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Health for all must include mental health

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Health for all must include mental health

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Health for all: why is mental health often left out?

With Universal Health Coverage (UHC) day upon us, and the launch of our mental health appeal, we take a look at how to make sure mental health is central to improving health worldwide.
Universal Health Coverage (UHC) means that everyone, everywhere should have access to quality healthcare without suffering financial hardship. While half the world's population still lack access to essential health services, we are even further away from achieving universal access to mental health treatment, care and support. Between 76% and 85% of people with severe mental health conditions in Global South countries receive no treatment at all for their conditions.

National health budgets in the poorest countries often allocate less than 1% to mental health. In fact, most countries across the world fail to spend enough on mental health services. This results in far too few mental health workers, and a huge gap in community-based mental healthcare - where people can be supported with a range of appropriate services, local to them.

Lack of funding for mental health services is a major reason people have so few options for care and support in the Global South, if they have any at all. Yet the lack of money for these governments to spend on mental health services is fuelled in part by decisions made by governments like ours. When governments in the Global North allow and enable global tax dodging by big corporations, for example, countries miss out on vast sums in tax which could be spent on public services - like quality mental healthcare.

For those people living with mental health conditions who are able to receive treatment and care, they often have to pay upfront for services. Yet having to pay out-of-pocket for healthcare prevents many people from accessing treatment they may need, and is a major cause of poverty worldwide.

The good news is this picture is changing. Many mental health services providing care through Community Health Workers in the Global South have seen real success and show great potential for expansion.

At Health Poverty Action we know that communities are at the heart of achieving good mental health, and are proud to be working with local people and health workers to help people receive the care and support the need. We are also working with governments to integrate quality mental health treatment and care into existing health services. And we are speaking out on the root causes of poverty and inequality, because we know that the way our world is structured undermines mental health worldwide.

Mental health is crucial to the overall wellbeing of individuals, societies, and countries. With the right conditions put in place, the right barriers lifted, and the right approach to mental health incorporated into UHC - where communities and people living with mental health conditions come first - we can help make good mental health and wellbeing a reality worldwide.
By Hamimu Masudi, Policy and Campaigns Officer for Health Poverty Action, based in East Africa.

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Health for all must include mental health | Health Poverty Action

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Health for all: why is mental health often left out? With Universal Health Coverage (UHC) day upon us, and the launch of our mental health appeal, we take a look at how to make sure mental health is central to improving health worldwide.

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Fact: Mental health issues can affect anyone. In 2020, about:

One in 5 American adults experienced a mental health condition in a given year

One in 6 young people have experienced a major depressive episode

One in 20 Americans have lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

Additionally, suicide is a leading cause of death in the United States. In fact, it was the second leading cause of death for people ages 10-24. Suicide has accounted for the loss of more than 45,979 American lives in 2020, nearly double the number of lives lost to homicide.

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Can you tell the difference between a mental health myth and fact? Learn the truth about the most common mental health myths and information to help destigmatize them.

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17 Mental Health Cheat Sheets That Everyone Should Have Bookmarked, Honestly

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17 Mental Health Cheat Sheets That Everyone Should Have Bookmarked, Honestly

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You never know when you or someone you know might need them.

For Mental Health Awareness Month, I thought it'd be nice to compile some of my favorite graphics to help you navigate and understand your own mental health and the mental health of others. I hope these help. 💖

YouTube / giphy.com

WARNING: Mentions of suicide, abuse.

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17 Helpful Mental Health Charts You'll Probably Want To Bookmark

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You never know when you or someone you know might need them.

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Illustrator Draws Humorous Comics About Her Mental Illness to Help Destigmatize It

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Illustrator Draws Humorous Comics About Her Mental Illness to Help Destigmatize It

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Humor is a powerful way to deal with the barbs of life. On its face, mental illness is nothing to laugh about, but illustrator Gemma Correll has used her biting wit as a coping mechanism for her own depression and anxiety. They take the form of relatable mental health comics and illustrations that allow us to commiserate with Correll, as well as many others who share her condition.

Statically, 1 in 13 people in the world suffer from anxiety, and depression affects an estimated 350 million people. Even if someone doesn't personally know what it's like to feel the way that Correll depicts, it allows them to better understand the struggle.

By pointing out the perils of dealing with mental illness, Correll is also de-stigmatizing it. With her humorous, charming illustration style and clever one-liners, it's no surprise that her work is very popular. As it goes viral online, people from around the world better know the dread of a phone call, excessive worrying about worrying, and the mental spiral that one negative comment can bring. Their presence also creates an open dialogue on brain health, and best of all, people realize that they aren't alone in these feelings. "I think that it's a lot more prevalent than people realize," Correll told Mashable. "I know that I would have felt a little better as an anxiety-ridden teenager if I knew that I wasn't completely alone in my fears."

Gemma Correll's charming mental health comics bring lightness to a dark place.

Gemma Correll: Website | Tumblr | Facebook | Instagram
h/t: [ Bored Panda]

All images via Gemma Correll.

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Illustrator Draws Humorous Comics About Her Mental Illness to Help Destigmatize It

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Humor is a powerful way to deal with the barbs of life. On its face, mental illness is nothing to laugh about, but illustrator Gemma Correll has used her biting wit as a coping mechanism for her own depression and anxiety.

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Este cartoon está dividido em dois retângulos do mesmo tamanho na horizontal. No primeiro retângulo, há uma garota vestindo uma blusa azul com estampa de corações, ela está sorrindo. Ao lado da sua cabeça há um balão de fala que diz "You're always so positive and happy!" saindo da lateral do cartoon, o que indica que essa fala é de alguém que não está sendo ilustrado no cartoon. E a menina responde "Yeah". No retângulo de baixo há um desenho da mesma garota, dessa vez de costas, e ela está dizendo "Thank you" para o comentário do primeiro quadrinho. Podemos ler alguns balões saindo das costas da garota, esses balões são da cor azul escuro e têm um formato e design assustador. Dentro dos balões estão escritas as seguintes expressões: "Imposter Syndrom"; "Anxiety"; "Self doubt"; e "Depression".

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Mental Health treatment cartoon by crazyheadcomics

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Mental Health treatment cartoon by crazyheadcomics

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Este cartoon está dividido em dois retângulos do mesmo tamanho na horizontal. No primeiro retêngulo há uma garota loira, de cabelo liso e com a pele branca usando uma blusa azul e da boca dela está saindo o balão de fala que diz "how can you put all that pharmacutical crap inside you? natural is the way to go, those pills will do more harm than good". No retângulo de baixo, há uma garota preta, de cabelo crespo e preto, usando uma blusa verde e da boca dela também está saindo um balão de fala que diz "how can you believe in these ridiculous natural remedies and alternative medicine? that garbage does nothingg and you need proper meds".

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Mental Illness Is More Visible Than Ever Yet The Stigma Remains The Same

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Mental Illness Is More Visible Than Ever Yet The Stigma Remains The Same

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When you think of someone with a mental illness, what type of person comes to mind? You might conjure up an image of a homeless person, or a drunk- someone disheveled and on the fringes of society. You probably don't think of your friend, your neighbour or your work colleague and yet I'm sure you know someone who has an undisclosed mental health issue. Mental health is an issue talked about frequently online and in the media- with many posts and campaigns urging people suffering with mental ill health to "just talk to someone". However our society is not educated on mental health and the stigma has remained the same. I'd argue it's even dangerous to urge people suffering to just talk to someone because many people will give harmful advice and quite frankly just not have the tools or knowledge to support someone who's struggling.

