An Unwinnable Tug Of War

Continuing on from my last post, I’m really struggling to climb back out of the pit I currently find myself in. My mind is full of unending doubts and negative assertions, and my body is in a constant state of anxiety. Time seems to drag, and my goal each day is to reach nighttime where I can sleep and find temporary respite. I’ve been dreaming a lot more than usual recently, and have found that these nightly imaginings are formed of idealised life events or pursuits: developing a relationship and ultimately having a family, being with friends and feeling like I belong, and being a child again with all the potential ahead and none of the burdens. Whilst these are pleasurable to engage with, the disappointment upon waking and realising they are not real brings with it a great sense of sadness.

The thing I’m finding most challenging is the persistent tug of war of that is occurring… on the one hand I want to be on my own and shut myself away from the world, whilst on the other hand I feel desperately alone with a unwavering worry that I am alienating my friends. It’s the biggest challenge of the illness, as there are so many contradictions, and conflicting emotions. Balancing a desperate need to reach out to people, with a heartfelt desire not to alienate those same people by being too full on, is a constant source of mental disharmony. When I’m at my most down I sometimes message people with perhaps a little too much honesty about how I’m feeling, and if I subsequently read into this that I may have upset someone or made them feel uncomfortable, then it only leads to more worry and anxiety. Unfortunately I can’t prevent this need to reach out.

It doesn’t help that the NHS ended my therapy last June before I felt I was ready to finish, and after consequently being re-referred by my GP, I haven’t heard anything from them for over 8 months. To say that I’m frustrated by this is the understatement of the year. I went back to the doctor today, to chase the re-referral for a fourth time, and his response was ‘oh, you should have heard something by now’. Thanks, that’s really helpful. With hope already funneling it’s way out of my body like sand through a sieve, this lack of purposeful help from the doctor does nothing to help curb the flow, and in fact just makes the holes in the sieve bigger, and the rush of sand quicker. If the very people who are supposed to help you cannot or will not, then how are you expected to carry on?

I’m going away for a few days now, which may present a chance to reflect. My worry is that it will only act as a temporary respite, and that the knowledge that I will be returning to the darkness very soon will be a burden. That’s assuming it doesn’t follow me away, which it has a devilish tendency to do. Whether it follows, or merely waits, I find myself running out of ways to deal with it, and lacking the  energy to go on fighting the good fight.

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In The Waiting Line

The National Health Service is one of Britains’ greatest achievements, and an establishment that we undeniably take for granted on a daily basis. We are incredibly lucky to have it, and would miss it severely if it were to disappear. It’s an institution, a pioneering organisation, and doesn’t prejudice between people from different backgrounds, creeds, wealth groups or ages. But despite this, it is deeply flawed when it comes to treating mental health, and that needs to change urgently.

This inadequacy comes in two areas; speed and quality of service, both of which I have first hand experience of. The time taken to receive therapy or counselling is ludicrous. Last year I waited about 9 months from referral to my first appointment, which is utterly unacceptable. In that time the mental health of an individual can deteriorate severely, and therefore this wait is deeply troubling as it doesn’t seem to have the best interests of the patient at the forefront. I realise that its impossible for everyone who is referred for therapy to be seen immediately, but 9 months is too long for an illness that at its worst can make you feel unable to function or see any hope of getting better. You wouldn’t say to someone with cancer or a broken leg, ‘unfortunately you are going to have to wait 9 months for treatment’. It again highlights the lack of education around mental health, as well as a significant shortfall in funding for an illness which at the end of the day, can be a life threatening.

This article from the BBC News website shows the stark reality of waiting for mental health treatment, in this case in Wales. “In north Wales, Betsi Cadwaladr University Health Board patients can wait up to 26 months’ and ‘ At Hywel Dda University Health Board, current waits are between 54 weeks for cognitive behavioural psychotherapy and 119 weeks for psychodynamic therapy” Admittedly those are the worst case scenarios, but as my own experiences can attest to, 9 months is a perfectly typical waiting time, and in my opinion, this is disgraceful. As touched upon, these long waits can cause a deterioration in the patient’s mental health, due to the frustration and anger at the perceived lack of support available. Personally I have felt during these lengthy periods of waiting that there is no one to turn to, or nobody that can help me, and this contributed to a further downward spiral of feelings and emotions.

The other major issue is that most GP’s are relatively ignorant of mental health, perfectly willing to just put you on any old antidepressant and suggest that you “see how you feel in 3 months time”. Then if there has been no change they just increase the dose for another 3 months, and so on, until before you know it a year has passed, and you are no closer to feeling any better, or getting to the route of the problem. All this waiting is remarkably demoralising, and time is something a sufferer of mental health doesn’t necessarily have. It’s one of the few illnesses where time isn’t necessarily a healer. I actually visited a doctor once who had to get out a catalogue of medications and browse it to find one that he could suggest. When I asked him about its benefits, side effects etc, he just read them out from the book. This didn’t fill me with any confidence whatsoever, and he may have well just opened his laptop and typed ‘how to treat depression?’ into Google. Similarly another doctor responded to my plea for help with the suggestion  ‘why don’t you do an activity that you enjoy doing’. Really? Is that the advice that you have garnered after 7 years medical training? Besides that being one of the worst and most patronising comments to say to a person suffering with depression, it surely also shows a complete lack of understanding of the illness, as well as an inability to offer any meaningful medical advice. If it was as easy as getting a hobby, or doing an activity you enjoy, then depression wouldn’t exist. I came out of that appointment feeling utterly helpless and lost, thinking that if a GP couldn’t help me, then what hope did I have?

I’m not proposing the notion that the NHS doesn’t offer any support, but simply that it takes far too long and is not nearly thorough enough. A lucky few are able to engage in private healthcare, but the majority of people only have the NHS as a viable option. I realise I’m biased in this as its such a personal and emotive issue, but I suggest that a significant amount of money needs to be thrown at mental health, as well as training many more specialised metal health practitioners. We are at a pivotal point, with admissions for mental illness treatment increasing, and consequently the next 10 years are crucial to tackling the problem before the damage becomes irreparable. Around 90% of people who take their own lives have a mental illness, and if we have any hope of bringing this rate down, we must tackle the methods of treating the illness, and ensure that it is given a priority status. One of the core principles of the NHS was to ‘meet the needs of everyone’, and quite frankly this isn’t being done. The only way we can achieve this is by raising awareness, shouting from the rooftops if necessary. Elizabeth Wurtzel said: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key.” Lets find that key, and lift the fog, before its too late.