The thing I hate most about Depression

Here is the thing I hate most about depression: the way it removes my ability to feel or even remember joy.

The last fortnight has been hellish. I have struggled to do anything at all. Waking up in the mornings, I have come round already dreading the day ahead. Waking up to palpitations, a sort of fuzzy sense of unreality and the feeling that today is the day that will prove to be too much is exhausting. My anxiety has been so high I have spent most of the days trembling in anticipation of some nebulous, indefinable awful thing that I feel certain is going to happen, soon. 

It's been so bad that I found myself planning out in intricate detail how to end my life. Just because that is a bad thing, so if that bad thing happens then it's done with. No more worry. No more pain. Live or die, something will have happened and either I won't be around to deal with it, or I will but at least there will be something to deal with. A problem I can name and point out to people. Rather than this constant, terrible dread which I can't name, can't describe, can't explain to people.

I've wanted help, desperately. But depression does something truly awful to me, it takes away my voice, my language, my ability to communicate. It's why I've written nothing on here. It's why I've spent hours staring blankly at the phone trying to remember how to speak, how to use it to get in touch with my doctor, the hospital, a friend. Anyone. In place of my voice it leaves me only apathy and fear, it leaves me exhausted to the point that moving becomes next to impossible. 

I am not proud to say that there was a day that was so bad, even moving from my bed as far as the bathroom was too much. I lay there in my own  pee and cried. For five hours. 

This is what an acute episode of depression looks like, for me. The only good thing, really, is that for all my planning I never once had the energy to try and enact it. Even ending this thing - the only way in the pits of despair that seemed possible - was beyond me.

And right now, as I finally feel able to drag myself far enough out of this pit to find people again, to find my voice just enough to whisper a cry for help I am glad of that. Even if a week ago I wouldn't have been.

But none of this is what I hate most about depression. No, what I hate most is that when things get that bad, it seems impossible that they will ever get better again. It seems impossible that they have ever been better in the past, that I have ever been happy. Or even simply not actively unhappy.

Depression at it's worst makes it impossible for me to feel joy, to recall a time when I ever have felt joy. To know that joy is something which even exists.Instead it tells me I have never been happy and never will be. It tells me this so effectively that even when presented with evidence to the contrary - a friend sharing a

memory of a great night out, photos of holidays I enjoyed, time spent with my beloved - it still wins. Because I try to remember those times but it's like watching a movie about somebody else, with completely different experiences to me and in a foreign language. The pictures in my mind are of somebody smiling, laughing, joyful but there is nothing I can relate to. I try, but I can't summon even the faintest echo of joy. In it's place is  a hollow, dull empty feeling. Nothing. No joy to be found. No tools to fight back with. Just, nothing.

So, that's why the blog has been quiet. It's why I've not been in touch with my friends. It's why I've not been to work. It's why I ran out of me medication when I needed it most and it's why I failed utterly to get to the doctor for another prescription.

But here's the amazing thing that depression always conspires to make me forget. It get's better. It does. Because right now, things are still awful. They are. But today I made it to the bathroom. Today I got dressed. Today I managed to write these words. Today, there is no joy or smiles or laughter, but I found a photo of me smiling and recognised the girl as me, recognised the emotion as one I had felt and as one I will feel again. Today I made it to the doctors and asked for help. Today I told a friend I wasn't coping. Today I regained my voice. 

Maybe tomorrow I will remember what joy is but if I don't there will always be the day after and all the days after that because I know it's real, I know I've felt it before and therefore I'm capable of feeling it again. Right now, all I have is the vague memory of joy to guide me back towards it. It's not much, but it's more than I had yesterday and it will have to be enough, because the alternative is horrific.

A bit about BDD

Today I want to try and write a little about Body Dysmorphic Disorder (BDD) and my experience of living with it. This is probably the hardest thing for me to write about, to think about. Harder, in many ways, than even the abuse by my father. I don't know why that is the case, I only know that it is true. I'm making the effort though because of all the mental illnesses I struggle with, this is is the one I've found it is hardest for people to understand.

When I have tried to explain it to people, their responses have been varied. Mostly, I have been met with words along the lines of 'but you look great, you've got nothing to worry about.' Which is sweet, and appreciated. It doesn't actually help though. The thing people seem to find so hard to grasp is that whatever they are seeing, it's not what I am seeing. So whilst on the one hand I can understand that they probably do think I look perfectly OK, my reality is different. So very different.

In my reality, my body is out of proportion. My lower arms and legs are like spindly insect legs, growing out of a bulbous, segmented body. My head is tiny, my features uneven and lopsided, my hair stringy and thin, my neck is bigger than my head. It honestly doesn't matter how much other people tell me this isn't true because for me it is. For me, this is exactly what I see when I look in the mirror. Whilst it's nice that other people don't find me physically abhorrent, at the end of the day it's how I feel about my body and looks that matters. So whilst I appreciate that people are trying to make me feel better, the reality is that until I can learn to not care so much about what I see - or to perhaps, one day, see something different in the mirror - all the compliments in the world won't help.

It goes deeper than that though. It's not only that I hate how I look. According to an old therapist of mine my obsession with my looks is a way of masking the underlying fears that I am wrong somehow. I think there is some truth in that. Certainly most of my anxiety seems based around the idea that I am simply not right in some way. Whatever the case, telling me that I look fine isn't enough to make me see it. 

I suspect the best way for me to deal with this issue is not to focus on my looks at all. I'm not there yet, but I'm trying. It is certainly the case that when I can become engaged enough in something else that I stop thinking about, I'm happier. This is something I want to work on further when I am back in therapy once more.

In the meantime, my life is an exhausting one. It's one of constantly adjusting clothing, touching up make-up, teasing hair into exactly the right place. It's one of anxiety almost every second that everybody else can see what I see and they hate it as much as I do. 

In the past, it was one where I starved myself to make everything smaller, so that my head and body 'matched.' Sure, there were other reasons for my eating disorders, but this was an increasingly big part of it. I still hold the scars where I carved the words 'fat' and 'wrong' into my leg. I once tried to carve off the bits I didn't like, the excess fat and bone that made my frame 'wrong.' 

So this place I am in now, this is progress of a sort. I no longer resort to such drastic measures as trying to alter my body by harming it. I am still a very long way however from being able to view it with anything other than disgust and terror.  After over a decade of work, I can finally accept that other people don't see me the way I do. I can finally understand that what I see is not real but is only a cruel distortion of reality.

My hope is that when I return to therapy, I will find I am more able to discuss BDD, to work on this illness as it has never been the focus in the past. 

I feel small today. :( Trigger warnings apply.

