Tag Archives: Therapy

Living with thorns

Last month I was invited to take part in a teaching series my church has been running on mental health. Each session had looked at a different aspect of mental health from the perspectives of scripture, a mental health professional, and a testimony from a church member. I was invited to be the testimony for the session on depression.

I was actually very excited to speak about this, as being open about my mental health is really important to me personally and in terms of creating a space for others to talk about it too. You can listen to the whole teaching slot here (search for ‘Living With Thorns’), featuring myself and a therapist from the congregation being interviewed by the preacher as part of the talk, but here is my testimony itself:

Interview:

In your darkest moments what is it like for you to live with depression?

I found this first question a bit difficult as I’ve had two experiences of depression, one severe in my teens and before I became a Christian (I was actually spontaneously healed when I fist met Jesus!), and more recently a spell of mild depression, mainly through 2016, though I’m still very much walking through recovery from that now, it can be a bit of a process. So the lows are all very much past tense, and day-to-day now it is pretty mundane. Maybe that’s helpful to note in itself?

Depression takes many forms. Back in my teens I had severe depression and it manifested in suicidal thoughts, hopelessness and emotional numbness. My recent, mild, illness has been more like a crushing lack of energy and motivation and a tendency to feel so overwhelmed it paralyses me, only occasionally spilling over into low mood. But it’s all the same illness, it presses down on you as a heavy weight. For me, recently, the bad days have felt like a spiral out of control; my thoughts assail me so heavily it feels like being beaten round the head and knocked down. Thoughts of failure, of not being enough, of inadequacy, and on top of that, of all the myriad things I ‘should’ be doing, and you can imagine how upsetting is would be to have someone have that sort of rant at you – it’s like that, I break down in tears and can’t easily separate out what really needs to be done now from all those ‘should’s under the weight of it all. So – I get stuck, end up lying on the sofa, having an uphill battle to even make myself drink a glass of water…

So that’s the worst of the current beast I live with! Most days now it just manifests as a lack of energy, a frustratingly low burn-out point, despite my hope and joy and love of life.

But the darkest I’ve known previously has felt like absolute hopelessness. It is dark and terrifying to be unable to see any hope or potential for change. Depression can lie so convincingly that there is no hope it feels like an objective fact that no-one else could ever possibly understand from outside. But having come out the other side I can tell you it is a lie, and that there absolutely is always hope, in God’s big picture that is bigger than us and our lives if nothing more, and as long as you are breathing you can live for that and be part of it.

We know you have faith in Jesus so could you tell us what it is like to follow Jesus through depression?

Positives and negatives; because my illness lies to me it can be harder to hang onto the truth, I easily find myself projecting my own insecurities onto God (ie in my case I first realised I wasn’t well when I noticed I was starting to wonder if God had a place for me or had just made me ‘for decoration’ without a real purpose in God’s plan… in truth, finding my place and purpose is not easy. I’m struggling with that myself. But that’s not God!). Faith is also potentially an area I can beat myself up over, for example when I want to read the Bible but don’t for whatever reason – it’s normal I think to feel bad about that, but when depression weighs in on it it can feel really bad (I can start telling myself I’m a bad Christian…).

On the other hand, I’m more aware of my need for God, even if God feels distant or silent sometimes. Sometimes God has felt extremely close in the silence. And there’s been something special and important about giving God some very raw prayers, rants, tears… Sometimes, when things have felt very dark and I’ve lost hope for myself, I’ve seen God’s light and the big-picture hope of God’s Kingdom coming shine so strongly in contrast to it that it takes my breath away! Without the dark I couldn’t see how strong and bright that hope is. That’s been very good for me. So too has seeing God using my experiences to help others – that’s been an incredible honour and I know God’s been using me there.

What were the best and worst parts of being part of church during times of depression?

It’s made me flaky (even in recovery!). I struggle to commit to things, have to take things one day at a time, pull out of things if I don’t feel up to it (I can easily get overwhelmed, I’ve less capacity, and things get on top of me easier), and can struggle with motivation (ie to go out, or to do certain things). All this makes it very hard to get more actively involved in church, and get to know people and become part of the community (it makes it very hard to arrange to see friends too…). That in itself can feed back into the illness as it doesn’t feel good. Church/homegroup is particularly hard if it feels like everyone else is doing fine and has their life in order! On the other hand church/homegroup can be a supportive and safe environment and somewhere I can get out the house and most importantly seek God and truth.

What helps you to cope?

Talking about it. Depression thrives on secrecy, but getting it out in the open lessens its grip, whilst also helping you to find help and support from others, solidarity with others also going through it that helps you feel less alone, and also helps you find others you can walk alongside too.