It leaves people suffering with mental health in an incredibly isolated position. Not wanting to tell friends or family because of the stigma and not getting access to treatment because of the atrocious NHS waiting times. According to the NHS Digital Study in England mental health problems are on the increase and yet it is one of the most underfunded parts of the NHS. 23% of NHS activity is taken up by mental illness but mental health trusts have been receiving only 11% of funding in recent years. I've been on the waiting list for therapy for over a year and a half and I don't think I'll be getting treatment anytime soon. This lack of support has of course made my condition worse and I've had little support from friends or family either; instead I've faced a lot of opposition.

The way mental illness is treated and viewed needs a radical rethink. We can't just view mental health/mental illness as an issue that is excluded from the larger picture. We have to look at all facets of life and all facets of ourselves as human beings. We have to look at psychology, spirituality and conciousness as well as biology and physical aspects. We must examine the society in which we live and why mental illness is such a huge problem within it, we can't address the stigma without addressing the society that we've created the stigma in. Society's beliefs around mental health and mental illness need to be completely re-evaluated. I believe we should get rid of the term mental illness itself as it's so loaded and negative. It conjures up a feeling that people with mental health struggles are sick and defective. The way mental health models are being used in this country right now is to focus completely on the symptoms and pathologise people by diagnosing them and sticking them in boxes. Often times depression and anxiety are normal and appropriate reactions to difficult life circumstances, even personality disorders are normal reactions to childhood trauma and issues from the past yet mental health professionals place all the onus on your current symptoms and they treat those symptoms as "wrong" rather than a normal reaction to whatever has gone on in your life. They don't see a person, they only see symptoms and that will not lead to healing.

When I was 16/17 I was reaching out for help with my mental health. I'd had some counseling and CBT and they were constantly trying to diagnose me and figure out "what was wrong with me" because I was self-harming and taking drugs etc. (I'll spare you the gory details). I had these awful symptoms and the whole focus was on me- there must be something wrong with me because I'm doing these things. As I've grown older and can look back at what was happening to me at the time I see that every symptom I had was a normal reaction to the circumstances of my life at the time. I lived in an abusive home with my mother, and I couldn't escape. My father and grandmother were aware of the situation and let it happen. I had no one. Of course I was in despair and self-harming and trying to escape my experience with drugs. It doesn't take a genius to figure that out but if I hadn't done a lot of research myself I could still be in that place of "oh it's just me", I could still believe there's just something wrong with me rather than what was happening to me. I don't have any of those symptoms anymore because I'm no longer in that situation. I have residual effects of the trauma, but that's to be expected. I'm truly shocked that no one working with me at the time could connect the abuse I was suffering with why my mental health was so awful. If doctors and services can't see people struggling with mental health issues as complete people then they will never heal them.

Many times, mental and emotional problems can be caused by things that aren't an obvious trauma but just the general dynamic of one's family and childhood. Things like covert emotional incest, parentification and emotional neglect are all things that run rampant in family systems but that we are not taught about. Unless you go out of your way to educate yourself you're just not going to have this knowledge. Often it's the case that many people think they had perfectly happy and healthy family lives/childhoods yet are experiencing all these issues in their personal and emotional lives. They assume it must be something wrong with them since most of us have little grasp of psychology and how certain things can continue to affect us into adulthood. In the words of Carl Jung "Nothing influences children more than the silent facts in the background".

As well as examining someone's childhood, life experiences and personal life we also have to examine the larger society in which we live. We live in a capitalist society where we have to pay to live- that's pretty anxiety inducing, especially if you don't fit into that system very well. There are many societal factors that impact people's mental wellbeing that simply aren't talked about in a clinical context. Women and BAME (Black & Ethnic Minorites) are massively over represented within the mental health system; I have no doubt that the everyday effects of sexism and racism have something to do with this, and yet mental health practitioners focus purely on the individual and their symptoms- never considering their environment and the potential effects of it.

We have to ask the question - is our society conducive to mental wellbeing?

I truly believe most people live with a low grade depression that simply becomes the background radiation of their lives. We've created a system and society where most people function "well enough". They go to work, they have a job they don't really like, they get drunk on the weekends. Is that really living? Sure they're functioning but are they happy? Generation Z (those of us born from 1995-2009) is significantly more likely to report their mental health as 'poor' and more likely to have received some type of treatment regarding their mental health. Money and work has been noted as at the top of the list of significant stressors for this generation, and with good reason.

However, as I've noted before it's not only people diagnosed with mental health issues who are struggling. 84 men per week commit suicide in the UK. Just take that in for a moment. That's an alarmingly high number and quite frankly it's completely unacceptable. Usually these are men who "seem fine" to everyone around them, they haven't sought help for any mental health struggles and we really need to address why. Perhaps they see the way people with mental illness are treated and don't want to go down that route. The biggest killer of men under 45 is suicide. The tragic deaths of these men should be sending us a huge message- we need to radically change not only the mental health system but our society at large. Many of us seem to be silently struggling, it's just that people who seek help for their mental health are brave enough (or maybe just fed up enough) to speak out about it.

Sculptures from "Project 84" to raise awareness around male suicide in the UK.

The cost of university, housing and basic amenities have all gone up and don't seem to be stopping. The fact that homelessness is still a massive problem speaks volumes about where we are as a society. People with mental health issues are often times incredibly vulnerable and can easily end up homeless, involved with drugs or in jail. According to The National Alliance on Mental Illness - 2 million people with mental illness are booked into jails each year, with nearly 15% of men and 30% of women booked into jails having a serious mental health condition. They state that in a mental health crisis people are more likely to encounter police than get medical help. We don't value people, we value their productivity- hence the massive stigma of not working even if you have a perfectly valid reason. In a society that values work and money above all else where does that leave the people who simply can't participate? To not be able to work, or cope with the everyday stresses of modern life is to admit you've failed, which most people simply won't do. We all want to be accepted, even if it means being unhappy, but some of us simply can't pretend. There will always be people with mental health struggles, people with disabilities who simply can't participate in society in the way we're all expected to. Historically society's answer has been to lock them away in institutions and ostracise them from society, simply pretend they don't exist, and it isn't much different today.

When I try to open up about my mental health struggles and the fact I struggle with complex PTSD I usually don't get anywhere. It ends up being me trying to educate people on the condition and justify why I'm not working at the moment because of it. The fact that my doctor has signed me off work doesn't seem to be enough for them. Any time I've opened up about my mental health I've been met with judgment and not support. I think the way we picture people with mental illness has a lot to do with this. Because I dress nicely and present well people can't seem to believe I have any issues. Mental illness is just as real as physical illness and yet we say things to people struggling with their mental health that we would never say to someone suffering with their physical health. "Get a job", "Just think more positively", "You need to get over it" - these are things we hear constantly.