Today I have had many flashbacks. It has not been the best day. During one of them  I drew the following. I don't have many words this evening, so I thought I would share these instead.

Dissociation and me, a love/hate relationship

Ah, dissociation my old friend and nemesis. It's about time I talk about this I think, if only because it's one of my most troubling symptoms. We all dissociate, it's an important defence mechanism. I remember the day my mum died. A relative sat me down and told me what had happened. I calmly nodded my head, said I understood and went outside to be by myself for a bit. I knew that I should be upset but actually I was just numb. It didn't feel real, everything felt very far away and I didn't really feel much of anything. When I came back inside, I spent a lot of time making sure everyone else was OK. People were crying in the front room, talking in hushed voices in the kitchen. Someone punched a wall and sat stating at his injured hand for a bit. I made tea, handed out hugs and otherwise did what I could. I still didn't really feel anything myself. It didn't seem possible to me that mum was gone.

I remember shopping for an outfit for the funeral, determined to find something nice so I looked good for the day. I felt a sort of weird disjointed guilt that this was what was bothering me, but my mum's death still didn't feel real. I still found myself sitting on the bottom of the stairs in the evenings, waiting for someone to take me to the hospital to see her. I remember just sitting there and staring at the wall, not really thinking about anything. In the days leading up to the funeral people started to talk about what would happen to us kids now, whether it would be best for the family to move so we were nearer our aunts and uncles and cousins, our grandparents. I felt panicky and upset by these conversations, but not really about my mum's death. Then it was the day of the funeral. I put on my nice outfit and we went to the church. My aunt explained we'd be going to stay with her for a bit so we wouldn't be going home afterwards, we'd be going to her house.

Reality started to sink in. Mum was gone, nothing would be the same again. Finally, I found my tears. I balled my eyes out during the service, I almost passed out at the grave side. My hand was shaking so much when it came to throwing the dirt in on top of the coffin. It didn't seem possible that my wonderful mum was in there, that we were burying her, that she was gone. But whilst I couldn't relate that coffin to my mum, I was finally starting to come round to the idea that she was gone. I was a mess, for days I couldn't eat, talk to anyone or do anything much but cry. Grief had set in.

That numbness, that feeling of unreality which allowed me to carry on and look after everyone else - that was dissociation very much coupled with denial. It couldn't be real so I didn't let it upset me. It was useful, it allowed me to carry on and do things that needed to be done - such as preparing for the funeral - but if it had gone on longer than that I would never have been able to grieve, to accept my loss and start to come to terms with it.

To a lesser degree, I've done the same thing with exams, interviews and other stressful situations. Generally speaking, I have no recollection of how I've done, what I've written or said after these events but I seem to do well because all the stress and panic is set aside for a bit and allows me to get on with it with a clear head. Very useful. It's times like this I love dissociation.

These aren't the only times I've dissociated though, not by a long shot. I used to dissociate when I was being abused. It's why I can't remember all of the incidents and why many of my memories are sort of fuzzy and distant. Growing up, I was able to dissociate so heavily from the abuse that I quite literally forgot about it when I wasn't reminded of it. It meant I had this really awesome relationship with my father at times, and this really awful one with him at others. For me, it was like the abuse happened to somebody else so when I wasn't alone with dad, I was able to enjoy our time together. Then as soon as we were alone, the panic and anxiety would set in.

I was often anxious as a child and teenager. In my teens, I experienced angry outburst, I hurt myself and starved myself and I honestly had no idea why I did these things much of the time. As I got older it got harder to separate myself from the abuse. I could remember it happening, I knew my father hurt me on a regular basis. I started to find other ways to protect myself, such as staying out late and avoiding time alone with him. Things that hadn't been available to me when I was younger. Yet I still dissociated. The first time I told a GP about the abuse I was 20. She asked me gently if I thought that my self harm and depression were related to this. I thought she was mad. I honestly couldn't see how the two things could be connected. The me that experienced those things simply wasn't the same person who had been abused. In much the same way, the person I was when I went out with friends, found a job and generally speaking enjoyed life wasn't, in my mind, the same person who hurt herself, refused to eat and tried to kill herself.

I felt like several different people, and this is a form of dissociation too. I could remember what had happened to me if confronted with it, such as when I saw anything to do with child abuse on the telly or experienced a flashback but the rest of the time I simply didn't think about it and for me it was like it ceased to exist. When I was happy, I didn't forget that there were months at a time of depression, I didn't forget that I still self harmed regularly but again, unless this was brought up - for instance by people asking if I was feeling better - it simply vanished from my mind.

Then there are the flashbacks. Oh the flashbacks. This is different to memories. I used to remember the abuse at odd times and it was always upsetting. I often dissociated when faced with these memories. I would become detached and numb, everything would feel fuzzy and unreal but that was better by far than the flashbacks. The sudden rush of panic, the over riding fear that I'm in danger. The confusion when I can't make sense of where I am because I simply don't recognise this place.The inevitable finding somewhere to hide, the frequent cutting and tugging at my hair, my skin. The inability at times to even recognise those nearest and dearest to me, because quite simply I am someone else. I am that girl, the one who was abused. The one I find it hard to accept even today was really me.

It's like time travel but with none of the fun and adventure, or ability to change things no matter how ill advised. It's not like going back and seeing yourself - though I often experience memories this way. It's being back there, going through it all again.

Flashbacks are often where my hard won coping mechanisms fail. I'm no longer the person who's had the benefit of therapy and medication, who has a list of handy things to do or numbers to call to help me calm down and feel safe. I stare at such lists in confusion. They aren't mine, I don't know these people and I can't do these things. I am a girl, just a child who hasn't yet learned these things. I've overdosed mid flashback before, I've cut. I often have no recollection afterwards of doing these things, of what happened. I simply remember the fear and distress. Sometimes there are images, sounds or smells I can recall after the fact. In many ways these are the best times, they give me a clue as to what happened to me - what I was reliving. That gives me something to work with. More often, I don't remember. I am just left with a feeling of being small, young and scared. There are less extreme flashbacks too, where I know where I am but I still experience the distress and panic, where superimposed over who I am now is the person I was then.

At the time I was experiencing the abuse, dissociation was my best friend, absolutely. Without it I would have been truly helpless, truly unable to cope. I wouldn't have been able to get up every day, go to school, make friends and do 'normal' things. I would have been fearful wreck, all the time. As it was I was an anxious kid, though I didn't know why most of the time. Without dissociation I wouldn't have been able to function at all.

