S1E3 – Diagnosis through the lens of bipolar disorder

Original podcast aired on 8th May 2019

**Quick content warning: we are going to be discussing mental-health and may discuss suicide and other content that may alarm you.**

Welcome! 

In Stephs head this week 

I am actually having a really positive week! I’m having a good time with mental health work and  meditation, feeling on an even keel and just in general quite nice ALTHOUGH… something happened that wasn’t the greatest…

So, I’m trying to be more assertive, trying to be more honest with how I’m feeling and being able to say no; everyday I try to get out of the office and have my lunch in nature and listen to a meditation to ground myself outside of work. 

On this particular day I set myself up with a meditation on the Headspace app and hit play JUST as a colleague walked into the park. Usually, I am pretty antisocial on lunch breaks anyway. So this lovely colleague asked if she could sit with me, so I said “Look I am actually just about to do a meditation sorry so I won’t be much company!” so off the colleague goes off and finds her own spot to sit. Point one for Stephs assertiveness! Except… when I get back to the office I find out that it is actually the lovely colleagues’ BIRTHDAY! Doh!! 

And in Ems head this week.

I am totally overwhelmed with everything at the moment, even having a panic attack before work once this week. The only thing bringing me happiness is the podcast! I actually decided this week to defer from uni to focus more on my mental health for a while. I have mixed emotions about this, I am feeling down on myself and like I am failing and wasting time, but at the same time I think; better to do that and recognise I’m not ok at the moment so I can look after myself and uni will be there when I am ready. 

So! What are we talking about today? DIAGNOSIS! Is a diagnosis always a good thing? We are going to try to break it down a bit. When talking about diagnosis, for a physical illness it is a doctor trying to assess your symptoms, usually with tests like x ray, blood samples etc. However when diagnosing mental health it can get trickier, it starts with talking and trying to rule out symptoms, like a process of elimination. Assuming you find the correct diagnosis, this can be positive as you can understand your symptoms, give yourself some relief around blame, get effective treatment and find some sense of belonging. Finding a diagnosis can also be distressing, create an unhealthy obsession or preoccupation with the illness. It is generally how you use your diagnosis and move forward that makes the difference.

Em finds her diagnosis (depression) liberating, useful and comforting, whereas Steph feels locked in and put in a box by her diagnosis (health anxiety) and finds herself often questioning: does the diagnosis control you or the other way around?

So, to unpack this topic a little we are talking to someone very special to me, my iddy biddy baby sister Sarah. Over the last 10 years, Sarah has struggled and fought damn hard for her life, and just a short time before we created this podcast at the young age of 23 she was diagnosed with bipolar disorder type 1. I think she is pretty inspirational; she has come up against some massive challenges and has done so with the stubborn toughness that anyone who knows Sarah will recognise. Although if you asked her, she would probably say she didn’t really do anything at all, everything is owed to the people around her, but isn’t that so classic? We never give ourselves the credit we are due!

Sarah, left, aged 3 and Em, right, aged 5

We welcomed Sarah to our virtual studio and began by asking her, what’s in her head today? Well, she has been giving up smoking so that’s about all she has room for she said.

We wanted to know; what is her current formal diagnosis? Sarah explained that she has been diagnosed with bipolar disorder, and that while there are many different types of bipolar disorder, type 1 is her specific diagnosis. For Sarah that means generally long episodes of depression, and then in between those episodes, periods of mania, or sometimes hypomania (similar to mania but without the more psychotic symptoms). Sarah is 23 now, and the first time she saw a mental health professional she was 13, however the diagnosis of bipolar didn’t come around until around 5 years ago. 

On asking her if she remembered the first time she felt like her brain worked a little differently, she said the first time she had suicidal thoughts was when she was around 12 years old which definitely felt weird at the time, she remembers feeling as though there was something wrong with her brain. Steph followed on by asking; Was that a time when it flagged in her mind that there was something mental health related going on, or was there perhaps things leading up to the suicidal thoughts, even that she couldn’t quite put her finger on. Sarah said that yes, while that was the first time she felt that she had a problem regardless of other warning signs or precursors there may have been, but she wasn’t ready to talk about it yet. 

Em asks, what was the progression of Sarah’s illness? When Sarah was 12, that was the first suicidal thoughts and jarring indication something might be a bit off, this is also when she began to self harm. Around about a year later when Sarah (and Em’s!) parents realised what was going on, this is when professional help was sought. She was put on antidepressants, which she was on for around 10 years (until just recently). Her diagnosis until she was around 18 was anxiety and depression, however when she was 18 and started seeing a new psychiatrist things changed a little, and she was diagnosed with bipolar disorder type 2. Pretty recently she had a manic episode which has meant her diagnosis has been updated to bipolar disorder type 2.

Steph wanted to know, how did it feel having so many different diagnoses floating around the place? Sarah said it got really confusing, she explained that even as recently as a year ago she saw a different psychiatrist again who misdiagnosed her with borderline personality disorder, which really threw her through a loop for a while, it was so different to anything she had ever heard before. She further explains how frustrating it is to have so many incorrect diagnoses floating around, and she does say she wished she had the correct diagnosis sooner so she could have got onto the correct medication and treatment. On this topic Em asks if there were things that were directly bad for Sarah in having the incorrect diagnosis, or is it just a matter of “lost time”? Sarah explains that the anti-depressants she was on for around 10 years are really bad for people with bipolar disorder, especially type 1, as they can actually induce mania in those with bipolar disorder. In fact, recently when Sarah had her first manic episode was right after she started taking her antidepressants again. She hadn’t been taking them and when she started again all of a sudden she found herself in the middle of her first truly manic episode. 

We wanted to know; why did her diagnosis take so long and why was she misdiagnosed a few times? Sarah points out that one indicator of bipolar disorder is depressive episodes, and especially for her, the depressive episodes tend to be a lot longer and more frequent than her manic or hypomanic episodes, so for this reason it is quite easy for bipolar to be misdiagnosed as depression. Anxiety is something that Sarah has on top of the bipolar disorder, so this is not a misdiagnosis however it probably led to the correct diagnosis being even more difficult (just a note on this, people with bipolar disorder and obsessive compulsive disorder are actually at high risk of suffering an anxiety disorder such as generalized anxiety disorder, social phobia, or panic disorder!). She said she thought bipolar has a lot of symptoms that are shared with other disorders, making it quite difficult to pin down. She says that most people she met in psychiatric wards did have more than one diagnosis (medically known as “comorbid diagnoses”) making it more difficult and less efficient to get a correct diagnosis and therefore correct treatment, especially when you are a child or a teenager.

