Returning to work after mental health leave

It has been four weeks since I went back to work. This week marks the fifth, and I am awake far too early because I have Monday morning anxiety. I have to be fair on myself though, I didn't just go back to work four weeks ago, I also started group therapy and DBT, began art classes and threw myself in the deep end with a full schedule after three months of down time.

November was a big month. I have both achieved and struggled, so instead of researching and finding facts, I want to give an account of returning to life after a mental breakdown.

The three months I had off were not a lovely holiday break. I spent much of the time hoveled up in my room crying, staring at nothing, and trying to make sense of myself. I toyed with the point of going on and let myself act on urges. I saw very few people and canceled most of the social plans that I did make. I yelled and screamed at my parents over things unrelated to them and then sobbed in their arms from the confusion of why I just did that. I watched all of Parks and Rec over again in the space of two weeks. I also saw therapists- Doctors, Psychologists and Psychiatrists. I broke down in their offices repeatedly. I resisted their advise, I fought to be in control of my situation. I talked to friends, I cried in their arms, I slept in their beds. I went home and did it all again.

Gradually, the fog started to lift. I started waking up a bit earlier each day and felt rested. I picked up pencils and started drawing. I began talking to my parents about how that darkness had felt, and conversations with therapists moved from surviving to problem solving. I went outside, went on walks, enjoyed time outside of my room. I used my time to go to the gym and start some new healthy habits. I followed through on plans with friends, stopped beating myself up when I needed to cancel, and even initiated some social activities. I talked to friends, enjoyed their company and explored my inner world with them.

Assessments, discussions, plans. Acceptance to the DBT program, starting art class. Accepting myself and my needs through therapy. I built a routine for my days that moved around self care and my goals. I felt like I had a life to live. Then it seemed that I needed something more structured and the idea of returning to work was a possibility. I wanted to earn my own money and take steps towards ownership of my life again. I had discussions with therapists and work and negotiated a return to work plan. Returning two days a week for three weeks, then bump it up to three days. Only three days work for the foreseeable future, work load on my terms, with DBT one day a week. This was a very good plan in my mind, and a better one than I had hoped for. I was ready.

First day back and I was shaking as I walked in the door. All the interactions I had with people were calm, but I was on edge and very anxious. The day was hectic due to staffing and more than once I wanted to run out and admit I had pushed myself back too soon. Day two wasn't much better as circumstances triggered feelings of 'not being good enough' and comparison with others. The next day I had my first group therapy session, I was a heightened mess and could barely talk. The week finished with my new art class where I struggled to grasp concepts due to high anxiety from the week. I walked away feeling worthless and untalented.

The whole week was an unexpected slap in the face. I had felt so ready, I had done so much work and really took time to plan and make my return to life go well. It was like I had been in a lovely dream world of support, worth, confidence and fluffy cushions, then suddenly woke up in a grey concrete world of cold, hard reality. It wasn't that work had even pushed me too hard, they were very gentle and checked in with me often. I was all me, and I considered myself a fool to ever believe I could go back. Thoughts of worthlessness and inability to ever have autonomy took over and I felt myself slipping into familiar worlds that I had been in thee months earlier. However, I took stock over the weekend, utilised therapy, took it easy and tried to accept that my feelings were reasonable and would pass.

Week two began with little sleep and anxiety which caused muscle cramps and nausea. Work wise, it was calmer and more productive than the first week, I felt that I had contributed and did well. But the anxiety was too much and I hit a breaking point. I had cried all night before the first day and had not slept. I told my parents I was fine and put on a strong act, but once I was alone thoughts of self-harm were vivid and persistent. Proudly, I can say I did not follow through, mostly because I didn't want to jeopardise my place in the DBT program.

Then the breakthrough came. The night after the first day of week two my negative thinking was increasing and I could feel myself loosing grip. I lay in my dark room sobbing and tempting those thoughts to overtake me, and then I had a thought- I didn't want to be alone through this, and I shouldn't be. I got up and went out to be with my parents. When they saw my distress, they did all the right things. I cried and sobbed and lost all sense of reality, but I had them there to take care of the reality for me so I could have the feelings I needed too. I was able to have all the feelings I needed to have in a safe space, which meant I could explore them in their entirety. After hours of sobbing and gibberish on their shoulders, I made it through the emotions. I was exhausted, they were exhausted, but I made it through.

I woke up the next day tired and puffy. I went to work, I had to give it another try. I made it through the day and felt calm afterwards, then spent the next few days sleeping and recovering. I debriefed in my group therapy and with my psychologist. While the experience of returning to work had been a shock, it was also what I wanted. I needed to work through why I reacted the way I did rather than rule out my capability to work. Week three went better, week four was almost easy. Coming into week five and I feel the stability of routine building so I have a space where I can deal with the emotions and still perform my job.

For anyone returning to work after a breakdown, my message would be this- It will not be easy, but that is not your fault. Be gentle with yourself, give yourself time and let yourself draw on your support networks till you settle in. If it doesn't work, it doesn't work, your wellbeing is more important than a job. But if working is what you want to do, then keep your mind on your goal and use the skills you have learnt in your time off. You are capable.

DBT, Mental Healthcare and all the other Possibilities

Coming off the back of Mental Health Week, I am finally dredging up and editing a rant that I wrote well over a month ago. At the time, I was struggling to get my head around what steps were needed for me to recover from a 'breakdown' (I don't know what else to call it). I felt frustration towards and confusion about the system that I was being tumbled around in. It was meant to help me, yet it seemed to be intentionally getting me nowhere. 

Flash forward to the present moment and I have been accepted into a DBT program (Click here for info) starting next month, and am attending regular therapy. I wouldn't say I feel happy, but I do feel like I have more control of my life, rather than being victim of my emotions. I also feel like I have a better understanding of what my needs are and what it means to take ownership of them. I'm returning to work part time next month, a plan which I took charge in negotiating with my employers.

The road to get here was not a well marked path. I have been in and out of therapy, and on and off medication, since I was 19. Usually I would attend therapy in crisis mode as part of the 10 sessions offered through medicare in a 'mental healthcare plan'. Either the therapy would stop after those 10 free sessions due to cost, or I would stop attending because the crisis would die out and I no longer knew what to do with the therapy. At the moment, I have been seeing my current psychiatrist for over a year, along with regular G.P. visits. It wasn't until 3 months ago, when I became a genuine suicide risk, that I was given a Personality Disorder diagnosis and directed to a more appropriate course of treatment. 

