Turning 30.

I feel I should write something about turning 30, as I am about to do so in July. I don’t dread it but it is a bit of a mile stone, so here is a ramble on my thoughts.

For me turning 30 is the next big step after turning 18 and becoming an adult (21 didn’t mean much in all honesty). I feel I am now a proper grown up, an adult, responsible and I do grown up things. Don’t get me wrong I still do immature things and have my silly moments, but I do own a house, I have a career and I have debt. They are grown up things, right?

I know it is incredibly cliché but I do think I now know myself better, I have “grown as a person” (I actually shuddered as I wrote that). What I mean by this is that at the age of 18 you think you know it all and the world is your oyster, at 30 you are more realistic (well I am anyway). I have cemented some beliefs and opinions, and on some of those opinions I even think I have enough knowledge to argue my point. The thing is, that I don’t think it is necessarily the fact I am almost 30, it could have taken me until I was 31 to feel like this, or I could have felt it earlier. A lot has happened in the last few months to make me feel more comfortable with my sense of self, but I know that my life experiences also had a lot to do with it, the ended relationships, the times at university, jobs, and the choices I have made. The only way in which this is linked to me turning 30 is that at this point in my life I have chosen to reflect on the last few years, as I believe may be a bit of a tradition.

In all honesty when reflecting there is a tiny sense of fear. Have I done enough by this age? But then I am rational now. I used to have a list of things I wanted to achieve by the time I was 30. I will embarrass myself and tell you what they were and then explain how I feel about them now (I’m hoping I will get them straight in my own head and feel ok).

- Goal 1 – Be married by the time I am 30 (it was actually by my late 20s). This was one of those dreams I had when I was 18, when life was simple. Of course it would be easy to meet a man, fall in love and be married by the time I was 30. In reality it is not, don’t get me wrong I have thought I have been close, I have been in committed relationships, they did of course end for various reasons. I now realise (as I have blogged about before) that not only is love not that simple, but that I’m not even sure I feel the need to get married anymore. I would like to meet someone and be in love, who wouldn’t? But I have enjoyed my recent spell of being single. I no longer feel the need to do what is expected of me by society (not all of you I know), I just want to be happy, and right now I am.

- Goal 2 – Have my first child at the age of 30. Yet again another dream from when I was younger. I thought having a child at the age of 30 was the ideal age. I could have established a career and had some fun, and have a child before I am too old for it to be a more difficult process and I had the energy. Again as I have got older I have realised that I am not even sure that I want children. I’m not sure I don’t either. I think it will depend on if/when I meet the right person and how our life grows together. I like the idea of the freedom of not having children, in that I can be selfish and live my life how I want to, without the added responsibilities. But I also know the great rewards from having children. For now I am happy with my 14 nieces and nephews and 4 god children (yes my friend does know I am an atheist, but we have agreed it is about moral guardianship and being close to the children). I get the benefits without the responsibilities. Some of my family and friends do seem to judge me, asking “When are you going to have kids? You need to find a man.”. To me this is just wrong, to rush into having children or a relationship is dangerous, I know for some people it does work, good for them. But for many it is the beginning of the end, without the right foundations these things can go wrong and be a struggle (I know they can go wrong even with the right foundations). So for this particular goal, what will be, will be, I’m in no rush. And if it doesn’t happen, I can live with that.

- Goal 3 – Have a career. Not an unrealistic goal I feel. I was always determined to go to university and I did. I was the first person in my extended family to do so. After university I was lost for a while. I chose to do psychology and then found I could not access an assistant psychology post as I got a 2:1 and didn’t have a wealth of voluntary experience as I had to work my way through university, so had little spare time. So I drifted unsure what to do, working in retail (the careers advice at university really should have been better). Until I stumbled upon an advert in the local paper for mental health nursing training. The rest is history. I have a career. I have progressed within it gained promotions and I am really looking forward to the way my career is going to change in the next few months as our services are developed. Job done. (I did also want to earn my age, as a pipe dream, which would mean I should earn 30k now. I don’t, I guess I shouldn’t have chosen nursing if it was about the money. I am happy with my choice).