Sarah goes on to explain that medical professionals are hesitant to diagnose patients with anything such as bipolar disorder while people are in their adolescence. We discuss whether this is a positive or a negative, and Sarah believes this is a positive. She clarifies by saying she is not a professional, however hormones can often get in the way of a correct diagnosis, and symptoms of puberty can present as signs of a mental illness.

Em asks a little about support from family, friends but also from the government and mental health services. Sarah responds that she had great family support, but what she would say about government funded mental health support is that unfortunately, unless you present a danger to yourself or the community, you don’t get the support. She expands that this is mostly because they are extremely underfunded, understaffed, and under resourced. Sarah says however that she currently has a really great mental health team provided by a government service who are really helpful and have more resources that they share with her (however Em notes this is only following the diagnosis of bipolar type 1 which is prioritised a little higher by these services, it took a lot for Sarah to be provided with this support!).

Steph inquires, as someone who isn’t as savvy on bipolar disorder, what is the difference between manic and depressive episodes? For Sarah, depressive episodes last a lot longer than manic episodes, and these are characterised by really low energy/motivation, low confidence and self esteem, and low mood. Sarah has only had 1 manic episode, in the past she would have hypomanic episodes, which includes being hyperactive, talkative, high mood, high confidence, high energy and these last around a month-6 weeks for her. Is mania and hypomania a good thing when coming out of a depressive episode though? Sarah says it is definitely something to look forward to after experiencing a depressive episode for a year or so which is typically how long Sarah’s depressive episodes last. It feels good for the person in the manic or hypomanic state, however it is the people around them who are often quite uncomfortable and/or concerned about this behaviour. She also stipulates that hypomania and mania are quite different, however yes, these higher moods can be enjoyable but can make the person “annoying” (Sarah’s words, not ours!). The other thing can be that people do things they regret, that don’t  necessarily line-up with who they are as a person. During hypomania and more commonly, mania, infidelity is really common, overspending is common, just generally acting as though you are invincible and above risk, which can be quite damaging to the person going through it in the long run. 

Steph then wants to know how having this disorder has affected Sarah’s relationships, and Sarah describes having a very supportive family, and partner. She says she honestly doesn’t think it has changed these relationships too much at all except that her family and partner are often worrying about her, sometimes that isn’t so fun… When she was in high school however it was a bit of a different story. She explains that she would go from the person who would ignore all her friends and not talk to them for a long time, to jumping around, writing on people with pens and being a tad overbearing. It is hard to put this much strain on your friendships, especially at this age, and it is hard for people to stand by someone through all of that without knowing exactly what is going on, and Sarah understands that.

Coming back to the actual diagnosis, we asked Sarah how it felt to have arrived at seemingly the correct diagnosis, how has it been for her getting the correct treatment and what was it like to receive this diagnosis? She says she is really glad to have this diagnosis that feels right and means she can get the correct treatment. She can look back at her past behaviours and see that this diagnosis fits, and she can trust in the people who gave her this diagnosis, and trust that she will now get better treatment and have a better prognosis. It’s a relief! Bipolar disorder is often very easy to treat once you are on the correct medications and therapies available to you, and you can go on to live a relatively normal life. 

Em asks what IS important to Sarah’s treatment that may be more unique to people with bipolar disorder. Sarah responds that the number 1 thing is for her to take her medication. She explains that there are stories of people overcoming their bipolar disorder without medication, which is fantastic, however a lot of the time the one thing that makes the biggest difference with bipolar disorder is taking the correct medication, so this is Sarah’s number one focus at the moment. Sarah also says mood tracking is such a helpful thing for bipolar disorder. Once you have tracked your thoughts, feelings, energy levels etc for a while you can start to notice the patterns that come along with bipolar disorder and you can nip any issues in the bud as they come up. There are a lot of great mood tracking apps, or you can go for a traditional paper and pen!

We then discuss a YouTube video by Dr Tracey Marks about a phenomenon called imposter syndrome (see episode 7 of season 1 for more on this topic!) and whether this is another reason to mood journal. Sarah explains that yes, legitimising your behaviours by being able to see them written down by you is so important, as well as being able to see what actually lead up to the episode, it didn’t come from nowhere, there were probably red flags that you missed to get to that stage, so discovering these insights is important!

Steph then asks, what are some of the biggest misconceptions about bipolar disorder? Sarah says that she thinks the biggest misconception about bipolar disorder is that if you are somebody who flies off the handle easily, or if in one day you are happy, then sad, then angry, then happy again, that you must be bipolar, but this is not what bipolar disorder is. It doesn’t necessarily mean there is nothing wrong if this is what you are going through, but bipolar really is long term episodic mood changes.

So then, to the last question… if we could wave a magic wand and Sarah could wish for one thing for the future of mental health, what would the wish be? Sarah says she would really like to see more funding, so that people can get help before they get to the critical stages where they are hurting themselves or other people.

We are NOT medical professionals, so what we discuss in our episodes cannot be taken as medical advice, if you ever need to reach out for support, please do so;

**And if you are ever in immediate danger please call 000, or the emergency number in your country**

Beyond Blue – 1300 22 46 36

https://www.beyondblue.org.au/

Lifeline – 13 11 14

https://www.lifeline.org.au/

Mind Australia

https://www.mindaustralia.org.au

Sane Australia

https://www.sane.org/

Surprise! I’m not OK…

And the 5 steps I am taking to get back to “OK”.

Boy oh boy, do I have an admission to make.

So as many of you may know, not only am I blogging on here now but myself and my best friend Steph do a podcast on mental health and how important it is to be opennnnnnn and honesttttttttt…. So can you imagine my surprise when I realised that I am totally, completely, and utterly NOT OK!?

It was like the bit in the horror movie where the to-be victim has been pottering around the kitchen in a cloud of ignorant bliss, unaware of the viewers building suspense, going about their day thinking about the pleasantries of their life and marveling at how damn well they are doing, then… BAM out pops a serial killer wearing a terrifying mask and brandishing a machete.

Image result for crazy serial killer movie

Well that was me at the end of last week, except the machete weilding maniac is depression, and I really shouldnt have been that shocked to be completely honest, tiredly underwhelmed would have been a more appropriate reaction.