I brought this up in one of my assessments for the DBT program. I wanted to know why my psychiatrist hadn't referred me there earlier? Why it took me ending up in hospital and being assessed by a psychiatrist there to be referred to this program? Even then, I needed to specifically seek the referral to the program, it was not offered independently. Her response was that I was lucky, most people will be admitted to hospital, with suicide attempts, multiple times before they find their way to a program like DBT. 

As I said, I was classed as a suicide risk, but did not attempt. By the numbers she gave me, I am beyond fortunate to ALREADY have been directed to DBT. To think that some people had to attempt to take their lives more than once to find a program like this was unbelievable to me. That I had to find myself in hospital from a risk of suicide before getting this support should be the height of unacceptable situations, but instead I find myself in a world where I am the lucky one.

When professionals have discussed DBT with me, it often comes with very positive phrases like 'this program works' and 'it has been proven effective for many mental health conditions'. I rarely hear anyone speak with such certainty as I have with regards to DBT (I'll let you know if these are true statements for me once I've done it). To take an evidence based approach, here is a study conducted in Berlin from 2014. This study showed that after a 1 year DBT cycle participants experienced reductions in self-harming behaviours, hospital admissions and the severity of their symptoms. To top it off "77% of the patients no longer met criteria for BPD diagnosis". Looking locally, this abstract of a similar Australian study from 2011 indicates similar results in regards to self-harm, hospital admissions and improvement in depression and anxiety symptoms (Unfortunately, I couldn't get the full study). The authors conclude that "providing DBT to patients within routine public mental health settings can be both clinically effective and cost effective".

After my reading, I am amazed that this program is not being better utilised, especially if it is both "clinically effective and cost effective". To consider why it is not, there are certainly reasons that it would be problematic if it were rolled out the way, say Cognitive Behaviour Therapy is. Firstly: DBT is a 1 year commitment. Understandably, it would be very difficult to guarantee or enforce attendance for that amount of time, most people barely utilise the gym memberships they are paying for. Imagine trying to attend something every week, especially if it were government subsidised and didn't leave you out of pocket? This leads to the second point: to gain results you have to put in effort. If a person is not willing or ready for life changes, they will not get much out of the program. They could even do the opposite and prove disruptive for other participants. This is why I underwent assessments, to determine if I am ready to commit and if I really want it. Attendance has to be driven by a willingness to change. Other issues which could arise are things like cost, personal support networks available and the risk of putting people into the program who are not suitable or not ready. There are probably countless others that I am not qualified to even invent. No doubt there would be many little details that had to be nutted out before it was pushed as a high priority recommendation or even government subsidised, but surely it is a possibility that would be worth considering 

The issue is that our system wasn't designed with mental health built in. It was designed around physical illness- it is difficult to fit mental illness into this system because it presents uniquely in each case. In an interview with Hack, the the federal health minister, Sussan Ley said that reforms to the mental health system are "long overdue". How these reforms will look is currently anyone's guess, and that is why the public discussions that happen during times like Mental Health Week are so important.

This sentiment, of why our health system treats mental health the way it does, was voiced very well in an interview with Hanna Pickard on "the Philosopher's Zone". Perhaps it rang more true to me because she was talking about people with BDP. Often patients will attend a session presenting with self-harming behaviour, suicidal attempts, depression, anxiety or many other symptoms. She explained that these symptoms can be interpreted as a loss of control and the attending professional may stop viewing the patient as a person with the ability to change and will move to the role of rescuer.

Rescuing works very well with a medical model. Medical models identify an issue and then take measures to fix it. For example, you have a broken arm, I will put a cast on it. You have bronchitis, I will give you medication. We can do things to help healing along, like resting, eating healthier foods, or increasing fluids but the bulk of the problem is solved by medicine- which is utterly amazing when you really think about it!

A large part of psychological intervention is the belief that all people have the ability to make positive change, and it is important to not only believe in them, but to help them believe in themselves (Google 'Person-Centred Therapy' if you want to learn more). As mental healthcare is part of a medical based system, it is geared towards fixing people, not supporting them to fix themselves. I should clarify here that this does not mean I am against medication or medical support for mental illness. I believe medication can be vital and effective, but can be more effective when used as a tool rather than a cure. The reprieve and stability that can come from the correct medication and medical care can provide a space of clarity where new skills and ideas can be nurtured. This may mean needing medication for a lifetime or a few months, it may mean needing therapy for a lifetime or a few months. Everyone is different, there cannot be one set procedure for dealing with all mental illness. 

At this point in my original rant, I opened into a glorious tale of a wonderful furture that would need 'Imagine' by John Lennon sung in the background by a choir of multi-ethnic children wearing the clothes of their heritage. I find that unnecessary because my idea of an ideal will be different from yours. What I do want end on is this- What I have outlined here is just one possibility for different ways we can move forward in treating mental illness. Possibility is where discussions can happen, ideas can emerge and plans can be made. We are at a unique point in the mental health arena in Australia where how the future system looks can be decided by the people. Keep the conversation going and the kind of change we want will happen.

You MTHFRing vegan

If you have read any of my recent anything, it should come as no surprise that I am in therapy. As I may be starting DBT in the near future, I thought it would be important to find a therapist who I feel I can work with long term, so I have started 'shopping around'. My experience with my current therapist and the health goals it has lead to have turned out to be beneficial, even if they were indirect.

This therapist is a little on the alternate side. In the first session I was informed that she takes a holistic approach and that diet and physical health should also be discussed in our sessions, which I had no issue with. I agree that the body's health can play a major role in mental wellbeing so this seemed sensible to me. In our second session, I was asked a series of yes/no questions about my general wellbeing, both physically and mentally. Long story short, my answers apparently indicated that I may have a MTHFR genetic mutation...

Sounds serious, what does it mean? I was told that this mutation could be identified with a blood test (this is true), but many GPs would probably not know enough to accurately interpret the results (mmm...). I could be referred to a GP who specialises in this issue. While the initial session was pricey ($400), subsequent session were more reasonable. If that was not affordable, a naturopath could certainly interpret the results (warning bells). I said I would do some research and think about my options.