Prayer. Honesty before God. God is big enough to handle our rawest emotions, let it all out.

Self care. It’s not an easy ‘just do this and you won’t be depressed’, but it genuinely does help to be more intentional about things like exercise, healthy eating, socialising, doing things you enjoy(ed) of find/found relaxing.

Work. Having a job with a lot of structure and regular hours, and supportive colleagues and a good mental health and wellbeing culture, really, really helps.

Perspective. I need the big picture hope narrative of the Bible to pull me out of myself and keep reminding me that whatever happens in my lifetime, God’s Kingdom is coming and love wins.

Therapy. I’ve been to a CBT course, it felt frustratingly like being taught how to walk – but if I’d had a debilitating accident and lost the full use of my legs I would need just that, so why expect different of my injured mind? It’s been helpful. I’ve also been seeing a counsellor to try tackling my underlying issues.

Switchfoot! I’m only semi-joking; admittedly I am a megafan of theirs and was already before I got ill, however, the work of Christian artists who are grappling with this stuff can be a real help and support. Switchfoot is one such band and certainly do a lot for me, but there are other musicians and other forms of artists whose work explores depression and mental illness at times, and I recommend finding artists who can give words to what you’re experiencing and point you towards hope.

Here’s the vid of the interview that we recorded as a back-up in case I couldn’t speak in person on the day (featuring a feline cameo!).


If you’re struggling, or just not feeling quite right, please do try to get help – it isn’t always straightforward, but help, and hope, are out there. For a start, try this if you are in the UK, and this might be useful wherever you are.

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Liturgy in the waves

Whilst I’ve been quiet on the blog, I’ve got really into bodyboarding this warm sea season.

I’ve been having an occasional go for about five years now, but this is the first time it’s really got hold of me. My previous attempts were embarrassingly laughable. I’ve joked that I spent more time clinging to the underside of the board , thinking I’m sure this isn’t how it’s supposed to work and wondering what went wrong, than actually riding on top of it! And I was only half joking; upside-down boards happened far too frequently! I was scared of any waves approaching my own size or bigger. I couldn’t read the sea so waves would rear up and take me by surprise. My attempts at catching them were complete trial and error, launching at waves of any stage of formation and just hoping I didn’t fall off if I happened to time it right. And most of the times, I did fall off! But it was so much fun when I did catch one – even if at some point down the beach I did end up on the wrong side of the board.

This summer we had two consecutive weekends away in good surf spots with different sets of friends who wanted to spend time bodyboarding. Over those two weekends we had five whole days catching waves, and although I had boasted of my unfortunate talent for upside-down waveriding, I was surprised to find I was actually staying on top of the board. What’s more, over the five days, I found I was making a lot of discoveries and truly learning something each day. By the end of the first weekend I was reading the waves, knowing when to launch, and catching the majority of the waves I attempted… and pushing out further into the larger waves further out too. I learnt how to choose a good wave, how to steer, how to angle the board, and how the waves change in mood, power and difficulty from beach to beach, day to day, tide to tide. Of course I developed a new special talent for overshooting the board when launching out and sliding right over the top, and once or twice found myself barrelled head over heels under a massive breaker, momentarily wondering how I was going to escape, but on the whole it’s been going great.

I’ve been out boarding several times since to take advantage of the nice autumn sea temperatures and quieter beaches. I’ve officially got the bug!

So, is it play? Is it therapy? Or is it worship?

I think it’s definitely all three, but the mix varies depending on where the sea and I are at. It began as pure play, but it’s been healing at times too, and I’ve started to find it can be an act of worship.

A couple of Sundays ago I was in Wales with fiends. We spent the morning celebrating Harvest at St David’s Cathedral, and then went down to Whitesands Bay for the afternoon. Wowww!! I was already feeling celebratory and full of joy and thankfulness as a result of the Harvest service, but the place was so stunning and the waves so beautiful and glittery it all just overflowed. The worship on the beach felt like a seamless continuation of the worship in church.

First of all, it is nearly impossible not to bodyboard in a state of mindfulness. All the senses are involved, and you have to pay attention to what is immediately going on around you and be immersed completely in the moment, fully awake to where you are and what you are doing. You smell the sea air; your eyes feast on the colours, light, contrast, drama and movement of the sea and sky and wildlife and other beachgoers; there’s no avoiding the taste of saltwater; you hear the hiss, fizz, and roar of the waves, and your own laughter and whooping; and you feel all the textures of the sea, the sting of salt, and of cold water on hot skin, the feel of the board, soft sand, rough stones, the sometimes violent slap of waves, gentle rising and falling, warmth, wet… In the sea I am really in the now, and it is incredibly centring.

