Tackling The Mental Health Minefield Part 10 - Hot-bedding

(This post continues the story from Tackling The Mental Health Minefield Part 9 - The Nurses: Carers or Prison Warders)

Hot-bedding is a military term, particularly used by the Royal Navy but understood by the other Armed Forces equally, that indicates that there are insufficient beds for all on board and that as one seaman climbs out of his bed to get ready for his watch, so a seaman coming off watch climbs into it to get some sleep. It isn't actually that common these days, although I suspect that it may still be necessary on some submarines.

Beds are at a premium in all NHS hospitals. Many hospitals have more than 100% occupancy (I know that sounds impossible but it happens) and the fact that is that as soon as one patient is discharged, and sometimes even before that happens, another patient is admitted to take the bed. There have been huge cuts in the number of beds available in an effort to save money. If these cuts have been bad in main stream hospitals, in mental hospitals they have been catastrophic.

The problems that arise from this policy are something like this in the Mental Health Trust that looks after my area of London. The trust has seven hospitals which either take patients from a particular area or are specialist psychiatric facilities (eating disorders, young people, addiction). The hospital that you are put in is therefore dependent on which borough you live in, and then the ward that you are assigned to is decided by whereabouts in the borough you live. This is hardly ever deviated from so even though you may be in desperate need of a bed, if there is no-one who is well enough to be discharged then you are left on your own. There can be no doubt that having to operate in this way that there are more attempted suicides or successful suicides than there would be if there had been a bed available when the patient needed it. To show this happened in the hospital that I was in, it is only necessary for me to relate what happened to me.

I was moved from the admissions ward to my permanent ward at no notice because they needed my bed in the admissions ward. This was on a Thursday evening; the following Wednesday I went home for my ill-fated overnight leave. When I went back the next day, my room was already being occupied by somebody else, so it became necessary to discharge someone so that a bed could be made available for me. A couple of days later I was told that I had to vacate my room because it was needed for a male patient being admitted to the ward. I wasn't in any fit state to be discharged or sent home on leave, so I was told that I would be given a bed for the night on another ward. I was to spend the rest of the day on my ward, up to and including night-time medication, then I was to move to this other ward, where I didn't know any of the patients or the staff, for the night only to return to my proper ward for breakfast the next morning when it was hoped that a bed would be available for me. I'm afraid that I really lost it at that point.

My immediate question for the staff was why it was necessary for me to be moved in this way; wouldn't it make more sense for the male patient to be put on the other ward. There seemed to be no sensible answer to this; I was told that this was just the way it had to be. I decided to dig my heels in at this point and said that I would not be leaving the ward after medication and that it was up to the staff to find me a bed somewhere on the ward. And so it came about that I spent the night sleeping on one of the settees in the ladies' TV lounge. The following day, one of the patients was sent out on home leave and I moved into their room. A few day's later I was moved again. The room that I was occupying was in the main corridor and they wanted this room for someone else, so a bed was made available for me in the female corridor. I remained in that room until I went to the assisted-living accommodation about a week later.

In the period that I was in the hospital I was on two wards and slept in six different rooms, one of them not even a bedroom. One of the most important things that most mental patients require is a sense of stability something that was definitely lacking in my case and I am sure that it was this sense of not belonging that caused me to be in hospital as long as I was.

To be continued.

Just So You Know

I have been out of action since Sunday. It wasn't the computer; it was me. I was feeling so depressed and suicidal Sunday morning after another night without sleep that I took myself of to A&E to seek help from the psychiatric liaison team. The net result of this is that I have spent the week back in the psychiatric hospital. The lovely Lily from The Student Doctor Diaries came to visit me on Monday and Tuesday and kept me from going completely up the wall.

I have been discharged this evening even though I am far from well with a sheaf of pamphlets and the instruction to call the psychiatric liaison team if I am having trouble coping over the weekend. I will, of course, be adding this experience to the Tackling the Mental Health Minefied Series, but it may be a few days in appearing.

I'm afraid that one of the consultants and I seem to have differing views on my safety at home. In hospital I was able to do considerable self-harm to a number of parts of my body and that was without recourse to sharp instruments; why he should think that I won't partake of a large number of tablets and use a sharp knife at home in furtherance of this, I really don't know. And I still haven't had a night's sleep even though the medication that I was taking to help with sleep was increased to a dose that could fell an elephant but I was to be found three or four hours after taking the medication playing games on my Nintendo DSi, doing Sudoku puzzles or reading a book.

Winter Gold

After an interval of 30 years, a solo British athlete has won a gold medal at the Winter Olympics. We don't have a great history of medal winning in the Winter Olympics, after all we don't have the weather and facilities for many of the sports involved, but we do have a good record in the Women's Skeleton. In the last three Winter Olympics, our ladies have brought home first a Bronze Medal, then a Silver Medal, and now Amy Williams has won the Gold Medal and deserves our hearty congratulations.

This particular event is relatively new to the Winter Olympics and it is surprising that British athletes should do so well at it. We don't have a track in this country, so all practice has to be undertaken elsewhere. And it's not exactly the kind of event that many of us would want to take part in anyway. The thought of travelling headfirst at speeds approaching 100mph down an icy course consisting of twists and turns while lying on something that resembles a tea tray must require either a special form of courage or a spirit of foolhardiness.

