Formulating formulation

As a CPN I am frequently reminded that we provide episodic care, that those on my caseload should be recovered to the point of no longer requiring secondary care within a desired number of sessions. Now that is a lot of pressure on both me and the service user, with an overwhelming feeling of failure when we don’t manage that. I sometimes think we have gone beyond austerity and that this is me simply applying a dressing on the wound until the person is re-referred back in to the team. I don’t want that, I don’t think any nurse wants that, we want to walk side by side along a journey of recovery then wave the person we have nursed off into their future stronger than ever.

We CPN’s all work in different ways but I think despite knowing the time pressures it is impossible for me to walk into a persons home and say ‘Hi my name is xxxxx and could you please start engaging in this treatment plan I think is right for you’, the person and I need to build a therapeutic relationship. Maybe one or two sessions whereby we get to know each other a bit, where I tell them their dog is cute and ask them about the pictures on the fireplace, if we share a love of reading I may recommend a novel to them. I need to put them at ease, they need to be able to trust me if I want them to feel comfortable to off load their deepest and often darkest thoughts.

So the first session or two are ‘get to know you/build a therapeutic relationship’ type sessions and during the time over these couple of sessions I would try to build up a picture of risk and document this on the FACE risk which is the tool my trust uses, I’d get them to complete a consent to share document so we both know and understand where the restrictions lie. Get the basics done from a documentation point of view.

Next thing I probably ought to document is care plans but I am of the mindset that we can’t produce a care plan until we have a decent formulation. How can we decide a plan of treatment if we aren’t even 100% sure where the main issues are?

I use the 5P’s formulation which includes considering:

  1. Presenting problem(s)
  2. Predisposing factors which made the individual vulnerable to the problem
  3. Precipitating factors which triggered the problem
  4. Perpectuating factors such as mechanisms which keep a problem going or unintended consequences of an attempt to cope with the problem
  5. Protective factors

It is important for the person to know that what is important to them is important to me. As you may have noticed if you read my last blog was that I plan on having a few sessions of talking therapy myself to consider my current all encompassing worry that my work place and colleagues will connect my illness and my competence. As I plan on only having a couple of sessions to talk it through I thought it would save time if I arrived with my formulation already done… so because I am living the rock n roll life I thought I would make a start on it tonight. A Saturday night on formulation.

Whilst sat wondering if there was anything else to add to my precipitating factors list I began to realise that maybe I am more than a list (who knew?!?!?). We are all more than a list. Now I am not saying here that the 5P’s formulation is not a great tool because it is a fab way to capture what is sometimes a difficult narrative to grasp in the minimal time we as clinicians have. I always do the 5P’s formulation with the person but attempting to produce my own made me acutely aware that maybe I need to consider how I capture this vital background in a less formal and more human. I was reminded also this evening how emotional it can be to see all of this written down in black and white, reminded not to underestimate that because these formulation sessions are not ‘therapy’ as such they can still be difficult for the person I am working with and depending upon their level of distress and how much they are able to tolerate may take more than one session to complete.

It is not until now that we can even begin to produce care plans. Again this is something I do with the person I am nursing, in a session. it makes sense to co-produce them, why would someone be invested in care done to them rather than care done with them?

So now if we consider that on average with a caseload of 35 people are seen 3 weekly and taking just the above into account at roughly five sessions, which in itself is conservative as some people may take much longer to engage then this is around 15 weeks, add a couple of extra weeks for annual lave of the CPN and without any other hiatus this is four months before any actual therapeutic intervention takes place. Those four months will hopefully have helped to build trust and to have aided the person to have hope once more.  They certainly aren’t wasted weeks but they don’t fit neatly with the episodic care model as comfortably as most trusts would like. Whilst I absolutely agree that the days of the Community Mental Health Team CMHT are over and the new player is the Community Treatment Team CTT and this is a good thing however (you didn’t think you would get away from me without a however did you?) for some people the rational unbiased support and the sharing of hope that comes with that is vital and is treatment in itself. Lets never minimise the role of hand holding, sometimes we all need our hand held to get us through.

Too often we declare people as ‘treatment resistant’ when actually maybe we just need to rethink the treatment we offer rather than absolve ourselves of guilt by referring to our episodic model of care. Illness is not episodic. People are not episodic. If we explore the formulation with a solution focused approach then this in itself could be the most appropriate treatment going. I will never rush a formulation, strange that it took producing my own in a bid to save time to realise that.

That sounds like fun. Mania.

But mania, that’s brilliant isn’t it? That’s the fun part. The compensation for the horrific, crippling lows of bipolar disorder. Let me set that particular record straight; this episode has not been fun.

Getting there ‘the ascentthat felt fun and coming back down ‘the descent’ well that journey was pretty fun in parts too. The middle bit though, not fun at all. I felt afraid, terrified even and at that point I was no where near even having to face the embarrassment and destruction I had caused.

I do remember feeling afraid of my own brain, it was almost like I had several brains and each of them was stuck on a speed I could no longer keep up with like a dysfunctional record player with the vinyl record being unsure if or when it will ever stop.

Just a week prior to this my brain going faster held a mild irritation that everyone and everything seemed to be going particularly slowly. This was hideous but manageable, if it had stayed here I may have just embraced my productivity levels but it didn’t. The ascent had barely begun.

At its height though I could hear my myself talking and I was aware that this inconsistent monologue was coming from my mouth however I had no more knowledge than anyone else in the room as to what I would say next as I hadn’t processed it.

Just a week before this conversely everything made total sense and I mean everything. The words that rolled off my tongue and the tongues of others were connected, not everyone understood the connections but this simply confirmed what I was already beginning to realise that I was a superior being destined for great things. I could hear the poetry.

I wonder, in hind sight, if it was this ridiculously inflated sense of self that led me to start writing a sitcom (based in an office of CPN’s) then being certain, I can’t say pretty sure because I was certain that it would be such a hit so much so that I actually penned my resignation and put it on my bosses desk. Maybe?

I heard myself swear at people in a seemingly deliberate, verbally abusive way, which is so far from my norm that this added to my being afraid of myself. What was I going to do next?

This time it had gone beyond baking cakes at 3am, it had gone beyond deciding to decorate and starting to impulsively strip wallpaper at 11pm when I ought to be heading to bed, it had even gone beyond the time that I was unable to decide which bunch of flowers to buy in Sainsbury’s so I bought them all. These things made me slightly unpopular in my marriage but they weren’t the end of the world.

I have nearly always been able to pull it back before, I have too much to lose not to and I am rather cross with myself that I didn’t spot this in time. Accepting that this wasn’t my fault may take some time. Self compassion and time.

When I feel my thoughts getting faster and my senses becoming enhanced I know it is time for extreme self care. I cancel everything in my diary, even the good stuff like meeting friends or going to the theatre and take medication that I keep in the house to make me sleep and sleep I do. No TV, no music with lyrics, nothing, I create a beige mundane world where my brain has the opportunity to rest. To fulfil its obligation to rest.

A few years ago the last time I had one of the occasions when I missed the opportunity to get a handle on my ever elevating mood which my husband was putting up with as patiently as ever even when I struggled to decide between all the wonderfully colourful and beautiful flowers in Sainsbury’s so I bought them all, my dear husband embraces my eccentricities, he always has so the line between that and illness is sometimes blurred. I was probably just getting to the stage whereby I needed an intervention when I had a nasty accident and hurt my back, I was put on opiate based painkillers and huge doses of diazapam for my back pain and the combination of those two forced my body to sleep and therefore resolved over time my high mood.

