Is this such a bad thing? I mean, we’ve all put things off ’til tomorrow, next week etc. Right? i.e. I’ll start my new diet Monday but never do, I’ll start cramming for my exams soon, I’ll wait ’til hubby’s in a better mood to tell him about the latest credit card bill. And who hasn’t made New Year resolutions? Or who’s said, I must start saving for retirement?
For many people, a little procrastination isn’t harmful — like 15 minutes lost in Facebook or putting off doing the ironing for a few days. However, for some people, procrastination can create massive problems at home, at university and in their workplace. In fact, it can impact on every area of their lives.
According to Joseph Ferrari (Professor of psychology at DePaul University in Chicago and author of Still Procrastinating: The No Regret Guide to Getting It Done), around 20 percent of U.S. adults are chronic procrastinators. Psychology Today UK agrees “Approximately 20 percent of people are chronic procrastinators.” Yet more, a recent poll by Nationwide Building Society found that nearly two-thirds (63%) of those questioned identify themselves as procrastinators (Luke O’Reilly, The Metro, UK, 2014).
A common misconception is that procrastinators have poor time management skills and tho’ this can sometimes be the case, there could be deeper issues at play. Ferrari says “It really has nothing to do with time-management – to tell the chronic procrastinator to just do it would be like saying to a clinically depressed person, cheer up.”
Neil Fiore (The Now Habit, 2007) also wrote that “procrastination is not typically a function of laziness, apathy or work ethic.” It may be a self-defense behavior that develops to protect a person’s sense of self-worth i.e. better not to start the diet than to start it and admit failure to lose weight or better not to put in the exam paper/essay than to put it in and fail – some would rather be seen as being unable to manage time than fail the task itself.
Maria Lamia (What Motivates Getting Things Done: Procrastination, Emotions, and Success) says our emotions are what motivate our behaviour, and that procrastinators are motivated by their own particular emotional history. She wrote about two types of procrastinator: those who procrastinate and don’t get the job done and those deadline-driven procrastinators who do get the job done (and they almost always do it well).
“Many people who delay and don’t get the job done – they delay and fail – often say ‘my problem is that I’m a procrastinator’. We have to remember that failure, for some, creates shame, and people who continuously fail have a lot of shame. They’re not motivated by emotional responses at a deadline, but rather they’re inhibited by them. So when a deadline passes, they blame it on procrastination in order to save face… what’s better than blaming it on procrastinating, rather than look at the emotional issues that are really interfering with you doing the work?” So there are some psychological and emotional elements at work here. Is it a mental health problem?
Although procrastination itself is not a mental health diagnosis, it is linked to a number of disorders, including ADHD, depression and anxiety. On the other hand, procrastination can prompt depression and anxiety.
My youngest son had a real problem with procrastination a few years ago and, at the time, I hadn’t really understood how much it affected him emotionally or mentally. As Head of the Science Department (at the tender age of 26) for a large inner-London High School his procrastination had him preparing lesson plans last thing on a Sunday evening, ready for Monday mornings. Subsequently, leaving it so late led to anxiety and panic attacks. He obviously did well as the school’s Science grades went from being one of the lowest in England to having the biggest increase in grades that year. However, he then became depressed and I was so afraid for him, knowing what that feels like. Fortunately, he sought counselling, where he was able to discuss what was going on for him and work through the emotional issues affecting him. Thankfully he left that job to return to study and now enjoys being a Physiotherapist. He still catches up with his counsellor now and then and I’m really proud of him for seeking help when he needs it.
I suppose I procrastinate too – it’s taken me three days to get this far through my post. But I don’t think I’m a chronic procrastinator and I don’t believe it’s about emotional issues for me – on this post anyway.
Wow! I swear, I have literally just realised why I’m finding it difficult to complete my post about my Psychotic depression – I started it on the 7th of this month! Duh! Emotional issues.
Are you a procrastinator? Does procrastination impact on areas of your life? I’d really love to know.
V from Milleniallifecrisis recently posed the question: Do you have any stories of horrible bosses? Although there’s many I could mention, I thought I’d tell you about just one.
My manager, Peter, at one of the mental health units I worked on was a miserable so and so at the best of times but he always saved his worst for me. Unfortunately for him, I had more CPD courses under my belt, which enabled me to provide a wide range of different treatment therapies for our clients. I was also able to offer lots of group therapies, which meant more patients had access to talking therapy, relaxation, visualisation etc. (note that I swing between patients and clients – this always depended on the latest trends and which department you worked in).
