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Just because you can’t see it, doesn’t mean it’s not there!

Mental health is a sensitive topic. People do tend to shy away from it, even today with the fear of the association and stigma attached. The worry that your making it up, you’re not a coper or ‘it’s all in your head’ make mental health a taboo subject.  I think the problem with Mental health is that it is not visible or tangible. However, just because you can’t see it, does not mean it is not there. You can’t see or feel oxygen but we accept it is essential for life.

There has been quite a brave stance on speaking out about mental health issues on twitter recently, with many people posting about their personal experiences of dealing with their condition, whether it be depression, post natal depression, and Bi-polar disorder . I actually haven’t seen anyone write about experiences of suffering from schizophrenia yet but I am sure and hope that it will happen. People need to be more aware.

So where am I coming from on this? Have I experienced mental health issues? So far in life I have been fortunate that I have not experienced any acute form of mental illness. I have however treated people in their acute stage of illness back when I worked as an Occupational Therapist in London. My first job was working in an Acute Mental Health hospital in East London and it was my passion. Due to me being a newly qualified OT I had to rotate onto a different area of healthcare after 6 months and this moved me from mental health to physical health and it was there that I lost my want to be an OT. So this is me trying to inform you a bit more about mental health from a health professional perspective.

So what did my job involve?

I worked on a ward where we had some very poorly patients. It was then a locked ward as the clients at this point of their illness were either at risk to themselves or others. Mostly themselves. Symptoms, depending on the condition varied, it could range from self neglect and care, withdrawn, no inhibitions, aggression, high arousal, lack of libido, delusions of grandeur, hearing voices, and heightened emotions.

Sectioning sounds like a very frightening word. To be locked up. The thing with sectioning is that you have to be deemed without capacity, meaning you are not capable of making rational decisions for your own well-being due to your ill-health and therefore doctors are allowed to take over your care. This is important as the condition is out of the control of patient, and often they will refuse care and support. You could argue that if you refused treatment for cancer, that would be accepted, but only if you were not experiencing symptoms like believing you are related to the Royal Family (delusion of grandeur)  with it! To refuse treatment of physical health you still have to be deemed of sound mind.

In the first few weeks of admittance I would go to do an initial interview. I would be lucky if the patient was willing to talk to me at this point. Usually I would be waiting for their medication to kick in. This has its own issues, as although ill, the patient was not stupid, and if they did not want to take their meds, they would find ways to trick staff and very successfully on some occasions.

At this acute stage there is no reasoning or rational explanation. You cannot educate at this point. The treatment is very clinical. However once the medication does start to relieve symptoms that is when I could come in.

We ran relaxation groups,  Cookery schools, Self esteem course, anxiety management,  self-care classes, art therapy, psychotherapy. Often patients would only come to begin with because they were desperate to get off the ward, but slowly and surely the sessions started to work and the patients could start to see the benefits. Within weeks of their care we would be out again into the community and then looking at returning to home and ensuring a key-worker and care package if needed was in place.

When I retrained as a teacher and I would talk to high school students about mental health, and they had very limited knowledge. As far as they were concerned it meant crazy. They did not see it as unwell, but as odd. Re-educating their understanding was something I loved.

We would go to the drama suite and I would start by asking if anyone had a health issue they didn’t mind talking about. Usually some one had an allergy or diabetes to discuss. We talked about treatment, how it affected life and whether people were different towards them. The answer was always no. It was accepted that they had a ‘physical health’ condition that required treatment.

The condition they are mostly interested in is schizophrenia, and is commonly misunderstood as split personality. This is not the case as all. It is not Jekyll and Hyde! Most commonly diagnosed by hearing voices or experiencing delusions of grandeur schizophrenia is a frightening place to be in its acute stage however, once treated and in control, with support, medication and therapy a person can live a ‘normal’ (if such a thing exists – I know I am still searching), happy life. That is not to stay they won’t experience relapses or triggers that set it off, however this is no difference to a heart condition that has been well medicated and in control that suddenly relapses.