According to The Mental Health Foundation people with mental illness are amongst the least likely of any group with a long term health condition or disability to:

*Find work

*Be in a steady, long term relationship

*Live in decent housing

*Be socially included in mainstream society

In Britain we live in a society built on colonialism, we live in a society that was founded on the backs of slaves and that's wealth was amassed from stolen resources from other countries. This is the foundation of our society today and it runs through every institution we have- which means it also runs through every idea and system within the society- however subtle or minute. Britain notoriously doesn't seem to have come to grips with its colonial past either. We are not taught about it, there are still statues of slave owners outside of prestigious universities in London. What does this have to do with mental health? Well, a society built on such a violent foundation is not an empathetic society. It's not a society that cares about its people (or any people for that matter). It's also created a superiority complex around Western thought and especially Western medicine. Even though historically Western medicine hasn't actually been around for that long we seem to believe it is the only way and the best way to treat everything. We won't even entertain alternative or more holistic remedies. As a colonial society we view Western medicine as the pinnacle of knowledge and we view things like Chinese medicine (which has been around for thousands of years)and traditional herbal remedies and ideas as primitive, especially if they come from what we consider to be third world countries.

The society that went over and killed and enslaved these people views them as primitive. In more traditional medicine the whole person is considered- for example with Chinese medicine yes they give you herbal supplements to take but they'll also prescribe things like meditating, taking walks in nature and socialising with friends. They take into consideration all facets of the human being. The treatment of the mentally ill in the west has historically been a pseudoscience and I would argue it largely still is. During the Victorian era the mentally ill were locked away in mental asylums and subjected to horrifying abuse. Common treatments included electric shocks, labotomies and insulin treatment. Insulin treatment involved injecting large doses of insulin into the body to induce a coma. The thinking was that this would allow the mind to completely relax and reset upon waking. Padded cells and straight jackets were also routinely used in these institutions. We seem to believe this is all in some distant past but there are still people alive today who experienced this.

These asylums often had their own farms, shops and sometimes even railway stations. They were designed to make sure the patients had no access to the larger community. In the BBC documentary Mental: A History Of The Madhouse, a psychiatric nurse named Tom Booth who practiced from 1954-1995 at High Royds asylum said:

"A lot of patients were socially inadequate. Not strictly speaking mentally ill. Not disturbed or hearing voices. Not suffering from delusions. No disorders at all- simply inadequate and couldn't cope. They weren't wanted and High Royds was a convenient place for them."

High Royds Asylum

We look back at how mental health was treated in the past with horror. The methods used seem barbaric and ineffective to us now and I'm going to argue that in 100 years from now we'll look back at how we treat mental health today with shock and disbelief. The absolute disregard for mental wellbeing in this country is unacceptable. Having a serious mental health condition and waiting almost 2 years for treatment with no support or buffer service in between is not acceptable and yet it's happening all the time. A Guardian investigation into the NHS mental health services found that 271 highly vulnerable patients died between 2012 and 2017 after 706 failings. I don't doubt there have been many more since.

The model we're using for mental health in this country simply isn't working. The very idea of mental illness itself is deeply flawed and could be applied to anyone who can't fit into the system or thinks differently than the narrow confines of our society allow for. The way we are viewing mental illness is wrong. Ultimately it's not just about the individual it's about the whole system. If we're not going to address the way in which our society is causing these illnesses we'll never get anywhere. I'd argue we also have to take it a step further than society and the system we live in.

Our understanding of the mind, the psyche and mental health is still very limited. The fact remains that we don't know that much about the physical world let alone our soul, mind, consciousness, and spiritual landscape- and how they all intersect and affect each other. Let's consider the fact that 95% of the world's oceans remain unexplored and 99% of the ocean floor is unexplored. If we think of our soul, mind, and consciousness as an ocean, how much of it do you think we've explored? Our understanding of mental illnesses such as depression and anxiety may have improved, and I would argue are largely created by the society we live in, we still remain in the dark about more complex issues such as schizophrenia and psychosis. These illnesses are widely misunderstood and even feared by the public and medical professionals alike- perhaps because they remind us how little we actually know about our reality.

From a spiritual and philosophical point of view we really don't know why we're here, we don't know what we are in essence. We have some theories and and some ideas. We have religion and we have science, but we still don't have concrete answers. We're thrown onto this planet in the middle of this black universe and we're thrown into the current system that was put in place before we were born- which for us is capitalism and a society built on colonialism. We take that as normal and we take on the values of the society we're born into without ever really questioning them until it becomes absolutely imperative for us to do so. Having a mental health problem is a prime example because you suddenly realise nobody actually knows what they're doing. Most mental illnesses are treated with a combination of talking therapies and medication, to varying degrees of success. But how can we attempt to treat these illnesses when our understanding of ourselves as human beings is so limited?

The observable universe, by NASA

Essentially we are all having an existential crisis, but things like a 9-hour working day, drinking, shopping, and television cover it up. I'd argue most of us are mentally unwell to some extent as it's almost impossible not to be in this society where your worth is tied to your productivity. Where does that leave people who are disabled or who simply function differently? On the fringes of society where we've always been. I think the concept of mental illness also relies on the concept of a "default human" who is productive and sociable and *insert whatever other quality is deemed normal. That in itself is a fallacy, we are all unique and different. We should be working to create a society where that is not only accepted but celebrated.

The fact that by simply perceiving something out of our physical reality can land you the label "crazy" should scare us all. I've had psychic dreams and visions since I was a young child but would rarely ever tell anyone about it because I already knew from a young age that I wasn't supposed to talk to anyone about things that were out of the ordinary. It still scares people now. I remember being with my ex boyfriend one evening and telling him his boss was going to have a heart attack the next day- I'd seen it in a dream in vivid detail. He responded by telling me "not to talk about things like that" because I was scaring him. The next day he called me, he was at work and his boss had had a heart attack. It happened exactly how I described in my dream and I wasn't surprised. Spiritual and psychic phenomena have been around since the dawn of time and yet mainstream science doesn't want to go anywhere near the subject. This in itself suggests that there is so much more to the human psyche and to our reality than we can comprehend. Mental helath treatment comes at one angle and it's usually a physical one. They don't consider the whole of the human being- we must encorporate and consider all facets of someone being treated.

We have to consider and be open to the possibility that perhaps some people with psychosis or schizophrenia are actually perceiving other realities most people simply can't pick up on. Many people have psychic and supernatural experiences but never tell anyone about it because they don't want to be labeled insane. Hearing voices and having hallucinations can also be valid reactions to trauma and are largely misunderstood. "Hearing voices or feeling paranoid are common experiences which can often be a reaction to trauma, abuse or deprivation. Calling them symptoms of mental illness, psychosis or schizophrenia is only one way of thinking about them, with advantages and disadvantages"- The British Psychological Association: Understanding Psychosis and Schizophrenia. Tribal and shamanic communities treat mental illness (and mentally ill people themselves) completely differently than we do. They consider them as "a bridge between worlds" with important and special insight to give to the tribe. They include them in everyday life and value them as members of the community.

"They (shamanic cultures) have a cultural context. The physiological crisis, although it's difficult they put it in a positive light. It's something the person is going to come out of and be stronger for in the end, and have more abilities. The other thing that's a big advantage is it's not stigmatized" - Phil Borges, film maker.