I was also sent specialist referrals from the Consultants on each ward, asking me to offer a particular therapy (CBT for Schizophrenia, in particular) for individual clients, which really p’d him off.
The Trust CEO, who I’d met many times, was visiting our ward one day and she asked how my sons were so we had a brief chat and shared a giggle or two. When she’d gone, he was apoplectic – yelling “why are you speaking with the CEO? That’s my job, not yours. Who do you think you are? Do you want my job or something?” Although I didn’t think I needed an excuse, I told him she’d engaged me in conversation and asked why shouldn’t I be able to talk to her. He was red in the face and his eyes were bulging as he spluttered and spat something incomprehensible when he stormed away to his office, giving the door an almighty kick.
Peter was moody in general but at least he acknowledged the other staff on the unit, which didn’t go unnoticed by them. My greetings were completely ignored and he delighted in trying to undermine me in front of our junior staff tho’ I’m not sure why he kept it up, as it normally backfired on him and everyone ended up sniggering.
I’ve mentioned elsewhere that I worked in HR for many years prior to becoming a mental health nurse and the skills I’d gained from HR were easily transferrable to my current job, something else for him to hate.
Still, whenever he had a difficult audit or report to complete he’d pass it on to me, knowing the job would be completed quickly and accurately. Then he’d pass the results off as his own. Neither of us were keen on presentations at high levels but he’d have me do them for Head Office conferences while he sat there, arms folded, smirking at me, almost willing me to trip up and make a fool of myself.
Then he’d ask me awkward questions throughout the presentation, trying to unnerve me and put me off. I’d ask him to wait until the end as his question would be answered in due course or I’d ask the audience “Would anyone like to answer Peter?” and generally someone would. As people applauded, he’d take to the stage and say “I’ve been working on this for weeks so I thought I’d let Nancy present it to you so she can get to grips with it all. He didn’t even realise, he was only actually making a fool of himself.
I tried to approach him many times about his behaviour but he denied there was a problem and even said, despite NMC guidelines to the contrary, “I don’t have to engage in chit chat with you, I’m your boss and I just have to tell you what to do.”
In the end, all I could do was put in a formal complaint, but that’s another post.
Have you ever had to complain about a horrible boss? Both V from Milleniallifecrisis and I would love to know this and how you dealt with it.
Many books, articles and blogs have discussed schizophrenia and often there are differences in terminology. As an ex-mental health nurse/ward manager and someone who has experienced a lengthy psychotic episode, this is my take on schizophrenia.
Schizophrenia can be separated into positive and negative symptoms. These are not positive and negative in the way you might think. A positive symptom is one that adds a behaviour, thought or feeling, whereas a negative symptom takes away a behaviour, thought or feeling.
Schizophrenia has five types of symptoms: hallucinations,delusions,disorganized speech, disorganized behaviour (the positive symptoms), and negative symptoms. However, the symptoms of schizophrenia vary dramatically from person to person, both in pattern and severity. Not every person with schizophrenia will have all the symptoms, and the symptoms of schizophrenia may also change over time.
Most people with schizophrenia are not violent. More typically, they prefer to withdraw and be left alone. In some cases, however, people with mental illness may engage in dangerous or violent behaviours that are generally a result of their psychosis and the resulting fear from feelings of being threatened in some way by their surroundings.
People with schizophrenia might hear (the most common hallucination), see, smell, taste or feel (the five senses) things no one else does i.e. hearing voices talking in the first person, to them or about them, they might see other people, animals, faces, things that we can’t see. One patient could smell sh*t everywhere he went, causing him to retch and another said he could taste tin or metal so someone was trying to poison him. He wouldn’t eat the hospital food or take the drinks. He’d only drink bottled water that he brought in from home. One patient felt like he had spiders crawling all over him and inside his body.
A delusion is a firmly-held belief that a person has despite evidence that it isn’t true. Delusions are extremely common in schizophrenia, occurring in more than 90% of those who have the disorder. Often, these delusions involve illogical or bizarre ideas or fantasies, such as:
Delusions of control – Belief that your thoughts or actions are being controlled by outside, alien forces. Common delusions of control include thought broadcasting “My private thoughts are being transmitted to others so people can hear what I’m thinking”, thought insertion “Someone is planting thoughts in my head”, and thought withdrawal “The CIA is robbing me of my thoughts”.
