Thoughts / cards for mental illness

A Designer (Trudy) reports on 'Picture This' (an exhibition)

Working in a marketing agency, the amount of hours I’ve racked up seemingly trawling through online stock photo libraries is a number I don't even want to admit to. An often incredibly mundane task, that no one volunteers for, and “just looking for a couple of stock photos for a client” is never an efficient job. You're usually faced with volumes of unusable, staged images, that are never quite what you're looking for.

Not long ago I got to work on some branding work for a client who worked in a specific mental illness research field, and had to undertake one of these stock image searches. Not surprisingly seeking images representative of mental illness proved to be a huge challenge and often had me disapprovingly shaking my head at inappropriate tags on images and at the search keywords I was having to use. And I found that regardless, there were not a huge number of images that came back that were representative of either the client's or the wider Australian audience's genuine interests and understanding of mental illness.

 

It’s quite refreshing, therefore, to have been able to check out the small but mighty Melbourne display of ‘Picture This’, a research project conducted by SANE Australia and Getty Images. In 2015 the project sought to survey more than 5,000 Aussies to get an understanding of what they thought was a fair and accurate representation of mental illness. The results showed that we wanted to see ‘images of real people which convey a sense of both struggle and hope.’

Based on these responses SANE Australia and Getty developed a short list of recommendations for photographers and publishers, to guide a more accurate depiction of mental illness. Listed below, the five guidelines give realistic and appropriate best practice around the way we depict, tag and search for images - consideration that would truly help the communications industry to illustrate information better and support the right conversation going forward.

Recommendation 1: Human experience

Emphasise the human experience of mental illness rather than featuring abstract depictions.

Recommendation 2: Hidden adversity

Provide images depicting people from diverse backgrounds doing 'everyday' things while also illustrating a hidden experience of adversity.

Recommendation 3: Diversity of experience

Use a diverse range of images that represent isolation or pain. For example, images such as people in the dark holding their heads in their hands or standing alone in a crowded place. 

 Recommendation 4: Search words

Tag images with diagnostic terms (such as 'postnatal depression', 'bipolar') or emotions (such as 'sadness' and 'loneliness') to make them easier to locate via online searches.

Recommendation 5: Non-violent

Do not tag or associate image depicting violence (blood, knives etc) with mental illness.

To check out the recommendations via the Picture This exhibition, head to The Atrium, Federation Square Melbourne - showing up until Friday 18 March.

 Alternatively head to SANE Australia for all the project details.

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The #complimentbombing Experiment

Well that little experiment was a bit fun! For those of you who may not follow Hope Street Cards on the social media, this weekend just gone by we got together a super wonderful crew of volunteers all across the east coast of Australia to deliver compliments. From Brisbane to Melbourne, from Byron Bay to Canberra, little cards of complimentary love were left waiting to be found in the most extraordinary of places. (For images of the experiment check out our Facebook album ‘#complimentbombing’ or search #complimentbombing on Instagram).

“I can live for two months on a good compliment” – Mark Twain.

Compliments are one of the most special components of social life. They’re like little gifts of love. They’re not asked for or demanded and they tell a person that they are worthy of notice. Such powerful, powerful gifts.

After a weekend of giving little compliment cards to loved ones, strangers and just leaving them around for people to find (fingers crossed) here’s some of the things I learnt about complimenting this weekend:

