Category: information

It’s not my fault I treated you like that, I have depression

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This is something I have been meaning to write about for a while. I feel some people might not agree, but it’s something more people need to understand.

Mental illness is still being stigmatised. Some disorders are misunderstood, others aren’t taken seriously and undermined. Many organisations are yet to put into practice a solid structure and policies to help those with illnesses thrive. We spend so much time raising awareness to others outside the community, we sometimes miss the important issues within.

Some people are using the idea of supporting those with mental illness to their advantage by using it to excuse toxic and abusive behaviours by blaming their diagnoses.

I’m ashamed to admit that before I got help, I was an arsehole and blamed all my anger and toxic behaviour on what I was going through. It wasn’t until I stopped for a minute to evaluate my life, did I realise that I needed to change.

So I’m just going to come out and say it. Mental illness is not a free pass to be cruel or toxic. No matter what your diagnosis, if you are repeatedly negative towards those trying to support you, you need to have a serious look at your actions.

Before I go into what kind of actions I am talking about, I would first like to say that I am not talking about involuntary symptoms. I am explicitly talking about behavioural choices made that negatively impact those around us.

Types of behaviours used to project or misdirect anger/frustration, manipulate people and abuse others are choices.

If you repeatedly say cruel things to others when you are angry or stressed, this isn’t okay.

If you threaten to break up with your partner when you aren’t getting your own way, this isn’t okay.

If someone confronts you about your behaviour and you play the victim, blaming your mental illness and placing guilt tripping them, this isn’t okay.

These behaviours can be changed and must be addressed, because it is not fair to those trying to support you.

If you find yourself constantly hurting people with the things you say or do, it’s important that you reach out for help to tackle this.

If you know you are repeating this pattern of behaviour and someone approaches you about it, don’t immediately call them out for attacking you or bullying. Take some time and reflect on what they have said, is this the case?

In brushing people off and taking no responsibility will ultimately push them away and you’ll find yourself alone.

Anxiety: the new pandemic?

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As lock-down eases and people start to take their first steps back into the world, something has begun to affect many of us. Anxiety.

I’ve seen a lot of people express their feelings of worry and discomfort about integrating back into society. Those living an average life pre-corona have now found themselves with a racing heart while out shopping for socks. Others are very reluctant to return to work, which I can totally relate to. I was fine until given a date and now I am feeling those little butterflies resurfacing for the first time since lock-down began.

Despite being stuck inside for months, people across the UK aren’t so ready to venture back outside just yet. Don’t get me wrong, I imagine there are plenty of people at the pub today and I definitely saw those queues for Ikea and Primark all over social media. Although looking at the comments of articles, you can see a lot of people stating that they will be staying at home for the foreseeable.

In amongst all this uncertainty and change, I find myself in a unique position in that I am a recovering Agoraphobic. I have been housebound before and have made my way back to the point where I can hold down a job. Obviously my journey will be a little different from yours in that my thoughts and fears stemmed from something completely unfounded and irrational as apposed to what has been happening in the real world. I do think however I may be able to provide some insight into how you can begin to accept change and feel more comfortable with the current situation.

Why am I anxious?

This is a common question I have found people asking themselves. People have expressed to me that they have had the “first day at a new job” nervousness and when asked why, they couldn’t really tell me. Similarly, others have said they they found themselves avoiding going into town and when putting their discomfort aside and venturing in, finding themselves feeling incredibly anxious in a place they have known and frequented for years. Again, when asked why, they couldn’t tell me.

It can be very distressing to find that places you once enjoyed visiting are now places that hold negative feelings and even more so when you can’t pinpoint why you are feeling the way you are.

I’m going to explore several reasons why you might find yourself in this situation.

  • Big changes to your routine and lifestyle
    People that are used to going to work 5 days a week suddenly are at home 24/7, people who are still working don’t get to see friends and family to blow off steam. Everyone in the country had a period of adjustment when going into lock-down and after months of living like this, it’s only natural to need the same period of adjustment when lock-down eases. Disruption can be very uncomfortable and some of us are coming out of lock-down in a very different situation with the loss of jobs and loved ones.
  • Uncertainty
    Re-entering a familiar society with unfamiliar rules and restrictions can create a lot of uncertainty. We as humans can often struggle a lot with this and especially when we can’t base this on anything we have experienced in the past. Going into places and not knowing what to expect, having to navigate this situation potentially on your own. It can be very daunting.
  • Worried about doing something wrong
    Going the wrong way down an aisle, walking up to the bar when it’s now table service; no one likes feeling that their every move is being scrutinised or that they are being judged negatively by their peers.
  • Worried about catching or unknowingly passing on COVID
    This is pretty self-explanatory. Not everyone is going to stick to restrictions and rules and with the virus still present, it can easily be at the forefront of your mind. It is a rational concern and you won’t catch me at the pub anytime soon.