I'm not a particular follower of the Winter Olympics unlike the Summer Olympics which I watch avidly. However, this particular event holds an interest for me because I personally know one the British ladies who have excelled at this event. Alex Coomber, who won the Bronze Medal (competing even though she had a broken wrist) eight years ago, used to work for me.

Well, when I say that she worked for me, what I mean is that she was a member of staff of the office of which I was the head. Alex was a junior officer in the RAF and I was the civilian Head of Section. I remember clearly the day that she told me that she was going to enter the RAF Winter Sports Championships in the Skeleton Bobsleigh as it was referred to back then. I told her that she must be mad, especially as she had never taken part in the event before. She won the championship and went on to become World Cup Champion in the event three years running. In addition, she also won a Silver Medal in the World Championships in 2001.

Highlights

Don't get too excited. It was just that I decided that I needed to do something to try to lift my spirits a little. So I rang the hairdresser's this morning and managed to get an appointment to get some highlights put in my hair. I needed something to help to disguise some of the grey.

Unfortunately is hasn't helped much. I'm still feeling desperately low and wondering whether things will ever get better. I am still finding it difficult to focus on anything for more than about five minutes at a time and I haven't even been able to manage to read a book for a couple of weeks now.

In my few rational moments I know that things will get better, but it still doesn't help much. I just wish that the horrible thoughts would go away and that I could be normal again. But I haven't been normal for more than 11 years now and I think that I have forgotten what it is like. Would I even be able to recognise it if it were to happen? I wonder.

Grey And Miserable

I'm feeling like the weather today. Grey and miserable.

I had to go to see my GP yesterday. I have something that is not talked about in polite society and things were so painful that I couldn't even sit down on the sofa which is nice and soft. He gave me a prescription for pain killers, anti-inflammatories, and some cream for the problem. There was supposed to be some antibiotics too but he forgot to add them to the prescription so I had to go back to the surgery this morning to get a prescription for them. There was also a referral to the hospital so I shall be seeing them in a few weeks time.

Teddy progressed a bit more yesterday with his body parts being completed. I also started the back of his head. I don't feel like knitting at the moment so progress has slowed but as he isn't needed immediately that isn't a problem. He will be ready in plenty of time. This morning the postman brought me two books that I had ordered from Amazon. they are both knitting books, one has patterns for 15 wild animals, and the other has knitted pirates, princesses, witches, wizards and fairies. Some of the patterns in the second book are fabulous and I really want to have a go at a couple of them. The dolls are knitted to a basic pattern and then their character is changed by the addition of hair, features, and the most wonderful clothes. There are a couple of patterns in the book that I am sure any little girl would be pleased to receive (and one or two bigger ones too).

When We Were Young

I am a great fan of BBC iPlayer. It allows me to watch programmes that I may have missed or that I have enjoyed and want to watch again. Why would I want to watch something again so soon after it has been broadcast? Well, sometimes it's because I have been knitting while watching it and sometimes, particularly at the moment, it's because my concentration is so bad that I don't actually take in what the programme was about.

The channel that I am most likely to want to watch programmes from is BBC4. This channel, which is only available for those who watch in a digital format, has some absolutely wonderful programmes. Much of its output is in the form of documentaries. I like documentaries, probably because I like factual programmes more than those that are more entertainment. particularly when I am well. I have a real interest in science and history and there have been some wonderful programmes that fall into these categories over recent months. Having studied the history of science, the history of medicine, the history of technology and the history of religion, there have been some excellent programmes from the BBC covering these subjects and I am particularly enjoying Light Fantastic at the moment.

However, yesterday I watched a couple of programmes on iPlayer that were more to do with my childhood. The first was Skippy: Australia's First Superstar. I can't say that I was a fan of Skippy when it was shown on television, probably because I was a bit old to be in its target audience, but I have to say that it was interesting to listen to those who worked on the programme talk about how it changed their lives and, of course, the problems that they with the kangaroos that were used in the filming. There were some funny moments, such as being told that the emu had to be given a drink of whiskey before he appeared on the set in order to be a suitable set to stand still. There were also some clips from the series showing many of the unique Australian animals and seeing them brought back memories of the long holiday that my husband and I had there in 1996. We spent five and a half weeks travelling down the east coast from Cairns in the north to Melbourne, via Brisbane and Sydney and many places in between.

The second programme that I watched was the Time Shift programme about Oliver Postgate. I did grow up watching his wonderful little films. I remember Ivor the Engine in black and white (I was a bit old for it when it was made in colour but as it was usually on just before the early evening news I do remember seeing that too). My favourite was always Noggin the Nog. I'm not sure why, it just was. There were others too. The Clangers, those little pink knitted creatures who lived on the Moon, and the Pingwings, a family of knitted penguins, and, of course, Bagpuss, that saggy old cat that Emily loved. Again I was a bit old for Bagpuss, but as with all of Oliver Postgate's films, they tended to be slotted in between programmes and you were likely to catch them as you sat down to watch a programme that you were waiting for.

I think the thing that I remember most about the films was Oliver Postgate's voice. Hearing it again after all these years brought back many memories of childhood and made me realise just how good they were in comparison to the present day programmes for children with their cartoons full of violence and monsters and their associated merchandise that make our children constantly want the latest toys. We may have been much more naive then, but at least we were allowed to be children and to enjoy the simple things that were produced for us without the need for consumerism showing its face.

No Longer 'Armless

I started work on the teddy bear yesterday. It is amazing knitting something that is made up from such small pieces. None of them take very long to knit but they can be a bit fiddly. There are 16 pieces to make him; two legs, two soles, two arms, four pieces to make his head, four pieces for his ears. So far I have knitted the legs, the soles and the arms. So Teddy is no longer armless.