Delusions of grandeur – Belief that you are a famous or important figure, such as Jesus Christ or Napoleon. One of our patients believed he wrote all Michael Jackson’s lyrics. Alternately, delusions of grandeur may involve the belief that you have unusual powers, such as the ability to fly.
Delusions of persecution – Belief that others, often a vague “they,” are out to get you. These persecutory delusions often involve bizarre ideas and plots e.g. “Martians are trying to poison me with radioactive particles delivered through my tap water” or “they’ve put a chip in my neck so they can follow me, they followed me to San Francisco once and had me deported back to the UK.” He had actually been deported once it was noticed he had been on Section 3 of the Mental Health Act 1983 as you cannot enter the States if you have been on Section 3*.
Delusions of reference – A neutral environmental event is believed to have a special and personal meaning. For example, you might believe a billboard or a person on TV is sending a message meant specifically for you.
3. Disorganised speech
People lose their train of thought during conversations, make loose associations of topics (jumping from one topic to another), and give answers to unrelated questions. They might make up words that only they know the meaning to (word salad), rhyme without noticing they’re doing it, and repeat the same things over and over again when trying to keep up a conversation.
4. Disorganised behaviour
Patients often have a very hard time functioning independently and this is easily seen in the difficulty they have in starting or finishing a task without help from other people. Mundane tasks such as taking a shower or cooking a simple meal become massive tasks. Patients start to lose independence and not being able to perform normal everyday activities and they start to lose routines to the point where they can be completely lost.
5. Negative symptoms include:
Blunted affect – reduced intensity and range of emotional expression including vocal, facial expression, body movement and hand gestures.
Alogia – decreased quantity of speech, reduced spontaneous speech and loss of conversational fluency.
Amotivation – lack of motivation i.e. in school, work, personal hygiene etc.
Anhedonia – inability to feel pleasure in normally pleasurable activities.
Asociality – lack of motivation to engage in social interaction and/or the preference for solitary activities
Five to 6% of people with schizophrenia die by suicide, about 20% make suicide attempts on more than one occasion, and many more have significant suicidal thoughts. Suicidal behaviour can be in response to hallucinations and suicide risk remains high over the lifespan of individuals with schizophrenia.
7. Early warning signs of schizophrenia
In the early phase of schizophrenia, a person might seem reclusive, unmotivated, eccentric and emotionless to others. They might start to say odd things, isolate themselves, show a general indifference to life and begin neglecting their appearance. They may abandon activities or hobbies, and their performance at university, school or work can deteriorate.
8. The most common early warning signs include:
Odd or irrational statements; strange use of words or way of speaking
Depression, social withdrawal
Flat, expressionless gaze
Inability to cry or express joy or inappropriate laughter or crying
Oversleeping or insomnia; forgetful, unable to concentrate
Hostility or suspiciousness, extreme reaction to criticism
Deterioration of personal hygiene
If you are worried that odd or out of the ordinary behaviour is causing problems in your life or the life of a loved one, please seek medical advice. The earlier you get treatment, the better the prognosis.m
Is there anything else you would like to know about schizophrenia? Is there anything you think I’ve missed?
* Section 3 of the Mental Health Act is commonly known as “treatment order” it allows for the detention of the service user for treatment in the hospital-based on certain criteria and conditions being met.
For immigrants with a mental disorder or disability, seeking entry to the United States is not easy. U.S. immigration law imposes barriers to entry for persons with certain kinds of physical or mental illness, particularly when it appears that the chances of harm to persons or property are high or when an immigrant may likely have no financial support in the United States.
Last week I was offered the Sunshine Blogger Award by Kacha at Journey through life. I’ve been so busy the last few days, at a family wedding in Scotland, so have been unable to respond as quickly as I would have liked.
“The Sunshine Blogger Award is an award of recognition given to bloggers from fellow bloggers. It recognizes those who are creative, positive, and inspiring. It celebrates people who spread sunshine.”
What a wonderful way to keep the sun shining in our blogs by passing on the celebration of creativity and positivity.
I was certainly surprised that my blog, about mental illness, made it onto the list. I’m delighted to have been offered the award and accept it gratefully. I’d like to thank Kacha, who I have the utmost respect for and who I share a lot in common with. Head on over to read her inspiring story and much more Journey through life.
What are the Rules?
