RCGP session two!

The clock is ticking down on my next session at the Royal College of General Practitioners on Friday, and I have to say the suspense and stress is building. It will be my second rush-hour trip to Central London in the week, which never bodes well with me even at the best of times.

The first session I did was a real eye opener, and while it was fun, it was quite draining too. That was starting from a nice high spot in my mental cycle. This time around I am somewhat lower than I was before, so it will be interesting to see what impact that has. Whatever the cost to me, the important thing is being able to help the students understand the presentation of anxiety and depression.

On the plus side, the whole day is a known thing now, it is not full of surprises and uncertainty, so that will help enormously I am sure. I will just get there nice and early again, missing the majority of the morning rush, and have a little wind down walk before getting started.

I will have to put some thought into the scenario for this time too. I am quite happy with the original, but it is good to mix things up a bit. As much for my sanity as theirs. Really is quite draining mentally, recalling events from your life, and playing them out in a scenario over and over for a day. By the end of the day you are mentally exhausted. I kind of envy the actors who also participate in these events. Surely it is much easier to pretend to suffer with something you don't already struggle with. Maybe I am wrong, who knows.

Either way, as I say, the main thing is the students come away from it all with a better understanding. I really do want to have more time to answer questions, and help in any way I can. With so much work being done to raise awareness of mental health issues, it is only right to make sure it can be identified and caught nice and early, so help can be given before the issue worsens for the patient.

Which reminds me actually, I have got to read back through my emails, and do a submission to the BMJ as suggested by Niki. It may come to nothing, it may be the beginnings of being able to do something more positive, time will tell. Not like I don't like writing now is it!

Right, better get my head in gear and thinking cap on, ready for the (next) big day.

Thanks for reading.

PS, students, you can now find all my MH writings on my new website www.snazy.co.uk (if you are not already reading this entry there)

New beginnings.

Having recently engaged with a bunch of great medical students, as well as the Royal College of General Practitioners, I gave some thought into a fresh approach to the blog. Separating certain sections of the blog off onto a different platform.

New domain, new interface, and just focus on the personal and mental health aspects of the blog in one place. No mish mash of other entries, just plain and simple "ME"!

Fingers crossed I can get this set up over the weekend, and see about duplicating some of the posts from here onto the other one, and in future keep things separate.

I shall of course refer to the new platform on here from time to time, as I know some have found a lot of information, which has helped in all sorts of ways, from some of the MH posts I have made, so I will do everything I can to ensure that this remains easy to find, and is available to people.

I had an Instagram project of a picture a day for a year running from Oct 17- Oct 18 which has now ended, obviously. So I thought now was a good a time as any to get a new project running, and hopefully I can spend more time on it in the coming year. Something to sink my teeth into so to speak.

The plan is to get the domain and platform sorted today or over the weekend, just got to do a last little bit of research before committing.

Watch this space :)

Education and enlightenment on anxiety.

Today has been a very exciting, educational, and rather exhausting day.

Many months back when climbing back to the top of the mountain from my trip to the depths of depression and anxiety, my GP contacted me and asked if I would be interested in playing a part in the education of some future GP's. In the form of group sit down sessions, and mock GP consults at the Royal College of General Practitioners in London.

The initial group session was a blast, with a GP I knew, and trusted, having been on a long mental health journey with her, however the latter, which started today was a whole different ball game. A new location, new people, and travelling on public transport at peak time, what could go wrong, eh!

I left early, and missed the most of the rush hour, so at least I would arrive quite fresh. That worked well. 30 mins early, a walk to get some fresh air, and all was well. Arriving on Euston Road, I went into the building and soon found my way to the right place. Handed a sheet with my schedule for the day, a voucher (which I was not aware I would receive until recently) and a heads up of what to expect and when.

Settling down in the waiting area, I was immediately in awe of the grandeur of the place, stunning and modern, if not futuristic. Looking for friendly faces to try and make conversation with, I noticed that a large number of people there seemed to know each other already. Awkward, new kid on the block in the house!! Within minutes, the ice was broken with a lovely guy Brian. Making conversation with strangers is really not my forte, but this just seemed to work, super friendly and chatty, putting all my fears about the day at rest, one by one.

What soon became apparent was that the majority of the "role players" were in fact actors, given a brief of their character and symptoms. I however, along with Brian and a few more had no brief. Brian explained that we were presenting as ourselves. This was soon confirmed by the briefing and a quick Q&A at the end.  Take my experience with depression and anxiety, choose an aspect of it to focus on, and work with that. Sounded simple enough, I know my mental health pretty well these days.

As the clock ticked down to the first group going in, I wondered what it would be like to try and role play a real life experience. The first GP came out and introduced himself, and reiterated the original brief, choose a symptom and work with it. I was ready!

Michael Snasdell..... the first student called. It was time.

In I went, to find not only them and the GP but another 3-4 students in there observing too. A group of strangers, excellent! Given anxiety was my planned focus, it wasn't hard to get my head into the role. Anxiety was very much present. Not in a terrible way, but at least in a way I am familiar with. So I guess if nothing else, it was an authentic performance.
As the first session went on, I opened up a bit, and really offered an insight into how I actually presented on the day when I really did go to see my GP for the first time. 20 mins in, the consult was wrapping up, and CUT.... Finally I can just be me again. Time for a debrief. I have to say I was impressed, thoroughly. Given the lack of experience in diagnosing mental health issues that the students apparently had, I was amazed at how comfortable I felt, and how realistic it all was. Certainly brought back some memories for me!

With four sessions before lunch, and four more after, I have to admit I was feeling rather exhausted mentally by the time the break came around. I grabbed a bit of the lunch they had laid on, then went out for some fresh air, space, and distraction from it all. My conversation skills were waning slightly by this point. Off to an exhibition over the road, then a stroll up and down Euston Road, taking some time to stare at the awesome St Pancras Station, before heading back in for the afternoon session.

Come the first PM session I was more prepared for the students, and if I am honest, a little harder on them, partially through not wanting to repeat the same story another four times, and partly as I could tell that I was presenting a little too easily. Sorry PM students, I did it for with your best interests at heart, and you all did an amazing job.

The afternoon was pretty much like the morning, if anything over with a bit quicker. Quick enough in fact for me to get out and away before the evening rush hour took hold, which was a huge bonus given how exhausted I was by the end of it all. After the final session  popped back to the first floor and spoke with Madeleine and Niki about how the day had gone.

As a whole it was a massive thrill to be giving back to a profession that is almost completely responsible for my recovery from various mental health trials I have faced in life. From telling my GP a couple of years back that I wanted to give something, anything, back to the health service, and help as many people as I could along the way, deal with their own mental health issues, here I was. Doing it!!
It doesn't get much better than that! Genuinely.

Knowing I will be doing a couple more sessions of this is a great feeling, and I would love to be able to continue to do this, and anything else I can along the way, to help with the battle against depression and anxiety.

I was a little rather touched at being asked for a link to this blog, for them to read, as well as pass on to the students who had asked about it. Any regular and long term readers of the blog will know that I have documented my most testing of times right here, and left it all laid bare for others to read, and maybe benefit from should the need arise. I am pleased that some have already given feedback on it, and found some benefit or comfort in what they have read. It was the aim all along,


A huge thank you to everyone from Dr Elizabeth Paul at my GP surgery for suggesting this, and putting me forward to do these sessions. To Madeleine and Niki the facilitators of the course (I hope that title gives you enough credit for the amazing work you do). Not forgetting of course the amazing students who endured a day of mock consultations, and what I believe were some of your first experiences at dealing with mental health. And of course, had to put up with me!

Going back to the experiences shared with the students, I kept it as near to real life as possible, expressing fears and concerns which the conditions had presented me with at the time. Even referring back to the blog at lunch time to make sure I was staying on track. Open and honest, at times maybe even seeming a little "un-bothered" about things such as death. I won't say it was nice to see some of them struggle a bit with the questioning phase of things. Having been under exam conditions myself in recent years, I know all too well what it is like trying to keep the structure of the scenario, while following the lead of the fluid situation. I am delighted to say that by the end of it all, it was a straight 8 for 8. I would happily have revisited any of them as a GP based on my initial interactions with them. Maybe preference towards one or two over the others, but that is just a personal thing, Professionally, bravo all !!

The debrief at the end of each session gave me the opportunity to feed back to the students in the room, not only the one doing the consult. As well of course as the GP mentoring them. This was my chance to offer them a little guidance on how the session had gone, any pointers for improvements for demeanor, and give any other trinkets of information about anxiety, depression, and dealing with mental health in general. Referencing this blog a few times, I explained that while there are drugs and treatments for certain aspects of mental health, the most important bits for me had been striking up a great rapport with my GP, which enabled me to touch base from time to time,and feel like I was speaking to someone who knew me. And of course the self help side of things, such as a diary and the blog, which I often re-read to remind myself of the journeys I have been on over the years.

I will be returning next month to do another session with some more students, and in the meantime will continue to seek out other opportunities to share my experiences and knowledge with the groups of people who are the future helpers for people like myself.

A massive thank you again to Elizabeth, Madeleine and Niki for this opportunity.