Now, this kind of dissociation is not really my friend at all. There are days where I look back and can't remember what I've done. There are days where I need help but can't ask for it, because I'm the 'wrong' person. There are days when I look OK, so that nobody knows inside I am screaming. There are days where what I have to do is difficult or scary, but necessary. These things go undone half the time, because I dissociate and 'forget' about them. Until I am reminded that I didn't do them. When this can include really important things like paying bills, going to work or eating food, that's an issue.

I frequently have no idea if I've eaten or not, or if I've spent money or not. I find things and can't remember buying them, writing them, drawing them. Or I do remember, but it feels like 'someone else's' problem and so I promptly put the associated memories 'away' somewhere in my head.

Dissociation for me has stopped being a helpful way to survive and cope with past events, and has instead become a barrier to me learning how to survive and cope with current ones. It's a problem, a huge one. One I am still trying to figure out how to deal with, one day at a time.Hopefully I will be starting another course of therapy soon, which should help.

I wrote about this here partly because it helps me to write but mostly because I know I'm not the only one dealing with this and it's rare I see or read anything about it that isn't in a medical textbook or a support forum. In trying to talk to other people about this, I often find they are scared or disbelieving. They either think I'm 'mad' or a liar.

So, this is me doing my best to help someone, anyone understand even a little bit about dissociation. It's me trying to reach out to people struggling with this to know they aren't alone, to invite them to share their experiences or talk about them if they want to. To help those who know someone struggling with dissociation to support them. As ever, I hope it helps somebody.

Some thoughts on self harm

I've had many conversations with people over the years about self harm. I've discussed it with friends, family, doctor's, nurses and therapists. I've discussed it with a line manager at work and I've even discussed it with a stranger on the train once, after they noticed the scars on my arms. So, I thought I'd take the time to share some of my thoughts based on my experiences both of self harming and of talking about it.

Firstly, I would like to make it really clear that self harm is not a failed suicide attempt, nor is it necessarily an indication that someone is contemplating suicide. People self harm for a whole variety of reasons, often the same person engages in self harming behaviour for different reasons at different times. I know that I've harmed myself in different ways, at different times for a variety of different reasons.

Sometimes it's been a way to cope with overwhelming emotion or racing thoughts that seem beyond my control. At other times I've self harmed simply in order to feel something, to prove to myself that I still could. Then there have been the times I've dissociated so heavily I can't remember what I've done or why. There is very little more upsetting than 'coming round' somewhere to find yourself with clearly self inflicted injuries and no idea why they are there. Finally, I've self harmed when the suicidal thoughts became too much to deal with, when I was truly afraid I would give in and act on them. Somehow, hurting myself seems to hold those thoughts at bay, reduce them for a time. I have quite literally hurt myself in order to keep living. For me, self harm is often the direct opposite of an attempt on my life.

Something which comes up often when talking about self harm is the idea that it is wrong, a maladaptive behaviour which is only ever harmful. I am not entirely sure this is true. Certainly, it looks like an unhealthy behaviour. I would accept that a mentally healthy person doesn't engage in self harming behaviours. Where I would argue is that it is automatically maladaptive. There are times when I have tried very hard to engage in more 'healthy' behaviours to control my thoughts and emotions, to get back to a place where I can fight them again. There are times those techniques - many developed in conjunction with a therapist - haven't worked. At that point, I would argue that harming myself is in fact a valid response. Particularly if the only remaining alternative is suicide.

For me, suicidal behaviour can be a compulsion which I find it very hard to fight. There are times it hasn't been, times where it has seemed like the best way out. On those occasions, as soon as any other alternative has been found the desire to take my life has ceased. There are other times though where that isn't the case. Where the compulsion is so strong there simply isn't time to think. Times where the compulsion is so powerful I can't simply sit and wait for the feeling to pass. On those occasions, self harm can help alleviate the compulsion. It's almost like by giving in a little, the urge is lessened to the point I can fight it once more. To the point I am able to put into practice the techniques and tools I've been given to keep myself safe. There have also been times where suicide seemed like the best option and I wasn't in the position to seek advice or help in finding another.

I am thinking now about when I was much younger and being abused by my father. I was too young to move out, running away hadn't worked and I had nobody to talk to. No where I could go for help and advice. At ten years old, I didn't even have the language to talk about what was going on even if I had found someone to talk to. By thirteen, when I made the first attempt on my life I had the language but my depression had deepened to the point that things liked talking to people seemed entirely beyond me. In situations like this, where any form of help or support seem impossible suicide can seem like a frighteningly welcome idea. At times like these, self harm provided a temporary relief from such thoughts and feelings. Temporary, but accessible as often as I needed it. It allowed me to maintain a degree of functionality, it allowed me to continue living until I reached a point that alternatives became available.

I am writing this now as someone who hasn't hurt herself on purpose for three years. It's the longest I've ever managed and I'm pleased to report that I have developed many other ways of fighting suicidal urges, of dealing with racing or intrusive thoughts and emotions so strong I struggle to cope with them. I still remember very strongly being that other, younger girl however. The one who turned so often to self harm because she didn't yet have tools to handle things any other way, or found herself in situations where those tools didn't work. I can say with a hundred per cent certainty that my life is better without self harm, but also that I wouldn't be here to realise that if I hadn't had this tool at my disposal.

I guess I want three things from this post. Firstly, to address the assumptions which can be made about self harm - it's not a suicide attempt, and whilst it can be connected to suicidal ideation or thoughts that's not necessarily the case. Secondly, some understanding that self harm serves a purpose, it can work, albeit temporarily and that for each person, each time they self harm the reasons can be different. Finally, I want anyone who reads this and identifies as a self harmer, there is hope that one day in the future you won't need that particular tool any more.

So, if you are reading this and know somebody who self harms, please try not to assume you understand and please don't judge. Anybody who self harms would be happy to find a safer, healthier way of dealing with things but there will be times this really is the best option they have available. Understand and accept that and you'll find helping them reach a place where it's no longer necessary will be easier for everyone involved.

Listening, an often underrated skill

One of the things I hate most about talking to my friends and loved ones about my mental health is this: they often assume what I want or need from them is advice and a way to fix things. There are times when that is what I'm asking for, sure but most of the time all I want is someone to listen. There are times when I need to just talk, to get thoughts out of my head and to share my experience. 

What often happens instead is a horrible cycle of frustration and upset for everyone involved. I try to talk, my confidant jumps in to offer advice. I become upset and frustrated because I'm not being listened too, because someone is trying to 'fix' me and tell me what I should be doing. They become frustrated because their advice isn't being taken on board, it can feel like I don't want to get better and ultimately they are trying to help but clearly aren't. Not a nice position for anybody to be in. We both tend to walk away from such conversations exhausted and unhappy, often with each other. 

