Eating disorders
Biggest myth: Anorexia nervosa is the only eating disorder
Facts: eating disorders include anorexia nervosa (starvation), bulimia (forced vomiting) and several other conditions.
True story: Growing up I had always had a funny relationship with food, always trying out new diets and reading up on what I should and shouldn’t be eating.
But six years ago I hit rock bottom. I was admitted to a mental health adolescent hospital.
My hair thinning, my skin a yellowy colour, I stood in the entrance with my suitcase as my Mum dropped me off. For the first time in years, the anger disappeared, tears streamed down my face and I was absolutely terrified. I pleaded with Mum to let me come home and promised I would eat but it was too late.
I don’t know where I lost control. Was it when I was attending Child and Adolescent Mental Services (CAMHs)? When my exercise became compulsory? When I began to lie about what I was eating and where I was going? Was it when I realised I would rather be dead than fat? Or when I was too afraid to go out for dinner or eat anything because of the fear I would put on weight?
At the hospital, I had barely dropped my suitcase in my room when the hard work started. The snacks, the meals, the bed rest, the group work - every day merged into one long battle to fight my anorexia and get out of hospital so I could start living my life.
Throughout my whole childhood my relationship with food wasn’t right. In my mind if I ate, I would put on weight. But this equation only related to Hope Virgo, no one else. I had learnt this equation as a child and it had stuck with me. I had to completely relearn the importance of eating. I had to learn to remove all feelings from the food and then talk about it once I succeeded with eating something.
_As the days in hospital turned quickly into months, my weight went up. I felt like the physical problems were changing too quickly and my mind wasn’t keeping up. When I first started my recovery I had to take every day as it came. If I thought too far ahead I panicked or I would become preoccupied with obsessional planning of exercise and when I could miss a meal. _
_When I was in hospital I never thought or knew recovery was possible. I never imagined a day not governed by calories or feeling like a beached whale. I was curious about how people got through a day with eating without calorie counting. _
But now six years on am I fully recovered from my anorexia? To people looking on, they see me as a normal working girl in my twenties. Living in London, a healthy weight, training for a marathon, and someone who enjoys healthy food. But to me and those closest to me, it is not always that straightforward. To those around me they worry about me running a marathon, they worry I will become obsessed with food and exercise again.
_And yes, some days I still wake up and feel huge and completely unhappy with myself. I have moments when I panic at a meal time and frantically try to add up all the calories on my plate. It still scares me when this happens, but I do feel in control of it and able to manage myself with it. _
_People need to start understanding more about anorexia, and mental health problems. Just because someone doesn’t look physically unwell, doesn’t always mean they are okay. This year, everyone needs to take more time to listen to those around them if they want to talk and make sure they offer support when needed. I am six years in to my recovery from a mental health problem, completely physically healthy, but this doesn’t mean I am always okay with it - I just feel confident with where I am in my recovery that I can fight it. _
Bipolar disorder
Biggest myth: people with bipolar disorder have constantly unstable emotions
Facts: people with bipolar disorder often vary from highs of feeling on-top-of-the-world (mania) and rushed to lows of depression and feeling sad.
True Story: Since I was about 18, I’ve suffered with mental health problems. I went to see the doctor and was diagnosed with depression but sometimes I’d feel a bit ‘high’. My friends and family didn’t really know much about mental health or illness so when I‘d go a little wild they’d just think
That’s Gwen just doing a Gwen
And then when I was about 25 I was diagnosed with bipolar disorder. Around the same time, someone close to me died by suicide and that caused me even more mental distress. I was having rapid cycling through emotions and had mixed bipolar episodes and I was on so many tablets. At the time I was also self-harming.
So I decided – because I was so ill and didn’t really understand it – that I would research into mental health and illness myself to try to make sense out of it all.
_Through researching, I discovered how to manage my illness that I will I have for the rest of my life. And what I discovered helped were things like eating healthily – no one ever wants to hear this – but, eating healthily, exercise, practicing mindfulness and meditation. And I can remember the first time I heard that I thought that sounds a little hippy’ _
But it really works and it helps if my mind is racing or I’m feeling stressed in work, or just in life in general.
I used to be a secondary school teacher but when I was ill, around 2013, I had to stop teaching. I couldn’t continue as I was. But by that point, as I had been researching for 2 years, I applied for a job working in mental health and now I have the honour of working in the mental health sector and I find that helps me, too, with my condition.
Because…I can help other people now.
Because of the research, I did…
Because I know what it’s like to feel mentally unwell and what it feels like to have people not understand.
It’s a privilege to be able to educate and train people so that they understand.
If they are suffering themselves, or it’s someone they know, I can help inform them and help get rid of the stigma surrounding mental health problems and that’s very important to me.