* Thank the person who nominated you and provide a link back to their blogging sites
* Answer their questions
* Nominate up to 11 other bloggers and ask them 11 new questions
* Notify the nominees about their nomination via their blog or social media
* List the rules and display the Sunshine Blogger Award logo in your post
Kacha’s Questions for the Nominees
What is the best advice you’ve ever heard? If you can’t say anything nice, say nothing at all.
What is a lie you tell frequently/with ease? Haha, not sure I should be answering this. I tell my partner I’m concentrating on my blog if he thinks I’m online and ignoring him – I’m not checking Facebook, honestly!
Do you have a blogging routine? If so, enlighten us. Nope. For me, it’s just most waking minutes 🙂 Just kidding, but I don’t have a schedule. My illness and sleep pattern don’t lend well to schedules.
What is one thing you really want to do/accomplish? Ah. Probably like most peeps, I’d really love to write a book.
What is your biggest pet peeve? Hhmm. I have many but if you’re pushing me, it’s got to be rudeness. There’s no need for it. A please and thank you goes a long way in my book.
Do you have a ‘pick me up’ song? I was at my niece’s wedding at the weekend and they played so many old ‘pick me up’ tunes along with the silly dances like YMCA, Hey Macarena, The Loco-motion, The twist and so on but the winner is (drum roll) I feel good by James Brown.
What do you like the most about blogging? Please pick the most important one. Again, not sure but so far, I love the community feel about blogging; meeting other people who enjoy blogging and reading what they have to say.
Which household chore are you most likely to skip? Ironing. But, I’m lucky enough to have a great lady who comes to do it for me.
Which event from history is most fascinating to you? U.S. Civil Rights Movement:1954-1968 (US) and Rosa Parks refuses to sit in the back of the bus, sparking Montgomery bus boycott in 1955 – that woman had guts.
Are you superstitious? If so, what do you do or believe? Not really but I still remember when it’s a Friday 13th.
What made you happy today? Mum’s homemade soup (in my birthplace, Scotland).
What are you most grateful for? My amazing family.
My nominees (and in no particular order, cos I love them all) for the Sunshine blogger award are:
Kally from Middleme who is really passionate about what she’s doing; she has an inspiring blog and a quirky way with words, sharing her own experiences, offering tips on how to improve your current situation and career advice.
Maria from mysoulbalm – She writes about mental health in layman’s terms, sharing her personal experiences and providing information to help people navigate their own illness. Her blog is open and honest and creates a space where people can speak openly about mental illness without fear of judgment.
Ashley from mentalhealthathome who was a pharmacist and is now a mental health nurse and author. She has a treatment-resistant major depressive disorder, for which she’s been hospitalized multiple times. I love that she’s so knowledgeable and writes informatively and eloquently about both her own experiences and about nursing. She is an author and details about her books can be found on the above link. Ashley regularly invites new mental health bloggers over for guest posts, helping to raise awareness about mental illness.
Beckie at beckiesmentalmess.blog is a lighthearted blog and I enjoy the way she prompts readers to answer questions, to engage with the blogging community and to get involved posts like Share Your World
Dr Tanya at Salted Caramel – A blog about you and me; it’s ever-changing topics and lighthearted look at life will appeal to everyone. She loves engaging with the blogging community and invites guests to write on her blog on a regular basis, so pop on over.
V from millenniallifecrisis is often hilarious when she writes about her life and things that bug her. She writes well and posts often, inviting like-minded rants from her readers so we can get things of our chest too.
Pooja at lifesfinewine who’s a lifestyle and beauty blogger in the main but poetry, psychology, inspiration, positivity and all things interesting including travel and food blogs are featured regularly.
Yeka from It’s all about love blogs about Sunshine and Love. She’s sweet, adorable and always so positive about her life and others.
Honestly, I could go on…………….
Now, for my questions:
Who, famous or otherwise, has inspired you in recent years?
Where do you live and is that where you were born?
What makes you want to get up in the morning?
Why do you blog and sum up your blog in one line?
How, if at all, did you celebrate your last birthday or how will you celebrate the next one?
When did you last party all night?
What did your school reports say about you and were they right?
Tell us about the worst food you’ve ever tasted and what would be the one food you would never wish to taste.
What would your perfect weekend look like?
If you could be transported immediately (no travelling necessary), where in the world would you go?
What accomplishment are you most proud of?
Thank you so much for the nomination Kacha, to everyone who reads my blog and to the nominated blogs who will hopefully accept my nomination. I can see some of you appear on my blog twin Kacha’s nomination list, just proving how wonderful you all are. Still, I’m looking forward to reading your answers and to seeing the sunshine spreading!