- Goal 4 – Own a house. I do. I would say job done on that score except it is not that simple. I have a huge financial commitment hanging over my head. Times have changed, this may not be such a good thing. With the economy the way it is I actually probably owe more on my house than it is worth. I hope that as the economy improves (and I hope it does) things will change. This does put me in a difficult position. I have itchy feet, I want to move to London or even Manchester (where I went to university). I crave the independence and adventure. To find a job there wouldn’t be too hard as I have 6 and half years of experience and a lot of extra training, but I have a house here. Perhaps my rush and desire to own a house was flawed. It is too late now. I will have to wait it out or look at other options if I do ever seriously decide to move.

They were my goals. I don’t think I have done too bad, or at least I have reassessed my goals and what is important to me. So turning 30 is not so scary, it is not too old to do anything. I now try not to have such fixed goals, but to be happy. I have realised more recently that I have been more happy as I have had more fun experiences. It has not been about possessions, money or having things, or even babies. Experiences have given me memories, but before that they have given me excitement in the build up and the opportunity to meet new people. I have just started reading Prof Richard Wiseman’s 59 Seconds: Think a Little Change A Lot and my suspicions have been confirmed in the research cited within the first couple of chapters. People are more happy if they have more fun experiences rather than if they have material needs met. It is also about connections with people and giving to others where you can (not necessarily money/gifts but time and compliments). This is how I plan to continue.

So in summary, I haven’t achieved my goals I wanted to by the time I was 30, but I don’t care. My goals have changed, I have changed. I look forward to the adventure of the coming years and try my best to not see it as a ticking clock where the time is running out. I aim to make the most of all the time I have, after all none of us know how long we have (yes, you may be a little bit sick in your mouth thanks to that mushy outburst). Thanks for reading my ramble. I do feel better now. See it worked.

Oh and it may be worth pointing out that I have avoided the traditional 30^th birthday party with my twin sister (yes she is annoyed so I have to go to Alton Towers with her the week before). I am spending the weekend in London having some comedy adventures with some lovely people I have met over the last few months. Then on my actual birthday I am going to the #PreciousLittle live podcast party, where I hope to meet more new people and I am pretty much guaranteed laughs and beer. Perfect.

In Touch With Reality?

Last night I went to Skeptics in the Pub in Sheffield, where Professor Chris French was speaking around the subject of memory and cognitive processes in relation to anomalistic psychology and the paranormal. It was a very interesting but what followed stirred my interest further. It was something that was said in the Q&A after, Chris said “It is not always a good thing to be in touch with reality”, this is an idea I want explore in this blog. It was discussed last night and I will dip into the ideas mentioned there but it inspired me to think further about it.

The main idea discussed was that reality is based on a spectrum and is largely culturally grounded. I’m sure some people in the world would consider someone who believed that some wine was the actual blood of Christ, or that shouting at the sky would make it rain are totally delusional ideas, yet with cultural relevance of a tribe or religion they make some sense. I am not saying they are logical or have any grounding in evidence, just that you would not have someone sectioned under the Mental Health Act for it.

I will warn you, I go a little off topic here, but I will be back...

This was how it was discussed last night. It is in fact more serious than you might consider, when people are detained under the Mental Health Act for the first time it is initially for a period of assessment, this can be 72 hours (if brought on a section 136 or 135 by the police to a place of safety, or already an inpatient, requiring further assessment by another doctor and a social worker) or it can be up to 28 days (Section2). Of course there are other sections of the Mental Health used to detain patients in hospital for longer periods, but the initial decision/diagnosis of a mental health problem should be done in that brief period. The reason why there is a period of assessment is that there can be many reasons for the appearance of what some people may consider a “mental health problem”. For someone to even get put on a Section 2, 3 health professionals (and or a nearest relative) must agree that it is the appropriate course of action.

