Sunday, 5 April 2020

Quarantine and mental health

It's been a long time coming (well, approximately two weeks or so), but I have finally decided to break my 'I am not going to write about mental health during the coronavirus crisis' rule. I've been worn down by the lack of structure, the lack of going outside. I'm as sorry as you are, believe me. I cannot imagine I have anything to say that you won't read somewhere else so save yourself the time...and well, carry on, as you have literally nothing better to do. So, for what it is worth, my two-cents.

Go outside

Obviously, stay away from other people. Only actually exercise. Walking counts. But please don't start sunbathing in little groups with a BBQ and a Bluetooth speaker and then tell the police I said you could do it. But do go outside. It's good for you. The air is good for you. The sunlight is good for you. Trust the British weather to suddenly go really quite nice the moment we have to stay inside. It's wonderfully ironic and given our love of irony, I am sure we can all appreciate it. Outside, whilst walking 2m away from anyone not in our household for at least 30 minutes per day.

I cannot stress this one enough. I know people keep going on about it, but it really can change your mood. It'll also help with temperature regulation, give your muscles something to do that isn't changing the channel or scrolling through Instagram, and there are LOADS of dogs around. You shouldn't go and pet them because #socialdistancing, but you can look at them and they're normally really happy and cute. If you have a dog at home, take it outside so other people can look at him or her. Your dog also needs to walk, but if you have a dog you knew that already.

Go easy on yourself

Twitter is helpfully full of accounts telling us that Shakespeare wrote King Lear whilst in quarantine, Isaac Newton began to come up with his theory of gravity and so on. This is not helpful. We are in the middle of a pandemic. It is okay not to be productive. If you have ideas and things you want to accomplish or write (look at me, I'm writing a whole blogpost. In the lockdowns of the future, I hope to be an example to many) or read, go for it. I really want to learn Ancient Greek. I've not started yet, but I keep saying I will. If you fancy picking up drawing or learning to code then great. If not, or you lack motivation or whatever, then that's really okay too. It does not matter if whenever this is all over you are the same basically mediocre person with no new skills or talents. Don't beat yourself up. Just look after yourself, try and eat three meals a day and keep yourself entertained. It does not need to be groundbreaking or revolutionary. Developing a new skill or writing a novel (or the next King Lear, of course) is a great way to pass the time but then again so are series 1-5 of Mad Men, 1-10 of Friends and 1-6 of Brooklyn 99, which are all on Netflix right now. Sitting in your room for a few hours and watching TV or rereading your favourite books or doodling or whatever it is that you do that you probably think is not productive is perfectly acceptable. 

This is not the time to convince yourself that if you haven't read Plato's complete works, written 32 new plays, learnt French and Russian and run a marathon in your back garden by the time this is over, you've somehow wasted this time and are a bad person. 

Find structure where you can

Most of us have nothing to do. Or nothing pressing to do. Things can be put off, we aren't in work or study and there's just a lot of empty space on our calendars. Having said all that, there are still things we must do. We need to eat. We need to wake up. We need to go outside (see above). We also need social contact (video chat, please). So eat three meals a day at vaguely the same times. Go outside around the same time. If you enjoy reading, set aside time for it and if you can, try and stick to it. Organise video chats and skype calls. Talk on the phone with your grandparents if they are still alive at the same time (they'll appreciate the consistency and contact, as well). If you can say, right, I am going to wake up at 9am or 8am or 6am every day and eat breakfast 30 minutes later, lunch at 1pm, walk at 4pm, phone grandma at 6pm and so on, it'll help your day so much. It won't feel so much like a black-nothingness. There will be things to look forward to. And if there are things to look forward to, you'll be more motivated to do them and keep doing them. And add more things to do. 

Eat properly

This is good advice generally, but even more so now. Try try try and try again to eat regularly and properly. Good meals will help. If you can cook, cook for yourself. It will fill time. If you can't cook, now is a good time to learn (though, no pressure, see above) but still, try and eat properly and regularly. Fresh fruit and vegetables. Etc. 