I have spent approximately the last 2 months telling everyone how well I am, it was going something like this:
“Yeah, I have a lot going on at work at the moment, I’m kinda behind actually and I feel like I’m not doing a very good job. Oh yeah, and now I have been stood down due to Covid-19. Buuuuut I think it will be fine. It’s fine. And yeah I just separated from my husband who I have been with for 10 years too which should really be overwhelming me but I am actually fine, I feel totally fine. Oh my sleep hygeine? Shocking, I am having so much trouble sleeping, the first time in over a year my insomnia has kicked back in, but yeah nah yeah it is actually OK, I don’t feel that bad and I’m sure I will start sleeping properly again soon. When was the last time I meditated or did any form of self care? Gosh, a while back, I have just been so busy and tired, but I’m actually fine and I am sure I will get back to it soon.”

Image result for im fine im fine meme]

So why. Why oh why was it a shock to me when I found myself bawling my eyes out at work, coming down with tonsillitus and having a complete breakdown?

I will tell you exactly why.
Because I broke the cardinal rule of good mental health:
Never stop flexing your mental health muscles.

As my idol (pun definitely intended, sorry Andrew G) Osher Gunsberg has said on multiple occasions; you don’t stop going to the gym because you have finally got the muscles you always wanted, you keep going so you can maintain them. I had stopped listening to Osher’s advice, as well as the advice I was preaching on the weekly to my lovely listeners. Oops.

Image result for mental health meme

So how did I come to the conclusion I am not OK? Surely there were signs along the way?
Yep, there were, signs that I ignored. Like the simple fact I was so behind at work, red flag. That I had stopped shaving my legs or washing my hair? Not a huge deal but… red flag. That when I looked in the mirror everything was distorted and confusing and had me thinking about starving myself. And most recently that Steph had to ask me why it was that I had worn the same dress for about 2 weeks straight (for comfort, I said).

It’s hard to not get angry at myself for letting my mental health go, again, however I think those of us who have long term struggles need to be able to pause and reflect. I think back to when I was around 18-19 and I hit my (to-date) rock bottom. I could barely function, I couldn’t communicate to those around me what was wrong, or ask for help. I couldn’t conceive of a way life would ever get better… This time around I could stop myself in my tracks, recognise what was happening, and say (both to myself, and out-loud) “I am not ok. I will be ok, but right now I am not and I need some help”.

This is why I think that the harder times in our life, whatever that may be for you, need to be followed with reflective periods. We need to be recognising that while there is nothing pleasant about these times, if we are able to get through them then we gain more insight, and more tools going forward. That with these challenges come learning experiences, and every little thing we do to improve our mental health adds to our mental health practice.

And as we say: it is a PRACTICE, not a PERFECT!

So… what is the point of this rambling? I have decided to put in place my 5 must do things. (Most of which can be done in self-isolation life!) These things may seem simple, however they can be very difficult for those in the middle of a depressive episode. These steps are enormously important to being able to get through these times, and I would love to share this insight with others who may need a bit of advice.

Savour a shower.
When I am not feeling great mentally, the first thing that goes belly up is my hygeine routine. Luckily, because I usually have a full time job (pre-corona) and can’t get away with it I haven’t stopped showering all together, however a quick rinse everyday is not good enough.
I make sure I have a shower speaker for some tunes, and products that make me feel good ready to go (I love a good coffee scrub), and see shower time as a luxury rather than a chore. This is easier said than done sometimes, but on those days where the only thing I manage is a shower, at least it was a good one!

Image result for shower meme mental health

Bite sized bits
One of my worst habits when I am in the DEPTHS OF DESPAIR is to then wallow in the feelings of total inadeqacy and failure and get totally overwhelmed by the sheer volume of “things to do”. The advice that I ignored for years is to just pick one thing, and make it your mission for the day. Sure, a fully functioning adult can knock out their to-do list within an hour or two, but guess what? If you have a mental illness, you are not fully functioning, and your capacity is different to when you are well… I know, a revelation for me too! Now do not misunderstand me, I do not in any way mean that since I have depression, I don’t have to do anything. BUT it is about understanding that you cannot go from 0 to 100 in a matter of seconds.
So, back to picking one thing: Pick one single thing on your to-do list, and make sure you do it. Maybe nothing else will get done, but you did something. Which is surprisingly difficult sometimes.

One of the worst things about the fatigue that comes along with depression is that it feeds right into our feelings of worthlessness. You can’t do anything, so you feel worthless, which makes you more fatigued, making you less likely to do anything… Ya feel me?

By breaking this cycle in any way you possibly can, you are making it more possible to somehow work your way out of the spiral. For example, a few weeks ago on a Saturday I made it my mission that I would clean my bedside table off by the end of the day. That was my one and only commitment I made to myself. It took me around 2 hours to muster up the energy, but once I had done that, I also found myself going through the draws and tidying those, then all of a sudden I was vacumming the bedroom floor. Sure there were some pretty sizeable naps in between, and other people may have cleaned their whole house top to bottom in this time, but I went to bed feeling like I had actually done something, sound in the knowledge I very easily could have napped the day away.

Image result for to do list meme mental health

Communicate… somehow
I am absolutely shithouse at asking for help or admitting I need help, or realising I need help if we are being totally honest…
My dad, sister, and I use the mental health number system which I find super helpful, knowing I don’t need to reach out for help in a way that feels daunting, I can just shoot them a message saying something along the lines of “Feeling closer to a 5 today…” and they will talk me through things. With others, it’s knowing which people I can say “Not feeling good today” to and they won’t spiral into panic mode, or jump into problem solving or action, they will just question me a little and gently talk me through things. I am lucky enough to have a pretty big support system including not just my sister and dad, but also my mum aaaaand BEST FRIEND STEPH!

Image result for mental health number scale

Go outside, and move your body
I’m rejecting the “Just go for a 40km run every day, the endorphines will cure you” sentiment.
Take it back to bite sized chunks; Whatever length of time you can manage, go stand outside, let the sun touch your skin, breathe some fresh air. 30 seconds, 2 hours, whatever you can manage. When you have had your fill of the fresh air and potential sunshine (I’m not going to try to guess the weather) it is time to move your body. On worse days for me this can even just look like me lying on the ground in front of the TV on my back stretching out my legs, arms, and back. On a medium day perhaps a little yoga, working up toward a good day I may muster up the energy for a walk with my dogs, or even the elusive full gym sesh!