I understand that sometimes it can be overwhelming to listen to me talk. If you don't think you can listen right now, much as that might be painful for me to hear it's also OK for you to say. If you think you might be able to listen at a different time please make that clear, though also don't assume or expect I will be able to talk at the same point you are able to listen.

When I am telling you I don't know what to do, that I feel lost, alone or helpless that's not me asking you to tell me what I should do or how to fix things. When I say I don't know what to do, have you got any ideas? Or when I ask what you think I could or should be doing, that's different. 

 Sometimes people tell me in a slightly injured tone that they don't feel they get the chance to add anything to the conversation. This is simply not true. By listening to me you are doing so much, providing something I need so very badly. Every time you start to think that not having something to add, by not having magical answers that will fix everything you aren't helping please take a deep breath and remind yourself of this fact. Listening is the single most useful and helpful thing you could be doing, taking time out of your day to hear me - someone who has spent so much of her life not being heard - is showing me that you care, that you want to help, that you are there for me in the ways I need you to be. Not many people are able to do this, so when it feels like you aren't doing enough I need you to know you are doing everything.

It's hard to just listen, I get that. I've been there too. I understand that you might also be having a tough time, that you might want to talk too. Or that you simply can't sit back and listen right now. I understand too that it's really hard to sit and listen to someone you care about in pain when all your instincts are telling you you must be doing something, when you really want to just make it all better.

That's in part why I'm writing this. None of us get it right all the time, I'm no more able to simply listen every time than you are. I think we need to be kind to each other here and simply try to understand. Every time you are able to listen, that's a time I will treasure. Every time you aren't, I will do my best not to be hurt and angry. I won't be able to do that every time but I'll do my best, you do the same and hopefully we can help each other. 

Talking about suicide

After many years of dealing with mental illness I’ve reached a point where I’m quite open about my mental health. I’ve had negative experiences when sharing my story but I’ve had many positive ones as well. Perhaps the best thing to come out of it has been the way that my openness has helped other people to talk about their experiences too. Learning that I’m not alone, whilst in some ways sad has also helped me overcome some of the isolation which seems to be the lot of a person with mental illness. Helping other people by providing a listening ear or supporting them while they access professional help has done wonders for my self-esteem too.

Yet there is still something I find it difficult to talk about. Suicide, whether that be relating my past experiences or discussing the still recurrent ideas or urges that pop up, is a difficult topic to tackle. Firstly, there are other people’s reactions to is. Far too often I face a lecture on how selfish it is. Frequently instead of being able to talk about why I feel like I do I end up having a discussion about how my suicidal ideation is upsetting and distressing for those I’m talking to. I’m sure that it is and I’m happy to talk about that, but right then in that moment what I need to talk about is me.

There is a common belief that if you are talking about suicide you aren’t at risk of taking that step, but that’s not true at all. If I’m talking about it, thinking about it, contemplating it then what I need is someone to listen. To set aside their distress and help me work through mine because when I’m at that stage I’m simply not in a place to be offering support. I’m in desperate need of it myself.

I can honestly say that I don’t want to die, what I want is to no longer be in the situation I’m in. There are times when my depression and anxiety become so bad I honestly can’t see any way out that doesn’t involve death. What I need at those times is another option, another way to improve my lot. In talking about it that’s what I’m seeking.

It’s not about being selfish, or wanting attention. It’s not about having given up. It’s about not wanting to live with things the way they are and being unable at that moment to see a way to change my life. Sometimes it’s about being so afraid of my suicidal thoughts that I fear I will give in to them, simply to make them stop. Thoughts of suicide can be horribly intrusive, hard to deal with and often times come with a compulsion to act on them.

All I ask is that if I – or anybody else – talks to you about suicide, listen. Take them seriously, but don’t panic. Keep listening and keep me talking. While I’m talking I’m still fighting, still seeking an alternative. It may be that I’m not safe to be alone. Perhaps I need to be seeking professional help and support. You can help me do those things and I’m not saying that you have to deal with the situation alone. All I’m saying is that if I’m talking about this it’s because I’ve recognised that I’m not coping alone.

Later, when I’m coping better I will be happy to listen to your side of the story. I think it’s important to do so. I just need you to recognise that in the moment, I’m not able to help you. All of my energy and ability to think is taken up trying to survive until this current urge passes.

A bit about OCD

When I tell someone I have OCD I am often met with disbelief. Anyone who knows me will tell you that I'm far from the tidiest person. I don't obsessively wash my hands, compulsively clean up after myself/other people. This is part of the problem with the common misperception that OCD is a disorder categorised by cleaning. Whilst it can present that way for some that isn't what this disorder is about.

I've met and spoken with a number of fellow sufferers, only one is a compulsive cleaner. She cleans because she can't escape the thought that if anything in her home is out of place then the rest of her life will fall apart. For me, my experience of OCD is different but it does share some common factors. Namely intrusive thoughts of things going wrong and the compulsion to repeat a behaviour which helps me to feel calmer about this possibility.

It started when I was a kid, after the loss of someone very close to me. Much like any other child faced with death and grief for the first time I was upset and worried. If one person I loved could die, so could another. So could I. In fact anybody could die! It was someone of a revelation and it was an idea which has haunted me ever since. I have been calmly walking into town when suddenly I am plagued with the image of myself being run over, or slipping off the curb and dashing my brains out. This image will not go away, it sticks in my head and it feels so real I have found myself reached up to touch my head and check for blood before now. Or I will struggle to get to sleep at night because I can't get the idea out of my head that someone I love is dead. At times this has gotten so bad I've phoned someone up at four in the morning just to make sure they are OK.

Since this first started happening I've developed little rituals, things I can do to 'banish' the thoughts, or somehow prevent them from happening. I know that there is no way my bizarre little habits can actually stop events occurring, in the same way as I know that I can't cause something to happen simply by thinking about it. Yet I can't stop these thoughts, these fears from happening and I haven't yet been able to fight the compulsions that accompany them.

I have a ritual that involves light switches, which I have to engage in every night and every morning. I have a set of numbers which has to be repeated a set number of times, in a particular order to prevent harm coming to my loved ones when those thoughts occur. Then there is another one where I have to pull at my hair until the thoughts have faded away.

This is what OCD is like, for me. It's not always visible to other people - in fact, quietly tugging at hair is something commonly written off as just a nervous tick, counting happens in my head not aloud, you'd have to be around to witness my light switch ritual in order to know about it. Yet it is always with me, it is something I deal with on a daily basis.

