Mental Health & Wellbeing

Category Archives: Mental Health & Wellbeing

Mental Health & Wellbeing

Online Hate – Words will never harm me, or will they?

My emotional spoons are spent. Defending oneself against attacks based upon ignorance of both fact and zero personal acquaintance seems a futile endeavour. Were it not for my inner justice and defence mechanisms I might just let it lie. I would probably be better off was I able to bear the injustice of false accusations and insinuations floating around. I could never be a full-time media glare person for I’d ever be fighting off the slings and arrows of bigoted hate and sharp criticism. My anxiety and sensitivity couldn’t take it.

“Sticks and stones may break my bones, but words will never harm me

Online ad-hominem attacks are like playground bullying without the sticks and stones. The difference on social media is that when one is surrounded by bullies, it’s not a class or year-group but potentially hundreds and thousands or more. It is that much harder to just turn the other cheek and not seek to defend yourself.

“A blow with a word strikes deeper than a blow with a sword” – Robert Burton, The Anatomy of Melancholy, 1621

Carry the Ideal Waterman pen, the weapon of peace, l'arme de la paix
Carry the Ideal Waterman pen, the weapon of peace, l’arme de la paix

If the pen is mightier than the sword then sometimes it is as much a poison pen as a weapon of peace or beauty.

I love words. The longer the better! Words though, however simple, are neutral munitions that can be used and misused in the name of any cause. 

Gerard Kelly wrote in awe of words and of Dylan Thomas‘ poetry that:

“To love words. To take account of their power. To stand in awe of their beauty. To splash and swim in the rivers and tributaries of thinking they make possible; going where they take you; trusting them to guide; knowing that the waterfalls they bring you to will leave you stronger, not drowned.”

Artist Johann Heinrich Füssli, Henry Fuseli's painting of Odysseus facing the choice between Scylla and Charybdis, 1794-6
Artist Johann Heinrich Füssli, Henry Fuseli’s painting of Odysseus facing the choice between Scylla and Charybdis, 1794-6

Sadly, I feel drowned and not stronger by a torrent of online abuse, caught between Scylla and Charybdis or the clashing Symplegades, between a rock and a hard place.

The reason? Trying to steer a middle course between hardened opinions, polarised politics, and the victim-centric anger and hate that comes from suffering and oppression and yet leaves little room for gentleness, patience, or understanding, let alone benefit of the doubt.

It’s not the first time by a long chalk. I’ve been hammered by the gentle folk of Mumsnet and other feminist forums. I’ve been falsely accused of terrorism, rape and paedophilia online just to get me in trouble with the police in attempts to ruin my reputation. I’ve received death threats for being political and opposing Brexit or standing up for migrants. I’ve been attacked in transgender forums for being open-minded, moderate and willing to listen to those who oppose trans rights, some of whom are labelled quite accurately TERFs (Trans Exclusionary Radical Feminists).

“The dash of a Pen, is more grievous than the counterbuff of a Lance.” – George Whetstone, An Heptameron of Civil Discourses, 1582

Keyboard warriors seem to have become just as vehement and sometimes venomous as their real world counterparts. Discourse is rarely civil. It is easy to lash out first and think about the impact second, if at all. Distance in argument or debate makes personal attack easier, the things we wouldn’t say to each other’s faces.

“The tongue is mightier than the blade” – Robert Graves, quoting Euripides, Claudius the God, 1934

Self-defence involves verbal justification, reporting, blocking, or just taking time-out.  When I was repeatedly attacked online, dozens of times in a week, the Police simply said “come off social media then”. Apparently, sharing your opinion online means you are not entitled to fair treatment.

“The toll and troll of online aggression hits deep into real-world emotions and mental health.”

Take care how and whom you debate or challenge online. Being gracious, courteous, offering the benefit of the doubt, costs little extra, but makes the world a better place to achieve common aims.

Choosing between self-defence and self-care does sometimes mean taking a break, but it would be better if we lived in a world of greater care, that was more considerate in how we argue, comment, respond, or challenge. 

In the end, I will, of course, return to the fray, to countering hate and injustice with love and understanding, but when the spoons are replenished. 

 

Mental Health & Wellbeing

Stephen Hawking, a long history of defying the odds of the dice thrown him

Stephen Hawking, 1942-2018

Stephen Hawking, a fellow alumnus of my adolescent alma mater, St Albans School, has just died, over 50-years after he was forecast to by doctors upon his diagnosis of Motor Neurone Disease. Stubborn and resilient to the last, he also added humour to help overcome his physical and mental health challenges.

“Life would be tragic if it weren’t funny.” – Stephen Hawking

“Keeping an active mind has been vital to my survival, as has been maintaining a sense of humour.”

Even in his older years he still regarded himself as a “child, who has never grown up”, maintaining his curiosity till the end. Best known for A Brief History of Time – on many people’s shelves but less often read, we were lucky to have had his challenging mind and courageous heart on this planet and in this universe for so long.

“We are just an advanced breed of monkeys on a minor planet of a very average star. But we can understand the Universe. That makes us something very special.”

Hawking was a profound thinker who found women more complex than the universe, questioned religious and scientific views alike, but for all his deep wisdom and intelligent theories, I like his saying that –

“It matters if you just don’t give up.”

At school, apart from traditional studies, he messed around manufacturing fireworks and building computers, the latter inspired and aided by his British-Armenian Maths teacher Dikran Tahta, of whom Hawking said:

“…behind every exceptional person, there is an exceptional teacher”.

Although intelligent, Hawking was initially not very hardworking nor academically successful and used risky tactics in both his studies and when coxing an Oxford University boat crew resulting in a few scrapes and crashes. Too busy “enjoying himself” rather than working, he spent an average of just an hour-a-day on his degree. 

“I was never top of the class at school, but my classmates must have seen potential in me, because my nickname was ‘Einstein.'”

He described himself as essentially an introvert yet needing the stimulation of others. Speaking on Desert Island Discs, Stephen Hawking said: 

“I need discussion with other people to stimulate me. I find it a great help in my work to describe my ideas to others. Even if they don’t offer any suggestions, the mere fact of having to organise my thoughts so that I can explain them to others often shows me a new way forward.” 

He did not see progress as inevitably leading to utopian improvement, instead, he cautioned that greater inequality could result.

“Everyone can enjoy a life of luxurious leisure if the machine-produced wealth is shared, or most people can end up miserably poor if the machine-owners successfully lobby against wealth redistribution. So far, the trend seems to be toward the second option, with technology driving ever-increasing inequality.” Hawking on Reddit

Given that the announcement of his death came on the same day as the reigniting of Cold War tit-for-tat expulsions between Britain and Russia, and sitting alongside the incendiary dialogue between North Korea and the US, one hopes that Hawking was wrong that:

“I believe alien life is quite common in the universe, although intelligent life is less so. Some say it has yet to appear on planet Earth.”

To most people, it is Stephen Hawking’s mind that inspires or his positive attitude in overcoming disability. To me, it was his attitude to life and his mental health that encourages me.

“Intelligence is the ability to adapt to change.”

His changing health being the biggest adaptation he had to choose to deal with. He recognised that you could not be angry with the world and be a part of educating it.

“People won’t have time for you if you are always angry or complaining.”

Focus on the good, on what you have, be a glass-half-full person:

“My advice to other disabled people would be, concentrate on things your disability doesn’t prevent you doing well, and don’t regret the things it interferes with. Don’t be disabled in spirit as well as physically.”

Not only intelligent but wise Stephen Hawking used humour to help overcome his physical and mental health challenges, his legacy is his spirit as much as his mind. He chose Je ne regrette rien, on Desert Island Discs, and that is as inspirational an attitude as all his writing.

