Tag Archive: Mental Health

I am deeply concerned about the working world. Already the statistics of people with long term and serious mental health conditions obtaining and/or maintaining long-term work are very poor and speaking as someone in work with such conditions it is very easy to see why.  I will concede that the discussion around Mental Health has improved to an extent over the last 20 years from what I have witnessed.  What was once very specifically taboo can now be discussed more openly, people are able to declare and people are coming forward to seek professional help.  But in my experience and that of many I see that structure to cope with people needing help just isn’t there, it isn’t there at a clinical level and then you leave someone in a heightened state of vulnerability more alone to face the world, at which point they may be more aware of the help they need at a time no one is willing to provide it.  It goes the same way at work.  I have long since declared my Mental Health conditions in the workplace formally, I have my reservations about doing so and I understand those that do not but the nature of the job I know means I do not feel I could counsel others to do it in their workplace if I had not done so in mine. I am aware though that when speaking to others about it I am cautious to try to assess into what environment they would be placing themselves if they do.

We are still in a world where if you are in many jobs and off work for a reason that is a disability your absence remains recorded just as if you had a cold. Whilst this is direct discrimination if you were to suffer any detriment such as hitting trigger points for review meetings etc. the law has no real recourse unless you were to lose your job and most people are aware enough of the difficulty of getting a job that to risk it on the basis of the law helping out seems foolish and indeed most certainly would be.  The law is not there for the little person, its protections are scant and difficult to enact, there are many loopholes for employers to avoid falling foul of it that only really the most naive or the most dogmatically nasty should do so.

Of course employers know how to play the game and will talk about the importance of mental health and wellbeing as if it is at the forefront of their agenda, they may even cite the very sort of research that suggests it indeed should be.  ‘Thriving At Work’ [2017] a study commissioned by the last government some years ago showed as a result of extensive Deloitte research that money proactively invested in promoting and maintaining good Mental Health in the workplace had a return on investment in £ pounds of up to 9:1 and very often at least 5:1+ whilst reactively trying to clean up the problems of poor Mental Health and wellbeing could show only 2:1 at very best. You might reasonably therefore think that if even the bean counters should be impressed that the agenda must move along.  I have heard anecdotally about companies looking to utilise this information and take a proactive approach and have Mental Health First Aiders in the workplace and the promotion of positive mental health and in the examples I have heard it has proven hugely beneficial.  But these have been anecdotal and from small enlightened environments and very very much in the minority.

The problem I would assert is a sense of risk aversion coupled with a lack of humanity.  We have moved in the workplace often to a position of default mistrust, more people have to spend vast swathes of their time justifying what they have been doing rather than actually doing it. The people they are justifying it to often have little or no idea about the actual job and therefore it is more about justifying the latter’s existence than anyone actually doing any work.  In this culture you must therefore be able to show what you have been doing all the time and that just isn’t how people tend to work.  Everyone has time when they are productive and time when they are not, days when we are more ‘on it’ than others are not restricted to those with Mental Health conditions this is just the nature of Mental Health in general. The great problem for Mental Health is you can’t easily verify it and in the position of mistrust there is an assumption that perhaps someone is putting it on if they should refer to having issues in a way that would be unthinkable for a physical disability.  The damage that sort of rhetoric is allowed to do is seismic and should be stamped out but it isn’t because to do so would require admitting the scale of many problems, not least what the hell the tranche of middle managers are doing and whether or not the best way to get service running wouldn’t be to have more people trained and happy working at the coal face.

I have worked in many environments in the Public-, Private- and Third Sectors and none had their act together on Mental Health apart from a Disabled People’s User-Led Organisation which took a sufficiently enlightened view towards Mental Health and sought to support as much as possible that I felt empowered enough during my 6 months there that I never needed to call upon them to support me because I felt it was there and my productivity remained pleasingly constant for all parties.  Most organisations however enlightened they may like to portray themselves, whether or not they believe their own rhetoric, when it comes to issues of disability are only interested in covering their own backsides, the risk aversion runs to simply ensuring they cannot be sued.

What worries me most is that although I know my rights and am not afraid to exercise them I also know when to hold ’em and when to fold ’em, I know certain battles that aren’t worth fighting and other times when a point of principle has to be held firm and that the former usually vastly outnumber the latter.  Yet I have found the working world to be intransigent to the point of belligerence, the ignorance and lack of compassion is astounding even when it becomes clear (and not by ramming it down someone’s throat).  I have tried to work to help better things but invariably been seen as someone being difficult to the point where it has made my position untenable on more than one occasion.  By and large I have managed to just about stay in work but it has not been at all easy.  I worry for the others who are not so bolshy, who for reasons of childcare or accommodation simply cannot afford to fold and have to trudge through the anguish and take it again and again. The long term implications of this are huge and I believe ultimately will lead to the premature death of a great many people who did nothing more than try to keep going in the face of it all.

Song Of the Day ~ Sinkane – Everybody

At times things can feel as if survival is hard enough and progression is really too much to ask for.  One has to make a distinction between the times here when you are having a little wallow in self-pity and need hauling out of it or between those times when a darkened room and foetal position is the best method of survival.  It isn’t always easy to know which is which and if we don’t know how can we expect others to know how they might be able to react?  There are times however when progress feels possible and others where it clearly isn’t, again it isn’t always clear, nor is it always within your control to determine the results or variables that come into play. How many times might you hear 2 steps forward 3 steps back, everyone has these moments, maybe stretching into longer periods of time where progress appeared hampered such that they feel despite working towards something the goal appears to be further away than if they had done nothing. Sometimes it’s to do with specific tasks we undertake to complete, projects, DIY, even interpersonal relationships, indeed the concept that things must get worse before they can get better is not entirely alien to us. Provided we remain of the opinion that the ultimate goal is on track, that progress of a fashion is being made we may reasonably encounter adversity and carry on, besides which by and large ‘initial setbacks’ are considered par for the course so we accept this tenet. The key is that sense of forward motion however gradual it may be for 2 steps forward 3 steps back over a period of time represents a cumulative negative, if not offset at some stage by more even than 3 steps forwards and only 2 steps back we may never realistically pass the part at which we started.  That’s a long-winded and roundabout way of saying that sometimes it feels like you’re walking through treacle and you might be better off stopping for at least a time.

A continual press against a seemingly immovable object where progression is not made might be better expressed as a war of attrition, that any ground won would probably just as easily be offset by ground lost elsewhere and a sense of enduring and debilitating stalemate. I think with mental health this can often feel very much the case and especially in darker times because each moment of work is all the more difficult not just to achieve but even to attempt in the first place and thus any sense that it has not been ultimately successful becomes a bitter pill to swallow as it hints at further work to come and sometimes even the very thought of that can be more debilitating than the job at hand itself. I know of a method of representing privilege which is to do with determining someone’s starting point and it is a useful model that can be adapted for other things I believe.

The premise is this, everyone stands in a line whilst societal influences act as filters to determine where someone ultimately begins – those of an ethnic minority background take one step back from the line, those who are women take a step back, those who have a disability take a step back and so on until a certain number of filters have been applied to reveal your starting position. These steps back can of course be cumulative, if you fit the criteria of several factors such that you may be many steps behind others at the outset given certain factors that are beyond your control.  If you therefore take certain life progressions as a step forward it is easy to see that even were everyone to have the same amount of progress they would not be in the same position and that for someone who started behind someone else they would have to have more steps forward to mitigate the filters that set them back.  This model works well for applying a sense of context to what would be the nature of any progress, it counteracts the argument of the classic white middle class educated male claiming that they got where they are today on the basis of hard work and not because the system has afforded them anything for free.  With this model one can see that they may well have worked hard to progress several steps but those who may not be at the same forward line as them may indeed have worked just as hard getting themselves to the starting point of those born with privilege.

