Psychosis on tour: Cuba Libre

So here we are, the last post of the series. I want to end by saying that despite my description of the ‘episodes’ as psychosis, my official diagnosis is bipolar 1. So are they episodes of psychosis or mania? This has been a bone of contention between the various psychiatrists I have seen. It also corroborates the well-worn anecdote of ‘sit seven different psychiatrists down in a room with a patient and you’ll get seven different diagnoses’.

So why describe them as psychosis? Well for me, that’s what these incidents most strongly resemble. During them, I do feel elated at times, which would fit in with bipolar, but my mood can drop significantly and the delusions, paranoia, hallucinations and grandiosity can all combine into a rather potent cocktail. I usually return to better mental health with anti-psychotics which seems to indicate that these are responding to a psychosis.

There is such a matchstick between the more severe mental illnesses that it is difficult to categorise who falls under what label. It can take years to get a diagnosis that fits. Sometimes, drugs which seemed to be the silver bullet no longer have the same efficacy. Perhaps what is most worrying is that you can seemingly be doing all the right things to keep you well and yet still you fall victim to mental illness’ unforgiving grip.

Anyway, turning to this final post about a very short lived holiday in Cuba, I think it’s safe to say that before going  I was doing quite well. I had a voluntary job I enjoyed, was eating fine, a good group of friends but perhaps not exercising enough.

I had had an iffy stomach a few days leading up to departure to Cuba which may have altered the level of lithium in my system, so perhaps the scales had already been tipped. I also remember feeling strange at the airport on the way over. There was a fire evacuation in departures and I felt that as a spy, my duty was to blend into the crowd to avoid detection from potential assailants (and I very rarely watch action films, so a florid imagination was perhaps at work!). Nevertheless, we flew to Havana with Mum and Dad ready for an adventure. We’d never really done a holiday like this before, and had pre-arranged some walking tours and excursions into the further reaches of the island.

I remember feeling not quite right again as soon as we got off the plane. Again the heat was suffocating and I felt that we were being watched and judged by spies, which seemed to be the overriding theme of this episode, should there be one.

We got the taxi to the hotel and I am now means a petrolhead but, out of character, I spent the entire journey in the front seat talking to the driver about cars. The hotel itself was cool and draughty but as we walked in I felt the gaze of the locals, fuelling my idea that I was on some sort of secret mission.

That night, we went out for a meal on a rooftop as the sounds of the city exploded into life. However, on return to the hotel, I once again had an upset stomach and was on the loo all night. What’s worse, what sounded like a mariachi band was playing over the road from the hotel into the early hours. So no sleep, dehydration and paranoia were already in play.

The following morning at breakfast I broke down in tears in front of the whole dining room, completely unprovoked, so it was decided it would be best to return home. As we waited in the hotel reception, I had the Hot Chip song ‘Over and Over’ stuck in my head, its metronomic melody rattling around my brain. I repetitively began to climb and descend the steps in the reception, followed closely behind by Dad.

One of the last memories I have of Cuba is visiting the doctor in a health centre. Presumably having reported stomach problems, he felt for any swelling etc. and concluded that there didn’t seem to be anything wrong. The doctor was kind and patient and I’m not sure what he eventually diagnosed, probably a recurrence of mania/psychosis.

After a while, we managed to get a flight back to Britain and arrived back under the blanket of nightfall. It was so nice to be in cooler weather, although a stop at a service station ratcheted up my paranoia as I walked past a group of police officers, still believing myself to be a spy.

I went into hospital again for three months and was very unwell, only responding to a new type of medication.

What have I learned from all of these experiences? I think looking after yourself is very important and never give up trying, there’s always new things to try. If you do this well, hopefully you will circumnavigate the hazards to your mental health. Heat and dehydration seem to be common factors, but I have been away to hot places since diagnosis and been fine.

Be thankful for your support systems and when the good times come around, enjoy! I am currently doing well, which I mainly put down to having a steady voluntary job, a decent social life and I also have been training for triathlons and running races with a local club.

I have enjoyed writing this series of posts and don’t feel traumatised by the events in the posts. Writing them has not felt cathartic; just reporting the facts with a bit of embellishment.

I hope you have found them informative and educational. Psychosis may come across in the media as strange,  but honestly, I feel it to be the brain’s natural response to extreme stress. I’d be interested to know the brain’s reaction to extreme heat, so on the off chance there are any neuroscientists reading, do get in touch.