What can I do?

First I want to point out that feeling anxious about this situation is completely normal. If you find yourself questioning how you are going to cope with the constantly evolving rules, again that’s perfectly fine. To use 2020’s favourite word, this whole situation is ‘unprecedented.’ Not many of us have anything to base our next steps on.

There are three points I would like to make that I think you will find helpful going forward:

  1. Take your time
    Just because the world is re-opening, doesn’t mean you have to jump back in head-first. Plenty of people have decided to skip their holidays regardless of government advice. Not everyone will be going back to the pub today and with gyms supposedly opening in the next couple of weeks, I can’t see people flooding back to those either. If you don’t feel that it is safe to do so, then you have every right to stay at home. I know I will be. If you want to go shopping, maybe go at quieter times, go for a walk when it’s quieter. If you still want to do your online Tesco shop, absolutely fine. Don’t let people pressure you into going places and doing things you aren’t comfortable with.
  2. Communicate
    I cannot state this enough, it is okay to talk about how you are feeling. It is okay to speak out if you are struggling. It is okay to question things you don’t understand or aren’t sure of.
    Communication is key, I would argue now more than ever.
    If you are struggling with your mental health or feel like you are really struggling to reintegrate into society, speak to your GP. We have all been through our own version of lock-down, so just because your friend on Facebook is doing fine and dandy, doesn’t mean that it’s wrong or weak of you to feel any different.
    The same goes for returning to work. Speak to your employer if you have any concerns or questions about returning. No question is a stupid question. It might be that if you have a health condition, you may be asked to remain on furlough until further notice.
    Speak out about how you are feeling, reach out for help. If you don’t feel like there is anyone else, I’m always here.
  3. Be kind to yourself.
    Just because Margaret down the road is going out to the shops and sipping a pint in the pub, doesn’t mean that you have to be too. Looking after yourself, physically, mentally and emotionally is more important than keeping up appearances.

Final Note: if the place you are going to wants you to wear a mask, wear a mask. Unless you have medical exemption, there is no excuse not to be respectful of rules in someone else’s establishment. If someone wants to wear a mask where it’s not required, then again just be respectful. We’re all reaching for normality, the least you can do it be kind to others too.

Mental Health vs The Sun

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So you’re sat outside in the sun, hanging out in the park. It’s 33c and you are wearing weather appropriate clothing. The next thing you know your anxiety is through the roof and you have to go home. Sound familiar?

Those of you in the UK will know, it’s a bit warm and it’s set to get warmer.

For many it is a time to get to the beach, hang out at the pub or go on an adventure.

Not for all of us.

Hot weather can be tough for a lot of people and for those with mental and physical illnesses it can feel impossible. I saw a few people in the Twitter community who cancelled their plans or cut plans short due to the heat affecting their mental health.

But why is this?

The Science

On a hot day, our body is fighting hard to keep our body temperature within a normal range. In order to cool down, we tend to sweat more and our capillaries dilate to increase the rate of heat loss.

Good stuff.

However, our heart rate also increases and blood pressure rises.
Studies show that hot weather has been linked to higher levels of irritability and lower concentration and mood.

All this combined with a poor quality of sleep due to humidity and heat, is a bad mixture for those with mental health issues.

My Experience

Tiredness, irritability and high heart rate is an unfortunate combination which can culminate in a panic attack. For me feeling hot with an increased heart rate is a sign that I’m panicking. So when I’m too hot, the physical reaction tells my brain I am panicking, when in reality, I’m not. But the thought that I might be panicking, causes me to panic.
I love the human brain sometimes.
So logical.

Increased irritability also makes me less tolerant of people. In a busy place, instead of being calm and working through it, it’s just so easy to get overwhelmed. Again. Panic.

How to help yourself

You may be tempted to just stay inside and avoid making any plans during the hot weather, but do you really want to miss out on a nice day?

While it will take some perseverance, having fun during a heatwave is possible.

Plan accordingly. If you are out in the sun all day you want water and sun cream. Dehydration increases the risk of heat related illnesses and suncream is always important. Dress in a way that makes you feel comfortable, but will also prevent you from overheating. Cotton and linen are good materials as they are light and airy.

Choose your destination. Maybe avoid sitting inside when eating at a restaurant or avoid using the oven when at home. Avoid staying in confined spaces for an extended period of time. Anything that is going to make you feel warmer just be careful. Why not go to the beach, to the park or go swimming?
If you are going to be somewhere where it will be warmer, keep drinking water and maybe splash your face from time to time to stay cool.