Treat yourself

Finally, treat yourself. This is a bloody hard time for everyone. We are stuck inside. We don't know when it is going to end. We can't see our loved ones, we can't hug our grandparents and many of us have family and friends working tirelessly for the NHS and other key services, and we're worried about them. We deserve a treat. Regularly. Because, if we are complying with the guidance, and going outside only when we need to and social distancing when we do, then we are doing our bit. And our bit is hard. Yes, it's not hard like working for the NHS is hard. Or being a police officer trying to understand the new regulations. But it is still hard, and it will take its toll. So loads of treats are necessary. Anything you like. Enjoy it. Believe me, you deserve it.

Things will get better. People will stop dying and soon we will go outside again and have BBQs and all talk about that time we had to stay inside for weeks without any sign of it improving. We will get married and have parties and move into new homes and make new memories with family and friends. We will see our grandparents again and hug them and love them in close proximity rather than from afar. Friends will be in our rooms physically, rather than as images on a screen. We can go on dates and to restaurants and, yes, shock-horror, we will be able to go back to work and study. And we will all be so grateful for it. But for now, it's difficult and the light at the end of the tunnel is at best very faint. We will get there, we just need to keep going. So look after yourselves, treat yourselves, smile and be happy. We can do this.

Monday, 24 February 2020

Would you stop complaining?

Universities are really really really really bad at mental health. Like really unbelievably bad. They just have no idea, hiding behind their inflexible rules and procedures as they ignore the fact that they are dealing with real people and individual circumstances. Writing things like “we have to apply the rules fairly and equally” displaying a maddening ignorance of indirect discrimination and disgraceful lack of basic common sense. Confusing ‘there’s nothing we can do’ with ‘there’s nothing we want to do’, claiming they mean the former when really they mean the latter because they cannot be bothered to get it right; they cannot be bothered to accept that people are different and therefore need individualised solutions that take into account personal circumstances. That would mean actually thinking what is the best solution in this case and that requires effort. That requires actually bloody caring about the students they teach when really they care about their research and that’s about it. It is alarming how badly wrong they get it, how well-meaning, apparently and supposedly intelligent people, simply do not understand how things they say will be interpreted.

Starting with the brute bureaucracy. The 8 million different departments dealing with seemingly the same topic that never communicate because that would be too easy; that would be too simple; that would make too much damn sense; because otherwise how would universities force students to navigate an impossibly complicated system to ensure that they can never actually ask for counselling or mental health support or disability assistance because not even G_D knows who the hell they should contact. And then when you have contacted someone and sorted out, say, counselling, you’re entitled to four sessions because everyone in the entire world knows that you’re cured after four hours of talking about your childhood and why would anyone need more time, that’s just absurd. And then, you need a letter from your therapist saying you saw him or her but that letter needs to be current if you need to rely on it in an extenuating circumstances claim but how can it be current if you’re only allowed four sessions and they were 6 months ago but you’re anxious now and your family member died now and that’s why you need extra time on your assignment but the letter is 6 months old so it doesn’t count anymore and even though it says you’re not better because you may never be better because what does better even mean, it won’t help you now. So your claim is rejected or a decision is deferred until you can submit more evidence, more evidence that you literally cannot obtain because you are not allowed to see the counsellor again and you've been on the NHS waiting list since you were born. So you email again and there’s nothing they can do or want to do. So you’re screwed basically but it’s okay because every else is screwed or they would be screwed if they were like you or the same as you but they aren’t but anyway shut up and stop complaining. Complaining, because that’s what it is. And then it turns out that you should have contacted the mental health department not the counselling department because they deal with this type of mental health but you never knew this when you applied because you didn’t realise there were two departments because why would there be? And it turns out that they have a 6-month waiting list but that’s too late because you need the help now or well actually last year when you first contacted the wrong department who didn’t tell you to contact the right department, so what’s the point now anyway? But you email anyway knowing it’s pointless and fruitless, hoping for the best and hoping to be proved wrong because you don’t want to feel abandoned and irrelevant and if only people stopped making you feel that way it would be better.

