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A phrase we have become accustomed to using over our lives. One we use when something has gone wrong for us. Nothing life changing, nothing actually too serious, but when it occurs it really throws a spanner in the works. Didn't get the concert tickets you wanted, the new game you wanted has sold out, your phone breaks, or you lose some money. All things that really do make you feel a slump in the moment. So when given the chance to express ourselves, we will generally use this phrase, or similar.

The strange thing is, when people truly are depressed, it is the last thing they will say. A person recognising they are dropping into a state of depression is more likely to make excuses, such as tired, un-bothered, or just not in the mood to do something. In the moment they have time to seek support and help, they just shut down and hide from the feeling.

The two kind of go hand in hand, with the first use of the word diminishing the seriousness of the word, and the person in the second example just doesn't want to be mixed in with the slightly over dramatic use of the word. Running the risk of being told "it will be ok" or "get over it"
Neither of which are of any help to someone struggling with their mind.

The over exaggerated use of the term "depressed" has just become fashionable now, just like "I'm so OCD" (no you are just tidy), or comparing your over excited, hyperactive child to someone with  ADHD. These are all serious matters, but the fashionable use of these phrases has really taken the focus away from the true sufferers. Now the services who deal with all these issues are at breaking point, with people being assessed for conditions, and some entering treatment, while in reality there are other issues which are presenting as the real thing.

I know that sounds a bit far fetched, but from experience with depression, just seeing the mix of people who turn up and describe their symptoms, it is clear that some are better suited to community and social projects, which allow them to frequently interact with others, rather than going through a long process of learning to deal with issues they clearly don't have. And I say that not selfishly or blinkered, but with the confidence that when someone cannot relate to a single issue anyone else has, but wants to complain about the health service for half an hour, there is more to it that depression.

This isn't to say that these people don't deserve treatment or attention, of course they do. They are clearly facing issues of their own, which a GP has put down as depression, but need to be assessed in a way that doesn't just say "depression Y/N". The same applies to others with behavioural issues. Easier to put them down as an attention disorder, than challenge the parent on their parenting skills. Not every naughty child has a condition, but sometimes it is easier to just say "I can't control him", than taking the time out to see if it is something you are doing which is promoting this behaviour.

Like I say, I am not for one second sneering at the actual conditions. But on all fronts, there is a fine line (actually a mighty chasm) between feeling down, and being depressed, or misbehaving and ADHD. One remains in your control to a large degree, the other you are just a passenger along for the ride, with no control over the direction it all goes in.

Now I am no expert in child behavior, so I will not say another word on the matter, other than to tip my hat to the parents who have kids with any of these conditions, and don't make excuses. Digging your heels in and getting on with what life has presented you with is an incredibly brave and strong thing to do. In fact I would go so far as to say that you are some of the best parents out there, and side by side with a spoiled brat, your children probably shines brighter than most. And no reason whatsoever that they should not.

As for depression, I can certainly speak on this matter with good authority, at least from my own experiences. I would not for one second wish to even start to belittle someone who has been on a different journey to me, and suffers in other ways. There are many forms of depression, it comes in many shapes and sizes. My experience is just one. But one I want to share as much as possible to ensure that it stops being such a forbidden topic, the social shame is lifted from over the condition, and people suffering can lift their heads and say " I am depressed, and proud to be dealing with it"

Depression is in short the suppression of our ability to engage, think rationally,  interact, and form trust bonds with others. There are many other symptoms, but these four cover a lot of those in an umbrella kind of way. So having our whole existence suppressed, the last thing we need. Without existing, how do we recover. Hidden away in a dark room every spare moment of our lives. Managing to put on an brave face to do the things we need to do. Going to work looking like all is well, head down like we are busy. Daring to speak to no-one in case we give the game away.

Once outside of work, shunning social opportunities, avoiding going shopping in busy places where possible, running from people, decisions, pressure or anything we cannot control the outcome of. Or as it is described in Cognitive Behavioural Therapy (CBT), seeing things through a negative filter.  Assuming anything we choose to do will turn to crap, fearing the worst outcome of doing anything other than hiding ourselves away. Even worrying that our closest friends will reject us if we dare to tell them we are suffering from depression.

Nope, admission of depression is between you and the medical practitioners, and is top secret. Taking your medication in private, even hiding it at home from loved ones. Maybe even just throwing it away, or to the back of a drawer, as the stigma surrounding "anti depressants" is just all too much to be mixed up in. In truth, it is the people who DO actually sneer at people struggling with depression who have the issue. Being so judgmental, pointing the finger and mocking people who are brave enough to face their demons in public. Maybe it is those trying to mock, who actually suppress their own issues the best. Is it they who are most in need of support, trying to deflect their own issues onto someone standing tall at such a tough time?

I am not sure why in this day and age, with so many people having suffered a breakdown, or on going depression or anxiety, there is so much stigma attached to the conditions. Given how many well loved and highly acclaimed celebrities have come out openly, talking about their battles through their lives. Facing their demons, while putting on such a strong public face. Hiding it all away for the sake of their image, before saying enough is enough, and speaking out urging people to support those suffering. Even some of the most loved, taking their own lives, only for the world to realise what a terrifying and lonely world their idol lived with .

Quotes like "Despite being surrounded by people, I feel so alone" is a good example of what it can feel like to be in a state of depression. I know Robin Williams was apparently quoted as saying similar. Happiness and sanity is not found in popularity, wealth, or a lavish lifestyle. Being surrounded by so called friends does not make you emotionally rich. If anything it numbs the senses even more, and draws you away from the important things in life. By the time you realise how far you have strayed from the sanctity of your comfort zone, you are out there being preyed on by the wolves of the mind.