Helpful purchase. A small handheld electric fan can be a lifesaver, especially if you find yourself on public transport or a busy place. Make sure you pack some spare batteries!

Working? Again wearing light clothing, ensuring that you have access to a fan and eating cooler foods such as a salad can make a big difference. Take frequent breaks and If you do feel like the heat is affecting your health make sure you let your boss know. Employees have a right to a safe working environment.

Remind yourself that if you are feeling hot, you are not panicking. It’s just hot. Then maybe take some time inside or in the shade to cool down.

These things all sound relatively basic, but taking extra care in the heat can really help you face a hot day.

Last but certainly not least, be kind to yourself.
Being too hot isn’t a pleasant experience for anyone and it can be daunting to make plans in the midst of a heatwave. If you need to head home for a shower or need a couple of minutes in front of a fan, that’s okay. Don’t make yourself ill.

Also as a side note, make sure you check on elderly or vulnerable neighbours and family during the heat to make sure they have the means to stay cool.

Stay safe and look out for each other my dudes and dudettes!

5 Little Signs Of Depression

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Now I want to make this very clear. This is not a diagnosis. There are many other things these symptoms could indicate. If you are worried about any changes you have noticed or feel something is not quite right, please speak to a GP.

I want to make a blog post around this topic as depression is often spoken about as sadness and not getting out of bed. If you find yourself struggling in your day to day life, it might be good to speak to a professional.

Aches and pains

While researching for this post, I came across this symptom that I wasn’t aware of.
Muscle aches can be an indicator of psychological distress. While research in this area is limited, there have been some recent studies suggesting a direct link between muscle ache and depression. Click here, here and here for more information. Obviously muscle aches can be the result of a number of different ailments, but keep an eye on any other symptoms that may present.

Can’t make up your mind

Having trouble making the simplest of decisions? It could be fear of making the wrong one, it could be low self-esteem. It could be depression. Depression can cause cognitive impairments such as an effect on decision making and memory. There has been a lot of research looking into this, I feel like I have linked a lot of articles in this blog, so I would really encourage you to go out and do some more research.

You find yourself up at night

You often here tales of people that stay in bed all day with the curtains closed, which can happen. However, insomnia and trouble getting to sleep/staying asleep can be a sign of depression. Bad quality sleep can lead to lack of concentration, irritability and lower cognitive functioning.

Your toilet habits have suddenly changed

Believe it or not, there is a well documented connection between mental health issues and digestive issues. See here, here and here. When it comes to depression, research suggests that constipation and abdominal pain are symptoms to be aware of.
Change in diet, medication, lifestyle change or stress can be factors that contribute to changes in the way your digestive system functions. Again, just keep an eye on it and if it persists, see your GP. Depression or not, it maybe an indicator of other health issues.

You find yourself getting irritated over the little things

Do you find yourself getting angry at the smallest inconvenience? Are you becoming noticeably more irritable? Irritability and anger are commonly overlooked when it comes to depression. There are documented cases of people going years without getting a diagnosis, discussed here. One idea is based on Freud’s theory that depression is anger turned inwards, however other believe that this is a simplistic approach.
There are other conditions that cause people to be quick to anger, however if you find yourself in this position, I would advise speaking with someone. Unresolved maladaptive anger can develop into further issues.

So if you find yourself with any of these symptoms, it may be worth looking into. Depression or not, it might indicate underlying issues, so don’t tell yourself it’s nothing or make an excuse. You might find that a trip to the doctor can make everyday that little easier.

Safe Spaces: Are They Useful?

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Safe spaces; it’s safe to say that this phrase has caused a lot of controversy over the past couple of years, with institutions like Universities offering places for students to be in a space free of conflict and bias while the students are then being branded “special snowflakes.”
As someone who has never needed one of these safe spaces, I will refrain from giving my opinion and leave that to the people who are more invested in the subject.

I want to instead talk about safe spaces in regards to anxiety. This is not a place for a collective to gather, it is a place for an anxious person to feel…well…safe. Most times for an Agoraphobic, this will be at home. A place where they won’t be subject to stressful stimuli or panic attacks.

A safe space where you can sit and take a moment to breathe, a place you aim to get to. For me safe spaces are my home, my sisters, my nans, a car and a toilet. When I was going away, the lounge was safe space, the plane was a safe space and the hotel was a safe space.

These are places I am not constantly thinking about the world around me and super aware of every little thing my body is feeling. It’s a place I can eat, a place where I can enjoy myself.

But the question is, are they truly helpful?

A safe space can help reduce your anxiety, it is a place to recharge and a place to just be you. For a lot of us this space is somewhere we want to be, somewhere we can’t wait to get back to.

And that’s part of the problem.