And rules are blindly followed because rules are fair, right? Because if there’s a rule, it exists for a reason and it promotes fairness because then everyone is treated equally so there’s certainty across cases and that’s fair. Except it isn’t fair. Because rules don’t take into account circumstances and this is the criticism of Kant, right, because he’d have you tell the axe murderer where your children are, because never lie, except maybe sometimes, only sometimes, lying is a good thing to do and we should lie because axe murderers do exist. But rules are certain and certainty is fair a lot of the time but not always because some people have individual circumstances like they literally can’t get into a building without wheelchair access and obviously the fact the class has to be in that building is the same for everyone but only one person loses out, and even though there’s a rule, maybe you need to change the rules or soften the edges because people who need a wheelchair need to be able to get into buildings where their classes are. Or, if class had to be on a Friday afternoon and everyone had to attend the rule is fair and equally applied but it’s the religious Jew that misses all those classes so maybe the rule could be changed. But no, because another jew who is less religious will go to those classes so why won’t you, you’re both Jews but only you have an issue so really why should we change the rules, you should be more like this other Jew who has no issues because that’s how it works, you check Jew on a form and you’re all the same and have the same needs so the rules are fair because this Jew can come to class. So stop complaining, because your classes are important too and yes you have a religion but you also have class and this other Jew has religion and he or she is okay. So the rule might be fair and it might be equally applied and everyone might subscribe to the same rules but they can still discriminate against individuals and you need to be aware of that and mental health is no different because sometimes you’re fine and sometimes you have a panic attack and can’t move so you don’t move and other times you can’t speak so you don't speak. So you can’t go to class or don’t want to but you try your best because the rules say that everyone has to go to class, and that’s fine, except sometimes you just can’t and it’s not the same as that other person with mental health problems because maybe they can go to class but that doesn’t mean they don’t have an issue and it doesn’t mean that you don’t either. It means the rules need to be different, to take those circumstances into account so that everyone is catered for and yes that’s hard and expensive and difficult and time-consuming but people are killing themselves because they feel alone, people are hurting themselves because they feel no one understands. And I don’t think it’s true, I think people do understand and you’re never alone but I’ve felt alone and I’ve felt misunderstood and like no one cares so I know how it feels and I empathise and I sympathise and more needs to be done. 

And then there are the emails you receive. The ‘stop looking for special treatment’ that just means ‘stop complaining’ and the ‘we’ve been very supportive’ which means ‘stop complaining’ and the ‘there’s nothing we can do’ which means ‘stop complaining’ and the ‘this is wasting time and energy’ which means ‘stop complaining.’ So you do. You stop complaining because it’s true, you do want special treatment. But that’s only because you need it because the words jump around on the page when you sit for too long or your grandmother just died and you know what you’re really really damn upset and don’t want to deal with that essay right now because life goes on and is more important than Descartes’ views on mind-body dualism. And you stop, because they did give you that extension last time and you think maybe you’re just being ungrateful forgetting that you had to jump through 23 million hoops just to get that extension and it arrived three weeks late so it was meaningless anyway. And then you think maybe there is nothing they can do, forgetting there’s always something they can do, they just don’t want to do it because that means actually paying attention and helping you and that takes time and effort. And, well, yes it is taking time and energy so you stop, forgetting it takes more time and energy to deal with their system at every turn, the system that doesn’t see a human and doesn’t see a person but a nuisance with fingers that can type. So you go away, quietly, hoping that no one will trample on you and that it’ll be okay but it won’t be because that’s not how life works, you need to speak up but you’re tired and your voice hurts and you’re sick of fighting because it’s really not getting anywhere because they don’t care and they don’t listen. And they keep sending emails that you misunderstand because they’ve made no effort to understand you and emails that make you feel worse and make you feel more anxious because no one stops for a minute to remember that they’re dealing with a real person, not a computer, but a person with feelings and emotions. Maybe we should phrase this a bit more nicely. Because it’s not their fault. No one ever thinks that. And that’s the problem.