Wishing you all the best and a brilliant summer and thanks again for reading!

Psychosis on tour: A Kick in the Balearics

Although this episode was dealt with very effectively, it was possibly the most upsetting for me on a personal level.

I had been going to Menorca on holiday with family and friends pretty much every year for twenty years prior to this bout of illness, and got to know the island very well. We had the whole place pretty much mapped out – where to go for the best afternoon paella, which bar to get freshly squeezed orange juice in the island’s capital and which place was best for sunbathing and getting chicken and chips.

I used to also enjoy going to practise my Spanish and year upon year I grew in confidence, reaching a peak on my year abroad having lived in Valencia. That year in Menorca, I could understand the waiters’ whispered jokes and respond in kind.

It was a home from home, but each year there were new places to explore. Also, despite being a relatively small island, there were always new places to try and restaurants and bars to sample. Many of my fondest memories come from long afternoons in the retreating heat, either by a pool or the sea, with my family and friends before a short rest and back out for a meal or staying in and firing up the barbecue.

So you’d imagine that this island getaway, just a short hop from the UK would be stress free. When I look back on it, this episode wasn’t really preceded by much stress. I was interning at a local health organisation but in no way felt any undue pressure.

I think the heat played its part in this crisis and not staying sufficiently hydrated played an even bigger part in this one. I was training for a half marathon and even mid-morning, the temperature was searing. I went for a run with Mum and Dad, a dry wind hampering our progress. It’s so important to keep your fluid levels topped up as the lithium I take to stave off illness is in constant ebb and flow in terms of titration in your body; either too much or too little in your system can be very dangerous. It seems as though this energy-sapping, sweat-soaked run may have been the first inroad into another psychosis.

I remember going to a roadside bar for tapas with Mum and Dad and thinking everyone was watching me, hyper-vigilant to the extreme. I became convinced that I was a celebrity of sorts, and every person I saw talking in a phone I believed to be undercover reporters, tracking my every move.

I then went home to the villa that night and thought a moored yacht near where we were staying was beaming its spotlight through the shutters in my room, keeping me awake. I woke my parents to tell them, also letting them know I could hear a loud radio. They could not, and became concerned.

The following morning, we went for breakfast and after we ordered the waitress handed Dad and I the cafe’s card. I interpreted this as some sort of invitation to a Masonic event. Clearly, things were going awry.

We then went down to the beach bar and again I felt the eyes of others on me. For some reason, I decided to play up to it and perform magic tricks. Some friends called by later for lunch, and I think my strange behaviour was becoming more and more apparent.

Back at the villa, Mum and Dad tried to keep me calm by getting me to listen to relaxing music, but I was getting more and more frantic. We tried to go to one of our favourite places in the evening, but I became too upset.

I needed to get home and go into hospital, so a flight home was swiftly arranged. I was still very upset in the airport departure lounge. The only thing I remember about the flight back was thinking I was controlling the plane using the click wheel on my iPod. In these instances, I now realise that hospital is the most appropriate treatment option.

I came home and was just about getting by, but after just over a week the strain of looking after me became too much for my parents and I was admitted into the local psych ward. I spent three months there, including a torrid time on the PICU. I also spent my thirtieth birthday there. Not how I had envisioned that particular milestone, but Mum made an absolutely incredible cake for me which cheered me up, and kept the staff well fed too haha!

So if you’ve read the other posts you’ll see some common strands with causes, symptoms and warning signs. It would only be a year later that I would become unwell again, this time in Cuba.

Psychosis on tour: Day Tripper

Now I know Liverpool is not abroad but I feel I should write about this experience to show that my psychoses haven’t always depended on being overseas. I also wanted to write about it to show how quickly they can come on and also how they are treated from a medical perspective in the UK.