If you haven’t read Part I and Part II and you want to, you can find them here (Part I) and here (Part II).
If you see anything of yourself or your own experiences in this post, perhaps you’ll feel relieved that you are not alone. Maybe you’ll even recognise some of the symptoms in a friend or family member? Or it’s feasible you’ll gain insight into different mental health problems and see how difficult it is for people who experience mental ill health?
……….I was struggling desperately. I couldn’t see an end to the pain. I felt scared, worthless, hopeless and I honestly felt suicidal. It was then that I had my own ‘break down‘. And that’s exactly what it felt like; both physically and mentally, I was broken.
I was having panic attacks throughout the day and particularly at night, keeping me awake. Alongside the huge purple sacks under my eyes, the weight loss, dizziness and nausea, I looked bloody awful and felt even worse. It was torturous; twenty-four-seven, week on week and, with no end in sight, I wished I was dead.
Natural Stress Relief
I tried every natural and herbal stress relief, sleep inducing, over-the-counter remedy known to man, without effect.As an aromatherapist, I made up lots of pretty little bottles of stress relief oils then bathed in them and doused myself liberally. However, despite all the lovely citrusy, spicy and fruity oils, all I could smell was the lavender, reminiscent of my grannies old underwear drawers. This didn’t work either.
As a qualified massage therapist, I was aware of the benefits so I booked myself in for a few sessions. However, the first lady almost pecked at me like a small bird trying to feed itself for the first time; there was no pressure applied and she missed areas of my body out! The second time, I went for seated massage, which ought to involve sitting on the massage chair with your upper body leaning forward, your arms on armrests and your face peeking through a hole. Looks comfortable, right? This lady, who’d attended the seated massage course with me, had me sit on a swivelling office chair! With my muscles tensing, I tried using my feet and legs to keep the chair from spinning, to no avail so told her to stop. She couldn’t understand why I refused to pay?
I joined the local gym and went seven days a week, twice on Sunday; pounding the treadmill and pedalling like fury on the exercise bike. I got so wound up if I couldn’t go to the gym for any reason but made up by jogging on the spot and running up and down our stairs. I tried most everything to relieve the constant anxiety and to wear myself out so I could sleep, but even the excessive exercise proved fruitless.
Hallucinations and paranoia
I was permanently exhausted and after three nights in a row without sleep, I started to hear, see and feel odd things. People (I didn’t recognise the voices – but they were very real) were talking to me and about me, saying I was no good, I was dirty, together with lots of other negative comments and expletives. I could see things; mice running along my wooden floorboards and unidentifiable faces at my windows. Worse still, one night I was wide awake curled up on my kitchen floor, with my back against the heater and it came to me – I’d killed someone.
I remembered how and where I’d buried that someone; by a huge tree outside my aunt’s flats, but I couldn’t think who it was that I’d killed. The next day, I saw a police car and thought ‘This is it. They’re coming for me.’ Jeez! I was terrified. For months, if I saw a police car down our street, I’d turn and retrace my steps or go round to my back door. If the police were in the square at the back, I’d whizz round the front. I sometimes wondered if I should just hand myself in and let them find out who this someone was that I’d killed. In hindsight, obviously if they were after me, they would have got me.
Mad, nuts or crazy
Although close friends and family were aware of my break-up with the boys’ dad and knew how devastated I was, I couldn’t tell anyone what was going through my head. I was afraid they’d think I was mad, nuts, crazyand that I should be locked away. Seeing mice or rats scurrying under my sofa and the unknown ugly faces frightened me, but if I closed my eyes at least I would get some temporary relief. However, the voices were incessant and unbearable; the constant rabble of people discussing what only I knew as my fears. They played on them, they were cruel, repeating the negative thoughts I’d so often had myself. They knew which buttons to push.
When I attempted to sleep in my bed the voices seemingly delighted in keeping me awake with their constant and irrepressible verbal abuse. One day, after work and before picking up my youngest, I bought a cd player, ear plugs and a few ‘out there’ cds with relaxing music, water sounds and dolphins in the background. I played these throughout the nights but still, my heart pounded in my chest and thundered in my ears, my breathing was irregular and the panic attacks raged.