So that’s my story and hopefully it will be of help to somebody. It’s just very important, I think, to get rid of the stigma. Everyone suffers from the flu or something at some point in their lives. Everyone at some point will suffer from some type of loss or a heartache.
It’s vital to take care of our mental health and I feel very fortunate to be able to help others and I feel very lucky that I have that understanding now.
So: research, eat healthily, try some exercise, and perhaps try some Meditation. And maybe that will help you, too.
Borderline personality disorder
Biggest myth: people with BPD are dangerous
Facts: people with BPD can have trouble resisting compulsions to do dangerous or inappropriate things and can struggle to see the consequences in advance.
True story: After struggling with eating problems, depression, anxiety and self-harm since my early teens I was given the diagnosis of borderline personality disorder (BPD) during my first admission to an acute psychiatric ward, aged 23. Initially, like most, I knew nothing about BPD and was both horrified and ashamed at those words being used to describe me. Some friends and family even chuckled when I told them and who could blame them. A disordered personality? It sounded awful!
I became so focused on the words in the label that I found myself searching for ways to reject it. I discovered that part of the criteria for BPD was ‘difficulty maintaining relationships’. So how could I have BPD? I was (and still am) in a long term relationship, happily engaged and living together.
So I ignored the diagnosis and I fought hard to get on with life as “normal”, trying desperately to complete my nursing degree with the support of community psychiatric services.
“The stress was too much”
Unfortunately as I reached the end of my final year the stress was too much for me and I once again turned to using self-harm and suicidal behaviours to cope. I ended up being sectioned and taken back to the psychiatric ward. Even after this admission I continued on my path of self-destruction, seeing nothing left to fight for.
Unsurprisingly this resulted in further admissions. After a particularly distressing admission involving the police, I decided things couldn’t continue on as they were. I had lost my career path, my family were getting increasingly frustrated and my partner was becoming unwell too. My care coordinator at that time recognised the cycle I was stuck in and did some research into places I could go to get help and break free. She told me about a specialist inpatient Dialectical Behavioural Therapy (DBT) focused programme for women with BPD.
“I was going to have to accept the diagnosis of BPD”
DBT is a type of therapy specifically for individuals with BPD, so to access these services it was clear I was going to have to accept the diagnosis. This was something I had been reluctant to do before. I read the information I was given on the programme and was invited to go and be assessed for a place. The real turning point for me was meeting and talking to the other women on the programme. When I saw how much we had in common, it forced me to look beyond the words in the label and learn about what people meant when they said ‘BPD’.
I learnt there is a list of criteria that needs to be met in order to be diagnosed with BPD, but crucially for me I found out you don’t necessarily need to experience ALL of these symptoms. This taught me that people who share the same diagnosis can present very differently dependent on their predominant symptoms. It also challenged the main argument I had against accepting my diagnosis as it showed me I didn’t need to have difficulty maintaining relationships to have BPD.
As well as learning about the condition DBT taught me to notice what I was doing to myself, understand why, consider whether I deserved to feel this way and begin to do things differently.
_Learning about and how to use DBT skills wasn’t easy. It was anything but. I still struggle to get my head around some of the concepts even now. Some of the terms such as “half-smile” and “self-soothe” made me literally squirm with discomfort at the thought of them. However I do recognise this was more to do with how I feel about myself. _
Despite the effort required, I know it was what finally allowed me to begin my recovery.
“I do still have days when everything feels too much”
I struggle to accept myself and I get stuck in comparisons between myself and my siblings or peers, wondering why I have BPD and they don’t. But these days are fewer in number, and with the insight I have gained, a hell of a lot easier to manage!
Looking back, I would say being given a diagnosis of BPD has actually turned out to be beneficial to me. It has allowed me to access particular services that supported me to break free from my cycle of self destruction and transform my life for the better.
I do recognise and know of others who do not share my view, some can’t accept it or feel ashamed because of the stigma still attached and others because of poor treatment they have received following being diagnosed. Which is very sad given the widespread acceptance of individuals with other mental health conditions.
I feel strongly that educating everybody better about personality disorders could help some of those facing the diagnosis to reach acceptance and access the help they need quicker. This will allow them to get to the point where having BPD is only part of who they are and not what defines them.
Depression
Biggest myth: depression is just feeling a bit down
Facts: depression is a debilitating condition featuring feelings of hopelessness that lasts more than just the odd week.
True story: For me, some good has come from having depression. I’m more compassionate, more motivated and I know more about how my brain works. I try to understand other people better: that colleague who seems blunt probably doesn’t dislike me but is just having a bad day. But in spite of these benefits, having depression wasn’t exactly a walk in the park.