To give you some idea of what he is going to look like when he is finished you might want to look here.

A New Project

The weather today is horrible. The sky has been almost black most of the day, a bit like my mood. I did manage to go out this morning so that I could get some wool to make a teddy bear for a baby that is due in August, and to get some food.

I was fairly lucky because I managed to dodge most of the torrential rain that we have had; the buses seem to have arrived at just the right moment each time. I'm not usually that lucky.

Since I have been back home I have been working on the teddy bear. So far I have knitted one leg with its foot and the sole for the foot. I am now trying to decide whether to sew these two pieces together or to start knitting the little creatures other lower limb.

Strange as it may sound considering that I have been a knitter nearly all my life, I have never knitted any toys before. This little chap will be about 11 inches in height and will be dressed in a nightshirt, nightcap and slippers. He should look quite dapper when completed and for those of you who like to see what I have been making, I will take a photograph of him when he is finished.

Revisiting My Lecture

This time last year I was struggling to write a lecture on a patient's perspective of psychotherapy to be delivered on a Master's course at one of London's universities. It took me quite a long time to put the lecture together and was based on posts from this blog and emails between myself and Mr Smiley. The lecture went down very well and I can remember the thrill of receiving a spontaneous round of applause from the audience. Like so much of what has happened in my life during the last 18 months or so, I wrote about the experience on this blog.

I have been asked to deliver the lecture again this year and because of what has happened in the intervening period I feel that it needs updating. In order to do this I had to find out where the lecture script was stored. I have to admit that I had a nasty feeling that I might have to type it all up again, but as luck would have it I have found the relevant file and it has now been transferred onto my new laptop so that I can spend some time working on updating it.

I have quite a bit to add. I have to talk about the termination of my psychotherapy and the terrible effect that it had on me. It is important that these students understand that the way that therapy is terminated is as important as the therapy itself. I will have to mention that I have spent some time in a mental hospital and how, as a result of that hospitalization, I am in therapy again albeit only short-term this time and to deal with slightly different problems.

I have a couple of weeks to do this updating but I know that I am going to find it quite difficult so I will have to start in the next day or two. Trying to do this when I'm really having difficulty doing the simplest things is not the way that I would want to do things, but I know that if I do what I can, when I can, it will get done.

And S has said that he will take me out to lunch afterwards, so I have that to look forward to.

No Regrets

It seems as though what I wrote in Part 9 of Tackling the Mental Health Minefield has upset a few people. In answer to them, I can only say that this is my blog, and the accounts of my stay in hospital are true. Nothing is made up, in fact some of the things that happened were worse than those that I have written about.

While we probably don't have the institutional ill-treatment of patients that was so common 20 or 40 years ago, there is still a problem that so many of the people, that is to say the nurses, who should be helping those who are in mental hospitals, whether they be there voluntarily or because they have been sectioned, treat being a mental nurse as just a means of earning money and make no effort to interact with the patients or understand how they are feeling during what is probably a very scary period of their life.

One of the reasons that I began writing the series of posts was so that others could read a first hand account of what is happening in one of our mental hospitals and see that not everything is rosy. I have tried to ensure that no prejudice is apparent in what I write. It is not easy, but I believe that I have been successful in doing this. The discrimination that I saw exhibited while I was in hospital was appalling because it was the nurses who were responsible for it. The fact that a West Indian member of staff would make time for a patient who was of West Indian origin and yet tell a white English girl to go back to her room and stop being a nuisance when all she wanted was a clean towel was a classic example of the kind of discrimination that I saw.

So, if anyone was upset by what was said in the post, then I am afraid that is your problem. Me, I have no regrets about what I wrote and will continue to write in the same way that I always have. Truthfully, and with no holds barred.

Tackling The Mental Health Minefield Part 9 - The Nurses: Carers Or Prison Warders

(This post continues the story from Tackling The Mental Health Minefield Part 8 - OT? What OT?)

The people that patients have most interaction with while in hospital (apart from other patients) are the nurses. Although in these days of tight budgets the number of nurses on a ward is supplemented with the addition of unqualified staff and in the hospital that I was in these members of staff are known as Care Support Workers. When in an ordinary hospital you have a reasonable idea of who is staff (they wear a uniform) and who is a patient (they will generally be lying in a bed or wearing night clothes and a dressing gown. In a mental hospital it is often far more difficult to make the differentiation. The nurses don't wear uniform and the patients are usually wearing normal every day clothes.

The funny side of all this is that on more than one occasion I had both patients and staff speak to me thinking that I was a member of staff. I'm not sure why this should have happened; whether it was because I didn't look like a mental patient or because I looked as though I knew what I was doing, I'm not sure.

This post will be broken down into several sections and cover areas and say things that I am sure may be upsetting to some mental nurses. Any criticisms that I make are directed at the staff that I had interaction with during my stay in hospital and not to all mental nurses, so those professionals who read this please do not think too harshly of me for I am only reporting it as it was during my incarceration.

Named Nurses

Okay, we all know about named nurses. They are the one's who you can go to when you have problems and they are supposed to be your first port of call if you are having problems. That's fine if the nurses work some sort of regular shifts, but the nurses on the two wards that I was on seemed to work a fair amount of double shifts so you would see a nurse for a couple of days and then you might well not see them again during your stay on the ward. On the first ward I was on I was assigned a male nurse 'M' as my named nurse and I can report that at no time while I was on the ward, and he worked at least four of the eight days that I was on the ward, did he ever introduce himself to me or even talk to me. This defeats the object of having a named nurse, doesn't it?

