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It has been a long time since I last wrote an entry here, and for the most part I would put that down to the vastly improved state of mind I have had over the past year to 15 months. There have of course been lows, but nothing in comparison to what I would usually go through in my yearly rollercoaster ride of mental state. 

So much has happened in the past year, I really don't know where to start, so in no particular chronological order, I will break it down into pieces, and have a ramble. 

RCGP. I have been working with them again this year, helping medical students better understand the presentation, diagnosis, and treatment of anxiety and depression. It never ceases to amaze me how natural some are with the situation, and show genuine compassion. While others struggle a little, almost suffering from reverse stigma, and feeling uncomfortable about discussing someone elses mental health. It is those I hope to make an impression on the most. This years sessions have been very different, moving to online Teams consultations. Which in itself has taught me a lot about myself, whilst making life a whole lot more comfortable. Mainly because it avoids the commute into town to the RCGP, which in itself is hugely stressful for someone with social anxiety.

Working from home has been a complete game changer for me, I should have started with this really, as it could drag on, but here goes anyway. 

Being quite and introvert and socially anxious person, personal interactions with others can be quite draining. Over the past year or so, I have felt much more alert, and fresh throughout the working day. Not spending mental energy on social things that actually have no impact on my working day, and rather spending the extra energy I find myself with, getting stuck into projects at work. The physical aspect of getting to the office has never been an issue for me, in fact I enjoyed my daily 10 mile each way commute by bike, as it gave me time and space to prepare myself for the shift ahead. The more exhausting part was being in an office, and that was purely mental exhaustion.

That is just the tip of the iceberg for working from home for me. There are SO many pros, and at best a sprinkling of cons. Being able to work whatever hours the day demands is no longer a stress. Getting a call to say there is a sickness, or something is up and I am needed in ASAP, once meant rushing my routine (which is very important to me) and driving into work. This was always the start of a bad day. Now, the same call means walking into my home office and logging in. Be it for 5 mins, or the rest of the day, I am in effect "on call" whenever needed. 

As far as mental wellbeing goes, I can honestly say, in 15-16 months now, I have had one dip. It lasted about a week, I had a lot going on at home too at the time, and at worst it meant a slight lack of focus for me, nothing more. Even through the winter months, which we have effectively had 2 cycles of during WFH now, I have been much better than I can ever recall being in many years gone by. The much expected low simply hasn't arrived. I have no doubt in my mind whatsoever, that working from home has been the key to this massive shift for me. 

Although as I write this, I am more than aware that the end of June is just over a month away. This is the date for the next "checkpoint" for the UK Government, and indeed my employer to consider, and detail the next stages of what is to come for the "new normal". This in itself has probably wobbled me more than anything in the past year or more. The uncertainty of what comes next. Will it be all back to the office, will there be a choice? Flexible working from home and office throughout the week has been mentioned. As has the "choice" of home or office. Personally, for me, home is the best way, and the only way I can stay on this level. 

I know it is expecting way too much, and it is far from a demand. Having worked for the company for over 20 years now, I know how important oversight is for management, and appreciate the trust put in us to work from home, and be trusted to go the best possible job we can. But you cannot ignore the fact that during the pandemic, while it has suited, it has been OK. The idea for certain departments to work from home in the past was simply out of the question, and not a discussion even worth starting. However I think, if the recent events have shown us anything, it is that it IS possible, and the outcome is probably more a more productive, coercive workgroup.

I think it is clear from the paragraphs above, what my feelings are on returning to an office environment. I simply don't want to. I am happy to be checked up on, visited at home, or whatever other measures are required to keep me safe and alone in my home office. Which I have to say is a lot better equipped than my office based desk was. Mainly through buying things at my own expense, but something I am quite happy to do in the longterm. Heck I would even consider a pay freeze for a while, How's that for an offer?

Anyway, enough about working from home, for now at least.

In other areas of life, the fresher state of mind for me has allowed me to look after myself physically too. Cutting out a lot of the junk food, which was mainly whilst in the office at work. Taking the time I would have spent commuting to take better care of myself. Getting back into running has been huge for me. Since Xmas I have gone from doing Couch to 5K, to running a half marathon distance. A distance I have never achieved before, so to day I am feeling good is an understatement. That on top of working out, and still getting as much cycling done as I can, and that all rounds up to another huge tick in the box for this new normal.

I think one of the strangest parts of the whole thing has been the social isolation. Something I crave most of the time, suddenly became something everyone was doing. No longer was it a fight to get personal space, in fact it was insisted upon. It has been quite incredible, and I know that there have been other friends of mine who have found it equally as much of a relief.  That is not to say the isolation for many has not been crippling. 