In the shamanic view mental illness signals the birth of a healer. They believe that people who become what we see as mentally ill, and what they see as shamans are naturally more sensitive and that their senses have not been anaesthetised which allows them to be a suitable bridge between this world and the spirit world. Malidoma Some- a West African shaman explains that in his culture they do not view the symptoms as something that must be stopped, but as something that must be worked through. The shamanic approach is to work on aligning the person and getting rid of any spiritual blockages so that they may become the healer they were meant to be. Eleanor Longden, a patient diagnosed with schizophrenia explains how viewing her auditory hallucinations as a negative symptom only made her experience worse: "Having been encouraged to see the voice, not as an experience, but as a symptom - my fear and resistence towards it intensified. Now essentially this represented taking an aggressive stance towards my own mind - a kind of psychic civil war, and in turn this caused the number of voices to increase and grow progressively hostile and menacing".

I'm not suggesting that everyone experiencing these types of symptoms are actually having some kind of cosmic experience and is a shaman in the making, as stated before there's lot of different explanations for these symptoms from natural reactions to trauma and abuse to a legitimate issue with the brain. However I think some of these people are accessing other dimensions and realities most of us can't, and we need to be open to that possibility. It's all down to the individual and we have to view it on a case by case basis, we can't really generalise here. Being open to these possibilities will lead to a whole new era in how we view and treat mental health, and perhaps how we view ourselves and the universe. "The only true wisdom is in knowing you know nothing" - Socrates.

Western medicine has not been around for that long in the grand scheme of things and yet we view it as the pinnacle of knowledge. For example, traditional Chinese medicine has been around for thousands of years and yet is looked down upon by the west. They consider the energy systems of the patient, their emotional and social life, and as well as prescribing herbal remedies they also prescribe things like meditation and taking walks in nature. Shamanic and tribal communities treat mental illness in a similar way, with an emphasis on community, nature, and joy. We seem to regard these ideas as primitive and useless but I believe we have much to learn from these cultures; to truly see their wisdom it will take some reviewing of what we deem respectable or a legitimate source of knowledge. I'd just like to point out some differences in their way of life vs ours: They are self-sustainable whereas we rely on the government and other institutions for most of our needs; they have a deep connection to the earth and the universe and to each other; they harvest food and hunt and are in touch with the seasons and stars. They're in touch with all these things we are so disconnected from. We live in a very artificial society (especially if you live in a city). Not only have aboriginal and tribal people been around much longer but they live in a sustainable way that doesn't harm the environment. We live in a way that completely destroys it.

Who is really more primitive? It makes you wonder about how they may also be more connected to their own consciousness, mind, and spirituality. Britain colonised these countries and murdered their people; you can't do that to the earth and it's people and expect to have a healthy, thriving society. What's more you can't expect the ideas that come from that society to be healthy or right or even beneficial.

"We had a lot of trouble with western mental health workers who came here immediately after the genocide and we had to ask some of them to leave. They came and their practice did not involve being outside in the sun where you begin to feel better. There was no music or drumming to get your blood flowing again. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out again. Instead they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to ask them to leave" - A Rwandan talking to writer Andrew Soloman.

We must open our minds when it comes to mental illness, and we must prioritise community, joy, and a connection to the earth. We need to stop seeing "mentally ill" people as defective and simply respect that they are different. We have to build a society where mental wellbeing is a priority for everyone- no matter their abilities.

Today we use talking therapies and medication to varying degrees of success. Being mentally ill is still surrounded in stigma and mentally ill people are still locked up in prisons and hospitals. The NHS is failing in terms of mental health and so is society at large. Mentally ill people are more likely to be isolated and fall into crime and drugs. Being isolated has serious and long lasting health risks- socially isolated people are 40% more likely to die an early death than the general population. An Australian survey reported that two thirds of people affected by a mental illness feel lonely "often" or "all of the time", in contrast just 10% of the general population reported feelings of loneliness. We have to stop pushing people with mental health issues on to the fringes of society, we have to change the system so that it can include all of us.

I met up with my friend Alex who is a 23-year-old university student who struggles with mental health issues to get her perspective on mental health stigma and how we treat mental illness in this country. We came onto the topic of the suicide of Mike Thalassitis from reality TV show Love Island. Many people have been sharing condolences on social media and posting suidice hotline numbers as well as posts such as "my dms are always open if anyone is struggling". We discussed how this just isn't good enough and the fact that people around him were unaware of his suicidality speaks volumes about how much the general public need to be educated about mental health.

"Someone shouldn't have to come to you. It's very difficult to say to other people that you're not doing great. I don't really mention it to my friends, they'd probably have to me but when I'm in a really really bad place I'm not messaging them. It shouldn't be people saying 'my dms are open'. Be open and honest with your friends and notice things - if they aren't replying or withdrawing. It's something we all need to learn how to do a bit better; which is to reach out to other people first and educate yourself, learn about what these things are. Everyone knows what anxiety and depression are and there's obviously a stigma but as soon as you mention anything else they don't understand what it is."

We spoke about our individual experiences with the NHS and the different services it offers. Alex expressed her frustration at calling an NHS crisis line. "The first time I rang they didn't answer the phone. You couldn't make it up. I rang about an hour later and someone answered after leaving a message. I said I was feeling suicidal and don't know what to do. I was waiting for an appointment but I needed to see someone as soon as possible. They said they'd get a primary care worker to ring me and they asked if I was around people. They told me to distract myself and said they'd get her to ring me in the morning. That's just too long. I should never ever have to ring a crisis line if I've been going to appointments and saying 'help me', it should never get to that point".

Capitalism doesn't allow for people with disabilities or mental health issues and as a result we have a system that simply doesn't know how to handle them. We don't value people, we value their productivity so how can we value people we deem mentally ill? Many people with mental health problems are amazing artists or thinkers and have lots of different talents but we simply don't value those kinds of things. You tell someone you're an artist or musician and they say "get a real job". I had an old friend who didn't work due to serious mental health issues, she told me she would tell people she was on a gap year if anyone ever asked because she was tired of justifying herself and the gap year excuse was an acceptable answer. She had had a psychotic break and needed to have the most stress-free life possible, but still people would ask when she'd be getting a job.

Ending stigma towards mentally ill people means we need to restructure our value system completely. Having such a rigidly structured system creates mental illness because if you don't fit into it you assume there's something wrong with you rather than the system itself. A system that can't adapt and accommodate to everyone's unique needs and abilities is not a system I want to be a part of. As I said before, I think this sysyem makes everyone unwell. We all need to come together as a community and place the proper importance on our mental wellbeing. We should all have relationships that are emotionally close enough to be able to say we are struggling rather than pretending everything's fine.

"It is no measure of health to be well adjusted to a profoundly sick society" - Jiddu Krishnamurti

Here's some ways to help people who you know are struggling. There's no point telling people to reach out if we're not going to educate people on how to respond and how to end the stigma. Many people won't disclose their mental illness on job applications because they know it will affect their job chances badly, some people won't even tell their significant other or close family. The stigma and the effects of the stigma itself can make our illnesses that much worse and more isolating. I don't reach out to people on bad days, I keep it to myself and I stay home because I know that being judged for how I'm looking after myself will make me feel even worse. If someone you know has come forward about their mental health struggles then you need to recognise that it probably took a huge amount of courage for them to do so. Here are some ways you can support them:

Just listen to what they're saying. Respect the amount of info they're willing to put forward and don't push them for anymore.

If they have been signed off work then they've been signed off work. I'm pretty sure their doctor knows better than you do. Even if they don't have anything official, trust that they know what they need to do to heal. Don't push them to do things they simply aren't ready for. That includes socialising or whatever it is they find difficult/triggering.