The way this can be applied to mental health is not dissimilar. For most people getting out of bed in the morning is a factor of life we go through day after day, it does not have to mean we feel rested or enjoy the time we have to do it but we have the capability to accomplish it and move on to the next task and by and large this is what we do. When we are physically unwell it is clear that there are times when this is more difficult or may be impossible but it is less obvious when we are mentally unwell.  I was once told the difference between having a cold and flu is the £50 note test, someone tells you there is a £50 on the doorstep outside and that if you hurry you will catch it before it blows away.  If you are able to get yourself out of bed no matter how much of a struggle then you don’t have flu.  Having had flu 3 times in my life I can verify that it would not matter if you raised the payout on the doorstep then result would be the same because the capability to function is just not there.  That type of flu is apparent to people looking at you as it exudes from the crumpled nature of your being.  Mentally there are times too when the result would be the same but these are difficult for anyone outside to be able to see and not always easy for me to define.  We not only have a mask we don ourselves but I think those who know us have a mask of presumption too, one that means they think they see us as ok if generally speaking that is what they see, or want to see.  

I have found it frustrating that in spite of one of the most isolationist periods in our times, not exclusively but hugely exacerbated by the Covid pandemic, precious few people have reached out to me amidst the silence despite many knowing specifically that I am at my worst when left alone in darkness.  Whether they have had their own demons, issues, crises, whether they have felt that to remove the veneer of their assumption about me might reveal more than they are realistically willing or able to attend to I cannot say.  I can only say it has been a period of some of the most intense, sustained darkness and solitude I have experienced, to breaking point. If you know people out there from whom you’ve not heard, try to say something to them, try to tell them you care.  You may never know whether it has an impact on them, however their continuing existence may be enhanced by it, or in some cases perhaps even depend on it.

Song Of The Day ~ Mazhar Ve Fuat – Adimiz Miskindir Bizim


— Trigger warning —*

A couple of years ago when given a new diagnosis of my mental health condition I did what I suspect a number of people have done in those situations and googled about the condition.  I do not take Dr. Google in any way as gospel, fear not, but it is often a useful staring point for where I might be able to find out more or things I may need to go back and refer to my actual Dr. Like using Wikipedia to determine whether something you didn’t know is really obvious and you ought to have known or a bit more obscure and an interesting little interlude.

What was most stark was a study I found that suggested the average life expectancy for someone with my condition was 49.  I am now 49.

I nearly finished this entry right there with the last sentence, such is its power for me but it does require some further extrapolation and of course an average age is just a figure, the sum of all part as it were, but to say it shocked me genuinely would be an understatement because whether just to do with me or not this data was taken on the basis of other people’s lives.  Medical information that I find now a few years later suggests that actually life expectancy for those diagnosed with Bipolar is shortened by between 11 and 20 years, more factual specific data, not quite as punchy but certainly no less shocking.  To put this into perspective Obesity is thought to shorten life in men by up to 20 years and in women up to 5 years and there are national campaigns everywhere seeking to address the problem. The difficulty is that mental health doesn’t do things the way physical health does and therefore is far less easy to see, to diagnose or to treat but it is no less dangerous a phenomenon of our times and the impact no less debilitating as a disability to those suffering from it.

There are deaths that are directly attributable to a specific mental health condition, suicide being the most common and most tragic but what are less easy to factor in is all the co-morbidities that impact on the life of someone with a mental health condition, the greater likelihood of substance abuse or the damage caused by stress which are directly relevant but are practically impossible to quantify. I know my own capacity to deal with certain types of stress is drastically reduced, in particular at certain times, and that my own crutches include matters that tend towards greater likelihood of obesity and the like, which then bring the statistics associated with those conditions into play as well.

There is much talk of the beneficial effects of good diet and exercise and the effect this has on mental health, things which in lucid logical moments are of clear defined benefit but the watchword is in lucidity, much of the time when not in a good place one is not thinking about good diet, some people fail to eat, others eat too much and seldom is a good healthy balance the most obvious thing.  Likewise exercise is something that can not only bring health but joy to people, they enjoy going out for a walk, run, cycle etc. but when joy is the furthest thing from your mind what occurs with exercise can often be the same type of chore as cooking a healthy meal. You want to live by numbers, the lowest common denominator until things feel better, whenever that may be.  You make deals with yourself about how you will tackle things when you feel well again but very often that time never comes and this leads back into shame just as the financial crises we can end up in do the same.

We find crutches that make us feel a little better whatever that may be and like crutches there may be certain times when for short-term recovery these may not be a bad thing. But, like crutches there comes a point in time where you have to put weight on the leg and walk properly again or your ability to do so in the future will become compromised eventually perhaps irrevocably so and what was once a help becomes the very thing causing the maximum amount of damage.

Vicious circles abound in mental health, from the smaller consequences to much larger ones, for example lack of healthy diet means you may develop conditions which manifest physically on your skin or affect your build.  External appearance may not bother you in the good times but under the microscope of the bad times you see the flaws and you understand why they are there, the narrative becomes so easily self-critical – they are there because you are bad, broken, derelict, a failure.  You know the risks, you know the dangers and yet still you repeat the same patterns, what is wrong with you? You cannot even sort your own self out so what chance is there of sorting out anything else…? Where’s my crutch…?

Lack of healthy diet may lead to being overweight and the scrutiny is the same.  Yes it is my choice what I do and don’t eat by and large because I am an adult with an income and I can buy healthy or non-healthy foods.  I try to ensure I shop when I feel ok because the contents of that shop are geared around me looking after myself.  But then there are the downturns and the non-essential trips to buy the non-essential things because I might be feeling low and hungry for some comfort food.  Or maybe it’s the takeaways or the extra beers… etc.  Then I have spent money I didn’t need to spend, I have perfectly adequate food in the house, why have I gone and bought something I didn’t need and shouldn’t have again, why am I adding to my debts, why am I allowing food to go off because I’m eating crap?  I am bad, broken, derelict, a failure. I know the risks, I know the dangers and yet still I repeat the same patterns, what is wrong with me?  Where’s my crutch…?

I know these circles so well, often before during and after I am able to see the cycle for what it is, before I may try to put into place what I can to stop it and after the recriminations of the shame may make me also do similar and yet time and again the pattern goes on.

I am not seen as a risk to others nor to myself, what that means in medical terms is that I show no signs of physical violence nor activity that suggests I would commit suicide and those factors are correct.  But to assert from that that I am not causing myself harm completely misses the point.  I know the harm I cause both emotionally and physically, I imprison myself, frustrate myself, am ashamed of myself constantly. I know that I am rendered a less able, less successful, less happy person for those around me and therefore am I not causing them harm too?  The damage I have caused to others is unquantifiable and that ambiguity feeds so easily into a critical narrative.  Should it matter? Well perhaps, perhaps not but because I am who I am it does matter, how I have treated people matters to me in a sort of final reckoning way. I am not at all religious, any judgement comes from myself but I am aware of the tallies and I have a memory that retains the worst things all too easily whilst often forgetting the good ones which seems grossly unfair.

