What I have learned through recovery

An episode of clinical depression isn’t sadness. For me, it starts with brittleness and a growing sense of doom. I stop sleeping and become increasingly irrational and irritable. Beyond a certain point, I am unable to ignore or control it. Eventually, something snaps. I am smothered by a suffocating blanket of nothingness. The only feelings to permeate are deep guilt and self-loathing. All perspective is gone; I ruminate endlessly over things I have messed up and those I have hurt. I am frozen, unable to speak, or crying. The tears do not soothe. I detest myself.

Luckily I don’t feel like this all the time. Having been on my latest road to recovery for the best part of a year, I have learned a few things about looking after myself that I want to share.

  1. Choose to be all of me: having learned that it is so much better to be open about my experiences of mental illness, I now have to work hard at not allowing depression to become my defining characteristic. It is just one thing about me.

  2. Expect less: if someone likes something I have done, that’s lovely. But I need not feel disappointed if they don’t.

  3. Mindfulness: live in the world and be in the moment. Enjoy the little things – rinsing a cup, the warmth of the cat’s fur. Stop rushing.

  4. Going out: notice how exercise in the fresh air, even in wind and rain, makes me feel strong and alive. Embrace it and do more.

  5. Stop ruminating: I’ve wasted a lot of time going over and over things. It is important to learn lessons when something goes wrong – CBT has taught me to face the difficult stuff with less fear. But knowing when it is time to move on is a skill that needs frequent practice.

  6. Choose to forgive: This goes with number 5, and I like to think I am better at it than I was. Again, I have to practise every day.

  7. Create order from chaos: people think I’m tidy, but the more distracted I am, the messier I get. I have learned that, on a day when I am feeling low or anxious, I need to create order. Write a list, tidy a shelf, weed a flowerbed – completing a small task that brings order is soothing.

  8. Buy less stuff: I thought I loved shopping, but it made me feel guilty to spend money I couldn’t afford or could have given to someone more in need. Now I try to buy less. Except fresh vegetables.

  9. Make do: this goes with 8. I gain increasing satisfaction from mending things, making something from something else, or giving something of mine to someone who can make good use of it.

  10. Treating myself: on bad days, addictive substances such as alcohol, caffeine and chocolate can seem like treats. It takes some of us a lifetime to learn that they aren’t. A soak in the bath, a walk by the sea or some quiet contemplation in a sacred space can feed the soul rather than flooding the brain with dopamine.

  11. Competition: for me, best avoided, except with myself when trying to improve personal performance.

  12. Listen hard: I used to miss so much or misunderstand because I was too busy interpreting what people were saying and working out what response I should give. I am learning the value of listening really carefully. It is amazing what you hear when you listen properly.

  13. Don’t shy away from things that feel difficult or scary: it takes huge courage even to leave the house when you are in the early stages of recovery from depression. Standing up in front of 200 people in my first week back at work, I wanted to die. But I am so proud that I did it. I have found that, as I get better, I thrive from the boost to my endorphins that comes from feeling fearful yet excited about a new challenge, preparing carefully and managing my nerves so that I do a good job. I feel very lucky that in my new world, there are plenty of opportunities.

  14. Stop pretending: when someone asked me how I was, I used truly to believe it was a dereliction of duty to say I was anything other than great. I have learned to tell the truth about how I am – some days I am good, and some just OK. And when I am not OK, I am better at saying this too.

  15. Choose kindness: people have often said of me that I am kind and generous. This came at a cost. I have learned that to be truly and effortlessly kind, one must start with oneself. The love I feel for other people and the kindness that flows from me towards them has multiplied as I have let go of negative feelings towards myself. I am far from perfect and still have many faults, but I am worthy of love. This helps me to help others more than I ever could before.

These are just my thoughts; if they help someone else, that’s great. But please, don’t shout at me if you disagree. We are all different. And that’s what makes us so amazing xxx



Whatever happens at the Oscars, you must see Selma

If you haven’t been to see the film Selma yet, here are 10 reasons why I think you should go.