I will leave it there for now, but will sure to revisit this very soon when my mind is a bit more relaxed. I just thought it important to get this blogged asap, while it was all fresh in my mind.

What can I do to help?

It is so frustrating at times to site idle while others suffer. Knowing you have information which could help others, you have the ability and time to talk to people who need someone to speak to. Yet no way or means to get involved at the grass roots level.

Over the past few days I have been looking into jobs in mental health, what qualifications are needed, and how I can help with the basic skill set I have. Apparently there isn't a way. Which while understandable, is also frustrating. Sure you can teach people the basics of mental health, draw up a curriculum which covers all the bases, make sure people understand the fundamentals of depression and anxiety. But you can't teach experience.

Somewhere there should surely be a crossover point, where experience and education meet, and can be combined to provide the services which are needed most by those suffering. It is great seeing big names coming out and admitting they are affected by depression, and explain their struggles. Saying things others can relate to, and feel like someone understands them. But that is where it ends. When you come forward and look for help, the understanding ends, and the empathy of education presents itself for the first time.

Having someone tell you they understand, because they have read about it is NOT the same as having someone share stories, or finish your tale for you, showing they truly know what the moment can do to you. The lack of this actual understanding is crippling for some, I certainly lost all faith for quite some time. Luckily I had the guidance to keep pushing me to keep going to the meetings, and to try and see what I could inject into the meetings to try and make them a little more "real" for others so to speak.

The thing I found was, as soon as I started openly sharing how certain incidents and events had made me feel, the whole group seemed to engage, waiting to share their experience too. A few meetings later and it had become the norm for me to offer a story, a real life example of such a feeling, to get the ball rolling, and by the end of the session we were all much more open about yet another aspect of depression or anxiety.

The difference to the first few weeks, and the attempts by the course tutors you try and get people talking, asking complete strangers to interact was almost troubling rather than helpful. Only being able to teach and discuss what you have learned from a book or lectures, while on paper might sound great, really isn't. I reflect back to when my daughter was being born, and the midwife told her mum to relax and enjoy the beauty of birth. When asked how many children she had, she replied none. That didn't get a great response. How can you tell someone how to feel about an experience you have never had... Quite simple, you can't.
In very few walks of life would you take advice from someone who only has theoretical experience in something. So when it comes to something as personal and unique as depression, the textbooks just don't cut it.

I desperately want to be able to intervene. Play a role in getting people who are hidden away in their heads, suffering in silence, speaking out. Not to the world, but just to a human who can be compassionate and genuinely empathise with them. Someone who can give their thoughts the time of day, and allow them to vent all the negativity that is drowning them.
You see, for me, and in my experience, speaking out is the first and most important key to the whole experience. While I have always been open enough to speak to a lot of people about it, there is a time when you feel you have exhausted them with the same stories, and you need someone else to talk to, a blank canvas. Unbiased, non judgemental, and willing to listen.
For me on my last round of depression, that person was Dr Elizabeth Paul at Wells Park Surgery. As my original entry says, I walked in silent, sat and just gazed. There was no immediate prompt from her, just a simple smile which gave me the courage to start trying to explain myself.

The whole entry is here... http://michaelsnasdell.blogspot.co.uk/2015/11/the-trip-to-doctors.html

My point here is really, that there is no one right person or way for everyone, we each need to find our own. The person or situation we feel comfortable with, to finally take the first meaningful step. When I have spoken to others about their depression, the common thing I find is the almost relief shown by the person, when you can actually, first hand, appreciate the magnitude of what you are saying.
An example being, going to meet with a friend while I was mid way through my fight with depression most recently. I chose a place to have lunch, somewhere I knew would be quiet, no crowds. My anxiety at that stage was very bad, so people were not my favourite things.
All was fine to start with, however when we started eating, more people started coming in, sitting closer and closer to us. Paradise lost! Matt had no idea what was going on inside my head, but mad panic is the only thing I can describe it as.
When we left and were talking afterwards, in the nicest possible way, it was impossible for him to understand the difference 4-6 more people coming in had made. However speaking to other friends who have been through the same, they got it straight away.

The big issue here is, a lot of people just don't have "that person" around them, and most of the help on hand seems to be from people who are well educated in the field, but really can't fully grasp what you mean. This is a big stumbling block for people. Having finally spoken out about how you are feeling, to suddenly be faced with a stranger who wants to help you, but doesn't understand you, is crippling.

From my experience, things didn't go well from the start. From my first face to face with someone, it felt like I was doomed. The full blog of my first impressions is here.... http://michaelsnasdell.blogspot.co.uk/2016/01/touching-base.html

You may be able to tell from the words that it didn't really go too well, and I was left with a rather bitter taste in my mouth. If you read entries further into January, you will see things didn't exactly get much better, not for a while.
Had this interaction been with someone who could understand and properly empathise and assess what I was going through, I think I would have felt much better about the matter. Seeing the speed at which some people dropped out of the subsequent CBT course, I guess for some it didn't get better soon enough. When CBT was explained to me, it was a very rough and vague explanation, reading up on it wasn't much help either. It was only being there, and manipulating it to my own needs, that finally started to make a difference.

After the initial discussion about what CBT was, these were my thoughts.

But the thought I can't get out of my head right now, is the was CBT has been presented to me. My interpretation being that I am in control of my thoughts, and therefore if my thoughts are my problem, and I am in control, it is all my fault. That's how my brain takes it right now. Being told you simply CAN'T do or think something is not a cure. Breaking the cycle, which I know is what CBT is really about is the key. But how do do you that when there are so many triggers and issues to over come?

Here was a person of sound mind, with questionable experience with depression, certainly first hand, telling me in short that I was the issue, and I needed to just forget about the past, and look forwards. Not a great deal of help.

I would dearly love to be able to help people get through this first major step in the program. But it appears academics comes first. To me that feels like teaching someone who can already run, to walk again, because they didn't learn properly. Sometimes, certificates, diplomas and grades count for absolutely nothing at all. Sure, along the process they are without a doubt very important, but for some aspects, you just need to understand, properly. Especially when trying to convince someone to walk out of their door into daylight for the first time in a month.

So here I am, frustrated that due to my lack of qualifications, I am near helpless to play a role in this. Sure some will say, volunteer for Samaritans or similar, but that is just not it. Could I turn my hand to such a thing, probably, would it be as fulfilling as the feeling I felt helping my fellow sufferers through their battle with depression, probably not.

At the end of my CBT course I did consider asking to be the plant in the room, the one who has been through the course, but is there to go through the course again, and try and get things moving. Sure the tutors are doing their best, but from speaking to them, the drop out rate is high, and our group had a "good" retention rate compared to some. That left me thinking that there must be more that can be done.
In the end the course certainly played its part in my recovery, as did a network of friends, and carefully considered distractions. But I honestly feel that I was very close to not bothering with the course, as my blogs show. Had I had some understanding and encouragement from someone who got it, earlier in te process, I might have started feeling a bit more positive sooner.

I applaud anyone who trains to work in mental health. It is a huge problem for our nation, and one which is only getting better. Lack of funding, not enough genuine cases being recognised, but for me, the biggest issue is the lack of understanding in what really helps people in such crisis.


So I am off to scour the internet fr ways I can be more helpful to others. I will also be speaking to my favourite GP about the matter when we meet on Tuesday. I know she won't have the answers, but it is a start, and keeps my mind heading in the right direction.
Any thoughts on how I can get involved are welcomed, so please drop me an email or similar.

Thanks for reading, and here's to getting a better understanding for those suffering.

Depression!

Yes, I know I write a lot about depression. Strange really, but it does consume quite a large chunk of my life in fairness. But this time it is a different perspective.
In the past I have recorded the lows of my days, expressing the loss of control, the uncontrollable feeling of nothingness, and the pointless battle of trying to get out from the slump. Then there have been the fight backs, the recovery, and the jubilation of once again rising from the pit of despair.
Not forgetting my attempts to explain the inexplicable to those who want to, or think they do understand the true depth of depression.

But like I say, this is different. A recent consultation offered me a unique new perspective on the whole matter, and made me realise there is more I could do, should the opportunities arise. To date, I have not sought such a thing. Although have recently set out on a vlogging mission, thanks to another chance encounter with another medical professional.

Back when I did my CBT course, I became aware that I grew in strength and self understanding, while talking to others about my journey. Not counsellors, but a group who were too suffering from anxiety and depression. As the course went on, so I realised that telling your stories, as you understand them, to others, helps them see patterns, and routines in their own lives. Once aware, you are slightly more able to take control. Spurred on by the confidence gained from realising you are not alone, and you are indeed understood by someone at least.
By the end of the course, I was overwhelmed by the number of people from the group who felt I had played a positive part in their improvements, and that my openness was key to that.

On speaking to my GP yesterday, I was very surprised when she expressed an interest in me helping educate a group of medical students. As we discussed it, the idea grew. On agreeing to the the seminar , I realised it is something that really interests me. When my mind is clear, I love trying to put things together and help others understand depression, from my perspective at least. Both medical professionals, and sufferers have something to gain from such discussions.
I am not saying I am the Messiah, and the key to depression. I am not for one second suggesting I understand depression in all its guises, I really don't. However I do believe I have built an understanding of what you might call standard depression and anxiety can drive you to.