I consider myself very wealthy as far as the quality of my life goes. I have the material objects I desire, none of which make me happy, they just help cocoon me in a bubble I share with the richer things in my life. My dogs, my few true friends, my mental strength, and the belief in myself that I can make a positive impact on others lives, using the experiences in my own life. My circle of friends has changed a lot in the past few years. Realisation that knowing someone for a long time does NOT make them a good friend, just an old acquaintance. And now knowing that support and genuine friendships can come at any stage in life, and sometimes from the most unlikely places. Two true friends coming from an internet forum that drove me to the brink last time I was suffering with depression. Sleepers who sat an observed, and helped me back on my feet when the time was right. With no prompting, no pleading, just their own selfless actions. For this I thank them.

But this is the real problem, the support network.
Anyone who knows me, and if you read my blog, you will understand I am far from timid with the written word. I don't hold back, and I rarely paint a pretty picture when underneath life is bleak. If its dark, I say it as it is. Sometimes a strong point, other times a bit of a mood killer, but it's who I am.
After spending many years trying to please others, and meet their expectations, I decided to be me, and I stay true to that every day. Again, it is not always what people want to see, but the days of faking and pleasing are in the past, so please don't ask me to be someone I am not.

For others however, even those with outgoing personalities, dealing with the realisation that you are actually depressed is a tough one. Admitting to it is something huge, possibly only choosing to tell one or two people, and most of the time not your nearest and dearest. The truth be told, some of the outgoing personalities are just what I was doing. The brave face, the loud deflecting voice, desperate to save my dignity, and not let on I was falling apart inside. See that is what depression is all about. Losing control, but desperately fighting to maintain image.

To admit you are depressed, genuinely, is for some like admitting defeat or weakness. It's like backing out of a challenge of any level, before even trying. And even the most grounded person knows that is never a good feeling to do once, let alone over and over. Convinced you will fail, sure you cannot achieve what you need to, and being scared of facing the consequences, and how your peers will react.
Have you ever dreamt that you have left your house with no clothes on, or that you are running away from something, but seem to be running on the spot. The level of helplessness you wake with, the panic and fear of losing all control of your dignity and self control. Well that is how it can feel every minute of every day.
One of the biggest fears in my experience of depression was being judged. I think as a whole, when you breakdown all the different aspects of depression, a lot of them come down to the same thing, how other will perceive us.

Walking down a street, feeling anxious that everyone you make eye contact with is staring at you, and judging you. You look strange, messy hair, cheap clothes, and so on. The list is endless, but you will read far more into their glance than they could possibly have gathered and judged you on. A simple exchange of words with someone, over analysed until it was meant with such hatred and malice. Everything is dark and negative, nothing can possibly be positive for a second. This continues until staying indoors, or going shopping late at night, or in the smallest shop possible is the only way to go on. Now hidden away, safely separated from society.

As I have said though, the only people who would really look at you in such a way are most likely suppressing issues of their own, and just fighting back their own fears of others judging them.

So what does a depressed person need from you? If you think someone is depressed, what can you do to make things better for them. And by better I mean help them on the road to recovery, rather than a patronising "there there there" and a pat on the back, making it all better for them.
I have to say there is no single simple answer to such a question, with all cases presenting differently. You may have noticed a change in their behaviour, withdrawn from group events, or just being quiet for a long period of time. Trouble engaging as they usually would.
For me, I would say I benefited simply from knowing people were there when I was ready for them to play their part. Having already declared my depression made that easier, but I know that isn't every ones approach.
If it is not clear what the issue is, but you suspect things might not be great, don't barrel in full of questions and suggestions. Just tread gently, but be the friend they know and trust. There is no need to smother someone, just indirect reassurances that you are about if they fancy a drink or a chat some time, in their own time.

There is no right way, go with your instincts. You know the person you know as a friend, so be yourself, if your help is needed, your support wanted, I am sure the time will come when this is obvious, and it can all flow naturally from there. I kept a lot of my friends out of the loop when I was at my lowest. Partially where I didn't want to bother them, and partly because they were the wrong person for the job at the time. It's nothing personal, just how the mind can be at times. You wouldn't turn to an outgoing party animal to be there in silence while you grieve, or an introvert friend to support you in a confrontational situation, so accept it that there is a tool for every job.

The biggest question for me in all this, from a sufferers perspective is why so many people live in a constant state of depression, and either refuse to act on it, or fail to identify their state of mind.
I guess there are logical answers to both, but for me I don't want to see others suffer in silence. Even those who seek help, get meds and go to counselling, will avoid telling friends for some reason. Again speaking from experience of others who have admitted after a long time they too fought with depression.
Identifying you are struggling with depression or anxiety is understandable. It is so easy to assume "everyone feels this way", but the reality is, they're not. It is not normal to dread getting up and facing the world day after day. Holding your tongue at home or at work, just to avoid the confrontation, and instead living in a suppressed state is not normal, contrary to belief. Fear of being judged by people when you are out in public, refusing to make eye contact or even waiting for the automated paying in machine in a bank while 3 cashiers are free just to avoid speaking to someone (like I did) is NOT normal.

Sometimes overcoming these issues can be as simple as taking a look from afar and making changes in the way you look at life, and accept treatment from your peers. Other times some form of help is needed. From counselling to chatting to friends and letting it all go. To entering the system so to speak, and going on record with your GP to seek help. None of these actions in any way make you weak or a failure. A little vulnerable yes, but for the right reasons. Sometimes being laid bare is an enlightening and empowering experience. Throwing caution to the wind, and only caring about yourself for once. Taking the steps to make life better, and trusting others to help you achieve that.

I am determined to keep talking about depression. Hopefully slowly but surely helping as many people as I can realise that being depressed is nothing to be ashamed of. It should not be hidden, and the stigma attached to the condition needs to go away. Over the past few years there are more and more campaigns to raise awareness of depression and mental health. Not a minute too soon I say, in fact maybe a decade too late. But the movement has started. I applaud those spearheading the campaigns, and praise anyone willing to share their stories of how desperate they have felt at times. There is no demographic description for someone who will become depressed. Rich, poor, outgoing, introvert, it takes all types. Even famous people, yup, that's right, even the rich and famous battle with mental health.

