Friday, 1 June 2018

Mental Health - Part 4

Given that we have recently had Mental Health awareness week, I feel that I should highlight one more very important thing: untreated depression can easily morph into something more serious. Psychosis and/or suicide are scary terms, the first one perhaps not always fully understood (click link to learn more). I have noted that several dramas and British soaps on TV have had psychosis as a theme in recent months (Silent Witness and Emmerdale among them). This suggests that perhaps either it is becoming more prevalent, or that it is becoming more recognised - or just that we are edging towards being better able to talk about such things. Perhaps the stigma really is beginning to lift on mental health? And if it is, then it is perhaps also because we are starting to publicly acknowledge it.

A few years back I knew someone locally whose brother had started to suffer from depression as a teenager. There were family traumas going on and he'd started a drug habit, unfortunately neither of which were going to help his mental stability. As time went on, the depression degenerated into psychosis. He became increasingly reclusive, not leaving his flat for days, certainly no longer able to work or function in normal society, and was often found with silver foil on his head and insisting there were soon to be alien invasions. While this may sound highly comical to the uninitiated, these are in fact very common symptoms of severe psychosis. He got admitted to a psychiatric unit but unfortunately was found dead not long after, having committed suicide. While this is an extreme, and very tragic story, it nevertheless has very important resonances - and is not as uncommon as you may think.

I have recently had direct experience of trying to deal with someone whom I love dearly but who lives far from me and, as became increasingly apparent, was suffering from psychosis following a long-term and poorly medicated depression. It was distressing, alarming, disorientating, surreal - and so hard to deal with long-distance. It was also almost impossible to get the right help from the medical fraternity. This is not a dig at the NHS. It is merely the way things are set up: patient confidentiality is all well and good in some circumstances, but when it comes to mental health this becomes an impenetrable barrier to trying to help the person who absolutely can't help themselves. I telephoned, I emailed, I documented my concerns with medical and observational evidence of someone I knew inside out. I did the research. I knew what I was talking about. Yet still it was nigh on impossible to get the right level of help and support. It took an overdose to do that.

It's that same old problem - because mental health is largely INVISIBLE, it is very hard to get the right diagnosis and consequent strategies in place. Telling a psychotic person who lives alone in a new neighbourhood of a large urban environment and who totally believes they are being 'watched' and 'monitored' that they should pop along to the drop-in clinic for an initial assessment, involving complicated bus journeys and set times to visit, is about as likely to happen as pigs flying. Basically it's like trying to guide a terrified five-year old child alone in a big city by remote control. Scary stuff. Especially when 'home' is a flat several floors up with balconies....

The question which most doctors ask if mental health issues are flagged up with a patient is, 'Have you had suicidal thoughts?' This question usually comes reluctantly and with an 'apology' for having to ask it. Does this not say it all? Such still is the shame associated with severe mental health - a hangover perhaps from when the Church viewed ending your life willingly as a Sin - that you have to apologise before asking a question which perhaps should have been asked some time back and which is asked out of love and concern. It is a common held myth that if you mention the S word, then you might put thoughts into a vulnerable person's head. In fact the exact opposite is true - if you shy away from talking about it, it is more likely to happen.

The most famous recent example of how talking about it is exactly what you should do, is the story of the young man on a bridge in London who was about to end it all until a passing stranger noticed him and made that crucial, selfless, intelligent, loving decision to stop and talk to him. He offered him a coffee. He held out the hand of friendship and understanding to a vulnerable person who is alive today - and thankfully spreading the word - because of that one act of compassion. The story has now been published as The Stranger on The Bridge by Jonny Benjamin and is available through Amazon (click on the link).

In the UK, 15 people per day die due to suicide (2017 stats). 10-15 times more attempt suicide. Bristol University has hit the headlines recently with a spate of student suicides from the famous Clifton Suspension Bridge. The ex-girlfriend of a very old friend, with whom we travelled around Greece with in student holidays many moons ago when we were young and carefree, threw herself under a train a few years ago despite a loving husband and children and a prestigious career. Mental Health can hit any one of us at any time - young, old and everywhere in-between. It is a massive problem and we need to acknowlege it and address it. We can no longer afford to skirt the issue. We have to look it straight in the eyes and not blink.

Primarily, we need to nip situations in the bud. The over-riding feeling with people suffering from mental health issues - from depression, through anxiety and panic attacks, self-harming and psychosis - is a total sense of isolation, alienation and abandonment. The connection with the world has been lost. Loneliness really can be a killer. This is why it is so vital to talk. Human beings were never actually designed to live individualistically. We are community animals. We lived in packs. We shared our skills, helped and supported each other. We survived because of our togetherness. The time has come to try and re-work our modern lives. We need to reconnect - in the real world, not the virtual world. It will be a long uphill battle but it will be a battle worth fighting for and ultimately winning.

Useful links:-

HeadsTogether - mental health charity
Samaritans - myths about suicide
Rethink Mental Illness - charity and support
Jonny Benjamin - mental health campaigner

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