to push through with useful healthy coping mechanisms. In my example, I tried to imagine some of the content like icebreakers and discussions of suicide and think about how much I was comfortable to share or say.

It always amazes me how little is said about mental health and yet, when the tap is opened and that awkward threshold is crossed, everyone has some experience. Whether it is friend, a relative or a patient or customer. When you begin to realise how much mental health has touched every person, you begin to realise how few people will judge you in a negative way. 

The role of being a Mental Health First Aider isn't to solve every problem or become Counsellor Deanna Troy of your organisation; in the same way your First Aider isn't your organisation's Paramedic or Dr Beverly Crusher. It's more about having someone ready to listen and offer a signpost whether it be to a manager, to ACAS, to a union, to the GP, to a local support group or in times of crisis to the emergency services. The problem doesn't have to be a psychotic episode but it can be. It can be helping someone after a nasty call or offering a calming cup of tea after the loss of a loved one.

Helping another person, even if its just listening, can be incredibly rewarding. In fact, you can save a life.

If you are interested in becoming a Mental Health First Aider, email your HR department today or have a look at https://mhfaengland.org/













We Were Pregnant - Dad's Diary

By our maths, we were around 11 weeks pregnant although speaking to the GP it could be 9-11 weeks. The medical term is "anembryonic pregnancy". In some parts of the world its called a blighted ovum which sounds more like a parasite affecting this year's crop harvest. 


Below is a video Caroline initially wanted to record. She's been upset and hurt but is trying to be pragmatic about the whole experience. Below the video I'll share a bit more my internal monologue. You'll also find links to key resources.



I was shocked when I found out we were pregnant. We were trying but I knew that it doesn't always happen right away. Some couples try for months or years and then the babies come along like buses.

We were already making small changes to our lives and Caroline changed her diet too. We started slowly cleaning, decorating and nestling in our flat. In the early days, we felt that it was work that needed doing either way but as the weeks passed we slowly became more and more confident that this was becoming real. In fact over the past couple of weeks we started shopping for maternity wear and buying baby magazines. I started reading books on parenting especially aimed at new dads. Our tracking apps showed the acorn slowly growing from acorn to catapillar.

It was around Saturday 23rd May that Caroline has spotting. For men like me with little biological knowledge, this is wear tiny drips of blood appear either when your lady wipes herself or on her underwear. Caroline showed me some the tissues and aside from normal discharge (sorry, there isn't a better word!) there was trace samples of blood. Think a drip of red food dye in your bowl of icing.

A quick Google and text chat with midwife confirmed that it wasn't enough to be bleeding and monitoring it is the best course of action. I was worried but I needed to be a rock for Caroline and reassured myself that I'd had paper cuts produce more blood. I remember thinking that this couldn't be a miscarriage: you'd notice a catapillar and their sac falling out right? 
Over the next few days the volume of blood increases. Still tiny pipette amounts. Again, still being strong yet secretly worried, I found a local private clinic that for a far more reasonable fee than I imagined would give us a reassurance scan the next evening.

Thursday evening arrived. Caroline's anxiety was through the roof. So was mine but again I had to be strong. Being 'the strong one' is something we seem to take in turns. Life can really wear you down. 
They do an external and internal scan. To my eyes, it's the 1960's opening credits to Doctor Who. We had spoken about the worst case scenario. If I'm prepared for worst case scenario then anything else is an improvement. Right? Maybe not this time.

The sac is there but it's empty. They write a report and offer their sympathies before taking payment. As I mentioned in the video, it's not the outcome we wanted but it is the best £59 we've ever spent. Due to Covid19, I would be unable to attend any NHS scans. The thought of Caroline finding out by herself, alone, is horrific.

That night we spoke directly with my parents - knowing Caroline's parents would likely be in bed. In the space of a hour or so, Caroline went from being upset into angry into pragmatic. Eventually she became hopeful. Looking back, I was still being strong. I was in my old habits of emergency mode.

Some of info online has been rather 'it's bad luck, try again' which I feel I was woefully prepared for. I am little taken back how many couples have been 'unlucky' but felt they couldn't or shouldn't share their story.

We woke up positive on Friday 29th May. I'd done some research the previous night before bed while Caroline woke up early. We both agreed that many couples go on to have healthy pregnancies and babies and that maybe this time wasn't meant to be. It was the test run the body needs to get ready. By lunchtime, the spotting was increased and the occasional clot appeared. By early afternoon Caroline was on the Early Pregnancy Ward of Wexham Park due to the pain. She described the cramping as in waves and the level of pain being slightly more than her normal periods. I knew she was in pain and I could see it was worse than she was letting on. The lovely staff reassured her that the pain and cramping is OK. She is signed off work but will take it easy while her body resets. The current plan is to allow her body to expell the sac like some horrible mega period. 
Total respect for women. I couldn't do this so easily.

