Anxiety, health and the way out

My first experience of depression and anxiety was my own as a young adult. It was a while ago, but I remember that there was nobody to talk to, no help to reach out for. It felt very lonely. In a quite natural way, I got drawn to Yoga, religion and to nature, where the healing moments helped me see hope and gave me strength to pull myself out of my low moods and low energy levels.

More recently, during my work at the University, where I was teaching Undergraduate students, I realised how wide-spread mental health issues are today and how many students I was seeing on a daily basis struggled with anxiety or depression. I remember one bright and lovely female student, who was in my class last September. She came regularly and although she was rather quiet, she managed all coursework well and visibly enjoyed the seminars. After the first half of the semester, she suddenly stopped coming to class. One week, two weeks, three weeks… This is when Student Support start checking what may be the reason for longer absence. I was told later that the student had mental health problems and paused her studies. My initial thoughts were: could I have done anything more to help, could I have shown more interest in the student, engaged her more in class discussions, boost her confidence? It is a difficult call. There is a very fine line between encouraging a student to participate and making them too scared about being called out to come to class. This delicate balance is what we try to find with every group. Sometimes it works, sometimes it doesn’t.

Half a year ago, a member of my family has been diagnosed with fibromyalgia, a neurological condition, for which there is currently no cure or medication. Amongst the symptoms is severe pain all over the body, a pain which is not real, but seems real. It is caused by a malfunction of the central nervous system. As if this was not enough, my daughter has developed a health-related anxiety. Living with fibromyalgia means that it is difficult to tell if the pain is “real” or “fake”. As a result of the uncertainty patients are often anxious that there is something seriously wrong with their health, to the point of fearing for their life. Trying to help my daughter manage the pain and find a way out of the anxiety she is experiencing due to the long-term extreme physical symptoms, we have discovered numerous mindfulness apps and methods, learned about neuroplastic pain and somatic tracking, explored pain management methods. As much as I wished that my child did not have this condition, I give her a huge credit for courage, optimism and drive, which I see in her every day.

There is no denying that many of us will experience anxiety or depression in one form or another. Sometimes it affects us, sometimes our loved ones or friends and colleagues. There can be many sources and triggers. One thing I know for sure is that it is in our power to train our brain to overcome these issues and that there are many ways to find hope and help.

I recommend to read “The Way Out” by Alan Gordon to see how to deal with chronic pain and “Seven and a Half Lessons About the Brain” by Lisa Feldman Barrett to find out about the fascinating history of our brain and how it works and interacts with our body.

Dr Beata Kohlbek

(former DELC Teaching Fellow, currently director of an online tuition centre: https://bktutoring.co.uk)

How to be a good friend to someone who is struggling with their mental health

Watching one of the people you love the most struggle mentally can be one of the most heart-breaking feelings in the world. It can overwhelm you with guilt, a sense that you are not doing enough, or a feeling of helplessness. But it doesn’t have to be this way.

As someone who has suffered with trauma, which consequently lead to mental health problems, I thought this would be easy. Having been in the position of that person who needs a friend, it wasn’t something I worried about.

But I was wrong.

When one of my friends lost her brother suddenly last year, I was overwhelmed with all of these feelings. Heartbreak, helplessness and guilt. I didn’t know what to say, or do, to help take some of the pain away.

The funny thing about struggling with your mental health, losing someone, or going through some kind of trauma is that it doesn’t always gravitate people towards you. TV and movies would have you think that every person in your life would suddenly drop everything to come to your aid, but that’s not the reality. In a lot of cases, people do the opposite – they pull away. They look at you in a different way, they don’t know what to do or say, so they don’t do anything. But something I’ve learnt is that doing something kind, reaching out in some way, is better than doing nothing. Even if that person is not ready to talk, knowing that when they are ready, they can talk to you is invaluable.

The seemingly sad reality is that if you are struggling, you might lose some people you thought were important in your life along the way. But that’s not something to feel sad about. Not everyone is in a place in their life where they can deal with such situations, and that is no loss. The beautiful thing about it is that you realise the people who truly are there for you, the people who are prepared to step up when you need them. The people who don’t look at you differently because you take antidepressants, or see you as ‘the boy whose Mum died’ or ‘the girl who had a troubled childhood.’ They still see you as the warm, kind person who makes them laugh, even if you are not in a position to do that right now.

The most important thing you can do for a friend who is struggling is to reach out, and keep an eye on them. Look out for that friend who normally enjoys preparing the best outfit every day, doing their hair and make-up immaculately, and who now appears to have no interest in doing so. Look out for that friend who normally never misses their gym class, their hockey social, their 9am lecture, and now rarely turns up to anything. Look out for your friend who seems to be in their room all the time, not answering their phone, or going out at all all the time uncharacteristically. Maybe it is something innocent, or just a phase, but you never know unless you ask.

As much as it is a cliché: you never know what someone is going through.

To conclude, I surveyed a group of people about something their friend did for them when they were struggling, that made a difference. The results were as follows:

• “I was really overwhelmed because my health hadn’t been great, and I hadn’t managed to get out the house that day. My boyfriend knew I needed PJs, so he took me to Primark and bought me new fluffy pyjamas and paid for my dinner.”

• “They took me on a day trip to St Andrews.”

• “Lasagne, lots of lasagne.”

• “My flatmate used to do tea rounds for everyone in the flat.”