On the second ward that I was on, my named nurse introduced herself to me on my second day on the ward, and then told me that she was going to be off for the next week. At no time during my three weeks on the ward did she make any effort to actually talk to me, and I am afraid that I have to say that she was the nurse who ran around like a headless chicken when I had my angina attack and wouldn't give me my GTN spray until she had found a second nurse to be with her while she opened the drug trolley.

As far as I can see the named nurse is a good idea in theory but it is rarely going to work properly because of shift patterns and the fact that the nurses rarely seem to leave the office.

The Office

From reading other blogs it is apparent that those of us who have been inpatients in a mental hospital all have the same opinion that the nurses spend far too much time in the office writing reports about the patients and nowhere near enough time actually interacting with the patients that they are writing reports on.

My first ward had a large office that was big enough for most of the nurses and care support workers to spend much of their shift in there. Sometimes the only member of staff who was not in the office was the one going round doing the hourly checks on where the patients were. the office on the second ward I was on wasn't large enough to swing a cat in and yet at most times of the day all the members of staff would be locked away in there except for the person going round the ward doing the hourly checks and the person sat outside the office keeping an eye on one of the patients, J.

J would walk up and down the main corridor of the ward for hours. She wasn't allowed any leave and rarely had visitors; the only time that she left the ward was to go to the meeting room where ward rounds were held. J also ate constantly if she could get her hands on food. Any food. She would go into the kitchen area and take handfuls of sugar and eat it. The result was that the staff stopped putting sugar out for us to use in hot drinks except in sachets. this didn't stop J, because she would just take a handful of them and eat the sugar, throwing the packets down wherever she happened to be at the time. She would also take the little containers of jam, marmalade and honey that we had at breakfast and supper by the handful and lick the contents out of the containers while walking up and down the corridor. All that the staff ever did was to tell her not to eat the sugar or the jam. She was not told to pick up the rubbish that she would leave lying around. It was the patients who decided that something needed to be done because we were sick of finding half-eaten containers of jam in the box in which the jam and butter were stored. By watching J, and every time she threw rubbish on the floor or put empty containers anywhere other than in the bin, one of the patients would tell her to pick up the rubbish and put it in the bin, likewise with the jam containers. After a week or so of this J started to put the rubbish in the bin automatically. Because the staff spoke to her in such weak tones, and the patients used authoritative voices as one would with a naughty child, so J learnt what was acceptable and what was not. If the member of staff who was assigned to watch her walk up and down the corridor for hours during the day had been used to engage her in some meaningful activity then I am sure that it would not have been long before it was no longer necessary to have a member of staff monitoring her all the time.

My question is, why do so many of the staff need to spend so much time in the office ostensibly writing reports on the patients? Because they spend so much time in there and so little time with the patients, anything that they write must be a fairytale anyway.

Protected Time

Protected times are something that seem to exist in all mental hospitals. They are useful because it means that certain things can be done on the ward without unnecessary people (and that does include visitors) being around. This means that mealtimes were protected times and each morning the hour between 11am and midday, was protected time. There were notices to this effect at the entrance to the wards and they made it quite clear that the hour of protected time before lunch was for the nurses and patients to interact.

The problem was that this never seemed to happen. This hour each morning when nothing was happening (no OT, no psychotherapy group, nobody allowed to use the gym) was, except for Monday mornings when a ward meeting was held, were just an excuse for all the staff to congregate in the office.

It was near the end of my stay in the hospital that I was asked to take part in the group psychology session. Four patients, including myself, one of the nurses, the ward psychologist (who is the psychologist that I see for psychotherapy now) and his trainee were sat in a room with the aim of doing some talking. The other three patients had been present at the group session the previous week so the had done all the introductory stuff and their input was to talk about how things had been since that last session. I, however, was new to this and I was expected to do a bit more talking, which somewhat surprisingly I did, about why I was in hospital and about how long I had suffered from depression. After having done this, the psychologist asked if there was anything else that we wanted to talk about, or to raise for the group to discuss.

I'm not sure how it happened because I am not naturally someone who would speak up in these circumstances, but I found myself talking about how little interaction had taken place between me and the nurses. I said that I had been in hospital for nearly a month and during that time only two nurses had taken the time to actually sit down and talk with me, to find out whether there was anything that they could do for me, and to generally put me at my ease. I questioned the point of the hour of protected time in the morning if the nurses were just going to sit in the office as they did for the rest of the day and ignore the patients. At this point, the other patients at the session also joined in and made similar comments all of which left the nurse, who had decided to come to the session to see what went on, somewhat red-faced.

I think that what I said struck home because the next day on the stroke of 11am, the office emptied and the nurses went in search of a patient with whom they could interact. This practice continued after I had left the ward, but I would question whether they have gone back to their bad habits now we are a few more months down the line.

Conclusions

It is important that anyone reading this should recognize that the views expressed here are my own based on my experience of a month in a mental hospital. I don't wish to offend anyone but I am telling it how it was in the hospital that I was in; I am sure that things are not as bad everywhere, and it is possible that there may be some hospitals that are even worse.