The fact that I am still here at 49 is not a testament to fortitude, it is not some form of success story, it is a set of circumstances by which one of my main vices, a sort of frustrated indolence, has led to there being no other option.  In actual fact I might muse that for me to be here at all represents in some way a tragedy like a strangled cry echoing or the light from a star existing in our sky long after its source has ceased to exist. Something that is noise after the usefulness has gone.  I don’t always feel like that but it is a train of thought I am familiar with.  To look at that which I might have done and the differences I could have made is the road to madness and one I have walked for many a year. The path is never easier nor the way back any clearer, the journey itself is so often tainted with fear, regret and shame that it is almost an emotional Sisyphusian struggle.  I wonder then how many others are in a situation where the reasons they expire might just be fatigue, the lacking of the ability to push the weight any more.  I hope they found rest.

*I put the trigger warning at the top not for effect and not because I feel it would specifically trigger anything but because I now know that if you’re just not in the mood sometimes it is helpful to know when to just walk away and come back to it later when you feel more ‘on it’. Prior to this year I knew of people talking about potential triggers but had no direct experience of it to draw on and I am very much an empirical beast.  Now I understand, in a relatively small confined way but no less significant for the window it affords me I had an incident that rendered me specifically in crisis at the time, disproportionately so, and mentions of it or reading through matters regarding it retained the power for some time to put me back in that place and experiencing the same level of distress.  I experienced a physical manifestation of what was going on in my head such that made me physically shake incapable of stopping.  This is not usual for me at all.  So now I understand the need sometimes for a trigger warning.

Song Of The Day ~ Honeyblood – Walking At Midnight

The almost inexorable link between mental health and financial problems is long established and has been much written and oft debated by better people than me.  You might reasonably think therefore given that fact that there would be a structure in place to help people suffering with such circumstances, coming as they do on the back of mental ill-health.  All I can say is that if there is then it is news to me, in fact here once again is an example of where those suffering from mental ill-health or more specific Mental Health conditions are left to fend for themselves for long periods of time of sometimes acute suffering and where the system whilst all too aware of the problem is all too late with offers of potential solution.

This is not to say all Mental Health conditions lead to inevitable issues with finances, neither are all debt-related problems solely the proviso of those with Mental Health conditions, however it is sufficiently known as a phenomenon by both Mental Health charities and debt charities alike to be something that is seen as synonymous.  There are several exacerbating factors as to why this may be the case and they work on both levels namely when someone is in the depths as well as when they may not be. I should point out that whilst I may speculate upon certain aspects and areas of Mental Health I am not an expert nor a practitioner, however I am someone with diagnosed Mental Health conditions, who has also suffered periods of mental ill-health at various points and these have had a specific and profound effect on my financial stability far more so than I am comfortable with.  I will therefore be speaking from personal experience and knowledge of that of others with whom I have spoken over the years.  It is also not to say that I am advocating any random wiping of debt because that is the equivalent of giving the man the fish rather than the rod and the knowledge of how to fish. It could well work in certain circumstances to give some a brief lift up but is no guarantee of success for anyone and leaves the underlying problems unaddressed.

The most obvious cause of debt-related mental ill-health comes from short-term gratification, it is something all of us as humans are often guilty of, not at all restricted to those with mental health concerns.  From the extra chocolate from the box we know we oughtn’t to have to the impulse purchase that cheers us up when it’s been a bad day, to warm, to cajole, to pamper in order to alleviate stress, boredom, fatigue or distress.  All of these little indulgences need to be paid for, physically and emotionally, and if we are not living beyond our means then there should be little reason for concern.  It is though important at this point to ensure that we delineate between mental health conditions such as clinical depression and people in circumstances where they are feeling temporarily a bit low and need cheering up.  The reason why this is important a distinction to draw right now is because one is any more important than the other, they are different and the consequences from these ‘cheering up’ situations is therefore equally different.  Someone feeling down may have a realistic chance of picking themselves back up again in due course, they may or may not need some method of assisting themselves to cheer up but the need will be probably only for the period of time in question.

When suffering from mental ill-health the need to cheer yourself up may take a different form, one for example that you already know is detrimental, whether physically, financially or emotionally.  This immediately lessens the impact of it before you have even begun because those consequences can easily dilute any possible pleasure, one can find oneself easily regretting the decision before it is even fully complete.  The trouble is that having given in to the temptation the damage is already done, weakness has been exposed and capitulation of sorts has occurred and it is then we may feel ashamed.

In my view there is almost nothing more damaging that that which one can do to oneself as a result of shame and the avoidance of shame or the spiral in which it can quickly hold you.  Akin to something Alfred Hitchcock alluded to about the fear within being the most frightening so the crueller recesses of the brain can exploit far more clinically the elements about ourselves that bring shame.

As a personal example I found myself some years ago in a position where I would buy things from eBay, there was a double pleasure here because the element of finding oneself a bargain was coupled with the competition against someone else who might also want it.  What was interesting was that very quickly having won the auction there was no pleasure or exciting anticipation of the items arrival. Quite the opposite I felt almost a dread at it coming for the very fact that it would bring with it the shame of my having succumbed again.  When I say that I would buy things from eBay I don’t necessarily mean that I would simply buy a pair of jeans too many or the odd trinket, sometimes it would be pieces of technology for hundreds of pounds and on more than one occasion a car!

There were undoubtedly times when I was able to resist any such temptation, others when there was a genuine need for me to buy something of a particular nature but there were far too many when what I was trying to do was make up for the disappointment of the everyday by bringing something extraordinary into it.  I was often very lucky, I was for 15 years an IT engineer, the things I bought I could often make something of, frequently turning a very small profit, enough to cover my losses not enough to remove the sense of guilt.  Some of the cars I bought I spent years with and really enjoyed, whilst others languished and never went anywhere.  I managed to keep a roof over my head, just about, and not put my family at risk but this was often a combination of luck and having the gift of the gab rather than judgement.

Ebay was not the only vice either, the credit cards came and went, never thousands but often hundreds, I never lived an opulent lifestyle to go down in a blaze of glory merely just that slight shade beyond my means buying things in a vicious circle that themselves would lead to the shame that precipitated the next purchasing process. The feeling disappointed with myself would feed the nature of the need to alleviate that and the whole process perpetuated itself time after time.  It would have been a very different thing if I had gone mad and built up many thousands, it would probably have resulted in far earlier closure of the means to do any of it and it would also have been very visible at that point that it was an issue which might, though I doubt it, have led to me getting some help.  As it was it ticked along under the radar for years, decades truth be told, never enough to alert attention but always enough to be a source of embarrassment, shame and immense frustration.  I was being pursued by debt collectors just enough to be stressful but always doing just enough to prevent things getting more serious into areas like court action, this also meant I was making enough mistakes to have a poor credit rating but never enough to justify the idea of bankruptcy and ripping it up and starting again.  I never know whether to envy those that have gone down this route, I often wonder about it when you hear of people that have formerly been declared bankrupt being involved in other things, whether good or bad, I wonder whether or not the drawing a line under it all has afforded them catharsis or not and also whether it has been a salutary enough lesson to then act as a deterrent in the future, there are enough negative stories to suggest this is not the case with all people.