So this particular story begins with me interning at a PR firm in Liverpool. It was going reasonably well but as with most jobs, it came with its own stresses and strains. I frequently had to drop off last minute tenders to other businesses on the other side of the city and regularly attended talks and conferences where the pressure was on to represent the company well and network with other delegates at the events. I always had one project on the go, if not several, and was never short of work.
I felt like I was performing quite well and coming up with fresh ideas at team meetings and coming up with new ideas to problem solve. However, I was starting to come into conflict with a colleague, who I felt was asking unreasonable demands of me. Really, I  should either have had a chat with him or reported it to a senior manager, but I felt like I held little clout as an intern and perhaps the situation may peter out with the passage of time. I also was exercising devoutly, losing about two and a half stone in 3 months. I was probably overdoing it and I was going out at the weekends and burning the candle at both ends.
Occasionally I would drop in on a friend who lived in the city centre during my lunch and play video games. I remember being overtly more emotional and outgoing than usual – perhaps an early warning sign.
I was getting more and more worked up about a particular issue with my colleague and a task he had given me but didn’t really let on to anyone else about it. Eventually, I came in to work one day and the switch just flipped. For some reason, I started googling the band The Grateful Dead, perhaps again believing myself to be in purgatory (a similar belief I held in Marrakech).
If you look at the Grateful Dead’s logo, it is of a skull with half of the brain area in red and half in blue. In my mind, I made the supposedly logical jump was that this represented Liverpool (these are the colours of its two football teams), and that the band’s music soundtracked being in hell/heaven’s waiting room. I became increasingly distressed and the colleague who sat facing me got me a drink of water. I drank it quickly and left the building.
I suddenly felt compelled to visit the Anglican Cathedral and felt I had been given neat vodka to drink not water. I was very upset by this point, and it was only when I sat down in one of the side chapels in the cathedral I calmed somewhat.
I then decided to take the lift in the cathedral and throw away my wallet and its contents, thinking I was renouncing my worldly possessions. I was evidently seriously unwell by this point, now deciding to lie down on the pavement outside the cathedral, like the protagonist in the Radiohead video, ‘Just’.
An ambulance was called, and I remember being determined to keep my eyes shut, to prove I was worthy of going to heaven. The paramedic was squeezing my earlobe, which I now believe is how they judge people to be conscious or not.
I was carted off to a general hospital in Liverpool, and as I had discarded all forms of ID, I could not be formally identified. Thankfully, a family friend was a doctor in the hospital and found me in one of the wards, much to my family’s relief, as really I could have been anywhere.
I was hearing voices at this point and having strange ideas about my right hand side of my body being ‘good’ and my left being ‘bad’ and would only take medication from someone standing on my right side. Eventually, I had taken on enough medication to get a decent night’s rest.
I was discharged the following day and after the previous experiences of psychiatric wards, it was agreed I would recover at home. I continued to be very unwell for a while, and my family was extremely patient, forgiving and caring at what must have been a very difficult time.
I gradually recuperated and had good mental health until a family holiday to Menorca, where yet again psychosis reared its ugly head.
I hope this blog has been interesting and informative and I look forward to posting about Menorca soon.

Psychosis on tour: Marrakech Express

It wasn’t until five years later from Rome that I had my next psychotic episode, again whilst on the road, this time in Marrakech.

That summer, I had graduated from Leeds University with a first class degree in Spanish. I felt a strange variety of emotions upon graduation; euphoria, pride, excitement at what was to come, but also fear, that what lay ahead was unpredictable. I also knew that aside from a few periods of moderate depression, my mental health had generally been quite good. Whether that was down to the helpful therapy I accessed, the mental health society I established, the care and patience of my friends or the support systems within the university, I don’t know. Maybe it was all of these factors.

So I was in a bit of an odd place, not sure what my step into the world of work would entail, with one last summer before reality kicked in. I had been discussing going away with a friend who I had been away with to both Berlin and Krakow previously. We eventually settled on Morocco, using Marrakech as our starting point then going on from there to explore the rest of the country.

We set out in the height of British summer and weather wise it was even hotter over in Marrakech, the kind of heat that envelopes you as soon as you step off the plane. I can’t quite remember how we travelled from the airport to the riad we had booked – it may have been a taxi, or it may have been a bus.

On arrival, the immediate impression you got of the riad was absolute calm, a true oasis of tranquility from a city in which we would soon experience a focal point of activity and life.

The rooms had air conditioning (and I’m not sure they even had windows) so they were lovely and cool. Once we were settled, we headed to the bank just off the Djemaa el Fnaa, Marrakech’s main square so my friend could get some money.

It was a jaw on the floor, ears pinned back experience. Small children whizzed past on motor bikes as wizened old men charmed cobras. Temporary tattoo artists inked Arabic text onto tourists’ arms as the scent of spiced, cooked meat drifted through the square. We were totally taken aback. You didn’t know where to look, as everywhere little vignetttes unfolded in compelling, dramatic fashion.