I have been on surgical wards with as many patients as there were in the wards in the mental hospital that I was in, which operated with a similar number of nurses, where the patients were not as mobile as they tend to be in a mental hospital, and yet where I would have regular periods of interaction with the nurses. And on the surgical ward the nurses had to do proper nursing things like changing dressings and helping the patients with their ablutions. So why do mental nurses consistently fail to interact with the patients?

One thing that concerned me greatly was the number of coloured nurses on the ward and the difference in their attitudes to the coloured patients and those who were white. It is bad enough to suffer discrimination because you have a mental illness, it is appalling when the discrimination is actually being shown by the people who are supposed to be helping you, not only because you have a mental illness but also because you are white. Another bad practice that was common among a particular group of nurses was their having conversations in front of the patients in a foreign language. The Nigerian staff were the offenders here, breaking Mental Health Trust policy by so doing.

I found, and have mentioned this in various of the posts in this series, that the nurses seemed to have little respect for the consultant psychiatrists and had no qualms about contradicting their (the consultant's) decisions or arguing with the consultants over what had been said. To have done this is bad enough, to have done it in front of a patient is unprofessional.

So all in all, I do not have a high opinion of the mental nurses (and care support workers) that I came in contact with. Yes, there were a few very good nurses and I was thankful when they were on duty, but the majority of them left a lot to be desired. I was left with the feeling of being discriminated against because I was not schizophrenic or a drug addict, because I was white, and as another patient said of me, because I was probably more intelligent than most of them.

To be continued.

Life Sucks

It's a bad day. I haven't spent much time out of bed because I feel so low. There just doesn't seem to be any point in doing anything. I really ought to have gone out today to get some money and a few essential food items, but it was just too cold. I will have to go out tomorrow no matter how I feel otherwise I won't have anything to eat.

At the moment, life really sucks.

Another Milestone

A couple of minutes after midday the 20,000th visitor to my blog arrived. According to FEEDJIT they live in Ilford, Redbridge, their computer runs Windows Vista and they use Firefox as their browser. They are also a regular reader as they came direct to the blog rather than from another blog. It's not a lot of information but it will perhaps allow the person who was that visitor to recognize themselves.

When I started this blog in June 2008 I wasn't sure whether it would be something that lasted for a long time or would merely be one of those things that was started and then became too much of a chore and fell by the wayside. It seems as though I may be here for the long haul though because even when I was in hospital I was concerned about not being able to write to let regular readers know why I wasn't able to post. And what was heart-warming to me was that several regular readers were concerned enough about me to have sent me emails asking if I was okay.

When we start writing a blog we all wonder whether anyone will bother reading it. Will it be interesting enough to attract comments? Will we be able to find things to write about? How much of ourselves should we reveal? Many of us blog anonymously. It is a way of writing about things that affect us or that interest us or that we feel strongly about. We can say things on our blogs that we might never express in person.

I started this blog with the intention of using it to record how depression affected me and how I dealt with depression. Much of it is still about depression, it can't help but be so because that is what shapes me at the moment. Here I can write about how I am feeling rather than bottling it up inside me. It helps; it helps a lot. But the blog has become much more than that. I have included my trips out to various museums and galleries in London. I have blogged about going to the theatre, about meeting other bloggers, and about my knitting.

Sometimes it has been very difficult to write about things that were happening to me. Mr Smiley has been making regular appearances in my blog almost from the start. He is a very dear friend who has seen me at my worst and my best. He has known me as a shy 18-year old who was shy and very unsure of herself and he has seen me as a confident woman who had found her true vocation in life. He helped me through the early days of my widowhood by listening to me when I needed someone who I could talk to. He has visited me in hospital after major surgery; he has even carried my handbag in public to bring it to me in hospital after I was taken from work by ambulance one Friday morning (and many husbands wouldn't do that). And most of all he encouraged me when I told him about the blog and became a frequent commenter. He told me that he thought that it had made a difference to me and at times when I found it difficult to write he was the one who said that I should just write about whatever I thought of at the time. It was Mr Smiley who, when I mooted the idea of writing about my incarceration in a mental hospital, said that I should do it because he was sure it would help other people. So the series of posts Tackling the Mental Health Minefield was begun and it resulted in me winning an award from Mental Nurse. One of the most difficult posts that I have ever written was the one that I wrote on hearing the news about Mr Smiley having terminal cancer.

One of the things that this blog has taught me is that I love to write. Maybe that was why I was so good at my job. That involved a great deal of writing and my reports were always well received. Mr Smiley has suggested on more than one occasion that I should write a book. More recently my GP has also suggested this as something that I should do. The short course that I have just done with the OU has shown me that I am not a writer of fiction. My tutor thought that a couple of my short stories were very good, but he did not realise that they were actually based on things that had happened to me. So, if I am going to write something it will either have to be factual, something that I can research and then write about, or I am going to have to write about me, but as that sounds a bit pretentious, perhaps it will have to be about depression and me.

After nearly 500 posts the blog has received 20.000 visits. I am amazed and hugely gratified that something that has been a form of therapy for me has been interesting enough for people to visit and return again to see what I have to say. Yes, it is a big day for the blog and it is a day that has meant a lot to me too. Thank you visitors, you make it worthwhile my sitting here day by day trying to think up things that you may find interesting and that may provide you with food for thought.

Lost For Words

I finally managed to get some sleep and I didn't resort to sleep medication either. By 10pm last night I could hardly keep my eyes open so I went to bed, laid my head on the pillow and was asleep almost immediately. I woke at just before 7am, made myself some breakfast and went back to bed again and slept some more. I now don't feel so exhausted but I still feel low.