We all like to think we know what's best for the people around us but most of the time we just don't. Trust that they know what is best for them and their condition.

Some people with mental illness can work, some can't. Some can socialise frequently and some can't. Everyone's different and just because someone is highly functioning in one way doesn't mean they're highly functioning in all aspects of their life. Remember that you probably don't see the breakdowns and bad days- you probably see the good days. Mental illness is largely invisible but that doesn't give you the right to deny it.

If they have shared their diagnosis with you then read up on it and educate yourself. You'll probably understand a lot more about their behaviour and the issues they're facing- plus it's just a great way to show you actually care. Bare in mind that info around certain conditions (such as BPD) can be incredibly negative because they are highly stigmatized. Stick to reliable sources on mental illness such as Mind and the NHS.

As stated throughout the article most people suffering with mental health issues are incredibly isolated and this has hugely negative impacts on not only mental health but physical health too. Invite them out, even if they don't come. Call them, message them, let them know you care. Make sure they don't become just another statistic.

The way we talk about and view mental illness needs to be completely changed, as does the mental health system- but all we can do as individuals is educate ourselves and listen to the voices of those suffering. My journey with CPTSD and trying to get help has been an incredible struggle and I still don't have all the support I need. I've never felt more judged in my life than when trying to access mental health services and when telling people I'm not working. I've faced judgement not only from friends and family but from mental health practitioners themselves. In an initial assessment at a well respected mental health facility I told the woman interviewing me about my struggles with work and why my Dr. had signed me off, she responded "lucky for some" as if it was some kind of personal life choice rather than the result of my illness. She also went on to comment that I "looked very well". The way I look/present has absolutely nothing to do with the state of my mental health and dealing with people not believing me on top of the struggles of CPTSD and trying to get treatment feels unbearable at times.

It's society's job to fight for the rights of those who can't, but sadly the only people speaking up are the ones who are suffering.

I sincerely hope that we can start treating people with mental illness with more compassion and empathy. We need to respect everyone's differences rather than trying to get them to fit the mould society has set out for everyone. The nature of our capitalist society creates stress and mental illness as it is- implying our worth lies in our productivity and how much we earn. We need to start valuing people for who they are not what they do. If you know someone with a mental health problem then reach out to them, read up about their condition and start advocating for change in the mental health system but also change in all aspects of society.

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Mental Illness Is More Visible Than Ever Yet The Stigma Remains The Same

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When you think of someone with a mental illness, what type of person comes to mind? You might conjure up an image of a homeless person, or a drunk- someone disheveled and on the fringes of society.

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Neste cartoon, há duas personagens e ambas estão no que parece ser uma recepção de escola. A primeira personagem é uma adulta e é funcionária da escola, a pele dela é escura e os cabelos brancos. Ela está usando uma blusa azul escura e segurando uma caneta, ela está sentada atrás de um balcão. Esta personagem está se dirigindo à segunda personagem com a seguinte pergunta: "You're unwell? You're not even running a fever". A segunda personagem é uma adolescente e está trajando o que parece ser um uniforme escolar. A pele dela é branca e ela está usando um rabo de cavalo. A expressão dela é de cansaço e ela está arrastando um grande saco cinza pra fora de uma porta onde lê-se "School Nursing". O saco cinza tem uma etiqueta escrito "anxieties" na boca e dentro do saco podemos ler as palavras "grades, pandemic, relationship, social media, elections, college apps".

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Mentally Interesting: I couldn’t hold my baby

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Mentally Interesting: I couldn’t hold my baby

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This is the full transcript of Ouch - Mentally Interesting the cabin fever podcast as broadcast on the 20th April 2021, and presented by Mark Brown and Seaneen Molloy.

jingle - BBC Sounds: music, radio, podcasts.

[Music]

Mark - This is Mentally Interesting, a podcast series for BBC Ouch. I'm Mark Brown.

seaneen - And I'm Seaneen Molloy. We've been friends for ages. We've got years and years of personal and professional experience of mental health between us. And we're here to talk about the awkward stuff so you don't have to.

Mark - And oh my gosh is it awkward. Each episode has a broad theme; this time it's growth. If you've not listened to this podcast before then we've probably got a little bit of back story to fill you in with. Seaneen, my co-host, has recently given birth to her second child. I recently lost my sister. And Seaneen today is going to be taking the time to fill us in on her mental health journey since her young baby arrived. What's the young baby called, Seaneen?

seaneen - He's called baby Jack, which is a startlingly normal name considering his parents, but there you go. He has got Cantona as a middle name so that kind of helps.

Mark - He hasn't, has he?

seaneen - He does, yeah.

Mark - Was that your choice?

seaneen - No, that was Robert. It's Jack Dahay Cantona Beasley.

Mark - That is incredible. So, what have you got coming up in this episode, Seaneen?

seaneen - Well, as well as lots of me and Jack Cantona, we'll be joined by artist and mum of two, Kate Lovell to continue the chat about parenting with a mental health diagnosis. And we'll finish with a cringey conundrum from the Book of Awkward Questions. If you want to get in touch, ouch@bbc.co.uk is the email address, and we're also on Twitter and Facebook @bbcouch. We want to hear your thoughts, your questions and your stories too.

[Music]

seaneen - In our last but one podcast I left you on a cliff hanger about the COVID test. Dah, dah, dah it was negative.

Yay. So, I'm going to talk a little bit about what happened next. Some of this stuff can be kind of heavy. I just want to say I'm okay to talk about it because I already have a diagnosis of mental illness bipolar disorder, that means that the mental health team were involved basically since the moment of conception. They were right there watching - no, they weren't. But I've been with the perinatal mental health team the whole way through. The perinatal team are like a specialist crack squad of professionals who understand that being mental in pregnancy is a little bit different, and also that pregnancy can cause you to become a bit mental in a different way. I didn't think I was going to get ill because I thought I've got the perinatal mental health team and I'm on medication, I've got a great husband, but I did and it happened extremely quickly. So, basically I went from one hour being like oh, I'm sick of these visits from the perinatal team, I just want to be left alone, there's nothing wrong with me, to an anxious delusional mess. It happened extremely, extremely quickly. So, I got completely convinced that I was going not die of a blood clot, and I was also convinced that Jack was going to die, not in a kind of way that I could be reassured or talked down, but in a way where I was crying and screaming and couldn't sit still. So, that happened extraordinarily quickly and I didn't expect it to, because everyone was looking out for mania or psychosis or depression, but I did not know that you could be hit with anxiety like that. It was completely all consuming. And that was a bit of a shock, even for me, seasoned mental with 20 years' experience it was a bit of a shock, for everyone, because I had been doing so well.

Mark - So, what happened then?

seaneen - The crisis team and psychiatrist came out and basically my medication, I was on an anti-psychotic medication, was ramped up to the max and diazepam was also added, which I was kind of surprised about because my diagnosis has kind of shifted around over the years, like from bipolar to borderline personality disorder, back to bipolar again. And if I'd still had a borderline personality disorder diagnosis I think one, I wouldn't have had the perinatal team, and two, they wouldn't have given me diazepam because they're very, very reluctant to prescribe any sort of medication to people with BPD, borderline personality disorder. So, I was even in my state going isn't it good not to have such a stigmatising diagnosis and wouldn't it be crap if I still did because my treatment would be totally different and they wouldn't have taken it so seriously.