At risk of sounding clichéd, it is something like baptism with every wave or spray that breaks over me, reminding me of what is washed away and blessing me with new life.

It’s a humbling experience. In the sea I get the smallest glimpse of the size and power of its maker, and my contrasting insignificance. It’s amazing to be out in nature, surrounded by this huge unknown, unpredictable, power, tumbled about in it, but to be able to play in its edges and get to know it a little nonetheless.

I find myself full of thankfulness! It’s a grace experience, an undeserving land creature immersed in such beauty and laughter that’s completely not my own element, and seeing waves presented to me as perfect curls to play with. At its most beautiful I can never believe I’m experiencing it. Every good wave finishes in hallelujah, thank You, as it brings me to rest on the beach. More often than not I find I fetch up in a prayer posture, on my knees or face down at the edge of the surf, and thanking the sea and our God just flows, before I get up and run back in. It comes naturally, but I’ve also begun to make a conscious discipline of turning to say thank You for every good ride, as it develops in me a lasting attitude of thankfulness.

There are moments of quiet contemplative solitude…  and then there are moments of shared joy when catching the same wave, high fiving and cheering at each other’s good waves, and teaching one another skills.

At the end of a good beach day I come away full of joy, re-set, with a bigger, truer perspective on our size and significance compared to our beautiful world and the one it comes from. I am reminded so much how good the world can be, and that for all its problems, that is only ever part of the reality and there is still so much to enjoy and celebrate. We get immersed in the big news of the day, and forget that we are transient, and that some things are that much bigger and better and more lasting than we are. The sea brings me back to that truth.

I come home with waves in my mind, still feeling the rise and fall of the swell, the sea still alive before me every time I close my eyes.

Bodyboarding is no substitute for church. That day at Whitesands was made all the more meaningful following on from a service, and a service of thanksgiving in particular. But it can definitely be a powerful, playful worship experience, as the formal liturgy of church finds its way into the everyday world, and I hope I never lose that.

Looking for Europe 3: Paris – therapy

May 28th

Well that was healing! What an incredible show!

The day did not start well, waking up at 4am with a heavy heart and having to pack down a dew-drenched tent and carry it to the car, then getting lost en route and almost missing the train. But miracles happened; time dilated somehow so we arrived just on time, and the train was delayed and the staff sympathetic. We made it! And we got to the hostel ok, and even got our room early so we could shower and change before the show (much needed in the heat!), though we ended up in a stressful rush but then had to wait ages for the VIP event.

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But when we eventually did get in, Switchfoot were soundchecking Holy Water and Oh Gravity, two of the best songs I’ve ever heard live! That was really awesome. Because Meet and Greet was running late I barely got a chance to tell Jon about last night, but I got to say a bit and told him this show was my therapy. I worried afterwards it had sounded more of a moan than an apology for not being there/ ‘this-is-what-you-mean-to-me’ as I’d meant it to be. But he sympathised a little and told me there would be other aftershows… and then made everything worse by telling me, casually, he was playing a solo show in the UK, that week, whilst we are travelling!!

I was literally speechless. I think I just stared open mouthed with my head going ‘Nooo!!! Why didn’t I know this?! I cannot miss two solo shows in a week after waiting all these years?!’

I cried crazy tears after that, on the pavement outside the venue, partly at the irony of this, partly the despair, partly the ridiculousness of my silly self! I have issues for sure 😀 Then it got surreal. Jude went to buy a drink, but came back with a massive box of salad from a deli, absolutely not the sort of thing I expected to find in a random Paris backstreet, nor the sort of thing one can easily eat standing up! So there I was, on the pavement outside the venue, freaking out in tears, eating an amazing, messy, crazy vegan salad box and finding it all hilarious 😀 Oh Jon, what are you doing to me?! We met some more wonderful French and American SwitchFam though (including a sweet guy who lent Jude a phone charging pack for the night), and enjoyed hanging out. If any of you are reading this; I do apologise for the state I was in!

Then the show! A fun, sweary band opened for them, with amazing rhythms and time signature changes. Then Switchfoot came on with a totally rocked out set! It was crazy, hot and sweaty, so rocked out, and the guys were just having a great time. It was the first time they’d ever played in France! They were so happy to be there, and the crowd was overjoyed to be hosting them. I got front row near Drew, so I got to watch his soloing and guitar work up close. The stage was very low, and the venue small and intimate, which made for an incredible show.