Withdrawing money turned out to be a bureaucratic nightmare, but eventually currency was handed over to my friend and we returned to the riad. We were served with some delicious mint tea on our return, sugary sweet but just what you needed having braved the fearsome Moroccan sunshine.

It is here where I reach the point where my memory has become fragmented regarding the timeframe of events, perhaps the psychological change in climate from a ‘normal’ experience of reality to an ‘abnormal’ one.

I remember going to visit a museum and being overwhelmed by how hot it was. We walked from place to place and I was consistently thirsty, stopping off for a drink seemingly on every street corner as groups of locals crowded round TVs to watch foreign football, much to what I perceived to be my friend’s annoyance.

We got tickets to an outdoor show in a beautiful setting, almost palatial. Traditional Moroccan music set the backdrop to the darkening skies as dancers graced the stage. It was a fantastic event and was one of the highlights of the trip, despite my erratic mental state.

It was around this point we changed accommodation to a small hotel right off the Djemaa el Fnaa, possibly the day after the show. This was when things really took a turn for the worse. I remember being in the reception of the hotel and feeling very strange, as if things were moved in the room each time we returned.

The first indication things were not right visibly to my friend were the first night we spent in the hotel. I thought he was trying to keep me awake by fiddling with the air con so I took both controllers and kept a close eye on them.

Every hour, the call to prayer would echo through the city, and this highly evocative, spiritual address stirred up the strange religious hallucinations and delusions similar to the ones I had experienced previously in Rome.

My friend rang my parents who instructed him to give me extra antipsychotic medication. Thankfully, he was a recently graduated medic and stayed up with me the whole night as the episode ebbed and flowed.

At times I thought I was being poisoned with the medication, and at other times I thought my mate to be the Devil incarnate. Religious fervour was racing through me and for a time I also believed I was in purgatory. It was my job to prove I wanted to get into heaven (on the other side of the room). So I punched through the window, gashing my hand. I must have passed out, as my hand was stitched, presumably by my friend, when I awoke.

My parents flew out having heard how ill I was from my friend, and I remember feeling very relieved to see them, and vice versa. They had been giving medication advice to my friend on advice from the local community mental health team so they came prepared to help as best they could. I remember them taking me for a walk around the first floor and I thought with the heat, the birdsong and the palm trees that I was in the Garden of Eden, on heaven’s doorstep.

This was the second consecutive time during a psychotic episode that I had believed that I had died and gone to heaven. For those wondering what that feels like, I can vouch for the fact that whatever evidence exists to the contrary, you find a way to dismiss it. It’s not especially frightening or scary. You feel liberated, but at the same time unsure – has this really happened? So there is a degree of rationality to the thought processes.

After a time I plateaued and given the experience in the Rome psychiatric ward, it was decided to manage the illness away from hospital. I’m pretty sure a psychiatric ward in Marrakech would be just as bad, if not worse than the one on Rome. The four of us checked in to a beautiful hotel on the outskirts of the city and gradually the symptoms dulled to the background.

We flew home and I continued to recover at home. I am extremely grateful to my friend and my parents who between them played the roles of psychiatrist, nurse, support worker and pharmacist. It was a few months’ later that I took a tailspin into depression and that the now commonly agreed diagnosis of bipolar was given to me. I slowly recovered and secured a job in a PR firm in Liverpool, where I had a particularly florid episode in the city centre.

Thank you for reading and please do comment and get in touch with questions, and I hope you have found this post engaging and enlightening, if nothing else!

Psychosis on tour: Roman Holiday

It’s taken me a while to finally get to this point where I feel comfortable recounting my experiences of psychosis whilst abroad, although I have been wanting to tell my version of events for a long time. Not necessarily as a form of catharsis, but as a way of shaping the narrative into something that could be understood, at least parts of it anyway. I think because these events and experiences are pushed to the edge of human existence, by telling the story I hope to make it seem as though the psychosis was actually a natural, in-built response to the stressors that were going on at the time.

My first experience of Rome didn’t quite hold a candle to the gilded glamour on show in Roman Holiday, although the power of the surreal exoticism of the city no doubt fed into my first encounter of psychosis. The overpowering, imposing religious iconography also played a part, with every street corner featuring beautiful statues, fountains and churches.

The trip (no pun intended) began in the fashion that for me would be repeated for several weeks until under heavy psychiatric medication – no sleep. A friend and I got the last train down to Coventry Airport and rather than get a decent night’s kip as anyone in their late twenties and beyond would do in an airport hotel, we opted to try and sleep at the airport, the wet behind the ears scamps we were.