This is where I believe again it is important to draw some form of distinction on certain areas because just as with those who might be addicted to certain types of behaviour so the key is whether or not you can get yourself out of it when you see the damage it causes.  For most people the odd little treat whether good for you or not does not, or should not, tip them into a spiralling cycle of self-loathing and need for revalidation.  True there may be slight recrimination, a need to rebalance things, New Year’s resolutions to make good the excesses of the previous days, weeks, months, years.  It is not as if a great many people don’t have at least a sense of what those at the sharper end go through.

The tragedy is that left alone this becomes all encompassing, when reaching out for help there is not any sense of immediacy on Mental Health and therefore whilst there may be debt charities looking to help people in debt these may not be the logical first port of call for some people because they are a symptom rather than the root cause.  The difficulty is that even if identified as a mental health issue the person goes back into the system to wait, weeks and months pass someone who has reached out, possibly trying to overcome their own shame and recrimination in the process, is left to consider their actions at the point in time when they are at their most vulnerable.  It doesn’t take a genius to work out the likely consequences.

Song Of The Day ~ Icehouse – Hey Little Girl

What has become clear to me is the scale of the crisis that I think we are now facing. Some time ago I wrote a series of pieces called Future Shocks which may or may not merit revisiting now that we are a decade or more along the line. What I could not have foreseen was the nature of the last 12 months, however I was aware of the trend towards a world where the increasingly isolationist nature of our lives was going to have an impact on our mental health. My mistake perhaps or naivety was the belief that with the rise in disclosures and discussion of mental health which had been taking place so the effects would become clearer at least in some quarters there would be moves to alleviate the damage. Covid-19 has robbed us of so much collaborative working, rendered so many people dead, ill, damaged, shellshocked and in crisis such that it is impossible to quantify the human cost and the likely impact on our species because it cannot be measured merely in the figures of the dead, there is scarcely a person anywhere that will not have been affected by it all in some way. My greatest concern is how long some of those things will take to manifest and come out into an arena where it can be identified and the individual, hopefully, helped through it and whether or not our society has the capacity to care as much and for as long as is going to be necessary.

‘Coming out’ with a condition or general mental ill-health is no easy task. There remains a stigma in many arenas to the idea, such as there is for many of the equality strands still. The lack of understanding coupled with the nature of the world in which we live makes people fearful declaring anything that demonstrates such a personal sense of vulnerability and giving what they may reasonably see as ammunition to other people in whom they may have little reason to trust. I have spent a great deal of time working in environments supporting people with mental health conditions and trying to navigate the line between when to declare it and when not, sure the legal protections are there if the condition qualifies and is officially declared, but these protections only come in against behaviour that constitutes a ‘due detriment’ in UK law, I would be interested how it is elsewhere. Due detriment means that there has to be a definable method of determining exactly what the person has suffered as apart from those who do not have the condition so as to claim the treatment was less favourable. In most circumstances this means action such as dismissal, however those with mental health conditions in work know just how fragile that situation can be and therefore are likely to be disinclined brazenly going down the line to dismissal with the intent of taking their employer to court. They are more likely to just try to keep their head down until they feel better because to tackle something like this when you are already feeling less than 100% does not sound like a good idea to many people and thereby the discriminatory behaviour against them manifests and entrenches and the circle continues.

I’m not saying things haven’t improved in certain areas, they have, there is more knowledge, more research, more legal protection than there ever has been and yet one could say the same about race relations and I hardly think anyone would consider that fight for equality anywhere near complete. The difference is that when your characteristic is hidden and you feel that your environment is not embracing of ‘your kind’ you face a choice as to whether to come out of the woodwork and assert your rights but risk persecution or to stay beneath the surface at a point in time you feel perhaps the most weak anyway. It’s a bold choice to take the former route. It is worth noting that whilst many strides in equality have been made until 2013 the Mental Health Act still prevented people who had been sectioned due to their mental health from officially being able to be School Governors, sit on a jury, be certain types of company director or be a sitting MP. This was in spite of the widely circulated figure that 1 in 4 people would suffer from an episode of Mental ill-health each year, yes not merely in their lives, every year, imagine that as a part of the population, it would be like the whole of London, Birmingham and Manchester getting the plague and the government decided to ignore it or determining that former plague victims no longer had rights. Yes this may sound flippant but there is sometimes no more evidence that someone will have a relapse of mental ill-health than there would be of them contracting the Black Death again!

For me it was ‘easier’ this time round, by which I mean I had no choice, the manifestation of the impact on my mental health was swift and left me incapable of work for some time. Similar to how I see the world in general that process had in some ways been a long time coming in me, in as much as there was a combination of factors at play, but also symptomatic of many in the world I had for some time been coasting and just about getting by, depending on your method of measuring these things. Often if left to get on with things you can cope for a long time and maybe even return to dealing with things better than that, especially if other factors recede. However if matters continue to pile up then at some point there is going to be an explosion of some kind. I had been open before about mental health, but not always with my employer or work colleagues and that speaks volumes because I am no shrinking violet and will seldom shirk that kind of fight but that workplace environment is one from which there can feel like little escape. On this particular occasion though what precipitated my crisis was not of my own making and therefore the consequent absence needed to be explained.

Being back at the mental health coal face means I get to see first hand what is going on, what facilities are made available, how quickly to people respond and what methods are offered in order to help. Of course there is an element here that is entirely subjective, there will always be much of that because as I have elaborated on before the whole issue owes as much to meeting the right person at the right time as anything. Sadly it seems little has changed over the last few years in that sense. I have a good key worker from a mental health charity and an at times ambivalent general practitioner who only sprang into action metaphorically when I sent him a lengthy diatribe explaining that perhaps telling someone they seemed to be coping ok when you hadn’t seen them in well over a year and had no idea really what they were or were not coping with was a bad idea.  This is not the ideal foundation by any means and relies on you having the staying power to keep banging your head against the brick wall in the hope that you may break it before it breaks you.

In the 21st Century I simply do not see that as acceptable in a society that spends money on all sorts of things designed to ‘enhance our lives’ and ‘keep us safe’, what is the point of any of it if people in crisis of any kind are not helped, it is a form of discriminatory behaviour predicated on pandering to the needs of those who do not need much at the expense of those who need something, most of all some help. It is a random and short-sighted arrogance for anyone to feel that they may not be one of the people in need one day because we know that money does not buy happiness and does immunise against mental ill health.

Such an injustice for those in need will not change overnight, it will take time and pressure but most of all it will take a debunking of the nature that this is somehow uncommon.  Many strides have been taken on account of people speaking out and declaring their mental health conditions, in some cases one might be cynical and claim that some had something to gain from that, be it publicity or such like, ultimately though it has still helped to shatter the myth of this being a low level problem that affects an underclass of people.  As more people come out and share their experiences so others are emboldened to do so and the general awareness of conditions and their proliferation increases, from that, one hopes the idea that ‘they didn’t have this much depression in the old days, people just got on with it’ will be consigned, rightly, to the dustbin.

Song Of The Day ~ Courtney Barnett – Avant Gardener

Had I been the sort of person to be able to accept things as they are the first 2 parts of the story might reasonably have been where matters stopped. Indeed when I visited the Dr in 2017 it was not because I was feeling especially bad or in need of assistance, the commentary I gave to the Dr at that point was that given the relative stability of my life I was aware that whilst things in the world around me were fine things inside my head were not exactly how I wanted them to be and that this might be a good time to look at what the options were, principally because to do so when in a state of flux would be folly.