18 Depression "Cures" That'll Make You Laugh So Hard You'll Be Cured

And finally… give yourself a damn break!
Honestly the most important and in my humble opinion, most difficult self care step. Those of us who suffer from bad mental health, or mental illness love to beat ourselves up about what we can’t control.
We are not going to feel well 100% of the time, mentally OR physically, and that HAS to be ok. The more I have accepted that I am going to have bad days, weeks, months etc the shorter and more manageable these times get. Know that if you just do the little things, practice some self love if you can, seek help from a professional if you haven’t already, things can get better.
Of course sometimes I get stuck in these negative thought patterns (obviously, or I wouldnt be writing this right now), of course I forget to follow my own advice, of course I f*** up my own mental and physical health from time to time, but hating on myself for that doesn’t help.
So one thing I constantly try to do better: Focus on what you can control, and practice accepting the rest. Try not to beat yourself up when you *shock horror* don’t manage to vanquish depression in a single day. Don’t hate yourself for something that is NOT your choice and instead make a choice about what you will do with this funny brain you have.

Pin on Mental Health

I believe in you.
I love you.
I accept you.
You can do this.

Good luck, and sleep well, xxEm

S1 E2 – Back to Basics

Original podcast aired on 2nd May 2019

**Quick content warning: we are going to be discussing mental-health and may discuss suicide and other content that may alarm you.** 

Welcome! This is the first real episode of It’s Not All In Your Head. Just in case we didn’t say it enough last time we would love rates, reviews, subscribes and shares!

In Stephs head this week.

I’ve been struggling a bit with prioritisation and organisational skills so probably something that everyone struggles with, but I’ve really been struggling to fit everything on my plate without something falling off and how to fit everything together into the 24 hours of the day. I’ve been pretty overwhelmed and a bit stressed, even with this podcast which is probably one of the best things that ever happened to me… apart from my dog and husband and house oops I’m so sorry… 

Apart from those wonderful things that have happened even good things like this podcast, they do overwhelm me and I do have times where I think “God can we do this?” but I think it is normal to feel those times where it’s a bit overwhelming. What’s helping for me is just sitting down, writing out everything that I’ve got on my plate at the moment (both work and outside of work) and allocating a time that’s appropriate for them for the week. 

So obviously podcast is sitting at 72 hours which is all my time outside of work! Done! So yes that’s what’s been going on in my head this week.

And in Ems head this week.

I actually think I have made a bit of a big mistake. When we first discussed this podcast and decided I wanted to be really open and tell everyone everything so that would make everyone else be able to be open… I’m immediately wishing I hadn’t said any of that so that I don’t have to talk about any of her problems and she can just ignore them and they’ll all just go away! I like to avoid my problems and not talk about them and hope that they go away. This week, this thing resurfaced that hasn’t happened in a while and I ended up falling down a rabbit hole, kinda like Alice. I experience this thing sometimes where I will look in the mirror and all of a sudden what I see is just completely different to what I think is reality. Just for some context I’ve lost about 20 kilos in the last 2 years. So I’ve lost a fair bit of weight and the other day I looked in the mirror and I panicked I thought oh my god I’ve put on all of my weight! I had this back issue, but only for 2 weeks so it’s not possible that I’ve put on 20 kilos in 2 weeks… I panicked. Literally all I could think about it for the last couple of hours at work was “I need to go home I need to weigh myself” it was an obsession. It was this loop in my brain almost, and it was kind of like being on a carousel just going around and around and around, I would feel like I had talked to myself out of it but then I would come back around to those thoughts and be back in it again. it’s kind of funny to explain… in the moment it’s uncomfortable but it’s not a catastrophe, the worst thing was when I came home and weighed myself and realised oh, I haven’t put on any weight. then I kind of went about my day. It was more the next day all of a sudden I was like fuck… I can’t trust my brain. How do I trust my version of reality? For the moment I weighed myself I felt a bit better, but then all this other stuff surfaced and I felt like my brain was tricking me. At the end of the day it doesn’t matter what I look like I’m relatively healthy and working on my body imaging confidence levels, but that feeling of “Can I trust anything that I see?”… so yeah that’s what’s been going on in my brain. The only thing that has helped has been talking about it with lots of different people, saying “This is what’s going on with me”. I had a couple of people surprise me a little bit, in my brain, I always think that when I talk about these things people are just going to say “Oh no you look fine, don’t worry about it”, and that’s not what I need to hear because that’s not what it’s about, and so to be able to have open conversations with people where they say “Oh you know actually I’ve felt that before” or “I felt similar before” and not be judged for what I’m going through has been amazing. 

So! This week we are going to talk about what mental illness is. Honestly when we first sort of started talking about it but we need to do a back to basics episode I felt like I knew it all… but actually I know very little! We thought for our first episode it would be good to touch base with our own knowledge but also get back to basics about what mental health is, what mental illness is, who is at risk, and what can we do about it. We also want to know; what are some red flags…. but of course we are not professionals, we needed someone who is a professional to help us out with this so today we are chatting with psychologist Richard Brown. Richard studied to be a psychologist in his third 30s, so he hasn’t always been a psychologist, and yet over his career as a psychologist he’s been involved in Men’s Sheds community groups the Black Dog Ride, and he even started his own practice, as well as doing workshops, providing training, and posessing a really amazing passion for mental health and suicide prevention… basically, he is a busy little beaver!

We sat down with Richard in our humble little studio. We wanted to know, where does Richards passion for mental health come from?
He told us he’s always had a fascination for how people tick, and figuring out how people think, and it had really gone from there. He’s had first hand experience with mental illness which is a story for another day.

This was the perfect segue, so we asked what is mental illness?
Richard said this is a bit of a tricky question, however he would try and answer it simply. If we have distortions of perception, or we have emotional problems that are what we call clinically significant then they are classified as a mental illness. Clinically significant means that it impairs our functioning and stops us from living our lives to the fullest. There is a sort of spectrum, and it’s really when it’s interrupting our lifestyle that it becomes a mental illness. When you look up the book on mental illness (the DSM/Diagnostic and Statistical Manual) there are around 300 different types of mental illness classified, a huge list. In comparison, mental health is looking after yourself in terms of your emotions, trying to reduce stress levels, all of those sorts of things.