  1. Giving compliments can give our mood a burst, by giving someone else’s a lift. The aim of these compliments was to spread some cheer outwards and whilst I’m sure it had some positive effects on the people receiving the compliments as the giver of the compliments I got some pretty sweet benefits. I felt awesome.
  2. Compliments can have an incredible power on someone. My favourite thing to do was actually watch the person’s face as they read the compliment on the card (sometimes this was from my stealth hiding position. I maintain this was not ‘stalking’, but ‘experimenting’). It was beautiful. On one occasion I saw a lady who returned to her car with a shopping trolley full of groceries and a toddler who was screaming. After unloading the groceries and the toddler into the car, she saw the compliment card and appeared somewhat upset that someone had left something on her windscreen. But when she read the card her face changed from what appeared to be agony, to a face of peace and calm and then even a smile came out. The effect of the words on that little card was quite breathtaking. I nearly cried with happy feels.
  3. By giving compliments you become better at noticing and then accepting compliments. For most my life I have not been very comfortable with receiving appreciation. In other words, I am quite good at discounting compliments. If someone compliments my outfit, I’ll be sure to alert them to the fact I’ve owned it for ages, I bought it second hand and that I had to mend it and I did a dodgy job. Such a response instantly sucks the positivity out of the air and can really deflate the person giving the compliment. At worst, it has the power to totally invalidate the person’s judgment. At the very least, things become a bit awkward. But this experiment really opened my eyes to how many compliments are floating around in the world. And how easy it is to respond appropriately – graciously. With a smile.
  4. It can feel really awkward to compliment a stranger. Initially, anyway. But with a little bit of courage and practice it gets way easier and is heaps of fun. Complimenting a stranger is a wonderful way to open up a conversation and a connection that probably wouldn’t occur otherwise. Because compliments make other people feel good, they’re probably more likely to associate that good feeling with you. Thus making awkward conversation with strangers’ way more comfortable. 
  5. When you pay someone a compliment you are looking outside of yourself. This seems pretty obvious and straightforward, but sometimes it can be easy to get caught up in all the goings on of my own busy/hectic/chaotic life. Focusing on and noticing the good qualities in the world around me was like a kind of cognitive training, a training in attention. And by taking notice of praiseworthy situations and efforts I was really able to cultivate an awareness of all the good developments that were happening. And once I became aware, there were heaps. And gee whiz they made me feel nice. Furthermore, when you acknowledge something special in someone, you are looking outside of yourself. People then recognise that you can recognise goodness and in some magical way, they begin to show you more of it (or you become better at noticing it!).

So there you have it, my five big learnings following a weekend of compliment bombing. Massive, massive gratitude to our wonderful team of volunteers who helped shared the love. You all took to the task with brilliant enthusiasm and energy and we adore you all for it!

And the compliments aren’t quite over yet! Tuesday 1st March 2016 is World Compliment Day and we’re going to do our best to make sure everyone gets complimented properly.

We have 10 packs or our ‘Positive Pocket Reinforcers’ or ‘Compliment Card’ packs to give away. To win one all you need to do is head to our Instagram (@hopestreetcards) or Facebook page (Hope Street Cards) and tag someone you know on the link provided with a compliment. The competition will be open all day – Tuesday 1st March. The authors of the ten most wonderful compliments will each receive a pack of cards to continue their complimenting adventures.

Happy World Compliment Day!

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The Hippo that Acknowledges Frustration

We made another card! It’s a card for anxiety disorders and this is what it looks like:

This card wasn’t born out of any clever psychological theory or any observed societal need. It was born out of the honest truth that when someone is experiencing a mental illness it can be really, really frustrating, sad and scary at times. And I’m not referring to the person who has the illness. I’m talking about everyone around them. This card was written for the card givers. (In the hope they’d still give them away to others).

Finding out that someone close to you has a mental illness can lead to any number of feelings and these feelings can have a serious emotional impact on you. Some loved ones might struggle to find a reason for the illness and wonder if they are in some way responsible, leading to strong feelings of guilt. People might feel angry and frustrated that this is happening, that the illness has become a dominant focus of life and disrupted the normality of the family or friendship group. It can be normal to feel confused as to what the hell is going on and what in the heavens this means. A lot of people report feeling a significant sense of loss and grief. It can be possible to begin grieving the loss of the relationship as it was and the life you had, the opportunities and plans that have now changed and to feel overwhelming sadness as to how much the person that they really, really love has been changed by their illness. Mental illness is still a stigmatised condition and for some people they might feel embarrassed or ashamed about what others might think of themselves and their loved one. And it’s scary. Loved ones are particularly likely to worry about what might happen to a person with a mental illness and if they will ever get better.

This exhaustive list of emotions is shit. But all of these, or a combination of a few, is a pretty common and normal experience for loved ones to go through when someone close to them has been diagnosed with a mental health condition.

As a supporter of someone with a mental illness, it’s really, really, really important that you acknowledge and talk about these feelings. Whether that’s with your own friends and family, a mental health professional or a support group. Acknowledging these feelings is the first step towards resolving them. It is important to understand that neither you nor the person with the mental illness are to blame for any of these events or feelings. They just are.