Seeing others speaking out on a larger platform about how they have battled with mental health makes me almost feel like I could do more. Be it making myself available to speak to others, getting going on the vlogging, or writing more, I'm not sure. But I do know one thing without a modicum of doubt, I feel compelled to make a difference, and I am truly passionate about helping with depression and anxiety. Maybe sharing my stories with medical students is just the beginning. Maybe I can do this more often?Who knows, but I will be sure to speak to the GP about this.

When I am low, I don't look for help, but occasionally will reach out to someone I know I can trust. I am truly blessed to have a small group of friends who understand this, and are amazing at what they offer at these times. However I am so very aware of how long it takes to build the trust to speak to someone you know about it, or even find someone in your circles who you can talk to. Believe me when I say, that alone is one of the toughest parts of recovery.
For some people, they will either never gain such confidence in their friends, or simply not have the network there to embrace them. This is where it becomes problematic.

When you finally reach out for help, you speak to a GP. The standard assessment will be made, the score will be taken, and if necessary, medication will be prescribed. Sadly for some this is the start of the end. With a health service under pressure, and quite frankly such little understanding of depression from the majority of GP's , you take the pills, feel a bit more balanced, and on you continue. No big attempt to solve the cause of the issue. Being such a vast condition, to a degree I totally understand why this happens.

However, if you fall and bend your leg awkwardly, you are not given painkillers and crutches and sent on your way. Investigations are possible to see the cause of the pain, and treatment given accordingly. Unfortunately the physical body is far easier to make sense of than the brain. And we are full circle on why most cases of depression or anxiety are left unexplained.

If you are lucky like me, and you get an amazing and passionate GP, like Dr Paul, your hopes are better. Along with Dr Mason (my work doctor) they supported me to the point where I could carry on without support. Like the leg injury, they were my crutches which carried me until I could manage alone. From simple sit downs to express where I was mentally, to dosing changes. And of course shoving me in the right direction to get CBT, and stick at it.

Of the tens of thousands of people in the UK on Citalopram and other such medications, I would be curious to know what percentage have ever had any further interventions than being medicated.
I am not saying medication is a bad thing, or evil and addictive. Far from it in fact. But as in my early blog, for me the medication is only there for me to rise back up from the depths of depression, and regain control over the matters which influence my mental state.

Debts, relationships, work and so much more can influence our state of mind.We can get down about it for a while, or we can fall further, lose control and begin to curl up to hide away from it all. That is the point where intervention is needed, and not always just in the medication way. Meds are not the solution for all. In fact I would bet most could be back off them, and balanced of their own accord within a year or so. Depending of course on the changes in their lives, and the root causes of their initial downward spiral.

Sitting here tapping away, I would love to learn more about the subject, and write something meaningful about it, something helpful. A first hand account of what some are going through, and a look through window into the future of hope. I am not the solution, I am not the cure, but I am experienced, and open enough to discuss it with others. Knowing my blog has been read by strangers and impacted them positively just increases my drive to help more.
Speaking to the students could just be the beginning. For the rest of the journey, I need to find my way.

Wild ramblings for Monday

I have a quiet period in my day, and a head full of things that are praying on my mind, so I thought I would unload a few of them onto the poor unsuspecting readers of the blog (both of you!)

First up, my bloody back! I have spent the weekend taking ibuprofen by the bucket load just to keep mobile. I am pretty sure running a 5k at the Queen Elizabeth Olympic Park has not helped matters, but in fairness it did give me half an hour of relief after the run. So small mercies eh!
The more it develops, the more I realise that I need to get some professional help with it. Starting in the middle of my lower back, then travelling as far as down my thighs now, it is clear it's getting worse.
I have reached the point now where after a short walk, stairs are just not possible without stopping to squat and stretch out first.
Advice varies, from chiropractor to osteopath, and even long term maintenance with pilates or yoga. Whatever the case, I need to get my finger out soon and do it, especially with the London to Brighton ride coming up this weekend.

Speaking of exercise, that is my next gripe.
Since my huge lows of the end of last year, I have fought back with exercise. Keeping myself busy, fit and exhausted with a regime of running, cycling and working out at home. Sadly, the back problems have really affected my ability to do much of any of the above, which in turn has had a huge impact on my mental health. Tired, unmotivated, reluctant to get going for the day. Too long in bed, grazing all day. None of which is helpful to the situation with my back. I am sure the first thing any medical practitioner says when I present with lower back pain is "you are over weight"
Now don't get me wrong here, I am not bed bound, and I still manage to run from time to time and ride when I get the chance. I am far from a couch potato. But the inability to do as much as I want to do, leaves my stats falling behind, my PB's flailing, and my pride taking a real beating.

The introduction of my new fitness gadget, my Garmin Forerunner 230 has helped a little. Now able to run without my phone for Strava, and have my HR available to me on my wrist (with HR chest band), and to be able to monitor my activities has been a booster. On the flip side, looking at my 5k times, and seeing myself 4 mins or so off my normal pace makes me realise the situation I am in, and has also made me accept I need to do something about it. I haven't lost that much time through nothing, my body is clearly suffering right now.

If I can get anything done in time, i.e the next 4 days is another matter. I am caught up, do I get treatment and hope it doesn't leave me too uncomfortable to do the ride on Sunday? Or do I hold off on treatment until next week, then risk doing the ride and failing because of the back pain? Just a bit of info, the back pain has not yet reared its ugly head while riding, so to date is not an issue.
Both chiro and osteo are new things to me, so I don't know what to expect from either. After effects, restrictions, or how soon to feel the benefits. I don't actually fully understand the differences either, but am doing my best to educate myself now.

The next one is a weird one really. Local community. What does that phrase mean to you? If you are
doing something for and in the name of the community you live in, should it involve everyone within that community, or just the clique you choose to associate with. Those people who share your ideals and beliefs?
Having run an online community for a good few years, encompassing a lot of the UK, it was always important to start with an open mind as to what to expect from so many different groups of people. The UK as a whole is a pretty diverse place. Seeing some of the randomness that people would post on the forum was always interesting. Granted this was quite a young audience with cars in common, but there was always scope for the wild card topics which would for some reason be driven by emotive responses, and passionate beliefs. Had we insisted that the forum only be used for car related topics, and imposed rules prohibiting certain subjects, I don't think we would all have ever gotton to know each other the way we did.
Remember this is a forum which had a direct effect on marriages and the birth of kids! So it wasn't all childish humour.

I guess what I am trying to say is, what makes a community is knowing who people are, and accepting they may have different opinions to you own, but still feeling comfortable engaging with them.

Anyway, back to me....
Well there isn't much more really, I am just currently feeling lazy and down. The back issue is really holding me back with a lot of things.
Each day I get up wanting to get things done, but the knowledge that my back will start hurting within 10-15 mins puts me off. My existence feels very slow and lazy right now. Usually a feeling I get when in depression, but this is clearly driven by something else, and thankfully I know what.

I guess really I should start looking for a local specialist to twist me into weird shapes and make my body make noise to feel a bit better. My lower back feels like it has a MASSIVE crack or pop hidden within it. I just want to believe that it is as simple as that, but am pretty sure it is not.
The areas the pain is referring to now are just silly. Even writing this now I am noticing my posture is changing to allow some relief for my lower back, so in turn my shoulders are getting tight now.

Right, that's it! I'm off to find someone to sort this out.

Passed from pillar to post.

It's no secret that I am "in the system" as such for therapy to try and deal with whatever it is that is eating away at me. Strangely as things have progressed, so have the feelings and symptoms of it all. Today I made a breakthrough all on my own, realising that anxiety is almost my coping mechanism for depression. As the cycle goes around from deep thinking and low moods, so the anxiety begins while I search for the reasons for the depression. Somehow I trap myself at depression almost subconsciously protecting myself from the lows of depression. Knowing I can still function on some level with anxiety, but very little function when depressed. This I know for a fact. But how I have come to this coping mechanism I have no idea.

Blocking the outside out, disengaging from people, and avoiding social situations of all kinds happens with both anxiety and depression for me, but when only anxious, I say "only", I can still manage to get to smaller shops, communicate with a small few people, and of course exercise. With the depression I know that my day consists of dark rooms and staying in bed, and withdrawing from society to the point where even housework and day to day responsibilities suffer.

Anyway, back to therapy, that's what this entry is meant to be about.
Quickly looking back over the timeline.
Mid Nov, GP referred me to IAPT, the therapy section of the local NHS.
Early Dec, I received a letter acknowledging my referral, followed by an hour long phone call to see what therapy I needed.
Mid Dec, I received notice of my first therapy appointment for early Jan
Early Jan, went to first session and later blogged about it. I had been sent for CBT, but didn't feel it was going to work for me, but agreed to stick at it.