It's not a life choice, it is not something we bring upon ourselves. Mental heath issues affect who they want, how they want, and when they want. There is no choice in the matter whatsoever. The only choices we have are how we will cope with an issue if and when it strikes. Standing tall, not hiding, and reaching out are some of the best things you can do. However, when you are able to do that is all a matter of time. The second you realise, or a month after starting medication, that bit is all down to you.

I have rambled on for long enough now, but want to close by saying this.
Mental health is a serious issue in the UK, and one reaching epidemic proportions in some regions. Awareness is poor, understanding is hit and miss. Acceptance of the conditions is growing, and this is a positive step for the sufferers. However treatment varies, funding is seemingly inadequate, and the focus from the top down seems to be somewhat sporadic. The whole matter needs serious reappraisal, and a proper plan needs to be drawn up to deal with the rising number of cases. Not by sidelining people, and leaving them waiting months and months to receive some help, in the hope that they will just get better. And certainly not discharging people for missing a couple of sessions of a course, making it seem that they have successfully recovered. This is what I was told after missing one session due to heightened anxiety one day. Miss another, be discharged. Not dismissed, but discharged as OK.

Initial assessments need to be timely and thorough. Actual issues need to be properly identified, and the correct course of treatment should be made available in a reasonable time frame. Once someone is diagnosed as depressed, the clock is well and truly ticking, so time is of the essence. I don't expect things to change and improve over night, I am realistic. However I also appreciate the importance of the right help at the right time, and understand the implications of drawing things out, and not receiving the help you need in time. I was lucky, my meds were helping and my core of friends were reaching out to keep me afloat. But if I had been alone, I don't know if I would have made it in the right state of mind to the CBT course. I may have been too far gone by that stage.

I really do hope that there is an improvement to the system over the next few years. Certainly from my perspective, knowing that depression is usually a reoccurring condition, and from both experience and education, each case being worse than the last, I really hope that by the next time I am hit with a bout of depression, the mental health system on the NHS is as prepared as my friends are to hold me up and get me back on my feet as soon as possible.

Please feel free to email me directly with any feedback on this entry, to chat, to discuss etc. No one should suffer alone, so please don't.

Before I even get started I want to make something perfectly clear.. I am NOT having a dig at the NHS. I know plenty of people out there have their issues with the service, some quite rightly so, others just over expectational of what the service exist for, and what medical science is actually capable of.
Contrary to believe, not all lives can be saved, no all conditions resolved. Of course it is sad to lose a loved one, but blaming a service as mighty as the NHS is not always the right way to vent that feeling.
Mistakes have been made, lives lost for sure, and no that is not right. But on the grand scale, if we frown on the bad, then we should also celebrate the huge achievements of the NHS every day. But as usual, we are quick to complain, but slow to commend.

Right, now to what  I started writing this whole entry about. Not sure about its direction just yet, so lets see how it pans out. In short, I want to address the mental health service offered by the NHS. Obviously this is something I am quite familiar with, having been treated for depression and anxiety a number of times now, so I am not just grasping at straws here, and want to use some of my own experiences, and stories of others I know to try and put across a balanced opinion, so lets try this.

The first time I  suffered from a bout of depression was long before I was ever treated for depression. In the late 90's, losing touch with my daughter drove my to the brink. And thinking back about that now, reminds me very much of my most recent experience. Both dealt with by me with irrational amounts of physical activity, training twice a day 6 days a week at the gym. Good for the body, terrible for the mind.

Back then I was a lost soul, still in my 20's seeing my daughter torn away from me, and worst still, seeing my child move forwards in her life without her father, just like I had. Something I had vowed no child of mine would EVER go through. And there is was. One afternoon I found myself in casualty with a large gash on my hand, as a result of punching through a laminated screen in frustration. A scar I still carry today, and a reminder that physical reactions to feeling unstable mentally need to be limited and controlled. I didn't intend harm to myself, but ended up doing so. I never recognised what I was going through as being a mental health issue, so plugged on for the next year, finally slowly returning to my old self.

It would be another 10 years before I would see depression again, properly at least. As the condition of my mother worsened, and her need for a carer grew, I took on a new lifestyle. Combined with the recovery of a recent operation and a bad time at work, my mental condition dropped, and I soon realised I was in a very dark and desperate place, struggling to sleep, socialise, or even care about my own well being. On seeing a doctor I was prescribed Citalopram 20mh, soon rising to 40mg. Thankfully work provided some one to one counselling for me, and with the help of Peter my brilliant counsellor, I made a strong recovery, again, after about a year or so. Meds were reduced and phased out.

Move on another 5 years or so, and there we were again. A huge slump in mood drove me to possibly the deepest and most desperate point I have ever been in, long term. I have had huge lows, but never stayed this low. Seeing a new GP, I was back on Citalopram, and referred for counselling. This is where it really begun.

I was phone assessed by what felt like a very robotic and uncaring person, who decided my condition was mild and I should go to Cognitive Behavioural Therapy (CBT) For those not familiar with it, the only way I can summarise it is like this. You are taught to  identify points from early life which may have shaped your behaviour today, then to concentrate on what triggers your depression, and the cycles you go through which perpetuate the depression. Learning coping mechanisms, how to isolate each component, and on ways to avoid the spiral of depression. It sounds a bit hopeless and complex, but I must confess by the end I was understanding myself a lot better. In short, CBT isn't as bad as I first thought it was, but still don't believe it is for everyone.

As I was first introduced to the CBT service, I started to understand why some people were so frustrated with the NHS for their MH provisions, or at least the way they manage it. A few weeks after my somewhat uncaring phone assessment I received a letter to go to the Jenner Health centre for a one to one, with some vague information about this CBT thing. Having looked it up on the internet I was curious but not convinced.
On my arrival there I realised that not only was there no reception for the CBT dept (as noted in the letter) but there was barely a sign that I was even in the right place. Bad start for anxious people. My appointment was for about 12.00, but by about 12.30 I hadn't seen a single person on the floor or in the waiting room. Finally someone did come in, and was swiftly collected by a post natal class person. Now I am wondering if I am in the right place, anxiety levels rising.  Eventually someone came out to get me, apologising as we walked down the hallway. Little comfort for the way I was now feeling.