I had been on medication which was ok, and I use that term very specifically, they raised me up above rock bottom, at least that is certainly how it felt, whilst never quite elevating me to feeling what I might presume was ‘fine’, it was better than being consistently crap that much was certainly true. I had fluctuations that seemed cyclical, where my perception of things would suddenly change for no discernible reason and I would have a period of a couple of days when I really was not at all ‘on it’ before returning to my baseline state. In wider life I was comparatively comfortable where I was living, I liked the area, it felt like home and reminded me of where I was born. I had a stable job that didn’t pay well but was enough to just about get by on the whole, the key advantage of it was I felt I was worth something there and that I was valued. I was also able to cycle to work, which I was doing every day, so the fitness angle was certainly a major help. I was in a relationship which, whilst neither conventional nor easy was nevertheless rewarding and with someone I loved, all things considered therefore it was as good a basis to look at what changes to the internal me might be enacted as any.

I could not have known the nature of the year that was about to unfold and therefore had no method of determining what the impact of it would have been. None of the elements of stability were ones I presumed temporary. To an extent I was taking a chance on things but I was also, I felt, leaving myself in the hands of the medical profession at a point when perhaps there might be some ways of accessing further help and defining the nature of me and how to live long-term with that. There is a phrase ‘if it ain’t broke, don’t fix it’ and this might well be levelled at me at this point but I wasn’t feeling unbroken as such, I just didn’t feel the breaking process was worsening and therefore it might be a time to look at fixing. I felt there was more to things, that I was running at about 50% capacity and that if I were able to harness the rest of things that I might then be a better parent, partner, colleague etc. It is easy to look back with hindsight to determine things but I know that give the factors I had at the time and the way I was feeling I felt ready to try to push ahead and be just a better version of the me I felt I was. Never being happy or satisfied with myself is in part I suspect to do with the nature of my mental health but a small amount of such introspection is not a bad thing as I believe it does give you a little drive to be better. Conversely too much self-analysis if it involves constant critique robs you of any drive entirely and this has been my lot on and off for much of my life and the last couple of years in particular.

On the advice of my Dr I went for the first time in my life into the Secondary Care sector. Here I was given information about the Lithium trial, a common enough drug used to treat types of cyclical depression but the high-end one so to speak. I thought it worth a go as I had heard someone of late eulogising about it and how it had been a game changer – when what you are looking for is a game changer of your own such words are seductive. The nature of clinical trials is that you are first assigned a test group during which you are given either a placebo or the live drug, you are not aware of which until after the trial period. Having come off my normal medication without major incident I felt no real tangible difference, though some others said I seemed to be more myself, whatever that meant. I did feel though that I was not really engaging properly in ways I should have been, matters that needed attending to that might be important but not imminent were consistently pushed back and this felt like a problem. Which in itself is interesting as I have been a perennial procrastinator much of my life so for me to notice it suggests it may have worsened. The first part of the year the weather was pleasant and things were ok so there wasn’t a great deal to really test either hypothesis. That was to change.

Had a single sphere alone changed it would perhaps have been difficult to tell whether or not things were in hand, by which I mean one out of the home, work, love, family side of things but flux in all areas made for a great deal more upheaval both physically and emotionally with little chance of the respite of one area going well to retreat to. It is easier to focus on an area when the others are stable, not necessarily easy as it depends on the nature of change but watching one plate spinning and attending to it is less of a challenge than watching and attending to multiples. Looking back the changes within that space of time were significant and would have represented enough to keep one occupied on their own, altogether they were more than a significant hurdle and I don’t feel I managed any of them well. I was forced to move house, I changed jobs on the basis of a promise of something full-time that turned out not to come to fruition and my relationship came to an end in a way I hadn’t wanted but left me speculating over whether or not I would have allowed it to happen had my head been in the right place.

Some of the turmoil that ensued was not entirely my fault, on the house front I was let down by several people who had said they would do things which they then reneged on, I was left with a great deal to do to find someone to move anywhere at all but I did manage it, just. The person turned out to be a disaster for a variety of reasons and made the place utterly uncomfortable to live in whilst I was tied into a 1 year lease.

On the work front the finances of my workplace were in fluctuation but there should not have been much reason to change things around however my boss hadn’t been in the best of health and had decided to undertake a restructure without consultation and in a way which left me feeling far less valued than I had been and looking at the fact that it was one thing to be earning the money I was on at 30 but to be doing it at 45 was becoming a problem and without prospect of change. I found another job, it was long-term sickness cover, I was assured that the likelihood was that it would be made full-time. It wasn’t. I took it in the knowledge that it was a risk and weighing the career benefits of the job against where I was but I traded security at a time I felt I was ok and it bit me in the backside at a time I definitely was not.

On the relationship front I stopped fighting, I certainly never stopped caring, far from it, but the circumstances were somewhat enigmatic and at times difficult and I imagine my partner may, quite understandably have confused my detachment as being something to do with her whereas it was the first signs of a process that resulted in detachment from everything from which I am yet to really recover. The nature of the breakup though left many questions unanswered and didn’t feel right. We split and I fell into the arms of another quite by chance without planning or forethought, but feelings do not just dissipate and the memory is at times like the tail of a comet from the heart, it is long until the light subsides if indeed it ever does.

How much of all this was because of, in spite of or conjunction with the fact that it transpired I had been on the placebo to begin with followed by having been put on the live medication without any discernible effect during the transition or thereafter is impossible to determine, what I can state with certainty was that the lithium did nothing at all for me. I didn’t notice an effect going on it, neither did I notice an effect coming off it which I did after about 18 months. The timings were awful, the consequences far-reaching and whilst having rebuilt certain things out of logistical necessity such as having found another job and somewhere to live it has been a long time since I have felt either stability or joy within it.

The single biggest betrayal for me was that of the medical establishment which having been happy to take me on whilst I fit a potentially lucrative research profile was quick to shoo me out of the door when it was clear I was not the easy option they were looking for. When you are at your wit’s end having explained especially dark thoughts to a medical professional you do not expect to be dismissed and told that there isn’t really anything they can do because you won’t take the medication they put you on despite it being clear it doesn’t work. It remains an open wound that I went for help and was denied it, a scenario I am sadly not alone in experiencing and one where the profession takes advantage of the fact that individuals are at a point of sufficient vulnerability that the prospect of them having the energy and lucidity to complain is as low as their mood. Such things if occurring in the physical world would be seen as scandalous but those struggling with their mental health are the silently oppressed.

Song Of The Day ~ Orla Gartland – Heavy

Realistically whilst it was evident from an early age that all was not always well my run-ins with the medical establishment didn’t really begin until I sought help in 2006. It is difficult to put myself back in the mindset in which I was then but it was sufficiently serious that I agreed to trial antidepressant medication. I was assured that this was not something to be anxious about etc. in this instance they did at least put me at my ease on that score. What they failed to instruct me on was what to do if something went wrong, which it did, on the first set of meds they put me on, a very common SSRI called citalopram. No one could have foreseen such effects, I recognise this, I do not blame anyone, shit of this nature happens all the time to people struggling everywhere, you take the chance that the meds might help and if they do, happy days, if they don’t then you can console yourself that you are in the minority. Of course that consolation is a little hollow at the point you are standing in the queue at a supermarket with a full trolley of shopping and the whole place starts to close in on you such that your only thought is to get the f*** out as quickly as possible.