What we hadn’t factored into the equation was that even regional airports close overnight, so whilst we could we slept in the lobby which occasionally filled with a baltic blast of air as the automatic doors opened. We were then turfed out and had to sleep, or try to, in the entrance to the airport. I must have got about half an hour’s sleep, certainly not ideal for the start of a holiday.

We caught the early flight and arrived in sweltering heat in Rome. My memory fails me as to how we got from the airport to the city centre, although I am sure we got fined for not buying a ticket for the metro pretty early into the holiday. We also did not have accommodation sorted, so we went off scouring the city for a place to stay.

We found somewhere and soon after met with our employer for the holiday. He let us know what our job would entail much to our pleasure it would involve lots of drinks and hi-jinks with hard partying tourists. Throughout the day, we were to try and get as many people to meet up with us in a terrace near the Coliseum, where we would be encouraging drinking games such as beer pong, before heading round Rome’s bars and clubs for discounted drinks, with the odd free shot of questionable origin to be thrown in too.

Some more friends came out to stay and it was, for a short time, good fun. However, a number of factors started to stack up against my favour. Firstly, and most apparently, I was drinking far too much. I was pretty consistently drinking as soon as we arrived to host the evening pub crawl. In fact, for our evening meal, we would go to a buffet at a local Irish pub. Free food, on the proviso that you bought a couple of pints. So from then on in, it was drink after drink. And as host of a pub crawl, you couldn’t show to be slacking, could you?

Secondly, and what seems to be a consistent theme in my psychoses, was the heat. It was hot from the moment you emerged from alcohol induced slumber to the moment you drifted off fourteen hours later. All through the day, it was claggy, uncomfortable. The only saving grace was a shower in the hostel that didn’t actually heat up.

I think the third factor was having to speak to people all day, selling the pub crawl. I wouldn’t describe myself as a natural salesman, so having to come up with new ways to reach out to people was difficult, as often people I stopped just wanted to amble around the Coliseum and its grounds without being hassled by pub crawl touts, was difficult. I felt like a spring was tightly coiling inside of me; the more I tried to cajole people into coming to the pub crawl, the more I felt on edge, that something wasn’t sitting right.

As has already been mentioned, I was getting by on practically no sleep, and any sleep I was getting was alcohol induced. So basically the brain was getting no time to subconsciously process all the stimuli it was getting in the day. I was walking round the city semi-comatose, yet summoned the energy each and every night to entertain the masses.

There is a strange phenomenon reported by a minority of visitors to Jerusalem. They report powerfully religious hallucinations, voices and delusions which stem from the manifestations of Christianity in the city. But it’s not only Christians who experience these symptoms but Jews and Muslims have been know to show signs of the illness too. Now I’m not claiming that I went through something akin to Rome Syndrome, but the possibility is there that our visit to the Vatican or the eminence of Catholicism in the city may have affected me. It may be, like the other possible explanations, conjecture. But it may be down to a combination of some if not all of the factors mentioned, even some I may not have considered.

The year leading up to it also had its fair shares of ups and downs. I didn’t really settle down into university until halfway through the year after a long distance relationship ended. I made a lot of new friends and was socially doing very well. However, I was scraping by with my law course and only just passed my exams. So it was a fairly turbulent year all in all, and really I should’ve taken time off to take stock and relax. Instead I went to Glastonbury, and loved it. It was a massive release after a lot of self-imposed pressure and I saw some of my favourite bands with a few good mates.

My memory of the fallout is pretty hazy and fragmented. Throughout the episode (I hate that word as it fails to convey the extremity of the experience), I was emotionally labile, elated one minute, aggressive and hostile the next. I remember several isolated incidents which added up seem to indicate that I was extremely psychotic and distressed. What follows is a series of recollections which are not chronological so it may be hard to follow but some common threads may be identifiable.

From what I recall, I think the first sign of stress starting to boil was when I was paid for my work. It was on commission, and whether rightly or wrongly I thought I had performed equal to or better than my friend. I let it simmer under the surface; everything was fine and dandy as long as the beer flowed and the punters kept coming.

We managed to get a flat in the outskirts of town which from memory was very nice, but almost as soon as we moved in I started to get worse, going through my friends’ things at night, reading special meanings into the various guide books we had bought and getting unexplainably upset to Oasis’ song She’s Electric (you’ll notice that music tends to play a a part in these situations).