The Basics

I am far from a geneticist, but from what I can gather the MTHFR gene helps turn folate and B12 into something the body can use (Click here to read a more sciencey and correct explanation). According to Genetics Home Reference there are at least 40 known mutations of the gene. I have read different statistics, but it seems a large proportion of people have a mutation (40% seems most consistent). This can have any number of impacts on the body, as you would imagine if your body is not receiving or using necessary vitamins or minerals. In my particular case, it is assumed this mutation would be causing or influencing my depressed mood, fatigue, PCOS and possibly most signs of ill health that I have.

My Research

The first result when you google will be mthfrsupport.com.au. This site offers some simple explanation about what the MTHFR gene and folate does. It lists all the possible conditions that the mutation could cause. They have videos and information available, some for free and some at a cost. For many people who have received the diagnosis, I'm sure the support offered through a group like this is a useful tool in facilitating lifestyle changes.

But that wasn't really enough for me so I kept looking. Generally speaking, there is a lot of information out there which is both interesting and conflicting. The jury is out in regards to how or if MTHFR mutations correlate directly to depression or other mental health issues (Click here for a scientific review on current research). The impact of B vitamins on mental wellbeing is generally accepted (fun fact, folate is B9), so an issue in the body's production is bound to lead to some health concerns- the same as with any other vitamin deficiency. Although nothing I read is as dire as alternate health circles seem to promote, there is a 'watch this space' vibe in relation to the research that is being done. The American Journal of Epidemiology, for example, note that a connection between the MTHFR variant and certain mental illnesses may lead to the use of folate as a treatment and preventative measure. It also may not, but if it doesn't, at least we will know. I love when potential is explored!

Where to now?

Yes, after my research I am open to the possibility that a genetic mutation may be contributing to my currently poor mental and physical wellbeing (family history and past experience also add to my consideration). I am not, however, convinced that this is the root cause of every woe that has or will befall upon me. Humans are an intricate web of biology, emotion, experience and environment. Different triggers lead to different results for all of us, even on a genetic level. I am also far from convinced by the industry that has built up around it. People are spending exorbitant amounts of money to be tested, see specialists and receive treatment. Did I really need to embark on such a journey to get healthy and escape the clutches of the MTHFRing gene?

I've decided on no. According to Science Based Medicine, high homocysteine and low folate levels can indicate a mutation and both can be checked with blood tests. Even if you go the extra mile and get genetic tests, NSW Health state that "there are currently no recommended changes in clinical management based on an MTHFR test result."

Regardless of who you see, the answer to low folate and/or B12 will be supplementation, with or without a genetic mutation. If there is a deficiency in folate or B12, levels should be monitored by a professional because too much can cause as many problems as too little. I'm pretty confident my bulk billed doctor can help with that. The debate is still raging for me in regards to folic acid vs activated folic acid. Methylfolate currently makes sense, but I haven't found much research on it yet. You can google the meanings of that yourself.

A change in diet and lifestyle habits may be just as effective and will have other positive health outcomes. While researching, I found that chickpeas, spinach, dried beans and lentils are top sources of folate, which reminded me of how good I felt when I did the 30 day vegan challenge a couple of years ago. I had a lot more energy, lost excess weight and my skin was so clear. Coincidently, my food staples at the time were chickpeas, spinach and lentils, all the high sources of folate. The positive results were no doubt due to increased vegetable intake and reduction of processed foods, but the possibility that a higher intake of folate helped is not lost on me.

Nom, Chickpeas

So I am experimenting with my body, taking it back to basics and testing how I feel, starting with a 30 day modified vegan challenge (I'm going to eat eggs, don't want to make it too unachievable). I may or may not have the MTHFR genetic mutation, but I am certain that I will benefit from a healthier diet. I will be getting a blood test done next week to see where I am at with folate and B12 and work from there.

For all those who have had positive results by chasing the MTHFR specialist route, I'm happy for you. If you feel better, have a more fulfilling life and absolutely incredible results, then you should be happy. For those at the start who choose to take that path, I hope you have equally great results too, I do not underestimate the value of support networks when making lifestyle changes. If you are reading this and something resonates with you, don't just do what I am doing either. Go and do the research yourself to find what will work for you. If you think seeing specialists is the best way to tackle the changes you need to make, then do it, but don't just follow their lead blindly. Read, research and take charge of the direction you want your life to go in. The people you pay to help you should be worth your money. I'll be sure to keep you updated on  my progress, because even if it fails it is a lesson learnt.

And of course, discuss! If you have ideas, thoughts or related articles to share, lets do this. Nothing bad can come out of a conversation (unless we make it bad, in which case I'll delete all my posts and comments and run away from the internet).

Ask RUOK? again and again and again

What began as a post to ease myself into some vulnerability about expressing opinions turned into an epic rant (don't worry, below is the edited version, chapter 1). Turns out I have some strong opinions surrounding social structures...that ultimately leads to an opinion of 'but it is what it is'. I wish there was succinct way to express why that opinion is not passive, but as my writing skills are still developing I think it will be have to explained gradually over many posts.

To the point- Today is RUOK day, so it seemed appropriate to begin posts discussing my own mental health. I'm not going to talk too much about my history (you can read a little teeny bit about it here), instead I'm going to talk about where I am with it now.

I am coming to this post following a long period of frustration about how my mental health has been handled. Although not ideal, I also think that I would not be at a point of taking my mental wellbeing into my own hands if it had not been for the spectrum of experiences I have had to date. Like many, I have been in and out of therapy for years. Usually I would land in therapy during crisis, I would stay there until I was functioning again, then I wouldn't know what to do with my therapist after that point so I would leave. This occurred either within the ten free sessions offered under the medicare system, or just after, when the outcome was not justifying the out of pocket expense. Also, like many, I was offered medication during these times and reminded to 'do things I enjoy' and 'get some exercise'. I have no criticism of this process, these are a combination of methods that have been proven effective in supporting people through depression. There were times in my life when this process pushed me through.

However, this has been a cycle where I was being treated for a symptom, not the cause. It has taken repeated trips to many professionals over many years for someone to pull all the pieces together. Now I am starting a process to work on the core issues.