It was Friday night when it hit me. I felt really low and sad. I think it was the first time I had actually sat still long enough for the words I'd been saying to become reality in my head. No baby. Not now anyway.

As the video was shared online - and please feel free to share my post too - friends and family reached out to us either in public or private. I still can't believe how many couples just go through similar events and feel they couldn't or shouldn't share it. I feel angry they had to be silent. It sad that their catapillar is negative quiet memory.

Even though our catapillers didn't become butterflies they were still part of our lives.

Caroline is in a fair amount of pain but has some time off to reset - body and mind. She can also have alcohol for the first time in a few months!
I'm OK. Now I'm able to sit down at home and think, I'm not as pragmatic as Caroline is right now. But there is a next time. 
It's good to openly talk and raise awareness.

https://www.nhs.uk/conditions/miscarriage/

https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/expert-answers/blighted-ovum/faq-20057783

Thank you for your love and support.
My Story/MattStreuli.uk 
Twitter/@mattstreuli
Istagram/MatthewStreuli
YouTube/MattStreuli 

Thank you to the staff at the private clinic, Caroline's GP and our colleagues at Wexham Park Hospital.



Mayday

My mind has been racing. Stuck in a loop for over an hour now. Despite my best efforts to clear it through mindfulness and controlled breathing, I'm just drawn back to the same loop. Stuck on anxiety and fear. 
I've laid here for over an hour trying to focus on my inhale and gently letting go with the exhale only to find myself draw to the points below. 

My first concern is my wife. Today is our 4 year anniversary of when we started dating. Most years we celebrate this with a trip to Brighton where our relationship officially started - a trip down the peir is better than celebrating in the pub of our first date. I can't go into every detail but I am concerned for her welfare and safety. Due to the medications she takes, she is more at risk than I am from this blasted Coronavirus Covid19. She too works for the NHS however her location is far more central in the hospital compared to the wooden outbuilding I call home. There isn't much I can do  but over the next few weeks maybe it is something we can address together for some reasonable adjustments to limit her exposure and risk. 
My Nan died at the start of April. My nan was a key role in my upbringing and for many years was the only reliable mother figure of my childhood. Much like my cousins, as I grew older I found my own hobbies and spent more time with my now wife. My nan ended up in a home last year and, maybe selfishly, I hadn't seen her since. I felt the last time I saw her, she wasn't 'Nan' any more. Maybe I was just being cowardly but I knew that she didn't know if I was there or not. I don't know how she died and due to conflict and Covid19, I don't think I'll be told. She was a brilliant parent to me and, while I regret I didn't spend more time with her over the last few months, I cherish the fun weekends we had together. 

One of the key themes stuck in my head is my own work. Covid19 has stripped us of the ability to be with our closest friends and family which is key way to recentre and refresh ourselves. I have wondered if I have been becoming 'short fused'. Maybe with the pressure we all are. Work has changed as we've moved far from normality. In some ways the work has massively decreased but only to grow elsewhere. To paraphrase an email I sent a few weeks ago: it is a challenge but we will rise to it. The angry voice in my head is aware that some areas (not just NHS) have more support (maybe unjustifiably) and have been able to cope and adjust with more ease. Currently, I'm doing two jobs and my own self doubt questions if I'm doing either well. Why do they get better resources than us? 
The hesitant voice in my head can't help but hope that everyone who is clapping now, remembers the efforts of everyone in the NHS and the public sector when they next stand at the ballot box. I wonder how many deaths were caused by the poor funding, the do more with less attitude that has screwed over too many key workers, over the past decade. 

Either way, it will take months to recover to any normality after the pandemic is over. Please remember this when you next call your GP Surgery or hospital and expect to be seen 'lickity split'. 

Perhaps I should focus on the positives. At least I am able to go to work, interact with different people and focus on projects. I'd like to be able to work from home a bjt but who knows. I have a very strong and supportive wife who makes me laugh and tolerates me when I'm low. 

Since the early days of lockdown we've been streaming games and chat most evenings via YouTube. It's been a nice way to stay in touch with our friends rather than the desolate pings of a Facebook chat. We've met new friends who've stumbled across our stream, enjoyed our content and become part of the team. At the moment we play jackbox but I'd like to find new ways to interact with people. Would you watch a online chat show? 