By the time I got the boys up for school, I was a wreck; my eyes were red-rimmed and it felt like there sand in them. I was sluggish and jittery, but I somehow managed to hide it from the boys. My job at a high end clothing company was demanding, which helped abate the voices for a few hours but the anxiety, depression negative thoughts and panic remained. Colleagues at work noticed the 4 stone weight loss and saw how my clothes fell from my gaunt body. It certainly wasn’t a good image for the brand. Fortunately, a good friend in the sewing department kindly offered to take them in.
I even tried extortionately priced hypnotherapy but I couldn’t relax enough to go into a trance-like state. However, I’d bought myself a Paul McKenna relaxation video and when the boys were I bed I’d get it out. I’d half sit, half lie in one of my padded beach chairs, directly in front of the t.v so I could get the full effects of both the visuals and the sounds. Amazingly, I managed to relax and as the video ended, I’d carefully take this relaxation up to bed with me and finally managed to get a few good hours sleep. Sometimes it didn’t work and I suffered the torture again but I was so grateful for the times it did work.
What’s the problem?
After a while, not sure how long as I was in a constant haze back then, I took the boys to see our GP about their asthma. Once he’d seen them he sent them out, turned to me and, with his hand resting lightly on my arm, he said “Tell me, what’s the problem? You so thin and though you smile, I think you very sad.” The floodgates opened and it all came tumbling out; I sobbed and wiped the tears and snot on my hand as I explained how the boys’ dad had been seeing someone else and about the breakup around eighteen months ago. He told me to let the boys go home, he would make some telephone calls and I was to come back in to see him.
Having spoken to a colleague who agreed to see me, like – now, at our local general hospital, Dr Nga was going to drop me off! I knew it was a general hospital, rather than a mental one, but I soon found out that there was one mental health ward there.
I thought back to how, as kids we’d all say stupid things like “The men in white coats will come to get you.” or “You’ll end up in Stratheden, (our nearest asylum) you will.” We were all terrified just at the mention of the asylum.
Well, one day mum said my stepdad was taking her to hospital for a few days and I asked if I could go with them. Dad said no, mum said “Yes; she’ll be fine.” So off we went and when I noticed we’d gone past the hospital, I didn’t think too much of it – until I saw the huge sign looming up – Stratheden Hospital.
I assumed and hoped we’d just drive past that too. However, when we pulled up at the foreboding buildings and the grounds surrounded by high metal railings – and gates that were opened by the porter who otherwise sat in his wooden lodge, reading a paper. I was petrified and felt a certain shame; my mum was going into an asylum. Oh my God!
From the car park I could see people roaming around, some with an odd gait, others making strange utterances. A lady with long scraggly grey hair, wearing unusual clothing, waved at me frantically then cackled like an old witch. Not sure if it was designed to frighten me, but that she did! Mum and dad got out of the car but I wasn’t allowed to go into the building with them so was left sitting in the car and told not to open the doors to anyone. Ha, as if.
In later years I would learn that mum had been in an asylum once before and on both occasions she had ECT (Electroconvulsive therapy), which is given under general anesthesia. Doctors use a course of ECT
if you have severe or life-threatening depression where your life is at risk so you need urgent treatment
and to treat severe depression where there’s a lack of response or intolerance to medication.
I’d say it looks barbaric but ECT is said to be one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal people. Some people find ECT helpful while others don’t and repeated ECT is only recommended if you have previously responded well to it, or if all other options have been considered.
Back to the future
Dr Nga had dropped me off at the hospital and fortunately, although I had suicidal thoughts, the Consultant Psychiatrist and the Psychology team were confident that I had no intention of killing myself – I’d said even though I felt suicidal, I knew I couldn’t do that to my sons. I couldn’t possibly leave them with that legacy. So, no admission was necessary and three years of weekly painful, gut-wrenching counselling followed – on and off, because sometimes I was too afraid of myself and my responses to the psychologist. I didn’t want to hear what I had to say, so how would the counsellor feel?
I do hope you’ll continue to read My story, Part IV (The finale) which will follow shortly. You’ll learn about my suicide attempt and the hell I went through during my Psychotic Depression. Thank you for staying with me.
In nursing you’re supposed to treat everyone equally and not have favourites. However, we are all human and some people we just click with, for whatever reasons. I loved all my patients, well 99.9% of them, but some are more memorable. Out of the thousands of patients I had the honour and pleasure to work with, these are just 3 of them. I think you’ll like them too.