Once many years ago and long before I gained enough knowledge and insight into my patterns very nearly ended up married to someone I had only known for a couple of weeks, we were turned away from the registry office for being intoxicated (big phew!). The ‘episode’ seemed to last for months but I felt great, it never ended up like this. I rode the wave and enjoyed every minute. I was young and had nothing to lose, people saw me as the life and soul of the party. They probably thought I was on drugs to keep going but I wasn’t. I even have a couple of tattoo’s from periods of elation… hidden ones mind!

The temptation to ‘ride the wave’ is more than just temptation it is a powerful force, this offer of bubbling excitement and an overwhelming feeling of happiness. What’s not to love? Who wouldn’t want to feel like that?

To medicate and try to rest my brain with sleep and low stimulation is not easy, it goes against everything I am feeling in that moment.

The ascent is seductive.

Inevitably what goes up must come down and with a little encouragement (read medication!) from the crisis team my descent started.

A few people had tried to tell me they thought I was poorly the previous week and I thought they were ridiculous, I kept telling them “I feel great, I’m not depressed” they agreed with me that I absolutely wasn’t depressed but I didn’t understand or want to understand what they meant. I felt great how could I be poorly? Insight was slowly seeping away…

By the weekend my dear friend and my husband decided it was time to ring the Crisis team. Even the ascent was gaining speed now so by the Monday when I was assessed I was irritable and agitated, as much with how I was feeling as with the Crisis clinicians who were there to assess me. I wondered why on Earth they could not see that I just needed a couple of good nights sleep?

I agreed to the Crisis team giving me some medication and coming to see me at home partly to get rid of them, it’s pointless arguing; experience has taught me that any disagreement as a patient in mental health services becomes a symptom of something (a whole other blog for a whole other day!). And partly because I was becoming increasingly afraid of where my own thoughts were going to lead me next.

The Crisis team were great, once they realised I was being concordant with medication they gave me control of how often I saw them (as little as possible!). After a few nights where I slept a bit better and took significant doses of sedating medication during the day which barely touched me we moved on in that after a few decent hours of medication induced sleep I felt rested, energised in my brain but my body felt rested and this was apparent with my thoughts being a bit slower and my speech certainly being slower and more comprehensible. I was still flirting from subject to subject and folk were still talking in rhymes here there and everywhere but it was slightly slower which was a relief.

As the day went on and I became more stimulated by the world around me the speed went up a gear but this lessened as the days and weeks went on.

Eventually I began to feel ‘normal’ whatever that is, but normal for me however was still aware how this could alter rapidly with my environment as I was still very vulnerable to elation. I think that’s gone now although maybe don’t ask me about the pay deal 😉

I hate the medication I am on. Last time I took it I gained five stone in four months which I am still carrying and which upsets me greatly. But it works. Laughably after recent weeks I am now complaining to my hubby I feel so tired all of the time because of the meds!

Then came the apologies. The red cheeked conversations were I have expressed my regret over things I have said and done recently, I feel so mortified over some things. The late night texts ‘because I had a brilliant idea’ to the knowledge I have sworn at people and shouted in church and that’s only the tip of the iceberg called mania that I was climbing. When I reflect I can see how close to the top of the hypomania scale I came and how easily it would have been to leap over that hurdle into full mania.

I knew what was coming the day the psychiatrist mentioned hypomania and bipolar, it’s a conversation I have avoided for just over a decade which was my first ever contact with mental health services after I had our daughter. I even tried making up a diagnostic term and telling the Dr I simple have a Hyperthymic Personality Structure… which I still think is a great diagnosis and it should be included in DSM 6!

I am ashamed of the self stigma I have shown since being branded with this diagnosis. I say branded because I feel like it has been written on my forehead with hot irons, for all to see and me to feel.

I lost so much to stigma when I was diagnosed with severe depression and hospitalised after I had my daughter. I lost my career which laughably was in HR and employment law and I lost some friends who just ‘didn’t get it’. I can not lose anything else to stigma, I just can’t.

Even last year it was suggested to me that maybe someone with a history of mental illness should consider a less stressful job than nursing. Stigma ladies and gentlemen is still alive and well. I am a good nurse, a competent nurse. When I am well I like to think I make a difference, I am a good nurse because of my lived experience not in-spite of it.

This recent episode has knocked my confidence which I was only just regaining after the last episode of depression I experienced. I am wearing greys and blacks as I am afraid if I wear colour people will assume I am ill, I am leaving the room when something funny is said to ‘go to the printer’ because if I laugh they may think I am hypomanic again or if I don’t laugh people might assume I have crashed into a deep depression.

Rock. Hard place. Yeah that’s me stuck in the middle.

I am so worried that colleagues will relate my illness and my competence, it’s matterless how many people try to reassure me that is the internal monologue I am running at present, I’m hoping a couple of sessions of talking therapy may help me work through that.

Mental Illness has taken so much from me but I refuse to be subservient. I am wearing my armour which consists of family, friends, Jesus and medication and then I am ready to fight, or I will be, just not yet. First I need to heal.

Depression is like needing your ears syringed – A reflection on my experiences.

Depression is a word we hear a great deal these days, which in some respects is great as mental health has held its stigma like a shield to keep us from the rest of society for too long. In other ways however it has become over used for example “I’ve got to work this weekend I’m so depressed” which over time minimises and on occasions ridicules what can be a disabling and debilitating illness which sadly sometimes proves fatal. It is that narrow view of depression which leaves so many sufferers delaying seeking help as they don’t want to be seen as weak, I’m a mental health nurse and fear of that view from those around me certainly influenced me seeking support and I ought to know better.
Here I shall outline my personal experience of depression, this isn’t from a textbook and it isn’t from my work as a mental health nurse this is my experience. My life.

Depression is more than sadness and tears.

It is a brain so slow that a simple ‘yes’ or ‘no’ response feels more pressured than a post graduate dissertation deadline even when the person waiting for the answer is a patient loved one who repeats the question until you can process with a kind smile on their face.

It is eating tins of sweetcorn or tubs of glace cherries as decisions over food mean making a sandwich becomes simply too challenging and that is without the lack of motivation which becomes all encompassing.

It is having thoughts which are so far removed from your usual belief system yet being really angry when the lovely nurse suggested they were symptoms of psychosis in your care plan. I’m a nurse, I’d know obviously.

It is legs so hairy that never mind the worry over being detained under the Mental Health Act the worry should in fact be being taken by the local zoo or animal park.

It is, in the early stages, when motivation is beginning to dwindle but some ability to process thoughts still exists putting sugar in coffee to save the energy of making a meal.

It is staying for the whole day in pyjamas as no motivation to wash or dress and further through the recovery process still staying in pyjamas as now no clothes in the wardrobe fit due to a combination or medication, inactivity and the kindness of friends bringing treats.

It is seeing that ‘light at the end of the tunnel’ that folk talk about but then looking in the mirror and seeing the physical damage this mental illness has done to your body; googling teeth whitening as you think it may be weeks since you last brushed them.

It is starting medication which makes your mouth really dry so drinking more and therefore in turn never being able to be far from a toilet.

It is your feet seemingly growing but when the light of recovery begins to shine realising it is simply your toe nails having grown so long that they are on the verge of needing minor surgery rather than a pedicure.