Part of my healing means to let myself express my feelings, and I can't help but feel let down. There are reasons why it has played out this way and logically I know I am very lucky to live in the country I do and have even received the treatment I have had, but I still feel that initial pain of being let down. After all these years of struggling, I have questions. Why was a personality disorder not identified before? Why was I not offered more extensive therapy, like DBT, prior to this? Why was medication always pushed but other techniques were not?

I (like everyone) try to console myself by thinking that I would not have been ready for a program like DBT any earlier, that this timing is right and for it to happen any earlier would have proven ineffective. I can't really know that though, I may have responded well to it ten years ago and could have lead a very different life as a result (oh, but then I wouldn't have met such and such or experienced that thing that made me happy that one time... I love watching my mind try to make me feel better ^_^).

The truth is I am here now, I have this opportunity now, and I want to make the most of it now while I can. I am fortunate (while seething with white middle class guilt) that I have parents who can support me temporarily while things are set in motion. I am fortunate that I have people who have come into my life that are capable of understanding. I have a job where management not only identified that I was struggling, but also have given me the time that I need to get things back on track- for this I am fortunate, but I will take credit in knowing that I work hard, am good at my job and have made myself an asset who deserves to be well cared for by my workplace. I would be a fool to not harness all the aces in my hand during this dark time, but I didn't figure that out until recently.

It has been a lifetime in the making, but I am in a place to get the help I have needed for years because people took the time to ask. They didn't just as once on one day, they asked repeatedly because they saw something was off despite the fact that I kept saying 'I'm fine'. Let today be the first time you ask, but also make it a reminder to keep asking. It can take a lot more than one question to open a door that has been sealed shut.

To all those who asked, even if I lied in response, thank you. Because of you, I am still here.

As I said earlier, my original rant was very insightful (for me) regarding some of my opinions about use of medication in treatment of depression, systems surrounding mental healthcare, socio-economic structures and a few other bits (loooooonnnngggg rant). I have saved the draft and will work through editing and sharing those ideas over the next couple of weeks, there is no way I would bombard you with all that in one post. I have some interesting writing to look forward to.

Tate Watercolour Manual

I've spent a few minutes today wondering what my first post back should be about. Obviously I would want it to be insightful, witty and on the pulse. I also thought about how it should be nothing like a buzzfeed article, yet still be able to draw in that clickbait (impossible, buzzfeed is clickbait entirely because of how it is written).

After that little bit of contemplation, I accepted that I wasn't going to put that much thought or proof reading into any of my posts, so instead I'm going to post about art, because today I did art.

I went on an overseas trip recently and was able to take a day to go to the Tate Britain Gallery in London. Before I left for the trip I had picked up an interest in watercolour, so cause and effect lead me to purchase the Tate Watercolour Manual while I was there. I bought it because it seemed a nice way for me to make a statement of my artistic desires, fuelled by the day of inspiration at the gallery. Usually items like that go on my bookshelf of good intentions, but it has turned out to be a great and really practical purchase.

The book starts with a clear introduction to the history of watercolour. This includes how the paints, paper and paintbrushes were originally created and used, and how they evolved into the forms we know today. Written simply and succinctly, I was surprised at how this little bit of knowledge helped when I started playing with the medium.

The exercises were easy to follow, giving a chance to play with colour mixing and becoming familiar with how watercolours work (sparking a new found interest in the skill of colour mixing- black and yellow makes green???). The authors suggest coming back to these exercises often, treating them like drills to develop skills, which I definitely will do. By the end of the exercises, which took me only a couple of enjoyable hours, I had a range of images that simultaneously made me feel like I had been successful while wanting to do it all again in hopes of creating something better.

The final exercise was a practice scenery, so I had something to put on the fridge and gloat about as an example of my afternoon's work.

I made this

The next stage of the book takes you through work of the Masters, showing techniques so that they can be mimicked and replicated. No doubt I'll be showing these as I work through the book, I'll probably be really proud of them considering how excited I am even a small scenery exercise.

Tomorrow will be an appointment with a new psychologist. If I continue with the trend from today I will be talking mental health tomorrow.

Whipit back to the drawing board

Whipit is getting started up again with some new direction. Click here for updates and watch this space for new blog posts.

The stigma in my mind

Trigger warning if you experience depressive episodes- I explain some of my experience further down.

This month's topic of guilt is a rather big one for me. It is a lifelong issue that I still struggle to find the starting point of. Im not talking about feeling a little bad about actions that should be assessed to support our growth as a human. I'm talking about a 'laying awake at night for weeks on end because I said I couldn't go to an event due to prior arrangements' sort of guilt.

Almost as soon as I had decided on the topic, I came across this article listing things that you do not owe anyone. A wonderful read, but gut wrenching because I know that if I did any of those things, I would have to manage the resulting guilt for days. Nonetheless, the majority of the things listed are now on my list of aspirations for the year.

But one prominent example for me came as a realisation about my experience with depression (this is getting a lot of air time at the moment because I'm working through a down phase at the moment. Sorry not sorry). This struck me when I had to leave work early one day this week. I have called into work sick with 'headaches' fairly often in the last 18 months. By headaches, I mean I had a depressive episode the night before (why always at night?) and was too tired to function, let alone work. 

Starry Night seemed appropriate for too many reasons to list

It is important here, for the purpose of this post, that I do not down play what I mean by a depressive episode. I live with depression and for most part I am doing well. I am learning a lot about me, my needs, my strengths, my limitations and the fact that I have to do things differently from the norm to support my mental health. It can be very hard, but I have good supports and am learning. 

Depressive episodes, however, are different from my daily experience (self named- I don't know the technical term). Much of what I do in my daily life is to try to hold them at bay or lessen their severity. They can take me up to 2 weeks to recover from. They usually involve fits of uncontrollable sobbing (that I try desperately to muffle so not to disturb anyone), the kind where I can't get my body to fit in a small enough ball, hair pulling, head banging and self-harm till I basically pass out from exhaustion. I write 'pass out' because sleep is not an option. This can last for hours. These physical descriptions are minuscule compared to the thoughts which are flying around my mind. So full of self loathing, so factual about how horrible I am, how desolate my future is, and completely uncontrollable. I couldn't stop them if I tried, it is as if someone is standing next to me screaming all the things that are wrong with me and all my worst fears so loudly, I can't even dull the sound by blocking my ears with earmuffs encased with pillows. If it were another person, I would do all I could to shut them up- rip their jaw off, pull out their tongue, stab them through the throat. 