Unfortunately, it can often be the use of drugs or alcohol, where use of or withdrawal from can lead to psychotic symptoms. Sometimes, particularly in the elderly an infection or illness can produce such symptoms. In such cases it is often found that once cause is established and treatment started the condition rapidly improves (although not always with drug induced psychosis, as repeated episodes can lead to slower recovery, prolonged illness and a diagnosis of schizophrenia) further detention in hospital is not usually necessary.

In other cases, and here is why I am on this topic, an interpreter needs to be sought and explanations looked into for behaviours that have or are still occurring. I have seen cases where clinicians have believed phrases/actions to be evidence of psychosis, but with further knowledge found that they are actually expressions of grief/religion in other cultures. In our catchment area there are a lot of refugees/asylum seekers, this means that not only do we get a large variety of languages/cultures to understand but also a lot of people who have been through traumatic events and may seek mental health services. Understanding such cases, does take some time and digging for relevant information. The reason I bring this up, is that we should all be aware of our own cultural biases. What we may judge as abnormal or even insane behaviour may be perfectly “normal” (for want of a better word) in another culture, just as some behaviours we see as everyday things may be perceived differently in another country. We should all make an effort to be aware of such perceptions and judgements. I am as guilty as the next person of such bias; even the other day as I tucked into my sausage sandwich, I was shocked at my friend Geoff for eating okra and chilli for breakfast with his fingers, but in Ghana that was perfectly normal. (A less extreme example I know, but I am aware of confidentiality issues).

Now back to reality (I mean back on topic)...

As stated before it should be seen as a scale, and in fact some loss of touch with reality can be a good thing. As Professor Chris French said last night, you or I have an unrealistic optimism; we believe good things will happen in life (lottery win, pay rise, better job, or fall in love) where as when it is looked at depressed people have it more accurate than us. I don’t want us to all get depressed, optimism is good, but it is not based on facts and figures, on evidence, therefore it is not based on reality. Yet it is a cultural norm, for thousands and thousands of people to play the lottery every week, something I believe some cultures would neither approve of nor understand when you consider what could be done with that kind of money. I want to continue to hope for a better job/life but I have no evidence it will happen (I do not however believe in fate, I do believe in consequences and coincidences, and if the right ones occur I may have some unexpected wonderful experiences, I choose to look at life this way instead of the pessimistic way).

Some people like to be a little eccentric, different, odd maybe. And in my opinion (and I am sure there are numerous references for it) there are people who like being “a little bit mad” (I know not a PC term, but let me explain).There are people with personality traits that do not fit “the norm”, they may appear a little odd, sometimes make people uncomfortable, but they get on with life and do no one any harm.

I have met several patients who have had mental health problems for a number of years, this is something they learn to cope with in their own unique ways, yes we offer advice, support, education and medication, but they still have to cope on a daily basis. Occasionally we may suggest a new treatment to a patient, at this point I have had discussions where a patient has to consider what it would be like to not “have voices” or fixed beliefs, something which can be frightening and incomprehensible, especially if they cannot remember how they were prior to being unwell. Some people as they recover have even reported missing their “voices” (not all auditory hallucinations are negative or abusive, some are supportive although this is less common) a sense of loss. I know this is more about coping with change and regaining “touch with reality” but we must consider that it is not always what the person wants it is sometimes what society wants, and therefore a much more difficult transition.

People with Bipolar disorder often report that they like being “slightly high”, that is just on the edge of a manic episode, and why not? There is elevation of mood, motivation, energy, creativity, a lack of need for sleep, however as mania worsens there is even less sleep and a detrimental effect on health including irrational behaviours (which can include spending, sexual dis-inhibition, mood swings, aggression, risk taking). There is point at which mania is for some people, rather nice, imagine an overwhelming optimism and belief in your own abilities (not necessarily an accurate belief), unfortunately health professionals and relatives (and many patients) know this stage does not last and that medication and support are needed to stabilise the condition or treat the full manic episode, this can mean a substantial period in hospital.