Today, I had my second appointment with the therapist. Last week I was given a sheet to fill out for 7 days, every two hours. Logging my activity, mood, mood intensity, sense of achievement, contact level and enjoyment. And also a test sheet to score my anxiety and depression. On arrival at the appointment I handed them over only to be given the log back telling me it was for me. Errm I lived those days, so am pretty sure I know how I felt. Thanks for giving me something pointless to do!
The test score sheet was glanced at then put away.

At the opening of the session I was told that the therapist had spoken to her boss, who had agreed with her that I should probably be referred to a "depression group". Run by 3 people, and considered high intensity, they felt that this would be a better way for me to progress. Or I could stay at one to one therapy and carry on as I am. No pressure.... but choose NOW, you can't do both to see which is best, its one or the other. In reality the sales technique used felt quite bullish, so naturally I went with the easy option and accepted the group sessions.

By all accounts it is more a course than a group, with presentations and education on depression and self esteem, touching on anxiety. Or there was another group dealing with anxiety and stress. But tackling my two issues together seems impossible. In the therapists own words, having a depression and anxiety group would take forever to to get through. Well sorry for being awkward. We can help with one or the other, but not both, choose!
So the course lasts til April, 90 mins a week, in Lewisham. Active participation is not required so I am told. On describing the course to me, she explained it was 90 mins with a break and refreshments in the middle. And that during these breaks people can mingle and interact. My reaction was "oh god, strange people", to which I was told it was good for me to be "forced" into a social situation and to interact with people. Guess you didn't read the section on my test score where I rated interactions with people as stressful and upsetting then.

All that said and done, most of my worry is caused by the anxiety and the unknown, I could get there and feel fine, I know this. But I can't help but feel that so far this whole therapy effort has been a farce, so am really not encouraged to hold out much hope for the next stage.  With having an hour long phone assessment, then my first appointment being an assessment and introduction to CBT. Only for my second appointment to scrap everything that has happened so far, be given a huge pile of hand outs to read and be told, start with someone new again on a different road next week, really undermines my faith in trying any of this. I know these are tried and tested methods, but can't help feel ignored when I have said over and over that conventional counselling has worked for me before. Encouraging interaction, dealing with my past, and digging deep to find the root of this feeling. But hey, what do I know, I'm only the one trapped in my own head.

The outcome of todays session was about as negative as it can get really. I came home, tried to walk the dogs, managed Tuvaaq, got to the top of the road with Aana and turned back giving up. Great, too fed up to even walk! Coming back home with Aana, I ran a bath, had a quick soak, realised I was dropping off, so got out, dried off and went to bed for a couple of hours.
I would have to check back in my mood diary to see the last time I felt so low that I just completely shut down. But it has been a while. So to come from a help session and feel SO damn low, well that just sucks!

Since getting back up I have been for a walk on my own listening to music. I know I am not physically exhausted as my legs had plenty in them, but the motivation to keep moving, even with music in my ears was a struggle to say the least. So I am left feeling alone, withdrawn and misunderstood. Thrown from pillar to post as they make some kind of effort to help me. If I were to see my GP any time soon my feed back would be poor. If I could afford to go private with counselling, I would in a heartbeat.

Right, here is hoping the mood passes by tomorrow, and see if I can get back in the saddle, metaphorically speaking, and depending on the weather, maybe in the actual bike saddle.

Oh one other thing. Last week I expressed to the therapist how much exercise and walking I was doing, telling her distances and durations. Today she mentioned this, and I said yesterday I walked 15 miles and rode 25. She cocked her head and looked and me and said "in one day?" I said yes, I walk that most days. Glad she were listening last time!

I don't get it!

How can I go from feeling so positive, to quite frankly, so shit in such a short space of time. I mean, I do get it, it's what the bastard brain is capable of doing, but even though I understand it, it is SO frustrating knowing you can't do a thing about it.

Today I woke feeling sore from lots of walking and activity over the past few weeks. As I have said before, walking and music are my two escapes from the feeling of total madness that I fall into if I don't keep my mind occupied with simple things. Planning to take it easier than recently, I first took a walk to the GP's to get myself a telephone consult with my doctor. Having spoken to the company doctor the other day, and taking his suggestions on board, I thought I would approach my doc with the recommendation of the increase in meds to get things stable. No point taking up a face to face, so a quick call should do the trick. That will be on Wednesday now.

After walking back home again, a few miles round trip in all, I took the dogs out. Now already walking more than I planned but my mind was starting to run away with me, so I did it to maintain control. Getting home I found I had a letter from the Psychological Therapy dept, with an appointment, for January. So in all so far it will have been 6-8 weeks to get to see someone to start the process. Or so you would think. But apparently the hour I spent on the phone a couple of weeks ago, answering questions, explaining myself, and doing the grading questionnaire wasn't enough. So my appointment in a couple of weeks time will in fact be.... An assessment... AGAIN ! So still no sign of actual help yet.

To say that makes me feel helpless is an understatement to say the least. I know the service is under a lot of pressure. But having approached my GP in early Nov, getting an appointment for January to assess me kinda sucks. Given that by assessment they acknowledge they are so far unaware of the extent of the situation.

With that slight hint of negativity I nose dived this afternoon, and by 1pm I was so tired I had to sleep. Brain just not wanting to keep thinking at the time, so back to bed I went. Waking a couple of hours later, feeling crap about myself, and in a worse state than when I went to bed in the first place. On waking my first thought was to go back to sleep. Since then I have tried to watch some TV, tried to do some bit around the house and failed on most counts. Resorting in the end to going for another walk, from which I have just returned. With a angry calf muscles, and very sore feet. I know I am not doing my body any favours doing this, but it's the lesser of two evils, so the body loses every time.

Speaking of the body, my latest thing is self loathing. Angry at myself for falling out of good shape, hating what I have become, and struggling with if I can even do anything about it. I have the equipment, I have the knowhow, but to actually get into the routine of it again seems impossible right now. I want to look good for me, I want to feel good about myself, and lets be honest, I want to be attractive to potential girlfriends. I would love to get into the best shape of my life next year. There is no real reason I can't, I just need the fire in my belly, and the encouragement of  some people around me to spur me on. But right now, all I can do is hate what I have become.

What I have become is over weight, under confident, unmotivated, and inward. Constantly questioning myself, looking back on past events in life, both recent and a long time ago, and wondering if I was a different person back then. Was that me, or is this really me? What changed, and what did I do over and over to get me into the place I am today. I don't think I am a bad person, but I know I have done some mean things over the years, not given people the attention or respect they deserved, and maybe that is coming back to bite me in the arse now? My retraction from interaction speaks volumes about how I feel about myself right now. Choosing only to communicate with a very limited group of people that I feel "safe" to speak with. No complications or awkwardness, no unexpected changes of subject. Just calm conversation.

And that's another thing. How two-faced do I feel at times. I can see someone I am comfortable around, and be happy, laugh and smile. Just opening up to them feels natural and good for me. With the chosen few I feel I am being the real me, the proper 100% actual me, the person I remember I am in times of clarity. Yet with others, and I apologise for this to you all, I am awkward, cold, and silent. Choosing not to even answer messages in case a question turns into a conversation. Avoiding silly things like a call to the Reebok engineer to get my cross trainer serviced, as I don't want to talk to strangers. Stupid as that sounds, I really can't bring myself to do that, or other calls right now. Unfortunate, as having a fully working cross trainer would be quite handy right now. Maybe I will try and call tomorrow ( like I have said for 2 weeks now).

I really didn't realise I was going to write so much right now. I know there is a lot in my head, that I have been unable to blog recently because of the lack of enthusiasm to sit at the desk and type, a lot of things building up and making matters worse for me. It is a really horrible feeling to know there are things I can do to make life easier, but not have the get up and go to do them. Almost trapped in my own head, by my malfunctioning brain. So much energy of varying sorts, all building up waiting to explode out of my mind.

With Xmas fast approaching, and the seasonal road trip to Wales, I am hoping I can get some fresh air, and relax my mind a little once the duties are taken care of. I feel bad though because in my head right now I don't want to see Chris and Dyfrig who I make a point of seeing every year. As much as I love our conversations, and how welcome I am made to feel, right now I can't bare the thought of sitting in the house and looking back over what has been quite a challenging year. I am sure I will do something to make amends for the lack of visit in person, but still feels wrong at the moment.

Right, I am going to leave it there as my concentration is waning a little and I may start to ramble more than I already am.

Just a quick thank you to those who continue to offer support and friendship, regardless of if I have accepted it or passed on it, I appreciate it all. My choices of who I am turning to right now in no way reflects how I feel about people in general, so please don't take what might appear as ignorance or shunning as a negative, it isn't something I feel I have control over right now.

On another note, and quite a macabre one, while I am struggling right now, and really fighting to stay active and in communication with the outside world, I can say thing with confidence, as I have said in person to a few people. I have no ill intent towards myself, no wish to no longer be around, or to harm myself. Strange as it sounds I know depression and anxiety affects people differently, and because of that it is a natural concern for some to have when they know a person they know is struggling a bit.
I promise that should that feeling ever change, phones would start ringing, doorbells would be rung, and I would reach out as soon as the first thought ever entered my mind.  So please don't worry about that, especially if I am not talking to you much right now.