 

Mental Health & Wellbeing

New Year Reflections on Light and Darkness; Health, Wealth and Madness

As New Year 2018 breaks, and on a bright light January mid-winter dawn at that, I realise that 2017 has been a year of two halves or even four quarters, much like the seasons. I’ve diaried most of my non-married adult life, including the last 11 years. Along with an insomniac’s sleep spreadsheet and a bipolar mood diary, I’ve a fairly good idea of my moods and their seasons. 

“I will love the light for it shows me the way, yet I will endure the darkness because it shows me the stars.” – Og Mandino

Light and Darkness

I’m going to pepper my reflections with random quotes about light and darkness, which diurnally deliver some of the starkest contrasts of daily existence, but which are at their hardest to endure when the nights are sixteen-hours long and the days excruciatingly short. And particularly hard, when one’s mood is low, insomnia debilitating, leaving one drawing the curtains at midday and getting up as the sun sets in deepest winter. I long for the lengthening days of 2018 as it progresses to June’s summer solstice.

“Every human being is a mixture of light and darkness, trust and fear, love and hate.” – Jean Vanier

MAD, BAD, and SAD

For someone who is or has Bipolar Affective Disorder (BAD), with an annual accretion of Seasonal Affective Disorder (SAD), it’s only appropriate that I confess to also being MAD. Whilst calling someone mad is deprecated, it is thoroughly modern to have a Mood Affective Disorder including various depressions, bipolar disorders, and anxiety disorders – yes I have a GAD (Generalised Anxiety Disorder) too. My OCD seems to be collecting three-letter mental health acronyms! 

“Where there is much light the shade is deepest.” – Johann Wolfgang von Goethe

Light falling on darkened tree branches
Light falling on darkened tree branches

The low moods are so deep that you feel your world is going to crush you like suffocating under a mountainous avalanche of rocks and soil or at the depths of the ocean as the air runs out and the pressure crushes your lungs.

“The sunrise and sunset shows us that in life there are ups and downs. There is light and darkness.” – Debasish Mridha

Whilst many of these seriously affect my wellbeing I also regard them as part of the range and spectrum of personality and psychology. So whether one has the clinical diagnosis or not (I do), one is not one’s label, or doomed by it, since we all experience anxiety, low mood, and the seasons, to varying degrees. The difference is the degree to which we suffer and are immobilised in one’s ability to function in life, hold down a job, pay bills, or maintain a healthy functioning loving relationship.

“Light isn’t always buoyant and shadows aren’t always despair; yet both, I believe, are limitless in lessons that they share.” – Carolyn Riker

Housed but feeling temporarily not at home

The last quarter has been one of my worst in some six years. Brought low by overexertion and exhaustion, insomnia, arthritis, whiplash, chronic anxiety and panic attacks over benefits renewals and appraisals, and a near six-month long house rewire that upended my comfort nest, I became uprooted, homeless within my own home. 

“The most precious light is the one that visits you in your darkest hour!” –  Mehmet Murat Ildan

Yet, I appreciate that I have a roof over my head, just enough flexible work to meet the difference between housing benefit and rent, enough security from family on months I’m short, to avoid a past history of extensive rent arrears and three eviction notices and an unsecured debt-pile equivalent to a middle-class mortgage without any house to show for it.

Others, in worse situations, have seen a doubling of people living rough since 2010, alongside a 50% cut in homelessness funding, a rise in food bank use, people losing their DLA/PIP assessments, being stuck on six-week Universal Credit delays, and seeing mental health services in crisis and special measures as they fail to match ‘service user’ needs. Austerity has worsened our wellbeing and failed in its fiscal justification.

Suicide Safety Net

My own darkness arrived at a time of maximum therapeutic support. I’d just managed to get a second package of 6 therapy sessions within a few years. The first took 3 years of asking and the second, around 6 months. But even with weekly therapy (extended to fortnightly for a longer period), bi-monthly care team support, regular mental health team check-in calls, a loving longterm partner, and a veritable army of support cats – I still suffered 4 days in 3 months where I was suicidal.

“Always surround yourself with friends that have plenty of light in them. That way, you will always have candles around you when days are dark.” – Suzy Kassem

Getting through the immediate seemingly life-threatening panic or manic anger or the aching raw bawling sadness has taken every ounce of my energy, and drawn on the understanding of my lovely partner in ways that I never wanted to. I nearly broke my girlfriend! She is, however, heroic in her ability to separate my needs (without being needy) from any responsibility to solve or salve, only to be a supportive companion and a candle in my darkness.

“Look at how a single candle can both defy and define the darkness.”  Anne Frank

Fortunately, due to my most serious past suicide attempt five-and-a-half years ago, I’d ensured that my house was empty of the means to take my life (via pills at least). It didn’t stop me from feeling my fragility and emotional rawness of having the same suicidal ideation but a better safety net in place. Driving is dangerous when one feels the power to take one’s own life beneath the foot pedal on an angry with the world day.

Not so Superman/girl

My superpowers have more than once met their psychosocial Kryptonite. I say psychosocial because I’m well aware that it is my psychological wiring and emotional responses to social and financial situations that trigger my darkness, anger, and powerlessness. 

Surviving rather than thriving is a temporary reward and respite. Living to face the terrors and panic attacks of another day. That is why dying feels like such a tempting relief, the only way to take a day off.

“And I find it kinda funny, I find it kinda sad
The dreams in which I’m dying are the best I’ve ever had” – Mad World

Faerie lights dancing in the relfections of the lens
Faerie lights dancing in the relfections of the lens

I have good days too, and in-between average days, that are nonetheless relief days. Being bipolar I’m never far from depression, nor elation. So I respect both. I can swing from scarily suicidal to aesthetic appreciation of art, beauty, food and kittens in just hours. Sadly, my rapid cycling rollercoaster can look fine, be engaged, and yet hours before or later be considering suicide or lying in the bath wondering what it would be like to drown in nihilistic comfort before the warm welcoming water got cold.

“If we never experience the chill of a dark winter, it is very unlikely that we will ever cherish the warmth of a bright summer’s day. Nothing stimulates our appetite for the simple joys of life more than the starvation caused by sadness or desperation. In order to complete our amazing life journey successfully, it is vital that we turn each and every dark tear into a pearl of wisdom, and find the blessing in every curse.” – Anthon St. Maarten

Life is full of light and dark, morning and night, summer and winter. Contrasts that make the extremes, well, more extreme. The highs are ecstatic and the lows are the end of the world.

“Life isn’t just about darkness or light, rather it’s about finding light within the darkness.” – Landon Parham

Yes, company, compassion, communication, the comfort of friends, are a solace though not a solution during those lonely days, weeks, months, and sadly, years. I’ve been anxious for 45 years, depressed for 15, bipolar (officially, at least) for 5. But, I’ve been alive for 50 years, continually by the thin thread of tenuous determination to live another day – despite several attempts, and many more close calls to end it.

“Why not dare yourself to become a shining positive light where darkness is the only thing known?” – Edmond Mbiaka

Getting through the night

Closing the curtains in winter at 4pm and waking at 4-5am some 3-4 hours before sunrise, leads to hours of wakeful darkness, and how to endure it. BBC iPlayer Radio plays are often an answer or cricket match commentary from Australian timezones.

The constant onslaught of dark days and anxious early mornings is like being pelted with a slinger’s stones or archer’s arrows from an infinite quiver where each would won’t kill you but like a death by a thousand cuts will make you weaker and even less likely to get up and face the next day.

 

 

Those 50 years, which feel like 500 at times, have taught me a healthy respect for mental wellbeing and to take pleasure in the little things like the fact that I woke up well today, and that it wasn’t raining. The longest night is past and longer days are around the corner, the light is returning, spring is coming.

I guess getting through the night is my daily version of other people’s getting through the winter. My rapid cycling mood means I experience the seasons on a quotidian basis. But I also learn from nature, that as sure as spring follows winter and morning follows night, so too will my mood lift or circumstance change. 