I know I have wondered off topic (again) from what we discussed at Skeptics in the Pub, into mental health but as was stated last night, being in touch with reality or not is absolutely fine, what matters is how it impacts on your life and the lives of those around you. You cannot believe you have the right to run the streets with a machete demanding things, and I’m sure there would be concerns if you would not leave your house due to fear of alien attack, to the point where you did not buy food. But for some people to believe in a man sitting on a cloud in the sky watching over them and they go to a building to talk or sing about this, or really believe that next week they might win the lottery if they are “lucky”, then fine, I can tolerate that. I can’t say it is logical or an opinion I share (although I have been guilty of buying random lottery tickets infrequently, even though I know the maths), but sometimes I may hold such beliefs even with flawed logic. A little blind optimism goes a long way (sometimes).

As a skeptic the way in which I find this unacceptable is if someone is provided with evidence for/against such beliefs (or fails to provide any evidence, but state they know it is true), and then they continue to hold their views. If a patient at work were to introduce me to the alien that had abducted him, or show me the implant via an x-ray, then of course I would believe them and help them barricade themselves in a suitably protected place, I would not give them anti-psychotic medication. I do jest slightly, there are extremes, believing in aliens is not necessarily evidence of mental health problems (I remain agnostic about them I have seen no evidence they exists, but am aware that there are probabilities suggesting it is possible). It is where there is significant impact on life despite a lack of evidence, where such beliefs are detrimental to a person’s or other people’s health or safety that steps need to be taken, whether it be the diagnosis of a mental health problem or correction of a flawed cultural system (e.g. the way in which religion impacted on and still does impact on education).

As stated at the beginning of this very long ramble, it all depends on cultural relevance as well as impact on daily life and other’s lives. I don’t think I do ever want to be truly logical all of the time, like some kind of Vulcan (yes I know they are fictional too). I like my occasional naivety, my small irrational beliefs. I do still press the button at a pedestrian crossing over and over, knowing it will not make the lights change faster. I don’t mind that some people hold stronger irrational beliefs than me, I do mind if it gets the way of people’s health or well being, so someone believing in faith healing for example and avoiding medicine in order to seek such “treatment” and encouraging others to do so, I cannot condone at all and I would openly object to. Yes, in an ideal world everyone would be a skeptic, but I don’t think we can be, nor should we be logical about everything all of the time, a little loss of touch with reality can be quite refreshing.

Thanks if you made it this far, feel free to correct me, disagree, agree. (please don't be too harsh I am poorly today).

Sayings I won’t say

I know it is being pedantic but I have realised particularly in the last few months that there are a number of sayings and phrases commonly used that I have decided I cannot use anymore. This is not as easy as it sounds, they are on the tip of my tongue. But I have a rationale so I am trying to teach myself to not use them. I will go through them and explain why.

Good Luck

I cannot believe in luck, it is to me illogical. I don’t believe in the concept of fate, that our lives are pre-determined by some greater being/cosmic force, so I cannot believe in luck for the same reasons. I cannot use good or bad luck as excuses for things that have or haven’t happened, to me things happen because people make them happen and a series of consequences. Yet every day I see someone wish someone or me luck. My problem with this one is that I want to pass on the sentiment used by saying “Good luck” but I now refuse to use those words. It has become “I hope it goes well” but it does seem to lack the oomph that good luck has. So any suggestions for rephrasing that saying would be gratefully accepted.

Touch Wood

This one is also illogical and can be applied to all such sayings, yet I still find I have to stop myself from doing it. Let’s be honest unless you believe in some kind of luck fairy or magic wood monster, then touching wood does absolutely nothing. I don’t even know where the saying came from (and am too lazy/not interested to google it). Even as recently as this week I have found myself going to do it, a creature of habit I guess. But yet again saying “Yeah I hope so.” seems to have less impact as the act of saying and actually touching wood. But I think this is due to how common the sayings are.

God

“God knows.” “Thank God.” You get the message. Sayings with God in them. Now I realise that many people I chat with online use them out if habit, but the pedant in me cringes when I know they are atheists. They don’t “Thank God” or care/believe that “God knows”, they don’t even believe he/she/it exists, neither do I. But I know it is that they are used in every day language, people use such sayings for their implied meanings not their literal ones. I know it is a little ridiculous that it has come my bugbear, but it has. I don’t point it out to people when they use them, but I do have an grumble to myself.

