March 2007

A few years back, I used to be something of an anti-psychiatrist. I could smugly quote Laing, Foucault, Szasz, Goffman. I could hold forth on “social labelling”, “biological reductionism” and the evils of “scientism”. I could deconstruct, for crying out loud.

Nowadays, I don’t feel that way about psychiatry. I’m not saying that Laing, Goffman, Szasz etc didn’t get anything right. Of course they did, and to some degree yes, mental illness is a social construct designed to deal with ways of thinking and behaving that society finds disturbing or unacceptable. And yes, the history of psychiatry is one riddled with stories of neglect and abuse.

But…and here comes the big But…well, the author of Pole to Polar: The Secret Life of a Manic Depressive has put it perfectly:

All I want, all I believe, is that bipolar disorder is real. As for the medications? If you make informed decisions and are supported, and if they help you, that’s the important thing. I am sick of the anti-med bandwagon. I rolled on it for such a long time. The churlish, “ddddduuuuh mental illness is fake!” belief just reinforces the stigma of mental illness. The most important thing to me is that people with mental illness, behavioural disorders, whatever the hell you want to call it, aren’t marginalised and discriminated against for something that- yes, even if they’re aware of it- feels out of their control. I have said time and time again here that I always felt that what was happening to me was biological. I fought the good fight. I went on the diets. Changed my scene. Did the mindfullness techniques. Had the therapy. Stopped the booze. Settled down and lived a quiet, careful life. And I am still a manic depressive. I still suffer intense depression. I still suffer highs and mixed episodes. And I even have the “broken home”, the “unstable background”. And yet, I’m okay with that. My broken home and unstable background is populated with people and experiences I cherish. It didn’t destroy me. It never will.

I don’t care if they’re a cluster of symptoms defined in an outdated manual. To me, they are real. They do not define me as a person. And knowing that, hanging on to that, is what gets me through when I feel I am losing the fight.

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Have been asked in a very nice email to link to the following information I thought I would just post the press release.

NESTA launches £20m initiative to stimulate innovation

The National Endowment for Science, Technology and the Arts (NESTA) (http://www.nesta.org.uk) is today launching a new £20 million initiative designed to encourage innovative solutions to some of the UK’s most pressing social issues including chronic disease, mental health and climate change.

NESTA’s ‘Innovation Challenges’ (http://www.nesta.org.uk/challenges) will focus on several key themes, starting with Health Innovation and followed by the Environment. Each theme will last for three years during which NESTA will conduct a series of high-impact projects with key partners, designed both to unearth existing ideas, and stimulate new approaches in response to recognised problems.

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For nearly three years now I’ve been a humble student nurse. In just four months, I’ll be leaving the world of academentia to become a slightly-less-humble staff nurse. Scary thought, eh?

With that, I can now break the news that I’ve been offered my first Proper Actual Job as a mental health nurse.

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Hi i have an interview next month, for my nursing diploma, i have wanted this for so many yrs. I have suffered bouts of depression for yrs, due to a bad childhood, but always worked through them, and carried on working. But last year i had a personal tragedy, the worst thing that could happen to a mother, i stayed strong for couple of months but then cracked. had a breakdown and tried suicide. I have never felt this feeling of despair ever in 40yrs of life. A monster took over me, i am now in therapy and feeling much better, i now look forward to the future again. I have been in college doing a-levels in all this trauma, so i know i can do it, i am so determined, i just had a flash of weakness. Anyway what i want to know, does my doctor have to give all my details like the suicide, as i am so ashamed now. I know OH have to look up records, but to what extent, and should i wait till it comes up to explain, or discuss it in the interview. Please help i am really worried, because i have done so much to get this far.

Thanks Calligas

Similar posts can be found here:

Mental Nurse - Help Wanted and also here.

Some sixty years ago the term “depression” did not exist. People experiencing what we would today consider to be depression were diagnosed as having a nervous disorder, possibly nervous exhaustion. I suppose a nervous breakdown equated to a depressive episode. Of huge interest to me are the official government statistics of the time which suggest that just 50 people per 1,000,000 suffered with this type of disorder. Rather a stark contrast to the modern day. 1 in 4 seems to be the currently accepted proportion of the population who experience mental health problems, although it is not at all difficult to find a 1 in 3 quote. I am living in anticipation of a 1 in 2 estimate appearing somewhere shortly. Returning the focus back to depression, some statistics suggest that 1 in 5 of us are likely to suffer a period of depression in our lifetimes. An astonishing 3,500,000 Britons, or 1 in 17 of the entire population are prescribed anti-depressant medication. That`s a monumental change over a mere couple of generations.

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She is not really. Sad though.

Zarathustra’s post got me thinking. What about the people we deal with who do have unlikely lives ? Quite often when a client says something unbelievable to us we, well, simply do not believe it. The classic is from nursing the elderly:

Very Old Confused Woman: Is my mum here yet? She’s normally here by now.

Mental: Good heavens woman ! Your mother must be dead by now. Sit down and I will get you a cup of tea.

Very Old Confused Upset Woman: My mum is dead ! Really ? Why did no one tell me … *sobs little heart out*

Mental: Here have a handkerchief.