And with this in mind, I wrote this card. The aim was for the supporter to be able to say “OMG, this is just so shit. I am feeling awful and I know you are probably feeling worse and I just wish by magic it could all go away and we could go back to how it was”. But in a way that wasn’t going to make the person with the mental illness feel more guilty/alone/afraid/insert awful consequence of anxiety here. (Obviously I tried to keep it a bit upbeat/empathic/loving).

Because if you, as the supporter, can acknowledge and move past these common, yet horrendously awful and possibly destructive feelings and develop a more positive attitude, you’ll be able to be such a wonderful support for your friend or family member with a mental illness.

And really, really nice feelings can come from supporting someone too. So many people reflect on how their love for their friend or partner or relative deepens and a closer bond develops as they venture through experiences such as this. The new relationship you form with your loved-one can bring growth, deeper connections and learning for you both.

You can find the card here.

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Power and Recovery

Dr M said a while ago – “People who have gone through recovery are very powerful”. And I would have to totally agree. It got me thinking though, where is it that that power comes from?

I think/hope it’s reasonably well known by now that there is no quick fix or stand alone cure for mental illness. Instead what we aim for - for ourselves and for our loved ones - is ‘recovery’.

This in itself can be a bit confusing. When we are physically unwell we do all we need to do in order to recover. We go to the doctor, we take the medicine, we get the physiotherapy or the surgery or the rest or the whatever it is we need. We can see and feel the results when we are recovering and they are obvious to others as well. From my understanding, in the medical world, recovery generally means cure or no current symptoms.

To add to general life complexities, in the psychiatric world the concept of recovery is not about being restored to your previous health. Indeed, it could be argued that nobody returns unchanged to a prior state after an event. We are changed, if not in the objective sense, certainly in the experiential sense and how we see the world. As such, mental health recovery does not always refer to the process of complete recovery from a psychiatric condition in the way that one might recover from a physical health problem.

For many people, the concept of recovery is about staying in control of their life despite experiencing a mental health problem. Recovery can be described as a process of change through which people improve their health and wellness, live a self-directed life, and strive to reach their full potential (SAMSHA, 2011).

Recovery is "a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness" – William Anthony, 1993.

So, just because the illness isn’t there anymore doesn’t mean the battle is over. I remember very clearly when Dr M and I were discussing my current state and experience well over a year ago and he cheerily said “Well, you’re not clinically depressed anymore.” I nearly cried. I was bordering on devastation. There was no celebratory dance for no longer meeting DSM-V criteria for a current psychiatric condition. No, I was upset because whilst I was not technically “unwell”, I knew I still had a really, really long way to go. I was in recovery again. And I knew what I was in for.

This wonderful picture explains recovery from a mental illness perfectly to me:

(Source: Anna Borges, Buzzfeed)

Recovery is messy. Really, really messy. And hard. Really, really hard. And time-consuming. And a bit shit. For me, the process has felt like trying to walk up a really steep hill on really unsteady legs during a cyclone.

And why wouldn’t it? I was in the process of building a meaningful and satisfying life, with the threat of recurring symptoms or mental health problems. The evidence suggests, the key themes of recovery are:

  • Agency: Gaining a sense of control over one’s life and one’s illness. Finding personal meaning, an identity which incorporates illness, but retains a positive sense of self.
  • Opportunity: Building a life beyond illness. Using non-mental health agencies, informal supports and natural social networks to achieve integration and social inclusion.
  • Hope: Believing that one can still pursue one’s own hopes and dreams even with the continuing presence of illness.

So what does recovery look like in action? I think this is what we’ve got so far. Diagnosis is helpful, but just because a person no longer is identified as a ‘patient’, doesn’t mean there’s not still work to be done. The development of resilience might still be required to meet the challenges of life. Also, based on the definition there is more than one road to recovery and treatment is just one route amongst many. Sure there are a lot of well researched pharmacological, psychological and social interventions widely available, but there are a lot of ways forward here. And possibly most importantly, the best judge of recovery is the person directly affected. How could anyone else possibly comment or judge on whether another individual is living the life they want to lead? It’s impossible.