It is having to sell items of sentimental value as your period of full salary from work runs out whilst reminding yourself that health and family are what is important not jewellery.

It is, whilst in the depths of despair, seeing messages with scrabble tile fridge magnets written by your hubby to try and encourage you to wash or even brush your hair then a friend having to spend hours brushing the tangles through when you don’t manage that.

It is a head which is itchy and hair which looks wet as it is so unclean.

It is skin peeling off as you are so dehydrated due to forgetting to drink.

It is not realising you are even cold until your husband comes home and wraps a blanket around you and puts the fire on as you are a pretty shade of blue but are still sat in the same position he left you in earlier.

It is not remembering Christmas Day due to ECT treatments and knowing you can’t get those memories back.

It is finding the jar of coffee in the fridge.

It is four inch roots and natural nails when you are usually known for beautiful nail designs.

It is family and friends arranging a rota to be with you after treatments to enable you to stay at home and to be in touch throughout the day to prompt drinking and visits to the toilet.

Its questioning your faith even though in hindsight that same faith is exactly what brought you through when you felt like giving up.

It is putting every ounce of hope in each person I see taking me in their arms and holding me to put my brokenness back together. It never worked for more than one magical second but still craving it with each person I saw and I am the sort of person who hates feeling or appearing to feel needy when well.

It is being told that this new medication which is working well and has you believing in the future again means that despite reaching the top of the list at the fertility clinic you should give up on your hope for another baby.

It is watching the same programme again and not even realising until your husband points this out.

It is wanting to be able to read again as recovery progresses but still not being able to do this with a concentration of no more than 140 characters. Thank you twitter for reintroducing me to the real world.

It is being exhausted and tried of living but equally being terrified of dying.

It is having to exfoliate your entire body once feeling better and watching several layers of skin come away as it is months since you have showered properly, you have stood under the water because hubby told you to but not had the energy to wash.

It is over a year later still having to set a reminder on your phone for taking your medication each evening because you owe it to everyone including yourself to do everything possible to stay well.

It is having tremulous hands because the previous day at work you were so busy you forgot to drink enough and the wonder drug that is lithium also kicks in with its side effects.

It is feeling like you have to prove yourself a little bit more than your colleagues to show how well you are.

It is feeling heartbroken at the reminder when you see three magpies that to have a fighting chance of staying mentally well that nursery rhyme will never fulfill itself.

It is remembering to take days just to be still and remembering that life is not an emergency.

It is being kind to yourself about being a mental health nurse who became so poorly and remembering that an RMN who has ECT is no different to a midwife who gives birth.

For me the decent into the depths of depression and the climb out of this vast quarry is like needing an ear syringe, its gradual; you know you are not right but have no idea how deaf you have become until your ears are syringed. Recovery is as terrifying as the illness for me as looking back it took me months to accept just how ill I had been. I am blessed with a tremendous circle of friends and family around me and a faith which means I believe that God never wastes a hurt and that I will be able to use my experiences to the benefit of others in the years to come.
The examples above aren’t in any sort of order, certainly not chronological, some were early in my period of illness, some were in the depths and some were as I was moving on in my recovery. Some I remember and some I have been told by friends and family as I have a period of time missing from my memory whether from the depression or from the ECT, either way I am stood stronger than ever and so glad every day to be alive.

Writing for Well Being

I was afforded the opportunity to attend a ‘Writing for Well Being’ workshop on Saturday and although I have blogged for years now which I do credit with being a prophylaxis in my own sense of well being but this workshop encouraged me to re-examine my sense of perspective. I LOVED this workshop, such a different way of writing for me.
We were encouraged to write with specific prompts given but then the freedom to let words flow as they entered our brains and exited via our pens.

The first task we were given was to think about a word we like, a favourite word maybe. I chose pomegranate, I just like the way it sounds.

We then had some discussion which led to a three minute task of starting with the words “In the garden…” this is what I penned:

In the garden there are flowers and grass and a slide for all of the children. This is my dream, I wish I had a garden. We are fortunate in so many ways but we don’t have a garden, or ‘outdoor space’ as all these property porn type tv shows refer to it these days.
I would like a garden filled with children but I know I am blessed with the one child I have. Some people will never know the joy of hearing a child shout ‘watch me mum’ on a slide at the park so why should I lust after a garden and more children?

The next task was to use the favourite word of the person to our right, and we passed our word on. The word I was given was ‘Blackbird’, so I had to use this word to inspire me to write for three minutes:

Listen to the blackbird singing. Its tune sings summer over and over. Its real; summer is here and my eyes know that as they are blinded by the bright daffodil yellow of the sun. The sun is just rising up from spring and venturing into summer. The blackbird wants to make sure everyone knows that by singing its song. It wants you to know summer brings hope, the cold of winter is past and summer brings more than the blackbirds song.

Again we had some fab discussion about where the prompt had taken us although thankfully we were never asked to read aloud what we have written. Our next task was a little longer, five minutes I think and our prompt was to start with ‘I feel happy when…’

I feel happy when I hear my daughter laugh. Not just a quiet smile but a raucous giggle. I feel happy when my husband and I get time just to be. We don’t have a lot of money at the moment but I feel happy when this makes me realise money doesn’t buy happiness. It does pay the mortgage however and knowing that is paid makes me happy too!
I feel happy when I am reminded how loved I am and when I am held in strong arms. I feel happy when I am well. Not every day because life is not linear it has ups and downs but when I stop to appreciate what I have. I am happy but happiness can be elusive.

The next task I found very difficult. I had to imagine I was an object in a room and write as that object about an emotion I was experiencing. Write from the view point of an inanimate object? What the heck?

I can’t say I picked because it was more like my pen picked as the thoughts flowed through the ink of my biro and I found myself writing from the point of view of a clock hanging on my living room wall:

I am ticking. Tick tock tick tock tick tock. She keeps looking over, I think she thinks I am getting louder. I think I am all she can hear. She has zoned out, she looks like she stopped listening as the nurse described how poorly she had found her upon first assessing her. Tick tock tick tock tick tock.I can see her almost processing her memories, trying desperately to put them in some sort of order. I have watched her for years hung on this wall but never seen her as distant or vacant as she has been in recent weeks. She usually runs the household looking at me but now she doesn’t even shower.
Tick tock tick tock tick tock… She can’t look at me and shout ‘come on we are late’ because she no longer goes anywhere.
The nurses visit and they glance over at me too. They see her desperation and try, try so hard to give her hope but they hear my call also, tick tock tick tock. She understands though, she is a nurse too.
As the weeks go by the nurses get to know her. She is more able to talk freely and without the delay which cursed her for weeks. One day she laughs and it drowned out my voice tick tock tick tock. I wish I could tell her not to count the minutes but to count the moments.
Moments are priceless and it is moments which give happiness which is what she craves. It is that we all crave. Tick tock tick tock tick…

The next task was to imagine we were a detective walking into our own homes and making a judgement about the person who lives there. I was to write from the perspective of this detective:

This person has so much to remember, no wonder they have a white board on the back of the front door. Nurse appointments, Doctor appointments, occupational health appointments and reminders about non-uniform days and money needing to be paid for school trip, Guides trip and Sunday School trip. I move through to the living room to see photos of a happy family, the mother looks so different to the tired looking woman who let me in.
I see a bible and a Christian book beside the fire. A tired woman but a woman with faith and therefore hope lives here. I see a basket of paste eggs on the side board, all brightly coloured. Maybe the mum did these with the daughter? Maybe she is feeling a little better?
I see a pile of paperwork next to a laptop; I am well and it looks overwhelming to me so how must this mother feel looking at this?
Cards on the fireplace suggest she is loved by many and that her colleagues hope she will be back at work soon, coupled with the letter half written on the open laptop which would suggest she wants to return too.
I thought the woman had gone out but wandering through this home I hear her breathing heavily and realise she is asleep.