A couple of posts ago, I spoke about safety behaviours. These are things that we do to trick ourselves into thinking that we are safer, when in reality we aren’t in danger in the first place. Examples are taking medication before you go out or carrying it with you, wearing non-restrictive clothing or going out with a person who you deem as a ‘safe’ person. These are behaviours that are unhelpful and a hindrance rather than a help.

Safe spaces act in a similar way. By viewing your house as a safe space, you are in effect calling all other areas that are not your house (or other places that you have given this label) unsafe. Like a safety behaviour, you are perpetuating the idea that there is danger. In reality this isn’t the case.

I’m not going to lie, I still use these and usually don’t realise I’m doing it. I go out on adventures and tell myself I can do it because chances are there will be a toilet or quiet pub I can sit in for a bit if it gets too much. I am in effect giving myself a safe space everywhere I go. While it has really helped me get out and go further than I thought was possible, in the grand scheme of things it hasn’t helped at all.

A good example of this is when I was travelling to the hotel in Tokyo. I didn’t think there was a toilet for the 2 hour bus journey. I was convinced as soon as the bus pulled off that I needed the loo and spent the first hour with my eyes closed praying that I would make it to the hotel toilets. Then I saw someone get up and use the hidden toilet at the back of the bus and all of a sudden the urge completely disappeared and I was fine.
The knowledge that I had access to the toilet and had an assigned seat next to the window was enough for me to now view the bus as a safe space. Once the perceived danger was removed, I felt completely different.

It’s not good for you and while you might feel like it is helping, I can promise you it isn’t. I can’t say that I have tried to change my thought process, but it is something I am figuring out. It’s the way I have thought for years now, even when I was younger I hated being away from home, even just for dinner at a friends house after school. I guess I was always destined to be a homebody.
It’s a long road, but if I don’t change my thinking, becoming housebound again could be on the horizon. Quite frankly, I’m not about that life.

Aim for the whole world be your safe space, you got this!

Coping With Loss: A Guide For All

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Losing someone in your life is never an easy thing. Whether it be your mum, your grandparent or your dog, loss affects us all. Despite this, it is still a taboo subject in many cultures and it is common to try to distance yourself from the topic of death.

This blog aims to be a guide for those who have lost someone, those who are supporting them and employers. I am not a health professional and therefore I have linked various websites throughout the post that expand on things I mention.

Before I talk about how to cope with loss, I would first like to define the words surrounding this topic.

Bereavement
This term is regularly used interchangeably with the term grief or mourning. However, I will be using it to describe the time after loss in which grief is experienced and mourning rituals take place.

Grief
I will be using the term grief to describe the reaction to loss. A mental, emotional, social and physical reaction. This can take shape in a number of ways depending a lot on the way a person passed, your beliefs and age.

Mourning
I will be using this term to describe the way in which a person overtly expresses grief and the process/rituals of adapting/coming to terms with this change. This again is displayed in many different ways dependent on culture, religion and relationship with the deceased. For example, funerals are a way of mourning,

Types of grief

There are many different types of grief we can experience, but this blog is going to be long enough already, so I will look at the 4 basic types of grief. Click this link to learn about the different types.

Acute Grief
This is experienced directly after loss and can be very intense. For someone experiencing it for the first time, the rollercoaster of emotions can be quite frightening. Be assured that what you are experiencing is completely normal and pretty much expected. Symptoms can include tearfulness, numbness, insomnia, shock, breathlessness, anger and depersonalisation. I have included a link to a fact sheet with a comprehensive list of symptoms here.

From this we will eventually move on to “integrated grief.” This is where we are able to look back at happy memories of the deceased and the grief we experience is not overwhelming. Many people will often have a more positive outlook during this stage. This is all part of the “uncomplicated grief” process, which I will be discussing next. Others may move into complicated grief, which I will speak about later.

Uncomplicated Grief
I have also seen this called normal grief, however I won’t be using that term. Grief is a very personal thing that can present in different ways, so for that reason I will refer to it as ‘uncomplicated grief.’

Many people know the 5 stages of grief to be denial, sadness, anger, bargaining, acceptance. While these emotions and behaviours can be experienced during the process, this is more of a guide than a rigid structure. Some people may skip backwards and forwards between stages, others may not experience all of these.

There are other models of grief which I have linked here. Grief can last for months or years, some theorise that it is never fully resolved. Birthdays and Christmas’ can be particularly difficult, even years later.

There are physical symptoms such as insomnia, change in appetite, illness and feeling sick. If these symptoms persist and do not fade overtime however, please speak to your GP.

Social symptoms: Withdrawal, again if this persists, please speak with you GP.

Emotional symptoms: shock and numbness are often experienced in the early stages of grief. Other common symptoms include sadness, anger, guilt.