OK, done, thanks and well done if you read this far.  Til next time.

I'm not you

Just something I have to get off my chest, and mean no offence by it. But I really need to speak my mind about it.

Over the past days and weeks, and even during the last period I was like this, people have been pretty good about speaking to me. Some bravely sharing their own experiences, some with great pick me up conversations, and others with the right intentions, but missing the mark. OK and a few who just really don't get it at all.

A few pointers.. Chin up, cheer up, don't stress, it's gonna be ok... All things you say to someone when they have just punctured a tyre, dropped a glass, or deleted a file they wanted. NOT things you say to people who are suffering with depression, anxiety or stress etc. I know it seems the right thing to say or do. I know it works when your mate just got brushed off by the girl they like, but this ISN'T the normal thought process here, and it is really not that simple.

Now I know we all have lows in our lives, some are listed above. There are things in day to day life that can make us feel pretty shitty for a while. Simple things, missed opportunities, rejections, or accidents. They all give us a sense of doom and gloom. But seeing the right person, hearing the right thing, or going to the right place makes it all seem like its OK again, and in no time you get over it.
The same when you are up against the clock, need to get so many things done at work or at home before time runs out, that feeling of stress, and momentary loss of ability to think straight. But it passes once the tasks are done, and is followed by relief and jubilation.

What you feel at that moment is certainly not nice. And when you are asked by someone what is up it is common to day how depressed you feel. Which is a fair comment, as you emotions are under pressure, you feel down, depressed fits.
When you work colleague asks you why you are so flustered, and you tell them "I'm so stressed, I have so much to get done" , again it's a fair assessment, and you are indeed feeling the effects of stress.

What I want to explain though it, as much as you know how it feels to experience those pressures, and emotions, and you can empathise with others who are under the cosh, there is a difference.
When you merely feel the pressure, but know why, can rationalise it, and understand the external pressures which are affecting you right now, be it a rejection for a job, or the workload of a current job, you can not only understand why you feel how you do, you also know that when that moment has passed, normality will return.

The difference for someone suffering with long term stress, depression, anxiety is quite simply, its irrational. Sure the initial trigger might make sense. Losing someone close to you, relationship break-up or something smaller and less significant like trouble at work, or just a lot to get done. So pretty much the same as the above. The real difference starts when simple, mundane tasks that you carry out daily without even thinking about, start to become problematic. You start over thinking , making easy things complicated or even impossible. Shy away from things you have done for years, and you mind reaches such a point of confusion, that it starts to shut down. Block things out, ignore important aspects of life like communication and personal care. Until it reaches a point where you cannot function properly.

Shutting out external forces is usually the first thing to happen. After all that is where most of the unwanted pressure is coming from, so eliminate that ASAP.
Then the differences between individuals start to appear. Functioning or non-functioning are the options. Some people struggling with life can go on like nothing has happened, go to work, coexist, and try to socialise. Others go the opposite way and become non functioning, shutting themselves away from everything, refusing help, and denying that anything is wrong.

Acknowledgement is key in both cases, and both realising and admitting that something is wrong is one of the hardest parts to come to terms with, let alone admitting to others. Partially because of the way people interpret what you mean when you say you are suffering with depression. As I said above, a lot of people don't have a clue what is going on in your mind, but try, sometimes too hard, to reassure and empathise. Sadly the effect of this misunderstanding is you will more than likely block this person out from any future attempts at help.

Where we go from here is very much an individual thing. It is nice and also reassuring that friends have shared their stories with me recently, and similarities clearly exist between our situations. That said, I do not and would not expect them to believe that I fully understand, nor that they fully understand my feelings. Anyone who has been to a true low point knows that it is a very individual feeling.

One thing I do have to say though is, I am NOT brave, bold, or stronger than others for speaking out so openly about this situation. I know people mean well when they say it, and I appreciate the sentiment, it means a lot. But I am no braver than anyone else living an coping with depression. It takes far more strength to fight your inner most thoughts and fear, than it does to write a blog and share some of the less emotive matters in the situation. All I am trying to do by writing this is show others suffering in silence that it is OK to admit how you feel, and you are not alone in the darkness. No one can take the pain from your mind, but sometimes just getting some of it out there and engaging in dialogue, is enough to make the pieces of the puzzle start to fall into place for you. A 5 min conversation can lead to days of clearer thoughts, and less weight on your shoulders.

My advise to anyone who has a friend, or even thinks a friend might be suffering with mental health issues. IF you have the time and the mindset, IF you care about their wellbeing, IF you can commit to them... Just let them know you are there. A quick "if you ever need a chat" and a reassuring smile, then leaving it alone, can do more than you can imagine. And when the time is right for that friend, and they feel you are the right person to speak to, they will come knocking. If they don't, please don't take offence to it. It's not them snubbing you, it is them making a brave decision, and starting a journey. Just not with you. But please be happy for them, and occasionally, with no pressure implied, remind them you are there. A quick text to say "heya, how's you" goes a long way.

PS, "mental health" merely relates to the wellbeing of the mind, and is a huge umbrella for a whole host of conditions. Someone diagnosed with a mental health issue is not immediately schizophrenic, bi-polar or a self harmer. So please don't be ignorant about it. People should be able to discuss their mental health issues without the above stigma being associated, and it is the ignorant people out there who immediately pigeon hole people like this who compound the issue for those suffering, and in turn prevent them from seeking help.

Right, that's me done. Said more than I intended to, but a brief moment of clarity got me caught up.

Just remember, whether self diagnosed, or clinically diagnosed and medicated for it, mental health issues are different for everyone. You are not me, I am not you. Empathy is fine, complete understanding, and advice like "cheer up" does NOT help.

Aaaah...... BOOM!

Waking up this morning after another night of broken sleep,  I felt clear and calm. You know like when you wake after a bad headache or pain,  and for a moment all is well. That false hope the body and mind give you, before switching everything back on again,  and turning the intensity up a notch. Well,  that just happened.

Not uncommon to feel that way,  but having not been here for quite some time,  I have to run it by a fellow nutcase,  just to get clarification that it was "normal".  The answer came back,  and confirmed genuinely nuts.

When I first woke,  the first thoughts through my mind were,  hey I feel good,  why am I even going to the doctors today. Starting to think it was all in my head,  then the penny dropped... Of course it's all I'm my head idiot,  it's my frickin brain!

A few minutes after that,  the first random thoughts of the day started to filter into my head,  and from there it all went downhill fast. Imagine the old days at the stock markets, on the trading floor. A few people doing the trades,  and a whole floor of traders shouting and waving at each other.
That's what goes on in my head over the most basic thoughts. Strangely enough,  writing like this blocks them out,  focusing on one thing,  being creative takes all the energy from the over active mind and puts it all in one place. Maybe that is why the recent entries have been longer than some others,  me desperately trying to keep writing,  stay focused and stop the inevitable slump that comes after.

So after waking wondering why I was going to the doctors,  I am back where I was before,  and glad I'm going there in an hours time. I wish I could explain how anxious I am about it right now though. Not a good feeling. So I am gonna get ready,  put my headphones on and take a walk up there. Get some fresh air,  bombard the voices and thoughts with poor choices of music,  and go see a pro,  in the hope we are on the same page. Fingers crossed.

Hi Doc, I'm going nuts!

For someone who has a past of, let's face it, mental health issues, but isn't receiving ongoing care for it, it's a really strange thing to have to go and see a doctor about. Usually you walk in, the doctor asks what's up, and you point to something, or present a symptom or injury to them. But when it's all in your head, you have to try and find a way of explaining yourself, without just saying "I'm depressed", or "I'm anxious".

Or at least I think you do! I'm not actually 100% sure how much explaining is necessary really, but I have always felt obliged to give some insight into the matter, just so they can make their own decisions on what the best course of action for you is. That said, as we know from numerous reports, GP's are only very basically trained for such issues, so how much information is really needed? That of course isn't a snipe at GP's, there is a limit to how much any one persons brain can absorb, so would rather the referral route, than the "I think I know what I am doing" one.

Last  night, after speaking with friends, and making the decision to go to the doctors, just to prove how messed up things are right now, I was fretting about it. That's right, after making the decision to get help, I was now worried about how to explain myself, and worried about how I would come across to them. Is that strange? Well it might be to you, but for me it is a classic symptom, and just reaffirms the issues I am having right now.

I got to about 1am and finally tried to change the subject in my head. So I imagined being underwater, scuba diving. Crystal clear waters, surrounded by a reef and loads of different species of fish. Just imagining myself drifting with the current, effortless. No finning, just gliding. That did the trick! That was also a eureka moment for me, and I realised that what would help right now is to get under the water again. Problem being, UK diving is rather nippy right now, and I have no drysuit, and obviously Red Sea etc costs money, and then there are the dogs etc. So it's unlikely I will be using that as therapy any time soon. But hey, I can try and find a way. Nemo 33 anyone?