Go to Hell

This one needs little explanation. As an atheist I do not believe in heaven or hell, so how can I want to tell someone to go to an imaginary place? I know it is the idea behind the saying that is implied “Go to some horrific torturous place where you will burn for eternity”, but if I were being logical and true to my believes I should say just that, for this one I do find that “Fuck off” replaces it quite nicely. And if I am in a social situation where fuck off is inappropriate, then I shouldn’t really be telling them to go to hell either, as it could also be judged as a little rude.

As sure as eggs is eggs

“Is” surely you mean “are”? Yes my pedantry knows no bounds. This one I don’t like just because the grammar sounds and feels wrong. “Eggs” is a plural so surely “are” should be used? I agree with the sentiment behind the saying it is based in logic, and yes I know that it is a jocular misquotation, but it irritates me.

I know there are many more sayings yo which I apply this logic, but they are difficult to think of when I haven’t seen them. I am not judging anyone who does use these sayings, merely pointing out that they are to me, illogical. I am slowly teaching myself to not use them, although it is not easy they are, as I said before, on the tip of the tongue just waiting for use. I’m not sure it makes me a better critical thinker at all to actually consider the meaning of what I am saying before I say it. But it is a habit I have got into. Please feel free to add any sayings you can’t stand in the comments section and of course tell me your thoughts on the matter.

Thanks for reading.

Knowledge is... scary

Prompted by a few online conversations I have realised how much I have learnt in the last year or so. Partly because I became a non medical prescriber (I blogged a bit about ignorance being bliss on this topic here). So I accumulated much more knowledge about psychopharmacology, legal and ethical issues in prescribing. But also through delving into skepticism, rationalism and critical thinking. (Let’s not forget comedy too, knowing about the comedy scene is also knowledge, perhaps not particularly useful although I have reaped some benefits.)

Don’t get me wrong, I have not mastered any of the above subjects yet. This is my point. By realising I have an interest in or a need to learn about such subjects, I have discovered how much information is out there that I do not know. It is almost overwhelming. The books I haven’t read, theories and views I don’t understand (the acts I haven’t seen yet). I realise that we can’t expect to be experts in all the subjects we have an interest in, but perhaps we do hope to acquire enough knowledge to have a reasonable informed conversation about such issues? (This is where I am ok with my comedy knowledge, but I still love to find/learn more).

I think my fear and realisation may stem from the fact that I think or assume that my memory is not very good. However, there may be evidence to the contrary. Firstly anecdotally, in a chat with a friend I said much the same and she exclaimed, “But you know loads!” and we discussed it from there. I guess I do have some knowledge about things, but I recall when at university the first time I used to memorise references for exam essays and could rattle off numerous theories and viewpoints easily. Thinking about this rationally I realise I used to study for hours in order to have such information at the forefront of my memory. Secondly, in certain subjects I do “know loads”, I know my job and am not bad on mental health law, NICE guidelines, Clozapine and ECT, but these are topics I work with on a daily basis. I am constantly learning but as a scenario crops up I can recall similar situations and figure out a solution or where to look for the answer. In my job I may be considered “an expert” (I am the Lead Clinician).

I would like to feel the same confidence in discussing other topics, one not work related but to my opinions and beliefs. However I find myself attempting to discuss the issues and relying on “Have you read...” then failing to summarise how the viewpoint in the book matched or differed from my own. I am hoping that as I read more, learn more and blog more my skills and memory for such facts may improve.

Much like when at university, and even more so when nurse training, I recall the panic in the first few weeks of not thinking I would be able to acquire all the knowledge I needed to pass the course/qualify. But bit by bit as these course progressed and my brain began to link the information and ground it in my daily knowledge, then hey presto. I knew stuff, and of course I passed and qualified. I must admit I had the same crippling fear when I began nursing and did my first week of night shifts. They were terrifying, and there were not many people around to back me up, what if I didn’t know what to do and people were busy? Thankfully in my first week of nights I had the pleasure of working with a very wise nurse (they don’t leave you on your own on nights at first) who told me “I have been a psych nurse for nearly 30 years and I am still learning.” Boom, it hit me then in that moment, I didn’t need to know everything I can keep learning, I can ask, I can look in books, journals, policies and guidance notes. From then on I was not frightened of my lack of knowledge and learned to enjoy finding things out I wasn’t so sure about, also as a team nurses and doctors constantly teach each other.