Personally, the thing that I have been most surprised about is that recovery is not all bad. I knew back when I was beginning recovery that I would probably not get my previous life back – because, really no one can go backwards – but I didn’t expect to have such a mixed reaction to it all. I would never, ever in my wildest dreams wish the experience of a mental illness recovery on my worst enemy, yet I also wouldn’t ever want to wish my own experience of mental illness recovery away. My recovery has helped to create a more meaningful life than I have ever had. It feels pretty powerful. And I’d never, ever wish that away.

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Hello Compliments!

Say a big ‘HELLO’ to our brand new product! The ‘Positive Pocket Reinforcers’. These are handy little cards with compliments ready to go. You can keep the compliments for yourself, deliver them to a loved one or hand them to a total stranger.

 

And, why would you want to hand out compliments? There are a few reasons and I’m more than happy to sell them to you.

The first reason is Pavlov and his dogs. In operant conditioning (the psychological theory brought to life by Dr Pavlov and his experiments on dogs) positive reinforcement involves the addition of a reinforcing stimulus following a behaviour that makes it more likely that the behaviour will occur again in the future. Positive reinforcement relies on the belief that when a favourable outcome, event, or reward occurs after an action, that particular response or behaviour will be strengthened.

Parents are often really good at positive reinforcement. When a very young little man mouths the word “poop” and then points to the potty for the first time, prior to relieving himself, the happy dance, kisses and hugs from his Mum are beautiful displays of positive reinforcement. Chances are he will now repeat that behaviour over and over given how exciting his Mum’s reaction was.

Compliments are another example of positive reinforcement. I think compliments are one of the most extraordinary components of social life. A compliment can create so much positive energy around two people that things can then move forward as if by magic. We can also imagine compliments as little gifts of love. They’re not asked for or demanded and tell a person they are worthy of notice. Powerful, powerful gifts.

Compliments are such powerful gifts and positive reinforcers that research has recently found that they can improve performance in a better way than receiving a cash reward can. In a recent study adults were asked to learn and perform a specific task on a keyboard. One group of participants received individual compliments on their performance from an evaluator, another group involved individuals watching another participant being complimented and the third group evaluated their own performance on a graph but were told improved performance would incur a monetary reward. When the participants had to repeat the task the next day, the group of participants who received direct compliments from the evaluator performed significantly better than participants from the other groups. Ha! Scientific evidence that receiving a social reward like a compliment is better for performance than money! Wowsers.

Selling Point #1 – These compliment cards could make your own or someone else’s daily performance better!

Secondly, these cards are closely linked to the emotion of kindness. And luckily for us, mammoth amounts of scientific studies have shown that one of the most significant ways to improve one’s wellbeing and life satisfaction is to engage in acts of kindness and prosocial behaviour. And these effects occur regardless of whether you are the giver, the receiver or even just the observer of the act of kindness – everyone reaps the rewards!

Kindness has been shown to result in an increased production of serotonin in the brain. Serotonin is the naturally occurring neurochemical that has a very calming, soothing and comforting effect on us. It helps regulate our mood and reduces our anxiety and generally makes us ‘feel good’. This is the mechanism of action in which a lot of anti-depressant medications work as they limit the reuptake of serotonin by the brain which helps to alleviate some symptoms of depression. So engage in an act of kindness and say hello to activation of the feel good pleasure centre in the brain! And this increase in serotonin happens to the giver, the receiver and the observer. That’s a win-win-win!

Selling Point #2 – These compliment cards will activate the magic pleasure spot in the brain and make everyone feel good!

Quite naturally we feel good when we give, help or serve others, a phenomenon called the ‘helper’s high’. This ‘high’ has been described as a feeling of exhilaration and burst of energy similar to the endorphin-based euphoria experienced after intense exercise which is then followed by a period of calmness and serenity.

Selling point #3 – Reap the benefits of exercise without actually exercising by giving someone a compliment card!

And there are physical benefits too. Research has shown that those who routinely engage in acts of kindness, such as volunteers, experience alleviation of stress, chronic pain, and even insomnia. Dr Christine Carter notes that:

“People who volunteer tend to experience fewer aches and pains. Giving kindness to others protects overall health twice as much as aspirin protects against heart disease. People 55 and older who volunteer for two or more organisations have an impressive 44% lower likelihood of dying early – and that’s after controlling for other contributing factors like physical health, exercise, gender, lifestyle habits and more”.