• “in 1st year I was very overwhelmed with work and uni and my flatmate wrote a card for me and slide it under my door when I was at work – I genuinely sat down and bawled my eyes out when I saw it.”

• “Showing me they were there for me.”

• “Came through to my room to have a chat when I was isolating myself.”

• “Sent me flowers.”

• “Bought me a box of cakes and brownies from my favourite café.”

• “They slept with their phone next to them on full volume in case I felt bad in the night and wanted to talk.”

• “Made me a cup of tea without asking.”

• “A big hug.”

• “Took me out for food and a chat.”

Internalised Stigma

When you hear that someone close to you is suffering from a mental illness, you aren’t embarrassed or ashamed to be around them. This person you love who has the best sense of humor, who you share your best memories with, is being tormented by an invisible thing that looks to be a part of them, but isn’t. If you could, you would make it so that their brain would just behave itself because you know they’ve done nothing to deserve their illness.

And yet it is impossible to apply the same logic to yourself. We are so fortunate to live in a time when more and more people are willing to be open about their mental health, as my dad who started experiencing depression in the 1980s often reminds me. However it is far more difficult to get rid of the internalized stigma many people with mental illnesses feel. On an intellectual level you can tell yourself that you are a good person, that you are loved but mental illness is not rational. Having your internal voice telling you you’re worthless is part of the deal.

As someone who spent years refusing to acknowledge my depression, I understand just how difficult it is to overcome the internalized stigma that comes with having a mental illness. Growing up in an environment where depression was common, I felt I understood that regardless of how my loved ones felt about themselves they always deserved all the help in the world. While I would spend evenings hearing people tell me the exact same things I was thinking about myself, I was so scared to consider that I might have a problem, the thought wasn’t even allowed to cross my mind. Knowing that I felt down a lot of the time wasn’t enough to make me get help because that would force me to recognize that the problem wasn’t me, it was the illness.

When I eventually got help it was not because I asked for it. In my last year of sixth form my depression intensified as I was surrounded by people who were talking to me about my future when I wasn’t even sure I wanted one. It’s one of the worst feelings to have well meaning people tell you all about how bright your future is and how excited you should be when you can’t feel anything at all. You create an idealized picture of your future and tell yourself ‘this is good, I should want this’ but somehow nothing you do can give the words any meaning. In every scenario where I told people I was struggling, they were mad at me for being ungrateful for whatever advantages they thought I had. I was so ashamed these kinds of thoughts were crossing my mind that I thought I wasn’t worth the care of other people.

I was extremely lucky that my English teacher, self proclaimed Archbishop of Banterbury Jayson Burns, noticed something was wrong. Looking back it’s clear that if Burnsy had not noticed I was struggling, I wouldn’t be here today. At the time, I did not feel anything close to gratitude. In fact when the head of sixth form called me to her office and told me a teacher had reported concerns about my wellbeing, I felt betrayed. Reluctantly I agreed to see Pam, the counsellor, just so Mrs Hobson would stop worrying.

The first thing Pam did when I showed up for some break time counseling was hand me a form asking on a scale of 1-5 how much I related to a series of statements. This is a standard form you get whenever you meet a new counsellor. I filled it out and handed it back. While she counted it up I sat in a deep state of cringe, since I was clearly wasting her time by being there. In her signature tone I would get to know so well, she told me a total of 19/30 was the benchmark for depressive symptoms- the point at which Mind would offer you more free sessions. My score was 29/30. Apparently this meant there was something wrong.

And so it began, the most basic questions about my life triggered answers that I thought were fairly standard but made Pam’s face turn stoney. To hear her tell me that what I was talking about went beyond normal teenage angst, made me burst into tears. It was the first time I had been unfiltered about what I was going through and voicing all these irrational thoughts made me realize that my impressive score was more than just a number- it was indisputable proof that there was something wrong with me. I blamed my illness on the fact that I was a bad person. The shame only intensified when I landed a doctor’s appointment, even though my GP Dr. Rafiq couldn’t have been friendlier. Walking into the chemists with my prescription for anti-depressants in hand, I felt like a fraud. I kept watching the face of the woman behind the counter assuming she would be angry at me for hogging medication that other people clearly deserved more than I did.

Over the next year I got locked into a cycle of being referred to counseling then dropping out after a few sessions, believing that I hadn’t done anything to warrant all this attention. Each time I would reach crisis point a couple of weeks later and have to go back though the whole process again. I will never forget one occasion just after I’d got back from holiday, I started spiraling to the point where I was truly scared by my own thoughts, so I texted Pam saying that I didn't think I could cope anymore. She replied immediately, putting my mind to rest as best as she could. Within a week I was back seeing her again.

No one at any point told me I was crazy or that I was unloveable or anything else stigmatizing. When the people around me knew what I was going through, the kindness that came pouring out of them was unbelievable. Every time I’ve had a new person become close to me I’ve worried about how to tell them the reasons I act odd sometimes and it has never been a problem for anyone. All of this self loathing was as much a product of my own brain as my illness.

Getting over internalized stigma is incredibly difficult, but thinking you’re a bad person for feeling the way you do shouldn’t stand in the way of getting help. Everyone deserves support for their mental health, and you never need to worry that you are wasting people’s time or that anyone is judging you.

Lucy Adkin - Second Year - French and Russian Studies