I got next to no sleep again and started to think my drink had been spiked on the pub crawl. I tried to flush it out of my system by taking on lots of water. I then went and sat outside the apartment in my pyjamas, stewing over conversations my friends had had at dinner, convinced they were talking about me in code. I then became very upset when next door’s baby started to cry. Things had quite apparently escalated.

Next thing I remember all four of us were in a park and for some reason I felt awful, a terrible mixture of paranoia, depression and elation. I ran away from everyone and my friend, extremely concerned, eventually found me.

The next thing I remember was being in a tanning shop and literally covering myself in tanning lotion before running out the shop. Quite what motivated me to do that I don’t know but I ended up with my friend chasing after me in a nearby metro station. A policeman prevented me from going through the gates, and as my friend came to try and explain, I hit him. More of a slap than a punch, but still well beyond the pale.

I then set off alone round the bars and cafes of central Rome, my friends increasingly concerned for my whereabouts. I had developed my own conspiracy theory, that the Euro 2004 football tournament had not in fact fully taken place and that if I undertook various tasks, I could win tickets for the real final.

All the while, I was phoning friends on my mobile asking for clues to help me on my quest. I don’t know what and why I was asking, but I’m sure my phone bill for the month was quite something. I remember going into one bar and having three or four iced coffees before going to the bathroom and trying to clean it, asking the bemused, if not concerned staff for a mop and bucket, despite knowing a handful of Italian words and phrases.

The mirror in the bathroom had an air freshener stuck to it, and as I recall it fell off as soon as I opened the door. I took this for a sign that I was being watched, and on a grand scale. I thought I was on TV, on something like Big Brother and this fuelled the grandiosity of the perceptions.

I went round a couple more places, sweeping up cigarette butts, in my mind as penance for the extravagant travels I had enjoyed the year before in my gap year. I was very lucky to visit the places I did, but feeling guilty about it does seem a little weird.

My last memory of the holiday (?!) pre-hospitalisation was stripping down to my Jack Daniels emblazoned boxer shorts (how’s that for a plug!) and just running. I didn’t know where I was and my feet were dirty, cracked and sore. Eventually, I just collapsed in the arms of a passing stranger. Who knows what could have happened had he not called for  an ambulance and stayed with me.

The oddness continued in hospital. I was heavily sedated and upon waking I thought I was in heaven, due to a water bottle with the French word for heaven, ciel, being offered to me. I was wheeled to the other side of the hospital and I thought I saw one of the members of the band The Strokes, wishing me well. As the trolley weaved its way through the hospital, I started to think I was being sent to Rome’s space station. I had read a few months previously about space travel in a men’s magazine, and I must have seen a connection between the two, whatever that may be.

I took some restraining as the doctors tried to diagnose me, once requiring about six of them to pin me down, awaking to find my wrists tied to the hospital bed. I kept opening my eyes wide open and jolting my body upwards. People thought I was fitting, but actually I was emulating the character in this music video who regains consciousness after a car crash (at 3.23). I was physically trying to wake myself from this nightmare, but it was of to no avail.

A kindly doctor realised that I could well be suffering from psychosis and I finally got the necessary care. I was moved to a psychiatric unit which I only remember very vaguely – the one and only memory being walking round its grounds heavily medicated with my Dad.

There was a final scare on a hotel rooftop when awaiting my air ambulance home. I had been discharged from the unit and I think it was decided just to have a drink where we were staying. The rooftop was probably not the best place for a psychotic young man to be, so we swiftly headed back to our rooms.

I flew home under a chemical cosh and checked in to the local psych ward for a torrid fortnight where my condition was brought under control as I paced the unit, fuelled on soggy chips and weak squash endlessly watching my DVD’s of The Office and Phoenix Nights.

What followed a few months later was my first experience of depression. I. Had dropped out of uni, stopped socialising and exercise was consigned to the back burner. I don’t cry very often but I broke down a few times at home, unable to understand what I had gone through. It was later agreed that I was also experiencing something akin to PTSD. It felt that now I had an albatross around my neck, I was that guy. I dreaded what people may have been saying, and I suddenly felt watched and an object of gossip. It was a year to forget no doubt, and after a long time sitting on the couch turning things over, I began talking therapy. This helped massively, combined with the new task of going to pick my brother up from work. I started at the gym, and began a course of anti-depressants. My mood lifted and I applied to Leeds University to study my favourite subject at school, Spanish.