Mark - Yeah.

seaneen - They did take it very seriously, so they hoicked up my medication to the very top and diazepam, which I really hoping it was gonna kind of space me out and I'd be very...

Mark - Floaty.

seaneen - Floaty.

Mark - With a lovely come down.

seaneen - Yeah, didn't touch the sides. Really disappointed. I thought, you people sell this? Nothing's happening. Diazepam, for the people who don't know, is a benzodiazepine which is a class of medication that can make you feel really chilled out. You might have heard of Valium, that's the most famous one of those. It's meant to make you feel really chilled out and relaxed. It's often used for people who have a lot of anxiety, or you might more hear of it for people who have things like they're worried about taking flights or about having dental treatment.

So, yeah, it was hoicked right up and I was basically staring at my child all the time, frightened to leave the room in case he died, frightened to leave the room in case I died. It was not fun at all. And with the medication being increased so quickly I was hit with severe, severe side effects. But on the plus side I do now have a new sofa and recliner because it took me a while to realise what was happening was side effects; I thought it was my furniture. I thought, this is a really uncomfortable sofa. I've only just realised how unbelievably uncomfortable this sofa is.

Mark - Psychiatric medications often do have side effects. What were the particular side effects of these ones on top of the world collapsing terror?

seaneen - I had a restlessness that was so severe I couldn't sit down, which is why I got new furniture - in case anyone thinks the BBC are paying me loads of money. I got them second-hand off street marketplace. I also started to have trouble moving my arms, and I had extremely bad restless legs. Again, thought it was something else. Bought loads of magnesium spray which apparently is good for that; sprayed it everywhere. I couldn't hold Jack, I couldn't sit down long enough to hold him and I couldn't move my arms properly so I couldn't get him into a proper position, they were really stiff. So, that was rubbish because it's kind of important to try and bond with your child, and one of the ways you do that is by holding them. So, because I wasn't doing those things I was also very determined I was going to do the night feeds because I could be a better parent when I was horizontal. So, I wasn't getting a great deal of sleep either, which obviously wasn't helping the insane anxiety. I had another side effect which wasn't good for bonding, which it's called parkinsonism, but what that means is that you look like a mental patient. Your classic One Flew over the Cuckoo's Nest mental patient look. And with me wearing a dressing gown basically constantly for a month really had topped it off. It means you - I say you, I - I couldn't walk properly; I was shuffling around. And I lost my facial expressions. So, couldn't hold my baby, when I did I couldn't make faces at him. And all through this I had a raging infection which I didn't realise until I landed myself in A&E.

Mark - This is a bit much to go through. How did you get through it? How are you getting through it?

seaneen - I'm starting to feel better. The medication did help. The side effects did not help, but on top of the medication I was taking was propranolol which is good for your physical symptoms of anxiety. And I eventually started lowering the dose of the medication down, which they were very, the psychiatrists and nurse were very, very not keen on me doing because of the risk of relapse, but I could not continue having those side effects. I wasn't prepared to take it anymore. But just gradually my anxiety started to decrease a bit. And now I feel anxious but not to the same kind of quasi delusional level of anxiety that I had.

Just to say I did lower the dose and cut down under the supervision of medical professionals. I didn't just do it off my own bat. If you have any issues with your medication talk about it with your doctor. I take no responsibility whatsoever for anyone's medication decisions or choices. I feel a bit robbed. I feel a bit like I got mugged from my first golden month. And now I'm slightly in the back of my mind worried that I've somehow damaged Jack by not being a very expressive, engaged parent for the first six weeks of his life. But I don't know.

Mark - I don't know. I grew up in Newcastle and I've turned out vaguely all right, and I'm sure there weren't too many facial expressions apart from grimacing and fag smoking when I was a bairn.

seaneen - But I do feel lucky because if the perinatal mental health team hadn't already been there I don't know what would have happened, because the reason they found out about the anxiety was Robert basically hit the emergency button. But at the same time they were seeing me anyway. But I had deteriorated so quickly that Robert did need to do that; he couldn't wait until they visited later that day anyway. But I live in the only trust in Northern Ireland who has access to that kind of support, so I feel lucky, even though I went mad. I'm an optimist, man!

Mark - Yeah, evidently, because that sounds absolutely awful and terrible. So, if any of you at home have anything to add to this discussion then please to email us at ouch@bbc.co.uk. We'd love to hear from you. You hear from us a lot, we'd love to hear from you more.

[Music]

MARK - You're listening to Mentally Interesting with Mark Brown and Seaneen Molloy. Still to come we have another clanger from the Book of Awkward Questions. But before that joining us now is Kate Lovell.

kate - Hi.

Mark - Hello. Kate is a writer, theatre maker and mum of two young daughters, and she also had a baby in the pandemic.

SEANEEN - I was going through all this terrible anxiety with a six year old in the house and a newborn. Do you explain mental health or your diagnosis to your children? How do you kind of experience mental health around them?

kate - This is really present for me at the moment. In fact I was having discussions with my three year old about it at the weekend. But it's the first time that I've tried to explain that I have bipolar disorder and what that is. And I felt quite nervous about broaching it because there is ultimately this innocent three year old and telling her about the darker sides of life - should I? But then the other part of me that thinks it's a part of who I am, it's not all bad at all. And I want her to understand what's happening because I witnessed adults having mental health difficulties as a child and sometimes there was a kind of ushering out of the room, don't let her see this. And actually your imagination can be more powerful than the truth and you start dreaming up reasons for what's happening that are not helpful at all. Sometimes the truth is a bit easier, I think.

So, we have a picture book called The Colour Monster which is all about emotions having different colours. So, seeing as it's one of her favourite books at the moment I thought, I'll use that as a kind of starting point. I tried to explain that my colours get all mixed up and I find it really difficult to separate out my colours, and sometimes my colours get really bright and I might get really angry or I might get really scared or really upset and it's really hard for me to bring my colours down so they're less bright. And I don't know whether it was a good explanation or not but she really engaged. And because she loves this book she started talking about the colours. And I thought it was a way in and it went better than I maybe anticipated. It's a conversation to be continued.

Mark - Historically the assumption is that people with mental health difficulties that have a diagnosis don't have children; they have hobbies instead apparently. And they don't have families and jobs and work and stuff like that. And I know that's changing over time, but there is that weird sense of well why would you have children if you also have a disability or a mental health difficulty, why would you add a burden to your life. So, I wanted to ask you both did that kind of stuff go through your heads when you were thinking about having young 'uns?

seaneen - No. Literally anyone can become disabled at any time. The discussions around it with professionals are always kind of very, oh you must be extremely careful, the risk of relapse is very, very high. And there are some medications that you can't take basically if you are, as they say, a woman of childbearing age. People go through life thinking that we are separated into camps of disabled and non-disabled, but it takes one thing. You could become physically disabled or you could experience a mental illness, anyone can; you can't tell what's going to happen. Maybe I'm just very optimistic. I don't know how you feel, Kate?

kate - No, the activist side of me is in complete agreement, and especially I think that I parent with more empathy, with a higher sensitivity to the emotions of my children, and also trying to teach them to be sensitive to the emotions of other people and themselves. I think that's something that we don't necessarily teach children enough about.