  1. The film has some of the best acting you will ever see. Within moments, David Oyelowo is Dr Martin Luther King. And Carmen Ojogo is Coretta Scott King, Tom Wilkinson is President Lyndon B Johnson, Tim Roth is loathsome Governor George Wallace, and Oprah Winfrey is quiet, noble Annie Lee Cooper who you would easily pass by in the street.
  2. The cinematography is stunning. The views of people marching together over the bridge in Selma, Alabama will make every hair on your body stand up.
  3. Vintage news footage is used with truthfulness and skill.
  4. The musical score is thrilling. The title track Glory by John Legend and Common, who also stars in the film, is up for best original song at the Oscars. Play it when you have something difficult to do; it will feel a little easier.
  5. The story is told with limited dramatic adaptation. For example, King’s reported infidelities are not brushed over, nor are they over-emphasised. We get a hint of the power of the media to ruin people’s reputations – sadly, no change there.
  6. King is just 35 when the film is set. We already knew about his rhetoric. His responsibility, political nous and shared approach to making decisions would be extraordinary in a person twice his age.
  7. The film contains a pithy argument between LBJ and Wallace about doing something for the people who are being prevented from registering to vote. Pure gold advice for anyone in a position of responsibility who tends to avoid the messy stuff.
  8. The film has only been nominated for two Oscars – best picture and best original song. It should have been up for best actor, best supporting actor, best actress and best supporting actress at least. There are all sorts of reasons being given for the modest number of nominations for Selma. I expect the truth is pretty ugly. You should decide on this film’s merits for yourself.
  9. The world is in trouble. Young people need role models that can relate to, people who are brilliant yet flawed, who they can identify with. I’m sorry, but posh white boys from public schools are not enough any more.
  10. People are being discouraged from voting in our forthcoming UK general election by the likes of Russell Brand. How dare he? Although, given the way our media present politicians in 2015, can we blame those turned off voting? Selma is the best explanation possible about why having the vote is a fundamental human right. People continue to be prepared to die for it in our lifetimes. The least we can do is make sure we use ours.

I hope Selma wins Best Picture and Best Original Song at the Oscars tonight. But anyway, it is my film of 2015.

I hope it will be yours.


It’s #NHSChangeDay. And it’s #TimeToChange

My blog today may be the most important thing I write this year. So forgive me if I seem to be plugging it rather a lot!.

We all have mental health. And we all experience mental distress from time to time. But only some of us (1:4) get mental illness. This 3 1/2 minute video explains it well.

One of the hardest things about mental illness is the stigma associated with it. From society but also family, friends and work colleagues. But most of all from ourselves. It stops us seeking help. For example, people wait a year on average before talking to someone else about their depression. This delay causes great suffering and harm.

Time to Talk Day  took place last Thursday, part of the national Time to Change campaign. The purpose of setting aside a day every year is to open up conversations of just 5 minutes between people, and to help each other. I had some amazing conversations via Twitter and face to face with people, including at a reception for the national mental health heroes held by Nick Clegg, Deputy Prime Minister.

You may feel that politicians are jumping on the mental health bandwagon in the run-up to the General Election. But I think that’s OK. Because after the election, we can join together and hold whoever is elected very firmly to account to make sure that mental health services stop being the Cinderella of the NHS that they still are. It’s not enough for politicians to say nice things. We need carefully thought-through policies that make a positive difference, and significant investment in real terms over the life of the next parliament.

Stigma has many other negative impacts as well as on policies and funding. Time to Change have found that, while the public are gradually improving their attitudes towards people who experience mental illness, there has been no discernible improvement of attitudes within the NHS. In fact some people who use mental health services say things have got worse.