“I restore my book to the bracing and buoyant equilibrium of concrete outdoor Nature, the only permanent reliance for sanity of book or human life.” – Walt Whitman

Today, I walked among the trees, chatted with my partner, ate simple but tasty food, and stroked cats – lots of cats. I’ve survived another day. 

 

Mental Health & Wellbeing

Lies, Damned Lies & Tory Jeremy Hunt’s Mental Health NHS Statistics

Lies, Damned Lies & Mental Health Statistics

This month saw World Mental Health Day. For the other 364 days of the year, we are forgotten. Austerity Britain has affected mental health services more than most. Despite promises to ringfence the NHS and bring parity between physical and mental health, this has not happened. Instead, beds have been cut, jobs have not kept pace with population growth, and my own trust, NSFT, has been placed back into special measures again, after being the first mental health trust in the country to be sanctioned in this way by the Care Quality Commission (CQC) in February 2015.

Mental health awareness and NHS service provision improvements are sorely needed as referrals have risen 20% in Norfolk and Suffolk, but staffing and beds have been cut. Complaints, locally, have risen from 430 to 592, 2013-16. The latest CQC report criticised inadequate staff and bed levels but praised staff the caring attitudes of staff as ‘good’.

The recent Stevenson/Farmer ‘Thriving at Work’ report has demonstrated the need to promote mental health at work due to its annual near £99bn cost to the UK economy.

  • 2010-20 will be the most austere decade in NHS history
  • 2010-17 UK population rose 5%, mental health staff up 0.87%
  • 2011-14 33% rise in Police cases with mental health component
  • 2010-13 56% rise in self-harm and suicide
  • Mental health at work costs UK economy up to £99bn
  • Entitlement to be seen <18 weeks applies to mental health too

A week ago, BBC Radio Norfolk ran a mental health week focus with Stephen Bumfrey featuring it each afternoon, and coming together with Nick Conrad, Sue Tebble and myself, on Friday 20th, for an hour-long special. (iPlayer episode – 2hr 32m in

On Radio Norfolk’s Matthew Gudgin programme, the BBC’s Bob Carter challenged Theresa May to apologise to the people of Norfolk and Suffolk for having the worst mental health trust in England. Listen to the interview below:

Theresa May

During a recent visit to Archant, home of the EDP, in Norwich, the Prime Minister said:

“overall if you look across the country there is a good record of actually being able to move trusts out of special measures” – Theresa May

This makes the failure to resolve the local NSFT crisis all the poorer. Patients, or the politically correct – ‘service users’, have complimented the staff but criticised the system, waits, and other failures. Patient deaths and out of hospital suicides have increased whilst beds and budgets have been cut. Hundreds of patients were sent out of county owing to the lack of beds, up to 225 miles away!

In 2012/13 the trust reported 53 unexpected deaths, 105 in 2013/14 and 14/15, 139 deaths, rising again in 15/16 to 158, and 140 in just 9 months of 16/17. When standardised for age it is above the average for England. The figures have risen across all regions during NHS austerity under this government, from 47 per 1,000 to 59 in England – up 25%, but from 44 to 66, a rise of 50% in Norfolk & Suffolk.

Jeremy Hunt

Jeremy Hunt, the Health Secretary, has boasted that provision for mental health has “got better” and that he has increased staffing by 30,000 posts. The reality of the lie, and statistics do indeed damn him, is that 4,100 mental health nurses, 4,596 mental health trust beds, have been cut, and just 692 extra staff employed  – an increase of just 0.87% over seven years, despite population growth of 5% during that time – so, in other words, a cut!

“Although NHS funding is rising in real terms, current plans mean that 2009/10 to 2020/21 will be the most austere decade in NHS history. Total spending on the NHS in England increased by an average of 1.2% a year under the 2010-15 coalition government (0.9% for the UK), and is set to increase at the same rate under the current Conservative government. Between 2009/10 and 2015/16, spending increased from £109.1bn to £119.0bn and is planned to rise to £123.2bn in 2020/21. This growth rate of around 1% is below the historical average for the UK of 3.7% per year.”The Health Foundation

In Norfolk and Suffolk, primary care mental health referrals rose 20% between 2013-16, nearly 7 times faster than the population increase.

Wider Societal Impact

Norfolk has a pioneering mental health within Police HQ service, but nationally, there has been a 33% increase in cases with a mental health component 2011-14. As much as 40% of Police time is spent dealing with mental health-related issues.

Eighteen Weeks, as if!

Under the NHS constitutional pledge, patients have a right to be treated within 18 weeks of referral, including mental health.

“the new waiting time standards will be as follows: 75% of people referred for talking therapies for treatment of common mental health problems like depression and anxiety will start their treatment within 6 weeks and 95% will start within 18 weeks.” Pledge of 2014 to be delivered by April 2016.

Yet, the wait for some treatments can be more like 18 months. Just try requesting something more complex than CBT or other less time-limited ‘quick-fix’ therapies. IAPT referrals seen within 6 weeks were apparently 93-96% in Norfolk and Suffolk.

My personal experience, and that of several friends, has been of much longer waits. Calling the acute care line at weekends can result in complete ignorance or lack of access to your medical records. Support lines have historically been cut. People fall between the cracks, and I know too many people no longer with us due to mental health funding and systemic failures.

Discovery or Recovery

Discharge centred mental health, is solution based, with as much an an economic imperative as a wellbeing focus.

“securing a minimum of 50 per cent recovery rate from treatment” NHS

Mental health in Norfolk has a Recovery College, a course-based approach to improving wellbeing. I prefer to see it as a discovery-centric way of improving self-management with community support. Some mental health issues do not just resolve, yet the NHS insists on “developing a recovery culture” (p13) in mental health which fails those with long term or lifetime conditions.

74% of NSFT patients represented with mental illness symptoms within 6 months, compared to a national figure of 63% (2015 data).

IAPT (Improving Access to Psychological Therapies) approaches such as CBT serve best those with mild to moderate conditions, whereas moderate to severe need additional and more specialised help, as e.g., with OCD.

Suicide Risk

Between 2010-13, there was a 56% rise in self-harm and suicide across 52 NHS mental health trusts. It has been suggested that the over-capacity of up to 138% and staffing cuts has increased the risk of incidents.

I find the language, even if it has a clinical meaning, and the reality of response to people at risk of suicide, horrifying. The provision of “low level psychiatric support” was referenced in a Norfolk and Suffolk response it its higher than average suicide rate:

“There is a gap between the Wellbeing Service, the counsellors employed by GP practices and what is on offer via the mainstream mental health services. Suicide rate in Norfolk & Suffolk is high. GP referrals to MH are only accepted 20% of the time. GPs are left to manage risk the rest of the time.”NSFT, pp11-12

The apparent aim is a “reduction in referrals to mainstream mental
health services by offering more low level psychiatric support in primary care.”

Care not Cuts

What worries me, is the low level of funding, of staff, of beds, and the cure rather than care attitude of the system. In contrast, the caring attitude of the staff is to be praised, and they need additional in-work support themselves to be able to deliver services under such tight austerity conditions.

Mental Health & Wellbeing

Kurt Cobain, RIP in memoriam; On Being Yourself and too much Empathy

Being Yourself by Kurt Cobain

Kurt Cobain - the Day the Music Died
Kurt Cobain – the Day the Music Died, 1994

Kurt Cobain, was born in 1967, and died 5 April by taking his own life, back in 1994, aged just 27. He flitted between narcissism, empathy, love and pain, trying to enjoy his life and simply be himself, but not feeling it, over-feeling everything else instead. He’d have been in his 50s now, just a month older than me. Some years ago, I also attempted suicide, after a lifelong struggle with identity and feeling too much.

Whilst Cobain is in nirvana now, where are we 20+ years on? Still struggling for identity, as individuals, and a generation? Cobain struggled with being seen as the voice of a generation. His band, Nirvana, was labelled “the flagship band” of Generation X, and Cobain himself proclaimed as “the spokesman of a generation”, something that did not sit well with him.