And I guess my husband was concerned will we as a team be able to cope if you get very unwell when we have children. And I had to undergo a medication change to get pregnant, and unfortunately it was very badly mismanaged and I had one of the worst depressions of my life, and it was very long. Part of me thought wow, I've had to go through all that just to get to this point of becoming a mum. But I wouldn't change. I mean I would rather have not had the depression, of course, but I just have to accept that as part of the package of me. And like you said, Seaneen, anyone can become disabled, can experience mental ill health. A lot of mums experience mental ill health for the first time postnatally; it's a trigger point, even if you don't have a pre-existing diagnosis. It's just something I think we need to be more accepting of as a society.

But I've been thinking a lot before having children and while they've been in the world about what it means to have a mental health diagnosis. Sometimes feeling guilty about having to prioritise my own needs. But then again realising I'm doing that so that I can parent and be the best parent that I can be. Things as well like sleep deprivation, no one copes well with that, and it's just heightened if you have a diagnosis.

Mark - Is there a big step change between the care that you receive from a perinatal mental health team and the care or the support you receive once you're just shuffled back into being an adult and no longer having the special status of being a new mum?

seaneen - Do you mean is the care during pregnancy better?

Mark - Yeah, or different.

seaneen - Yeah, it's definitely different. In my experience they're much more understanding and compassionate about having feelings, and things aren't pathologised to the extent that they can be outside pregnancy. You're allowed to have feelings of anger and you're allowed to have feelings of despair and hopelessness without it being tagged on to... I found the care I got during pregnancy I wish I always had that kind of care. It was very risk averse but very kind. I don't know, what about you, Kate?

kate - I feel almost like having another human involved makes them more interested than they were, which is a bit double-edged because you think it would have been nice if you'd cared before that as well a bit more. But there's a slight edge to it to me. For instance I went to my GP when I just had my one child because my anxiety was really awful and I needed some more support. And suddenly she says, "Well I may have to refer this on to a social worker". I'm kind of saying, "Why, why?" And she says, "Well that's just for me to worry about". The appointment carried on and I said, "Sorry I need to return to this idea, are you going to refer this to a social worker?" And she said, "Well that's for me to worry about". I said, "I really don't feel I need that so I'd rather you didn't". She said, "Well that's not up to you". No one's ever said that to me before about referring me to social support. I need the caveat and say, it's not a bad thing necessarily being referred to social support; you can get some great support. But it was the lack of information and the lack of control. And I just thought, well you could at least explain it to me even if I haven't got a choice. And I ended up I did actually make a complaint about my treatment, and I did feel it was related to my diagnosis.

But during the complaint I was told, "Oh you may like to know it was noted about the good bond with your daughter". I thought well I know that, I don't really need external, I don't know, professional stamp on the bond with my daughter, but thanks anyway.

seaneen - That's been my experience is that people like GPs and stuff are not great at all with this stuff. A similar thing happened a while after I had given birth as well to Aishling and the perinatal team had gone. Which is why I was grateful for the specialist team because they didn't seem to panic in the same way that the GP did, where the GP would hit the social services button. And I had a similar experience where there was no explanation. It was just clearly they were nervous about a woman with a mental health diagnosis having a child basically, that was it; it was pretty much being judgemental. But in my experience the perinatal team were a lot less, even though they were very risk averse, they were also a lot less freaked out I guess by the mere idea of a woman with a diagnosis having a child, which I think there is still amongst GPs in general healthcare, there is still quite a bit of stigma about it I think.

kate - Yeah, you're right. I've not really thought about it in those terms, but the perinatal team obviously they're specialists and they understand a lot more. Actually with the daughter I've just had, the six month old, they referred me to a peer support group for mums who have a mental health diagnosis, and either are pregnant or have just had a child, on Zoom. And to be honest I've been referred to everything under the sun so my first thoughts were cynical, like oh another group, yeah, yeah, whatever. So, I thought but I'd better do it, I'd better be a sensible good person with a mental health problem. And I actually really enjoyed it because I do sometimes hit a bit of a wall with mum friends, who are my dear friends, but most of them are not parenting with a diagnosis and you do start to talk about some things, "And then when your anxiety is so severe you can't eat, am I right?" And they're like, um... So, to have a group of people who understood a bit more deeply what that's like was really great.

seaneen - I kind of wish I'd been referred to something like that.

Mark - It sounds amazing. It's been absolutely wonderful. And as someone who doesn't have kids it's neither filled me with fear nor trepidation. I've got to learn a lot from both of you in that conversation.

kate - Oh I'm glad. Thank you again for having me.

[Music]

seaneen - It's time for the Book of Awkward Questions.

Mark - In my hands is a mysterious book. It's so heavy that I can hardly hold it. It's thick and leather bound, corners tipped with brass, it smells of dust and secret places. On its deep red cover in faded gold leaf is the title: the Big Book of Awkward Questions; handed down from generation to generation. Only two copies of the Big Book of Awkward Questions are known to be in existence. I have one copy, Seaneen has the other one. No one knows who compiled it or why, but in it are contained every single awkward question that has ever been asked of anyone about mental health. Each episode we're going to open the book and see which awkward question it suggests to us. So, what's today's awkward question, Seaneen?

seaneen - I'm opening the book, if you can imagine my hands trying to hold the heaviness. The question is: why did you agree to it if you aren't going to turn up and do it? I'm operating on about two hours' sleep, Mark, so I'm going to let you start with this one.

Mark - Well, that's literally the answer to that question always, isn't it, because when you live with a mental health difficulty or you live with mental illness there are peaks and troughs. There are times when you feel all right, there are times that you don't feel all right. And you can guarantee, especially if you have a diagnosis of something like bipolar or bipolar 2, like I do, there will be times when you feel on top of the world, you can do absolutely everything, you can take on everything, and solve all of the problems, you sign up for a load of things, you agree to a load of things, and then the night before funnily enough sleep doesn't come and then getting ready to go to the thing doesn't come. And then you ultimately end up either cancelling at the last moment or you end up turning up really late.

There's an incredibly good example about this that involves your wedding, Seaneen, which I went to, which you maybe don't know because you were a bit busy on the day getting married. But I turned up to your wedding do about three hours late, about 45 minutes before everyone went home, precisely because of that weird feeling that I get that sometimes even things that I really want to do at that point I don't feel like I'm enough or I've got enough. I always feel too tired; I always feel like my tongue's made of carpet, I feel absolutely terrified. My life is filled with agreeing to do things that I would really like, which I knew that I would really like, and then even getting all the way there and not being able to step across the threshold to do it. And it's really weird; I don't know whether it's anxiety, I don't know whether it's just exhaustion, I don't know whether it's fear of looking like an absolute fool, but I just get caught. Do you get that?

seaneen - Yeah. By the way I know that you were that late to my wedding.

Mark - I thought you might have done.

seaneen - But what you might not know is I was also late to my wedding.

Mark - Really?

seaneen - Yeah. I turned up basically in the complete nick of time, for very much the same reason.

Mark - Well, you looked lovely.

seaneen - Thank you. Yeah the thing is I've just stopped telling people I'm going to do anything, so that helps, because same reason, I just fluctuate a lot. I'm notoriously flaky and it's not something I like about myself.