The final task we did was a reflective piece of writing based upon a graded visualisation the leader of the workshop read out to us:

I found this more difficult than I imagined I would. I dislike sitting with my eyes closed in a room full of people. I don’t feel comfortable with that, I don’t know why. My discomfort with this took me a little by surprise. My dislike of this task overtook my thoughts and I missed the first part of the graded visualisation task. When I re-engaged with the teachers voice I heard her describe walking through a rocky cave or cavern and my mind wandered. I found myself thinking about the 1980’s film ‘The Goonies’ and about the characters walking through the underground cave and caverns. I was waiting to hear the teacher describe an opening leading to an amazing aqua blue lagoon with a traditional wooden pirate type ship. I desperately tried to bring my mind back but I was lost in this happy memory of a thirty odd year old film. Maybe I shall try to watch it with my daughter this Easter holidays?
I heard the teacher say that through the next cave was an opening with light pouring in and a luscious green hill in front of me. I was back engaging with the exercise. The green hill was so vibrant against the pale blue with only a scattering of bright whilte clouds of the sky. I could smell the grass, not the urban smell of grass recently cut but a natural smell of grass which has grown there for centuries and which is home to all manner of creatures. Lots of creatures including the ladybird I just saw, it had four spots and was the brightest scarlet red I have ever seen. The ladybird spread its wings and flew away; maybe it didn’t like being looked at?
I was stood still breathing in deep lungfuls of country air and feeling quite blessed by the absolute glory of God’s creation when I heard the teacher remind us this was an exercise and bring us back in the room.

It was time to go home.

I have never done anything like this before so these short writing tasks were a totally new experience for me. Whether it is any good or not I shall leave to the readers but I did enjoy it and I shall absolutely book on another workshop of writing for well being, it really got my brain ticking over in a way it haven’t for so many months whilst I’ve been ill.
Anyway I have typed this as it was hand written quickly in 3 minute bursts so feel free to ask if anything doesn’t make sense.

I really recommend the Writing for Wellbeing workshops Laura does… check out her website:

Circus Skills… CPN Life.


Oh my word by anyone’s standards 2016 has been difficult for me in so many ways with family illness then subsequent bereavement with one of those family members, our ongoing infertility issues, a cancer scare and a change of job with pressures which have left me questioning my own capabilities daily. I feel like I have spent months walking a tight rope with my own mental well being. I have written recently about how I have felt here

I’m a mental health nurse, not a circus acrobat, so walking an emotional tight rope has felt dangerous. I have stumbled and nearly fallen on so many occasions, arms outstretched with a wobble and a dance the one we all do until just at the last moment we correct out footing and just about manage to prevent the fall. My colleagues and I are all mental health professionals; nurses, psychiatrists, psychologists and social workers to name but a few and whilst we are acutely aware our own well being and that of each other what we aren’t overly good at is being kind to ourselves and looking after our own well being, we are for each other but rely on coffee and a couple of custard creams so sustain ourselves. Turns out that is not enough. Continue reading

The leaves are falling…

I look out of the office window as I write up my notes from the five service users I have seen that day, knowing I won’t get finished and that I will start tomorrow already behind. I look out of the window at the tree lined residential street where our team is based and note the blast of autumn in the colours on the trees. I feel sure they were still green last week but maybe I just didn’t notice? 

I do remember being shocked by the drop in temperature earlier this week as I went directly from air conditioning in the car to heating. No in between, all or nothing. That’s kind of how I feel about my job, it’s a love hate relationship. I love nursing but I hate what it is doing to me. 

I look at those changing shades on the trees outside my office with a sense of achievement. I survived another season. The trees were bare of leaves last winter when I moved to this role, then they blossomed a beautiful pink and white ‘snow’ which covered the road like God’s confetti. Those same trees have provided a stunning green contrast against the blue of the summer skies and now they are sporting all the reds, oranges and bronzes of autumn. Soon they will fall and the circle will be complete, the branches will be as bare as the day I first looked out of that window. 

Each change in colour is a sign I have survived a little bit longer when I thought I couldn’t possibly, my track record for survival therefore is pretty good. Winter is bleak though, the leaves fall and the branches look harsh and sharp against the low seasonal sun. The energy of the summer sun in providing the green of the leaves is gone and the tree is exhausted. I, like the trees, am exhausted. 

I am desperate for spring already, I yearn for my leaves to grow again and yet I wonder whether I will survive winter. 

Choose Life… (Trigger Warning – Suicide)



The night I tried to end my own life I was as calm as I had ever felt, I was sure that taking my own life was my only option. I had a new baby, a great husband, a well paid job and a home in a lovely village lined with blossom trees. You get where I am going with this? Suicidal thoughts are often, not exclusively, but often a symptom of mental illness and mental illness does not discriminate, it can affect anyone at any time. It affected me and it nearly cost me my life, my daughter her mother and my husband his wife. Continue reading

Waiting for the rain to fall…

I weep in the shower so no one will see my tears fall,

I scream silently so as not to make people feel uncomfortable,

I smile broadly when people ask how many children I have and I reply “just one beautiful daughter”

I cry when I chop onions and I cry when the wind blows against my face. I cry when no one will ask me why. 
I watch our daughter blossom and smile at the young lady she is becoming,

She doesn’t see my tears in the swimming pool as she says “watch me mum” knowing she won’t seek my approval for much longer.

Once again my tears are hidden by the water, yesterday the shower and today the swimming pool. I have enough love in my heart to have two children shout “watch me mum”, I can’t bear this being how the story ends in my journey of motherhood. 
My smile when I talk about my daughter is so genuine but my eyes remain sad. My eyes tell the story of a journey of motherhood different to the one I always anticipated I would have. 
I envisaged a big table with several children all doing their homework whilst I stood chatting asking them about their school day and cooking something nourishing for their dinner. 
Making the decision to have another child after such serious postnatal depression that left me hospitalised for 5 months last time was huge for us as a couple. We made the decision then decided I must complete my nursing degree first and establish my career again. So long before we were trying, which seems like forever now, we were planning therefore in the years since we made the choice we always anticipated our desire to have a baby would come to fruition quickly. We had an appointment with a perinatal psychiatrist a year ago now and formulated a plan which we anticipated we’d need before long, it hadn’t entered our head we might still be waiting. 

Some women are not as fortunate as me, some women will never answer “yes one beautiful daughter” and I can only imagine the torment they feel. I don’t feel worthy of the tears that fall when I remember the blessing of our daughter. God blessed me with a daughter and my tears are disrespectful. My tears show I don’t trust His plan for my life. 
I pray that one day I will hold another babe in my arms, the thought of not becoming a mum again is too much to bear. We haven’t planned anything this year, no holidays, no weekends away, I didn’t even enter the Great North Run. Why? Because we assumed I’d either be poorly with sickness (I had hyperemesis last time) or that I’d be hugely pregnant and not up to going far. Neither are true and yet our lives are still on hold. 
Each month it gets harder, each month I stand in the rain to disguise my tears for a little bit longer and peel a few more onions. Next time you go to make small talk and ask someone if they ever thought about having another baby or indeed whether they want children at all; don’t. Please don’t. It’s the hardest lie in the world to retain ones composure when waiting for the rain to fall. Hold my hand and stand with me in the rain please. 