Faking it, Being Someone Else

“Wanting to be someone else is a waste of who you are.” – Kurt Cobain

Cobain was trying to work out how to be himself amidst the pressures of fame, parental divorce, love and loss, and mental health conditions including bipolar mood swings between depression and mania, as described by his cousin, a nurse, who noted his childhood diagnosis of ADHD and as an adult Bipolar (unconfirmed?). Several relatives had also committed suicide in the same way. 

He struggled to feel what he thought he was meant to feel or enjoy. He couldn’t fake the enjoyment of fame, or life itself.

“I’ve tried everything within my power to appreciate it” – Kurt Cobain, suicide note

“The worst crime is faking it.” – Kurt Cobain

Empathy and Fame

Kurt Cobain suicide note
Kurt Cobain suicide note

He mentioned empathy four times in his suicide note, and the struggle between feeling too much and yet not feeling anything – or what he thought was the right thing, at all. 

“I think I simply love people too much, so much that it makes me feel too fucking sad. The sad little, sensitive, unappreciative, Pisces, Jesus, man, ‘Why don’t you just enjoy it?’ I don’t know!” – Kurt Cobain, suicide note

Nirvana sold over 25 million albums in the US, and over 75 million worldwide, but fame and success do not fill the void. He hated the fame, and was envious of Freddie Mercury and how he seemed to relish it.

“We’re so trendy we can’t even escape ourselves…I really miss being able to blend in with people.” – Kurt Cobain

Reading, Writing & Lyrics

Cobain “occasionally took refuge in the counter-cultural writings of authors such as William S. Burroughs, Jack Kerouac, Samuel Beckett and Charles Bukowski”. Yet, described himself as having the “tongue of an experienced simpleton”, and hating the Freudian analysis that people subjected his lyrics to. Another reason, to explore him in his own words, not the interpretation of others.

“I’m not well-read, but when I read, I read well.” – Kurt Cobain

“I like to have strong opinions with nothing to back them up with besides my primal sincerity. I like sincerity. I lack sincerity.” – Kurt Cobain

Sexuality

Kurt Cobain was seemingly bisexual, though gave mixed interviews on that side of his personal life, calling himself “gay for a while” yet “more sexually attracted to women”. As a teen he was arrested and fined $180 for graffitiing “Homosex Rules” on a wall. He once said, “I started being really proud of the fact that I was gay even though I wasn’t.” It is not clear if he ever consummated this part of his persona, despite saying:

“If I wouldn’t have found Courtney, I probably would have carried on with a bisexual lifestyle.” – Kurt Cobain

Whilst Generation Y, born early 80s to 2000, followed Cobain’s Generation X, we are now on the Gen Z cohort, born since the Millennium. A group happy to be neither gay nor straight, to question gender and express it fluidly.

Women’s Rights

Cobain wrote about women’s rights in his songs, including concerning the rape of a 14yo girl after a concert (not one of his). 

“I definitely feel closer to the feminine side of the human being than I do the male – or the American idea of what a male is supposed to be.” – Kurt Cobain

“He was himself”

Canadian musician and writer, Dave Bidini, in an article for the National Post entitled “Kurt Cobain, who died 20 years ago today, wasn’t a hero, martyr or vampire. He was himself” ended with this comment:

“He looked like he didn’t care (because he didn’t) … His arms hang down and he turns sideways from the crowd, as if he’s trying not to be seen, even though 20 million people have their eyes trained on him. In a society where ‘bringing it’ and ‘all or nothing’ and ‘going for it’ are sicknesses pumped by fools who aspire to drive people apart rather than draw them together, Cobain’s sense of oblivion was, in a way, brave and confrontational, and that’s why he cracked even the hardest edifice and ate through misplaced pop culture like a creeping disease. In the end, he made an enormous impression for someone who wasn’t even there.”  – Dave Bidini, National Post

Cobain did escape, “Rather be dead than cool”, others need not take that route if they can follow his other wisdom, to be yourself and find someone you can be yourself with and talk to.

“It’s better to burn out than to fade away” – suicide note

Remember him alive though, here’s an awesome unplugged hour-long Kurt Cobain MTV concert in NYC November 1993 just months before his suicide, my favourite line of which was “like this is my third cup of tea already” – how Rock’n’Roll!

I will remember him, as much for the angst music of a tortured soul, as the desire to find and be himself, a journey I am also on, aren’t we all to a degree?

“I’d rather be hated for who I am, than loved for who I am not.” – Kurt Cobain

Mental Health & Wellbeing

RIP Carrie Fisher – Actor, Author, Mental Health Advocate, in her own words

Carrie Fisher, died 27 December 2016

Carrie Fisher will be mostly remembered for being Princess Leia in Star Wars as the Space Western princess with a gun and rapid riposte to Harrison Ford’s Han Solo when he needed a put-down. It didn’t stop them having a recently revealed off-screen romance. Also, off-screen was her battle with the darker forces of addiction and bipolar mental health. Her website records her in the way she’d prefer to be remembered as an “actor, author” and shamelessly, a “mental health advocate”, her site listed mental health resources, and she was active in promoting mental health awareness.

Carrie Fisher, The Princess Diarist (2016)
Carrie Fisher, The Princess Diarist (2016)

For the record, she starred in 44 films from Shampoo (1975) to Star Wars: Episode VIII (2017), wrote 7 books, and well over half-a-dozen plays, scripts and screenplays.More a signature action than her Leia buns and Avenger/Charlie’s Angels-style with

Even more a signature action than her Leia buns and Avengers/Charlie’s Angels-style gun-aloft pose, her middle finger was often shot up at the press. She was a hero for her honesty, humour and heart, the media needs to treat mental health better.

As someone who battles and “sur-thrives” with Bipolar Affective Disorder, aka manic depression, myself, I find so many echoes in her statements on mental health, and her activism in helping others through honesty and sheer guts – or clitzpah, female “courage bordering on arrogance”, as a friend puts it.

A fitting tribute is, therefore, to remember her in her own words:

Carrie Fisher Quotes – In Her Own Words

“I really love the internet. They say chat-rooms are the trailer park of the internet but I find it amazing.”

On Writing as Therapy

Carrie Fisher, Shockaholic (2011)
Carrie Fisher, Shockaholic (2011)

“I have a mess in my head sometimes, and there’s something very satisfying about putting it into words. Certainly it’s not something that you’re in charge of, necessarily, but writing about it, putting it into your words, can be a very powerful experience.”

“I always kept a diary – not a diary like, ‘Dear Diary, we got up at 5 A.M., and I wore the weird hair again and that white dress! Hi-yeee!’ I’d just write.”

“Writing is a very calming thing for me.” 

I can echo those thoughts, totally! Writing slows my racing pacing thoughts down, coming up with the language that accurately and emotional reflects my thoughts on myself, life, the universe and everything, is a process that is cathartic, creative, and better than CBT.

Her humour

Whether scripted stand-up comedy or unscripted ad-lib, Carrie was quick witted, sharp, funny and could turn the tables on an interviewer. A vital skill in the harsh world of Hollywood and media criticism.

“I brought along Gary” (Carrie Fisher’s dog) “because his tongue matches my sweater” … “I think in my mouth so I don’t lie” … “what music makes [weight loss] worthwhile?” Not to mention some beautiful flirting with “DNA jackpot” GMA’s Amy Robach!

The humour, the jokey OCD matching, the flirting, she was my kind of inappropriate unboundaried, humourous getting-into-trouble, woman.

“There’s no room for demons when you’re self-possessed” via Twitter (2014)

“I googled myself without lubricant. I don’t I recommend it.” on David Letterman (2009)

“Sometimes I feel like I’ve got my nose pressed up against the window of a bakery, only I’m the bread” – Postcards from the Edge (1987)

“Pure lust is an oxymoron” via Twitter (2016)

On Life and Being Herself

“I am a spy in the house of me. I report back from the front lines of the battle that is me. I am somewhat nonplused by the event that is my life.”