But I can't. I can't do those things because that person is me. And I consider myself one of the lucky ones, because even though the thought has been toyed with, there is something in me, something which hasn't snapped and has held on. I don't know what it is, but if I knew, I would package it up and hand it out to all those people who need it, free of charge, far and wide. I would even pay them to take it if I knew what it was. I know I'm lucky. 

So when I left work one day this week, after only being there an hour, because I 'felt nauseous' (this excuse ran concurrent with a genuine cold I had over the weekend), I knew I should not feel guilty about it. Once I realised what was going on and how poorly I was functioning, I was surprised to find that I was even at work. I knew what had happened the night before, but I barely remembered waking up or even driving.

But I did feel guilty. The RAM in the back of my head was telling me 'I'm not sick, there is no reason I shouldn't be at work' 'I did this to myself, a day off is just me being lazy and not taking responsibility'.

How wrong those thoughts are. Sick means to not be in good health, which I was not. As I outlined above, I did not choose to have the night I did. I have diagnosed depression, this is something that can happen. Yes, there were things that lead to it, but I am still learning how the management of it works for me. I didn't lay there and think 'gee, Karen, you know what would be super awesome right now???...'.

So why do I still have to lie when I take sick days for this reason? Why can't I call in and say 'Sorry, not coming in, mental health day'? Why do I feel I need to hide it and hold onto this guilt? There is greater understanding of mental health now, so many campaigns, so much awareness and, gee willikers, depression is not uncommon. The stigma is both coming from me and from society. I have two theories at this point of my journey (other than the normal people pleasing, insecurity, pride etc etc).

Firstly, I think perception of mental illness is not true to the reality of living with it. 

There is still the perception that it is all in the mind and you can just change a few things and 'poof'! All better! "I spent the day talking to you and telling you all the nice things and we did the fun things, so you must be happy now!" Yes, I may be happy at this moment, I may not be sad at this moment, but it does not mean I no longer have depression. There is long term management needed, not quick fixes.

In my searching, I found an interesting write up about the use of everyday language and it's impact on the stigma of mental illness. We often hear people casually throw around off handed comments 'I missed the sales! I'm so depressed' 'Happy one minute, angry the next, she is so bipolar!' 'I like my pens to match, how OCD am I?'. All very casual phrases and not intended to downplay any conditions. However, phrases like these can be damaging to the silent discourse that is happening around mental health. They set unspoken perceptions at a different standard than what is actually happening for the people who suffer them. If I were to call work and say 'I'm depressed' it is likely to be underestimated what this means for me. People's view is that I'm a bit bummed right now, not the image I painted above. Even I feel like a dick when I say to people 'I'm depressed'- I feel like I need to add more serious language to convey what that actually means, because being depressed just isn't that big of a deal in terms of language.

For me, in this scenario, this perception (both my own and society's) creates an undercurrent of thought that taking time off due to a depressive episode is decadent- to get over a down you need to do fun things. You can do fun in your own time, not on company time.

Second, I think there may be concerns that if we start allowing people to take days to recover from mental health issues, they will take advantage of it. 

The difference between being sad and having depression is very hazy in the corporate eye. What if you call in and say 'mental health day' and what you really mean is 'I need a catch up on Game of Thrones day'? The broadness in how mental illness presents makes it difficult to box symptoms neatly for the sake of bureaucracy. Companies can't dispute employees claims and this is just horrible for them because 'mental health leave' could potentially cost them big money.

But come on- It isn't like we aren't already taking advantage of the common cold. If people misrepresenting their situation to take time off is a genuine concern, companies should be taking more time to consider why people do it. I've no doubt that there is ample research to show that staff who feel they are well supported by their companies take less sick leave. If people taking advantage of 'mental health leave' is a problem, then it is due to the work culture we are sustaining, not the individuals themselves. 

So why do I feel guilty?

Clearly there are many factors involved here, and my guilt around my mental health is not limited to just my work. Nor is my guilt limited to my mental health. I told you it was a big topic... and clearly I needed to get some stuff out in the air here.

How I overcame my fear of ringing phones

How quick the month goes by. I am so aware that my end of month write up is looming, but I'm cautious in maintaining a work-uni-life balance that doesn't tip me into a pit of anxiety.

I am quite lucky that the 'life' part of the balance formula doesn't involve a lot of social activities. I have had to cut back on that quite a lot. I used to be extremely social. Not in the context of lots of parties or big group things, I spent more time one on one with people. And I enjoyed it very much, but one on one with many people gets very time consuming and leaves you with little down time.

I look back on that time with a lot of fondness, I had a lot of fun, a lot of good quality conversations and learnt from wonderful people. But I couldn't keep it up, not after the depressive episode that came on last year. I had to start saying 'no' more and more. I know many of those people wanted to help, but the energy of getting to them to let them help was even too much. Eventually the requests become less and less frequent, till many of them stopped contacting me. I feel horrible that I wasn't able to maintain the friendships, I'm sure each of them like to believe that they are the one who I would hold on to even when I let everyone else go. And believe me when I say this, I wish they were. There is guilt that I will never be able to repay them their kindness, that they will never know that I know just how kind they were and that I took that kindness willingly, only to abandon them later. I am learning to accept this horribleness in me, but it still makes me cry. Maybe this is what remorse is.

Fortunately for me, I had a few people who clung to me and didn't let me slip away from them. That is not to say they are better friends, but they are clearly the kind of people that I need at this point. To be what a person needs by just being you is a rather extraordinary and rare occurrence. If you believe in divine intervention, to have someone like that cross your path at just the right junction is surely hard hitting proof.

But I'm not sure I believe in divine intervention, so instead, all I can call it is fortunate. Fortunate for me at least.

