By Jennifer Davies, Public Health Practitioner
It is estimated that 7.8% of adults meet the criteria for ‘mixed anxiety and depression’. In Telford this equates to approximately 10,296 people. But how are we meant to know when our low mood is normal or a reasonable emotional response to a difficult time, or something that we need to talk to our GP about?
It’s very important that people with mental ill-health talk to a professional like their GP so that they can receive help to manage their symptoms and recover. We also want to help people learn to look after their mental health and prevent any mild problems becoming more serious.
What both of these objectives have in common is that they require us firstly to recognise that our mental health is worse than what could be considered ‘normal’ or ‘usual’, and secondly to work up the courage to tell someone.
There are voices everywhere – charities, authorities, friends, celebrities, bloggers – telling us not to be ashamed of our mental health and to reach out when we need help. But I can’t help but feel like many are missing a crucial part of the story. How do we know when we need help?
It’s important to remember that people with mental health problems are not experiencing anything that is completely alien to everyone else. The symptoms of mental illness usually feelings, thoughts and behaviours that we all possess to various degrees.
What I mean by that is:
We all know what it feels like to be nervous – but when this anxiety is severe and stops you from doing the things you normally like to do, it may become an illness
We all know what it feels like to be sad – when low mood continues for a long time it could be called depression
We all have our routines and superstitions – when these are severe and controlling it might be obsessive compulsive disorder
We all have brains that under certain conditions (like substance misuse, fever or severe dehydration) can create hallucinations – when these are occurring without a known reason it might be considered psychosis.
So where is the line?
Unfortunately, there is no simply answer to this question because where a ‘normal feeling’ ends and an illness begins will feel and look different for everyone. There is no definitive criteria of what a mental illness has to look like or feel like. Yes, for a diagnosis a doctor will look for you to have several specific symptoms but how these symptoms will present will vary person by person and by the severity of your illness.
For some people, recognising something is wrong can be hard even when all of the symptoms are right in front of you. I put myself in this category. At the time that I was first diagnosed with a mental illness, I was studying for my master’s degree in Public Health and working in research on the side. Not to brag (ok, go on then) but I was aceing it. To the outside world I was on track for a Distinction in my degree, paying my rent, in a happy relationship and surrounded by friends. Inside, I was slowly but surely cracking up. I didn’t have what the professionals call ‘insight’ into my illness – it had crept up on me so slowly and insidiously that I barely noticed the lack of emotions and the strange thoughts let alone questioned them. With hindsight I can tell that this wasn’t even my first experience of mental illness, but it had honestly never occurred to me that something was medically wrong until a friend forced me to make an emergency GP appointment.
Whether we mean to or not we all carry around our own ideas of what mental illness looks like – I thought there was no way I could be depressed while I was being so productive. I thought depression was not being able to get out of bed or talk to anyone, and my own mental illness stereotypes held me back from recognising what was really going on. I know I’m not alone in this.
If you do recognise that you have felt empty or low, or you have been feeling anxious for a while, it’s also easy to dismiss it as just being silly. You might tell yourself that you will ‘snap out of it’ or that ‘lots of other people have it worse and I’m not as bad as them so I’ll just carry on’. This is especially true in the sad event that you do open up to someone, who perhaps isn’t very knowledgeable about mental health, and they deny that you are unwell too.
Here are some clues that you might need help:
- your ‘strange mood’ has lasted for several weeks
- your ‘strange mood’ interferes with things that you normally do i.e. leaving the house, socialising, sleeping, eating etc.
- Friends and family tell you that they are worried about you
The Catch
I also think that people, understandably, want to avoid the label. No one wants to be A Mentally Ill Person and so perhaps prefer to keep quiet and try to deal with things their own way. I don’t blame them for one minute.
But there’s a catch.
Dealing with your low mood or anxiety or any other worrying mental health symptoms on your own may not be very effective and you could find yourself only getting more and more miserable.
A Twitter follower of ours, Lynda, told me about when she first realised that she needed help. Although our experiences are not the same, there are similarities – namely fear and denial preventing us from getting help for longer than we should have done:
“Personally I knew something wasn’t right but was very frightened by my intrusive thoughts so I was in denial, and finding all manner of excuses for my behaviour. It was friends who took it upon themselves to get me sectioned. It sounds a bit harsh, and at the time I hated them for it, but you know what? It was it the best thing that could have happened to me, and shows how far true friends will go to help us” – @lynjobaggins
The other similarity I notice is the role of social support and friendships. Both of us had interventions from people who cared about us, and we were lucky to have people around us who were observant and bold enough to confront what was happening. This just emphasises the importance of having someone to talk to who you can be completely open with.
Ditch your stereotypes- there is no ‘right way’ to have a mental health problem
Telford IAPT (Integrated Access to Psychological Therapies) team work with people in Telford to help them recover from depression and anxiety through therapy. Anyone in Telford can talk to them if they are worried about their mental health and will receive non-judgmental, confidential support and will talk you through your options. They said:
“We generally say you should seek support if you have been feeling low or anxious for more than a few weeks. Sometimes we can feel low but have a reason for it such as a break up, a period of being physically unwell or a busy period of work etc. This often passes with a bit of time and self-care, but if you feel like its lingering, it might be worth checking in with a professional.” – @Telford_IAPT
Telford IAPT will arrange a telephone assessment for anyone who isn’t sure if they need support or not, and to talk through the options available. Just call 01952 457 415.
Another way of looking at how serious your symptoms are is to take some of the tests on their website: https://t.co/0vqvWvI9tZ The Moodzone on NHS Choices also has a lot of information that might help you understand what some of the symptoms some common mental illnesses are.
If you are feeling like you might harm yourself (or harm others, although people with mental illness pose a much greater risk to themselves to anyone else) you can call your GP, NHS 111 or the Samaritans on 116 123.
What will happen?
As a first port of call you will probably be advised to seek treatment from your GP alongside IAPT therapy or other counselling. You can discuss medication with your GP, something that is helpful for very many people. A small amount of people will need specialist care from a psychiatrist and a team of mental health nurses before they can get better, and a smaller proportion yet again might need to receive inpatient care. Again, it’s a spectrum, and there should be no shame associated with what level of care you need. Everyone is fighting a different battle.
My advice, as both professional and a person with lived experience, is to bite the bullet and talk. Find someone that you trust, whether it is a friend or partner or an anonymous person on the end of the helpline phone. Don’t write off your ‘strange feelings’ as being unimportant or wrong; reach out to someone who can help you figure out what is going on and help you get treatment. Except for in very specific high-risk situations, no one can help you until you ask for it. As soon as you do that, things can and will get better.
Healthy Lifestyles Service – 01952382582
Telford IAPT (Integrated Access to Psychological Therapies) – 01952457415
The Samaritans – 116123