Back to the whole doctor issue. I remember the last time, seeing a doctor I have known for years, and one I trust to listen before making a sweeping judgement. I felt at ease because I knew him I think. I explained that sleeping was a huge issue for me, getting my mind to stop was impossible, and it was affecting aspects of my day to day life. He got it, and we dealt with it step by step. I had counselling supplied by work, and at the end of it, I came out feeling alive again.
This time it is a doctor I have never met and know nothing about, so I am on the defensive straight away. I realise this sounds really stupid to some people, surely you just walk in and tell them what is up. But it isn't that simple and here is why.

Mental health issues span a huge expanse of conditions, and they all have very different ways of being dealt with. Especially when it comes to drugs, there are a multitude of pills and medications that can be prescribed. But it all depends on how your issues present.
For a physical issue the doctor can see it and assess it based on how it presents. For something in the head, it is very different, and it is also quite awkward. Have you ever tried to explain an object or a sensation to someone, without them having seen or experienced it. It really isn't easy, but the better you know someone, the easier it is to be on the same level and get your message across.

Then, even if you can explain it properly, you have the perception aspect of it. Example, tattooing. If two people with a tattoo discuss how it felt to have the procedure carried out, a lot of the time they will not only use different descriptive words, but also disagree about how the sensation felt.
Now take that to being a patient, trying to verbalise what is going on in your mind, in a way a complete stranger will understand.

I guess it comes back to the whole thing of keep it simple, but I don't do simple, so that in itself is a struggle for me.

So I have come up with this... And if need be I will have it in front of me when I see the doctor tomorrow. That way I won't ramble or lose my direction, but will say what is needed.

About 4-5 years ago I suffered quite badly with anxiety and depression. It wasn't the first time, but was the worst by far. Recently I have started having the same issues I had back then before I hit rock bottom, and am concerned that I am going back in that direction. Over thinking, trouble sleeping, lack of motivation, lack of concentration, and dwelling on certain aspects of life, both important and totally random.
A lot has changed for me over recent months, so I think the sudden instability has triggered this, as it did the last time. Last time I was put on medication, but would like to avoid that this time around, and see if I can shake it by other means first. Of course I am not ruling out the possibility.

Or words to that effect eh!

My appointment is early tomorrow morning, so I have about another 16-17 hours to get through before seeing someone about this.
Last night's blog entry alone had a positive effect for me, getting some thoughts and fears out there in the open, for me to understand a little better. Crazy as it might sound, typing and reading back most of the things I say, is like having the conversation I needed to have, but had no-one to have it with. Like one of those moments in something on TV, where something totally unrelated suddenly puts a case into perspective. It is the same for me, saying things, often typing them faster than I can think them (honestly, I think THAT slowly!.......... joke), words seem to appear from nowhere. Almost like opening the floodgates to my mind, and letting it all spill out, thoughts I could not access before are right there, and it makes sense.
Told you I was nuts!

So there we have it, the issue that has been smashing around inside my skull since late last night, driving me mad, and exhausting me mentally all day.
See there is another thing that has just come out that I had not even considered!

The mental exhaustion from the overthinking. Another classic symptom of the matter for me. Like a computer with some infected program running in the background sucking up all the resources, when you go into task manager, it is using 98% of CPU and memory, rendering the rest of the computers functions useless. THAT is how my head works when I am like this. A simple mundane issue will suck up all the resources and energy I have, and make it impossible for me to do the simplist of things. So sitting on the sofa staring at the TV which is switched off, is about all that is left within my limits of capabilities.

Right, before I run out of energy and shut down to conserve vital functions, I shall wrap things up here.

Basically the conclusion reached here is, keep things simple, explain the basics. That's all. Everything above was an example of my train of thought, just to come to a simple conclusion. Exhausting to read isn't it, and the real long way around.. Now imagine what it is like to have that thought process for most of the decisions you make every day. I kid you not, other than simple bodily requirements, everything else goes through the same mental red tape.
Needless to say, it is the reason I try and stick to a routine where decisions are not necessary. I can go the whole morning without needing to make any decisions, but once the first one arrives... Its over!

Right, that is enough this time. Here's to seeing the doctor. This time tomorrow I will have an idea of what their decision is.

Wish me luck.

Depression comes a knockin.

Before I say another word, I just want to get these few things out there.

Thank you to those who know me best, and understand the strange way my head works at times. And an even bigger thank you to those who go through the same processes and choose to share their thoughts with me. Your company on this journey makes it easier for sure.

Sorry to those who I impose my craziness on at times, who either don't understand what is going on, or would rightfully rather not be a part of it. I try and choose the right people to surround myself with when things start to go tits, up. Sometimes I get it wrong.

And finally sorry to those who don't get it at all. As most people who struggle with their own minds would agree, some things are best left unknown. This is certainly one of them.

Right, enough with the formalities, let's get down and dirty, but more down.... After all, that's what this entry is about.

Over the past week, a week which I have spent off work, some strange things have happened in my head. Totally understandable really, all things considered, but let's take a look all the same.

This week has been the first week I have spent "alone" for about 12-13 years. Not having spent such a long time in almost complete isolation can do strange things to you. Now before anyone jumps down my throat, yes I have kept company with some wonderful people in the past week too, but for the majority of the time, it's been alone. 

Before this week though, towards the end of last week in fact, I had a mini meltdown. Following a conversation with a friend, and some subsequent soul searching, I started to realise things were a little bit wrong upstairs, but skipped over it in the hope that it was just a glitch. However this week, slowly but surely the changes have started and the signs have started to appear that all is not well in paradise.  The last few days being the most telling, getting up later, losing focus on things, lack of motivation to name but a few. The worst of course being the slow demise of quality sleep due to over thinking. Once that part starts, I pretty much know I'm screwed, in the short term at least.

Some self destructive behaviour is the icing on the cake really, and in this case it is starting to consume foods which are usually avoided, and lack of interest in physical effects of them. Just the consumption of a few trigger foods for my gout alone is the sign that things ain't right. Fingers crossed now that I am realising why I'm doing it, I can do what's needed without a flare up of gout. Gout and depression together REALLY suck !

After being all melodramatic on Facebook earlier, I finally managed to speak to someone who gets me, enough to confirm what I was thinking, and get my head on the straight and narrow. We both agreed, I need to see a doctor, and ASAP!

Now before the eyes start rolling, and the tssk's being sounded, let me just say this. If you have not had depression or anxiety before, and I mean clinically recognised rather than just been a bit on edge, and have no idea what it does to your mind and your life, please politely shut the fuck up. 

But he is writing a blog, but he is going out with people, but he made a joke on Twitter.... YES ! Depressed people still live pretty normal lives most of the time, especially when things are just starting to take a downward turn.

Depressed people are humans, and do lots of things that normal people do on a day to day basis. But somewhere under the skin, a part or parts of their life is being shredded by their own mind. There is more than likely nothing wrong with what they are obsessing about, so even from the inside, say for example a work colleague, would not see for a second that something simple and petty is in fact destroying their life right now. 

For me, face to face, with people I know and care about, I am me. Same normal (slightly strange) Michael. Do I want to open up to them and get it all off my chest, of course I do! Will I, of course I won't. My respect for the relationship I have with that person prohibits me from burdening them with all my inner worries, which as I have said already, actually amount to nothing. Have you ever had a conversation with someone who is stressing about something, and it's ended with you both laughing and saying "don't worry about it"? Well, that is pretty much how most conversations would go with someone with anxiety or depression. On this level anyway. There are of course much worse forms, for which I am grateful I do not suffer with.

I know I blog quite a bit about feeling down, and in fairness it is one of the reasons I started blogging anyway, so if you hadn't worked that much out already, no prize for you. Is it attention seeking, another form of the vague status update on Facebook that we have all grown to hate. Hell there are even Meme's about vague status updates floating about, whining on about "attention seekers" etc. Well how about looking at it this way.

A vague status update is indeed attention seeking. But the question is, why?

You see most people who live with depression won't talk about it. And will have either never have spoken to a professional about it, or will just deny it is an issue, even though it has been identified. 

So that vague status update that you are posting Meme's about, or sniping about with other friends on private messages, could well be the subliminal cry for help from someone desperate for someone to speak to, but too afraid or embarrassed to ask. 

Have you ever been told no, or ignored about something trivial? I bet it pissed you off, or at least upset you a bit. Now imagine you are ready to lay it all down, share your innermost worries or fears. You think you know the person you can talk to about it, you build yourself up, and..... nothing! They either give you the "you will be ok" line, ignore you, or ask if you can talk about it another time.
Trust me when I say this, you really only get one shot at opening up about something as deep as this, and a single knockback can send you spiralling into what feels like an eternal pit of doom. 

So as corny as it sounds, next time someone, who doesn't post something vague and cryptic every day, posts a bit of a strange status, if you have the time, and actually care at all, please just drop them a one liner asking if they are ok, or wanted to vent to someone. For someone like me, venting goes a long way. Hell you don't even have to read half the stuff I'm saying, just check for question marks, so questions don't go unanswered. If of course their punctuation is abysmal, tough shit I say, no time for poorly educated depressed people! .... That's a joke by the way, even depressed people can make jokes, especially at the cost of other depressed people! 