The thoughts aren't always about physical harm or death, I have many more rituals or compulsions than I've listed here but the general theme remains. Each person's experiences of OCD will be different, just as we are all different. Yet there are some commonalities. OCD is often about anxiety, always about compulsive thoughts or behaviours and only sometimes about cleaning.

I have spent ages now trying to write this post and have deleted it several times. At this point I have no idea if I will manage to successfully get across what I want to say. Here goes, I'll give it one last shot.

I want children, I really do. I always have. I don't have any yet, partly by choice (the time isn't right) and partly because it's just worked out that way. I've been pregnant before and I would have chosen to keep that child despite the situation not being perfect but that choice was taken from me when I had a miscarriage. It sucks but there you go.

As a woman with mental illness I get hit with a lot of mixed messages about becoming a mother. On the one hand, my mental illness has interfered with my ability to develop a career and achieve any degree of financial stability. People keep telling me to sort out my career before I have kids. On the other hand, I'm not getting any younger and more often now people assume I've decided against having children or urge me to have them asap before the choice is taken away from me. Then there are the people who tell me having a child would be the best thing I could do. It would 'give me something to live for',  a reason to get better (apparently my own happiness and well being aren't good enough reasons). There are also the people who tell me the opposite, that as someone with mental illness I should never have children. It wouldn't be fair. I couldn't look after them. I could pass on my mental illness.

Now I'm not saying that these aren't things I should think about, of course they are. I do think about them, a lot. Particularly the stuff about my mental health and ability to be a good parent. I just don't think that other people's opinions are the best way for me to decide whether or not I'm ready to be a parent. Really, there are only two people who's views matter in this situation. Mine and my partners, as we'd be the ones going on to try for a child if we decided that was something we both wanted and felt ready for.

So then, career and finances. In an ideal world I'd have a career I loved and a steady income. It's not an ideal world and I don't. I might never achieve those things. In terms of having children this provides me with a difficulty as I'd like to provide my possible future children with an ideal life. One that's stable, where I can afford to provide them with everything they need. It's certainly something I give a lot of thought to. Right now I'm doing what I can to change my working situation. Stable employment, in a job I can stick with for more than a year or two at a time is the goal. Though I'll be honest and admit that this isn't something I'm trying to do just so I can have kids. It's more for my own benefit. It would be lovely not to have to worry constantly about money. Not to feel worthless because I have spent years at a time unemployed.

Let me tell you about my mum. She was physically ill and unable to work. In my mind, she was still a good mum. OK, so I was abused by my father and she didn't know about it because she was ill and bedridden or in hospital much of the time but I still think she was a good parent. In that situation it was my father who was the bad parent. Incidentally, my father also had a long term, steady job for the entirety of my childhood. It turns out the ability to work and provide for your children doesn't automatically translate into being a good parent. My mum wasn't well enough to work, she didn't bring in much if any money. Yet despite her illness she was always prepared to listen to us kids. When she couldn't get out of bed to play with us she used her awesome imagination to invent games we could play with her. She was the one who went through our homework with us, helping us find ways to figure it out when we got frustrated. She was the one we went to to have our knees plastered, to talk about our day and to read a bedtime story with. She wasn't perfect but she was an amazing mum. It turns out there's more to being a parent than providing financial support.

What about age? Well, age bothers me. I'm less than a decade away from the point where I can expect my ability to conceive and carry a child to start on a sharp decline. I'm not convinced I'm less than a decade away from establishing myself in a career, managing my mental health to a point where I'm happy and feeling ready to take responsibility for bringing a person into the world. That upsets me, because I want children. That said, more than half a decade is still a long time. For all my worries and concerns it is possible to achieve what I want to in that time, and if it takes a few years longer so what? My granny was having children into her early fifties. Her last pregnancy was problematic, but that was due to a non- age related illness. I know other women who have had children later on in life with no problems too.

Besides, what are these problems I could face? An increased chance of becoming infertile. That would be sad, but not the end of the world. I want children and I would be very upset if I can't have them. There's lots of things I've wanted in my life and not been able to have however. I didn't want to be abused growing up and it has had a long term negative effect on my life, but I'm learning to deal with it. I wanted a very specific career since a fairly young age and it's taken me time to make my peace with the fact that for various reasons I can't have it. It hurt and it continues to hurt, but I've still managed to have a life beyond that loss. People are amazingly adaptive. If I can't have children that will hurt, it will take time to come to terms with but I don't think it's impossible for me to do so if I'm faced with that possibility.

I could be at an increased risk of complications. That's a scary thought, but as with anything else in life you weigh up the risks versus the benefits. If the benefits seem worth the risk, then you do it. If the time comes then along with my partner I'll look at the risks, make sure I'm well informed and then make a choice. What about increased risk of disability in my child? Well, again I will make sure that I am as well informed as I can be but I imagine I'll go ahead anyway. I don't think a person with a disability is a person incapable of having a meaningful, fulfilling life. I know that not to be true. So I don't see why I would decide not to proceed just because there is a risk of having a disabled child.

So, moving on then. Should I have a child because it will give me a reason to live, because I think it will act as a miracle cure for my mental illness or so I have a purpose? No. Really, just no. Children aren't 'cures' or 'fix alls.' Children are people. Plus, I have a reason to live: Me. I've spent a whole lot of my life feeling like I didn't matter, I'm only just learning that I do. So please don't ignore me when we're talking about my life.

What about the opposite view? Should I not have children at all because I'm mentally ill? There's a lot to think about with this one. I need to consider how I'd cope with difficult times - and I know that there will be some. I have to think about how my mental health could impact on a child's mental health, quality of life and so on. Given that there are times I can't look after myself I need to think about whether I could look after a child. Of course I do. So should anybody who is thinking of becoming a parent.

Let me ask you something. Do you think people who have ever been physically ill shouldn't have children? I mean, they got better but they might become physically ill again. It's a risk isn't it? Mental illness is the same. It can improve, people recover and/or learn to manage their symptoms and mental health. Not everyone who has a mental illness will be mentally ill for the rest of their life. Most people aren't. My mental illnesses have been with me for most of my life, though I think they are better now than in my teens. More importantly, I've gotten better at recognising when I need help or support or to reconsider my treatment plan. I know how vital a good support network is.

I've never harmed or endangered anybody else, despite my mental illness. I've managed to care for and look out for other people, even when I've failed to look after and care for myself. I recognise that there is a difference between doing this on a short term basis and doing it long term, but I don't think the fact I have poor mental health should mean I will automatically fail at these things.

So there you go. I am not 100% sure I have really said what I wanted to but I've done my best. My basic point is simply that as a woman I already face a lot of pressure and judgement about my choices regarding parenthood. When you also factor in the fact that I'm mentally ill that seems to increase a whole load. And I don't think that's fair or right. Having lived with mental illness for a long time I'm much better equipped to judge how it affects my abilities and choices than a stranger.