This produces all sorts of horrible results:

  • People with mental illness can be treated without the compassion and respect that are essential for effective health care
  • People with mental illness may not receive the treatment that they need in a timely manner. They may have to fight to get the right care. And they may not even receive the right treatment at all
  • The links between mental and physical illness can be forgotten or ignored, causing detriment to people with either or both. For example, people with serious mental illnesses die on average 20 years earlier than the general population, often linked to preventable diseases such as heart and/or lung diseases, some types of cancer and strokes. People are people, not single diseases
  • People with mental illness report that NHS staff can have a pessimistic outlook on their life chances, including relationships, education, employment and social contribution
  • Staff who work in mental health services can be blamed for things that are not their fault, or criticised for not providing a service when it hasn’t been commissioned or adequately funded
  • NHS staff who themselves experience mental illness often feel the need to hide it from their colleagues, and when applying for jobs. Mental illness is not seen as something to be proud of overcoming in the way that some physical diseases are portrayed

Part of our #NHSChangeDay #TimeToChange campaign asks NHS staff who have experience of mental illness to consider talking about it with their colleagues. Please be assured, we are not in any way pushing people to do this. We ask anyone who is considering doing so to think about it carefully, and look after themselves, including getting support. There are some good resources here. I know from my own experience how hard making such a disclosure can be, and how significant are the ramifications. But that takes us back to stigma. It really shouldn’t be so hard. And if we cannot be compassionate towards our colleagues who may be experiencing mental illness, how can we, and they, be expected to be compassionate with patients?

When we find ourselves troubled about something that we hold dear, it is human to want to disagree. Or run away. I felt very upset when I first heard the findings of the Time to Change research, and wanted to say no, surely it must be better than this. But then I listened again, and realised that, unless we face up to what has been uncovered about attitudes within the NHS, things will never improve.

If you have 6 minutes to spare, you can watch me talking about it here. Including the long-lasting effect that one nurse’s probably unintentional lack of compassion had on me, also a nurse.

The #NHSChangeDay #TimeToChange campaign aims to tackle this stigma within the NHS head on, with compassion, but also with wisdom and hard work. From it, we are building a programme within Time to Change that we hope will leave a very important legacy for NHS staff and patients.

Whether you are a patient or an NHS clinician, a catering assistant or a Chief Executive, please join us. Everyone can commit to one of our actions or create an action of their own. It’s NHS Change Day on 11th March 2015. And it’s Time to Change.

Thank you.



The trouble with listening to other people is you end up changing your mind…which is the point, I guess!

Last night I chatted briefly via Twitter with Professor Louis Appleby about the proposed “target” for suicides being zero. I got his assurances that the intention is to have shared aspiration and concerted effort towards a significant reduction rather than an aim of absolute zero. I also heard from Dr Alys Cole-King who shares his views – we have a phone call booked this afternoon to talk about how I might help with her research and how she might get involved in Time to Change.

At the Guardian debate last night, I challenged the panel to say what they were going to do personally to make sure such a policy would not have the perverse impacts feared by me and many others who, from time to time, experience suicidal thoughts.

Their answers were really thoughtful. I know some people doubt The RH Norman Lamb‘s sincerity when he says that he has been battling for mental health within the corridors of Westminster since he was appointed as Minister in 2012. But I believe him, as I do his shining conviction for much greater aspiration for people who experience mental illness, and the importance of removing silos across health and social care. I was also convinced by Professor Sir Bruce Keogh who is not afraid to speak his mind, but engages people through his emotional and intellectual intelligence, and humility. He said that the aspiration within NHS England is for real investment in mental health and to break down unhelpful barriers between mental and physical illness. He also said that Norman Lamb was on their backs about it all the time. And Julia Manning not only talked about the financial disincentives for pharmaceutical companies to invest in new treatments. She also made the audience sit forward by talking with great courage about her own experience of mental illness since the age of 22.

So where am I now? I remain unsure about an absolute zero target for suicides, because it could set people – patients and staff – and services up to fail. And I think the work of NHS Change Day and Time to Change are vital because not everyone in public services is as well-informed or humane as members of that panel. But I do now believe that a target to reduce suicides, based on the sort of thing we are doing in Brighton and Hove to become a suicide safer city, engaging the whole community, will truly change lives. Anything that gets mental illness and effective treatment and support out of the ghetto and into the mainstream must be a good thing. As Dr Mark Porter said last night, we artificially separated mental illness from physical health when we built the asylums.

Now is the time to bring it all back together, and make mental health part of health, and everyone’s business. Onwards…