Again I have links here and here for a better insight into the symptoms. It is important to remember that everyone grieves in their own way and there is no wrong way to do it.
However, I would argue that if you are turning to excessive alcohol use/drug use/abusive behaviour, I would seek help ASAP.

As mentioned above if symptoms persist that impact your day to day life, please contact your doctor. I will speak more about this in the next section.

Complicated grief
Grieving is an important process and working through it in your own time is vital. However, it is also possible to get ‘stuck’ at a certain stage of grief. Someone experiencing complicated grief may experience continuing debilitating symptoms such as intense, persistent pining, isolation, continued guilt and self-blame, depression and an inability to carry out their everyday routine.

The relation to the deceased, other existing mental health problems and the circumstances surrounding their death may contribute to the development of complicated grief.
This needs to be addressed as soon as possible as if left, can develop into mental health or even physical issues.

If you feel like you are experiencing complicated or prolonged grieving, please contact your GP to look at your options

More information can be found here and here

Anticipatory Grief
While grief usually occurs after the death of a loved one, anticipatory grief is a little different. This type of grief is common amongst families and friends supporting someone with a terminal illness, it can also be experienced by the ill person too. Symptoms experienced can be the same as grief after death, also accompanied by feelings of dread.

Mental and physical exhaustion can also be experienced if you are a primary carer for your loved one. If you are aware that passing is fast approaching, every phone call, every change is very stressful and again can lead to exhaustion.

Grief can also be experienced as a response to decline health, change in cognitive functioning or physical abilities.

I will talk more about how to cope with anticipatory grief in the next section. Please see this and this and this link which goes into more depth.

Coping with loss

The death of a loved one is often the worst thing a person will experience and unfortunately everyone will experience loss in their lives. This next section will look at coping with loss as the bereaved, as a support network and as an employer. I will also add an extra section at the end briefly looking at coping with grief as someone with a terminal illness. Links to organisations that can provide support will be added at the end of this post.

The bereaved
As mentioned before, grief takes many forms and can affect you mentally, emotionally, socially and physically, so it is important to keep this in mind when you are working your way through the grief process.

Express yourself: There is nothing wrong with expressing your emotions while you are grieving. If you need a good cry, have a good cry, if you don’t feel the need to cry, don’t feel guilty about it. Everyone is different and there is no shame in expressing how you feel. It is healthy, especially during this time.

Talk to someone: Again there is nothing wrong with needing some extra help while you are grieving. There are counsellors/therapists trained especially for this situation that will listen to you with no judgement. They can be helpful in helping you to process your thoughts and emotions. However, if this is not something you feel comfortable with, talk to a friend, talk to a family member. People will be there to help you.

Take your time: Just because someone else seems to have moved through the initial stages of grief quicker than you, don’t feel like you need to push yourself to do the same. As I have said a million times in this article, grief is extremely personal. If however you do feel like you are unable to process your situation, please talk to someone.

Look after yourself: During this time self-care can be low on your list of priorities, however self-care is very important. Take some time for yourself if you need to, do something you enjoy, go out for a walk. By purely focusing on others or any paperwork and arrangements, it is easy to feel overwhelmed and stressed. You deserve to take some time for you.

Anticipatory Grief
As mentioned before, unlike other forms of grieving, anticipatory grief occurs prior to the death of a loved one. Dealing with this type of grief is similar to dealing with the above.
However, in addition to the above tips, there are the following things to consider:

Communicate: During this time, speak with your loved one about any unresolved issues, say things that you need to say.
“I love you”
“We will be okay”
“I’m sorry that…”
This is a chance for you to say goodbye and for you both to find peace and closure.

Communication is also important for the family. This time can be very stressful and emotions can run high. Keep open lines of communication and ensure that you are supporting each other. It is a very difficult time for all of you.

Talk about it: I tried my best to ignore it and hopefully it would all go away. I often refused to accept what was happening. Talking about it with other people can be comforting and can also help you find acceptance. Ignoring the situation will not make it go away.

Focus on quality of life: You both are aware nothing can be done and the inevitable will happen, but there is nothing to stop you from making the most of your time together. Ensuring that your loved one is comfortable, has everything they want and has some valuable time with you can mean a lot.
I remember coming home from work and sitting with mum, working our way through Gavin and Stacey and having a laugh. I just wish we’d had more time.

Supporting the bereaved
It can be difficult to comfort someone who has experienced loss, especially if this is not something you have experienced yourself. People tend to be worried about saying the same thing or their mind will just go blank. It’s a normal response, death isn’t a part of our everyday life and the person you know will be acting differently to what you are used to. However, being there for someone is easier than you think.