We wanted to know… can you have bad mental health without having a mental illness? The answer was yes a lot of people have that! A line can be drawn; there are a lot of people out there who may be stressed in their job, or worried about paying the bills, or their relationship however it’s not to the point where it’s a mental illness, this is very very common. Stress is a big issue in our society these days.

Then Em asked the question that had been on her mind the whole day… what is the quirkiest mental illness that Richard had heard of out of the 300 odd.

The answer: Paruresis. This means a phobia or fear of people hearing you urine.

Emilie immediately reacted “I have that!!” she exclaimed. A little awkward that the one Richard picked out happens to be one that Emilie relates to! She admits that she has gone to a public toilet, and then stayed in the cubicle and then left without even using it because there’s someone in there and it gets in her head. So out of interest we then discussed the best course of treatment, which would be for a phobia desensitisation. Steph thinks that the best course of action is for a whole heap of people to pee around Emilie, however Richard seem to think she perhaps had it the wrong way around and it’s in fact about Emilie getting out there and challenging her fear. We decided against peeing on the podcast, however let us know if that interests you at all…

We moved on from this bit of lightheartedness, and onto the causes and triggers for mental illness. We want to know if a mental illness is simply an imbalance in the brain, or is there more going on that. 

The answer is yet again, very complicated. Richard told us that “we” being the brain industry as a collective, don’t know as much about it as we say that we do. There are a lot of people out there saying you’re down on dopamine or you’re down on serotonin blah blah blah, and there’s a lot of scientific investigation gone into this however there isn’t a lot of evidence that we actually know exactly what is happening, we know medication can assist neurotransmitters in our brain and help us but we don’t really know why. Also, when we look at mental illness we can divide it in different ways; some forms of mental illness come on us for no apparent reason, we just can’t track back and figure out why it actually started, however a lot of the time with mental illness we will actually find that some sort of situation has caused it, usually some huge or long lasting stress in our life. Stress is a big trig trigger for the development of mental illness. We do still have a tendency in our society to think of those negatives and think of the danger when we’re not necessarily in real physical danger. For example, primitive man or woman faced with a sabre tooth tiger would have what we term a stress response, a shot of adrenaline, and a lot of other things happen in our system, prompting us to fight or to flee. This is vastly different to what happens nowadays, which is that the stresses aren’t short term, dangerous physical situations. Most of the stresses that we face are long-term. We are built to experience a stress response and then to recover. What is happening now is that our stresses are more psychological and ongoing, so we don’t get that recovery time we still have that fight or flight stress response but because the stress is so different it isn’t working. If we are in this state long-term we do develop certain types of mental illness but also it depletes our immune system and we can actually start to find that we are getting sick often. Being stressed takes your immune system down a bit, so when you see people who are really stressed, you’ll notice that they’re getting every flu and every cold that’s going around, that could be a warning sign of impending mental illness. If this is the case, is there anything that you can do to prevent a mental illness before it happens? Going back to the term mental health; if you’re looking after your mental health and being proactive about it, that should help avoid the onset of a mental illness, or at least drastically decrease your risk factor.

Richard tells us there are medical treatments such as medications for symptoms of a lot of illnesses. For some conditions and for some people they are very good, and for others they are a bit rough. Then we have talking therapy, or counselling. Sometimes medication is all someone needs, other times they simply need talking therapy, and on some occasions finding the perfect balance of both is needed. So, it really isn’t a one-size-fits-all, and it depends on the condition as well as each individual. As an example; if someone suffers from generalised anxiety disorder, which is the most common disorder, in a relatively mild way it’s possible to overcome that with counselling and learning self management strategies. If someone is suffering from the same disorder in an extreme way then it’s very very hard to treat that with counselling alone and usually people need medication plus counselling.

Very often it is after they’ve been suffering from a mental illness for quite some time that people seek help, Richard tells us, and there is a bit of an age and gender factor. He finds that if we are looking at young men 18 to 25 or 30, they very rarely show up for assistance. It’s more frequent to get men in their 40s and over, and then they are describing that they’ve had this same conditions for 20 years at least. It’s an old fashioned gender thing, however young women aren’t a huge amount better at seeking help, maybe a little bit better but still not perfect. In saying this, if we have been suffering from some mental illness for 20 years for example it has become chronic by that stage and it becomes a lot harder to treat, as a rough rule of thumb. The longer someone has been suffering from a certain illness the harder it is to treat.

Richard does see the big disparity in the way that we view physical vs mental illness, which is partly caused by people not understanding enough about mental health and mental illness, but is also caused by the fact that you can’t see it. Even physical injury such as chronic back pain; people don’t really understand or relate to that either even though it’s a medical condition and it’s real. It’s not just that we need to catch up and make people more aware of mental health, it’s also that you just can’t see mental health. Talking about mental illness is so important since you can’t see it… you can’t just wrap your head up with a bandage! Em suggested forehead tattoos that say “I have mental illness” however that was shot down pretty quickly. 

The most important thing ahead of us at the moment is raising awareness.

Everyone should be working on their mental health. If you don’t already suffer from a mental illness obviously you’re not going to take yourself off to the psychologist necessarily, but Richard had some insight into what we should be doing as it a mentally healthy person to ensure that we are never at risk of developing these illnesses. One big way to do this is looking at your lifestyle. Physical health contributes to our mental health so making sure you get enough exercise to lift your mood and de-stress, also things like making sure that when we leave work we leave it behind us mentally, and making your mental health part of your routine and what you do in your day.

We waved our magical mental health wand for Richard and asked what he hopes for the future of mental health. “I actually am involved with a national charity, and recently we were reshaping our mission and vision statement, in the vision statement we have written something along the lines of; our vision is for a community in the future that is well educated about mental health and knows what to look out for and a community that is well educated about suicide and suicide prevention. I guess I would come down to those couple of things.”

If you ever need to reach out for support, please do so;

**And if you are ever in immediate danger please call 000, or the emergency number in your country**

Beyond Blue – 1300 22 46 36

https://www.beyondblue.org.au/

Lifeline – 13 11 14

https://www.lifeline.org.au/

Mind Australia

https://www.mindaustralia.org.au

Sane Australia

https://www.sane.org/

What a year can bring.