As I hoped would happen, in typing this blog, I am now panicking much less. I should treat my new thirst for knowledge and fear of a lack of it, just as I did in university and when I started nursing. I should recognise that there will come a point when the information fits together and I gain some confidence, but that I will also continue to learn from a variety of sources. Phew, I feel better now.

Thanks if you read this.

Twittiquette

I have visited this subject before, but events this week have led me to ponder etiquette on twitter further. I remain unsure of the “rules” of twitter, mainly due to the fact that people use it in very different ways. Some people use it to gather information from many sources, others like myself to chat and connect with people and I would assume that many celebrities use it as a way of promoting their work and getting feedback (and rightly so). So I guess the rules are different depending on why and how you are using it.

I followed suit with a couple of fellow tweeters and unfollowed a few people this week. Not for any negative reason, but just because I felt I was following too many people, which meant if I spent time away from twitter I was struggling to catch up. Unfollowing is difficult. I selected tweeters who had not been very active lately and one or two I thought I hadn’t connected with very much. But the whole business feels a bit rude. I have been unfollowed by a couple of people recently that I have noticed (I tried to send DMs to them) and have to admit there was an initial sting. Why would someone unfollow me? What have I done? Am I dull or irritating on twitter? (Possibly)Then I thought about it and realised it does not matter. I have plenty of followers and it is not about numbers, it is for me, about connections, so as long as I can still chat to those people it does not matter that they unfollowed me, they may also want to clear their feed a little (I do tweet a lot). So long as I haven’t been blocked, then I assume I have caused no offence. I have had conversations with a couple of tweeters that I have met who have honestly said they don’t follow me because I tweet a lot, but they will from time to time check my feed and happily chat to me if I send a @ reply. Fair enough.

I have considered unfollowing a few more people but haven’t for fear of causing offence for exactly the reasons people have unfollowed me. If people chat a lot it is sometimes too much to catch up on. A solution would be to unfollow one or two people in a group so that the connection remains but as you don’t see all of the conversations unless you follow both parties, so your feed would not be as busy. However, how do you choose without causing offence? But I also want to remain involved in some conversations and wonder if I will miss a trick if I don’t always follow everyone in those groups. Being nosey has consequences, it means I have to see all the conversations I am not so interested in or don’t have time to read just to be able to get involved in the ones I am.

To me facebook makes it clear, if someone removes me as a friend on there it sends a clear message. I have removed people who added me because we went to school together, but then did not ever chat or get in touch, what is the point? But as facebook is not like twitter as it is updated with such frequency that it is easier to manage to have more “friends” on there and keep up with it, plus I often only go on to look what one or two individuals have been up to or read blogs. Twitter is not the same you don’t actually remove the person fully unless you block them.

Twitter is a social networking tool and as I have said before I have made new friends from it. In getting to know people online I also use messenger, facebook and email with various (but not all) tweeters (usually the ones I have met face to face). The people I have got to know better tend to use email or messenger for more personal chats. I don’t tend to put really personal information on twitter (which I have explained in previous blogs). So I don’t think it is necessarily a bad thing to unfollow someone you are still friends with if you have other ways of staying in touch. You can still have conversations on twitter (so long as the person you unfollow understands and continues to follow you, or if you just regularly check each other’s feed). I would unfollow celebrities and comedians if I was not amused or interested by them, but sometimes there is an ulterior motive, such as that they may give me information about gigs etc. With non celebs it is a much harder choice to make.

I think I can manage my current level for now, but if I struggle again I may have to reconsider who I follow. I am curious to know other people’s thoughts on unfollowing people. Does it feel personal? Does it matter if you are still in touch in other places like facebook, forums, messenger and via email?