Anyway, for me, I have spent the whole evening going back and forth in my mind, do I need to see a doctor, am I just being stupid, is there another reason etc. But the simple fact is, if I am thinking it, I already know the answer. It is just my over thinking, over complex mind trying to, yup you guessed it, over think  the reasons why I would need to. Unfortunately, once that thought process starts, everything gets a little blurry. Bringing in other unrelated issues, trying to see if they play a part in the situation, and before you know it the world is a shitty place, and EVERYTHING is screwed up. 

I know I am just feeling like this, because I am! Not because of breaking up, not because work is a pretty shitty place sometimes recently. And not because of anniversaries, Xmas, lack of diving, missing my mum, wanting more money or any of the other crazy considerations that have entered my mind over recent hours and days. 

To be honest, as usual, just writing most of this stuff down, and knowing I am about to press publish, and throw all my inner most thoughts out there into cyber space for anyone and everyone to read, is helping. But of course it is far from the end of the matter. Medication is something I do NOT desire right not, avoiding as much as I can these days, inc pain killers, so I really don't want to be starting a new daily regiment of pills. Besides, they are only a quick fix, the real fix happens up in my strange little head, and only when I have a clear enough mind to make things right. 

The long and the short of it is, I have been dropping down for over a week now, I have another week off work to come, and somewhere in that time, I am going to be seeing a GP. Sooner rather than later if I can help it.
In the meantime I will be trying to maintain my routine of dog walks, training and other things to keep my mind occupied, and giving me reasons to get out of bed early, leave the house, and take in daylight and fresh air. All key things for me to ensure I do, just to make sure the downward trend at least levels out for now. Fingers crossed as ever, this is me catching myself from falling, and not going to end with me picking myself up from the bottom. It's been about five years since I had any serious issues with depression, and I am hoping that by writing this, I am facing my demons head on, and refusing to bow to their demands. 

Depression sucks, but fighting back at it makes me a stronger person each and every time. Here's to beating it once again, and getting back to being the same annoying idiot people have grown to know and despise.

Thanks for reading.

PS, if you suffer from depression, know this. You are not alone, but each of our journeys are different. I cannot swear to understand your thoughts, nor expect you to understand mine. But we share a common ground of confusion, despair, and lack of hope. On his level we are united, and can support one another. Providing someone to hear our cries, give us strength, and show one another that we can overcome these feelings.

Stand tall, do not be ashamed of saying you can't cope or need help. 

There will always be those who do not, and cannot understand how mentally crippling depression and anxiety can really be. Their ignorance or lack of knowledge should not be seen as lack of compassion or caring, but instead just an inability to truly empathise with you at this time in your life. 

If you have made it this far, but still have no idea what you just read. Thank you, for bothering to carry on reading. I hope that one day, should the need arise, and you experience either the symptoms, or identify someone who is, that this makes sense at last, and helps in some way. 

PPS... To those people who have been around me and made things normal over the past few days, thank you once more. I appreciate it more than I can ever express.  

Struggles with emotions

For years now I have been perceived in many different ways,  from warm and caring,  to cold and callous. I see myself somewhere in the middle,  while I care about  things that are important to me,  I am somehow able to override or switch off from other emotions.

It seems the closer something or someone is to me,  the more I am able to ignore or at least mask my feelings about it.

Over the years friends and family have become ill or died suddenly,  yet I recall only ever crying once. When Adam died.  The first person I had ever spent a lot of time with,  dying. It was a bit of a shock to the system,  but passed quickly. Previously to that my aunt had passed after a short illness, and while I was openly saddened by it,  I somehow felt peace from knowing she wasn't hurting anymore.

But as the years have gone by,  I recall crying very little,  even about some rather traumatic times I have experienced. Is it normal not to cry,  is it strong or weak to cry? Everyone has a different answer.

Personally I have no shame or fear of the emotion,  and from past recollections,  I remember feeling relieved and exhausted by the experience,  but at the same time satisfied. So not being able to have a release when going through a tough time can really suck at times.

I have noticed over the past few years that I get choked up quite easily now,  emotional stories,  tear jerking films,  or even moments which get the heart racing and adrenaline pumping around the body,  the throat tightens,  the eyes water,  but it's far from crying.

Over a space of 4-5 years I have lost a lot of people very close and dear to me. When family you have known your whole life slowly slip away from you,  you expect  the mind and body to need a release,  turn a page,  start fresh,  cleanse the soul and all that.  But for some reason,  for me,  nothing! All just matter of fact,  all just par for the course.

So great has my concern grown at times about this,  I have actually sought counselling in the past,  to talk through my feelings and see if there is either a trigger I'm missing,  or a blockage in my mind stopping me letting go.  Something  from  my past which makes me fear crying,  but there isn't.

My only thought on the matter is that I have had a bit of a tough life in younger years,  learned to be a bit of a loner due to things which have happened,  and somehow shut down the part that shows weakness and sorrow.  I can express it verbally,  I can rationalise death so clearly,  but just can't rally up the physical emotion.

It's a strange feeling,  a horrible feeling,  emotional constipation to be blunt.  While I know there are people who think they are weak or silly to cry,  people who mock crying,  I can only envy those people who can actually tap in,  and let go.

I have never grieved,  rarely expressed emotion over any kind of break ups or partings of friends,  and look on helplessly as others around me express their emotion on a common subject.

This isn't a strength,  I know that for sure.  And while it makes me a strong character,  someone who can be relied on at a time of distress or upset,  it is a weakness in the same breath.  As you look  to me to help you cope,  as I hold you your hand and tell you it will be ok and to let it all out.  Deep inside I envy you and wish we could swap for just one minute,  and you could help me dig deep within my soul and open it up.

Not sure where this blog has come from,  guess it's like the lava of a volcano bubbling away under the surface.  It may never erupt,  it may never be seen,  but somewhere in the depths of me it a boiling pot of emotions.....

Thanks for reading.

A&E at breaking point

I am the first to admit that I have probably spent more time than some in hospital A&E departments, so coming from me this might all be a little hypocritical I know. But stick with me for this one, and see the subtle differences.

From an early age I have been 'unluckly' shall we say, and managed to find myself in many situations which have resulted in trips to the hospital. In the 80's growing up, I was so well known in fact at Sydenham Children's Hospital (now flats) that Sister Bell could get most of the paperwork done without asking my mum a single question. Broken arms (plural!), knocked down by a car, and referrals from the GP for various things like ingrowing toe nails, ruptured testicle (sorry I had to include that one)  etc. It all happened there.

But in my defence, as a child 'shit happens' Seemingly more to me than others, but kids just have accidents, fact.

As I have got older, I have managed to take the stupidity a bit, and my visits have become less and less frequent. Which I have to say is a blessing for two reasons. Firstly I'm not hurting myself as much, and secondly the kind of people you get in these places is alarming. And it's this point that it all really starts with.

For those lucky enough not to have visited an A&E or an ER, it will all be a little alien to them, seeing these shows like 24hours in A&E, and 999 what's your emergency. How it all works, what the system deals with, and who uses it.

Let's look at the name Accident and Emergency.

An accident which causes you harm requiring immediate attention, or an emergency situation where your physical well being is for some reason jeopardised. Now that's a wide spectrum and does indeed have scope for everyone and everything in there. But apply a little common sense for starters.

The TV shows occasionally show us scenes where someone has done something really quite minor and has chosen to blow it out of proportion, and turn it into a drama. Deciding that their situation is so horrific and unbearable, that they require IMMEDIATE attention. And I mean immediate. You see, for some reason, the more trivial the injury, the lesser the need for attention, the MORE irritation, anger and impatience oozes from these people.

'I have only sprained my finger and you want me to wait 4 hours?'... you know, you're right... FUCK OFF HOME THEN!

For anyone who has not visited an A&E dept, for you lucky people, allow me to tell you one thing for a fact... Certainly in London, if you visit one between 8pm and 6am, you can be sure that a LOT of the people seeking attention are under some level of influence of drink. And will see things like black eyes, sprained wrists and ankles, bumped heads, and other stupid falling over drunk kind of accidents.

Now of course, any incident causing injury to yourself which may require attention should be attended to, no doubt there. But maybe there needs to be some adjudication here, and maybe compare it to car insurance. Most of us pay PAYE tax and National Insurance which is our contribution towards health care, so consider this a third party insurance policy. Anyone making a genuine claim would be covered.

But... if you are a drunk who always likes to spend the early hours in A&E because you fell over for the 5th time this year, then maybe you need to be fully comp, or pay for your own repairs. I use drunks as an example, there are of course many more people who fall into the time wasting or self inflicted categories, as well as the pure time wasters.

Anyone visiting A&E is booked in, and 90% are at least seen by triage. People who think A&E is just like a GP but is a walk in clinic are clearly stupid, and people like this should be charged, or at least warned that charges may apply for further misuse. There are specific walk in clinics around the country, which are NOT A&E departments. Having just waited 2 days to get an appointment to see a GP, and having spent the end of last week and whole weekend in agony, with no sleep and in lots of pain, YES, I know it's not ideal, but sometimes you just have to wait your turn, plain and simple.