So believe, if I ever decide the time is right to have a child I will have considered all of these points and more at great length. I will have weighed up the risks and done everything in my power to reduce them, as will the person who decides to become a parent with me.

"If I had your life I'd try to kill myself too"

Today has reminded me of one of the most useless and hurtful things someone said to me. Picture the scene, if you will. I had been referred to a CPN (community psychiatric nurse) after attempting suicide. It was our first meeting and I was being assessed to see what help and support I needed. Part of that involved a risk assessment and part of it involved talking about why I had tried to kill myself. I'd just finished talking about the child abuse, the rapes, the eating disorders and the anxiety about everything ever. It was at this point that my CPN reached out, placed a comforting hand on my arm and looked into my eyes, her own brimming with sincerity and stated 'if I had your life I'd try to kill myself too.'

I think she was trying to express sympathy with the way I was feeling, trying to let me know that she understood where I was coming from and that it was OK for me to feel that way. I get it, she had the best of intentions. Yet here's the thing. I already knew how bad my situation was - that's why I was there, trying to find another better option than suicide to change it. What I didn't need to be told was that actually, my life really was so appalling it wasn't worth living. Thankfully she was able to arrange for me to see people better equipped than she was to help me out.

So, why has this whole experience reared it's ugly head again? I'll tell you. It's because of this post. It's because today I was reminded that we live in a society where a large number of people think being disabled is so awful they'd rather be dead than live with a disability. It's because we live in a society where people think it's OK to tell other people that they think they'd be better of dead. OK, so I don't think most people realise that's what they're saying, but it is.

If you tell someone you'd rather be dead than live their life then you're saying you don't think their life is one worth living. I can tell you first hand that being told that hurts. That being made to feel you should want to be dead is no fun at all - particularly if you already feel that way.

I was lucky. There were people around who felt that my life was worth saving, there were services around which provided me with the help and support I needed to realise that myself. To help me get to a point where I could look at my life and say 'well, I live in pain everyday which sucks but there are benefits to being alive which make dealing with the pain worthwhile.' Without that help and support, from mental health services and from friends and family I wouldn't be here today. I absolutely believe that.

Now I can't help but wonder what the situation would have been if I was not only severely depressed but also had a physical impairment. Would those services still have helped me? Would people still have been so supportive and determined to help me see I had reasons to live? Or would the combination of mental illness and physical impairment have been considered too much for anyone to live with?

Human beings are amazingly adaptive. Seriously. We do all kinds of things every day to make our lives work. If we move to another country we learn the language to enable better communication. If we find ourselves in pain we take medication to ease it. If we lose someone close to us we grieve, but we survive their loss. As a teen and well into adulthood I experienced a lot of emotional distress and I dealt with it, not always in ways that other people would recognise as healthy or well adapted but in ways that nonetheless allowed me to keep going. When those ways became problematic, I was given help to find new ways of coping and was able to carry on with my life.

If you have a disability, you might need to find ways to manage it. Such as using mobility aids, having your house adapted or taking medication to help with pain and bodily functions. The point is that it's possible to manage your disability and live with it. We know this because people do it every single day. People lead productive, fulfilling and worth while lives AND have a disability. Because a disability doesn't mean your life isn't worth living. Except when people make it so, by denying access to places, services or necessary equipment and treatment. By treating people like they aren't people because they have a disability. Or by telling someone they are better off dead.

Rant over for now. Thanks for reading.

Getting ready for summer

So, I have become infuriated by the number of 'how to get a bikini/summer body' adverts that keep popping up everywhere. This happens every year. Along with the 'how to lose X weight in X weeks' adverts I find them kind of triggering. It's taken me years to be able to gain weight in the first place without having some kind of horrific melt down. Now that I have gained weight, it takes a lot of will power not to turn to unhealthy habits to get rid of it all again.

Learning to love your body shouldn't be a difficult thing, but it is for me and many other people out there. We are constantly bombarded with the message that our bodies should look a certain way. Hey, for that matter we're also sent the message that our bodies should be able to do certain things, yay for disablism. That's a whole separate post though. It's not exactly news that I don't like my body, but that's something I really want to change.

Lately, I've come across this awesome blog. It's pretty inspirational. I want to feel that confident and happy in my self and my body, I want to be able to wear the clothes I like and go outside without living in constant fear of what other people think. Without worrying if I'm pretty enough or slim enough to look 'right' in them. I'm not there yet, but I'm pleased to report that I'm making progress.

Guilty confession time, I used to visit pro-ana websites and chat rooms when I was really ill. Until recently, I still had a folder of 'thinspiration' pictures to remind me what I thought I should look like. Part of my progress has been in deleting that folder and looking around the web for more positive ideals and role models. Given that I fully support the idea of health at every size, and given that I have found any number of women of all different shapes and sizes attractive it's time to start applying those beliefs to me.

So, here's my plan for summer preparation. I am going to formulate a new exercise regime. Which is a tricky one for me as in the past I've tended to over do it. However this time my focus is going to be different. I won't be exercising to make myself lose weight. No, instead I am going to be concentrating on making my body more able to do the stuff I want it to. Regular exercise, coupled with food will mean I can do more awesome stuff without become exhausted. Like dancing for longer when I go out, spending the whole day outside in the sun with my friends. That's the goal here.

Next, I am going to dare myself to do a few things. I want to leave the house without covering up my upper arms. Sounds simple but it won't be. Given how anxious I get leaving the house at the best of times leaving it with one of my 'problem' areas exposed is not going to be fun. But, if I can do it once and realise that I'm more comfortable physically, maybe I can do it again. And maybe by doing it over and over I can learn to stop worrying about doing it. That's the plan anyway.

Finally, I am going to enjoy the sun. I love the sun and here in the UK we just don't see enough of it. Sunshine makes me happy, which is a huge incentive to get out into it. A really sunny day is often enough to make me brave the outside world. So, I'm going to use that to my advantage and get myself outside, in summery clothes despite the anxiety.

With luck, by the end of the summer I'll have taken some huge steps towards feeling comfortable in my own skin.

Why I don't like the whole 'survivor' thing

I mentioned in an earlier post that I don't really like the term 'survivor' when it's applied to people who have experienced sexual violence. Now seems as good a time as any to talk about why.