A new chapter of my life began in September 2005 at Leeds. I had a few downs, but in first and second year I got on with my work and kept a fairly quiet social life. This all changed on my year abroad in Valencia, where I fell in with a large group of fellow British Erasmus students, and had a whale of a time. Final year was fairly pressured but I had some good mates and set up The Mind Matters Society, the university’s first mental health society.

I came away from the four years with a first, though I felt a bit hollow and ambivalent about it, perhaps a sign that my mood was changing. This would all spill over on a post exam holiday to Morocco, which you can read about in the following post, The Marrakech Express.

New petition seeks to align physical and mental health

A nationwide call to arms has been issued this week, known as ‘Equality for Mental Health‘. With over 200 signatories from Britain’s public eye, it is hoped that the campaign will finally make some headway into addressing the current imbalance between physical and mental health in this country.

It is a great idea to finally put some weight into parity of esteem, and goes beyond the ‘I wouldn’t get told to snap out of a broken leg’ maxim. The language is plain and clear – what we need now is for the Government and the NHS policymakers to go away and actually effect big changes.

The fact that it is a cross-party agreement also demonstrates that the current Government simply cannot sit on their hands about this. Pressure throughout the Commons will be placed upon the Prime Minister to act upon the issues raised in the statement.

There were roughly 200 signatories from well-known public figures but the stark reality is that it could easily have been 2000. Mental illness is so prevalent within our society and I think the 1 in 4 stat may be too conservative. After all doesn’t every adult go through anxiety, depression or grief? Perhaps they don’t use health services but a more accurate statistic may take some of the stigma away.

The petition was not without its faults however. It called for ‘the same right to timely access to evidence based treatment’ as physical health. Why not put a time period to the statement? Within 3 months of first registering symptoms? I once received a letter in the post 2 years after going to see my GP offering CBT, by which point I had arranged and completed a course of therapy with a private therapist. Using words like ‘timely’ just gives politicians the opportunity to hide behind them when called to defend their record.

It is also in the Government’s hands as to what happens when the maximum waiting point is reached and how any measures would be enforced. If it did become the case that certain areas were consistently generating long waiting times, would a task-force be deployed to help alleviate the problem?

What was rightly identified in the statement was that the health system is designed to underline inequality between physical and mental health. Now is the time to take action rather than tiptoe around the issue. Of course we need to ask why this is but nothing beats action.

And it is these celebrities who have signed the petition who need to stand up and do something about this. It’s not just a signature to yet another political plea but actually a commitment to a campaign which could change the lives of thousands of people. It’s about forming a network across the country of ambassadors for the cause. Such an agenda needs to go beyond your Ruby Waxes and your Stephen Frys. It means a dedication on the part of all signatories to help not only friends and family who are struggling but the millions in Britain fighting battles with mental illness.

The nation’s prisons are homes to people with mental illness, learning disabilities and autism and it could be argued that they would better be treated in specialist care. Indeed, the rate of mental illness in Britain’s prisons must be very high, I know in the US it’s in the high 80s. These institutions reproduce and perpetuate mental illness – just to glimpse them on TV is enough to know how hard life can be in them. Also, you certainly find this mixture of conditions on mental health units and think – should different treatment options be available to those with more complex needs?

It would be interesting to see how the Government currently spends on mental health and whether this petition will make a difference in terms of how much and on what. There are lots of good ideas coming from ‘Equality for Mental Health’, here’s hoping the movement for change carries on apace.

REVIEW Group Therapy: Mental Distress in a Digital Age

FACT, the arts centre in Liverpool, is currently hosting an exhibition examining the role of technology in our mental wellbeing. On the one hand, many new treatments and interventions have been enabled by digital developments. In a society so heavily dependent on tablets, smartphones and laptops, it seems only natural that people now look to these devices to help them feel better. On the other hand, with a constantly updating news feed on social media, increasingly immersive online games and new virtual reality technology that makes the real and the artificial more difficult to decipher, we are becoming more dependent on technology to take up our free time, interact with friends and in some cases define our reality.

So the new exhibition comes at a time that is both groundbreaking and concerning at the same time, and the exhibition seeks to present both sides of the argument to allow the viewer to reach their own conclusion. As you walk into the ground floor of the exhibition straight away you are greeted by a trailer for the 2011 film Consumed, which proposes that consumerism is to blame for mental illness. An interesting proposition that could be discussed at length in another post, but safe to say the frenzy of consumerism, the need to keep up with the Joneses and the constant desire for more could easily propel someone into mental illness. Whether it’s responsible for ALL mental illness remains to be seen.