I hope you are keeping well. Please follow me on the socials to keep up to date with my latest adventures - even if they are more confined than they used to be. 






Push through Anxiety or You'll Seize Up

RuPaul quite rightly says “If you can’t love yourself, how the hell you gonna love somebody else”. That same love can be applied to care and support; if you don’t help yourself, how the hell can you help anyone else?

Arthritis can be an incredibly painful condition and those who suffer from it should be admired. They push through the pain using coping strategies and medication because if you don’t mobilise those joints, they could seize up and the pain would be worse. In short, use it or you’ll lose it. Anxiety is a similar beast.  Anxiety wants to isolate you. It wants to clamp you down. It wants to shut you up.
There are days where it is exhausting just to open the curtains. There are days you can get to the local shops and back.  But whether it is agony in your knee or a burden on your mind, you have to try. 
The CDC (a department of the US government) encourages those with arthritis to take up their SMART challenge. I think the same can be applied to Anxiety and mental health in general.
Start low, go slow.
Modify activity when symptoms increase, try to stay active.
Activities should be “joint friendly.”
Recognize safe places and ways to be active.
Talk to a health professional or certified exercise specialist.

"To help yourself, you must be yourself. Be the best that you can be. When you make a mistake, learn from it, pick yourself up and move on."- Dave Pelzer

Start low, go slow.
Find an activity you can dip in and out of. Maybe something you can do for 10 minutes and take a break. Something where you can slowly build up and join in gradually.. Don’t expect to run a 5k on the first day. Consider activities like a walking club, singing for fun club, maybe part of the backstage team at your local drama club or even just volunteering at a care home or school.
Modify activity when symptoms increase, try to stay active.
If you all becomes too much (whether joints or pressure on your mental health) you can slip away for a while. If you can run 5k, you might not be able to do it every week. If you can’t run the 5k, do a little run instead. If you feel like going to singing or yoga this week is hard or you are already drained, maybe ask the leader if you can come for the first half and see how it goes. Sometimes the hardest part is getting over the first hurdle and once you are there you have the support and fun you really need.

Activities should be “joint friendly”.
For mental health, perhaps this is open to your interpretation. It might be that joining the local Drama Club provides you with the same ‘escapism’ it gave me or the idea of being on stage isn’t your thing, there are many groups like ‘Men In Sheds’ and ‘Library Games Club’ where you can be part of team taking part in casual activities. There is something to be said though for joining a sports activity and while it wasn’t for me personally, something like Netball or Lawn Bowls could be brilliant for physical and mental health. Being part of a team, a supportive team, can be very rewarding whether you win or lose.
CLICK the image to view full screen
With thanks to the Membership team at Mind, the mental health charity
Recognize safe places and ways to be active
For me this links in with the above activities but this also includes safe places where you can get support. Does you library offer a local drop in service? Is there a local Mind? Some cafes also offer a mental health afternoon. If there isn’t, could a chat with your local Costa manager help set on up? Another aspect of this is where would you go in an emergency? Or a time of crisis?
I really recommend an app called “Hub of Hope” which does a great job of signposting you to local services whether it is in a crisis such as Samaritans or more routine support. They have a website also at:  https://hubofhope.co.uk/

Talk to a health professional or certified exercise specialist
Have you recently spoken with your GP? Have you been referred to a NHS Mental Health services or to a community service?
Many areas now accept self-referral so if you find talking to your GP hard, taking the first step to NHS support can be as simple as filling out a form. There is a long wait in most areas. Sometimes month just to have an assessment appointment before your referral makes it way to the right team. I understand that the long wait puts people off. I completely get the “why bother” feeling especially when you think you are stable. In reality, you might be slowly declining – for anxiety you might be slowly isolating yourself more and more – and it’s so gradual you don’t realise until there is a crisis. Refer yourself at the start and even if it’s only a light level of support … preventative is better than reactive.
I know the above might seem daunting but with mental health, you do have to practise and gently push yourself. If you don’t, it makes it harder to even accept or use the help you can get. 


"Our prime purpose in this life is to help others. And if you can't help them, at least don't hurt them."- Dalai Lama
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As you can see below, I became a page three model this month as our story went nationwide in the summer edition of Mind’s Membership magazine. It has been lovely to hear your feedback and Mind even sent us a wedding present which is really sweet of them. If you live in Bucks, you might have even seen us in the county newspaper.
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With Thanks to the Bucks Free Press
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