“I don’t want my life to imitate art, I want my life to be art.”

Again, one feels like an actor in one’s own drama, there is sometimes a feeling of distance from the actions one takes, as if one were only playing a part, however grand a role.

On Body, Weight and Aging

“I don’t like looking at myself. I have such bad body dysmorphia.”

“I think of my body as a side effect of my mind.”

“I’m in a business where the only thing that matters is weight and appearance. That is so messed up. They might as well say ‘Get younger,’ because that’s how easy it is.”

“There were days I could barely struggle into a size 46 or 48, months of larges and XXLs, and endless rounds of leggings with the elastic at the waist stretched to its limit and beyond – topped with the fashion equivalent of a tea cozy. And always black, because I was in mourning for my slimmer self.”

“…when I do lose the weight, I don’t like that it makes me feel good about myself. It’s not who I am.”

“Along with aging comes life experience, so in every way that is consistent with even being human.”

On Mental Health & Bipolar Mood State

Carrie Fisher, Wishful Drinking (2008)
Carrie Fisher, Wishful Drinking (2008)

“I’m very sane about how crazy I am.” – Wishful Drinking, (2008)

“I now get awards all the time for being mentally ill. It’s better than being bad at being insane, right? How tragic would it be to be runner-up for Bipolar Woman of the Year?” – Wishful Drinking, (2008)

“Anything you can do in excess for the wrong reasons is exciting to me.”

“I have a chemical imbalance that, in its most extreme state, will lead me to a mental hospital.”

“Drugs made me feel more normal.”

“I went to a doctor and told him I felt normal on acid, that I was a light bulb in a world of moths. That is what the manic state is like.”

“I have two moods. One is Roy, rollicking Roy, the wild ride of a mood. And Pam, sediment Pam, who stands on the shore and sobs… Sometimes the tide is in, sometimes it’s out.”

The manic mood ride that is Roy and the pessimistic panic that is Pam, is very familiar. I’ve not heard anyone else echo my experience of drugs making one feel normal. I tried weed, ecstasy and minor drugs like that, even smoking and drinking, but they didn’t do anything for me, indeed ecstasy made me responsible, hyper-sensible! 

On Surviving and Thriving

“Ive [sic] stopped trying to take things a day at a time. I now take 2 or 3 days at once—hoping it’ll cause a blur effect & I might look younger.” via Twitter (2015)

“I don’t want to be thought of as a survivor because you have to continue getting involved in difficult situations to show off that particular gift…”

“If anything, my mother taught me how to sur-thrive. That’s my word for it.”

Boundaries and Bad Judgements

“The world of manic depression is a world of bad judgment calls.”

“I’ll never be known for my work with boundaries.”

“Mistakes are a drag, because you get in the area of regret and self-pity.”

Fortunately, it’s not all bad boundaries and manic mistakes, and the following day come-down into reality and realisation that one has overstepped, overdrawn, overdone it, and occasionally overdosed. Manic can be fun, or at least hypomanic can, with just enough awareness to feel empowered, energied, extrovert and not yet into the territory of relationship, finance and employment self-destruction.  

“The manic end of is a lot of fun.”

On acting as if all is well

“One of the great things to pretend is that you’re not only alright, you’re in great shape. Now to have that come true – I’ve actually gone on stage depressed and that’s worked its magic on me, ’cause if I can convince you that I’m alright, then maybe I can convince me.”

“Stay afraid but do it anyway. What’s important is the action. You don’t have to wait to be confident. Just do it and eventually the confidence will follow.”

“I’m fine, but I’m bipolar. I’m on seven medications, and I take medication three times a day. This constantly puts me in touch with the illness I have. I’m never quite allowed to be free of that for a day.”

She is free now, “drowned in moonlight, strangled by my own bra“. Whilst she was “nonplused” about her life, we are far from nonplused at her death and feel the disruption in the force in 2016, which has been a traumatic year of loss. RIP Carrie, Princess, Queen, General and very human being, “May the Force be with you.” 

Postscript: Carrie Fisher’s mother, Debbie Reynolds, star of Singin’ in the Rain, died aged 84 of a stroke within 24 hours of Carrie.

Mental Health & Wellbeing

International Mens Day, Mental Health and Male Suicide Rates

International Men’s Day, 19 Nov

Yesterday was #InternationalMensDay (IMD) – not a simple awareness retaliation day to Women’s Day but an acknowledgement, since 1999, that privilege and difference are often relative and contextual. Society does make it harder for men to talk, share, open up, acknowledge depression, career pressures etc. Men’s mental health is such that suicide can be their biggest killer, indeed, silence kills. Yes, feminists can argue that every day is men’s day, but in the particular sphere of suicide, there needs to be a spotlight on men and the fiscal and fragile crises that so often masculinity prefers to conceal. Similarly, whilst young LGBT people have high suicide risks, one group most prone to it is white men aged 85+ whose suicide rate in the US is six times the national average, closely followed by Native American males.

World Suicide Prevention Day, 10 Sep

Depressed manMen are more than 3 times as likely to take their lives as women (4 times in the USA), with rates of 16.8 per 100,000 for men and 5.2 per 100,000 for women in the UK. Women try suicide more than men, but male suicide methods are more likely to result in death.

The highest suicide rate in the UK in 2014 was for men aged 45-49 at 26.5 per 100,000 with the North East of England most vulnerable. Whilst the overall suicide rate fell 1981 to 2007, austerity and cuts to services have seen annual rises since with the male rate last year, the worst since 2001.

385 men-a-month take their own lives in the UK; it is even worse in the USA, at 2759, 1.5x more likely per capita. In Japan, it is the leading cause of death in men aged 20-44.

Even so, Japan is not the worst. Lithuania is twice as high at 51 per 100,000 and Guyana at 71 per 100k is ashamedly the world ‘leader’. The USA ranks #46 and the UK #101 for male suicide.

Not a laughing matter

World Toilet Day, access for all by 2030
World Toilet Day, access for all by 2030

Men’s mental health is not a joke. November 19 was also World Toilet Day, and whilst jokes about leaving the toilet seat up abounded on twitter – including by me, whilst not directly aimed at men’s health, sanitation and sanity are not laughing matters when one billion lack a toilet and half-a-million men each year die by suicide and many millions more try. Whilst depression and mental health issues account for the majority of cases, for men in particular, financial and career pressures are significant factors. Education, because it brings with it greater economic opportunities and perhaps better communication skills, is a reducing factor, except among certain professions whose jobs give them access to pharmaceutical drugs.

Learn to Talk & Listen

The old Second World War adage and poster campaign that “Careless talk costs lives” could be turned on its head – “Learn to talk and save lives”. Partners and friends of men in crisis, similarly, need to learn to listen and not diminish the pressures that drive them to drink, depression and suicide. Suicide, at one every 40 seconds and on the rise (predicted to be one every 20s by 2020) is preventable is we make it ok for everyone to talk about mental health, men in particular, and we also end the worst effects of austerity where health and welfare cuts are exacerbating the problem and denying access to solutions.

Mental Health & Wellbeing

WLMHT to let go of Charing Cross Gender Identity Clinic NOT to close it

Charing Cross Gender Identity Clinic NOT closing

The West London Mental Health Trust (WLMHT) has issued a statement and then after mass trans patient panic (well a few of us!) has clarified it. The Gender Identity Clinic at Charing Cross Hospital (CX GIC) is not to close but to seek new NHS England oversight, preferably not under the auspices of mental health care. This is both unnerving for existing patients on the long waiting lists and potentially radical.

The Charing Cross Gender Identity Clinic is, in their own words, “the largest and oldest clinic of its kind dating back to 1966”. The same year that Harry Benjamin published “The Transsexual Phenomenon“.

UPDATE: It has been confirmed that from April 2017 the Tavistock and Portman NHS Foundation Trust will take over the management and funding of the Charing Cross GIC, without its location changing. The T&P NHS FT also run Tavistock GIDS, London (child and adolescent service).