Selling point #4 – Buy our cards + Distribute = Live Longer!

So there you are. Some proof that sending some complimentary love either to yourself or someone else could have some really abundant effects – feelings of joyfulness, reducing negative feelings, diminishing the effects of diseases and disorders. Surely that’s plenty of reasons to give them a go!

Oh and did I mention they fit snuggly in your pocket? How handy!

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Hope Street Cards Book Club - January

Welcome to the ‘Last Wednesday Book Club’! It’s our very first meeting and this gathering probably would have started better had I properly invited you along or given you full notice in advance. But we will continue.

Here’s the down low. ‘Last Wednesday Book Club’ is new to Hope Street Cards for 2016 and what it will involve each month is me posting a blog reviewing a book which in some way discusses issues related to mental health or mental illness. It might be a self-help book (not to be scoffed at – some are actually helpful), a memoir or autobiography (we will NOT be reading anything related to Ben Cousins), it might even be a textbook of sorts. Each month I’ll let you know the book we will be reading for the month and if you wish, you can join in. And due to the powers of the Internet you can join in in the most wonderful ways. You can submit your own review by commenting on the blog, you might choose to leave your thoughts on our Facebook page (Hope Street Cards) or you might like to tag really lovely photos of you reading the book to our Instagram account (@hopestreetcards) or with the hashtag #lwbc. Again – how wonderful is the Internet?

So, I will know channel my inner Jennifer Byrne and kick it off. This Month I read Sane New World: Taming the Mind by Ruby Wax.

For those who haven’t come across her, Ruby Wax is/was a British comedian who apparently used to interview a lot of celebrities on the tele. As she discloses in the book, at one point she was involved in a television series where she interviewed people in their homes who were experiencing mental illnesses like OCD, depression and PTSD. Interestingly at this time she was also an inpatient at a (very nice) private psychiatric facility and would return to the hospital post-interview to receive treatment for her own depression. Following this, Wax began studying psychotherapy before going on to Oxford University and completing a Masters in mindfulness-based cognitive therapy in an attempt to understand the neuroscience behind her own experience of mental illness.

The book is split into four parts. The first part is a subjective look at depression and Wax’s formulation for why we are all “mad”. She moves on to make a compelling case for how certain “normal” human thought processes and behaviours were incredibly useful to the average hunter-gatherer – and how they’re not so well suited to the ins and outs of everyday modern life. The third section looks at the ways in which the brain controls and balances our emotional lives. There’s information about the structure and the function of different parts of the brain, and an outline of some of the better known neurochemicals. And in part four of the book she explores mindfulness – the practice of focusing one’s attention and becoming aware of one’s experience – and its use in self-regulating thoughts and emotions as a means of dealing with mental health problems. Replete with exercises that aim to put in practice the art of mindfulness, the book encourages readers to reconsider the way they deal with and think about their emotions and thoughts and ultimately the ways we can retrain our brains to improve our health and happiness.

I don’t really know how to write a book review. I was in a book club once before but it seemed as if our main priority in that club was reviewing the food available. So, I’m going to do this review motivational interviewing style, because that I know how to do.