And then there's the ignorance. There's the ignorance that says mental health works like physical health, that a broken mind looks like a broken arm and takes a few weeks to heal and being able to use your mind is evidence that it's no longer broken anymore. Except, it doesn't. Sometimes you can't move or breathe or think and sometimes you can and mental health is not physical health, it's different and looks different and works differently but, obviously, if you submitted a piece of work it means you're fine and that piece of work is fine. Right? Well, no. It's not the same, it's different and needs different systems and different fixes. There's the ignorance that you are complaining and, more crucially, you want to be complaining, that you're just obviously a difficult person who enjoys being difficult. So you crawl back under the bed and cuddle yourself, rocking gently as you cry and wonder maybe it is just you, maybe it's your fault, maybe you should be easier if only you could be easier things would be better. And you want to be easier, you wish you could be easier because despite everything, despite the lack of empathy and the lack of sympathy, despite being made to feel like an inconvenience and a nuisance, you can still empathise with them. You blame yourself because you know how difficult it is to deal with mental health because you've been struggling for 20+ years and you haven't figured it out so how could they figure it out, you don't even know what you want so how should they know? So you try and let them off, blame yourself because obviously it's your fault, everything is your fault...except, it's not your fault and you need to stop blaming yourself but that requires other people to stop blaming you as well. But the institutions won't stop. They keep blaming you, stop complaining, stop asking for better treatment, go away. It just makes it worse, and worse, and worse.

it’s an easy fix. Listen. Empathise. Stop hiding behind rules, they invariably ignore circumstances and treat people unfairly. They invariably assume all cases can be treated alike. Employ more staff. Care more about students and less about research. This isn’t rocket science. And even if it were, universities are full of people that understand rocket science. So they should know better. And they should do better.

Saturday, 1 February 2020

Feeling

Have you ever tried to kill yourself? Wondered how you’d do it? Crossed the street without looking, hoping and wishing and just wanting something, anything to hit you instead of life which keeps hitting you over and over and over again? Viewed every knife in your kitchen as a vehicle for sweet release from the pain, the difficulty, the sheer weight of everything crushing down on you? Looked at your wrists, the veins, thought about how much it would hurt and how long before it would stop hurting and how long but then didn’t matter because it hurts now, right now, and you’ve not done anything yet, you’re just looking at the knife and thinking about it but you've not done anything but yet it hurts, why does it hurt? And if it already hurts what’s a little more pain for just a little bit of time and then no pain surely no pain is good? What difference would it make? Maybe none but maybe all the difference in the world because there’s pain and there’s no pain and then there’s the complete absence of pain because there’s no feeling left. Have you ever tried to convince yourself that people would care or sometimes that they wouldn’t and that’s reason enough to do it but how would you know is there any way of knowing because sometimes that’s all that stops you that you don’t know if people would care and you need them to care because otherwise what was the point but would they and you wouldn’t know if they did because how would you know but if you cling on if you accept the pain and work through the pain they’ll show you that they care and then you won’t want to anymore because they’ll care but they don’t or they won’t or they haven’t? Thought about it but not done anything because that would be a cry for help and you don’t want to make a sound or have them notice, you just want to be quiet and be silent and for no one to notice you because then you can pretend you’re not breaking into a million small pieces because if they don’t notice then it isn’t happening and if you cry out then it’s real and you have to face it so you stay still and quiet and silent and motionless and you don’t do anything because somehow that seems easier and less real. So you don’t do it but every single time you go through all of that thinking and wondering and temptation and nearly doing it and nothing changes and it just gets worse and worse and worse and worse because you can't cry out because that would be too loud but you can't do nothing because it's too loud in your head. And you don’t know what’s really stopped you so far but you hope that it keeps stopping you because you don’t want to, you don’t want to end it you don’t want everything to stop because how would you feel but then you remember you feel pain and sad and it hurts and you don’t know if you want to feel at all because maybe that's better but how would you know but surely it is better. So you go back again and you start all over again and you go through it all again and reach the same point where you’re grateful you haven’t but also would but can’t but you don’t so you still feel and you don’t know if that’s a good thing but at least you’re here to ask the question because that’s something right? Right? And you really do not know but you're tired and too tired to keep doing this in your brain and sometimes it takes up entire days and weeks and you are still going and nothing has changed but you don't do anything because somehow that's easier than doing something.