I was briefly asked about what brought me there that day, then pummelled with piles of papers about CBT. Being told that the things I was talking about were not of consequence, and that CBT only looks forwards. The past can't be changed. Tell that to someone traumatised by their past!
The following week, after finding peace with myself and realising this was the help I was getting and to go with it, I arrived at my appointment to be told I had been referred elsewhere, and was now to join a group therapy class. Anxious and depressed, great, lets go sit in a circle and talk about it. I was told this was NOT the case, but on arrival it was just like that. A circle of chairs and two counsellors.

At this point I was feeling hopeless. Speaking to the counsellors about how I felt, I was told nicely just to stick with it, but with no real foundation to it.

So I guess this is where my concerns first start. As humans we are capable of compassion and empathy, to a degree at least. But the line "I know how you feel" is used all too freely. If you have never been bound by the ropes of depression, or had your thoughts suppressed by the worry and voices in your head. If you have never just wanted to spend the next week in bed, and not wanted to see ANYONE face to face for weeks on end.... Then you certainly should not tell a depressed person "I know how you feel", you really don't.

I applaud anyone choosing a career in mental health. As far as the NHS goes it is hardly financially rewarding, and to some degree it isn't an easy role to fill either. It takes a strong mind to deal with such matters day in, day out. However I do sometimes wonder what the criteria really is for getting such a role, and how many sufferers of depression actually work in the service. Maybe it is counter productive to have sufferers working in the field, but from my perspective, I am in my element working with people suffering, as I feel I have more ability to understand what they mean when thy express how helpless they feel. Rather than replying with the "hmmm, hmmm, yes" I seemed to get a lot of the time.

So before I go on anymore, thank you to anyone who seriously takes on a role to help sufferers of mental health issues, not just depression and anxiety. You DO make a difference for sure. But I wonder would more funding, training, or better selection of staff, and a better understanding of the conditions make a bigger difference.

Do I think I could do better? Well that is a very good question indeed, and a fair one. I don't have any qualifications in anything, let alone psychology, I have no further education either. So academically I am useless. But is that what counts? Who can lead you through a forest at night the best, an expert map reader who has never been to this forest, or a local who lives there, but can't read or write? I think the answer is obvious. Sometimes qualifications and certificates are not the be all and end all. Sometimes its more about understanding and empathy to the situation.

Obviously there is some information required. Not every experience is the same, and not all people react the same way. Understanding the mechanism of the mind is pretty darn important too of course. So there is a balance to be found for sure. The right level of input from sufferers, the correct level of understanding of the situation from a psychological perspective, and carefully planned academic coursework and structured action plans. Question is, is this being achieved?

From my experience, possibly, in fact probably not. Counsellors arriving late to groups, not understanding the impact that has on the recovering mind. Mixed up piles of photocopied coursework sheets, sometimes not enough to go around. Depending too much on patient participation to get the course moving. Without solid contribution of stories from those attending, sessions sometimes stalled. In my instance I was happy to share deep and past experiences, but it was quite clear to me that many others were less comfortable (rightly so). Counsellors unable to directly answer questions on the subject matter at times, with others in the group having to fumble for answers til it was decided one of them was right.

It is not all negative of course, I came out the other end feeling better for it. My question is, who did what for me. Did I get back on my feet myself, did my sharing and helping others inspire me to fight back, or did CBT save the day? Honestly, I think it is a combination, but not a very balanced one. CBT put me in a room with people, something I was uncomfortable with, but willing to try. It also gave me the opportunity to tell my story. However the coursework was mainly thinks I have been through on my own free will. Identifying triggers, identifying drops in mood, coping mechanisms, understanding how society makes me feel.  So the actual learning side was lost on me.

That said, helping others in the group identify with their own demons, and give my own examples to help them better understand their own, that was something. By half way through I was looking forwards to each week, to see what impact I could have, and getting people smiling or sharing was a powerful drug for me.
This in turn enabled me to help myself. Both understand myself a bit more, give me a purpose and some self worth back. All in all the right combination was found, for me at least.

As the course went on, and people showed up from time to time, it became obvious that some people were back for the second or third time. That part was lost on me. Learning about yourself, understanding the functions of the mind, and the cruel tricks it plays is one thing. But re-learning over and over.... I don't get it. If you need help after completing the first course, surely you need a different approach. In this respect the MH system is a bit lost and misguided. I wonder what it feels like to be re-sent on a 12 week course just because you have become depressed again. While the lessons learned are powerful and enlightening, they simply cannot stop the body and mind from throwing your life into turmoil, it's just not that simple.

Now the elephant in the room. Medication!
Having grown up watching programs with mental health patience receiving mind numbing sedation drugs to keep their minds rested, I have long thought that all anti depressants are of the same nature, making you sleepy and non functional, and silencing the issues, rather than helping tackle them.
However it turns out they are not. They all do different things, some indeed are sedative style, but others help the body produce more of what is needed to balance your moods. Apart from some strange side effects during early days, life after that, once on the right dose becomes pretty darn normal. Apart from remembering to take a tablet each day, you are just you again, certainly with Citalopram.

I know quite a few others who feel exactly the same way about the meds.
Being serious for a second, look at it this way. In most cases you can come off them when the depression and risk of it reoccurring has passed, reducing the dose, until none is needed. I have done that successfully myself after my last bout of depression 5 years ago.
Think of it this way, if you have something important to do which requires your full attention, and have a headache, you grab some ibuprofen, wait 45 mins, and you are fit to do the task at hand. There is no stigma attached to ibuprofen, so it is socially acceptable. With mental health, it is the same, but sadly its going to be 45 days or more rather than minutes. Once the levels in your body start to level out, and you are able to think straight again, you can help yourself understand what the issue is, and how best to overcome it. Sometimes without clearing the fog, you won't be able to see the path out of the forest.