Being patient being the patient… 

I offer a disingenuous smile as I accept directions from the nursing assistant to the xray department in our local hospital. I smile to stop tears from falling as I am so afraid. I found the lump in my breast on the bank holiday weekend we had at the end of last month so it was a few days before I could see my GP. I kept telling myself that it was ok and felt sure that my GP would say it was nothing, just fibrous tissue maybe?

My GP was lovely and smiled kindly as she said that usually at my age she would ask me to return in a couple of weeks at a different point in my cycle but that my new found lump was ‘so significant’ she didn’t want to wait and that she would refer me to our local hospital. My ears pricked up at that point when I heard her tell me that she was referring me on the two week pathway. I knew what she meant, she hadn’t said the words but I heard her questioning breast cancer loud and clear. 

I am a nurse, I’m used to examining the evidence base of my actions therefore that’s what I did with the help of Google when I got home. So now full possession of the evidence would tell me that statistically I am in a really low risk group for breast cancer, that most lumps in women my age are harmless but I could still close my eyes and see visions of my daughters graduation and her wedding day without me in it. 

My appointment came through in the post within a couple of days and as per the pathway was within two weeks of seeing my GP. 

As luck would have it, and I say that in the loosest sense of the word, we had a CQC inspection at work during those two weeks so I was left with little time to think about the lump and the implications which could come with that. 

My husband took the morning off work to come with me and my boss told me to take as much time as I needed today and not to rush back to the office, I had told a few friends and they text me to tell me they were thinking about me and praying for me. They reminded me my strength is always in Christ which never fails to make me feel stronger to face whatever challenge life throws at me. 

I arrived for my appointment and was seen by a consultant and a nurse who asked me about family history and my own medical history. The consultant then examined me, he agreed he could feel a lump so gave me a slip of paper to take to another department where I was to have a mammogram and an ultrasound scan. He spoke warmly with a reassuring tone in his voice which was exactly what I needed to hear at that moment. I attended for my mammogram first and realised in the small room how alone and how vulnerable I felt. As I undressed I was struck by how naked I felt, not just physically but emotionally. The radiographer sensed my nerves and talked me through the procedure. She asked me to sign a form to confirm I wasn’t pregnant and as we have been trying to become pregnant for a year now this stung more than a little as I signed to confirm not. The harsh clamp of the mammogram made me hold my breath, I wondered in those seconds whether I would ever breathe again. I felt like I was drowning, not in water but in a lust for life I was terrified I wouldn’t get to experience. I was drowning in moments I found myself wondering if I would maybe never have. 

I was then returned to my husband who knowingly squeezed my hand, we have seen off worse challenges than this as a couple. His hand squeeze told me it would be ok whatever the result. After a short wait I was called through to ultra sound where again I was asked to remove my clothes and felt so painfully vulnerable again. The consultant radiographer and her assistant were both wonderful putting me at ease, they talked me through what could have been a deeply dehumanising process whilst ensuring my dignity at all times. As I lay on my back in the ultrasound room I felt a lone tear roll down the side of my face, the emotions of the day beginning to escape without my permission. The radiographer noticed and offered a caring smile, I explained how long we had been trying to conceive and how I had envisaged being in an ultrasound room for such a different reason this year. I hide my disappointment over that behind a smile daily as people as questions such as how many children I have. I scream silently and try never to show that emotion other than to a select couple of people yet today it spilled out of my eyes and I told a complete stranger in the radiographer. 

Back to the clinic I went clutching an envelope which I knew sealed my fate, she she passed it to me the nurse said to use the walk back round to think of any questions and to use the time with the consultant to clear my mind of any worries so I can go home with less weight on my shoulders. Good advice I thought. It’s a strange thing to be the patient when so often I am the nurse, it’s a good reminder how the small comments of care and compassion make such a difference to a patients journey. I shall think on that this week as I plan the care I deliver. 

Waiting to be called back in to see the consultant my heart was beating so hard I thought my rib cage was at risk of bursting. What if it was bad news?

I suspect the consultant is an incredible poker player because I scanned his face for clues as we entered the room but nothing was disclosed by his face. He quickly told me that he had seen nothing sinister on the scan or the mammogram but as he can feel a lump he would like to do a needle biopsy. I have a blood clotting disorder so a needle biopsy would need clotting factor treatment beforehand therefore given the probability of risk after seeing the scans etc we decided to wait a few weeks and see if the lump disseminates on its own or if it is still there in 8 weeks when he has asked me to return to clinic he will do a biopsy then. 

I didn’t know whether to laugh or cry, my heart was going almost as fast as my brain which has been like a hamster wheel for the past week. I headed to work almost on automatic pilot, trying to process the morning. I felt such relief at what he had told me but with a much reduced but still evident sense of foreboding at the fact he may still do the biopsy in 8 weeks if the lump is still there. 

I usually do well to mask my emotions from the world so today was difficult for me to admit my vulnerability. The nursing and medical staff were to be highly commended for putting me at ease, for making a difficult day a little easier. As I reflect upon today I an reminded how frightening being the patient can be. Being a patient today will influence the nurse I am tomorrow with the care I deliver. Those who cared for me today personified the values we all aspire to hold in the NHS, I hope I do that for others. I’m so tired now yet my brain won’t switch off. Hopefully I will rest soon. Good night folks. Xx

Micro Managing

I consider myself blessed to have been able to remain mentally well without medication for while now but this doesn’t mean it’s all plain sailing. There are blips. Last week was a ‘near blip’ and although upon reflection it was a bit of a worry it is also a boost to my confidence that I was able to manage it. Now please don’t mistake the message in this blog, I am not anti medication; absolutely not, at times medication has been absolutely necessary and has saved my life, in fact Thursday evening last week it was medication which helped me avoid a bigger blip. This blog post is about me explaining how I manage on a day to day basis to stay well (or well-ish!), I know it likely won’t always be like that but I also know from experience that the correct medication works really well for me to aid my journey to remission.

Looking back on last week I am able to see how I caught my mood in the absolute nick of time and that even one day later and I may not have been able to recognise how damaging the effects could be. Let me put into context how I think I came close to a blip… Two weeks ago I worked Tuesday through to Friday which were busy in the way an acute ward is the always busy but actually were lovely shifts where I felt good about the amount of time I actually got to spend with patients that week. I was asked to do some overtime on the Saturday which is something I deliberately rarely do as I am very aware of my need for rest days with low stimulation but was swayed by the thought of weekend enhancement plus overtime rate so agreed. Continue reading

Self Worth

Self worth is a difficult thing to quantify, it is not defined by the possessions we have around us or even by the love others feel for us. I know this as I am loved beyond measure and have everything in a material sense that I actually need and yet most days I feel like a stain on society. To those looking from the outside I have it all, a nice home in an affluent area, a good husband and a wonderfully spirited little girl. I have a new career which I love and which affords me the opportunity to enjoy time with my loved ones but I worry every day that I don’t deserve this life. Let me start by saying how settled my mood is, I am not experiencing any symptomology of depression despite how negative some of this blog post may seem. My self esteem has been better than this and I hope this will once again be achievable. Self depreciation has always been my default setting but throughout my life I have had periods of being better able to challenge this. Right now I am struggling with this. Continue reading

Broken Vases…

Last year I published a blog post about my thoughts on the Rotherham report, I received some very kind feedback but also some heart wrenching disclosures from people about their own experiences. One person telling me that I was the first person she had ever told about what she had endured. That blog post was written in anger and not even proof read, I just knew I needed to get it out of my head via my laptop before I would be afforded the luxury of sleep that night. Continue reading

Another chance

So I graduated yesterday, I wore my cap and gown feeling so incredibly proud. Not necessarily because I got a degree but because of what that degree stands for. My BSc Honours in Mental Health Nursing means I get to register as a nurse and do a job I love every day and this means so much more than the qualification itself. It means even more than this to me though, it means society has given me another chance, having already lost a career and a business to my own mental health difficulties this made my graduation yesterday especially poignant.