For those who aren't familiar with it, 'survivor' is used in place of 'victim' and is supposed to be empowering. Well, for me I have never found it to be empowering, quite the opposite. Whilst I was being abused I was most definitely a victim, calling me something else couldn't change that fact. Once the abuse stopped I certainly didn't feel like I had survived the experience, at least not intact. In fact, I took matters into my own hands to try and do quite the opposite. I tried to kill myself several times.

When people refer to me as a survivor it feels like they are making an assumption that I did something to survive, that I am exceptionally brave or heroic of something. Which was entirely at odds with my actual lived experience. It might be more appropriate these days, when I have a vested interest in being here and having a life. But here's the thing, for years before I reached that point people kept insisting that I was a survivor despite the fact what I felt like was a victim.

They kept telling me not 'let myself' be made into a victim. Which was an idea that struck me as ridiculous. I hadn't allowed myself to be made into a victim, I had been victimised by someone who had power over me. It wasn't something over which I had a choice. I understand that what people were trying to do was help me change how I viewed myself, to present me with an option that seemed more positive. Instead, they made me feel that by acknowledging the fact I had been victimised I was showing weakness and letting my father win.

The truth is, it was vital for my recovery that I accepted how powerless I had been. It was the only way for me to realise that I hadn't been in any way responsible for what happened to me, which I needed to do to let go of the guilt I felt about what had happened. It was only then that I could start the lengthy process of moving on. The constant pressure to relabel myself a survivor rather than a victim seemed designed to skip this step.

It also seemed to deny and dismiss the way I felt. The fact that for many years I didn't even feel like a whole person but rather a broken, fracture being. Which is not to say that all people who have experienced sexual violence feel the same way I do. Of course they don't, we're all different. For me though, the survivor label didn't fit and when I tried to object to it I was made to feel that I was doing something wrong.

Lets skip on a bit, to a time where I started to feel able to move forward with my life. Where I'd had extensive therapy and was starting to accept that my father was 100% responsible for what he did to me. Where I was no longer determined to die and had started to build a life for myself beyond the abuse. Such as now. As I said earlier, survivor might be a more appropriate label these days. A victim is what I was but it doesn't need to be who I am now.

Only, I don't want to be a survivor either. I don't want who and what I am to be defined in any way by what happened to me as a child. It's already the case that much of who I am has been shaped by my early experiences, as is true for everybody. I don't really see the benefit in granting my abuser any more power to dictate who I am.  I'm not a survivor, I'm a person who happened to be abused growing up and who happened to live beyond that experience. I am so many other things; a feminist, a writer, a lover, a friend, a daughter, a carer, an activist, a goth. A person. That's how I chose to identify myself.

If other people find the label helpful then great, but please stop applying it to everybody who's ever experienced sexual violence. Not all of us find it helpful or useful, some of us find it quite the opposite.

Saying goodbye to Ana and Mia

I was always an anxious and insecure child. I used to chatter to anybody who'd listen, mostly out of a fear that if I wasn't talking or making noise I would be ignored or forgotten. When I was ten my father started to sexually abuse me, at that point I stopped being quite such a chatter box. I preferred to be ignored, the more invisible I felt the safer I felt. The last thing I wanted was to draw attention to myself. I never did feel invisible enough however, my father still noticed me on a regular basis.

Somehow, I lost my ability to talk to people easily and make friends. By the time I started secondary school I was a bit of a loner, though I made a few friends with some other shy, socially awkward girls. They weren't friends I could talk to though, not really. I didn't have the words to explain what was going on, how unhappy I was or my secret desire to vanish. It was during my first year at secondary school that I made the aquaintance of Ana.

I could tell Ana anything without fear of judgement. We'd make up stories together about how I'd already eaten, then we'd sit in my room until all hours unable to sleep but full of ideas. Ana held me close and promised to save me when my father abused me. Ana gave me the ability to smile and laugh at lunchtime, the confidence to appear a happy girl so that no one noticed or asked why I didn't eat. Ana was with me when I stood on the scales and watched the numbers go down, watched me get closer and closer to the dream of being small enough to hide.

By the time I started my second year people were starting to notice Ana. Ana hated the attention, the interference. We were worried that people would start to try and split us up. Ana was even more private than me. So Ana introduced me to somebody else, a new friend to add to our trip. Mia.

It was Mia who stuck with me when I ate to put people off the scent. Mia was with me late at night when I snuck downstairs to raid the cupboards. When I ate still frozen cheese cakes. Mia and Ana stood on either side while I threw everything back up again. Mia soothed me when the numbers on the scales went up again, Ana delighted when they went down.

For the next five years we played this see-saw game. Mia helped me get the numbers up, until people stopped caring. Ana helped me drop them again until the attention became too much. Then my two friends started to fall out. Mia let me get too big, Ana wanted me smaller. Mia thought it was perfectly OK to eat and eat and eat, so long as I got rid of it afterwards. Ana thought Mia got in the way, stopped us reaching our goal. They fought for a year.

The year I started university, Ana won the war. It was Ana that guided my steps as I dropped out, then moved out of home to avoid awkward questions. It was Ana who shut me away from life with just the scales and bottles of diet coke.

It was Mia who came to my rescue, when Ana had left me too weak to even leave my bed. It was Mia who picked up the pieces, who made it OK to eat again, as much as I wanted. So long as it didn't stay in me for too long. It was Mia who let me live a semblance of life, who helped me make new friends. I loved Mia so much. Mia stayed with me for the next decade, giving me permission to stay at home and eat instead of go out to work. Mia who encouraged me to end relationships when I was caught being sick after meals. Mia who said I didn't need to vanish completely, but just stay thin enough to feel like I could if I wanted to.

So it continued until one day I realised that it was Mia who denied me a career. Mia who denied me love. Mia who was never going to deliver on all those promises of happiness and a future.

Saying goodbye to Mia was hard, particularly with Ana waiting in the wings, hoping to step back in to the best friend spot. But I had finally realised something important. Ana had never been able to keep me safe or make me invisible, any more than Mia had been able to ensure happiness. Neither of them granted the promises they made so easily, yet I had given over half my life to them.

I needed new friends and real support. So I told people, I dragged Ana and Mia out into the open everybody could see them. I made myself visible again, and in doing so I found a world of hugs that were only hugs, safe and loving offered with no expectations. I found people willing to listen to what I had to say about things far more interesting than the numbers on the scale.

Ana and Mia still hang about the place, they aren't ready to go away without a fight. I argue with them every day and slowly but surely I'm getting there, with the help of my new friends.