The good things about this book:
• This book is really quite funny. Despite a lot of banging on about how most of society is really gloomy, Wax makes you laugh out loud. Whether it’s describing her Nazi-escaping parents (“child rearing was not their specialty”) or explaining the complex issues surrounding the evolution of human brains: “Millions of years of natural selection, and this is what we’ve come to. We want to be the most famous, the richest, the thinnest and the busiest. Darwin would shit himself in his pants”, you can't help but chuckle.
• The part of the book where she talks about the brain – the development, the structure, the way it works, the important neurotransmitters – is brilliant. Really well researched and informative. And because she brings in her humour, there’s a chance you’ll actually remember some of it. I really wish I had have been able to use this book to study for my second year undergrad neuroscience subject at Uni. The text I tried to rote learn was dull in comparison. Can’t remember a single thing. The diagrams in this book were also very good.
• In terms of celebrity memoir (of which there is quite a bit) it’s not too over the top or narcissistic or irrelevant here. That seems to happen with celebrity memoirs. A lot.
• Because of her inherent sarcasm and almost cynicism about the world around her, that Wax has faith in mindfulness practice adds further to her argument for neuroplasticity and mindfulness practice. For example, she scorns books that give 200 pages of advice “that boil down to ‘Think happy thoughts and your dreams will come true, just like Tinker Bell promised’”, yet she’s ultimately providing us with a 'self-help' book of sorts. And she puts in a lot of evidence-based research to support her theories.
• For a ‘self-help’ book it’s pretty brutal and honest. When outlining the predicament of the minds of all of western civilisation in part one there’s not much sympathy. In a nutshell, Wax sees us all as pretty stupid. And that was quite refreshing for a book of this genre.
• The overall message is one of hope. And this message is supported by the science. That we can change the way we think and improve our responses to things like depression and panic and feeling crap. Or as Wax puts it, “the brain is like a pliable 3lb piece of Play-doh, you can resculpt it by breaking old mental habits and creating new, more flexible ways of thinking”.

The less good things about this book:
• I can’t really figure out who this book is for. I think she thinks it’s for everyone, however it would be very difficult to read if you were experiencing a mental illness or in early recovery. The first part in particular is very heavy on the doom and gloom. If it’s for people who are functioning, however haunted by the “nag-nag” voices then it might be worthwhile. But then the parts regarding Wax’s own experiences with depression might make it feel less relevant. Still stumped on this one.
• It’s really quite a tiring read. And I don’t think it was the content, with all the brain information , research etc., that made me tired. It was all the quick sentences and punch lines and exclamation marks. It’s written in a very similar way to how she speaks on a comedy tour. And I found it a little relentless and exhausting. It was hard to read before going to bed. The irony of it all is that she’s writing at such a frenetic pace, yet telling us all we should all slow down.
• It might be funny (for some people), but I don’t think there’s anything to be gained by using terms like “mad” and “crazy” and “inmates” to describe oneself or other people. Nothing at all. We have so many other words at our disposal, yet Wax almost incessantly sticks to stigmatising mental illness language. I think it’s unhelpful. I’m not going to bang on about why it’s unhelpful. Now, anyways. (You can find one of my rants about it here though).

So, that’s my review. Overall I think it’s pretty good. And my take home message was if we don’t start paying attention to what’s happening in the present, we’ll miss it all. And that will suck.

If you’ve read it and have opinions get involved and let me know them. If you haven’t read it, but have opinions on my opinions get involved and let me know.

Next month I’ll review The Anti Cool Girl by Rosie Waterland. Last Wednesday of February. Happy mental health reading!

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Sending empathy, love and hope

Feedback from the ground (that’s you guys!) is that, buying a card for someone who is experiencing a mental illness is one thing. That perhaps is the easy bit. But writing and sending a card for someone experiencing a mental illness is a whole other story. This perhaps is the not so easy part.

Totally agree my friends. I still get a bit nervous or worried when someone I really like in my life is unwell. What can I say? Will I say the wrong thing? Will I be unhelpful? All valid points, thank you critical voice in my head. But do you know what’s probably worse? Knowing someone is unwell and not doing anything at all. Just pretending it’s not there and ignoring it all together.

Whilst everyone is unique and ultimately you know your loved one much better than me, here is a list of my general tips to fill in the blank spaces of your cards with compassion, empathy and hope.