I have been trying to write the next instalment of Tackling the Mental Health Minefield this afternoon. I started to write it 11 days ago and it is still only half finished. I know what I want to say, but I can't find the words. At work I was renowned for my writing ability. I could write clearly, concisely and articulately. Now it is as much as I can do to string two sentences together. I have lost the ability to concentrate; to focus on the thing that needs to be done.

Although I am still trying to complete that post, I felt the need to write something for the blog. It lets people know that I am still alive. I know that you don't know me personally, but the fact that you read what I write and bother to comment shows that you care. That means a lot to me.

I shall try to write some more of the other post this evening. Maybe I will finish it and publish it tonight, but I think that it is more likely that it will be tomorrow. In the meantime you'll just have to make do with this meagre morsel.

Psychotherapy Is Hard

I did eventually manage to get to sleep at about 3am this morning. I woke when the alarm went off at 9am; I had set it just in case I did get to sleep to make sure that I got up in plenty of time to get to the bus stop to catch the bus to the hospital for today's psychotherapy session.

Psychotherapy is not for the faint-hearted. In order to help one to make progress you have to commit to it wholeheartedly and invariably this means you will enter territory that you would rather avoid. This is not a new experience for me having undertaken a year of psychodynamic psychotherapy from May 2008 to May 2009. I learnt a lot about myself during that year and I had to delve back into my early life to find the triggers that had made me the person that I was and helped to explain why, having become so depressed, I was finding it so difficult to return to a normal happy life.

A more CBT approach is being taken with the psychotherapy that I am currently undergoing. the main aim of this therapy is to get me to stop the self-destructive pattern of anger suppression that I developed as a young child, with the aim that I learn to express my anger in a normal manner rather than turning it in on myself.

Deliberately trying to invoke a feeling of anger in someone cannot be easy, yet that is what my therapist has been doing over recent weeks. Today, he managed to bring about such anger in me that it was a physically painful experience for me. For the first time I realised just how much I had been turning that anger back in on myself and the the harm it has done. For the first time I realised how much it had affected my emotions over the years and how much and how often I had given way even when I knew I was in the right because I didn't want to get angry.

Anger is a normal emotion. There will always be thing that make us angry and we should learn how to deal with that anger when we are young. For some, anger is used as an excuse to be violent towards others. For others, anger causes raised voices and sometimes hurtful exchanges. For me, anger has become something which I am so afraid of that I strive not to show anger to others resulting in me turning it in on myself.

It's not easy to change things that have been part of me for 50 years. But I am working to make that change and that is why I can say

Psychotherapy is hard.

Another Bad Night

It's nearly 2am and I haven't managed to get to sleep yet. I'm half-sitting, half-lying in bed watching a film and wide awake. I've been awake for nearly 24 hours now and I would love to take some sleep medication but I can't because I have to get up early again in the morning for another trip to the hospital for my psychotherapy session.

I will also be picking up my prescription for the additional antidepressant from my GP's surgery so that will mean another tablet or two to take at night. I have to take so many tablets that I would probably rattle if you picked me up and shook me.

So, I will lie here for a few more hours, I'll try reading to see if that helps me to get to sleep, I'll wrap myself up well under the duvet so that the cold can't get at me. and if I manage a few hours of shut-eye it will be a bonus.

A Really Nice Consultant

I was there early, but then I always am; I can't help it. I sat in the garden having a cigarette while I waited for it to become a more reasonable time to go into out-patients. Having reported to reception to say that I had arrived, I sat in the waiting area until I was called.

My consultant was talking to someone in his consulting room when I arrived and when he called me I found out that it was a medical student that he had been talking to. He asked if it would be okay if the medical student stayed, and having agreed he invited me to take a chair. We then got down to introductions; he asked what I wanted to be called so I said that I didn't like being called by my full name so asked him to use the shortened version that I have used since I was about 11, He introduced himself and said I could either call him M or Dr S-M and then the medical student introduced herself. Then we got down to business.

First of all M asked me about the Home Treatment Team and my dealings with them. He said that as he was in effect their boss he would be interested in what I had to say and that I was to tell the truth. I was going to anyway, so I said that some of the people that I had seen were very good but with some of them I felt that they were just going through a mental checklist of questions and I felt that they really weren't that concerned about the answers. He took that onboard and thanked me for my frankness. He also asked me whether I was getting any other support and I said that I was having psychotherapy once a week at the moment and that this was likely to carry on until Easter and that JR, my psychologist, was going to refer me back to the hospital (which is the headquarters of the Mental Health Trust) where I had been receiving psychotherapy before.

Having read the notes from the HTT he said that when they had discharged me I seemed to be getting on quite well and he asked how I was now. I told him that I was very low and having asked why this was I replied that I had not got the job that I had seriously thought I had a very good chance of getting. We then discussed what the job was and when I had been told that I hadn't got it and he asked what my reaction had been on receiving the news. I said that I had been angry, devastated, felt that I was incapable of doing anything and that from that moment my mood had taken a nose-dive and I had lost what little self-confidence that I had built up over the last six months or so.