Awareness of mental health problems is rising, with the realisation that depression isn’t the emotion of sadness and an anxiety disorder isn’t the same as feeling anxious. For me, depression feels like the day before you get a horrible cold: you’re not sneezing and don’t look ill yet; but you feel like you can’t think and that all your five senses are smothered in cotton wool. Turning the wrong way out of the lift or spelling your own name wrong feels like the worst thing you’ve ever done. Depression can cause you to feel very sad, hopeless or guilty, to have no interest in anything and to find it difficult to make decisions.
I was lucky to access prompt treatment for my depression, which made a huge difference. Treatment can be a combination of medication; formal therapy and other therapeutic techniques such as mindfulness; increased activity and exercise; and changes in diet. Treatment, at whatever stage, doesn’t always mean a cure. Some mental health problems for some people can only be managed, and living with a mental health problem doesn’t have to mean an effect on performance at work.
But to get that help, I had to acknowledge the problem and admit that something was wrong. Misconceptions can paint people with mental health problems as weak, unable to cope with stress and not capable of further responsibility. These can be really damaging as no one wants to fit this description and so they force themselves to carry on as normal, often causing a downward spiral.
Deloitte colleagues I’ve told about my own experiences have been really helpful but there is still more to be done. The workplace is often where depression shows itself, so it’s here that we need to educate individuals and managers to recognise the signs of mental health problems and know how to help.
My advice? Don’t define a person by their mental health problem: treat them as people, and be a good listener. Don’t tell people to cheer up or pull themselves together. If that worked, I promise they’d be well already. Don’t ask people why they have the illness: at best it’s intrusive, and at worst could trigger a stress or anxiety reaction. Don’t use “mad” or “schizo” (or other words relating to mental health problems) as insults. It’s demeaning.
OCD
Biggest myth: OCD is about being clean and tidy
Facts: people with OCD are tortured with forced compulsions like flicking light switches and blinking to temporarily stop irrational thoughts telling them that terrible (at least to them) things are going to happen.
True story: When you’re growing up, and learning about the world around you, no matter what background you come from, the last thing you expect to be keeping you up at night is an overwhelming, unexplainable, intangible fear. This seems to be the case for far too many young men and women, but it doesn’t have to stay that way for anyone.
I was 15 when my Obsessive Compulsive Disorder (OCD) first manifested itself. I’ve always had quite a fortunate, easy life and I always noticed people around me with less good fortune. A close friend of mine had a mother who was terminally ill, and it was absolutely horrible for them to go through. As is the nature of her diagnosis, there was nothing I or anyone else could do. I really wanted to help. I was very, very worried about my friend, and his family (just for clarification they have coped with it fantastically).
I started to pray. This made little sense to me, as I wasn’t remotely religious, but it gave me some comfort that I was at least doing something. This was the beginning of the slippery slope. One thing that is very important to mention is that I told my parents I was doing this within the first couple of weeks - I think they knew I wanted to help, and like me, didn’t realise quite what I was doing.
Each day, I’d pray, and each day nothing worse happened to my friend’s mother. And so a pattern began to develop. I started to pray more and more. Twice, three times a day within a couple of weeks. And it wasn’t just about this family anymore, it was about everything that troubled me in the world. Naturally it began locally, people I saw unfairly treated in school, but eventually my capacity to worry led me to worrying about things completely outside of my control. I would pray for all of it, to make sure nothing bad happened.
_I had also developed other forms of compulsive behaviour. Other rituals. Dozens of them. I’d perform all of these on a daily basis, sometimes hourly, trying to make sure that I was doing everything in the world that I could to help those in a less advantaged position than myself. _
As if trying to prove my dedication to someone, or something, I made the execution of these rituals and prayers nigh on impossible with criteria and order that had to be executed perfectly. If I failed, I had to start again. Over about six months, the illness began to completely take over my day-to-day functioning. One of the biggest changes for me was a new sense of logic, things which were highly unlikely to happen became definite possibilities if I didn’t act out all of my rituals.
Solutions
My father pointed out to me that I had to think of the illness not as myself, or my own mind - it was a virus. We don’t blame ourselves when a virus comes into our body and knocks us down for a few days, we go to the doctors. But when it’s in our heads, our most sacred place, we blame ourselves. We end up fighting ourselves, and that’s what make mental illnesses so difficult to deal with, the perfect villain. You have to try to separate yourself from the illness. It’s not fair to allow it to control you.
My parents were invaluably helpful - they tried their best to stop the illness from getting worse, but there was only so much anyone non-professional could do. They advised we try some counselling with the NHS. I flat out refused, I didn’t want to publically admit I had a huge problem. But I wasn’t getting any better.