2019

A year can bring nothing and everything, and all that is in between.
It’s bizarre, our understanding of time is a human construct, it isn’t real. If you think about a year, to us it marks an ending and a beginning, but in reality everything keeps going as before. Even so, I think it is really beautiful the way humans have decided that it is important to reflect on a year gone by, and set intentions for the year to come, although I’m not going to lie, if I hear one more stock standard “2019 was so shit, bring on 2020, can’t be worse!” posts on social media I think I will vomit (jks, I don’t vomit). Because the idea of having a “bad” year and a “good” year is so strange if you really think about it. A year is a number, it isn’t a numbers fault if bad things have happened to us recently, and yet we take such solice in washing our hands of the “bad” number and deciding the next number will be better. It’s such a lovely concept to me, but I can’t quite get on board.

2019 started for me with the hospitalization of someone extremely important to me. My New Years Eve last year was spent sitting in my backyard, cuddling my dog in shock, making tearful phone calls and trying not to wake my husband up. It seemed like a bad omen for the year ahead. The first couple of weeks of 2019 felt like I was walking through fog. My mental health had already taken a massive nosedive toward the end of 2018 and this shock seemed to have given my brain the permission it was waiting on to completely stop functioning. On reflection, it probably wouldnt have taken much really for this breakdown to happen in the state I was in, but boy howdy this event did the trick. Panic attacks, self hatred, and suicidal ideation was all my brain could handle, however since I am pretty fucking terrible at asking for help I don’t think many people realised how bad things were for me. I went into 2019 thinking the world was ending, and many aspects of my world did in fact end, but it really was for the better.

As I continued to struggle my way out of bed and to work every day, inching further away from being half an hour early, to being 5 minutes late, most days having to stop my car on the side of the road for deep breaths to fend off impending panic attacks, I finally decided to ask for help. Asking for help is not something that comes naturally to me, in fact accepting help in any way shape or form is not something I do. Ask my Dad, he will tell you; “Never give Emilie real advice, she won’t take it, best tell her what NOT to do if you want any hope of steering her in the right direction.”

But I did it.

I asked for help. It was hard and it felt gross and it felt like a failure and it felt weak. I would love to tell you how every single person in my life rallied around me and proved it is easy to get help with your mental health, but this was not the case. The majority of the people around me, my friends and family, they were amazing, and they listened as I tried to blurt out what was going on for me and try to open about my mental health for the first time in my life, to confront things I could never admit out loud. I worked through things with my amazing psychologist and for the most part it was a real turning point for me. But unfortunately there were a couple of people who really proved that the stigma around mental health, anti-depressants/anti-anxiety meds are still alive and well.

People “noticed” I had become spaced out since going on my meds, when in actual fact it was the first time I could think clearly in months. They “noticed” I wasn’t working as hard, when I felt I was finally getting back to my heyday of multitasking and remembering what I was doing. They “noticed” I was lazy. They “noticed” I was trying to get out of things, “using” my psychologist appointments (1 hour every 6 weeks mind you, that averages to 10 minutes per week) and the fact my Sister was unwell.


I cannot stress this enough: This is stigma in action.
These same people hadn’t noticed how numb I had been for months. They hadn’t noticed that I looked like crap from lack of sleep. That I couldnt carry a conversation or remember what I was saying half way through my sentence. They hadn’t noticed the “toilet breaks” I had been taking to try to fight the panic attacks, or the fact that the tiniest confrontation had me shaking and barely able to speak. They hadn’t noticed how this fog started to lift around 3 weeks after I went on meds and 1 week after I had my first psychologist appointment in 3 years.

Stigma against mental health is a funny thing, especially in the workplace. I really didn’t need anything from these particular people, apart from patience while I dealt with my health. I was getting better, trying to find my way back to myself, including the fact that it is in my very DNA to be a complete workaholic (something I will be working on my whole life). Improving my mental health stood to benefit those feeling as though I was taking advantage.
And yet, some months later after becoming the focal point of the gossip mill, and after a series of ridiculous miscommunications and misunderstandings, I found myself unemployed without notice after 7 years in the same job. It was only after this I found out about most of what was going on unbenknownst to me; discussions about my performance with junior staff whom I was supposed to be in charge of, checking security footage for proof of my work output, and most hurtful (at the time) of all, one or two people I considered my friends outside of work had added to this drum-up of drama, which was, at the end of the day, about the chemistry of my brain.

The words I had used to ask for help and understanding 6 months earlier (“I feel I am not working at my best, but I am putting steps in place to improve and I would really appreciate your understanding.”) had been completely twisted and used against me. After all the hard work I had put in I felt so confused, hurt, and completely misunderstood. This is one of the best things that has ever happened to me (I’ll explain that later, sit tight).

The truth is, these people most likely had no idea why they had formed their opinions about me, or what effect their words and actions were having on my already pretty shithouse mental health. They probably still haven’t given it a second thought, and they probably never will. We have been force-fed these assumptions for so long now; mental illness is weakness that can’t be overcome, it makes people ill-equipped and useless to society, and, in more recent history, medication turns you into a zombie. And it is far easier to fall into these assumptions than to question, or try to understand things like mental illness, which you can’t see with your own eyes.

To use the age old comparison of the broken leg; If I had broken my leg, and come to work with a cast, and ask for understanding and patience while I heal, it would be a given. No one would think to say to someone else that I was being lazy or taking advantage, because it is way too easy for the other person to say “Hold on, can’t you see her cast? She is trying her best!”.

Thanks to my yummy brain pills and regular cognitive behavioural therapy, I managed to muddle my way through the 2 weeks of unemployment (luckily, because of all the yucky stuff going on I had already applied for this other job) and found myself stepping into my dream job. I immediately felt understood, welcomed, and encouraged. Some of the first things we were told in training were about work life balance and that asking for help would be an important part of enjoying and surviving the job. We were told to reach out to our EAP (Employee Assistance Program, if you don’t know what this is or if you are entitled to one, please check!) if we need it at any point.

It felt so right, and restored my faith that some workplaces are working on breaking down these stigmas, and understanding how to get the best out of their employees by supporting their wellbeing. I was now in a place where I could start to really heal.

Meanwhile, circling back. You may wonder about the hospitalization I mentioned at the beginning of this ridiculously long story. My amazing, intelligent, strong, beautiful, spirited little sister has been battling her own demons from a young age, and following a suicide attempt and her first full blown manic episode, she was finally given a correct dignosis. Speaking to stigma, the diagnosis of Bipolar Disorder carries some hefty presumptions. A life sentence, a sign that youre an amazing yet troubled artist, something that any woman who is happy and also sad in less than 24 hours has, these are Bipolar, according to stigma.