So I don't see them as a negative thing at all. And I really wish society would see this too. Alcohol alters the mind, so does tobacco, but somehow they are both social and acceptable drugs to use. "Overdosing" on them is common place, and abuse of them is an epidemic. But society seems to say that is ok. And yet at the same time frowns on simple, controlled, monitored medication taken by those needing that little tweak of the mind. I don't get it, not for one second. But then I don't drink or smoke, so how would I. Just as those who frown on medication for mental health don't get it, but still judge.

The drug side of the mental health treatment on the NHS seems to be aplenty. Churning out prescriptions many times a day, no scheduled reviews once prescribed. The face to face part, which in some cases is critical however seems very hit and miss. I felt that the whole process took far too long for me to get facetime with anyone. However it seems that this waiting time varies radically from borough to borough, just in London alone, so nationally, I dread to think what the variations are.
One example. I was referred in November 2015, and finally got face time in Jan 2016. To me, that was an eternity, and waiting for it was both scary and painful. Thankfully by that time I had started to find my own circle of support from a great group of friends.

For someone else I have gotten to know, they were referred at the same time as me, and here we are in August, coming on for a year later, and they are STILL waiting. Same are, different borough council, so different MH team and ethics it would seem. This is fundamentally where it all starts to fall apart.
I have all too often heard the term "NHS postcode lottery" and again wondered what the hell people are on about. But it would seem this is one example of this phenomena.

I just don't get how there can be differences in urgency, treatment, assessment, and over all ethics towards mental health from postcode to postcode. Surely the NHS as a whole, all the trusts combined have agreed a strategy for treating mental health. Moral codes of conduct, tiers of urgency and treatment nationwide. I don't understand how one body, overseen by one government, can be so fragmented, first into trusts, then into boroughs, and each fragment having its own ideals on treatment for a condition.
It also leaves me wondering if the same is true for others branches of the NHS, other fields of medicine. Should I move house to get considered more important by another boroughs health team?

Thankfully for me, in South London, under Lewisham, I cannot complain about any of the medical attention I have received over the years. Ultimately it has all worked out for me, and I am here writing annoyingly long blogs like this. But I has me now wondering about how different things are, and what can be done to make a change to the whole system.
I have read news reports for years which say the mental health section of the NHS is desperately under-funded, and spiralling out of control. I have also read reports of how people have been let down by the service, resulting in vulnerable people committing suicide, or harming others.

Somewhere in amongst that all is the answer. The right direction to take.
So my questions.

Why are counsellors photocopying literature for a course with a fixed program of learning. Buying paper,making thousands of copies on a photocopier, making a mess of things, and fumbling by. Is it not easier to have these put into booklets and handed out by every borough, every trust. Ensuring that everyone is receiving the same education on their condition. No missing pages, no topics accidentally overlooked. Surely it is cheaper to put it out to tender once, and print them all and distribute throughout the UK. Procurement for such things should be centralised. One of the faults maybe of the NHS being so top heavy and fragmented?

How many people working in the field actually have first hand experience of depression and anxiety. Statistically it is likely that most people working with cancer in the NHS no someone who has experienced cancer, so empathy is far easier to give.
However while depression and anxiety is at epidemic levels now, firstly it is in the shadows. Not discussed, never admitted, and sometimes denied by those diagnosed. So getting people to speak about it, let alone help in the field is really tough, I get that. But I am still curious to know how many are in the field, helping others understand. After my CBT course was done, I was hungry to help others, and as it turns out when I look back over my life, I have been doing this for ages.
I was shocked by the number of my friends who have suffered or still do, and touched by the positivity I received about my honest and open blog entries about the matter. I really didn't realise how wide spread it was, nor how secret it was.

I really wish I had the know how to start digging for information and understanding how things could be done differently, not only from my experiences, but from others too. If I had the time, I would dig deeper, and push harder to get heard, but for now I will carry on doing what I feel is right, and keep reaching out to others who are fighting their demons. Struggling every day against the voices in their heads, and the lack of understanding from the world around them.

I have more to say on this matter, watch this space. But in the meantime, if there is any official organisation I can lend my mind to, just call 🙂

Me apparently!.......................

Or at least that is how I feel right now.
Talking to a friend earlier today I was sure I was on top of things. I felt that as the afternoon turned into evening and night I would settle down. How wrong I was!

Coming from a massive high this morning, running my first 10km non stop outdoors, it was a hard high to beat. With the weather moving in fast this morning and afternoon, getting back out even just to walk the dogs was going to be a feat in itself. Needless to say it was late evening (now) before I could.

I guess it is only fair to say that I have kinda felt this drop coming for a couple of days now, with a series of events really giving my self esteem a proper battering. I won't go into detail as the intention of this entry is not to give anyone a hard time. Life has just gone on, but it is how my brain has interpreted certain aspects of the past days which has resulted in this low.

Walking a tightrope of emotions is a hard thing to do at the best of times, but in the social winds, there is always a gust waiting to take you off your feet, and throw you off balance. As it would seem has happened to me... AGAIN!

Trying to re-gain some self worth and dignity has been a hard slog recently, but I know it is what will eventually get me back on my feet. The running and cycling, as well as being a great distraction, has also given me some worth, and occasional senses of achievement. These go a long way to making me feel good about myself. Not to be mistaken for vanity of course. Those feel good photos shared to the world of social media as a bit of an ego boost, and very little more.

Realising people have been ashamed to be associated with you, hidden their connection with you, and pretended it's not like that is a real kick in the bollox, and can turn the road to recovery into a muddy trail which is impassable in a matter of minutes. Impossible to comprehend unless you are actually there, it is soul destroying and tears through your past like a tornado. What was ever real?

Breaking ties with a support network in the name of trying to go it alone is a strange and dangerous thing to do, but after an event like the one above, trust is really hard to give to anyone, and feeling secure only when isolated and hidden away comes naturally. Is it the wrong thing to do, probably yes.
So why do it? Because in isolation I am the only one who can affect my mood, my day and ultimately my recovery. Eliminating the possibility of misinterpretation leading to a mood swing which I then have someone to blame for. Reducing the chances of me ruining friendships which I value so much. Taking away the expectation on others to somehow magically make everything better, and then blaming them when it doesn't happen.