Let them know you are there: Reach out to the bereaved and let them know that you are there with a cup of tea and a chat if they need it. Don’t suggest public places as it can really discourage someone from opening up. Instead make sure you meet in a safe environment where they feel like they can talk and express themselves. Sometimes the person may not want to meet up and may need time for themselves, so don’t feel offended if they decline their offer. Just knowing that you are there can be a huge comfort.

Listen: For most of the time, people don’t know what to say, but in reality nothing you can say is going to magically make them better. Just ask how they are doing, if there is anything you can do for them and just listen to what they have to say.
Refrain from comparing their situation to something you have gone through yourself. It is important not to detract from their own feelings and situation. Let them express themselves, that is the important thing.

Be open and accepting of emotion: Be aware that their mood may swing from sadness, to appearing okay, to anger. This is natural. Don’t assume how they are feeling, for example “you must feel really sad”, if someone is having a more positive day, they may feel guilty that they aren’t feeling sad.

Look after yourself: I mentioned this in my ways to help someone with a mental illness post. Looking after yourself is very important too. Just because you are not acquainted with the person that has passed, does not mean that the reactions of your loved one and the situation itself will not affect you. Make sure you take time for yourself and address any feelings you may have.

Do something together: Maybe not in the first week or so, but maybe ask them out for a walk or get together for a film night. Getting them out of the house and doing something can make them feel like they have a support network and a change in environment can work wonders.

Employers
It can be difficult to know how to broach the subject of bereavement, even with policies in place. How much time do they need? When should I contact them about return to work? How do I manage their return to work?

The Law
The law entitles employees to take time off for emergencies, such as bereavement. During this time, there is no obligation to pay your employee, however as someone who has experienced bereavement, the last thing a person needs after they have lost someone, is added worry of bills if they don’t go to work. This might encourage someone to return before they are ready and that is not beneficial for them or you. So that’s something to consider.

My place of work were incredibly kind and understanding, I was allowed to work from home in what turned out to be mum’s final days, they offered my paid leave, sent me flowers and checked in with me. They contacted me about returning to work after a couple of weeks and were very understanding throughout the whole process.

Returning to work
Get in touch with your employee and offer your condolences, this lets them know you are thinking about them and creates a situation in which your employee feels that they are able to discuss this with you.

It is important that while you should not contact them regarding this in the first week or so, that you open a discussion about when they anticipate returning to work. Listen to them and act appropriately. Be mindful of the employees religion and customs as this may take place over a number of days.

Once they return to work, set up a meeting to gage how they are feeling and let them know that if they need any adjustments to ease them back into work, that these are arranged. It may be working from home, it may be a reduction in workload or it could be where they are placed on a shop floor. You must remember that even though your employee has returned to work, cognitively, physically and emotionally, they are still recovering and may not be at peak performance. Regular catch ups are very useful to see how your employee is coping and whether normal work roles can be reintroduced.

Further information regarding this can be found in this comprehensive guide (see link).

Following policy is important, but please keep in mind that you are dealing with a person, not just a member of the workforce.

Coping with terminal illness
This blog has spoken about relatives, colleagues and friends, however it is also important to recognise that those with terminal illness’ also experience grief.
If you find yourself in this situation, it can be frightening and isolating.

There are many steps you can take to easy the anxiety:

Talk to someone: Whether it be friends and family, a professional or with others experiencing the same thing. Talking about how you feel and expressing yourself can be a great way to get things off your chest and out into the open.

Make your arrangements: You may have many questions such as
“what will happen to my body?”
“How will my family cope?”
By making arrangements and sorting out your affairs can put your mind at rest as you won’t be left with unanswered questions.

Take it one step at a time: The news that you have a terminal illness can put you in a state of shock, numbness or feel completely overwhelmed. Write down your worries, things you’d like to do and things you want to get sorted. Don’t rush into everything all at once and cause yourself more stress. Take things one step at a time and ask for help if you need it.

Let people know how you feel: Tell people you love them, that you’re proud of them. Speak with people and work out your differences, I spoke a little bit about this further up.

Organisations and links

I have put a list of links down below as well as scattering them throughout the article. Please take your time to read through them and seek help if you need it

You are not alone

https://www.nhs.uk/conditions/end-of-life-care/coping-with-a-terminal-illness/
https://www.cancerresearchuk.org/about-cancer/coping/dying-with-cancer/coping-with-the-news/finding-out-you-are-dying https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691160/ http://www.npaonline.org/sites/default/files/8.%20Loss,%20Grief,%20and%20Bereavement_Smith.pdf
https://www.cruse.org.uk/
https://www.lullabytrust.org.uk/



5 Easy Ways To Help Someone With A Mental Illness

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I’m sure a lot of people reading this blog have at some point in their life been affected by mental illness. Whether that be yourself or someone you know.