To me, none of this fits my Sissy bliss. The truth about Bipolar, and many other mental illnesses are that it is completely different for everyone. These illnesses, they are simply labels for a cluster of symptoms which point us in the right direction toward effective treatment. Bipolar is not what my sister IS, it is what she has. It is a part of her, and part of her life, but it is not HER.

My sister is highly intelligent, she is thoughtful, kind, and caring. She has an energetic and curious nature, and thrives on new learning. She has a wicked sense of humour and is ridiculously good at games, like, seriously, I have never EVER ever beat her in a game of monopoly. So which of these things mean she is Bipolar? None of them.
So what good are those words then? Bipolar Disorder… these two words have meant that this year, my little Blister has finally been taken seriously by the mental health care team/s she has encountered. It has meant she could be prescribed medication that would help her, not throw her brain chemistry further out of whack. It has meant that there is hope. Not that she is “fixed” or “better now”, because what ridiculous things to think will happen over the space of some months, but there is hope.

I don’t know if she sees it this way. I’m not very good at asking her these questions. New Years Resolution #1, ask her about this.

For a long time, I grieved for her. I thought it inevitable that she would die at the hands of an undiagnosed mental illness. I felt myself scream out in my head, willing someone to realise she needed more than what myself or anyone in my family could possibly give her, on the outside probably seeming uncaring and immobilised. Battling the idea that we could (in the early days when we were teenagers and still under the same roof together) take her for a walk in the sunshine, play games with her, and walk on eggshells around her and she will be better. These things won’t change the chemicals and the hormone levels in her brain.
If I had a penny for every time I heard “Well have you tried taking her to a funny movie or something?” I might actually be able to afford to go see a movie (seriously, have you seen the prices they charge for a movie ticket these days… now THAT’S mental). All of this was unsolicited too, just by the way, from people who did not know me or my family well enought to be using their assumptions and stigmatised knowledge of mental illness to be dishing out well-meaning but absolutely terrible and useless advice. Then again how could I expect anyone else to understand when I don’t really understand it all myself?

This year has been an ungrieving, learning that she is here. I haven’t lost her, and I’m no longer sitting around waiting for that phone call (although I do still have my warpy anxiety brain moments of course). And it has been confusing as hell. My gorgeous sister, in so much pain and going through so much. Completely up against it and basically told by society that this is it for her now, she doesnt HAVE bipolar, she IS Bipolar. Watching my amazing parents come to terms with this diagnosis, not knowing what to say or do but just wishing with every ounce of my existence for them to be happy and not worried (whether they should be worried or not).

My Sister has come so far but can’t see it, she can’t see the quiet determination and strength that has brought her here. I know that to her it must feel like trying to get out of quicksand. But to me she is a freaking superstar. I can see this strength, and that is why I have hope. I know the strength and intelligence she has that will get her through the coming year, and I am so excited to see what she does with these things that make her who she is.

So how do I explain my relief because of something that has brought her, and my family pain and worry? Especially when I know the extra challenges Sis will face with this particular mental illness. And I can’t possibly begin to understand what it has felt like for her, what her experience has been, I have no idea… New Years Resolution #2: figure all that shit out.

Getting closer toward the end of 2019 I got tired. Really tired. So tired I went to the doctor and said “Um, I’m… really tired.” She adjusted my meds and we made another appointment for my psychologist. But I was still really bloody tired. Different tired, couldn’t lift my arms tired. I went back to the doctor, “Um, I’m… still really tired, and also kinda, confused” I was told I needed to wait to adjust to my new dosage. OK. Yup cool great fantastic amazing, I’m having trouble getting out of bed (for new reasons this time; my body seems to be made of lead and everything is aching, unlike the depressive reasons of the past), but yeah sure, I’ll wait. 2 months is heaps yeah? Yeah well “Doc, I’m STILL really tired. I can’t feed myself, I can’t go to the gym, I’m struggling to get through the day at work…” Have a guess what I got told by the doctor who until this debacle had actually been quite helpful, “Yes well look, you have depression. I just really don’t understand why. I think you should try to make it back to the gym at least once a week.”

I promptly made an appointment with a different doctor.

The first thing my new doctor did? Test my iron levels… Yup, I had dangerously low iron levels (I still do, but they are A LOT better after 3 months on heavy-weight iron tablets). I had spent months desperately trying to work on my mental health, while not once being tested for my physical health.

We talk about stigma a lot, but I don’t think I ever really understood its long reaching and unpredictable effects until this year.

If I had to sum up 2019, I would say it was the year I truly learned about stigma, froma number of perspectives. I learnt to let go of my anger towards people who are victims to our societal ideas on mental illness, I hope they never have to look stigma in the face. I learnt that I was right all along; my sister is one of the strongest and most amazing young women in the world. I learnt that sometimes if you have a mental illness, physical symptoms don’t get taken seriously.

In between these things I am telling you that were… not fun, there were fun things, excitement, delight. An Iggy pop concert, and overseas trip, my first cruise, a girls weekend to Uluru with my Mum and sister, spending weekends having deep conversations with my dad while he toiled away ona house he was renovating.

There was also a huge amount of growth. Massive. Impossible to begin to describe.

Not to throw shade at my old job, but I could no longer grow there. I was like a flower (a really pretty one, obvs) that needed repotting. I had been there 7 years! But I was stuck, not wanting to let go of my loyalty, of my friendships, of the lessons I had already learnt. But this is where some advice I got from some random lady I will probably never see again at a Womens Circle in Ubud, Bali kind of rings true for me on reflection; sometimes, you have to channel your inner dog, and drop a ball so you can catch a frisbee. I wasn’t capable of this at the start of the year, but now that I have had the ball wrenched out of my hand, I think I have what it takes to drop the ball if I need to, as much as it is fucking terrifying at the time and it feels like your whole life is going to end and the sky will fall in and the world will crumble (Jesus… drama queen!), you will catch a frisbee and be ok… or not, but dogs seem to do ok without either anyway…

But like I started to explain earlier, time is a construct. None of the things that happened this year would have happened without everything that happened the years before that. These things didn’t just “happen” this year, and things won’t just “happen” next year either. Everything is a collection and culmination of time past. It’s nice to draw these lines in the sand, to say “Ok, that’s the end of that shit, what’s next?”, but it isn’t accurate.