It has been slow. Nearly a year and a half and I have finally found a balance that is manageable for me. Not easy, but manageable. It involves less days work, boundaries for how much 'extra' I give to my work, less people, more quiet time and an exerted effort to notice that quiet time for what it is. It has also meant that I have become selfish and not the 'nice' person I always identified myself as. I love and loathe this concept in equal portions. I want to be perceived as nice, that is the right thing. But I have seen benefits to my selfishness- a prominent one is that I am more likely to answer phone calls.

I know that is odd, but just 2 months ago I would have anxiety the minute the phone rang and ignore it. I would then send a sheepish text later apologising, saying i'll call later etc etc. The truth was that I literally couldn't talk. The concept of suddenly having a conversation thrown on me was unbearable. And when I look back, this has been the case for the majority of my life.

And now... now I am happy to take a phone call and even chat. I can do this because my selfishness means I have no concerns for ending the call when I have had enough. My selfishness means my head is not full of conversations with countless people, so I have the energy to answer the phone. I am learning how to say no, and be honest about what I want and suddenly, I feel like I have more space in my mind to fit people. I don't seem to fear having to go into a conversation unprepared. It is very liberating to not be scared of the phone.

I enjoy this control of my mind, space and time much more than I ever enjoyed being nice.

I hope this lasts for a while.

Thanks, Cadburys

I am aware that I am falling further behind in my plans for this month's article, so was very fortunate when my uni reading lent me some inspiration for direction. Back at uni means it is harder to just daydream my way through thought processes. I like to take my time and let things just arrive in my mind as they do. This is lovely for my id, but the need for social approval that I have means I feel I should speed up the process.

I have realised that I am often feeling pressure from the world around me. However, it is not like this is pressure that is decidedly placed on me. It is more of a subconscious sense of obligation. Yes, I have to go to that party. Yes, I have to fit those three events into one day. Yes, I have to do more at work than I am contracted to do.

And it isn't a matter of me not wanting to be involved with activities, events and people. It is more of a pressure that I feel that if I don't, I am not a good person, friend or employee. It might not sound so dire while you are reading it, in fact even I think I'm being a drama queen as I reread it, but stop a moment and think. How many times have you been laying on bed on a Saturday, aware that you have to get up to be at your friend's BBQ and thought 'I don't really want to go' (insert whiny voice). I mean, you know you will have fun when you get there and all, but you would rather have a day in bed and to get a few things done after a hectic work week. Then you realise that you need to put petrol in the car so you can get there, and stop at the supermarket to bring what you a bring when you're told not to bring a thing

Thanks for the additional social pressure, Cadbury
(photo from www.colinskyba.com)

Ack, even more effort. And with that in mind, it means that you are now running late and have to rush to go to an event where, if you could choose to do anything, you might have still gone to. But because you feel obliged, it is an effort.

What about work? You know you are there and paid from 9-5. But your boss usually stays late, so you hang back a little later and later each day. You have your role that you are employed to do, but there are those little add ons that seem to pop up that are hard to say no to (sure, you can be the unpaid volunteer WHS rep for office, no worries). It isn't that you can't say no- in fact, if they tried to fire you for not doing those extras they wouldn't have a leg to stand on. You might even find workplace health and safety utterly riveting. The niggling feeling in you is the one that says 'you have to say yes. It is the socially correct thing to do'.

This is where the concept of superego has lead me this week.

According to psychology.about.com, the superego is "the component of personality composed of our internalized ideals that we have acquired from our parents and from society". In other words, it is the things that makes sure we do not isolate ourselves from society and our networks by doing the crazy shit that our id and ego would much rather be doing. It is not something we are born with, it is something that is built through our social interactions from the moment we are born.

I am guessing this can then lead to psycho-social theories and all kinds of fun, but I'll get to that in another post.

My real interest in the superego for this month is just where is the line between what is my superego and what is 'me'. Also, are the things my superego holds onto helpful to my journey of self-actualisation or detrimental? No doubt it is both, but I would like to have some more specifics.

Back to it, will be posting again soon!

Hi, my name is....

I would like to introduce you to Karen, 2 years ago.

I was happily married and had been with my husband for 9 years. We had met in a quirky way, had a whirlwind romance and engagement, lived in England for two years and relocated to Australia. We had our ups and downs, but our relationship and connection was an envy for friends. He had stuck by me through very rough bouts of depression early on and I believed that everything would be fine, as long as I knew I could fall asleep in his arms each night. He stuck with me through all my whims and supported me in my pursuits. While we had struggled with debt from the folly of our youth, we had just worked our way out of the worst of it and he finally had a job that he loved. Our lives were finally coming together.

On the professional front, I had a stressful but fulfilling work life. I worked 6 days a week, up to 10 hours per day for a spiritual organisation. I truly believed with all my soul that this was my life's calling and I would be there till I died. I was managing and establishing new branches, handling administration, presenting seminars, co-ordinating large scale events, running training programs, giving one-to-one support and I was on call for anyone who needed it. I was traveling overseas regularly to support activities and met countless amazing and inspirational people. I had faith, and faith really can move mountains. I was a star in my organisation and known world-wide within it.

Wanting to contribute more to helping people, I started a uni degree, majoring in counselling. I took on a full time study load despite my full work commitment. I got distinctions across the board. Hate me if you want but I'm honest when I say that while it was stressful, I did not find it difficult.

And I had great friends. I was constantly seeing people and had a creative and exciting social life. They came to me for help and advise. I felt that I was able to offer something to everyone that I met.

Oh, and I surfed.

How amazing I was!

But you can't spread yourself that thin for that long. In October 2013 it all crumbled around me. The study and work load burnt me out. I began doubting the direction of the organisation I worked for and my concept of faith began to crack. The only thing holding it together was thin tape made of people's expectations of how I should act. To try and maintain control of my increasingly unsteady beliefs, I decided it was best to take some time out from that world. I found a new job and told everyone that I took it to help with my uni degree. The decreased work hours did me a world of good and uni distracted me from the fact that something that I built my life on had been cracking.

Then the real blow to my fashioned reality came when my husband ended our 11 year relationship. It was not without reason, but it was unexpected. My final refuge of the life I had once had planned was swallowed up. I fell into a desperate depression, dropped out of uni and moved back in with my parents. Everything I once thought of as 'Karen', was gone.

<insert montage here> Snap to 2015...



Hi, my name is...

Fatty Boom Boom, Die Antwoord.
Google it if you are not easily offended and want to get the reference.