I am not going to sit here, and selfishly say how great things have been. The pandemic has been horrific on so many levels. Losing loved ones to a cruel virus, being kept apart from those we crave to be with, for long durations, business collapses and so many other horrible effects from it all. The pandemic is not one of those things this generation will ever forget. But on the flip side, some people learned what it is like to feel detached from society, unable to engage, as much as you would love to. A greater understanding has been found of what social anxiety feels like. In this case, afraid to go out in case of catching the virus, but to many like me, the same anxiety is found simply by going out and interacting with others, even when they are perfectly healthy, and of no threat.

OK, my brain is a little fried from this sudden outburst of expression, so I am going to leave it there for now. But will come back to this soon, and carry on my catch up on how things are. 

Thanks as ever for reading.

Take care

2

You may recall last year I did a few sessions with the Royal College of General Practitioners in Central London. Working as an "expert patient", I assist with role play scenarios, giving the students the chance to interview, assess and mock treat me.  For anyone not in the know, I have a long history of anxiety and depression, and was asked by my local GP if I would be interested in helping with teach the future generation of GP's better understand the conditions by doing these sessions. 

So, after last year, I thought it was all over with, and heard that there would be no more session. However to my delight and surprise I received an invite a couple of months back, to do a session in September 2019. Needless to say, I booked the time off work, and last Friday I went along. 

I should say before I go on, that these days in the past have proven to be quite mentally exhausting. With the travelling at peak times, to Central London, then doing 8-10 sittings with students, re-enacting the presentation of the condition, it all starts to become a little too real by the end of it all. So facing rush-hour on the way back home, can sometimes be almost a step too far. 

With this in mind, for this session I decided to switch things up a bit. Rather than presenting with anxiety, which is quite a high energy feeling, I decided to go with depression this time. Strange as it sounds, and in no way saying it is easier to cope with, the energy needed to present as depressed is far lower, so far less taxing on the mind. With 10 sessions to do on this day, it was the right decision. It probably worked out better for the students too, as this was their first few weeks as Year 3 students, and many have not even touched on mental health. Win win you might call it. 

Seeing the difference in reactions between the groups of students, presented with something that has no physical manifestation to examine was quite interesting, and secretly a little amusing. Their faces as the presentation started showed a fresh thought process was  underway. Each time I presented I would switch up the language used, the prompts given, and the assistance with the flow of the situation. I was delighted to see that none of the students felt they were entirely comfortable or confident in running through the whole scenario without the assistance of their colleagues and tutor who were all in the room. Not to proud to ask for a time out and see what others thought, very refreshing. 

To help matters along, my own state of mind was good this time. In the past I have wound myself up about the whole event, and started the day on a downward spiral, and finishing the day a lot lower than I started. On this day, due to good self management, finding my own time and space, and a smooth running session, all was well. For the first time, I didn't stay in for lunch, but instead opted for the fresh air and scenery of Tottenham Court Road. Not wanting to get caught out with a low battery on the phone, I had taken a portable power bank with me. Complete with the WRONG USB lead! £15 for a USB type C lead was somewhat upsetting, but needs must, and it kept me sane, so money well spent... I guess!

By the end of the day, I was fresh as a daisy, and ready to do battle with the commuters on the way home. Luckily for me, we were out a little before the main event of Friday rush hour in London begun, so by the time I got to Highbury and Islington for my train home, a seat awaited me. It was nice to be on a train at the start of a journey for once, and get a seat, while seeing others stand as they got on later into the journey, boarding at stations I have joined at in the past while commuting.

While at the RCGP, I connected with a few new people, one of which who co-ordinates other similar role play days for students etc, so I am hoping to hear back from her, and see if I can offer any help on other matters in due course.  I have been quite slack in my drive to help others fighting mental health issues, for numerous reasons, none of which are particularly astounding or worthy, so it feels good to have done another one of these sessions, to at least do a little bit to help. 

Til next time... Take care all. 

 

After a bit of a wobbly morning, and a nice long 3 or so mile walk at lunch, it was time for the afternoon session.

I have been trying to drip feed the info a bit more this time around, as the first time I was here, I felt I was giving it all away a little too easily

Morning sessions were all positive, great interaction with each of the students doing their differential. However this afternoon, I have just come out of the first session and am genuinely blown away by the approach  professionalism and thoroughness of the first student.

Her approach was spot on, as if she has done this 100 times already, however it turns out it is just her first  time doing mental health this week. Calm, interactive, patient led and compassionate. You can't teach that sort of persona.

This is not to detract from the other brilliant students I have interacted with already today. Each one of them is fantastic in their own right. Simply for being in the line of education they are in, they get my full respect. Not to mention how each one has been brilliant in diagnosis and patient interaction

But sometimes one person really stands out, and this was the one this time around.