 

Watching my videos back from this show after I returned I have to admit that they are truly terrible, there’s just noise and sweaty people and jumping; but they do give a good feel for how rocked-out this one was and what it was like to be front row there, so I’ve still put them online. Here are Sabotage, Bull In A China Shop and Stars, hope I don’t make you seasick 😉

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Jon came over and sang ‘Don’t let go’ to me during Needle, we brought out two packs of Oreos and danced with them during Love Alone (‘oreo, oreo…’), and though they almost played Healer Of Souls we got Sabotage instead, which I cannot complain about, it was much fun! Jon went into the crowd for Love Alone, and then as the energy was good he went right into Bull In A China Shop! Wow! There was some crazy Float dancing, which was fun! Jon gave one of his water bottles to a fan who was struggling with the heat. Then they brought it down a little and played Hello Hurricane and Only Hope in the middle of the crowd, 24, Live It Well and Dare.  Stars, Bull… and Live It Well really resonated with me that night, but it was 24 that brought on the tears again.

I could tell the guys were really enjoying themselves; even early on in the gig Jon told the crowd that night had the makings of being one of his favourite shows, and towards the end he echoed that, thanking France for the love and saying it was up there.

 

Then there was an aftershow, sadly cut short by the venue staff at just two songs, but it was still great. He played Before Our Time and Your Love Is Strong, though he was going to play Caroline (‘Is anyone here called Caroline?’ Random guy at the back: ‘I am!!’ ‘You’re the most beautiful Caroline I ever met!’ 😀 ) ‘Caroline’ got a couple of shoutouts at the end too 😀 I was right next to Jon and sang along… and then he was gone.

We both had dead phones by the end of the night and realised we were a bit stuck getting back to the hostel as I’d forgotten my paper map. We asked for directions, but in the end as it was a little complicated we ended up getting a lift back from our French friend, even though she only had one seat in her car and Jude had to hide in the boot! It made for a funny journey and a cute photo 😀

Wowowow! The very best therapy 🙂

Read Part 2 here and Part 4 here

 

Resurrecting me

Like so many of Jon Foreman’s songs, Resurrect Me has played a huge part in my story.
I stayed up till 3:30am last night watching (amongst other things in the beautiful, honest, hope-filled evening that was TWLOHA’s Heavy and Light concert) Jon singing this song. In a whole evening dedicated to being real, opening up about when life hurts, and affirming that hope is real, it struck me again that this song was what first inspired me to seek help for my own pain about a year ago.
I’d been back and forth between ‘ok’ and ‘not ok’ for some time, and keeping an eye on myself, aware I needed to take my mental health seriously but not sure at what point to reach out.
And then one day last spring I found myself listening to this song. I’ve listened to it hundreds of times, but that day one line jumped out at me: ‘I tried to drown the pain with a friend of mine, it didn’t seem to help, ah she’s got a pretty face with her wedding lace but I’m still waking up with myself
Suddenly it was obvious; if I’m not ok now, without a job, what makes me think I will be ok when I get one? Isn’t the problem right here, in me? A line in a book I was reading that same week confirmed it: Wherever we go, ‘We take ourselves with us’. I had to find a way to be ok with that!
Here is the truth. I was ‘ok’, but I was carrying pain that previous jobs had not fixed. Neither had my marriage, my relocation or my home. Maybe it was ok for that ‘ok’ to not be enough, and to seek help.
I can testify that it was absolutely worth it! There is help and support out there, none of us are alone in our pain, and as TWLOHA will tell you, hope is real, help is real and recovery is possible. I’m now on that road; I hope that I am learning to ‘take myself with me’ now, to be able to keep my eyes on the honest reality of the state of my soul and listen to both my ‘light’ and my ‘heavy’.
I don’t know where you are at. But if you find yourself waiting for something to complete you, I’d love to encourage you to find help to discover that you can be whole already, without that thing yet in place. If you’re not ok with yourself now, you will not be ok when that job, relationship, family, move, marriage, money, or home arrives. That pain is there, in you. And that’s ok. And you can be helped to find yourself whole, now.
Resurrection is real.

You can watch the whole of Heavy and Light here, I recommend the whole thing, a really affirming and honest event.

An ambush

Wolf,

I sense you lurking in the shadows

Behind my path

Watching

Waiting for another chance to attack

To beat me around the head and knock me down again.

As long as I keep walking on

You stalk me

You have control.

But what if…

What if I could lead you into a trap?

Lure you towards some waiting ambush?

Let a cage drop and catch you behind bars?

And then turn and face you

Who is in control now?

Shall we talk?