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Celebrate Recovery – A reflection

You may remember I blogged a while ago about starting to attend a group at church called ‘Celebrate Recovery’. It’s a Christ focussed twelve step programme which helps people with their hurts, habits and hang ups. You can find more details about Celebrate Recovery and whether it runs in your area from the link at the end of this blog. A standard introduction at celebrate recovery is “Hi my name is… , I am a Christian and I am in recovery from…” Which seems simple or so you’d think. Not to me it seems who over analyses everything I say and do. As a nurse I pride myself on being a reflective practitioner, which is a vital part of nursing, yet can’t help but berate myself for taking this too far and obsessing over my inadequacies. I have managed to skirt the introduction thing thus far and it has been without issue but tonight I was asked if I would be willing to read out the beatitudes which would involve an introduction in front of the whole group. I was happy to read out the beatitudes but quickly had a moment of realisation that I didn’t know what to say in my introduction. I could have confidently said I am in recovery from mental illness or childhood sexual abuse or even promiscuity if I go far enough back but however true those statements are they do not reflect why I am attending CR.

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Playing the swan…

The transition from student nurse to registrant is something I spent the final furlong of my nursing degree preparing for however nothing could have prepared me for that day when I introduced my self as a staff nurse.

My main concern is that the person I say “hello my name is Claire and I am your staff nurse” to has no idea whether I have been qualified for ten minutes or ten years and as they don’t know this they have high expectations of me. I worry all the time that I won’t be able to meet those expectations but I’m conscious to try to never show that worry as whether a patient or a family member they need to have faith in their nurse. The people I come into contact with must feel able to have confidence in my knowledge and ability and hopefully one day I may share that confidence!

By the end of my degree I was a fairly confident student who trusted my knowledge base and my skill set so have been surprised how this has changed and my internal monologue runs a mantra of ‘am I good enough?’
I question everything I do ten fold and I haven’t even take responsibility for meds rounds yet so goodness knows what I will feel like then! The feelings that registering with the NMC and its associated accountability generate are quite phenomenal.

I receive positive feedback from patients and from their families which is great as I am able to recognise that maybe I’m not the incompetent fool I manage convince myself I am. Staff on the ward are great too, they offer informal supervision each time I shout ‘help’ in a slightly hysterical tone in the nursing office, guiding me with their experience and nurturing my newness.

My first staff nurse job is on the ward where I did my management placement so I am fortunate to know the team well enough to lean on them when I need to and for them to pick me up when they recognise me struggling. The NHS trust I work for has a comprehensive, year long, preceptorship scheme so I know I am supported amazingly well as I fumble my way through my first year as a qualified mental health nurse. My preceptor is an experienced band six nurse who offers me reassurance and her experience as I need it with her also offering challenges of which she believes I am capable knowing it will boost my confidence when I achieve what she has asked of me.

Each time I think I am moving forward a new experience sets me another challenge to get through and my anxiety levels reduce a little when I achieve it. When I first started I was lucky if I slept for a couple of hours the night before a long shift but this has settled somewhat thank goodness!
A couple of weeks into the job and an incident knocked my confidence it left me wondering if I was capable of nursing at all, I dwelled upon it and worried to obscene and totally unnecessary levels making myself nauseous with anxiety but I can look back and realise that this will be the first of many situations which will come up over my career leaving me wondering ‘what if’. What if doesn’t have to be a negative thing if learning comes from it.
Throughout university we were encouraged to reflect and I would describe myself as a reflective practitioner as this is something I now do without hesitation however if anything I need to practice reflection without always being critical of myself something I am unconsciously prone to doing. I reflect daily as I make my 1.5 hour journey home from work and can sometimes have convinced myself I’m incompetent before I even leave the car park! I think those I work with would be shocked to hear how nervous I feel at the moment as I do my best to ensure for the most part that I at least look like I know what I’m doing!

Yesterday I was given positive feedback about how I handled a situation which escalated quickly and how I remained calm which was great to hear however I struggled to receive that praise, she pointed out that I had deflected back to debriefing over what had happened rather than simply accepting the praise. I wasn’t even aware I had done that until she pointed it out. I used to be able to graciously accept praise when it was offered and have no idea why I have lost this ability over recent years.
I lost so much to my own experience of mental illness, I lost my last career then I lost my business so I struggle to accept that this career which I have worked so hard for will not be taken in a heart beat also. I have a fear roaring away in the pit of my stomach which I hope will disappear eventually. Everyone assures me that as a new nurse a level of anxiety is normal and that I will not feel like this forever so I hope that one day I will just suddenly have a moment of awareness that I am no longer afraid and that I feel confident in my decision making. My preceptor who is very supportive is also very perceptive and I think she has begun to realise that I am playing the swan; gliding along gracefully on the surface and paddling away in a permanent state of utter panic underneath. She gave me a piece of advice that just about everything can wait so I should pause and take a moment if I find myself caught up in the hustle and bustle of the ward. An acute ward is a fast paced environment where decisions often seem to need making quickly but her words gave me the permission I need to tell myself it’s ok to wait a minute and take stock. Better to make the right decision than one I make in haste and regret later. I think this is a piece of advice I will value for years to come.
Today I co-ordinated the whole shift from 7.30am until 8.30pm and other than a couple of small oversights like writing the staffing allocations on the board in the main ward area for example I did ok. Some tasks I did came naturally and others felt more forced but the one thing I do feel confident in is that the patients and for the most part the staff did not register my nerves. Today felt like an achievement, a significant moment in my nursing career as a whole day’s co-ordination went without major issue, there were hic ups but then it’s an acute mental health ward so that is to be expected when nursing 16 very unwell people. Some people even had a good day, a board game mid afternoon generated laughter and friendship amongst ladies thrown together in illness.

The over arching thing I have learned since qualifying is how much I love being a nurse and how blessed I am to be doing a job I love in a team many of whom I class as friends as well as colleagues.
It’s terrifying and humbling in equal measure but it’s the best thing I ever did and I hope I will have a long, happy nursing career over the coming decades.


Self Sabotage

So this is more of a brain fart than a blog post, a bit of a diary entry marking the start of an important change in my life. I hope so anyway.
I spent my late teens and early twenties losing and gaining weight at a rapid pace, sometimes having gone between where a size eight hung off my frame and where a size eighteen was stretched across my vastness, I would sometimes go between these two extremes up to twice each year sometimes maintaining a ‘normal’ size for a few months but mainly expanding or decreasing with only my subconscious aware of why I was doing this.