One thing which is becoming abundantly clear to me right now is that I am not right. After all this time trying to find a path through all this mental mayhem, so many false hopes have led not only to disappointment, but also to a more damaging depth of depression.

Right at this point I have to call this my absolute low of this bout of depression. And one which has really gotten the better of me. Getting out of this hole is going to be a battle for sure, but one I hope I can win.
Already I have realised that my self destructive behaviour, obsessive exercise when my body is saying no, has returned. After the run today, sensible me knows that I should rest and go easy on myself. So a 5 mile walk followed by walking the dogs for another 3.5 miles is probably not the best way of resting.
I already have plans for tomorrow to keep me busy and exhausted, but am sure if I am home early enough I will make an effort to do even more.

A couple of weeks ago I had grand designs for my up and coming 43rd birthday, having decided it was my first in over a decade as a single man, and convinced by others I should make a bit of an effort, my brain was ready to do just that. Hell, I was even making plans for Valentine's (which is also my birthday), but quite frankly, fuck it! I can do without over-thinking another thing, especially as pointless as those above, so the day will pass with no interest from me whatsoever, again!

I need to see my doctor again, to discuss what is next, how to get out of this spiral which is growing ever tighter and faster. The CBT approach is really not for me, and even with a firm understanding of how it is supposed to work, I can see no way it will make a dent in my emotions. With my past biting me in the arse firmly again, I fail to see how putting it behind me with no further consideration is even considered possible.

Something is wrong, seriously wrong, and there is a limit to how many distractions I can hope or expect friends to provide for me, to take my mind away from it all long enough to feel better in the medium term. Times with friends are amazing, and I am eternally grateful for those showing me compassion, and taking time out of their own lives to give me a much needed lift. But I need to be able to do this for myself at some point, and not feel anger or bad in any way towards my support network when I am low and there is nothing anyone can do for me at that given time.

I feel pathetic even writing that, needy and full of unfair expectation, and that just compounds the issues I am struggling with, and makes me feel even more worthless.

I foresee a tough and lonely road ahead of me, and one I am not keen to even take my first step on, but if I want to overcome this, and rise once again, I really need to.

It's no secret that I am "in the system" as such for therapy to try and deal with whatever it is that is eating away at me. Strangely as things have progressed, so have the feelings and symptoms of it all. Today I made a breakthrough all on my own, realising that anxiety is almost my coping mechanism for depression. As the cycle goes around from deep thinking and low moods, so the anxiety begins while I search for the reasons for the depression. Somehow I trap myself at depression almost subconsciously protecting myself from the lows of depression. Knowing I can still function on some level with anxiety, but very little function when depressed. This I know for a fact. But how I have come to this coping mechanism I have no idea.

Blocking the outside out, disengaging from people, and avoiding social situations of all kinds happens with both anxiety and depression for me, but when only anxious, I say "only", I can still manage to get to smaller shops, communicate with a small few people, and of course exercise. With the depression I know that my day consists of dark rooms and staying in bed, and withdrawing from society to the point where even housework and day to day responsibilities suffer.

Anyway, back to therapy, that's what this entry is meant to be about.
Quickly looking back over the timeline.
Mid Nov, GP referred me to IAPT, the therapy section of the local NHS.
Early Dec, I received a letter acknowledging my referral, followed by an hour long phone call to see what therapy I needed.
Mid Dec, I received notice of my first therapy appointment for early Jan
Early Jan, went to first session and later blogged about it. I had been sent for CBT, but didn't feel it was going to work for me, but agreed to stick at it.

Today, I had my second appointment with the therapist. Last week I was given a sheet to fill out for 7 days, every two hours. Logging my activity, mood, mood intensity, sense of achievement, contact level and enjoyment. And also a test sheet to score my anxiety and depression. On arrival at the appointment I handed them over only to be given the log back telling me it was for me. Errm I lived those days, so am pretty sure I know how I felt. Thanks for giving me something pointless to do!
The test score sheet was glanced at then put away.

At the opening of the session I was told that the therapist had spoken to her boss, who had agreed with her that I should probably be referred to a "depression group". Run by 3 people, and considered high intensity, they felt that this would be a better way for me to progress. Or I could stay at one to one therapy and carry on as I am. No pressure.... but choose NOW, you can't do both to see which is best, its one or the other. In reality the sales technique used felt quite bullish, so naturally I went with the easy option and accepted the group sessions.

By all accounts it is more a course than a group, with presentations and education on depression and self esteem, touching on anxiety. Or there was another group dealing with anxiety and stress. But tackling my two issues together seems impossible. In the therapists own words, having a depression and anxiety group would take forever to to get through. Well sorry for being awkward. We can help with one or the other, but not both, choose!
So the course lasts til April, 90 mins a week, in Lewisham. Active participation is not required so I am told. On describing the course to me, she explained it was 90 mins with a break and refreshments in the middle. And that during these breaks people can mingle and interact. My reaction was "oh god, strange people", to which I was told it was good for me to be "forced" into a social situation and to interact with people. Guess you didn't read the section on my test score where I rated interactions with people as stressful and upsetting then.

All that said and done, most of my worry is caused by the anxiety and the unknown, I could get there and feel fine, I know this. But I can't help but feel that so far this whole therapy effort has been a farce, so am really not encouraged to hold out much hope for the next stage.  With having an hour long phone assessment, then my first appointment being an assessment and introduction to CBT. Only for my second appointment to scrap everything that has happened so far, be given a huge pile of hand outs to read and be told, start with someone new again on a different road next week, really undermines my faith in trying any of this. I know these are tried and tested methods, but can't help feel ignored when I have said over and over that conventional counselling has worked for me before. Encouraging interaction, dealing with my past, and digging deep to find the root of this feeling. But hey, what do I know, I'm only the one trapped in my own head.