Being thankful

We hosted a Thanksgiving dinner for the first time this year! This has not been an easy year at all, personally or politically, but aside from liking the tradition and fancying the cooking challenge, I wanted to do this as I felt that actually I still have a huge amount to be thankful for from the past year, and that in a time when circumstances make it harder to see the good things and feel thankful, setting aside a little time to focus on what I am truly thankful for is a good discipline. The more I’ve thought about it, the more good I’ve spotted amongst the mess, and it has left me feeling genuinely grateful for those good things and a lot more positive about the year. So; my list:

  • Time at home. My new year’s resolution this year was straightforward after last year’s wonderful chaos; to do nothing! Well, maybe not ‘nothing’, but no crazy plans, no charging around the country(/world) week after week, and to focus on spending time right here at home, with our local friends and church family, and making progress on our DIY projects. And we’ve done that! It’s been really nice being a little more settled.
  • Living in Devon. Related to the last point – we live in a nice place! It’s been good to spend more time just enjoying where we live. Our main holiday this year was to Lundy Island, an island off the north coast in a protected area, which is therefore jumping with sealife. We saw so many seabirds, seals, jellyfish, rockpoolies and dolphins, and it was beautiful – all almost on our doorstep! And the walks and beach trips we’ve done closer to home have been wonderful too. We made an effort this summer to go down to the coast on nice evenings for barbecues or chips on the beach as the sun goes down. I can’t help but be thankful that my life looks like this after years living and working in and near London, it’s a real blessing.
  • The support for our whitewashing nonviolent direct action last year. I’ve been blown away by the amount of support I and my fellow activists have received since our action last November. A huge crowd of supporters turned out to our trial, some coming a really long way to be there. There were far too many people to fit in the viewing gallery and many stood outside in driving rain for us all day, praying, holding banners and looking after us. I’m so humbled! And on top of that, when we received a (much smaller than expected) fine, friends, family and supporters crowdfunded enough to pay it off in full! We checked the amount that came in a week after the verdict, and it seemed a random amount; but then we totalled up our collective fine and realised it was the same amount to the nearest pound! Shortly after this we closed the crowdfunder early as we had exceeded our target, despite not expecting to meet it, and found the amount raised exactly covered our expenses for the action too! I am profoundly grateful to God for so fully honouring our imperfect willingness to do this, and to our supporters, both for the obvious practical help this was, but also for the solidarity of knowing we had so many people standing beside us and willing to also pay the price of speaking out on climate change.
  • Good news on climate change. Aside from the ratification of the Paris climate agreement, it seems politically that this has been a bad year for climate, as in practice the political world has barely moved into action at all, and in many cases we’re still seeing the politics moving backwards. However; more and more this year I’ve seen signs of change, almost in spite of the politics of it all. The economics are starting to shift. As renewables grow, in spite of policies that hamper them, and the combined pressure from increasingly cheap renewable energy, financial disinvestment, uncertainty over the future under international climate agreements and the cost of carbon hits the fossil fuel industries, a real practical shift away from fossil fuels has begun. We have a long way to go, and fast, but this is genuinely encouraging. We need to keep up the momentum on fossil fuel disinvestment, which is really a win-win situation, whilst at the same time urging our governments to think progressively and practically get behind this shift, which would really speed the process up.
  • Vegan abundance! Going vegan ten years ago was relatively straightforward, with plenty of choices available in ordinary shops, and at least something you could eat in most restaurants when out. But there has been such a fast shift over the last year or so! Several vegan/explicitly vegan-friendly businesses have popped up all over town, raised consciousness means I’m finding it more common for non-veggie friends to know how to make really nice things for us, little innovations the world seems to have just discovered (coconut cream makes wonderful whipped cream, chickpea water works like egg whites…) mean vegan baking has suddenly become even easier and cafes are cottoning on, and even some vegan cheese seems to be finally starting to resemble the real thing! I’m suddenly beginning to realise how much self-control I’ve lost over the years, now that what was a ‘special diet’ is becoming so mainstream; I’ve been used to luxuries being just that, and therefore jumping at the chance to indulge when the chance arose from time to time, but suddenly it seems there are easy luxuries everywhere and I have to be restrained for the sake of wallet and waistline! But at the same time, what a nice problem to have – such great news for me, and for animals and the environment 🙂
  • The mental health services. Wow am I thankful for the help that I’ve found available to me this year as I’ve found myself battling depression! I’ve heard the horror stories and know not everyone gets the help they need when they need it, even when they do seek it, but my experience has been good so I know that’s only one side of the picture. I’d love to see the day when mental health is taken as seriously as physical health, because it is, and everyone can find help. But I’m very thankful that I have a good GP, have been able to take part in a well-taught CBT course for free, and have had help from my church towards paying to see a counsellor. Each of these things have been a God-send in an unpleasant situation, and I am so thankful.
  • Supportive family and friends. And again on a related note, I am deeply thankful for the community of people I have in my life who have treated my illness as an illness, been understanding as they can be, and been there to encourage me and share advice. I feel honoured to be able to reciprocate that to others too, and am grateful to have that chance through this circumstance. It’s brought me closer to myself, to others, and to God.
  • The RSPB. Last year I was volunteering for several different charities, often on my own and with irregular hours. This year I decided to change and focus on my work with the RSPB nature conservation charity, filling my newly-free days in the week by taking on some scientific support work in their local office, which means I’m now working with others and with pretty regular office hours, and getting to use my science brain a bit. Simplifying my work this year has itself done me a lot of good; but so has the RSPB directly. Conservation is not always the most encouraging world to work in, with so many species and habitats under threat. But working with the RSPB, I see an amazing array of good news stories as hard work saving nature really does pay off. Both internally and externslly there’s a real emphasis on hope and encouragement around this. The project I’ve worked most with this year has just celebrated a milestone as a little bird we almost lost from the country has been brought back from the brink and is increasing (you can read more about that here, it’s a nice reminder that good news is out there!). But even in addition to this, the organisation takes staff wellbeing seriously (as a volunteeer I am still considered part of the staff team) and has done a lot of work to raise the profile of wellbeing and mental health and promote activities and support that can help. I’m not sure I could be working in a better environment right now!
  • Being able to ‘do autumn properly’. It’s no secret that I love autumn! I felt like I missed out on it a bit last year in my busyness, so this year I made an effort to give time to enjoying it as much as possible. So we went on holiday in the Lake District, swam and bodyboarded in the sea, went for walks in the local arboretum and elsewhere, picked up colourful leaves, made some of them into pretty decorations or collages, went birdwatching plenty to catch the migration in progress, baked for halloween and used it to pray over the world’s darkness, went to the legendary Nottingham Goose Fair (enormous cheesy funfair, and something I haven’t done since leaving home), went to an apple day and made apple fritters to celebrate, had a Thanksgiving party and a Harvest ploughman’s meal, went to a fireworks display, and planted trees in the garden. I don’t think I’ve missed anything this year, and although it’s been unusually warm and dry and the trees gave us a bit of a stop-start display this year it’s been wonderful – and I have far too many photos! 😀
  • Switchfoot. I confess, when I drafted this list, this was the first thing I wrote! A lot of bad things have happened in the world this year. But 2016 was also the year Switchfoot brought us their 10th album, Where The Light Shines Through. And in a dark year, it really has been where the light has shone through for me, not just a highlight of the year for a fan, but also an incredibly timely album full of messages of hope and strength and light, so much needed just now. This band has done more than anyone else this year to encourage me to look for the points of light breaking through the darkness, keep my eyes on the Source of my hope, and work to become where the light shines through myself.