We then moved on to how other things were in my life:
Smoking - far more than I usually do when I am depressed (I don't smoke when I'm not depressed)
Sleeping - Not very good; can't get to sleep most nights and have to resort to sleep medication to ensure that I actually get some sleep once in a while
Eating - Just not interested; haven't cooked a proper meal for some time, didn't eat anything yesterday and made do with a cheese roll on Saturday
Energy - Haven't got any
Concentration - Totally gone; unable to concentrate for anything for longer than five minutes
Drinking alcohol - Normally don't touch the stuff but have been indulging over the last few days and I have drunk about half a litre of ouzo (purely because I had it in the house)
Suicidal thoughts - Yes, I'm having them and I thought about gathering all the tablets together on Friday but didn't do it

Having gone through these questions fairly quickly we concentrated on the eating and sleeping ones a bit longer. I was asked if I thought I had lost any weight and thinking about it I said that I probably had because certain things seemed to be a bit loose. Then I was asked if the reason that I couldn't get to sleep was because I had things whirling around in my mind. I have been asked this question many times and I have to answer in the same way each time. I am not aware of having things whirling about in my brain when I lie down to go to sleep; I try to read before going to sleep each night, but recently I have found it difficult to concentrate even on what I would call easy-reading books. At the moment it's Harry Potter and the Philosopher's Stone that is causing me problems; it has taken me a week to read the first chapter.

We talked about how my ability to concentrate had gone completely and that I had not done any knitting for about 10 days now, which is pretty unusual for me because I just love to have lots of things on the go so that I can pick and choose what to work on and normally I will do at least three hours knitting each day when I am well.

M then decided that as my depression is proving so difficult to bring under control for any reasonable length of time that the time had come to add a second antidepressant to the one that I am already taking. There was discussion of admission to hospital if I don't improve or if I get worse than I am at the moment but this time I will know what to expect so it won't be so traumatic. We talked about my time in hospital last year and M asked whether it had been helpful and I said it had because I really didn't feel safe on my own at home and it was definitely the right thing to have happened.

So armed with a prescription for the additional antidepressants I was almost ready to leave. All that was left to discuss was when I would see M again. He said that he normally saw patients every four to six weeks, but because I was so low and because he wanted to see whether the additional antidepressants were starting to have any effect that he wanted to see me again in two weeks. I was also told that if I felt myself getting worse that I was to ring him or leave a message and he would get back to me and we could talk about what should happen.

So what was M like? Well, he is young for a consultant and I have to say that I found him very easy to talk to which is not always the case. Having read so many accounts of the problems that others have had with psychiatrists, all I can say is that I think that I am very lucky with the consultant that I have been allocated.

Off To See The Shrink

I've had to get up early this morning. I've been awake for hours unable to get back to sleep again. This morning I have an appointment with my new consultant psychiatrist and as it is my first appointment with him and my first appointment with a psychiatrist since I was discharged from hospital I expect that I will be going over a lot of old ground.

He is going to see me at pretty much my worst. Very low mood, problems with sleeping, not wanting to eat, no energy or enthusiasm to do anything, and finding it difficult to find anything positive in my life.

A Typical Saturday

When I was working Saturday was always the day of the week that I reserved to do whatever I fancied. If I felt like having a lie-in, then that was what I would do, although I rarely did because I often went to spend time with a friend who had a pottery.

When I was there I must have watched him throw thousands of pots of various kinds; mugs, cups, plates, bowls, vases, and lots of anything else that could be hand-thrown. However, for all my watching him throw pots, it was something that I never really managed to do very successfully. I did make some lovely little objects but they were never more than a couple of inches in height, except for one occasion when I managed to produce something that was a good size and shape and with the addition of a handle made an excellent cup-shaped mug. After it had been fired, glazed and fired again I took it into work and used it for my cups of tea from that day onwards.

The one thing that I learned from all this was that although I do have a lot of patience and I'm willing to keep trying to get something right, there comes a time when even I get frustrated and have to give up. There have sometimes been occasions when I have been knitting or crocheting something and no matter how hard I try, it doesn't seem to turn out how it should. I remember in the early days of this blog describing the trials and tribulations that I was suffering when I started knitting a Shetland Lace shawl. The shawl did get finished eventually, but I lost count of the number of times that I started to knit the centre section only to have to unpick it all and start again.

I had always thought that except for one or two minor things there was little difference in the terms used for knitting and crochet here and in the USA and Canada. I was to learn that I was very wrong when it came to crochet and it took me many hours of crocheting and then unpicking to find out that what we call trebles, across the Atlantic are called doubles. This came about because on one of my work trips to Canada I bought a book of patterns for crocheted baby blankets and the wool to make one with gingerbread men on it for Mr Smiley's first granddaughter. I kept starting the blocks that made up the blanket but they just weren't coming up to size. As I have always been lucky in that I knit and crochet to gauge, this understandably caused me a great deal of concern. I think that I had spent a couple of evenings in my hotel room trying to get the blocks to come out to the right size before I, by chance, looked at the pages at the back of the pattern book which showed you how to do the various crochet stitches and realised that I should have been doing trebles instead of doubles. Once I had found this out it didn't take me long to start to produce the nine blocks that were necessary to make up the bulk of the blanket and they all came up to the right size.

At the moment I would love to be able to sit down and do some knitting or crocheting but I just don't seem to have the enthusiasm for it, so on this Saturday I have spent my day writing emails, reading a few blogs, trying to write this post, and flicking through the channels to see if there is anything worth watching on television.

So, this has been a Saturday that follows the precedent that started when I was working. Do what you fancy and can manage and blow everything else, it will still be there tomorrow.