The outcome of todays session was about as negative as it can get really. I came home, tried to walk the dogs, managed Tuvaaq, got to the top of the road with Aana and turned back giving up. Great, too fed up to even walk! Coming back home with Aana, I ran a bath, had a quick soak, realised I was dropping off, so got out, dried off and went to bed for a couple of hours.
I would have to check back in my mood diary to see the last time I felt so low that I just completely shut down. But it has been a while. So to come from a help session and feel SO damn low, well that just sucks!

Since getting back up I have been for a walk on my own listening to music. I know I am not physically exhausted as my legs had plenty in them, but the motivation to keep moving, even with music in my ears was a struggle to say the least. So I am left feeling alone, withdrawn and misunderstood. Thrown from pillar to post as they make some kind of effort to help me. If I were to see my GP any time soon my feed back would be poor. If I could afford to go private with counselling, I would in a heartbeat.

Right, here is hoping the mood passes by tomorrow, and see if I can get back in the saddle, metaphorically speaking, and depending on the weather, maybe in the actual bike saddle.

Oh one other thing. Last week I expressed to the therapist how much exercise and walking I was doing, telling her distances and durations. Today she mentioned this, and I said yesterday I walked 15 miles and rode 25. She cocked her head and looked and me and said "in one day?" I said yes, I walk that most days. Glad she were listening last time!

It's been a while since I really updated any platform on my progress fighting the evil of the brain, so thought it was time I put fingers to keys again and got writing.
This all comes on what in theory is a breakthrough day for me. Having spent the majority of the past week away from social media, and deleting all my contacts on Facebook, today I flicked the switch to get back online. It is also the day that I saw my first real person face to face about the therapy I have been longing for since November.

Let's start at the beginning shall we. The social media blackout, why and did it help?
First up, why. Well because sometimes the world can become a really noisy place, and to hear yourself think, you need to turn off the distractions of what is for a better word a fake life, and concentrate on the realities surrounding you. Spending hours a day viewing and sharing words of wisdom, cute animals, and crazy peoples rants (yes mine!) is all well and good, but when the time comes to prioritise, it isn't hard to guess which has to go. The silence is amazing, in both a very calming way, and also a very anxious way, especially for me. With FB being a primary point of contact for some people, I feel I might have cut my nose off to spite my face.

So did it help. Obviously not from reading the above paragraph you might think.Well, wrong!
After a couple of days, and getting used to the differences it made in my day today life, things become a little more normal. Being what I would describe as an over active user on FB anyway, it is actually quite empowering to find other things to do, and keep things to yourself, for a while at least. That said, it did make me realise how important a role FB has had in certain elements of my life over the years.

Coming back on to FB I had a number of friend requests waiting for me, thankfully a small number, which allows me to adjust my feed as the number grows (if anyone else adds me). It was nice to see some genuine and friendly names, some who I have missed, right there. But in the new world, it's not about the numbers, but more about the quality. I don't want 5,000 friends to look special, I want everyone on there to want to be in contact with me, rather than add through obligation.
In short, I see a controlled reintroduction to FB to be a positive thing. That said, my interactions will be very limited, as will the content I choose to share on there. Old habits die hard, but that is one that has to go.

Next up, therapy, or should I say Psychological Therapies (PT).
Having first been referred back in mid November, and contacted a month later by phone for an assessment, I eventually received an appointment with a real person face to face, for January (2 months from referral). Today was the day.
With a Midday appointment, I was mindful to get there as close to the time as possible as waiting rooms, eye contact etc isn't good for me right now. I get anxious and twitchy. Imagine my delight when not only is there no receptionist to speak to, and confirm you are in the right place, but also no one to tell you the sessions are running 20 mins late. Suffering from anxiety, in a new place for the first time, with no one to speak to, and just left to wait. Is this some sort of acid test or something? Seriously though, I know it is a department of the NHS which is under huge strain right now, and only once you are in the system can you appreciate how stretched it is.
Eventually I was greeted and taken into a room to have a chat. My notes were flicked through, my documentation checked over, and it was agreed that my anxiety is on the increase right now. Imagine that!

She went on to explain that the type of therapy chosen for me by the phone assessor is CBT, or Cognitive Behavioural Therapy. I am no expert on it, and have some reading to do, but the fundamentals seem sound certainly for some issues. Breaking a situation down into 4 categories, thoughts, emotions, physical feelings and actions. So a situation leads you to think something, triggering an emotion, which in turn may result in physical feelings and / or an action. Simple really, and when you run through scenario's, it is easy to see how it works. Learning to take control of a situation which affects you, and preventing the 4 categories becoming negative. As I say though, for some situations that is easy, for others not so.

The session was 30 mins but over ran, partly being the first session, and secondly I think from the sheer complexity of the situation I was trying to put across. It's not just me getting anxious around people, it is a WHOLE lot more than that. A fact I feel was slightly lost, as each time I tried to introduce another part of the issue, it was somehow tied into something I had already said. They are the pro's, they know best, and if there is an association, fine. But from my perspective certain elements are very stand alone.

Towards the end I was asked to give some examples of goals I want to achieve through these sessions. Keeping in mind that the standard package is 6 x 30 min sessions. I think I will be hard pushed to achieve much in that time, especially as I am in a negative frame of mind about the process already. So I am going to think over the coming week and put together notes of issues and goals, and see how they want to approach the matter. I don't want to be patched up, I want to be fixed. I am a complex old beast, and I know I have issues to overcome, and the more I look, the more I find. The whole situation is like taking an old car that has been sitting for years to a garage and asking them to fix it up. The more you strip away, the more broken and damaged things you will find.

A couple of things I found amusing during the session are below.

On asking what kinds of counselling or therapy I have had before, I explained I had counselling and felt good to open up and offload things that had built up. I was told that that isn't what we will be doing, and to forget about the past, as CBT focuses on the here and now. Which is fine.... If your here and now issues aren't a product of the past! The idea that I will just sweep everything under the carpet and start over is a fantasy.