I then went on to trying to explain what hearing voices must be like. I would get one volunteer to walk around the room and two other to follow and obstruct but not touch their path by saying things to them. Inevitably you could see the student starting to get frustrated and we would stop before they got cross. I explained how upsetting hearing insulting things in you ears must be and that at least during this task they

1. Know it is made up/drama

2. Know what and who is causing it.

But to now know you have heard something but the body to the voice not be there must be terrifying. You may start to believe the radio is giving you messages or the T.V is talking to you. That could be considered a realistic conclusion. The problem by this point is however, that no-one else can hear the voices. The sufferer become paranoid and often fears conspiracy. They worry about harm to themselves or their family.

Hopefully this is the point at which the medics become involved.

We moved into paranoia and depression and the link to drug use. The area in which I teach is considered the most deprived in the country and drug and alcohol use within families is  high. I always explain it as the chicken and the egg..which comes first? The answer is in fact debatable. Now whether someone was always prone to a mental health condition and the drugs exacerbated it, or it caused it will never know but it is a huge risk. In my experience drug use and mental illness in the extreme cases (usually excluding depression – although many would then self medicate) went hand in hand. often we were treating dual diagnosis of a mental health condition and an addiction.

I have witnessed many people with acute mental illness get better. I am lucky that I have been fortunate enough to be involved in that care. I will never truly understand what it is the person actually experiences and nor will I ever pretend to. I can only report on what I see. However, mental health illness is real, it is there, and it needs to be acknowledged. Just because you can’t see it, does not mean it is not there.




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33 comments to Just because you can’t see it, doesn’t mean it’s not there!

  • Great post. My husband has suffered depression and mental illness for years. You can view my most recent update here: (if you would like to). I have lost count of the number of ‘friends’ we have lost over the years to them not understanding what is happening with him. It’s so sad.

    • That is so sad to think you have lost friends. People wouldn’t do it, if you said he had MS or cancer…in fact they are likely to be more supportive. I shall pop over to your post. Would love to read. x

  • […] This post was Twitted by MultipleMummy […]

  • Susan

    I suffered severe antenatal depression five and a half years ago and was sectioned as I was so incapable of looking after myself or my other 3 children. I felt broken and wanted to wear a bandage on my head to show the world. I figured if I’d broken my leg I would have a cast and people would expect a limp, therefore my head was broken which was why my behaviour was not the norm. It was about the time Britney shaved her head and I completely understood why. Anyhow thanks to the amazing care of the mental health service and my beloved mum I am now well, a normal functioning stressed out Mum. People don’t understand that when you are ill what seems bonkers and irrational is completely understandable in your own head. I don’t ever want to go back to that dark time.

    • Broken is a word that came up a lot with patients I treated. Well bones are one thing but the mind is far more complex to mend, especially if your not sure where the break is. I remember Britney shaving her head and screaming out at the TV for people to help her and stop passing judgement. I hope that you are in a stable place and are looking after yourself. Best wishes to you. x

  • Great post and a fantastic way to explain about mental illness – as you say, just because we can’t see it doesn’t mean that it isn’t there

  • What a super post from the other side of the fence. I suffer from depression adn have blogged about it (not on my madhouse blog)
    I have received fantastic care, both accute and long term and am keen to remove the stigma. Thank you for such an incisive post

    • I think the health care system is very effective nowadays and wards are not like the ‘prisons’ and ‘asylums’ people envision. The stigma is something that prevents someone that is now well from moving forward, it effects relationships and also returning to work. Glad your currently well. Thank you for reading. x

  • Great post – I did that hearing voices exercise as one of my OT tutorials at Uni – brings back memories!

    • Another OT – hello! Where did you train? Are you still practising and in what field! I am so nosy! The hearing voices exercise is very effective!