Tavistock and Portman NHS Foundation Trust
Tavistock and Portman NHS Foundation Trust

NHS Hospital Cuts

All this comes the same day the NHS has announced further cuts in a spiralling financial crisis – the biggest in its history, requiring the euphemistically named “sustainability and transformation” plans, in other words, “cuts”.

“We are seeing more and more pressures on staff trying to run harder and harder. We are reaching breaking point.” – Chris Hopson, Chief Executive of NHS Providers

West London Mental Health Trust statement

The Gender Identity Clinic at Charing Cross plays a leading role nationally and internationally in helping people experiencing gender dysphoria to feel more comfortable in their own bodies.

West London Mental Health Trust (WLMHT) is incredibly proud to have been at the forefront of developing gender identity services during a period in which societal attitudes and understanding of this issue has improved so vastly, and that the Charing Cross GIC and its staff have, since 1966, helped nearly 7500 people to lead happier, healthier lives.

Demand for gender identity services has risen sharply in recent years as society has grown more understanding and awareness of NHS services has developed. This has been challenging for the clinic and resulted in waiting times that are longer than we would like. However, the clinic’s staff have continued to invest huge amounts of energy and, working with NHS England, have made great strides in bringing these waiting times down while still providing a service which is rated highly by patients.

However, as WLMHT moves forward it is necessary to refocus the services that we provide. The Board has made a decision that the medium-term strategic focus for the Trust will be to develop mental health services, physical care and integration between the two.

As a result, the Trust has come to the conclusion that patients requiring gender identity services would be better served in the long term by another provider, and has therefore served notice on our contract to NHS England.

We know that many of the patients we see at the GIC are at difficult times in their lives and that this announcement may cause alarm; we would therefore like to offer the following reassurances:

  • This does not mean services are stopping now – we will continue to provide services as normal until such time as a new provider is able to take over; this is likely to be at least six months.
  • Patients from London and the South East will not be left without services or have to travel much further – NHS England as the commissioner for gender identity services will find a suitable alternative provider as quickly as possible.
  • Patients will not have to start their treatment all over again – continuity of care for our patients is the number one priority for clinic staff. GIC staff will work closely with NHS England and a new provider to ensure disruption to treatment is kept to an absolute minimum.
  • This does not mean we will let services deteriorate – WLMHT and the GIC will continue to deliver on plans we have developed with NHS England to improve access to and quality of services while it continues as the provider.
  • We will not reduce staffing levels – while we remain the provider of this service we have an obligation to ensure there are sufficient qualified staff to maintain and continue improvements in access and quality.
  • We will ensure a smooth handover to the new provider, working closely with our colleagues at the GIC and NHS England

Dr James Barrett, Lead Consultant at the Gender Identity Clinic (GIC), on behalf of GIC clinicians, later clarified:

The gender identity clinic is not closing. To clarify, we clinicians have long felt that West London Mental Health Trust is not a good fit for the unique and specific service we provide (the vast majority of those we see are not mentally ill).

“Increasingly, we feel our patients would be better served by us if we worked somewhere better able to support and develop a more tailored approach to gender.

“There are a number of options in terms of alternative providers. We would not make any move unless confident that patient care would be markedly improved.

“Until that point, current arrangements will still apply. Our aim is for any change to be a positive one, and any transition to be as seamless as possible.”

CX GIC psychiatrist, Dr Stuart Lorimer, sought to reassure people:

NHS Transgender Waiting Times

Waiting times for first appointments at the Charing Cross GIC are currently around 12 months from the initial referral but can often take 3-7 years in total, when you include surgery which only takes place after two psychiatric approvals and a pre-surgical assessment.

Referral times are not only a postcode lottery but constantly change – both up and down, according to staffing, and ever-increasing transgender service user demand. Norwich, alone, refers 50-60 adults a year not including the dozens of trans teens not yet in the adult system. It recently shifted its gender dysphoric population from Charing Cross to Nottingham GIC, having also, in the past, used Dr Richard Curtis’ TransHealth in London.

UK Trans Info has an excellent resource offering waiting times and estimated trans population surveys of all the GICs every three months. Last year Leeds were quoting 4 years for first appointments and Sheffield over 18 months! Nottingham’s 8 months has risen to 12 and now 18-19 months.

“Nottingham’s GIC saw the most marked growth, with a 2800% increase from 30 referrals in 2008 to 850 in 2015. More than 1000 are expected this year.” – Pink News

UK Trans Gender Identity Clinics

There are 7 adult and 1 adolescent-teen GICs in England, serving England and Wales – Wales has none of its own and London’s Charing Cross GIC also serves them.  The Tavistock and Portman is the sole young person clinic in England, based in London, but with clinics in Exeter and Leeds.

Scotland has 4 adult and 1 adolescent clinic. Belfast Health and Social Care Trust runs an adult and separate “Knowing Our Identity” (KOI) service for children and teens.

For a full list and contact details see GenderAgenda’s UK GICs page.

 

Mental Health & Wellbeing

International Transgender Day of Visibility #TDOV

Transgender Day of Visibility #TDOV

The last day of Women’s History Month, the day before April Fool’s, is the International Trans Day of Visibility (TDOV), 31 March. Since 2009, it has sought to celebrate transgender positivity in contrast to the Transgender Day of Remembrance (TDOR) events around 20 November that draw attention to the high levels of violence and murder that trans people suffer in some countries. Even where murder is less likely, bullying, harassment, and discrimination can be part of the transphobic package that can add to the likelihood of suicide, which some 40% of trans people attempt, and twice that number, consider.

TDOV is an opportunity to portray positive role models, to let the many trans just coming out know that “it gets better“. I’ve spent ten plus years ‘out’ and it’s been a rocky road, with the almost requisite marriage break-up, suicide attempts, looks in the street, and transphobic abuse online. But that need not be everyone’s experience and for many, it is getting easier, with better support and a more accepting society.

SuperTrans Coming Out Transgender Visibility
SuperTrans ‘Coming Out’

Ironically, many trans people don’t want to be visible, they’d rather not be noticed, hopefully passing as fellow human beings in a crowd. Inevitably, some of us stand out more than others, some by choice, some by fate. Don’t always assume a trans person wants to be recognised or feted as one, many would rather be seen as your common or garden variety man or woman. I’m of the louder and more visual variety, who’ll probably die still not conforming to gender stereotypes and expectations.

Non-Binary leads to inevitable visibility

I’ve found, indeed, that being non-binary is a better fit for me than the discrete categories of man or woman, male or female, boy or girl. I, personally, don’t mind whether anyone sees me as a “real woman” or not, I know basic biology, although mine is more complex and many people exist that makes one think again about binary sex default and gender constructs.

I am, however, also not a “real man”, that too is fine! Perhaps, as one of my godchildren once cheekily remarked to me upon opening the door, saying, “Half-ladies first”, I am a “Shim”, also his delightful invention. Other people should be respected, however they prefer to be addressed.

Beyond He or She Gender Time Magazine cover
Beyond He or She Gender Time Magazine cover, March 2017

Whilst 2014 has been regarded as the “Transgender tipping point”, 2016-17 seems to be the year of Non-Binary Genderqueer and Genderfluid. In January, National Geographic ran a “Gender Revolution” special issue, and this March, TIME Magazine ran with “Beyond He or She”. 

Half of young people now see gender as a spectrum and identify their own sexuality between gay and straight. Most now know someone who is trans and/or non-binary, and they are broadly accepting, the best it has ever been, teaching older adults the way to be around identity and expression. Whilst traditional feminists regard gender as a construct, it is young women who are most likely to see it as a spectrum, blurring the lines between gender and sex. Some 22% of young women identify as other than 100% female.