You’d have loved Jackie, you couldn’t help but adore her. This four foot nothing Scottish pocket rocket had a diagnosis of Bipolar disorder and often had me in hysterics as we enjoyed the same dry Scottish sense of humour. She’d use sayings I’d heard old aunties use when I was growing up like “I’m no as green as I am cabbage looking.” meaning I’m not stupid or “Do you peel oranges in your pocket too?” if you were eating sweets/cakes and didn’t offer her one. I’d said to her one day “I bet you were gorgeous when you were young,” and she shot back as she raced past me “Aye, I still am ye cheeky wee coo and I bet you were still offending people when you were young.” Another time she’d just returned to the ward, in her sopping wet slippers, from a few hours leave and told me what had happened as she was coming back through the hospital gates, “A cheeky wee b*stard asked me did a have a spare fag. I opened the box and counted 1, 2, 3, 4 ……16, 17, 18! 18 fags a telt him and not one of them’s spare!” Leaving me smiling, she speedwalked down the corridor to her room, chuckling all the way.
Bipolar is a mood disorder and can be a life-long mental health problem. It used to be called manic depression and can cause your mood to swing from an extreme high to an extreme low. Manic symptoms can include increased energy, excitement, impulsive behaviour, racing thoughts and agitation. Depressive symptoms can include lack of energy, feeling worthless, low self-esteem and suicidal thoughts. Jackie spoke the above when she was well so in no way am I making a fool of her.
I adored this tiny cockney lady like I did my nana, who she reminded me of. She was about four foot six and no more than 5 stone but boy could she put up a fight. She’d been brought in by her Community Nurse when they said they’d found her depressed and sitting alone in her dirty flat. As Manager of Juniper Ward, Older Adults, I’d arrived one morning and immediately I knew Jeannie was nearby because the stench smacked me right in the face. I wondered which cubby hole I’d find her in today; waiting for me, as she did most mornings. The poor thing had been on the ward ten days and we still hadn’t managed to get her into the bath or shower. She’d screamed and cursed furiously when the word wash was mentioned, more often taking it out on “all the effin foreigners” who “ain’t touching me.” She’d growl in their faces “Learn effin English.” or “Go back to where you bloody come from.” I soon found her and as I bent to give her a hug, I whispered “Jeannie, Sweetheart, I think we need to help you into a shower today, cos I know if you were well enough to look after yourself you wouldn’t want to smell this bad.”
“Smell? Me? You cheeky fucker. It’s you, your nose is too near your own effin arse.” she scowled up at me but I caught her sly grin. I smiled because, despite her fearsome outer shell, I knew she was beginning to trust me. Assuring her all the way, Jeannie let me inch her towards a bathroom and, before she changed her mind, I quickly grabbed another nurse who could help. It was pitiful as she wept when we were undressing her and saw her frail ravaged body. She cried out in shame and my heart bled for her. However, we’d finally managed to shower her and get her some clean clothes and I could have cried when she stood ten feet tall, shimmying into day area like a peacock spreading its wings.
Now there’s no way that smell was only ten days old; even Jeannie’s silver grey hair stank, it was matted at the roots and had clearly not been washed or managed for years. So why had the community team rang the ward, miscalling our team, saying that Jeannie’s been on the ward ten days now and she’s still in a state.Huh! What had they been doing for the last year or so? I asked them. And why did her family come storming onto the ward, thundering at my door, complaining that we hadn’t done anything with their mum’s hair. “Oh, I agree Jeannie’s hair is in a terrible state Sir, but your mum’s only been with us ten days, and you can see her hair hasn’t been touched for a long time.”
I explained to the buffoon of a son that his mum had the capacity to make an informed decision about bathing/showering or having her hair washed and she’d decided not to accept nursing support in attending to her hair. The Royal College of Nursing (RCN) 2017* states “If a person has capacity to make decisions independently then their decision is binding and the proposed examination, treatment, care or support cannot proceed, even if you think their decision is wrong.”
Eyes rolling. Pft! He tutted and sighed heavily, not quite sure what to say. So I saved him the bother and said “Look, if you’d like to make a formal complaint, I can let you have the appropriate forms -” Ptf! more heavy sighing and “No, it’s alright. No problem and thank you for looking after her anyway. She thinks a lot of this ward and I wouldn’t want to upset her; she can easily fly of the handle.” Really?
This thirty-nine year old lady had a Borderline Personality Disorder (BPD). People who suffer from BPD struggle to regulate their mood and emotions, which results in them being unstable – sometimes for long periods at a time. It can cause problems in relating to other people, and often makes controlling impulses difficult. Unfortunately, some people with BPD are more at risk of experiencing suicidal thinking and self-harm attempts.