*Edit*

Just come out of the second session, and again, amazing! Empathy in gallons, understanding, and all the right questions and replies. 

Going back to me for a bit. This morning was a little draining. Feeling situational anxiety I think would be the right way to put it. As expected, the slight drain on my energy levels of late has had an impact  However it has also taught me something about myself too.

Situational anxiety, is not the same as general clinical anxiety. They may present the same, but bounce back from situational is instant, where as being clinically anxious and going through a full on episode is completely different  thank heavens! I can understand more now when people say they feel anxious for a moment, and can better relate to what they mean by it. I have felt it many times before  but this is an eye opener for me, and I can now feel the difference.

Similar with depression really, although my feelings of genuine depression are a whole lot lower than when I feel, what I call "down". But I can understand when people call it being depressed about something all the same.

I do love a situation where everyone is coming away with new knowledge, and today is certainly one of those times. Last time I said I thought I felt anxious about talking about anxiety, and presenting with the symptoms again. I can confirm this is the case again. Reliving the visits to the doctors really does bring things to the front of your mind and can start to feel really real. However I won't stress as I know how it passed last time, and will again this time.

Well, here I am. Just got here on a rather wet an woeful day. Thankfully I have slept a little better over the last few nights, after having had a cold and struggled earlier in the week.

Currently sitting on the floor away from the group of actors and other real life patients, partly because I am still full of germs, and partly because its just nice to have some space after spending an hour on public transport

Second time around is a lot easier for sure, far less nerves about what to expect. That said, anxiety is knocking at the door, but in a very calm and gentle way. I got this! I have my rota for the day, and no quick escape this time. Rathe than a free session at the end of the rotation, I am in with a group, so my escape is delayed. Hopefully (and my biggest concern right now) I can get on a train and on the way home before the mad evening rush starts. Last time worked out just right.

Took a different route here today too, a little bit of variety is good for the soul  and keeps me trying new things, rather than sticking to the known all the time. Got to keep on top of things eh. Thankfully the longer section of my journey home starts at the first station  on the route, so the chances of a seat are much higher, especially as its London Overground. Fingers crossed eh. To get there is one stop on the Victoria line, which was rammed this morning, urrgh..

I travelled to London Bridge earlier in the week too, again around peak time, so if I say so myself, I have done well with the whole travelling thing. I think the hardest part has been the whole feeling crappy thing. Sniffles and travelling do not go well together.

Right, better get my head in the game, and think about my scenario for the day. Maybe the same as last time? That seemed to work out OK.

Oh no! I gave myself plenty of room here on the floor, away from the hustle and bustle of everyone else. But just like parking spaces, one person in an open area seems to attract others, so now people are setting up around me. Doh.

Not the end of the world, I am just making it out to be more than it is. Anxious thoughts, creating anxious feelings. Calm down Michael, its all OK. We will hopefully be going in for the briefing soon, then onto the sessions. I am straight in at 9.30 today, so time to calm down, prepare and do my thing.

Here goes...

Have a good day all.

The clock is ticking down on my next session at the Royal College of General Practitioners on Friday, and I have to say the suspense and stress is building. It will be my second rush-hour trip to Central London in the week, which never bodes well with me even at the best of times.

The first session I did was a real eye opener, and while it was fun, it was quite draining too. That was starting from a nice high spot in my mental cycle. This time around I am somewhat lower than I was before, so it will be interesting to see what impact that has. Whatever the cost to me, the important thing is being able to help the students understand the presentation of anxiety and depression.

On the plus side, the whole day is a known thing now, it is not full of surprises and uncertainty, so that will help enormously I am sure. I will just get there nice and early again, missing the majority of the morning rush, and have a little wind down walk before getting started.

I will have to put some thought into the scenario for this time too. I am quite happy with the original, but it is good to mix things up a bit. As much for my sanity as theirs. Really is quite draining mentally, recalling events from your life, and playing them out in a scenario over and over for a day. By the end of the day you are mentally exhausted. I kind of envy the actors who also participate in these events. Surely it is much easier to pretend to suffer with something you don't already struggle with. Maybe I am wrong, who knows.

Either way, as I say, the main thing is the students come away from it all with a better understanding. I really do want to have more time to answer questions, and help in any way I can. With so much work being done to raise awareness of mental health issues, it is only right to make sure it can be identified and caught nice and early, so help can be given before the issue worsens for the patient.

Which reminds me actually, I have got to read back through my emails, and do a submission to the BMJ as suggested by Niki. It may come to nothing, it may be the beginnings of being able to do something more positive, time will tell. Not like I don't like writing now is it!

Right, better get my head in gear and thinking cap on, ready for the (next) big day.

Thanks for reading.

PS, students, you can now find all my MH writings on my new website www.snazy.co.uk (if you are not already reading this entry there)