In The Corridors Of Power - Well Almost

I really didn't want to get out of bed yesterday, but I had said that I would attend the roundtable discussions, so I felt that I had to go. And I needed to make sure that patients were well represented. I know that technically we are all patients, but the other attendees were GPs and top-level executives from computer software firms and they really weren't looking at it from the patient's point of view. Anyway, I managed to get myself going and set off for the centre of London. I'm quite lucky because a bus that runs from the bus stop just a couple of minutes walk from home goes to where I needed to get to. This may sound logical, but sometimes it can take several buses to get to somewhere that is a much shorter distance away. Having got on the bus I then had to decide where to get off. I could either get off at Waterloo and walk from the station towards the London Eye and then across Westminster Bridge or get off in The Strand and walk down Whitehall. As it was my intention to have lunch out I decided to take latter option as I knew that I would have a better choice of eating places.

Having eaten my lunch, I then set out for a leisurely walk to Trafalgar Square and then down Whitehall. Driving in London is not something for the faint-hearted or those with high blood pressure and Trafalgar Square is definitely a place to avoid at the best of times but yesterday it was at a standstill as I approached it. Traffic was queuing in all directions and nothing was moving. There had to be a reason for this and as I crossed over Northumberland Avenue to turn down Whitehall I could see what the problem was. There were dozens of motorcyclists protesting about something and they had brought the traffic to a halt. Somewhat obviously it was attracting a lot of attention from people walking in the area but I had seen it all before and I had an appointment to keep so I just walked down Whitehall towards the Houses of Parliament and my first encounter with the corridors of power.

I know that I have written about my participation in these discussions several times in this blog and although I said I was going to the House of Commons, the meeting was actually being held in Portcullis House which is actually situated across the road from the Houses of Parliament but is part of the Parliamentary Estate. It stands to reason that there are just not enough meeting rooms in the House of Commons itself so this building helps to satisfy that need. It is quite an impressive building with a huge atrium and a large number of meeting rooms. There are television screens located in various places and in each of the meeting rooms there are two small monitors on the wall; one shows what is being debated in the House of Commons and the other what is being debated in the House of Lords. They don't show what is going on but they do tell you the subject of the debate, who is speaking, the time and the time that the speaker began speaking. And how do you work out which is which? They're colour-coded, of course.

The roundtable discussions were timetabled to begin at 2 o'clock, and somewhat unusually for such occasions, all the participants were seated and ready for action before that time so we began a couple of minutes early. The discussions were being held under the Chatham House Rule, which allows me to give you some idea of what we discussed but not say who said what.

At least five of the people around the table spent some of their working week as a GP and it was interesting to note that all of them bar one were not particularly happy at the idea of patients having access to their medical records when the discussions started. Fortunately they had changed their points of view by the end of the discussions, which is just as well because patients have a right to see their medical records under the Data Protection Act. There were significant discussions about how patients could access their data and the consensus was that it was best that as much information as possible should reside with the GP record. this would mean that patients only had to search one place to get the information and only have one set of passwords to remember. From experience I can say that this suits me very well although I believe that letters from some hospital consultations could probably do with containing a little more information about what has been carried out and full results of any tests conducted.

About halfway through the discussions the Shadow Health Secretary Stephen O'Brien, the person who had invited us all to attend, came to join us after having been in the House. He explained that what he wanted was for us to provide him with ideas and opinions on the subject so that it could be used to help to guide Conservative Party policy in the short and long term.

The discussions were extended by half an hour because we were covering so much ground and coming up with a lot of useful information, but eventually we finished and had probably provided a lot of food for thought. We were thanked cordially for taking part and were promised that the minutes that had been taken during the discussions would be passed on to us as well as to Stephen O'Brien. Then we all parted and went our separate ways.

Okay, so it wasn't exactly being in the corridors of power, but it was a privilege to have been invited to take part on this occasion and to think that I might have said something that may help to determine policy for a possible future government.

When I left the building I made my way across Westminster Bridge and headed towards Waterloo station and the bus stop to get my bus home. Even on a chilly and pretty wet February day there were hundreds of tourists in the area. One of the things that make London a difficult place to walk around these days is that all the tourists stand in the most inconvenient places to take their holiday photographs and videos. Yesterday I had to manoeuvre my way around them as they stood on Westminster Bridge so that they could be recorded standing with Big Ben in the background. Okay, so it's a bit of an inconvenience for anyone, like me, trying to get from one place to another as quickly as possible, but I do get annoyed when they get upset when you walk in front of their camera just as they take their magic shot. There are just so many of them that it is bound to happen because as you try to avoid one of them you will probably spoil the shot for two more. London would be great if there weren't all those tourists!

Still Here

Yes, I am still alive and I will be writing a post about my trip to the corridors of power (almost) later so you will have something a bit more substantial to read. I'm afraid that the depression means that my brain is not working as well as it should so it takes me a bit longer than usual to actually type the posts, but I'm sure you will forgive me.

Reaching Breaking Point

I have had not a wink of sleep for the last couple of nights and I am beginning to feel like a zombie. And on top of that I have lost interest in food. The black dog is back with a vengeance and it is as much as I can do to stop myself from crying all the time.

Being Tuesday, I have my psychotherapy appointment this morning and I have a feeling that my psychologist will notice that things are not good. If it is a gut-wrenching session as is normal, than I suspect that I will just want to die this afternoon.

I just don't seem to be able to pick myself up after the devastating disappointment of last week. I am seriously considering whether there is any point in carrying on as it seems that nothing good is happening in my life.