Many, though not all, patients who have BPD are known to have experienced parental neglect or physical, sexual or emotional abuse during their childhood. The symptoms of a personality disorder may range from mild to severe and usually emerge in adolescence, persisting into adulthood (NHS 2019).
Andrea had suffered many of the abuses at the hands of her mother and the men she took home. She had known her mother had given birth to several other children, both before and after Andrea, most of whom were adopted. Her young life had been chaotic, frightening and devoid of any love or kindness from her mother.
At the age of sixteen she met and fell in love with a young man and they ran away to Gretna Green in Scotland to get married. (In England you have to have parental consent if you wish to get married. However you can get married in Scotland at 16). Andrea felt loved, happy and secure, feelings she’d never known existed.
The young couple managed to get a one bedroom council flat and their happiness continued until one day her mother came to visit for the first time. She stank of cheap alcohol and cigarettes, as always, and she still treated Andrea with utter contempt saying she’d only come to get a look at her flat and this new fella.
She’d barged past Andrea into the sitting room, took one look at Andrea’s husband and said “Ere, you ain’t adopted are ya?” When he said yes she chuckled and asked his date of birth. “Oh my gawd! ‘Ere Andrea, I think you’ve only gone and married your flippin’ bruvver.” she said, laughing . Neither Andrea nor her husband could speak so her mother continued unabashed and guffawing “Everyone’s been tellin’ me how alike you looked and it got me thinkin’ -.”
It was true. Andrea’s world was turned upside down, the reality sank in and their marriage was annulled. The first of many suicide attempts followed and in between them her behaviour was erratic, she self-harmed and had many hospital admissions. She was given a range of diagnosis over the years and had been described a variety of antipsychotics and mood stabilisers which either didn’t work or the medications weren’t being managed correctly.
I first met Andrea on an acute ward where I initially thought her rather threatening and sullen, responding to any communication with one word answers. She was left alone for days by the staff and I wondered how this could be therapeutic, but nurses just said “She’s always here. She’s only on the ward for respite, she doesn’t need anything.” So I watched as Andrea stomped from her bedroom to the smoking room and back, to the dining area and back and to the medication room and back, glaring at everyone she passed and talking to no one.
I’d always said good morning or afternoon to Andrea, as I did with every patient, and wasn’t sure what else to say to her. I knocked on her open door one morning and asked if I could come in. “Everyone else just walks in anyway.” she muttered. I told her I wasn’t quite sure, as a new nurse, what to say to her but I’d like to get to know her. “At least you’re honest.” she smiled a little “No one else bothers.” I was sad but shocked and angry, I suppose. I asked her about the myriad of scars trailing like train tracks all the way down from her shoulders to her wrists and she showed me her legs which were also ravaged by years of cutting and slicing.
Myth: Self-harm is attention seeking
One of the most common stereotypes is that self-harm is about ‘attention seeking’. This is not the case. Many people who self-harm don’t talk to anyone about what they are going through for a long time and it can be very hard for people to find enough courage to ask for help. https://www.mentalhealth.org.uk/publications/truth-about-self-harm
Andrea explained how the cutting started as a way to alleviate the disgusting thoughts and feelings she gets. She told me she enjoys the pain and watching the blood trickle because it gives her something else to think about for a while.
We started spending more therapeutic time together and it wasn’t long before Andrea and I had built a great professional and therapeutic relationship. After a while, we disregarded her ancient care plans and developed new ones which involved Andrea in the planning, risk management and reviewing of her care. We developed goals specific to her to maximise coping mechanisms, medication management, engagement with services and social integration prior to her discharge but to be continued in the community. She began to engage more with her peer group and attended a variety of therapeutic groups. She even joined me on the hospital’s mixed football team and proved to be a terrific goalie.
Once I’d left that ward I often bumped into Andrea and always had time for a ciggie and a cup of coffee with her. On one of these occasions she quipped “This is all we all need; a ten minute dose of Nurse Nancy on the NHS each day.”
Could you be that nurse? The one that makes a difference. Could you be non-judgemental, kind, caring, compassionate and be a real listener where you actually hear the patient behind their story? We desperately need good mental health nurses to work for the NHS in the UK.
*Royal College of Nursing (RCN) 2017 Principles of Consent Guidance for nursing staff