On asking about my physical feelings and actions in a stressful situation, and explaining I use exercise, walking and cycling to get away from the situation, and prevent myself from being able to think, I was told this is a good thing.
When I then explained that these walks could be 8-10 miles, and some days I have done far more, resulting in causing physical pain and discomfort to my feet, legs and back. I was quite simply told, don't do that.
Oh OK, I I just told you a coping mechanism I have found, which I know can be negative, especially when walking in pain, but I should just stop. Turn off the desire to run away and escape, simple as that! I'm all fixed now!

If I tell you I went for a 90 minute 6 mile walk immediately after the session, it might give an indication of how I felt leaving there.
Looking back years in my blog I made an entry when I went for my first counselling session, and how positive I felt leaving there. Without even reading back, although I know I was right in the middle of one of the hardest times of my life, I know full well I felt relief and looked forward to the next counselling session. So I am yet to be convinced that CBT is the way to go for me right now.

In other matters, getting back into cycling has been a great thing for me, really remembering why I loved it so much before now. Slowly increasing the mileage.
Things in my head are far from settled yet, especially with today's adventure. Having built myself up to the fact that when therapy starts, the recovery will come with it. Now I am left with dread that this is going to be a long road.
Sleep improving with a change in diet and intake, planning my days a bit better, and trying not to lay in in the mornings, instead being up by 6.30. My mood diary has been of great help to me, I would recommend doing that to anyone. Weight loss has started, and starting out quite rapidly too, so that feels nice. And getting into a routine of training and making sure I challenge myself physically is also a good thing for me. Keeps me busy, distracted, and focused on myself.

Right, I shall end there for now, my back is hurting from over working myself recently, so time to rest, the only way I know how. Walk the dogs.

Final thanks to that small group of special people keeping me on the straight and narrow, even when I am being an arsehole! I wouldn't be making the progress I am without you all.

After another rather stressy day yesterday I turned in early for the night. Not that I got to sleep straight away, and neither did I sleep very well. It would seem the initial improvement is now a thing of the past. Relaxing thoughts, and well rehearsed techniques to get to sleep no longer work, and the spiral of association has come back. Taking a simple innocent thought, within a minute it spirals into something I dread or a subject that winds me up. Change the thought, and the process starts again. Thinking of a video game for example, within three twists of association, can become a past memory of something I have done, which in turn makes me sad or anxious. It's incredible, as my concious mind could never make those twisted associations. It is almost like my brain WANTS me to think about these other things, and manages to contort the subject accordingly.

Right now though I have no rational way of addressing the matters, and no means of outlet to vent them to, so they will just have to wait for now.

Speaking of waiting, that is the theme of today, waiting for a contractor (who has now arrived), and waiting for a call from the GP. Thankfully, one thing I am not waiting for any longer is the report from my company doctor. After seeing him last week all seemed to go well, but you know how it is. Like job interviews, it went well but the letter isn't what you expected. However on this occasion I am happy to say that the report is favourable, and supportive, which is a great relief to me for sure. Painting a similar picture to that which my GP has already done, recommending the increase in medication as per the consultation, and outlining a realistic timescale for improvement and return to work.
Now I just need to speak to the GP when she calls, to discuss the report and see if she goes with the increase in meds dose.

Also having now received the next appointment with the therapy people from the NHS, I can now add that to her information, so she can make decisions accordingly. With the first face to face appointment with the therapy people not being til January, and only being an assessment once again, treatment itself is yet to get a confirmed start date. That obviously puts the brakes on things a little bit, but the company GP has allowed for this in his recommendations.

So there are lots of positives there for sure.
In other parts of life there is little improvement in my day to day goings on. Still borderline hurting myself to try and stay clear headed and sane, and of course to end the day exhausted enough to sleep. Which doesn't seem to be working very well anymore, but the getting out alone is helping keep my head clear.
Support from friends, and company being offered is a great relief, now all I need to do is make some of that actually happen.

On Xmas day I will be making my usual trip to Wales to have a clean up of the family grave, lay some flowers, and have some down time breathing fresh coastal air. Come rain or shine, I look forwards to returning to a place which holds only the most innocent of memories for me, and offers no complications, painful reminders, or associations for my mind to play with. Memories of youth are the clearest and purest I have. So I think it is that which keeps me going back again and again. As well of course as wishing to maintain the headstone, and pay my respects.
Fingers crossed I can have a wide awake day, and stay focused enough to do the round trip in the day. I am sure I can, but as ever it is a solo trip, so keeping my mind distracted might be a bit of a test for me.

So that is my download for the morning. Here's to a positive outcome to the call from the GP, and a chance to get outside and recharge my solar batteries in my head.

Thanks for reading.

OK I love the NHS, and think that all areas I have encountered do a fantastic job, but there is a glitch.. And it is one that is reported about all the time, but I have always assumed was just bad press. Maybe I am just unlucky and they are usually great, I don't know. Time will tell I guess.

A few weeks ago my GP referred me for what is nicely named "Psychological Therapy". She filled out her referral, I filled out a questionnaire which included personal info and contact preferences, such as can a message be left.

A week or so later I got a text asking me to call and leave a message to confirm I wanted to go ahead with the service, I replied immediately. On Monday I got a letter asking me to contact them t confirm I wanted to go ahead, so I emailed straight back. Today I have received a letter saying they haven't been able to contact me, and if I don't within 10 days I will be referred back to my GP.

Over the past few days I have received a few calls from withheld or private numbers, no messages left. With the first being a cold call about upgrading my phone, I have ignored the rest. The last thing I need right now is cold calls etc. So it is possible that one or more of these calls has been from the PT department about the counselling. If that IS the case, why the hell don't they at least leave a message. I'm off work as my brain is melting, I can't be the only person that screens calls. Why ask if they can leave messages, if they won't bother anyway, then will just send you kick to the kerb letters.

When your brain is mush like mine at the moment, you really don't need this kind of stupidity.

Rant over!