Have you ever sat down and thought about it? Wondered who would find you? What they’d do? Realised you just feel too much and if only you could feel less but you don’t know what that means and you don’t know how to make yourself feel less because that’s not possible right because you can’t stop feeling that’s what it means to be human so maybe you decide you don’t want to be human anymore no one asked you right you just were born and then had to feel things and be human and grow up and do things and you wish you didn’t or couldn’t or wouldn’t but it doesn’t go away and you keep feeling things and you just don’t want to feel anymore so you think about it because you do not know much about it but you know you won’t feel. But then you remember you just want to feel less and you don’t know how to feel less maybe there’s a way of doing it a little bit and not completely so you just feel a tiny bit less instead of not at all because you want to feel something just not the bad things not the bad feelings or the hard ones or the ones that make you cry out silently to yourself because you still can’t tell anyone because you can’t bring yourself to do it and somehow that’s keeping you alive because death is too loud it’s too messy it’s too much and too noisy so you don’t, you just stay quiet and alive because that's easier. You just want to feel less. How can you feel less? What does it involve? Is there a switch or a button you can press like on a remote to make feeling less intense and less a lot and less there. Not the off switch that’s too much you still want something just less of it like a volume button that you can control and if you wanted to feel more that would be an option but right now you feel too much and it’s too loud but for some reason it’s only keeping you up late at night wondering where the volume button has gone and no one else seems to notice or know because you’re quiet but the volume in your mind is on so high that it’s deafening you from the inside out. Maybe a mute button where everything still works and carries on but it’s quiet and less distracting and just there in the background so you can turn it back up when it’s more interesting or fun or just plain less sad and hard. 

Have you ever tried to kill yourself? Because I have and it didn’t work because I’m writing this and yes it was some time ago now and yes I’m glad I didn’t and yes I was sad at the time and wished I was capable and yes I’m still alive and feeling but I tried. And I failed and somehow that was worse because living is difficult and messy and hard and noisy and loud and dying should be easy but I couldn’t even manage that. So I had no choice but to carry on even though I didn’t know if I wanted to, I just had to because I couldn’t kill myself because I was so useless or maybe because I didn’t want to and then I felt better because maybe I wanted to live and even if I didn’t feel like it my body or my brain or my mind or my subconscious or all of them wanted to live and didn’t let me die and then I realised it would be okay because I was alive. I was sad but alive and as long as you’re alive there’s hope and a chance and something that can be done and a way forwards into feeling less because after all, that was all I wanted just feel a little less but still feel. So as long as I was still alive things can change no matter how much I felt they can’t they can because that’s life and feeling and being alive so maybe it’s okay. So I clung onto that thing that kept me alive and I still don’t know what did but it doesn’t matter because I’m still here and I’m so grateful I’m still here because I can feel and now I feel less sad and just less. I still feel and sometimes it’s too much but I’m still here and I’m better at feeling less and I promise you you can feel less and I promise you that you can do it because you can control feeling less and you don’t need to take control by dying or hurting yourself because you can take control by feeling less and maybe you can’t take control by hurting yourself because I couldn’t but eventually I felt less and felt better. Just a bit better but better and it’s working and helping. 

I’m still here and I still feel and I’m glad I do.