New Gender Honorific Titles on Bank Cards

Just this week, HSBC announced 10 new non-binary honorifics besides the usual Mr, Mrs, Ms etc,. Metro Bank and RBS NatWest already allowed Mx (as I have) or no title. HSBC customers can now choose from:

  • Ind (individual)
  • M
  • Mx (pron. “mix” or “mux”)
  • Misc (miscellaneous)
  • Mre (mystery)
  • Msr (mix of miss/sir)
  • Myr
  • Pr (pron. “per”, for person)
  • Sai (pron. “sigh”)
  • Ser (pron. “sair”)

A Most Reluctant Transsexual

To be honest, I haven’t had it too hard, people have been accepting, and although gender dysphoric, at times I’ve been euphoric to finally be myself. Even with some trials and tribulations, it has been worth it.

Katy Went Transgender Voices NHS NSFT photoshoot
Katy Went “Transgender Voices” NHS NSFT magazine photoshoot

My ten-year journey as Norfolk’s “most reluctant transsexual” – as my psychiatrist once called me, has recently closed one chapter and turned the page to another. After nearly 6 years on hormones my resistance towards surgery shattered and I went ahead with a version of GRS that suited my identity and needs. It has made me a happier, healthier person, with no regrets. Rather surprisingly, to myself at least, it has improved my other mental health condition, bipolar, for now at least, with just pockets of extreme downs, rarer hypomanic highs, and many more days of productivity and calm.

In going ahead with surgery I found my mind changed as much as my body. It really was life-changing, even saving, surgery. Whilst I had near constant doubts leading up to it, I’ve had none since that no-going-back day of 6 February 2016, and felt as much lighter between the ears as between the legs. I feel like a psycho-emotional brain tumour has been removed, I have more space in my head, in my thoughts and feelings, no longer obsessed and disturbed by gender identity. I feel no more female, just less encumbered and more myself. Oddly, I feel just as non-binary, non-conformist as ever, and, if anything, less gendered, though more comfortable in my body.

NSFT NHS Insight Magazine
NSFT NHS Insight Magazine

Prevalence of transgender people

I am but one of millions of trans people worldwide, more than a million in the USA alone, perhaps 300-600,000 in the UK or more. The NHS used to say that there were around 1-in-30,000 people born male (AMAB) transitioning to female (MTF) and 1-in-100,000 people born female (AFAB) transitioning to male (FTM). Those serious underestimates are reflected in the huge waiting lists of 1000s of people to access the handful of UK Gender Identity Clinics (GICs).

Given that the incidence of trans people seeking NHS help is now around 7,000 new referrals p.a., figures over an adult working lifetime would suggest a prevalence of 300,000-600,000 adults, around 0.5%-1% of the population, 1-in-200 or 1-in-100 people, perhaps more. In addition, For every trans person not seeking HRT or surgery there are four or five feeling and presenting as gender questioning or non-conforming. Recent surveys suggest 2.5% may identify as non-binary, 1.75% may be born intersex, and 2% may identify as trans or genderfluid. Overlap between these populations may suggest around 5% total, 1-in-20 people. This isn’t to conflate intersex with trans, just that some can be both, and it shows the degree of sex and/or gender atypicality in the population as a whole.

National Geographic, Gender Revolution
National Geographic, Gender Revolution, January 2017

Visible Trans Persons

In the UK we have many visible trans already such as the comedian, actor and now marathon-addict, Eddie Izzard. Other trans comedians include Bethany Black and Andrew O’Neill. Then there’s the arts writer and ceramicist, Turner Prize winning artist, Grayson Perry. In the world of journalism, there’s LGBT Pink List-topping radio and print journalist Paris Lees, along with several contributors to the Guardian newspaper such as Jane Fae, Juliet Jacques, and Roz Kaveney. In the field of law and diversity, Professor of Equalities Law at Manchester – Stephen Whittle, Christine Burns, formerly of Press for Change, Rachel Reese of the University of Law, law partner Clare Fielding, and barrister, Caroline Harrison, QC.

In sport, there’s recently-out boxing promoter, Kellie Maloney, and MMA fighter Roxeanne/Alex Reid. In business, there is Kate Craig-Wood, an entrepreneur and founder of one of the UK’s largest IT groups. Musicians like CN Lester, Thomas Dolby’s son Harper, and a magician, Fay Presto. In politics, there are several trans people who have stood as councillors or for election, across the political spectrum. On television, there are actors and a spate of reality TV stars. Among people who came out in the 1960s and 70s, there’s models April Ashley and Caroline Cossey, and writer, Jan Morris –  all well known British women with open transgender histories. I could go on as I know of hundreds of trans lawyers, doctors, activists in public life, here in the UK alone.

Time Magazine Transgender Tipping Point Laverne Cox
Time Magazine “The Transgender Tipping Point” Laverne Cox

In the USA, Janet Mock, among others have blazed the way by being out and public in their defence of being themselves, creating a tipping point of trans visibility, perhaps leading to the timing of former Olympian Caitlyn Jenner’s coming out.

Also, recently, we’ve seen big names like Lana and Lilly Wachowski of the Matrix films, Chelsea Manning of Wikileaks fame, Cher’s son Chaz Bono, and Laura Jane Grace of Against Me. Actors like Alexis Arquette, Candis Cayne (“Dirty Sexy Money”), Laverne Cox (“Orange is the New Black”) and Calpernia Addams. Nor are “Gender Outlaw” author Kate Bornstein or Jennifer Boylan to be forgotten. Dr Marci Bowers, is an American gynaecologist and surgeon and actually carries out gender/sex-reassignment surgery. There’s the US biologist and author of “Evolution’s Rainbow” Joan Roughgarden.

The names above are just a sprinkling of the probably tens of millions of trans and gender-variant people million worldwide.

For more information about the transgender spectrum visit www.genderagenda.net.

 

Mental Health & Wellbeing

World Bipolar Day, BAD Mood Scale, Manic Creativity & Vincent van Gogh

World Bipolar Day

Today and every day is bipolar day for 2-3% of the population who have a Mood Affective Disorder including Cyclothymia and Bipolar I & II. A day to recognise the issues, struggles, and occasional joys and spurts of creativity – sometimes manic, experienced by people with Bipolar Affective Disorder (BAD), was created to coincide with Vincent van Gogh’s birthday, 30 March, since he was posthumously believed to have had a Bipolar type condition. World Bipolar Day aims to:

“bring world awareness to bipolar disorders and eliminate social stigma.” – International Society for Bipolar Disorders

Prevalence | Creativity | Mood Scale | van Gogh | 2018 update

Bipolar Incidence & Prevalence

Whilst 1-in-100 or 2.6% are commonly cited figures, some studies have shown wide variations, ranging from 2.6 to 20.0 per 100,000 per year, in the incidence of Bipolar Affective Disorder (Lloyd & Jones, 2002). These variations have been e.g., regional, SE London is twice that of Nottingham and Bristol, or by ethnicity, by socio-economic class, by childhood intelligence – especially high verbal IQ, or by hormones and gender – some studies show a much higher incidence in the female population, sometimes 2-3x.

“estrogen fluctuations may be an important factor in the etiology of bipolar disorder and it is obvious that more research on this topic is needed to clarify the role of estrogen in women with bipolar disorder…Why is it that rapid cycling occurs more often in women?” www.ncbi.nlm.nih.gov/pubmed/23510130

Link to Creativity?

It also alleged that among artistic and creative types there is a higher incidence of bipolar mood disorders, that may be genetic. Indeed, as many as 40x the national incidence, among a group of 30 American authors, studied over 15 years:

“43 per cent of them had bipolar disorder compared to only 10 per cent of the control group and 1 per cent of the general population.” – Bipolar Disorder and Creativity

A further survey of 47 British authors and visual artists from the British Royal Academy found that 38% had been treated for a mood disorder.