      • I trained in Coventry but never really worked as a ‘proper’ OT after graduating – long story! I went on to do behavioural therapy with children with autism before stopping work to have children – then started my own business.

  • What a great post. I have suffered from depression and never admitted it because of the stigmata attached. This is good to see from the other side x

  • Hi there. Found this post form the Brit Mums blog carnival where my friend Stacey is the bride at the end (I was her bridesmaid).

    Great post on MH. I am an OT lecturer and the hearing voices activity sounds really interesting.

    Sounds like you are still using your OT skills in your teaching role.

    We’ve been having an OT chat on Twitter tonight about occ therapy professional identity and about OTs not potentially doing occupational therapy in some settings etc. wonder if that it is what you felt.

    • Ah thank you for popping on over – it is alway lovely to find another OT.

      i found practising OT in physical health frustrating, most treatments were carried out by OTA’s, I prescribe equipment if their area allowed it (bloody postal code lottery) and signed the forms, wrote the nots and planned discharges. I missed the clinical aspect considerably.

      I love teaching and being in the classroom. It makes you think outside the box. You should use that activity with your students, it is very effective. What uni are you lecturing at?

  • A great post. I’ve suffered from depression since my teens and know that medication alone isn’t always the way to help. Many long-term sufferers of depression are moved from one med to another, which isn’t always helpful and can be distressing, especially when you ‘come off’ one form over 3 weeks and have to wait a similar amount of time for the new ones to kick in.
    Like a previous poster said about her husband, I too have lost friends and was estranged from my own family for years, due to their not being able to handle the illness and its symptoms. I think fear plays a big part in that. Your work seems to allow people to try to understand what it must be like, to take the fear away and open the doors to greater understanding. and hopefully more sympathy.
    Without my wife, I wouldn’t be here. Full stop. My children make me happier than any SSRI has, and they are my reasons to want to treat this illness and break the patterns in my life that cause the downward spirals. People like you, at the coalface so to speak, help sufferers to try to understand that a more settled and happier life is possible even when they are feeling at their lowest and I hope you know, that by doing what you do, you’ve made a positive difference.

    • Reading everyone’s brave responses has made me well up but yours has got me! Firstly I think people forget that men can suffer from mental health illness. It is sad that you have lost friends, but i feel sad for them, look at the family they are missing out on. Who would not want to be a part of that? You are very lucky to have such a supportive wife that knows you so well, and would be able to notice the signs and symptoms should you ever get poorly. I am so pleased to hear how much joy your children have brought to your life. They are a great trigger to make you want to stay well, when things can all get too much.

      Changing medication is a complete chore but often a necessity – like any illness the treatments are not always fun and pleasant. The kicking in time is always the worst bit, as you begin to doubt it will work.

      It is something I am passionate about and wish I could do more, but not a star, you guys are, the ones that battle illness everyday, and see the darkest times and still come out fighting the other side.

      By the way have you see the Talking mental campaign on channel 4 – it is trying to raise awareness of mental health and you can follow on twitter.

  • Jennykatexx

    I have suffered with depression & anxiety most of my
    life & still do . Most friends have been lost because they do
    not understand & now my life is very lonely.
    I am so pleased that people are speaking out about mental
    health , it’s very misunderstood by a lot of people & it’s about
    time ,”Mental health” is spoken about & accepted as the
    dabilitating ilness that it is .
    Thankyou :-)

    • I totally agree with you – it needs to be discussed more. Do you have a supportive family? Loneliness is not good for your well being lovely. Are you working? You should contact your mental health team for advice and support. xx

  • I’ve never really understood what schizophrenia is before, but I think you’ve explained it really well.

    My dad suffers from mental health issues due to brain damage in the past. The brain is such a delicate and unknown part of our bodies, and it takes such a lot of working out.

    Thanks for writing this.