In 2020 I want to continue to work hard on the things I now know truly matter, my own kindness and compassion, the way I treat others, the way I view the world, and the way I deal with setbacks. These are the things I can control. There will be negative, there will be positive, and there will be “not worth mentioning”. All I hope for 2020 is that I learn as much about myself and those around me as I did this year. My goodness I hope I have this much to say on this day in 1 years time!

I want to continue to use my voice to break down the stigma anyone with mental problems, bad mental health, and mental illness. I want to get better at communicating to my loved ones these things I seem to be able to type so easily but can’t make come out of my mouth. I want to be a better sister, daughter, friend, partner, earthling, dog and cat parent, and employee. I want to have positive impacts on people and on this planet. New Years resolution #3 be the most perfect person ever! I want to trust myself that if I think there is something mentally OR physically wrong with me I can (and should) seek help.

I don’t know what I hoped to acheive with my ramblings, but it has felt good to get it out onto a page. If you have read to the bottom: amazing work, good on you, you got guts kid.

Here’s to 2020: I hope you can cash in on your good deeds from years gone by, and that any horrible crappiness is a lesson in disguise, and more karma cash for the future.

Sleep Well.

-Em. xx

S1 E1 – Introduction

Original podcast aired on 1st May 2019

**Quick content warning: we are going to be discussing mental-health and may discuss suicide and other content that may alarm you.** 

This is the first time that either of us have produced a podcast which is pretty exciting… and terrifying.

This is a little, independant, self-produced podcast. We are sitting in our beautiful studio in Emilie’s house.  We call it a studio but it’s actually the spare room… We can see my beautifully self-constructed felt mood board  that I made out of leftover cardboard from the bed frame. So there is some context on where we are when we are talking to you.  

Obviously being the first time that we have produced a podcast we will need your help getting this off the ground. if you could please rate and review as well as subscribing and sharing, we would really appreciate it! 

We are also trying to get a little community up and running so we have a Facebook group called It’s not all in your head,  and you can find us on Instagram @itsnotallinyourheadpod or email us at itsnotallinyourhead@outlook.com.

So you probably want to know what we are going to talk about in this podcast, what are we about, and who are these two crazies that that you are listening to? Ooo  should we use the word crazies? It’s a bit on the nose but I think we have burnt the right…. When we say “crazies” we mean it as a term of endearment; we love crazy people, we are crazy people.

So what are we going to talk about? Look we are not experts and we are not professionals, but both of us have lived experience and a real passion for mental health, so I suppose we both want to leave no stone unturned in examining the past present and future of mental health.

And there are some pretty scary stats that maybe you’re not all aware of, but they are pretty daunting in the face of mental health problems, such as 1 in 5 Australians now experience mental illness but less than half of them are actually seeking treatment of any kind. We just aren’t having enough of these conversations. I think the chances are if you don’t have a mental illness someone close to you does, but how much do we know about it? It’s not something that’s regularly talked about so we just don’t know. Even us: we have mental illnesses and don’t know that much about it! There are also some pretty sobering statistics out there which might bring it a little closer to home; on average there a 36 suicide attempts every day in Australia including an average of 6 deaths, which is terrifying. That’s not just effecting those who have lost their battle with mental illness, that’s having an ongoing effect in families, friends and communities. Even the fact which I found very interesting: unemployment is 4% higher in those with mental illness. It’s having a tangible impact, it’s not all in your head.  One of the scariest facts is that the World Health Organisation has predicted that by year 2030, depression will be the world’s biggest health issue, which is pretty messed up considering how bad pollution and global warming are.

It’s so sad, we live in such a great time and we are so lucky (not everyone  obviously but definitely us) and blessed, and we wake up with a roof over our head. This is not something you can be vaccinated for or immunised against, this is something that is going to take a lot of effort and a lot of talking to treat which is why we’re here!

So how are we going to try and help? We will be investigating anything from specific mental illnesses, to specific treatments and self-care that you can use to improve your mental health…. we will scour the Earth for answers if we must! 

So it’s probably a good time to let you know who you’re actually listening to because if you’re committing to us, an entire half hour of your time once a week will be taken up!

I’m Emilie, I’m 25 and married I’m a self professed theatre nerd, I’ve got 4 furkids, I work full-time, study part-time and when I go into supermarkets I always check where all the exits are before I go in. 

OK this is going to sound a bit like a broken record; I’m Steph, I’m 25 years old and married… only have one for fur baby, I work full-time, most people see me as this bubbly outgoing person but the reality is I can often found crying on my kitchen floor.

We might move on now to why we have been inspired to do this podcast, why do we want to sit here rambling to each other and hopefully to some others half an hour each week? Part of it is wanting to contribute to the conversation around mental health, and feeling like we have come a long way in our society, but there is a lot more space to talk about it now. Any conversation that can be had about it and exploring more of it is a good thing to break down stigma. Being able to talk about it more and in a different way, have it been open conversation, just like if I said to you I fell over the other day and busted up my arm…. you wouldn’t tell me to shut up or not tell you about it! 

Think about what you talk about at a cafe with a friend,  this is how easy we want it to be to discuss mental health.  If you ask someone how they are, how often will they say, even if they’re not ok: “I’m fine” because it’s a lot harder to actually talk when we’re not fine, and we don’t want to be seen as different or to be ostracized. There is a massive stigma around mental health, mental issues, and mental illness, and we want to unpack that a little bit, and help people know that they can talk about it.

We are also really excited to get some free therapy, because we’re going to be talking to some really knowledgeable professionals, as well as some inspiring people who have gone through some pretty horrific mental illnesses.We guess we are getting to the point where we do want to know a lot more about mental health and what we can do to be at little bit better, and improve our mental health. It’s a really good opportunity for us to develop ourselves and our mental health while trying to help others.

Both of us have had our own experiences, very different experiences with mental illness over the past year I think we’ve both come a long way and have a long way to go.  If there is one person out there who is listening that we can help that’s our job well done.

If you ever need to reach out for support, please do so;

**And if you are ever in immediate danger please call 000, or the emergency number in your country**

Beyond Blue – 1300 22 46 36

https://www.beyondblue.org.au/

Lifeline – 13 11 14

https://www.lifeline.org.au/

Mind Australia

https://www.mindaustralia.org.au

Sane Australia

https://www.sane.org/