“A recent study carried out at Stanford University by Santosa and colleagues found that people with bipolar disorder and creative discipline controls scored significantly more highly than healthy controls on a measure of creativity called the Barron-Welsh Art Scale. In a related study the same authors sought to identify temperamental traits that people with bipolar disorder and creative people have in common. They found that both shared tendencies for mild elation and depression with gradual shifts from one to the other, openness, irritability, and neuroticism (roughly speaking, a combination of anxiety and perfectionism).” – Bipolar Disorder and Creativity

Vincent van Gogh

Vincent Van Gogh The Starry Night Google Art Project
Vincent Van Gogh, “The Starry Night”, 1889, MOMA, NYC via  Google Art Project

The famous Dutch post-Impressionist painter, Vincent van Gogh suffered quite wild swings in his mental health and many paintings were produced from his asylum room. Van Gogh is thought to have shot himself, after struggling with declining mental health in his mid-30s. He had spent most of the last 18-months of his life in an asylum, but two months later was dead as the result of a presumably, though not proven, self-induced shooting incident or suicide attempt.

Ironically, it was a period when he produced many iconic paintings, some en plein air. His famous image titled ‘The Starry Night’ was a pre-sunrise nocturne as seen from his East-facing asylum window, but finished in the asylum studio, as he was only allowed to draw in his room, not paint. Van Gogh’s beautiful and happier ‘Village Street and Steps in Auvers’ was painted just days after release from the asylum:

Vincent van Gogh Village Street and Steps in Auvers
Vincent van Gogh, “Dorfstraße undTreppe in Auvers mit Figuren” – ‘Village Street and Steps in Auvers’, 1890

Barely weeks later, and days before his death, he was painting several large wheat fields canvases and in a letter to his brother Theo, he wrote:

“I have painted three more large canvases. They are vast stretches of corn under troubled skies, and I did not have to go out of my way very much in order to try to express sadness and extreme loneliness….I’m fairly sure that these canvases will tell you what I cannot say in words, that is, how healthy and invigorating I find the countryside.” – Vincent van Gogh, Letter to Theo van Gogh, 10 July 1890

His late paintings demonstrate an artist at the height of his talent, yet also the depths of his troubles, for whom art and the outdoor landscape was creative catharsis and therapy. What would the art world have witnessed had he lived on?

Bipolar Mood Scale Diary

Bipolar Mood Scale & Insomnia Sleep Diary Nov 17-Jan 18
Bipolar Mood Scale & Insomnia Sleep Diary Nov 17-Jan 18

It is typical for accurate bipolar diagnosis to take a decade and work through several misdiagnoses en route. I was first diagnosed with Cyclothymia over 4 years ago, but subsequently told it was Mood Affective Disorder and then Bipolar II, along with rapid cycling and mixed mode variations, and exacerbated by Seasonal Affective Disorder during winter months.

CBT – Cognitive Behaviour Therapy, aided my own self-management, but so did self-knowledge, awareness, and diarying. I enjoy my hypomanic periods, less so the depressions which I’ve fought for 12 years or so. Finding balance when you only exist at the poles is a tricky act to accomplish and may involve staying in when you feel like going out and going out when you feel like staying in!

Risks, when hypomanic, for me include inappropriate conversation, loss of impulse control, manic spending, flirting, obsessional behaviours, and risk-seeking. Yet, the benefits when high are hyperactive stamina and energy, stream of consciousness ideas flooding, huge reading and writing output, charismatic and entertaining confidence and loquaciousness.

“I managed to rack up £300k of credit, hardly average! I was, and indeed am, very convincing when hypomanic, it made me a good salesperson, deal-maker, innovator, public speaker but terrible at time and money management.”May 2013

Having been in a balanced mood state for nearly 3 months now, a rare occurrence, possibly due to recent endocrine changes, I miss the hyper states. I also realise, however, how destructive they could be to life, economics, and relationships, whilst at the same time being a creative buzz. I don’t miss the lethargic, inactive, hopeless depressive episodes at all, although they were a great way of avoiding life and its stresses.

The best advice I was given was to monitor my mood on a daily basis, as I was already doing with my insomnia diary and general personal diary. The catharsis of writing and recording also came with the recognition that moods, highs, lows, sleeplessness all came in phases, that changed – they got better, and they got worse. Unlike, when I suffered with depression for 6-8 years as that felt like nothing would ever get better. The Bipolar Mood Scale diary has helped me to hold out for the good days, and to manage my moods better.

Bipolar Mood Scale

Mania
10Total loss of judgement, exorbitant spending, religious delusions and hallucinations.
9Lost touch with reality, incoherent, no sleep, paranoid and vindictive, reckless behaviour.
Hypomania
8Inflated self-esteem, rapid thoughts and speech, counter-productive simultaneous tasks.
7Very productive, everything to excess (phone calls, writing, smoking, tea), charming and talkative.)
Balanced Mood (Euthymia)
6Self-esteem good, optimistic, sociable and articulate, good decisions and get work done.
5Mood in balance, no symptoms of depression or mania. Life is going well and the outlook is good.
4Slight withdrawal from social situations, concentration less than usual, slight agitation.
Mild to Moderate Depression
3Feelings of panic and anxiety, concentration difficult and memory poor, some comfort in routine.
2Slow thinking, no appetite, need to be alone, sleep excessive or difficult, everything a struggle.
Severe Depression
1Feelings of hopelessness and guilt, thoughts of suicide, little movement, impossible to do anything.
0Endless suicidal thoughts, no way out, no movement, everything is bleak and it will always be like this.
0-10 Scale of mood from depression to mania

Living with Bipolar

I am BAD, Bipolar Affective Disorder
BAD, Bipolar Affective Disorder (also Danish for ‘bath’)

Being or having bipolar – people’s attitudes to which verb to use vary, should not be romanticised. It is both a blessing and a curse, and for some is very hard to live with. I’ve made friends with mine, though it is still unpredictable. I’ve come to appreciate the moment, mindful that it can change, but I take the rough with the smooth now. Hopefully, I can look back on past suicide attempts as distant memories, and seize the creative periods to be productive and expressive, whilst trying to rein it in when it tips into hypomania.

World Bipolar Day 2018 Update

The last 6 months have included the worst 3 months in 5-6 years (when I last seriously attempted suicide), and the best 2 months in a year or so. That’s Bipolar for you. The bad period leading into last winter included 4 suicidal days, the worst of which, thankfully, fell on the same day as therapy as I survived another near miss. That has kept me real and respectful of the risk of suicide. Paradoxically, I don’t treat suicide lightly I have a healthy recognition of its power, yet I do make light of it as I find humour lessens its hold and the fear of talking about it among others. Any jest at my multiple suicide ‘failures’ (a word not recommended to be used) is made at my expense and my expense alone. 

I’ve also had 2 months of whirlwind energy starting not long after the days started getting longer and post-equinox light improved. These have included lengthy travels, sometimes speaking at two events in one day or half-a-dozen in a week, of copious writing and presentation preps on everything from art to human rights, mental health to LGBTIQ history and awareness, culminating in a TEDx talk that was “naked, raw, and vulnerable” on my mental health and genderqueer journey.

I have made peace with my Bipolar, in fact, I wouldn’t give it up. I recognise the trade-offs, very serious ones at that, with regard to risk to life, health, bank balance, and relationships. I also enjoy the highs, the manic productivity and energy, the blue sky thinking as far outside of the box as one can imagine. I’ve never been on a fairground or amusement park rollercoaster, my life is one…

…but just because it’s a rollercoaster doesn’t mean it’s fun though. I hate amusement park rides! I experience the tops & bottoms, highs & lows, with little respite or moderation in between.

I guess I seek out calm attractions rather than wild rides to offset the bipolar which delivers enough of the latter itself. I’m also an ENFP ambivert, flitting between extrovert and introvert depending upon my mood.

Mostly, I survive, sometimes I thrive, often I hide. Thankfully, I have a support network of family, friends, super partner, cats, books, Netflix, and community mental health wellbeing service and great therapist = my safety net.