  • […] an ex Occupational Therapist who worked in mental health I know how therapeutic music can people and in fact it is a therapy within its own […]

  • I read this the other day but couldn’t quite put my comments down straight. Does that make sense??! My sister is a mental health nurse, now over in Australia and my family has a slight history of depression and schizophrenia, going back a few generations. I think the whole area is still shrouded and very much a taboo still. After my son was born, it took me 8 months to ask for help and when I did, my GP told me I had PND. It didn’t feel right and yes, I was ashamed. I have since been told that PTSD was a more suitable diagnosis but even now, I don’t like people who know me, to know this. Attitudes need to change. A colleague once told me that she was made to feel like the apple that was upsetting the apple cart after her PND diagnosis and her boss wanted rid of her. She is good at her job but people didn’t understand that she was ill, since she did not have an outward symptom such as a broken leg etc. Thanks for writing this, still not sure that my comments make sense though!
    ps, visiting via the BYOBH

    • I think you have explained yourself really clearly and have been really open. There is nothing to be ashamed of, and I think once it is more accepted, it will make those who suffer find there recovery a lot easier. xx

  • Hello. Great post. I am a counsellor/psychotherapist by profession so this is something I am familiar with. I also experienced antenatal depression and then PTSD after a traumatic birth. So many women are incorrectly misdiagnosed with PND when its a form of PTSD they are suffering from, especially as some of theb symptoms are similar to depression.

    • Mis- diagnosis is quite common, with the problem being it is done in the GP office and not seen by a specialist. I often found also that when they did not know what it was it was classed as a personality disorder. This diagnosis drives me mad. Thanks for reading.

  • Such a great post, well done you for writing it. As you know I have been really struggling with PND since my son was born almost 2 years ago and have had anxiety for as long as I can remember. It’s so hard to make people understand how crippling it can be.

    • Yes, I think people or have never suffered or seen anyone experience it, are really in the dark and because of lack of education are not corrected on their wrong information. x

  • Isn’t part of the stigma calling it a “mental illness” in the first place, when we’re discussing mental states that aren’t “typical” or normal? Some states are truly extreme, but the widespread and growing treatment of depression may be sign of something else.

    A fever is a body’s way of fending off infection. It’s a positive attempt to address an abnormal threat. Some mental states may be much the same – a coping method that we only poorly understand, to stresses too overwhelming to meet conventionally.

    Researchers note that many women report less depression, less tearful moments, and better mental health, when men help around the house more, for example.

    If we took better care of our mental health, our priorities might be different. But isn’t it better to treat the cause, rather the symptoms after things have gone well far beyond coping?

    • What an amazing response – I totally agree with you and prevention is always better than cure. In some parts of europe they are allowed to take sick days that coming under the heading of mental wellbeing, basically meaning if you are not in the mood, overworked, tired or just need a duvet day you can, where as in this country we slog on until the heart attack or mental illness is at critical!

      I don’t however believe it is like catching a cold, I believe it is something chemically occurring and the reasons why are not always known, so fending it off, or symptoms are not always there to recognise, just like when someone has a heart attack and you always thought they were healthy.

      I think we do need to address it as an illness especially in it’s acute stage as behaviour and well being is not normal on those occasions and it not something that can be lived with like being ‘eccentric’ for example. Most people are a danger to themselves or others. You would not not treat a diabetic (as they would die) and you would certainly not say their condition is normal or there sugar levels or insulin production are normal. The difference being is that we accept the condition of diabetes because it can be managed and this is what needs to occur in mental health – you may suffer from a condition but you can get well and control it, and again this links back to prevention, ensuring the right care and treatment is in place. I think that is the key, that mental illness and physical illness are real, it is just that one is more accepted than the other.

      Thanks for reading and commenting.

  • That was so interesting! It is such a minefield isn’t it. I am on the edge of it with PND but my Mother in Law is BiPolar. Schizophrenia must be even worse! And the alcohol? Hard to know whether it’s a comfort or a cause!
    Thank you so much for linking this up to Love Mummy Blogs last week

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