Then of course her mother walks in and asks me why her beloved daughter is sobbing.

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The title of this post has nothing to do with the subject matter. I just wanted to let those words breathe.

On the ward, a patient says to me, “Have you met my ex-girlfriend?”

Me: “No, I haven’t. What’s her name?”

Patient: “Kylie Minogue.”

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During my second year of university I suffered from severe depression which resulted in a very nearly successful suicide attempt. I can’t remember when during that year I started to hear voices and think delusional thoughts but about a year later I was diagnosed as suffering from psychotic depression.

Fast forward to the end of my student days - I spent a year working as a Nursing Assistant on a rehab/continuing care ward. I formed good strong relationships with many of the residents and the year I spent on the ward was undoubtedly one the things I have been most privileged to do during my life thus far. Not a day has passed when I haven’t found myself missing the residents.

Currently I work for an occupational psychology organisation and am studying psychology with a view to something psychologically career related. I made a conscious decision to leave nursing until I sort some of my personal demons out and then I shall return! I am not quite sure in what kind of capacity I shall return but I want to care and make a lasting difference.

However, enough about me and my background, I need your help!

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Dinner time at the Faerie Realm Hospital. A porter hauls in a trolley filled with trays of greasy chips, overcooked vegetables and tasteless curry.

A HCA and I go through the less-than-inspiring contents. It’s even less appetising than usual. We’re particularly confused by what appears to be a tray of minced beef, with nothing else added.

“What is it? Surely it can’t be just mincemeat?”

We poke around in it with a spoon. A single, solitary kidney bean floats to the surface. It looks lonely.

“Oh, it’s chilli.”

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I am not a mental nurse, but I think some of you might be interested in this.

I’m off to the Mind Annual Conference at the end of the month, and I have an opportunity to submit a question in advance to Patricia Hewitt, Andrew Lansley (Shadow Secretary of State for Health) and a representative from the Lib Dems. Presumably they’ve decided to do it this way this year after last year’s debacle with Louis Appleby, as featured on the 10 O’Clock News.

Anyway, I’m sure I can think of lots of things to ask them, but I wanted to hand it over to the mental nurse readership to see if they can come up with something better. Suggestions in the comments please! I’ll write the best ones down on my form and send it in.

I`m not exactly sure, I think it was the early `70`s, when natural gas came online. Prior to that the country was reliant on coal gas. Coal gas was toxic as a consequence of which switching on the gas and putting your head in the oven was a common method of taking your own life. Nowadays, a lot of people and a whole new generation of nurses won`t remember that.

What`s my point ?. I can`t help thinking that we`re going in circles. Human beings are quite ingenious, if you deny people one option in terms of taking their own life, they will quickly conjure up another. Of course, I`m not for one moment suggesting that we give up on managing the risk of suicide. I`m simply suggesting the time has come to think a little more smartly about it.

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The author of the Secret Life of a Manic Depressive blog has been an on-off acquaintance of mine for some years.

She made a post recently that left me a lot to think about, in which she suggested that accepting a diagnosis of mental illness is comparable to a grieving process.

After my diagnosis, I did go through, “The Five Stages of Grief”:

1.

Denial. Manic depression? Look, that shit is serious. There’s nothing seriously wrong with me. I’m just a bit, y’know *whistle*. Don’t be stupid.

2.

Anger. I was raging! After all I had been through in my life, why did I have to be manic depressive as well? This isn’t fair! Can’t something good happen to me? Why can’t I be normal? I’m so young! How could I let this happen? How could I let this happen to myself? I’m so weak. I’m so pathetic. Why wasn’t I stronger? What is wrong with me?

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Maria needs help. Remember that.

So after a few weeks of Crisis In The Community she turns up in the police cells after shouting and screaming in the street. Just boyfriend trouble but it spilled out and the neighbours got involved and there’s a touch of arson and a bit of self harm….anyway upshot is, she’s in the cells and then gets assessed and ends up voluntarily on the ward. Boyfriend wants nothing to do with her now. Its over, he’s had enough. Remember that.

Maria makes friends quite quickly on the ward. This makes staff suspicious. Read the rest of this entry »

50 years ago, Britain had 150,000 people incarcerated in psychiatric care. Large asylums dotted the countryside. Now, the number of psychiatric beds in this country is a small fraction of that number, and nearly all of the old asylums are gone, bulldozed to make way for luxury flats and shopping centres.

A very few of the old asylums are still open. I happen to live in the vicinity of one of them, and have been “lucky” enough to do three of my student nurse placements there. It was built at the beginning of the Twentieth Century, and originally housed over a thousand patients. Now, it has about 200-300 and dropping. It is one of the last its kind. For the purposes of this post, we’ll call it the Faerie Realm Hospital.

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A shameless plug for another blog by site regular Mr Mans Wife:

You have no idea how much I am struggling to write this letter. I want to write to you about the issue of cut backs in mental health services in our area, but it’s very difficult to find the words to express how I feel. However, I feel compelled to at least try, after someone recently said to me: “You might only be one voice saying what needs to be said but there are lots of people in the community that share the same problems that may not be able to speak out.”

Read the rest here. Please leave comments expressing your great Love for Mr Mans Wife and keep your fingers crossed for a positive response.