That was the beginning of the process of sampling all the medical profession were prepared to offer me, the only thing that had any realistically positive effect were the diazepam which were helpful for relaxing before sleep but they were reluctant to give me any repeat prescription for those, assuming perhaps that I might have friends for whom I could become a black market supplier. Other than that I had experiences that ranged from the utterly nondescript to the physically disassociating from my body and wondering if I were to jump under a bus whether I would feel the sensation or be immunised from it as an out of body onlooker! Thankfully I had foreseen the somewhat more turbulent nature of that medication and had taken myself off to a friends some days before for ‘observation.’ I was able then to order a lockdown of the premises on the instruction that I was not to be allowed out until I could describe why throwing oneself under the bus was a bad idea.

It’s fair to say that my medication experience was one I felt I had put behind me until 4 years later when a combination of 2 medical professionals taking the time to do no more really than what they were there for but doing so properly and for reasons of care, which made a huge difference. (The arbitrary nature of how this happens still makes me wince as it shows how random genuine support can be and this is just so wrong). I had changed Dr when I had moved house, I was muddling along in some form or another, just about getting by sometimes, occasionally enjoying things too but often still struggling. I moved to a nicer house to clear the head and the heart a bit and thought to try to make a slightly better fist of things elsewhere. I saw a GP at the new practice and started to explain things to him. He stopped me after around 25 minutes and said that officially we only had 10 minutes for an appointment and he was really sorry but given that there were other people waiting to see him he would have to cut me off there. He asked if I was free the following day, which I was, so he proposed booking me in for the last session of the day when we could take the time we needed without fear of eating into someone else’s. This gesture alone gave me what was and remains a fairly rare feeling of someone caring, I think the following day we talked for about another 45 minutes and he resolved several referrals for me and some other bits of go to and advice. Whilst this on its own would not have been enough to solve matters it started a process of renewed trust and meant I went into those referrals with my mind a little more open than I might otherwise have done.

One of the referrals was the next step in the coincidence list. I attended a clinic designed for psychological assessments and saw a clinician who seemed both friendly and knowledgeable. We spoke at considerable length and he made copious notes. He then proceeded to tell me that much of what I had thought previously about the normal state of things was not, it wasn’t patronising it was insightful, it showed that he had listened to what I had said carefully but had knowledge I did not. He explained things in a way that made a lot more sense about why I had not been understanding how most people lived up to now and provided a better structure for me to assess my own situation. I found it interesting and useful, he told me why in some detail the medications I had been on would not work for me and that there was a very different sort which might, were I minded to try it. I trusted him enough that I decided to give it a go and if it were an issue could come back. He explained how the dose would need looking at and over time and how I was to come back for a review in some weeks to look at the dose. He had explained he was a locum, so I’m pretty sure I had no expectation of seeing him personally again, I did look him up though and found that he was a somewhat highly-regarded Harley St clinician.

When I returned to the centre I was kept waiting nearly 45 minutes beyond my appointment time, with no apology offered when I was called in. The clinician asked me what medication I was on and when I replied said that this medication was usually used for epilepsy wasn’t it (which was indeed the main use for it) which puzzled me since I knew that the previous session had pages of accompanying notes that would have explained everything about the discussions that had been had and why. It became clear over the course of the session that this clinician had not read any of the notes and was expecting me to start again but was also much more of the ‘traditional’ mindset that I had previously encountered. So much so that I recall cutting the session short, ordering him to up the dose I was on to the that recommended for the second stage by the previous clinician and I would be on my way. The only useful thing he did was to do so without arguing and I left. I remained on that medication for 7 years. The diagnosis the first clinician supplied was as personal to me as it was comprehensive and remained the only diagnosis on file until 2017 and, ironically, is now being revisited due to suspicion that the updated diagnosis I received in 2017 may not be as accurate!

I leave that little diary part more as an indication of how arbitrary service provision is, how difficult it can be to get to see someone and then when you finally do how much of a lottery it is that you get someone who is even any good. For me it was the coincidental collation of a GP who cared enough to book a second session followed by a referral he made coinciding with the visit of a locum practitioner who took the time to listen to what I was saying. Those 2 individuals accomplished more in the 2 hours of their time that they gave me than all other professionals put together over more than 30 years, not because they were better clinically per se, though one might argue that fact on their behalf given the results they achieved, at least for me, but because they took the time, they bothered to do more than just tick the box.

It shouldn’t be the case that this is the exception to the rule, it angers me how random this makes healthcare provision, how people are subject to the most arbitrary of circumstances and competence of certain individuals to get the help they need. Would that I were a trailblazer, a campaigner passionate and motivated to further the cause but I’m neither diligent enough nor perhaps physically uncomfortable enough to be so. It is the path of least resistance to just keep going in some way ticking along, marking the days off and survival on that basis has in itself been at times challenging enough. All that’s missing is the date of release really, along with no sense that release brings anything, freedom or otherwise. It sounds nihilistic and sometimes it is though most of the time it lacks the buy-in even to be that, yet according to the medical profession, or at least certain parts of it the fact that I am still here, still holding down a job and relationship and family life means I am a success story and should take pleasure in the fact. I’m afraid their failure to understand the fact that taking pleasure from anything is simply not on the menu is as offensive as it is ironic.

Song Of The Day ~ Shame – One Rizla

For almost as long as I can remember I’ve tried to get the medical establishment to give enough of a toss for enough of a length of time to give me medical categorisation. This is for several reasons, firstly in a somewhat spectrum-like way I like the taxonomy of it, I like to know what I’m dealing with so that I can absorb salient information and figure it all out in my head. Specific diagnoses are therefore helpful in as much as they give more defined parameters as to the sorts of things that are and are not. Secondly there’s an identity sense afforded by the diagnosis of a condition, a community perhaps, solidarity with fellow sufferers but also possible coping strategies and mechanisms and a sharing of information.

When all is said and done though what I require most is comprehension and the ability to change. The way my head has been for as long as I can remember has been beyond my understanding, so many things that I seem to do that then infuriate myself for ages thereafter, now I’ll freely admit this is something most people can empathise with, some more than others, but I think generally these are things that muck around on the peripheries of people’s lives rather than come to underpin them or even engulf them – except in the cases of those who are in the vicious cycle of self-harm as I explained in my last post.

There have always been two hopes that come with the idea of an accurate diagnosis, the first is the naive one, one which is far more about the dream of suddenly being someone else, the better me, the me I thought I could, should and would be and that is that there is medication that flips a switch and ‘fixes’ who I am. I use that phraseology advisedly and specifically, I do not see mental ill-health as signifying someone is broken, unless of course they, like me, see themselves in that way. What I mean by it is that I can identify a core part in me that seems to know what is good and right and wants to follow it and another part that has the capacity to screw it up consistently. If it were hedonistically I might understand, down in the blaze of glory or notoriety and at least a bit of a laugh on the way out, but it is not like that, it is debilitatingly frustrating to me and cannot be easy for those around me either. Critically I think for the purposes of study and identification is that I do not enjoy it or the behaviour it brings, I am trapped in a room inside myself and I have lost where the door is. That there should be some Panacea Pill which should immediately have the capability to change precisely what it is I wish to change and not other facets and should be able to do so without side effects or effort on my part is frankly laughable. Nevertheless until all possibilities are exhausted there remains the hope. The more significant and realistic notion behind the issue of diagnoses is that having a diagnosis means the right direction can be taken on the next steps, medically, psychologically as well as physically, that to have a category in which to fall means that it should be a little clearer what lies beyond.