My body was younger so could take the abuse I threw at it in the form of bulimia or periods of restriction and excessive exercise but when I became pregnant eight years ago I knew that I could not pass my issues on to my child. Ironically I developed hyperemesis gravadarium and vomited between 25-30 times each day for my entire pregnancy but thankfully I managed to kick the habit not having using my previous behaviours since having our daughter in 2006.

Whether coincidence or not but when I gave up my coping tool I experienced a depression severe enough to have hospitalised me. I had experienced mood episodes prior to this but not to this intensity. Since this period of severe depression and another one a few years after that with treatment from medication which added to my weight gain and an inability to leave the house due to fear and anxiety my weight crept up and up. I am able to remain light hearted publicly re my weight but I feel repulsive alone. I am repulsed by my own reflection which is a huge shame as I have reached a point in my life where I actually like me as a person!

Over recent years I have tried a couple of times to lose the excess weight and for a while I do well, loosing a stone or two each time hindsight has taught me that this is the point when I seem to self sabotage. As soon as I get to the stage whereby friends and family begin to notice and complement me I struggle to accept that and my weight goes back on.

I consider myself to be quite an insightful and self aware person so when I looked back over and realised this was a pattern I was forming I began to explore why this may be the case and wonder what I could do to travel beyond this stage. That is when my epiphany took place and I realised I wear my weight like a mask. I use it to try and hide my emotions and to protect myself. I ought to explain that when I say protect myself I think that goes back further than me sabotaging my dieting efforts right back to my early life experiences. I think a psychoanalyst would have a field day with my theory here that my weight is there to shield me from unwanted attention, the sort of unwanted attention which shaped my early life in such a negative way. 

Now that I have realised where my weakness lies and how I self sabotage my attempts to lose weight and gain control over this one aspect of my life which remains out of reach I feel I owe myself the time and attention to concentrate my efforts on changing this. I am worthy of self acceptance over self sabotage and I will lose this weight.

In the past four weeks I have lost a stone in weight so know that soon I will reach my vulnerable time so must keep this self awareness at the fore and refuse to acknowledge the self depreciating thought patterns I am familiar with. I know everyone deals with things in differing ways but for me I plan on using a combination of self awareness and faith to hopefully succeed this time where I have failed before. I am joining a year long programme with church called ‘Celebrate Recovery’ some of you may have heard of this programme and I’d love to hear success stories if any of you have used it as a guide. If you haven’t heard of it then google it, it is a programme to help people work beyond their hurts, hang ups and habits and learn skills to aid them with this in the long term.
The programme covers everything from addiction, relationships, self harm, self esteem to weight management and even hurts from past abuse so I feel hopeful that it will help me.

I would never have had the confidence to go alone to this group but a chance conversation with a dear friend about our individual battles with our weight was what led me to my moment of realisation as we discovered that we both struggle with our weight for the same reason and vowed to support each other on this journey. So on Monday we will both go to our celebrate recovery group and we hope that this will be our final journey of weight loss. It was a chance conversation which led us to realise that this is why we hold on to our weight when we hate it so much, I wonder how many other women this is relevant to. I will likely share my weight loss with you via this blog and twitter and hopefully will make it beyond the point I usually get to… wish me luck!

Rotherham Report – My Thoughts

Trigger Warning – This post discusses childhood sexual abuse using language which some people may find deeply upsetting so please consider this before you continue reading. Helpline details are given at the bottom of this post should you read it then find you feel vulnerable.


The news of the Rotherham Report has deeply saddened me but I’m afraid not surprised me. Childhood sexual abuse is something which goes on in the undercurrent of our society, in your street and in mine every day, but this is something society chooses to erase from its consciousness. Society does not feel comfortable talking about something so abhorrent. It is something the vast majority of people are appalled by, appalled by the repeated news articles, written daily, outlining the prevalence of this in
our modern, so called, civilised nation.

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My Journey…

I gave a talk tonight at the Annual Members Meeting of the Mental Health trust for which I am a governor, my talk was about my journey of recovery and what it meant to me as I made the transition from service user to staff nurse, the words that follow are what I read:

My first contact with mental health services was in 2007 following the birth of my daughter, Eve. After she was born I knew straight away that I didn’t feel right. I spent the first five weeks after she was born racing around, I decorated my entire flat and held a dinner party every night for three weeks! When my daughter was five weeks old depression hit me like a shovel in the face, I didn’t just slow down, I stopped. Continue reading

Lived experience?

The issue of self disclosure in mental health setting is a controversial one and one to which I have given much thought. As I have blogged about previously I am a mental health professional who has lived experience of mental illness and the stigma which comes along with that. Continue reading

Happy Fathers Day!!!


So you’d have to be walking around in a bubble to have failed to notice all the father’s day posts across social media today, my facebook and twitter feed have been full of posts varying from those who are expressing their thanks and love felt towards their father to those saying how much they miss their now passed father. Lots of other variations were added to the mix too including the fathers who have posted how much their miss their children who their ex partner refuses to allow them access to and then the single mums posting how they do the job of both parents. All very valid and appropriate points to make. Continue reading

Recovery is a Process not a model


You may have noticed my tweets recently asking about whether your local mental health NHS trust has a recovery strategy or recovery policy statement in place. I’m asking because I am part of a working group within my local trust considering this but it has got me thinking when I have had lots of retweets but not one person has been able to confidently reply and say that their trust has one in place.

So maybe I ought to start by asking myself what recovery is? I’m a third year student mental health nurse so often hear people talk about working with a ‘recovery model’ but I dispute this; recovery is not a model it is a process. Continue reading

Nearly a statistic; Postnatal depression


Trigger Warning re childhood abuse/birth trauma/suicide

I have been involved with a piece of work with the midwifery education school at my local university, the same one incidentally I am due to graduate from this summer with a BSc Hons Mental Health Nursing although this is totally separate to my academic studies.
What started as an email saying ‘you’ve talked about having had postnatal depression haven’t you?’ has evolved over the past 14 months into something I am exceptionally proud of. The email was from someone I have come into contact with in a service user voice worker capacity and on behalf of a senior midwifery lecturer at the uni, we agreed to meet for a coffee in December 2012 to discuss what was being asked and how it could work. Continue reading

Tightening the student belt..


I knew that financially being a student again was going to be tough, I had been a student before I knew that there was always likely to be more month left at the end of the money than the other way around. Nothing prepared me for the hardship and sacrifices this past three years have brought us. Continue reading

Coastal therapy anyone?


I was sat at home preparing a presentation I have to give tomorrow at university dipping custard creams in my coffee and wondering whether I could provide myself with sufficient excuse to not go to bootcamp class tonight. It’s only my excuse for me, it’s only me I need to justify it to but still it needs to be a good reason or I’d have to force myself to go.
My brain was dulled and my eyes sore from staring at the laptop screen so I decided I needed some fresh air. I needed to blow the cobwebs away and the gale force wind out here has certainly done that! Continue reading

The 6 C’s of being a Student Nurse


All student nurses you will be familiar with the 6 C’s, the areas which the Francis report said nursing should concentrate upon. To be able to look after others though us student nurses must treat ourselves with those same 6 C’s that we afford our patients. This blog post is about how we can use those aspects of nursing we practice for others daily to get ourselves through the three gruelling years of nurse training. Continue reading

Nature or Nurture?