The culture of 24 hour shopping, banking, car washes and a life of convenience seems to have gone a little too far now, and people seems to misunderstand the role of these vital A&E departments.

They are over stretched, under staffed, and over run with time wasting morons who are drunk and think they are funny, bored and think it's a pass time, or people who are far too important to wait their turn. Meanwhile ambulances are stacking up, serious cases are being kept waiting, and seriously ill people are being left for hours undiagnosed or untreated, while 2 more stupid people have their little boo boos attended to.

Seriously now, WAKE UP BRITAIN!

It's the same time wasters and arrogant people who choke up these services with petty things, that sit there complaining that their toe nail which is torn needs URGENT attention, and that 3 hours is too long to wait, and how ridiculous is it. Stating that there should be more staff working, seeing people quicker, and then make sharp intakes of breath when they read the latest waiting time figures.

Don't you get it.... IT'S YOU! You are the cause of these issues. The staff are adequate on most shifts to deal with the genuine cases that come through the door. It's the time and resource wasting antics of stupid and arrogant people that cause these figures to skyrocket.

Responsibility for our actions was shunned a long time ago, and now society demands that whatever the cause, whatever the issue, public services should bow to your needs, and you should be given the attention you demand of it. Well, tell you what, NO! It needs to stop. 

Refuse collection used to be one bin fits all, now it's broken up, and people who don't comply end up with unemptied bins. Drink driving used to be tolerated, but now it is frowned upon.

So maybe it's time for the NHS to have bouncers at the reception desk, and to turn away anyone who is not an A or an E, and refer them to another service. 

Oh hold on, I can hear it now....'but its my human right'.... well that can fuck off too! Stop the pandering, ease up on the pussy footing around, and just get hard with it. Fast track these people the hell out the door, and give the people who deserve and need the attention, every second they need.

And while I'm on the matter.. If you rock up to an A&E with a genuine case, and the waiting time is a bit long, text a mate, slap it on Facebook, hell send a whiny tweet.... don't take it out on the staff eh!

I think that's my rant over for now. But will finish up by saying this.

The NHS as a whole is an amazing system, providing health care in a way that some countries envy. For someone who has spent a lot of time in the system both as a patient and as a carer, I think the NHS and all its staff are fantastic. From call centre staff right down to surgeons, and everything in between, I salute you and thank you for you choice in life to help others and work in some horrible conditions, with some truly foul and undeserving people.

Rant over :)

Thanks for reading.

PS, if you know a time wasting arsehole that likes to chew up the NHS's time, push them down a flight of stairs and show them the difference between a boo boo and a real emergency!

Regards
Michael

Sent from my BlackBerry Q10

Isolation within a crowd.Marbles in my mind.

Having had days to dwell on how im feeling right now, I have finally stumbled across this explanation  which I might add is an old one. Have you ever stood in a crowded room, surrounded by people you know, yet still felt alone? If so, then welcome inside my head right now.

Its a strange sensation, feeling like if you screamed for an hour, no one would hear it or even know you are there. While you hold conversation with the people around you all day long, and spend the whole time talking, at the same time you feel like there are conversations within you that cannot be had, exchanges of words needed, but no one to share them with. Its like being trapped inside your own head, with no one else to talk to.

By not being able to mentally reach out, all the conversations you are having in there just bounce around aimlessly. As we all know every good conversation leads to other conversations. So now put that inside a trapped mind. Imagine a marble rolling around in a box, each time a new conversation arises, another marble is added. And so it carried on, until instead of having that annoying nagging thought, or marble rolling about, it is dozens of them, crashing around inside your mind, making so much noise that day to day happenings seem impossible to deal with.

Its strange, hard to explain, how I can carry on functioning with doing things like writing this blog in a way which seems to make sense, but at the same time, other things, simple things from my day to day life just seem impossible to cope with or carry out. This morning I found every excuse possible not to walk the dogs, to avoid interaction with people, as it would just irritate me. Yet an hour later I was fine to get on a train to come to work and sit in a noisy office. And maybe thats just it...

Maybe the noise around the office, the strangers on the train etc all add up to be a distraction from ME! Not needing to engage in personal conversations, not having time to think about my life and myself, is just what I need right now, So for that I am very grateful.

But at the same time I am still left with the marbles. Ultimately they all need a way out of my head, all need dealing with, however at this time there is no logical way to get them out. Offers from friends to chat are gratefully accepted, but I feel like a burden to sit there saying 'me me me' all day long. It reminds me too much of people I already loath for doing just that. So I am still left with the quandary of how to get these thoughts out.
The big issue is the sensation of loneliness even WITH company. Dog walks in the evening have recently fallen silent with me just keeping my thoughts to myself, not wanting to touch on certain situations and conversations which have already been had a thousand times. But the problem is, half of the marbles in my mind are about these matters. Matters I cant control or change, but are driving me insane and eating away at my actual soul on a daily basis.

I guess time will take care of most of these things, then when the root is killed off, the weeds will die, or at least I hope so. If not I might just go completely crazy.

So for now, as I close this blog, its like a snail going back inside its shell. I just came outside into the wilderness to share these thoughts, and maybe even try and feel a little better by putting them out there. But now its time to go back inside, and back to the darkness of my mind, and the noise of the marbles crashing about inside my mind.

Thanks for reading.

At war with my demons.

Once again my demons of depression rear their ugly heads, and the pit of despair opens wide to try and swallow me up. Small things becoming the teeth of the demons, ready to consume me in a single vicious bite. An all too familiar feeling for me, and as usual there is no true reason for them to have broken free of their shackles.

My part here is to know what is happening, fight back, and refuse to allow them to catch me this time. Knowing all the warning signs of these bouts is key for me to fight back like this, and getting a grip on it early is important if I stand a chance of escaping without a mark on me.

Lack of energy, happy to sleep forever, no drive, and a touch of self loathing from time to time. Not to mention being emotionally delicate, and living on a short fuse. All the signs that things are going badly wrong in my head at this moment.

Why you ask? I have NO idea at all. Yes I have some stress in my life at the moment, but nothing worthy of feeling like shit. But I have a plan.

Not ignore it, not run away and hide, but to fight with every conscious thought I have each day. Refusal to let these little things weigh me down with doubt, anger and sorrow. Instead, turning negatives to positives, making the most of any situation thrown at me, and working towards the brightness of sunshine and happiness that awaits me on the other side.

As Waiting all Night (Rudimental) suddenly cues and plays into my ears, I picture the video and remember that the key to overcoming adversity and barriers in life is a two step progress. Positive mental attitude, and surrounding yourself with great people. Well I have the people, and I have the self belief, so it's just a matter of mixing them properly now to make it work out for me.

Typing furiously here, trying to get all these thoughts out of my mind and onto the WWW is a battle in itself, but something I need to do from time, now more than ever.

My name is Michael Snasdell, and from time to time I struggle with depression. I'm not ashamed, embarrassed or afraid to admit it, and nor should anyone be.

Thank you for reading. That in itself helps, believe me, being heard, seen and recognised is part of the process here. 

Regards
Michael

Sent from my BlackBerry Q10

Wow this is SO much fun!

The ambulance crews (yes 2 of them) spent the best part of 2 hours with mum. Talking to her, testing her, finding thingd wrong with her etc, and everything points to a trip to the hospital.
As soon as it was mentioned, the defences went up and the arguing started. Refusal to go to Lewisham hospital, they treat her like a prisoner and she is not going there.
A rethink and how about St Thomas's. No, their patient transport there is shocking and she is not going there. The list carried on, Kings College, Guys, but no no no.
Eventually they suggested taking her to St Christophers Hospice, amazing treatment and care etc, but shock horror, NO!
Apparently her visit there last week was very bad, she could not stand the noise there and now doesn't like it.

So after an almost 2 hour stand-off they finally had to offer her the "I don't want your help" form, which she signed quite happily.

So she is left with, a urine infection, severe dehydration, an irregular heart, no appetite, no strength and no will to go on.

The GP called shortly after they left and bluntly (as he usually is) asked did she not care about the impact she was having on others, she screamed down the phone at him that she was sick and tired of caring what other people wanted, and was doing what she wanted now, and that was doing nothing, and being left to do her own thing and slip away.

Problem with that is, none of the conditions from the symptoms she is displaying are related to the cancer, so it unlikely that "this is it" at all. So instead she is committing to lots of pain and discomfort, weakness and less dependency, and infection spreading to her kidneys. Which she will no doubt say the cancer is spreading to too.

So here I am, at home, on my birthday, 3 years to the day this journey begun, wondering what I am supposed to do. I will admit I am feeling VERY resentful right now. Disappointed that mum is doing this to herself, and feeling its fair on everyone else around her to be left to cope with this.

When my sister asked earlier if she had wished me happy birthday she just grunted "NO!".

Its not about my birthday really, its about her lack of comprehension of how this impacts me and my sister. Mum doesn't want to talk to me at the moment (in the devil), hung up on the doctor, but is nice as pie to my sister, laughing and joking with her.

Oh well, I guess I better get back on track, I was meant to be having celebration pizza today, but for some reason have lost my appetite!

Thanks for reading
Regards
Michael

Sent using BlackBerry®