I had always assumed that since rarely rendered incapable of speech, merely action, that I would be quite an easy candidate to be categorised, at least in as much as verbal submission were able to achieve. Reality has proven to be quite the opposite in an experience which would be bad enough were it only to be me on whom it had befallen but now I am more in touch with others who share mental ill-health if not the same condition I find it to be all too common and this suggests to me that the system as it currently stands is not fit for purpose and had not been for a very long time.

Mental ill-health happens to a wide range of people, we know this, the severity and duration are individual as is the capacity of the person to cope with it during their lives. What is also clear is that for some people it is a constant struggle whilst others have breaks of undefined amounts of time between episodes. I had always been aware of a rather cyclical nature of my situation such that there would rarely be any specific change in circumstance that lead to a change in mood merely my perception of those same circumstances. Thus I characterised myself as cyclical because this seemed the most logical thing that marked me out from the experiences of others that I saw who had more specifically external stimuli related episodes. Of course we are all beset by pitfalls and we all struggle at certain times to deal with them, when I would be feeling low certainly I was hyper-sensitive to anything going wrong around me which would like a blanket flying in a hurricane attach itself to me and wrap around in a method that made me see the world or this specific as having been my fault in some way.

This I feel is the most dangerous part of any mental health, firstly because of the ease with which one can misunderstand this self-loathing and confuse it with self-absorption and self-obsession, it may share similarities but is the direct antithesis of arrogance; secondly it is the part that can so easily lead to thoughts that the world, principally those you care about, would be better off were you not there anymore. I have never thought I would ever act on those thoughts but by the same token I am no stranger to them either and sometimes the very inability to carry through what would be an irrevocable change one way or another leaves one feeling even more trapped and wretched and just as much the burden to those around.

It is possible that I may be a bundle of such incredible specifics such as to be the nemesis of the medical establishment, though somehow I doubt it, what is more evident is the lack of time taken or actual expert eye cast over my case and the ease with which certain professionals think that if you are not presenting as needing immediate hospitalisation that you must be ‘coping rather well’. This is all very much dependent on how one might define ‘coping’ and where I believe my understanding of it is at odds seemingly with some of the professionals I have met. True, we all have stress, we all have to deal with adversity and there are times when this can set us back along a path and render us less capable, however the assumption, if I am not mistaken, would be that this would be finite, would it not? The point at which a failure to deal with things is the norm seems not to be the one I associate with everyone else, perhaps I am wrong, perhaps they hide it the way I used to hide it, perhaps the human condition is indeed merely one defined ultimately by pain.

Let’s assume for now that it isn’t because if it were to be then I think all bets are off and we might just as well give up en masse but I sense by the fact that broadly speaking people describe life as being a positive experience that there is hope out there in some form. The question then is where to find it?

Song Of The Day ~ Lloyd Cole & The Commotions – From The Hip

What’s My Point?

It is both rather egotistical not to mention somewhat bourgeois to ask the question to a point, certainly to voice it in such a fashion however I think many if not all have the questioning within and what divides us sometimes is the nature of both the question and valid answers to it.

I have long since been aware that having a purpose matters to me, I’m sure I am not alone in that fact at all however the purpose we feel we have will differ just as the people we are and the filters through which we see things differs. I feel a need to be of use, principally to other people, to help those in need, to stand up for those who have no voice, it is important but it is also a path not without danger. Firstly who determines that I have any right to do so, that I have the skills, the desire, the understanding to be the best representative for the people I seek to help? There is an easy trap of presumption to fall into that just because someone isn’t doing well alone means that your help will make them do better and it is a trap I have fallen into more than once, for the right reasons I would say but I suspect that might not be much of a consolation to those who find themselves plunged even further into the pit by my hamfisted do-goodery. Added to this is the realistic possibility that the desire to do the right thing not only imposes my version of the world onto the world of another but also that if I am not careful I might look to gain my reward from the act of trying rather than from the act of succeeding in the assistance. On the flip side of that one cannot presume that just because one has not been ultimately successful in a specific endeavour means one has not helped at some point along the way either in whole or in part. it is a physical and moral minefield and not something that can be undertaken lightly.

I have for many years though gravitated towards jobs where someone comes to me for help, that is to say they are more often than not assigned to me as the supposed expert in the field in which they require help, this removes the aspect of whether or not they require help (whilst not entirely alleviating the issue of whether I am the one always best placed to give it). I have had successes and I have had failures, in my opinion I have succeeded at times where others might not and I have failed in circumstances where others might have fared better, such is the nature of the work I do. I would like to hope that at no point does anyone feel that I don’t give a shit even if they might struggle occasionally to see where the evidence of it is, the truth is that at times I struggle to focus on the amount of different strands required to keep all the plates spinning at the same speed. This is a lack of capability not a lack of will, which is a shame in a way because were you not to care enough it stands to reason that you wouldn’t lose any sleep over it. Sleep is a precious commodity.

I don’t require much to keep me going in my efforts to help but the one thing I need above all others is belief and when I look at the rest of my life I think I have something of a reliance on that in wider terms, when the faith goes so my own ability to care begins to decay. As a consequence I don’t think I am always as well placed to work through adversity unless I am able to quantify it in logical and linear terms and of course faith and belief are seldom logical or linear. That leads me to question why this reliance might be and whether there is more to it than simply reinforcement to bolster my own lack of self-esteem. I do not believe I am so self-absorbed as to be functioning purely propelled by self-validation. I don’t say that glibly, the self-esteem angle is clearly a predominant factor but there are areas in which I have more belief than others and therefore perhaps it isn’t as simple as it might seem at first. I should at this stage point out that I am not approaching this knowing the answers to any questions posed per se, I might have suspicions or ideas but this is a journey into some of the less dark depths of the mind in order to look at what does and doesn’t stack up, whether any descent into the emotional abyss comes from it I can’t really say. I don’t feel dressed for a journey into the deep and therefore can only look to wander around the slightly less cold areas and hope that inspiration occurs.

Something I genuinely don’t know is whether my need to create, in a recording sense, outweighs my need to assist or whether they are symbiotic. Since I have had less to write and less to say so I have been less good at assisting, the loss of emotional attachment has affected both equally profoundly. I know that the nature of anything I write is not because of the idea that anyone might read it but it is enhanced by the possibility of that fact and indeed has greater significance should it bring a positive reaction to that person and crucially not merely in a sense of self-aggrandising for me but in the sense that something I have done would have presented someone else with a positive aspect to their life that might not otherwise have existed. It is this very fact that has kept me of the belief that at my core I veer towards the good more than towards the bad. Juxtaposed with that though is that I am aware of many negative traits and my failure to deal with any of these not only impacts on me but also on anyone else that I might otherwise have been able to bring positivity of any sort to and that does sadden me.

Another thing that has come to light during periods of reflection is that I all too often look for the signposts to ‘the right way’ which presents a number of potential issues: Firstly it makes thinking out of the box a great deal more difficult, secondly leading on from that is a danger of easy dogmatism and intransigence; thirdly is the fact that I may fell prey too easily to ideology rather than imperial evidence if the line is followed without questioning; finally it means that where ‘the right way’ is not clear and there is ambiguity so I can lack the motivation until matters make more structural sense. I have examples of all of these things littering my life and indeed there is no easy or right answer. Some of these areas make me better at my job, the eye for detail and adherence is good for policy and the law both of which come into play, the innovators with grandiose ideals and ‘all the best intentions’ sometimes lack a sense of grounding and an ability to pinpoint what the pitfalls might be whereas I lack very often the grandiose ideals in the first place but seldom lack the ability to pick apart someone else’s. However this is where it is important to draw the distinction as to why I might do so. It would be a very different task seeking to denigrate someone’s ideas, hopes, dreams in order to put them down but it is quite another to want them to be aware of what the possible impediments might be to their achieving it so that to be forewarned is indeed to be forearmed. This again is an area in which I am confident in my reasons and my intentions however all too aware that constant problem-finding and naysaying can be regarded as being purely negative because whilst not perhaps intended to be so if not juxtaposed with belief and faith it can come across simply as criticism for the sake of it. I guess what I long for is to be one that the ideas people come back to and say thanks for your input we couldn’t have done it without you, the one tasked with finding the bear traps and figuring out the way to circumvent them.