  1. Try and use statements that show you recognize that your loved one is unwell. This is called validation. Validating someone’s feelings and their illness rather than shaming, questioning or trying to analyse it can make a difference. Statements such as “That must be very hard for you”, or “You are important to me. You matter to me and so do your feelings”, can be very comforting for the person experiencing a mental illness and has the potential to relieve them from some of the shame they may be experiencing regarding their experience.
  2. Often when people are experiencing a mental illness their brain is being a total bitch. In a nutshell it can really attack the person from the inside, skewing their perception of themselves and the world around them. This is an excellent opportunity to bring them back to reality. Or try anyway. Pay your loved one some compliments. Remind them why you really, really like them. For example, “Please don’t forget that I think you are a kind/ generous/beautiful/insert-nice-adjective-here person to be around.” If you’re loved one is very unwell they might not believe it 100%, but it’s never harmful to hear these things. 
  3. Let your loved one know that you’re not going anywhere. And then don’t go anywhere. Everyone fears abandonment on some level, but often the experience of mental illness can be particularly isolating and lonely. As someone who has had a mental illness, or three, the fear that people are not going to stay around for much longer as a result of being so unwell was a real and significant fear. Who would want to hang around someone who hasn’t been able to wear anything but tracksuits and leave the house in a week? If you can say “I am here for you and I’ll be hanging around too”, this might just bring a massive sense of relief to your loved one.
  4. Ask your loved one what you can do to help. The key word here is ‘ask’. This is important because it shows your loved one that you’re ready to assist them in their way. When they’re ready.
  5. Remind your loved one that what they’re going through is really tough and they are doing an excellent job. Something along the lines of “Be kind and gentle with yourself. You are doing the best you can”, is realistic and factual, but probably the kind of feedback that your loved one is not giving them self right now.
  6. Provide some statements of hope. Unfortunately mental illness often comes with other friends attached. Friends like hopelessness and helplessness. If you can provide some realistic words of encouragement and hope it might slightly lessen the impact these friends are having. Statements like “You can get through this experience. I believe in you”, can let your loved one know that you are hopeful for them, even if they are unable to be right at this minute.
  7. Write about a ridiculously silly and incredibly funny story. Sometimes when people are experiencing psychological pain they need something to laugh about. And just because they have a mental illness does not mean they have lost their sense of humour. When I was in hospital my sister used to send me ridiculous photos, texts, emails and updates about her day. Like how many biscuits she’d eaten. The sheer ridiculous of these frequent daily updates (and the phenomenal number of biscuits she could consume in a work day) eventually bought me to belly laughs.
  8. Tell them you love them. Do this repeatedly. This is probably the simplest, best and most important thing you can do.

These things can all be hard to say – or write – but if you can find something that comes from love, acceptance and empathy I think you’ll be right. Remember, they’re still just that person you really, really like. And if they’re experiencing a mental illness they’d probably really love to hear that from you.

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Chatting and dreamin'

I had the most beautiful conversation today.

It came from the pleasure of lunching with two of my favourite human beings. Whilst this is a reasonably regular occurrence, special shit went down today.

These two friends have been having some difficult times of late. One is experiencing symptoms of a mental illness and undertakes outpatient therapy and has begun taking prescribed psychiatric medication. The other has started seeing a psychologist for support with managing the effects of someone close to her experiencing a mental illness.

Now there’s nothing beautiful about the situations my friends are in. Both of their experiences have been difficult to watch. It’s so incredibly hard to see your loved ones in distress. And unfortunately neither of these situations is uncommon. Nor are these things are easily fixed. It’s a continual adventure of gains and setbacks.

But at lunch today, I took a moment just to observe what was happening. And it was divine.

We were all discussing aspects of our emotional health with vulnerability and honesty and openness. And there didn’t appear to be any shame involved. We didn’t feel the need to lower the volume of our voices, in order to hide our experiences from those around us. We offered each other advice and support with compassion, empathy and love. We felt safe. We discussed our own experiences of therapy and referred to each other’s therapists by first name. We came up with hypothetical conceptualisations and formulations of our own and other people’s behaviour. And my non-mental-health-professional friends used psychological terms fluently, sporadically AND correctly. Terms like “co-rumination” and “validation”. As I mentioned – divine.

There’s so many things that are special about this. Firstly, and most importantly, these two loved ones have acknowledged that they value their mental health and have been brave and courageous in asking for help and professional support. And my hypothesis on this, is that with time, they’ll reap the rewards. Secondly, I didn’t feel one little bit guilty. Guilty about burdening others with my emotional issues. Thirdly, it was so very, very easy to talk about these things. We switched between the achievements of potty training to our mental health to illegal internet browsing at work without any hesitation at all. And I think it was easy because we came from a place of love. We were open and honest and discussing these things in a place of no judgment.

Even though I reasonably regularly have conversations about my mental health with my loved ones, the frequency of these conversations is still rare. I’m so glad I took that moment to observe this experience in all its beauty, because otherwise it might have just passed us by. We’ve probably had other lunches just like this and I've probably had other conversations on par with this, but just not noticed how special it was at all.