Sometimes it can feel like you don’t know what to say, how to help or what to do. I know that even when I approach someone else going through the same thing, I can find it difficult to know what to say.

That said, you don’t have to be a therapist or a master of advice to help.

I have compiled a list of 5 things I think could help anyone supporting someone having a rough time or opening up to you about their mental illness.

Obviously this is not an exhaustive list and if people are interested I may look at making a guide for email subscribers, let me know!

1. Hold them accountable for their behaviour

Now I’m not saying call them out when they are trying to cope with their situation in a positive way. Not at all.
But…
If you are helping someone it is important to set boundaries and let them know what behaviours are unacceptable or dangerous.
For example, abuse behaviour or language targeted at you should not be tolerated. Having a mental illness does not give you a free pass to treat people poorly. Ensuring that they are accountable for their behaviour protects the well being of both of you.

2. Don’t judge

Now this may sound contradictory to what I have just said. However, there is a big difference between judging someone and holding them accountable for their actions/words.
If your friend, family member, colleague approached you and confides in you about an issue you they having, the last thing they need is “don’t be silly” or “it’s just a crowd of people.” Understand what they are saying and keep an open-mind.

3. Research

There’s never any harm in doing a bit of research.
Mental health issues are often more complex than what the media shows e.g. depression is not sadness and Agoraphobia is not being scared of open spaces.
A bit of research can help both of you create a more supportive and trusting relationship.
A little understanding goes a long way.

4. Listen

This ties in with what I have said before. If someone opens up to you, it doesn’t matter if you have experienced something similar, have a degree in psychology or have your own thoughts about the topic.
Stop.
There’s nothing worse than trying to explain what you are going through to have someone else interject with “faux professional advice” or brushing off what you are saying.
Just listen.
Hear what they have to say, ask any questions you have, just give them space to talk. Everyone’s experience is different and while advice is fine, wait for them to ask.

5. Take care of yourself

This to me is the most important thing.
Helping someone is not easy, it can be difficult and stressful. Make sure you look after yourself mentally and physically and give yourself space if you need to.
Remember, you can’t help someone if you aren’t looking after yourself.

What Is Agoraphobia?

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Many believe that agoraphobia is a fear of open spaces, the reality is, it’s a lot more complex than that…


Photo by Denisse Leon on Unsplash

Lets Start at the beginning
The term agoraphobia was coined in 1981 by German Psychiatrist Carl Westphal, when he noted his patients would get anxious when out in social places. The term deriving from the Greek ‘agora’ meaning marketplace and ‘phobia’ meaning fear.

Research bringing about therapies and medication development for panic disorders in general was built upon through the decades, with notable contributions from Henri Legrand Du Saulle in 1878.

Modern day statistics and definitions
Agoraphobia is a complex disorder that manifests in a number of ways. It is usually characterised by fear and usually avoidance of being in a situation you perceive as being difficult to escape from, or unsafe. You may also find it difficult to be away from home or travel beyond a certain distance from home.

Examples of situations Agoraphobics may find stressful are eating with friends at a restaurant, riding on public transport, being alone or even standing in line.

In the UK, is is thought that 2 in 100 people will develop a panic disorder at some point in their life, with 1/3 of those going on to develop agoraphobia. Onset usually occurs between ages of 18-35 and is most prevalent in women. However, many people around the world of all ages, genders and ethnicity’s can develop agoraphobia.

You can find some more information here

Causes

I won’t give an in-depth look into causes as there are many.
It could be the result of another disorder such as depression, it could be the result of a traumatic event such as abuse or bereavement or it could be a number of other environmental/biological factors.
It could develop after having a panic attack in a certain situation or place leading to avoidance.
I could seriously write a whole book about this, so I’ll leave it at that.

Symptoms

There are both physical symptoms and cognitions that lead to changes in behaviour. Not all people experience every one of the following. Some people experience different symptoms depending on the severity of their disorder and their triggers; however these are some examples:

Physical

Sweating
Heart Palpitations
Increased heart-rate
Dizziness
Nausea
Hyperventilating
Feeling faint
Feeling of needing the toilet
Dry Mouth/Difficulty swallowing
Dissociation
Tiredness
Shaking
Tingling in arms and legs

Cognitive

Fear of embarrassment
Fear of incontinence
Fear of drawing attention to yourself
Fear of dying
Fear of having a panic attack
Fear that escape is difficult/impossible
Fear of being alone in social situations
Fear of vomiting
“I need to leave now”

Behaviour

Avoiding certain situations or places such as busy streets, public transport or restaurants.
Cutting contact with friends
Becoming housebound
Leaving the house only with a trusted person. i.e. family member or partner
Safety behaviours (see my post on this topic)

Please note, this is in no way meant to diagnose anyone with a panic disorder, if you feel that any of this relates to you, I would recommend that you speak to your GP.