It is I believe not important to me to be the Glory maker, I seek some respect rather than adulation, I like to make people laugh and think rather than obey, I would sooner be John the Baptist than Jesus, rather Sherpa Tenzing than Edmund Hilary. I want to get every last man, woman and child safely home and safely away from harm, no one is left behind on my watch. I know this is important to me I just hope that I am able to achieve it and that there are not paths along which I have walked strewn with those whom I have missed.

Song Of The Day ~ David Bowie – Ashes To Ashes

Given that we know any genuine chance of keeping any of the sorts of lofty, well-intentioned and/or healthy resolutions many make at this time of year lies with our own willpower it is perhaps testament to the likelihood of success that we have waited until an arbitrary point in time synonymous with group failure to choose to enact them. That said undoubtedly some will make it through, it does after all take two weeks for a habit to form, so they say, therefore the actual chances of success if the initial short-term obstacles are overcome rises exponentially. It interests me that at a point in time over the festive period that most people look to enjoy themselves, sometimes too much, the new year is beset with recrimination and efforts to make ourselves the person we feel we ought really to be. This lends itself all to easily to manipulation by forces around us, look no further than the issue of image and weight in particular. As someone who has suffered from weight problems since childhood I see this quite acutely, I am however only a man, the pressure brought to bear on me comes more from within and from the occasional friend or relative who may see me struggle from time to time. Where I have overcome some vices in the past this is the one that seems the most entrenched and tied to my psyche and therefore juxtaposed is the fact that it is the one that would make the biggest difference to my confidence if conquered.

I hear much about restraint, how people’s weight is to do with their own choices and this is undeniably true but a person’s choice hinges generally on their state of mind at that time, positive state of mind like as not healthy choices, negative state of mind and the minefield is laid out in front of you. Christmas therefore can be a time when presented with many choices but also with commensurate emotional baggage such to influence our state of mind and often even whole frame of reference given the likely involvement of family or sometimes the marked absence thereof.

Not everything we do to make us feel better is a vice, the key is whether if told at some point that it is bad for you that you be able to stop with immediate effect and not notice the lack of it. If there is a sense of longing or a sense that we would still have a desire or need in spite of the knowledge that it is not good for us then this is no longer an entirely benign influence. How malign it might be would depend on the balance of need over the likely damage caused by continuing. For some it is eating, for some the very opposite; for others it is substances of any description, from the socially more ‘acceptable’ drugs such as alcohol and tobacco to the more illicit narcotics. In all of these cases there are support groups across the land looking to help those who fall foul of the effects. However the root cause is seldom looked at properly and consequently other people suffering the same issues but with less tangibly identifiable effects may fall through the net. There are those who form relationships which are not good for them for a variety of reasons, there are those who hurt themselves physically and mentally and this can often only be seen should the scars show. What binds all of the people in all of the strands is that in all cases to varying degrees what is happening is self-harm.

The term self-harm often conjures up images of people inflicting specific physical damage on themselves, this is perhaps the most immediately alarming of the evidences and the one to which most people would feel themselves remote against, but if we look at it pragmatically we all know people who behave in a way that is clearly going to cause them harm and that this behaviour can be seen to be so by all parties in advance. The person that drinks/smokes/eats a little too much, a little too often. The person who stays too long in an abusive relationship/job they hate or simply tolerates behaviour from others towards them that could be seen as damaging. We may need to look no further than the mirror for that. Equally likely is that we may be part of the problem, putting expectations on people about things with which they are clearly struggling, we can be as much a part of that spiralling by caring enough to want someone to stop what it is they are doing when it is clearly harmful but not taking the time, for whatever reason, to understand why they might be. There may be a variety of reasons and it may be that the prospect of stopping and the reality that is left is far more terrifying than the consequences of the harm.

I remember a flippant example from my past when I was especially overweight. I had suffered from heartburn for many years, burning reflux at night that would wake me up in pain and never just recede. I could never fathom exactly why it was but what I did get to the bottom of was the fact that a glass of milk would assist. The greater the heartburn the more milk I needed to get it to go away, I tried plenty of heartburn remedies and these might assist briefly but rarely for more than the specific attack and usually not even for that, milk seemed the solution which had a degree of keeping it under control and tasting a great deal better not to mention being a lot cheaper. The only problem was I have a lactose intolerance that causes rhinitis if I drink milk, but in a toss up between gastric burn and blocked sinuses it was without question the milk which won out, by the pint. The consequences were sufficiently low level as to be outweighed by the need to assuage the more immediate pain and by and large I was reconciled to that dynamic. Whilst this is a flippant example there are elements here that map themselves to others quite easily, not least was the fact that when I was drinking milk I was in fact assisting myself to remain in the cycle for it was directly linked to my weight that I suffered the heartburn in the process therefore perpetuating a vicious circle. The principle point that I wished to make though was that the alleviation of immediate and acute pain will almost always win out over the potential prospect of problems later and that therefore to want to help a person in such a situation one must first understand the multidimensional reasons they are who the are and how many people have really the time or the inclination to do that?

Herein is the real problem, the lack of society, the lack of close-knit family, the lack of joined up services coupled with the pervasive ideology of self-aggrandisement, self-fulfilment and self-reliance has led us to where we are now. To me if you judge success and failure on anything other than the overall health and happiness of people then you are utterly missing the point. A country with a strong economy underpinned by slave labour is not a success, that is not to argue that a strong economy may not act as a vehicle for success if used properly but if that use is to grant tax breaks to the wealthy whilst mental-health funding is woefully inadequate then this is a time-bomb waiting to go off. What covid-19 has done is shine a light on where we are, who we are and for many people what is really important, the lack of proper structures of people around us has shown how interdependent we are. If that is something only now occurring to those who have hitherto felt themselves to be doing ok spare a thought for those who knew they were not and think about where this leaves them now.

Whilst I hesitate to speculate on what will happen with mental health from here and whilst I acknowledge the positive steps that have been taken bringing this one of the last great societal taboos more into the open I cannot help but fear that an already stretched health service with funding pared back to the very bone that has been struggling for some time to meet the needs of the declared mental health problems currently is going to be overwhelmed. In that circumstance where the bean counters may look at what can be done, the quick processing of people with milder forms of mental health issues in order to show some ‘results’ is a much easier path to take than to acknowledge that mental health is a lifetime condition and roadblocks along the way are part and parcel and require a lifetime’s attention. The prognosis therefore for those with deeper seated and more longer term mental health conditions who may not even have made it as far as the outside world let alone the workplace may not be a good one in the short or medium term. The onus therefore is on those of us in the middle tier who straddle both those environments to try to make our voice heard, not to do so may have fundamental implications for a long time to come.

Song Of The Day ~ Star Feminine Band – La Musique