With my past blown out of the water I had been given an amazing opportunity to start over. All I knew going into it is that I wanted to know 'me' and not cover myself in personas anymore. My depression and anxiety has given me a unique sounding board to feel my limitations and strengths (like the buzzers when you hit the edges in 'Operation'). So, here is where I'm at right now...

• I like to be alone at home drawing and writing. I enjoy being with people I know and I don't feel pressure to perform for. I like to spend short amounts of quality time rather than long periods of just being around someone. To be honest, I generally don't like being around people I don't know or in crowds, I find it overwhelming.

• When I have time and am having a good day emotionally, I'll do what is in my capability to be there for the people I care about. I like to help and feel like I am contributing to people's lives, but I can't compromise myself or I'll be taking 3 steps back. I'm learning to be selfish because I can't help anyone if I'm a mess, especially myself.

• I have yet to figure out what I offer to anyone, but I don't want to try to be of value. I would rather offer nothing and be honest with myself than try to be perceived as something for the sake of approval.

• I can come across as aloof, cold or just a plain bitch. In my mind I am actually being very considerate. I don't want to burden people with my problems, take your time with stories you don't care about or force you to spend time with me when you are just being polite. 

• I am excited by the prospect that people would consider me to be aloof, cold or bitchy. I never thought I would be described as any of those things in my previous life. 

• I believe that people work too much and we are not biologically made to exert ourselves the way we do. I believe that is why so many people need medication now, to make our bodies do things outside of their natural scope.

• I can't cope with more than 4 days work a week and the idea of studying again is terrifying me. 

• I don't want someone to be in love with me, but I do want to know someone cares. I like the idea of falling in love, but I don't think I will ever be able to feel that again. Knowing that scares me, but also fills me with a deep sense of relief.

You might think that all these things are negative, that I'm not helping my depression by thinking or acting these ways. But I'm tired of just pretending things that aren't socially OK aren't there. There is nothing wrong with me being me and acknowledging who I am. I know my limits. When I have an anxiety attack I can now back track and identify the point where I pushed a limit too far. I can also rejoice when I push a limit and had positive results. I don't know ultimately what is right or wrong, but I am closer to knowing what is right or wrong for me. I am becoming stronger everyday with this knowledge.

This list will just keep growing. I am learning new things about myself everyday. The old me was built on a lifetime of expectations. I had set up various paths and was acting accordingly, and this act hid who I really was. People may not like some of me, how I act, how I treat them, or the opinions I have. But I don't need them to...or do I?

My superego is moulding me into shape, using the signals and messages from the world outside of me to form who I am and who I will become, but for whose sake? For mine or for their's? The old me was built on acting according to other people's expectations of who I was to them, but this left me vulnerable and weak once the outside factors were taken away. I'm looking forward to where my reading takes me this month, maybe I'll have a new me to introduce come March.

Lets get technical

As the month draws to a close, I feel that I need to do more than just give you my opinions of what I have discovered within myself when I write my final article. I feel this way because I have been conditioned to believe that scientific enquiry is the only way to win true validity. It also happens that I agree with this because it allows room for at least some objectivity. When I only think of it from my perspective, it is easy to make excuses and create crevices for shortcomings to hide in. So today I am reading up about the psychological reasons for validation. I will still skew it to suit my needs, but such is life.

I wish I could be bothered doing some hardcore research on portals for original articles, but I'm just going to reach for google and let the internet do the leg work for me. A few hours into reading, scrolling, contemplating and computer shopping, I've noticed that Maslow's hierarchy of needs has popped up repeatedly. For a nice write up you can have a looksie here.

While I struggled to find any research on the psychological or neurological value of validation (If you have something, share a link in comments below), there were a lot of write ups on why we feel nice when we are validated. Reading these, validation seems to run across many of the levels in Maslow's theory:

• A few sites noted that validation was needed as a sense of safety, which is the second stage. This stage also covers stability and freedom from fear. I know when people around me validate my feelings, opinions and existence, I quite naturally feel safe and secure with any fear alleviated. 
• The third stage is love and belongingness. I think this one speaks for itself after what I wrote above. 
• The fourth stage is esteem. I know that I feel pretty good about myself and confident when I receive validation.

Then we arrive at self-actualisation. While validation is something I have needed through each stage, the goal of self-actualisation is why I am asking why I need it to start with.

According to simplypsychology.org, Maslow believed "human motivation is based on people seeking fulfillment and change through personal growth. Self-actualized people are those who were fulfilled and doing all they were capable of." I am trying to understand why I need validation because I wish to know all that I am capable of. I want to explore the depths of my self so I can continue to grow.

The truth is I need validation as a way of having lesser needs met so I can continue to explore my own self-actualisation. Keep it coming!

Tell me I'm beautiful

My pursuit into why we seek validation has found it's way into the realm of the ego. Lets be honest, every man and his dog knows something about ego and the word is used in many ways (mostly negative).

I study psychology, so I naturally have a view on ego and how it fits into constructing the individual. I also spent many years immersed in a religious organisation built on Buddhism, so I naturally have other views about the ego and how it restrains us from knowing our true self. When I consider these two views about the same topic, I can't help but be confused since they seem to sit completely opposite each other. However, as Freud said "contrary impulses can exist side by side, without cancelling each other out". So I have to explore each view within me separately. That will have to be for another day.

More to the point though, can you see how my view on ego was presented based on my involvement on two outside groupings? They were not my idea, but the ideas that someone involved in certain circles would be expected to think. This is the point of this post.

I went down the academic path first <cough> refreshed my mind on wikipedia <cough cough> and was struck first by the idea of the id. The instinctive drive in people. We often give the ego a bad wrap for all it's desires, but its function is to protect the id and give it what it desires. The ego is really just a pawn in the id's master plan for dominance and survival. So I thought, in this case, I can pinpoint what it is I am instinctively desiring by following my ego's games and tricks. We all have those subtle behaviours that we tweak to get us what we really want, even when we don't realise what that thing is.

I hope this isn't getting confusing, so I'll bring it back to the point of validation. If I can follow the patterns of situations under which my ego seeks validation, I will be able to see the desire my id is instinctively craving and sending the ego out to obtain.