Treatments

Again, this is a subject I could talk about all day, so I will limit this section to popular treatments and ones I have personally tried.

Therapy

Therapy is a great way to discover techniques and tools you can use to combat anxiety in your everyday life. Below are a couple of avenues you could take, however there are many options available to you so make sure to do some research and find something that works best for you.

CBT
Cognitive Behavioural Therapy is a form of short-course therapy which can usually be accessed via the NHS for those living in the UK.
The premise is basically that the way you think about a certain situation can influence the way you feel and behave.
E.g. What if I have a panic attack? (thought) = stress and anxiety (feeling) + avoidance (behaviour)
The idea is to work with your therapist to help identify these negative thoughts and with weekly sessions/homework, aim to challenge these thoughts.
CBT is one of the most common and effective ways to treat anxiety and agoraphobia.
I did an 8 week course of CBT and it really did help, I will talk about it in a later post.

Exposure Therapy
The idea of exposure therapy is that you face the situation or stimuli that you are afraid of, whether it be in real life, visualisation or VR. Within this therapy, there are a couple of types, but I will mainly focus on graded exposure.
I’ll use the idea of arachnophobia (fear of spiders) as an example as it may be easier for many of you to relate to.
Graded exposure is is where you create a fear hierarchy. For example at the bottom would be visualising a spider and at the top would be holding a spider. You slowly work your way up the hierarchy over a period of time until you eventually are able to tackle the top.

Medication

There are many different types of medication that are available to you. I will just name three types that I have personally experienced and tend to be most common. Please note that I am not a medical professional and that you will need to speak with your doctor to discuss the best option for you. Medication is often used alongside therapy for the best results for anxiety and panic-disorders.

SSRIs
SSRI stands for Selective Serotonin Reuptake inhibitors. Serotonin is a neurotransmitter, which amongst other things, is thought to regulate mood. Low serotonin can cause issues such as depression, anxiety and insomnia. By taking SSRIs, you limit the re-absorption and increase the levels of available serotonin.
Examples of SSRIs are Sertraline (Zoloft) or Fluoxetine (Prozac)

Beta-blockers
Panic attacks and feelings of anxiety release the hormone adrenaline. This increases your heart-rate, produces feelings of nausea, causes your body to shake and other common side-effects of panic and agoraphobia. A beta-blocker basically is used to block hormones such as adrenaline as well as improving blood-flow therefore reducing the effects of anxiety.
An examples of a beta-blocker is Propranolol, which can also be used for a range of issues, such cardiac problems and migraines.

Benzodiazepines
Benzos are a sedative and work by increasing the levels of GABA in your brain. GABA is a neurotransmitter responsible for reducing the activity of neurons in certain areas of the brain. The decrease in brain activity causes you to become calmer and also helps to relax muscles and aid sleep. These are a short term course of medication.
Examples of Benzos are Diazepam (Valium), Alprazolam (Xanax) and Clonazepam (Klonopin)

Many people choose medication as a treatment for anxiety and depression, which are more common than ever in today’s society. Not every medication works the same for each person and you may have to try a couple of different avenues before you find the right one for you. It is also important to remember medication is not a sign of weakness. I can’t stress that enough.

Relaxation

This is something that can be practiced anywhere at any time. Relaxation techniques are a great way to learn how to control your body and mind to be more prepared to tackle feelings of anxiety.
Some examples of techniques and practices include:
Breathing techniques – There are several techniques you can use to learn to control your breathing. During a panic attack or feelings of anxiety can create short, shallow breaths that can make you feel light-headed and increase your heart rate. Steady controlled breathing can prevent panic from taking over and slow your heart rate. This again can be practised any time, some people choose to do this when in bed to reinforce the idea of calm to help them fall asleep.
Visualisation – Visualising a place where you can feel calm and safe can help to release tension and reduce levels of anxiety. Engaging all your senses in a positive manner can help you reduce your heart-rate and blood pressure and help you to re-centre before panic takes over. Avoid visualising places such as home or bed as the aim is to change your idea of home being a ‘safe space’.
Yoga – This may or may not be for you, however I feel that yoga is a good way to help practice breathing, focusing and deal with stress. Research at Harvard medical school found that yoga is a good way to self-sooth, reducing the impact of an exaggerated stress response.

These are just some of the techniques I have tried throughout the years and overall, I have found most of them to be really useful. Although, it is important to remember that everyone is different, so if something doesn’t work for you, don’t be upset. Just try different things, speak with professionals and do some research to find what works for you.

So yeah, that is Agoraphobia. Don’t hesitate to get in touch if you have any questions or are looking for some support.
Always happy to help.

All publications and websites used are linked in this article.