We may well be offered an understanding of the roots of mental illness with We Feel, an experimental research tool you can browse through on a tablet which monitors 19,000 publicly available tweets for words such as joy, fear, sadness etc. The hope is that the researchers behind the tool will be able to build a map of society’s emotions. It might even be able to predict with more certainty times of year when a certain emotion may be felt, or where particular emotions are most prominent.

Technology has in the past been harnessed more directly to treat mental illness. The ECT machine on display serves as a ghostly reminder of prior attempts to cure asylum inmates. It got me thinking – will anything I use to help my mental wellbeing have such a ghastly legacy? Certain medications? Certain therapies? On a lighter note, will a cure ever be found? Perhaps there will always be people at the fringes of society, who do not fit into convention that will be classed as ‘ill’.

The Deviant Majority (2010) showed two groups who were proud of their outsider status. They were two psychiatric patient theatre groups, one in Trieste and one in Rio de Janeiro. What was apparent was the sense of humour that underpinned these groups, something so often lost in the mire of negativity, fear, doubt, anger etc. The members of the groups were treated with respect and dignity, and looked to live for what they were doing. Not only offering a sense of purpose but freedom of expression (the freedom to express the darkest corners of the psyche), these groups offered a tantalising glimpse of how mental discomfort can be alleviated without the need to resort to technology. There was also an interesting interview with activist Carmen Roll who spoke of ‘normalising’ psychiatric hospitals. A valid point – by separating the unwell into an unwell space, is this reinforcing illness rather than challenging it?

One example of how noxious technological remedies can be was Lauren Moffatt’s Not Eye (2013). The short film showed a female character who had developed a well-entrenched phobia of the gaze of others. She is distrustful of surveillance. In a bizarre attempt to insulate herself from these, she constructs a helmet which allowed her to see where she was going and have two cameras record what was in front of her. However, the helmet only intensifies the glare upon her, which she could still see. In a world where you want to disappear, it’s surely counter-productive to make yourself as conspicuous as possible. Perhaps it was a wider comment on the danger of letting new technologies grow to treat mental illness. One way or another, Moffatt succeeded in presenting a dystopian vision of the near future for mental health.

More successful technological solutions appeared in the form of several apps, including the Flowy app. Using one of the oldest methods of improving mental wellbeing, the app featured games that regulated breathing. This is a good example of fusing the old and the new to bring about better mental health. The Doc Ready app was also featured to prepare young people for a visit to the doctors to discuss their mental health. Practical interventions like Doc Ready and FACT’s very own In Hand (which offers motivational messages to those who report feeling sad) should definitely be encouraged. However, some apps have faced criticism for overstepping the mark when it comes to intervening in suicide prevention. The Samaritan’s Radar app was deactivated after many felt its tweet monitoring system for suicidal intent was an invasion of privacy and a worrying reminder that what we reveal online may be read by a host of companies, organisations and other third parties.

There was also what I thought a disturbing video of avatar therapy from New Scientist, where service users are encouraged to talk to a computer generated avatar that speaks to them with their own critical voices. Although the premise of separating out critical voices into a new, unknown entity is a good one, it seemed that this mediated therapy may serve to confuse and distort rather than to help those in need.

I decided to forgo Jennifer Kanary Nikolov(a)’s Labyrinth Psychotica, which sought through visual, auditory and olfactory means to replicate the effects of psychosis. Having more than enough experience to draw upon, despite curiosity as to how close it measured to the real thing (no pun intended), I thought it was best left to the uninitiated.

Group Therapy was a thorough, provocative examination on what it means to be mentally well and unwell in the digital age. Stretching across different media platforms and engaging people in both the forefront and periphery of technological responses to mental illness, exhibition goers were posed questions relating to otherness, identity, illness and recovery. The history of technology and mental illness was touched upon, but this was a meditation on the here and now in mental health terms, holding up a mirror to contemporary society, with its selfies, Tumblr posts and Bitcoins. It is great to see mental health treated with such detail and care in an artistic setting – here’s hoping FACT continues the good work.


NOTES

For futher discussion of the role of technology see my other blog post here which discusses the topic at length.

You may also find pertinent my post on the use of virtual reality to treat social anxiety.