Is blood thicker than water?

I am not stupid I know it is in the literal sense, but that is not what I want to ponder in this blog. Some things have happened with friends and family over the last few weeks (which I won’t go into detail about) which have left me wondering what it means to be “family”.

There seems to be an assumption that if you are related by blood or on some minute genetic level then you must automatically have a connection with and love that person. I disagree. There I said it. I do not love everyone in my family, is that controversial? I love all of my friends, if I didn’t we wouldn’t be friends we would be colleagues, friends who drifted apart or in the extreme enemies. I cannot choose my family, but genetics will not and cannot dictate my emotions. To me love is a connection, a mutual respect and liking of someone else, not having the knowledge that someone we are related to had sex resulting in a person’s existence.

In all honesty I do not like everyone in my family, I can even go as far to say there is one person I actually hate, I wouldn’t spit on him if he was on fire. I know that is a harsh statement, but obviously I have reasons for such feelings. That is my point; there are actions and consequences which lead to emotions. I am aware that evolution would suggest that I would have some innate need to protect my gene pool, and in a sense I do. But we have evolved since then and are now very complex creatures; it is no longer about survival of the fittest. The remnants of this evolutionary need are still there, I don’t know whether it is genetics, or the logical reasoning I give to it, but yes I do on some level care about my family. I still don’t love them all, the depth of the relationships are in groups, close family, people I know, who know me, we get on, we enjoy spending time together, I love those people (even if I don’t see them very often). Then the family I have spent lots of time with over the years, but perhaps not so much recently, our fond memories bond us and keep the love there, some of these people I wish I knew better, something I can remedy. Then the relatives I know, in that I know they are alive, but not much of their personalities, we have never spent much time together, I don’t know their interests, nor they mine. This is where I honestly don’t think I can say there is any love. There is some level of emotion, but in thinking about it logically, I think that it is that I care if something happens to those people because it will have an emotional impact on the people in my inner family circles, and I do love them. Then there are the relatives I have not met. In all honesty, I don’t know or care about those people, unless someone I am close to does, then I have the need to protect the distant relatives from harm in order to protect the feelings of those I do love. I’m aware this all sounds very harsh, but I honestly think it is true.

I guess I should admit that this partially because I have examined my feelings when some long lost relatives got in touch recently. We haven’t seen them in over 10 years, since they were very young. I don’t know them, so I don’t love them. Is this wrong, something tells me it is, but I have the need to be honest with myself. I’m not saying over time I won’t love them, but I also might not like them. I don’t understand the social need for me to have an instant connection with these people. Yes we have some aspect of shared history, but whether we get on will depend on if we both think we are nice people, we have common interests and values.

I have some close friends who know me much better than some of my family, I feel closer to them. I have discussed with such friends my feeling about them and family and they understand my logic. These feeling were concreted recently when I considered my will, thinking about which of your possessions and how much money would go to whom after I die puts a lot in perspective. I won’t be around to face the consequences of my actions, so I can be blunt and honest (although I must admit there were some token gifts to save my Mum some heartache). In doing this I realised I have lots of people close to me who I love, not all of them family. I have realised that if I don’t like someone I cannot love them, I don’t believe in the social construct that you have to love your family, “You may not like them, but you love them, they are family.” Wrong! I cannot have two conflicting emotions about one person. If I don’t like them, I don’t love them. I care if something happens to them because of the fall out, the consequences of this that someone I do love may be in distress, this should not be confused with love.

Thanks for reading, as usual please feel free to disagree with me, debate or comment via my blog, email or twitter.

Mental Health

I was inspired to write this blog when I saw this link and pledged to talk more about mental health. Mental health awareness is very important and not promoted enough. Of course I am a mental health nurse so I would say this, but if you read my blog regularly I need to ramble on such things, this is me trying to get my thoughts on mental health issues straight in my own head and hopefully encourage you to promote mental health awareness.