Self-help for anxiety and depression; part 2

I’ve now finished the CBT self-help classes I have been taking this summer. I wasn’t sure how to write this post as it isn’t such a personal perspective as the last, and I’m reluctant to turn this into a mental health blog in general; my aim is just to keep sharing where I’m at. But I felt I wanted to follow up my previous article on techniques for managing depression by sharing the treatment techniques we learnt on the remainder of the course, as I feel the more this information is shared about, the more we can help each other overcome our illnesses.

The second half of the course looked more at ways to overcome anxiety – first a session about understanding and handling panic attacks, then a session looking at worry and how to manage it healthily, and finally a short session on recovery and avoiding relapse*. I’ve been experiencing more anxiety than is normal for me since being ill, but not to the extent of being diagnosable, hence this being much less of a personal perspective than part 1; I haven’t had to deal with the symptoms to know how effective these treatments are. But here they are; they’ve helped me to understand anxiety more, and I hope they will help us to overcome any anxiety of our own, and to help others experiencing it:

Panic attacks – ‘Panic’ is one of those words that is in everyday use, and yet has a very specific meaning when talking about mental illness. We all ‘panic’ at times. But not everyone experiences panic attacks. Panic attacks are very common, affecting maybe 1 in 20 of us; they are extreme anxiety attacks, usually lasting just 10-20 minutes, that cause physical symptoms such as a pounding or skipping heart, breathlessness and/or hyperventilating, sweating, shaking, feeling like you will be sick or need the loo urgently, or feeling dizzy or faint, and feel terrifying. When a person is having a panic attack, they often feel like something awful is happening to them, for example that they are choking or having a heart attack. They feel so bad, people become anxious about having another.

The course leaders described what is going on here as being like a household smoke alarm, which goes off if there is a fire, but also reacts to burnt toast! Basically our brains interpret something as a threat, even if it may be a non-physical threat such as a deadline or a crowd, and release adrenaline, which would prepare our bodies for ‘fight or flight’ responses. The physical symptoms experienced in a panic attack are the direct result of this adrenaline, which increases heart rate, breathing, sweating etc to prepare our bodies for action in response to this ‘threat’; the symptoms may be scary but they are not dangerous, and the worst is not going to happen. Knowing this can in itself help break the fear cycle.