One day, I prayed, at full concentration for 45 minutes straight. I was exhausted by the end of it. I walked up the stairs to my parents’ room crying and told my mum to book an appointment as soon as possible. As I learned over the next few months, going to the NHS was not public, it was highly discreet. I started a course of Cognitive behavioural therapy (CBT) with a trainee counsellor, and 17 months after it had all started, four months after I had agreed to go to the NHS, I was free of the automatic negative thoughts, all of the rituals. I have been ever since.
I’m now in my second year at University, studying Film and Television Production, and hoping to one day show, through filmmaking, that mental illnesses are beatable, and have to be treated with the same respect and gravitas as physical illnesses.
It is not easy. OCD is the hardest thing I have ever had to deal with. But with the right help, I believe anything is possible. Please don’t hesitate to seek help, wherever from. And for those who see others suffering, please try, without forcing, to encourage seeking extra help. The NHS has made such a difference for me and many others I’ve met. It feels like a huge leap to book that initial GP appointment, and it is, but it’s achievable. Seek extra advice. Go to the doctors. Talk it through.
Schizophrenia
Biggest myth: schizophrenes are crazy
Facts: people with schizophrenia experiences episodes of hallucinations (not just visual) that they can often not tell are fake, as well as mood shifts and struggles with social interactions.
True story: My brother is in a police cell tonight, he’s spent the night there, back in the UK.
Tomorrow he goes to court after being found with an air rifle on him. He was walking through fields near home to practise shooting his air pellets at the rifle targets.
He loves the outdoors; he used to be a cowboy in Australia, loves to set up camp, start a campfire and brew some fireside tea.
The police have agreed that he didn’t have any malicious intent. Yet he’s spent the night all on his own, in a blank, four walls.
I wonder if there were windows?
_My brother has had schizophrenia for the last five years. You’ve probably heard about it – and you might be thinking, he sounds dangerous. _
But the facts show that most people with schizophrenia are not a danger to society.
It’s another example of the media skewing coverage of mental health to grab headlines and clicks.
You don’t often hear about those managing schizophrenia and getting on with their lives do you?
_But my brother with schizophrenia is very different from my brother before schizophrenia, I can see similarities but a lot has changed. _
How do I get to be on the other side of the world and my brother is in a cell tonight?
It’s phases like this, when I feel only a few steps away from the shame talk taking on a life of its own. In these moments, I hate myself but I feel closer to my brother.
I wonder what my brother is thinking as the sun starts to rise in the UK? And what he thinks of me?
Oceans and realities apart.
Place: Granada, Nicaragua
Time: 11 August 2016, 11:45
I’m now in Nicaragua, hot and humid and 7 hours behind the UK.
I’m exchanging Whatsapp voice messages with my brother, he’s in the garage at home.
He was denied bail by the local magistrate the morning after and sent back to his cell, on remand.
Although I was not able to speak to my brother in prison I was able to email him through emailaprisoner.com email service (I later found out these emails were printed and read to him).
He phoned home and spoke to my mum, not fully understanding why he’d been put there.
Due to the Easter weekend and unspent holiday in the judicial system my brother was in prison for ten days – ten days! The first five days he was not allowed any visitors because of the bureaucracy.
And he had been hit in the face for his cigarettes on his first morning.
Is this where vulnerable people with mental health issues should end up?
Compassion is needed here, not punishment.
Finally when his appeal was held, a judge decided he was allowed to go home under bail conditions.
When my brother came home, he was very hyper and anxious, arguably traumatised. He was paranoid about going to prison again, worried that his minor misdemeanours as a teenager might come back to haunt him as well as less rational concerns.
He wasn’t sleeping well, his speech and writing more detached than usual. It took more than ten days for him to be more relaxed.
We spoke more often during this period, I was often trying to say calming things in response to his worries but also talking about normal daily activities.
An anxious four weeks passed awaiting a court date, my mother helped pull together his case, building a picture of my brother above and beyond his mental illness.
My brother is a three dimensional character, complex with a pitted history, like most of us. He is not just his mental illness.
We are grateful that the judge believed in compassion not punishment as well.
My brother has been given 18 months probation and one-on-one workshops to talk through his choices. This programme will be built around my brother’s needs.
We are all very relieved with the outcome. Recently my brother had been falling through the mental health service cracks, not bad enough to be involved with the crisis team but his community support team had staff shortages and the focus always seems to be on medication not a more holistic approach.
There is renewed impetus with my brother’s care, I am delighted to say he is now meeting his community nurse regularly, they have a good rapport and play pool.
He has started seeing a psychologist and there have been some very thought-provoking workshops, so he tells me. My brother has also started volunteering at a local charity helping to plant new trees.
It is tragic that my brother had to go through such an ordeal to, in the end, receive the care he needed.
And he’s back in the garage again, doing his woodwork.
Yes, my brother is quite the carpenter too.
See the person, not the illness…