Of course in my chosen profession I think mental health awareness is extremely important. I see first-hand how stigmatising mental health problems can be, and sometimes from surprising places. I find than even other medical professionals who do not work in mental health have preconceived ideas about people with mental health problems, assuming they will be disruptive or need an escort for a procedure or test. This is not always the case, to me it should be our judgement as staff who know the *patient/client/service user (*choose your preferred term, I will use patient from now on) to decide if they need such support or of there is any risk. They do not ask every person who comes from home to have a nurse escort for an x-ray or some other test, do they? And to be honest a lot of the general public are much more scary than a person with mental health problems.

People ask me what it is like to work on a mental health ward, and in all honesty it can be very busy and stressful, but the reason why I and many other people choose it as a profession is that we get to meet some really nice people. Yes, they are unwell but to see improvement in them is our reward. And regardless of mental health problems, the patients still have a personality, they are people with feelings and opinions, yes they can be a bit muddled up in the case of psychosis but such people are still likeable/admirable/intelligent/nice people even in an acute episode. In the same vein, yes there are people I don’t particularly get on with too, but I am not expected to like everyone, so long as I fulfil my duty of care and treat them all with the respect I expect, it is fine.

The thing that annoys me most about other people’s perceptions of people with mental health problems is, well there are several...

• - They are not deaf or stupid, there is no need to talk really slowly or patronise them. They may have difficulty concentrating if really unwell (as they often are when admitted to acute wards), but this means you should keep it clear and simple in such cases and not always expect a coherent answer (I mean this when patients are really unwell not when recovered). Be patient and considerate, give them some time if it is obvious they are struggling. But most of all if they are an adult, speak to them as if they are one, they or their carer will tell you if further explanation is needed. Have some respect. You don’t know their level of functioning, don’t just assume it is very poor.

• - People get better and have full lives to varying degrees. Some mental health problems mean people need to relearn skills such as caring for themselves or social interaction. Some people need support for a long time or even their whole lives, but others recover more quickly and should not be “labelled” or assumed to be “crazy” or unable to function as well as you or I. I have seen people from many professions and for the want of a better word “classes” have issues with mental health problems. It can affect anyone at any time in their lives. Yes some social groups may be more likely to suffer such illnesses due to poverty, stressors, environment, social upbringing, nutrition, alcohol or illicit substance misuse. But none of us are immune. Many people have a serious mental health problem and either recover or learn to manage the symptoms and live happy and full lives. If you hear someone has had mental health problems, don’t make assumptions.

• - Getting back to work can be a big step. If people have not worked for months or years due to a serious mental health problem, it can be daunting. Such issues are made worse by the fact that employers can harbour such negative perceptions of mental health problems. When in reality, if they were unable to function at a level to do a job most patients would not even be applying. Judgements should not be made from a mental health problem being listed on an application form, meet the person and decide for yourself, ask questions. Everyone is different. Some people will only ever have one episode of mental health problems, others may have repeated episodes, but ask about coping strategies and relapse signatures (if they are comfortable talking to you about it and it is appropriate, again don’t assume they want to talk).

• I know I work at one extreme of the spectrum of mental health problems, but I do know from my work with outpatients and personal experiences that there is a stigma which can be very damaging for more than the above reasons. Even people who are managed by their GP face such problems. Mental health is not discussed enough fairly in the media. Even this week I saw a “celebrity” on the news talking about her mental health problems and sensationalising them. This does not help. Over exaggerated or dramatic stories or statements do not give the perception of most people’s experience. Celebrities need to think about the influence they have on the general public, use research and facts. Yes, by all means tell their story (as dramatically as they like, if they must), but remember it is not how everyone will experience such problems, they should promote using GPs, psychiatrists and the treatments available, seeking help is often the hardest step. They should not fall into the trap of reinforcing the negative perceptions of mental health.

In all I am saying, don’t make assumptions about people with mental health problems, talk to people about mental health issues, encourage others to do the same. We need to foster a society where it is possible to be open about such issues and have open discussion.

Thanks for reading, comments, tweets or emails of your thoughts would be lovely if you don’t mind and have the time.