The anxiety the onset of a panic attack causes can cause a vicious cycle of panicking thoughts and symptoms, and afterwards, the fear of a repeat can mean that consciously or even unconsciously a person can begin monitoring their body for small changes – which can trigger the ‘smoke alarm’, and mean a panic attack can seem to come on out of the blue. And so, we start to avoid certain situations we fear may bring on an attack or be hard to cope in if it happened, and develop ‘safety behaviours’ to cope, things like staying near to exits, having something to distract us like a phone or music, or seeking reassurance. In the short term, they help us feel less anxious; but in the long term they reinforce the problem. What if these things were not available to you? Could you cope? If not, it is a safety behaviour. Using it is training your brain to be dependent on it and that without it you would be unable to cope, whilst never giving yourself a chance to prove that you can cope.

To regain your independence from safety behaviour and feel able to cope in situations that made you anxious, the treatment is again going to involve hard work and perseverance, but apparently really does help people overcome crippling anxiety. It involves facing your fears in a very careful way. The aim is to retrain your brain not to be afraid of fear, but to accept that anxiety subsides with time and doesn’t need to be run from. Anxiety symptoms are caused by adrenaline, and adrenaline wears off; this treatment teaches you to feel the adrenaline wearing off and become used to that as a normal follow-on to the feeling of it increasing.

Firstly, grade the situations that make you anxious – give them a score out of 100 for how anxious they make you feel and rank them. Find one thing that ranks about 40-50, and work with that until it stops causing you anxiety before moving on to something tougher. Identify any safety behaviour you use, and perhaps incorporate that into your scores; maybe something is easier to face with a friend than alone for example, so would score lower. Taking that situation that scores about 40, work on putting yourself in that situation regularly, at least four times per week, scheduling it specifically into your diary to make sure you do it. Do not allow yourself to do anything to lessen the anxiety of the experience or distract yourself; you need to be able to feel that initial anxiety to feel it coming down with time. Stay in the situation long enough each time to experience the anxiety levels reducing to about half what they were initially. This way you teach yourself by experience that if you expose yourself to this situation, the anxiety will reduce.

We discussed reasons it may not work, and they mostly came down to not staying in the situation long enough, masking the anxious feelings, or incorrectly grading our anxiety, which obviously takes some practise (if you pick something you think will be a ‘40’ and it turns out to be much more anxiety-causing than that, you may not be able to handle sitting it out long enough to let the adrenaline come down and feel that effect, whereas if you go for something that turns out not to make you very anxious you won’t feel much either). Basically this aims to retrain our brains out of triggering the ‘smoke alarm’ over situations that are actually not dangerous, and get used to the physical sensations of increasing and decreasing adrenaline, whilst increasing our self-confidence.

This obviously only works for situations that we can experience regularly; for one-off situations such as a job interview or party for example, we were taught to try behavioural experiments. The first step in this case is to identify the anxious thought (perhaps ‘I won’t know what to say if I’m asked a question and will look stupid’ or ‘no-one will talk to me’). Then identify any safety behaviours you might use (maybe taking in notes to read from, or taking your phone to hide behind). Then plan an experiment (Can I do this thing without my safety behaviour?). Plan out how you will do it, then predict exactly what you think would happen if your anxious thought turned out to be true. Write it all down to keep a record of to refer back to. After the event has happened, come back to your experiment, and note down the actual, honest outcome, and exactly how it worked without your safety behaviour. How does it compare to your prediction, and what does that say about your initial anxious thought?

Finally, when we came to discuss this as a group, several people said that the controlled breathing techniques we learnt previously really helped overcome panic, firstly by shifting the attention onto the action of breathing, and secondly, physically working with the adrenaline by increasing oxygen intake whilst slowing breathing down, which helps the heart rate to come down and stop hyperventilation.

Worry – When we’re ill, our worrying can feel out of control. There are basically three types of ‘worry’: Practical worries (about something we are able to do something about); Hypothetical worry (‘what ifs’, which we can’t do anything about), and ‘Rumination’ (going over past events and thinking what you ‘should’ or ‘shouldn’t’ have done or wishing it had been different – which again we can’t do anything about). We handle worry differently because of differing basic beliefs about it – some negative (for example ‘I shouldn’t worry’, or that it will get out of control), some positive  (for example thinking it helps motivate or prepare us for things).