So my dream is that all – okay, I’ll go with most – conversations about mental health are like this. Filled with honesty, love and empathy. Devoid of shame, judgment and fear. My dream is that conversations like this don’t just occur between three really close friends. But occur between friends, colleagues, acquaintances even.

Imagine if you could run into a distant relative down the street and when they asked how you were, you could explain that actually you’ve been experiencing some panic attacks and they’ve been quite horrific and you’re really struggling, but you’re seeking some assistance from a professional. And you’re not scared or ashamed to do that. Because the basic human reaction that you’re expecting is compassion and love and support.

Wouldn’t that be divine? I hope it happens in my lifetime. I’m so glad the conversation I had today did.

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A new depression card and another man's dogs

You may not be able to immediately tell, but this brand new card comes from dogs.

Pretty much everyone has heard of Pavlov. And his dogs. But there’s another important psychologist who had dogs too. And he didn’t treat them all that well.

In 1965 Martin Seligman began electrically shocking dogs in an attempt to expand on the research of Pavlov - the genius who could make dogs salivate when they heard a bell ring. For nerds, he was the brains behind ‘classical conditioning’.

Seligman’s study involved fear and learning. To condition the dogs when Seligman rang his bell, instead of providing the animals with food, he zapped them with electricity. And to keep them still, he restrained them in a harness. It was predicted that the dog would learn to associate the bell with the shock and then in the future (when released from the harness) the dog would feel fear when it heard the bell. And that fear would cause the dog to run away or show some other signs of mild panic when the bell toned.

Following the conditioning/bell-electric-zapping-time, the dogs were put back into a box with a small fence dividing it into two halves. It was expected that when the bell rang, the dog would jump over the fence to escape it. It didn’t. The dog just sat there and copped it. When they shocked the conditioned dog without the bell, nothing happened. Again, the dog simply lay down and took it. Interestingly, when the researchers put a normal dog into the same box contraption, when zapped it immediately jumped over the fence to the other side to escape it.

Unfortunately for some people who experience depression they are just like Seligman’s dogs. I know I was.

Like the conditioned dogs, who had learned more than the connection between the bell and the shock, some people with depression may believe that escape from possible shocks is futile. In other words they have somehow learned to be helpless. According to Seligman, people experiencing depression may feel that whatever they do will be futile and that they have no control over their environments. This is called ‘learned helplessness’.

Seligman proposed that individuals who - over the course of their lives - had experienced defeat or abuse or loss of control, learned over time that there was no escape. To the point that if an escape was offered, it wouldn’t be acted upon. Initially this theory didn’t really explain how people who hadn’t experienced negative life events ended up going on to experience depression, so Seligman added in some important cognitive or thinking style components.

Studies of people with depression reveal that when these people fail they often will give up and stop trying. Whilst most people will look for external reasons and factors to explain failures, people experiencing depression will hold much stronger views – “It’s my fault”.” I’m stupid.”

Imagine having to carry these thoughts around with you – constantly - whilst feeling – constantly - shit and sad. It’s not then hard to imagine that an extended period of these feelings and thoughts could lead you to giving in to despair and accepting this as reality. Learned helplessness is very closely linked to a loss of feeling in control.

In 1976 Langer and Rodin found that in nursing homes where conformity and passivity is encouraged and where every patients need is attended too, the health and wellbeing of patients’ declines rapidly. In contrast, the patients in nursing homes who were given choices and responsibilities remained healthy and active. This research was repeated in prisons, finding that if inmates were able to move furniture around and control the television this kept them from developing health problems.

When someone is experiencing depression, there’s a strong possibility that feelings of helplessness might begin to occur and may become totally overwhelming. Making small choices and achieving daily tasks, like getting dressed or having a shower, are the things that can hold someone back from the crushingness of learned helplessness. And for someone with depression these tasks are not just tasks, they are massive fucking achievements. When you can succeed at something small, harder tasks might feel more possible. But if you don’t notice what you’re achieving, everything will seem too bloody difficult and useless.

Remind your loved one that you can unlearn learned helplessness. Don’t let them give in to it yet. Celebrate ALL the achievements.

You can find the card here.

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