Mark - Yeah, I hate it about myself.

seaneen - Yeah, it is the reason why. It's not on purpose; it's just my mental health it just changes.

Mark - When people talk about having physical disabilities or chronic conditions they talk a lot about they need to build in recovery time after doing something. Things take it out of you more than they might take it out of someone else. I feel like I need the mirror of a recovery period, which is like charging the batteries up period. It's like when you see someone doing like triple jump at athletics rocking backwards and forwards on their heels for ages. I find this so much, and it's not got any better as I've got older. It's not quite procrastination, but it is procrastination, and all of the tips that people give you to get over that just don't work and just make it worse.

seaneen - So, Mark, how do you feel then when you are, in my words, notoriously flaky?

Mark - Other people will see that I am not doing too well. And when I'm not doing too well I don't necessarily want other people to see that. Because I feel like it feels like being a constipation of a human: none of the words will come out, everything will feel awkward. Someone will say, "Would you like a crisp?", and then you can feel the beads of sweat forming on your head, oh what is the correct response to the question, do I like a crisp, what will they think of me, I don't really like cheese and onion, normal people like cheese and onion. And just being trapped in a horrible sense of self-consciousness, and wishing to avoid that feeling of being self-conscious. Because sometimes it's just really hard to be out there and be present when things aren't so good. So, maybe it's just a lack of feeling of safety or ultimately a lack of confidence, because it's not quite shyness, and it's not situational shyness because I'm not a shy person. But there are some times that I would much rather be run over by a forklift truck than I would talk to anyone. And that's a really weird thing because that's not a constant, because sometimes I will talk to people until their eyes roll back in their head and they desperately are looking to phone an Uber to escape from the situation they're in talking to me.

seaneen - I used to be a lot more up for it, but as I've gotten older and more crotchety and experienced I guess I've become a lot more insular, and just decide that I'm not going to go anywhere or do anything. Which I don't advise.

Mark - This is where we hit the fact that experiencing mental ill health is a chronic condition, and we're not talking about the way in which usually it impedes us physically; it impedes how we feel. And that's really, really hard. It's really hard to say to other people, I really would love to have this conversation with you today, but I can't because I'm not that person in this place at this time that can have this conversation. So, the obvious thing that comes up there is oh well, you should be kinder to yourself, you should look after yourself. But sometimes when you are feeling bad in general, like for me I don't know whether I'm being kinder to myself or I'm just indulging the worst elements of what I'm experiencing, and that's difficult. Because you run into people's advice which is, you have to challenge yourself, you have to get back into life, you can't withdraw totally and stuff like that. But the feeling of that being difficult is sometimes really hard to disentangle from the feeling of not feeling very well. So, it's hard to know when you should be kind to yourself, and it's hard to know when you should push yourself forward I find. Because I could quite easily go for months and months and months never signing up for anything, and ultimately I wouldn't know whether what I'd done was myself a great favour and looked after myself and nurtured my inner child and stuff, or whether I was just really, really low and depressed. It's really hard to see from outside of yourself.

What I do do these days is I don't go to things I don't think I'll like. So, if someone says, "Come round to ours, we're having a barbecue", I say, "No thanks, I don't want to stand next to a bit of smoking meat and discuss cars with some men, I'd rather stay at home thank you".

seaneen - I'm closing the Book of Awkward Questions. Another episode of Mentally Interesting has come to an end. Hopefully the next one will not be borne out of one of us experiencing a massive and traumatic life event.

Mark - Well, fingers crossed for that, because to be honest I'm not sure I have energy in my tanks for anything more traumatic than only getting five packets of crisps in a six-pack multipack. I don't know how I'm going to do it. So, thank you for listening to us talk about parenting and mental health. We know that many of you will relate listening at home, particularly to the ups and downs of having a new baby in this terrifying strange world of pandemic.

seaneen - If you feel able to share your thoughts on this or anything else email ouch@bbc.co.uk, putting Mentally Interesting in the subject line. Or drop us a line on Facebook and Twitter by searching for BBC Ouch.

Mark - If this podcast does it for you it will appear on your device as soon as it gets published when you subscribe to BBC Ouch on the BBC Sounds app. We'll be back next month when the broad theme will hopefully be something like joy or flowers or beautiful sunrises or the smile of every child and the raising of every sun, or just something that isn't about death and horror. But until then bye for now and we'll see you soon.

seaneen - Bye.

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BBC Sounds - Ouch!, Mentally Interesting: I couldn't hold my baby

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Music] Mark - This is Mentally Interesting, a podcast series for BBC Ouch. I'm Mark Brown. seaneen - And I'm Seaneen Molloy. We've been friends for ages. We've got years and years of personal and professional experience of mental health between us. And we're here to talk about the awkward stuff so you don't have to.

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STUDENT A's QUESTIONS (Do not show these to Student B.)

(1)

What comes to mind when you hear the term 'mental health'?

(2)

What do you think your mental health will be like in the future?

(3)

What do you do to maintain or improve your mental health?

(4)

Are you worried about the mental health of anyone you know?

(5)

Is mental health more important than physical health?

(6)

Are there many people with mental health problems in your country?

(7)

What does your government do for people with mental health diseases and problems?

(8)

How can society help people with mental health problems or stop people from developing them?

(9)

Do you think modern society increases the likelihood of mental health problems?

(10)

What advice would you give to someone with mental health issues?

STUDENT B's QUESTIONS (Do not show these to Student A.)

(1)

How is your mental health?

(2)

Has your mental health changed over the years?

(3)

What affects your mental health on a daily basis?

(4)

Are you worried about your mental health?

(5)

How does one's mental health deteriorate?

(6)

What is the relationship between sleep and mental health?

(7)

What mental health disorders and problems do you know of?

(8)

One of the most common mental health problems is depression. How can we help people who suffer from this?

(9)

If someone has a mental health disorder, should they be kept in a special mental health institution?

(10)

Are murderers with mental health problems really murderers?

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STUDENT A's QUESTIONS (Do not show these to Student B.) (1) What comes to mind when you hear the term 'mental health'? (2) What do you think your mental health will be like in the future? (3) What do you do to maintain or improve your mental health?

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Why students should have mental health days

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Why students should have mental health days

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Why students should have mental health days | Hailey Hardcastle

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What If Physical Illness Were Treated Like Mental Illness?

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What If Physical Illness Were Treated Like Mental Illness?

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What If Physical Illness Were Treated Like Mental Illness?

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One of the most widely believed and most damaging myths is that mental illness is not a physical disease. Consider what would happen if we treated physical illness the same way many people treat mental illness.

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There's no shame in taking care of your mental health

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There's no shame in taking care of your mental health

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Sangu Delle: There's no shame in taking care of your mental health

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When stress got to be too much for TED Fellow Sangu Delle, he had to confront his own deep prejudice: that men shouldn't take care of their mental health. In a personal talk, Delle shares how he learned to handle anxiety in a society that's uncomfortable with emotions.

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Mental Health Care in a Pandemic: Dealing with Anxiety and More

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Mental Health Care in a Pandemic: Dealing with Anxiety and More

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Mental Health Care in a Pandemic: Dealing with Anxiety and More

# data[].attributes.headline
Looking After your Mental Health in Times of Coronavirus

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Looking After your Mental Health in Times of Coronavirus

# data[].attributes.attachment_link.title
Looking After your Mental Health in Times of Coronavirus