We all worry, and that’s ok, but we can’t deal with worry by simply trying not to worry; that just makes us worry more. To deal with excessive worry healthily, try keeping a diary for a short while to identify your worries. Are they practical or hypothetical worries, rumination, or negative thoughts? Negative thoughts are better dealt with by thought challenging.

Set aside a short period 15 minutes of the day as a worry time – a time when you won’t be busy with other things and not too late in the day so you go to sleep with anxiety; you need time to relax afterwards. Through the day, write down all your worries as you go, maybe on post it notes so they can be discarded once dealt with, and put them aside to look at in that planned worry time – that way you acknowledge them rather than trying not to think about them but can shelve them for later; you can think about them but don’t have to think about it right now. Practise drawing your attention back to the here and now after writing down a worry, perhaps by focussing on your breath or on your physical senses (what can you physically hear right now for example). In the worry time, allow yourself to think about the things you’ve written down, but discard them at the end of the allotted time.

Any that turn out to be practical worries, you can think through a strategy for how you will deal with them. When you do this, think as creatively and even outrageously as possible to list all the possible ways you can think of to solve the problem: For example, if the problem is having no money for the bills, solutions could be to change jobs, cancel a subscription to something you don’t use… or rob a bank! Then go through the advantages or disadvantages of each, make a plan, schedule it, and once you’ve done it, review how it went.

I’ve found a massive difference in my own excessive worrying simply from categorising my worries; once I’ve noticed what I’m thinking it seems to have interrupted the worry process enough for me to bring me out of the worry. The techniques we’ve already learnt for motivating ourselves and challenging negative thoughts have also really helped me with worries too, meaning I get on with addressing practical stuff rather than getting into a cycle of letting tasks become overwhelming. As for rumination… I’m going to need counselling for some of that.

Recovery – It is normal to experience both good days and bad days during the recovery process. Keep a diary and monitor how you’re doing to see if the bad days are increasing or decreasing, and to keep a record of the symptoms you experience. If they’re increasing, you may be able to troubleshoot by looking to see if there’s a technique you’ve forgotten that could help, or maybe you need further help – in which case, do seek it out. The treatment techniques require a lot of practise so keep trying, and monitor how they are going alongside how you feel. Keep practicing them until they become second nature again.

So, how am I?

As I write, I am doing really well! For the past three weeks I’ve been feeling far more myself than I have for maybe a year or more. Maybe all my self-care efforts are paying off; maybe prayers are being answered; maybe the CBT is having an effect; maybe these are good days, interspersed with bad days on the road to recovery, or the end of the first wave of illness before the next hits. Maybe it’s the season – I find it hard to feel down when the autumn is coming in, although it’s also a season when vulnerable feelings make more sense. Maybe it’s a combination of things. But I’m feeling good just now. That said, I’m taking one day at a time; I can feel the depression-monster lurking somewhere behind my back, and I’m having to keep checking over my shoulder the whole time to stop it sneaking up on me again. I can still hear it feeding me lies, and it’s still taking deliberate effort to put these things I’ve learnt into practise and stay healthy. I’ve now started seeing a counsellor. CBT treats the symptoms of mental illness really effectively, but many of us need more than that to fully recover; counselling aims to address the underlying causes. I definitely feel in need of both tackling the symptoms and the causes. I feel now like I have strategies for coping and re-developing my resilience to pain. But I am still carrying that pain around, and I really want to address that, to dig underneath and understand what’s really going on. I’m hoping counselling will help with this. Another step towards kicking this thing!

 


 

*We also had a quick look at medication; I’m absolutely unqualified to talk about this medically, so if you want to know more about it, please speak to a doctor or pharmacist for advice. I can’t tell you about all the different types of drug, how they work and what they do, except that it’s to do with healing the way chemical messages are passed within the brain, which gets disrupted when you are ill. But the main points I’ve learnt are that there are many different drugs out there, which work in different ways and have different associated side effects. Most take a few weeks to take effect, during which time they may make you feel worse before you get better, so you may need to persevere to get the benefits. Most of the side effects subside in that time too. Different people’s anxiety and depression illnesses respond differently to different medications, so you may need to try more than one before you find one that works, and that may mean finding a good doctor to work with you and be understanding of you. They are not addictive. Most people are able to start coming off medication after six months or so, some need longer. Those I know who do or have used medication are really keen to tell me the difference it has made to their lives, that they are able to feel like themselves again and live a normal life. As for the stigma attached – if you had cancer, and were recommended medication to treat it, you would take it and no-one would criticise you for it. If you had a condition, diabetes for example, that meant you needed to take medication daily to be able to lead a normal life, you would take it and no-one would criticise you for it. Mental illness is illness. Mental health medication is medication. Let’s not treat it any differently.