And what I found was that I crave significance. I desire to be something that is more than just everyone else. A reason as to why it is important that I survive. I look around, look at the world, look at the universe and I see the starkness of my insignificance. Depending on my mood, this thought can be amazingly beautiful. But for my id, this concept is horrifying- if I am insignificant, than what is the point of my survival? This needs to be fixed.

Quick haste, my id whips the ego into action 'Go! Find me my purpose! Find me the proof that I am worth my own survival!'.

And ego, fulfilling its mission, brings back wonderful examples. You made this person happy, you are so talented at your work, you look so young for your age, you are more attractive than other people, your drawing has so much potential.... if you did not survive, then the world would be missing out...

All these may be true. But they are fickle. There will always be someone else who can make more people happier. There will be people who are better at my job. There are younger people. There are more attractive people. There are people who are better at drawing. And this means that perhaps the world would not be missing out.

But in rushes ego!! No, no, no. There is proof! People tell me I make them happy, I'm talented, I'm beautiful, validate what I want to be true!!

That is why I seek validation. To cover up an innate fear within me that I am actually nothing. A fear that sits in my chest and squirms as I write those lines. We all know that feeling. If you think you don't, let Louis C.K explain it in a funny way so you will get it (if you haven't seen this, I'm surprised). Next, to consider a much more healthy alternative to my reliance on a transient world for my significance.

Shit...I forgot my line

As the month goes on and I have time to realise the mess I have gotten myself into, my need for validation seems more and more appropriate.

I have gone ahead and published my site and blog, even though I do not like the layout, the branding is extremely inconsistent and everything is still glitching (freaking social media, why can't we all just get along!). I'm not even 100% convinced on what it is I am trying to accomplish. Doing lots of no no's for any public endeavour.

But the fact I have published it all means I am clearly not the perfectionist my anxiety about this situation wants me to come across as. I would like to present to you all some amazing finished project that just rocked your socks off. Why? So I could maintain an outward image of someone who is collected, capable and just a straight up unicorn supergirl (logo idea?? thoughts?).

I am far from any of these things. I have had the experience a few times when my actual self has pushed aside my acted persona and caused problems in friendships. People place you in a certain role in their life and when you do not live up to it, they believe you are a fraud. Little do they know that you were playing them all along and you did such a damn fine job of it that they seriously think you are as perfect as you acted.

Wait- before you praise me for my genius, you should note that I am not the first great mind to contemplate this. Dramaturgy (click here for wikipedia to tell you what I can't be bothered to) implies that we are all actors. The only thing that is real about us is the fact we are all responding to our interaction with the world. I see this in me consistently, and the more time I spend in solitude and reflection, the more I see the real me behind it all.

And this awareness is causing the fourth wall to crack. So I am looking desperately to my fellow actors to remind me of my line and who I am meant to be in order for my world to be held together. That is part of the reason I seek validation. I spent many years creating a version of what I thought I should be. Now I realise that it was a lie, a realisation that is sometimes not far removed from grieving and I am looking for anything to distract me from the changes in my life.

Even when it came time to share this page, I couldn't bring myself to reach out to any more than 10 people. They were the only ones I felt comfortable enough to either not rock my foundations too much, or to be aware that I needed something sugar coated. Everyone else I thought of sharing it with were people I still need to validate my old life because there are elements I'm not quite ready to let go of.

January topic...Validation

Hello world, and welcome to Whipit. Yet another blog I have decided to start up. And just like all my blogs before it, it may result in nothing.

As I am working mostly on setting up the site this month, my topic of validation is chosen to figure out why I am so determined to have a blog in the first place. So lets be straight up honest here, I want people to read my opinions. I, for some reason, feel that my opinions and ideas are something worth putting on the internet for all to see.

At times where I have tried to do this in the past I have experienced normal internet interaction- people who just want to tell you that you are wrong. Even though there were more nice comments and responses, my mind puts them to the side while blowing up any little negative comment 20 fold. But why did this negativity get to me so much? Because the act of putting my thoughts on the internet was one of seeking approval and validation for my newly formed opinions. Since we as a western society are generally of the thought that 'we are what we think' and 'I think therefore I am', my thoughts and opinions were naturally inseparable from me. This means I was looking to have myself be recognised and (lets face it) praised. My misconceptions meant that any negativity was a personal attack. All blogs and evidence of their existence were quickly removed as they were proof that I was a horrible person.

Yet, I persist to want to be validated by the faceless masses, and here I am again. Putting on my act (we are all actors after all) to try to get a feel for which parts of me will be most appealing so I can become the most likeable person I can be. This is not just an act for the internet, it is across all my life.

On Friday I decided to go to the beach, contacted a friend to see if she wanted to meet up, and off I went. This particular friend lives life filled with experiences and puts a lot of dedication into everything she tries her hand at. She is persistent and steady in her endeavours so, as a result, lives a very active life. I, on the other hand, try lots of things but drop them just as quickly. I hope you can tell from this that I admire her greatly and desire to have traits more like hers.

She suggested we go snorkelling, which involved a bit of a swim. The problem with this was that my fitness is not at a great point, the water was choppy and I did not feel comfortable or safe with the idea. But I persisted in the 'yeah, lets go' 'awesome' talk, all the while dreading it. I even got in the water with my snorkel and flippers having mild anxiety attacks.

But why? It was because I wanted to be perceived a certain way, to keep up with her, to be validated as part of her world. I knew my body and mental state were in no way ready to do what she could do especially since she has spent a long time working towards confidence and ability to do that swim. And I was so arrogant as to act the part despite having spent the best part of the last 3 months either asleep, eating chocolate or justifying why I don't need to go to the gym. All so I could act out something I would like to be and have it acknowledged, that way I could say that this is who I am, even though I am not.

With all this flying through my mind, I decided that I should admit defeat. She and another friend did the swim, I played in the water and sat on the beach, content in knowing that this was what I actually wanted to do. This was what I planned on doing when I decided to go to the beach. I didn't want to go out there and push myself beyond my ability, I wanted to enjoy the beach. But for the sake of validation of a false self, I was willing to do something I didn't want to.

I want to be able to do that swim, but I also want to work my way up to that point of ability and earn the right to that experience.

Oh, the things I do to pretend to be someone I am not!