I have just watched the Kerry Katona documentary on catch up for Channel 5, it’s called ‘My Secret Past’ and is worth a watch. I have long believed that my battle with mental illness is a combination of the two, that I have a genetic predisposition but that trauma I experienced during my childhood triggered it off. I guess it’s no different to someone having a genetic predisposition to heart disease but whether that person eats a fry up for breakfast then sits on their backside everyday makes a difference to whether they trigger those heart problems off or not.

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Medication reduction…


had an appointment today with my GP who is exceptionally supportive with my mental health. I know at times she has been as frustrated as I have been with secondary mental health services on my behalf. To have the support of someone who truly believes in the concept of recovery is vital to achieve mental well being. My appointment was booked several weeks ago to discuss my next drop in dose of my Venlafaxine. Continue reading

Letter to my younger self…

Ten things I wish I could tell my younger self:

1. To always have hope. Through both mental illness and via situations I have faced I’ve felt hopeless at times in my life. I can’t necessarily change how I think or feel when in the grips of mental illness but I can change how I deal with situations that life will invariably throw at me in the future. I have ‘Dum vita est spes est’ tattooed around my ribs which means whilst there is life there is hope in Latin. I truly believe that no matter how utterly hopeless you may feel at any given moment if you just keep on going moment by moment it can get better. So no matter how low one feels it is important never to take a permanent action to solve a temporary feeling. Continue reading

It’s beginning to feel a lot like Christmas…

Christmas; the most wonderful time of the year? Or is it?
Not for everyone it isn’t. Three years ago I spent Christmas in a psychiatric ward away from my husband and daughter and that will always be at the back of my mind as the shops begin to fill with glitter and the TV adverts show perfect family Christmas’.

I can tell myself I ‘forgive me’ for missing that Christmas with my daughter and build lots of new happier memories in the years since then. What’s not to forgive? I was ill. Continue reading

“Gosh aren’t you getting tall?”

Yesterday was my daughters seventh birthday party and although I knew I was stressed trying to arrange it along with working full time and writing university assignments nothing prepared me for the reaction that this party provoked in me yesterday. Continue reading

Cost per use reduced…

Today I feel lighter. I feel like the honesty I entrusted upon someone today was the right thing to do.

Being open today also reduced my cost per use of the phrase “I’m no longer ashamed about my past” as that cost me around £4000 in therapy to be able to say out loud!!! Continue reading

Sickening stigma

Mental health stigma is not a new issue. What is new is how blatant it seems to have become of late.
Over recent months supermarkets Asda and Tesco both sold costumes for Halloween depicting the popular press’ vision of what a they believe a ‘mental patient’ looks like. The response to this on social media was phenomenal with lots of us within the service user movement posting pictures of ourselves on twitter showing that ‘This is what a mental patient looks like’, showing how fabulously boringly normal we all are.
Power to the people prevailed and the supermarkets withdrew these appallingly named costumes from sale. Continue reading

Happy Campers

Well another summer over and another family camping holiday had, good cheap family fun.
The very first time we went camping as a family I had to really persuade my husband to try it, he had no desire to leave his home comforts.
I had been unwell with a severe depression, been hospitalised for several months and during that time some dear friends had a collection to send flowers. They sent some gorgeous flowers but realised they had around £100 left and decided to buy me some leisure vouchers so we could do something nice as a family once I recovered. The leisure vouchers could be spent on a day at a theme park, or an over night stay in a hotel or at a small selection of retailers. One shop had an offer on a camping starter set including a tent and with that those friends have us the most amazing gift ever, the gift of memories being made for years to come.
We bought that tent set and never looked back, we have added to the kit we take over the last couple of years.
Once the tent is pitched and I sit in my folding chair admiring my hard work I literally feel my mental health improve. In the same way a dose of Valium can be felt lifting anxiety I can feel my body letting out a sigh in relief of the opportunity to regenerate with relaxation.
The flowers those friends bought were beautiful and yet the years of memory making that the tent the paid for has given us is priceless really.


A few people have asked me to write about my experiences of having had ECT or Electro Convulsive Therapy. I don’t mind as I feel there are a lot of myths to dispel around this, in my humble opinion, amazing treatment.

Several things about ECT are controversial, one of the main things being no one is exactly sure how or why it works! It was explained to me in simplistic terms that if a computer crashed the first thing most of us would do would be to turn it off and back on, reboot it. If we think of our brain as a computer and with mental illness it ‘crashes’ then ECT reboots it. I liked that explanation, it makes it seem logical somehow. Continue reading

Was Larkin right?

Did Phillip Larkin have it covered when he penned his famous poem which was entitled ‘They fuck you up your mum and dad’?
I know that my own father emigrating and sending me a post card to say he had moved and my mother choosing her emotionally abusive husband over her child who was already vulnerable did have a profound impact upon my adult life but I feel comfortable that I have processed the emotions linked to my own childhood. I have enough insight to know that whether someone has the seemingly perfect childhood or if someone has some dreadful experiences those experiences all help us from the person we become. Continue reading

Stop the Victim Blaming!

64166_10151526939649417_996056550_nToday April 3rd 2013 is International day against Victim Blaming. I have posted this on my social media accounts today and been amazed by the responses I have received, in both a positive and negative way. Continue reading

Is a mental health diagnosis a modern day equivalent of a straight jacket?

27521_103617956343859_280_nIs a mental health diagnosis a modern day equivalent of a straight jacket? I began to wonder this after a few conversations recently where the subject has come around to the different way people react to a person once they discover a diagnosis of mental illness. Continue reading

The best mum in the world…?

Mother’s Day, like Father’s Day, is a day which until I had my own child I dreaded. It has its own meaning now I am a mother and receive a card and treat, it’s a day to make me smile widely to show my pride at being a mammy.
Nearly all of the cards address ‘The best mother in the world’ and when that is not how you feel it seriously narrows the choice available to choose one. It’s not that I don’t love my mother, I do love her I just don’t feel that she deserves the title of Worlds Best Mother. Continue reading

Disclosure – The Sequel

Last month I blogged about how I respond when someone asks me why I have come into mental health nursing and received some positive feedback on that piece.
This morning a conversation between myself and a lovely, very dedicated and very experienced nurse turned to the subject of ECT or Electro Convulsive Therapy (I will write a whole blog on this in more depth sometime), she asked had I seen this treatment and it felt entirely natural to reply “seen it? I have had it!” Continue reading

Faith in Hope and Hope in Faith…

On a form if I am asked for ‘Religion’ I always put RC or Roman Catholic and recently I have questioned my allegiance to the Catholic Church. By this I do not mean I have questioned my faith as I feel strongly that I am guided in life but I mean that some of the actions or lack of actions of the Catholic Church have disturbed me and also I have been questioned as to how I can class myself as a catholic when I use contraception. I feel this blog may be as much for me to work out my thoughts on being a modern catholic woman as for me to share these thoughts with you.

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Tess of the D’Dubervilles…

Why do I find dieting so hard? Why can I not be happy when I look in the mirror?
I remember when I was at school studying ‘Tess of the D’Urbervilles’ understanding on a deep and very unfortunate level why Tess felt the need to shave off her eyebrows to disguise her beauty to men following her rape. I knew what it meant to wish that I hadn’t been so appealing in that way. Continue reading

Bad day or unwell?

Bad day? Or unwell?

It may seem like the most simple thing in the world to know whether you have had a bad day or whether you are unwell with a relapse of mental illness. It’s not easy at all.
I’m not sure why I get so worked up about this issue maybe it’s fear that I am becoming depressed again? To a point the reason is not important it is the way I deal with it that matters. Continue reading