A rant about A&E

OK, first off I want to say that I don't come close to understanding the high stress of working in an A&E department. I've never done it, I've only ever been there as a patient or with a patient. I recognise that it's a difficult and sometimes dangerous job and in general I have a lot of respect for the people who take it on. That said I have had some really distressing experiences in A&E departments and I doubt I'm alone. The one time I went it with a physical injury they were awesome, likewise when I've attended with somebody else for physical issues they've been pretty damn good. Not that I've never encountered issues on that front - I have, particularly waiting times - but my experiences have been better than when I've been in with mental health based issues.

I once went it because I was feeling suicidal, was genuinely scared I would act on that urge and was told by the out of hours service that it was the best place for me. When I got there I was told that I hadn't harmed myself so they had no idea what I thought they could do. Not reassuring.

I've been taken in via ambulance twice, post overdosing. On both occasions I was tutted at and told off. Once a nurse even told me that if I was really trying to kill myself I wouldn't have chosen those particular tablets as 'everyone' knows they don't kill you. There was also a running commentary on the scars and cuts on my arms, which included a doctor poking at one and asking if I could feel him doing so. Yes, I could feel it. It bloody hurt.

Here's the thing. Not every overdose is a suicide attempt. Overdosing can also be a form of self harm. Self harm is self harm, not a suicide attempt. They are, in fact, different.

In both cases, someone else phoned the ambulance. I didn't really want to go in but was persuaded to by lovely ambulance people who made me feel looked after. Only one of my hospital trips was post a suicide attempt. I was made to feel stupid that it hadn't worked/left me with permanent damage. Apparently that meant I wasn't trying hard enough and was thus wasting time. Not a good way for a suicidal person to feel.

I have been in with other people post suicide attempts and seen them treated in similarly appalling ways. It enrages me, it really does. In A&E your job is to treat people, not judge them. I think there are some simple rules people need to remember.

1) If someone is taken into hospital after harming themselves, whether in a bid to end their life or not, there is obviously something wrong. To find out what is wrong, talk to and listen to your patient with sympathy and understanding.

2) Alienating and upsetting your patient will make things harder both for them and you. It makes it harder for you to do your job and may lead to you missing something important and getting them the right help.

3) Nobody hurts them self with the intention of wasting your time, creating extra work for you or making it harder for you to treat other people. In fact, their actions before entering A&E had absolutely nothing to do with you and so shouldn't be taken personally.

4) Curtains are not walls and your voice will carry through them. If you really are annoyed with your patient and feel you must vent, do so out of earshot of both them and other patients.

5) There was a reason the person did this to them self, it may be a symptom of a mental illness. Blaming people for their symptoms is not on. Would you blame someone else for having an asthma attack or having a cough?

Every time I think about this subject I get choked up. I once wrote a very nasty letter to an A&E nurse, though I never sent it. This was after a friend of mine killed herself. It was the last of multiple attempts, on the previous attempt she was told by a nurse that if she really wanted to die she'd have done it by now and to stop wasting everyone's time. I've always wondered if the nurse knew that my friend did indeed stop wasting everyone's time. Forever.

To be fair and balance this out, I want to briefly talk about the time I went to A&E with a friend of mine who had taken a potentially fatal overdose. I went with her in the ambulance and stayed with her until she was admitted several hours later. The nurse who saw her was brilliant. She was calm and efficient, and constantly reassured my friend that they were doing everything they could to save her life and make her comfortable. After the doctor had seen my friend, she stopped by to make sure we'd understood what was said and what was being done. She popped in often to see how we were getting on. She held my friends hand and listened when she was off oxygen and talked about being angry that her life had been saved. She got her talking about why she was so determined to die and asked what would make my friend not want to die. She never once made her feel guilty for being there and in fact did quite the opposite, assuring her she had ever right to be treated.

So there are absolutely people out there doing it right and it's entirely possible I've just been unlucky. Only I've had a lot of people share similar experiences with me. Personally, I think there should be mandatory training aimed at raising awareness of mental health and giving staff the tools they need to handle it. Not only when they first train but on an annual basis.

It's not my fault, dammit.

I have just been reading this post on a blog I found last week. It's an interesting and insightful read which I think basically everybody should read. It reminded me of so many instances where I've been held accountable for my illnesses or been told that I'm not doing enough to get better. This isn't really something I should have to justify but I'll try, just in the hopes that someone reading this will realise that their words and action can be hurtful and uncalled for. Or that it will make someone feel less alone.

I remember the very first time I went to see someone about my mental health. I had not long left home and since moving in to the dingy little flat I shared with some friends I had barely left. I was jumping at shadows, suicidal and pretty much cried all the time. One of my friends pushed me into going to the GP, helped me register and make an emergency appointment all on the same day. They even came with me for moral support.

So then, here's what happened. I told the GP what was going on. That I'd felt low in mood for as long as I could remember. I self harmed, had tried to commit suicide multiple times, didn't eat and hated the way I looked. That I was scared of leaving the house or even being seen. The response was that I was young, attractive, had friends and a partner. Therefore there was no reason for me to depressed, so I should just stop being sad and concentrate on the good things in my life. Then I could go get a new job (I'd just lost one since I was too scared to leave the house and go to it) and all would be right with my world.

If only it was that easy, but it isn't. Depression hits despite the good things in your life and it makes it very difficult to appreciate them at times. Being told to focus on all the things I had going for me just made me feel awfully guilty about the way I was 'wasting' them by being mentally ill. This made me feel worse and in no way improved my mental health. So bad to the GP I trundled. This time they got annoyed with me and outright told me that I had no reason to be ill and just needed to grow up and accept everything wasn't going to be perfect all the time. At this point I broke down. I said I thought my mental health problems might have something to do with my father abusing me. Cue attitude change.

This time I left with a prescription for anti-depressants, a follow up appointment to see how I was getting on and a leaflet about the different services I could be referred to if necessary, which included talking therapies and support groups. Now that I had 'proved' that my illness had a cause it was accepted as real and the long process of treatment began. Of course, not everyone is lucky enough to be able to pinpoint a reason for their mental health issues, or isn't able to share them right off the bat. Thankfully most GP's in my experience don't demand that you have an explanation before they will consider your illness to be real.

I wish I could say that from this point my mental health was a) taken seriously and b) I wasn't blamed for being ill. Sadly, that hasn't been the case at all. After years of counselling, therapy, group therapy, various drugs, diets and exercise plans I am still ill. Now, my past is apparently something I should have dealt with by now and the fact I haven't is clearly my fault. I haven't been trying hard enough. I've had unrealistic expectations. I'm obviously lying about complying with my treatment. The message is always the same, if I wanted to get better I would. Since I clearly don't, there isn't any more that can be done for me and presumably I therefore deserve to feel like this.

I started with the medical side of things because that's where I foolishly expected people to be the most understanding. And I should be clear that some of them have been. My current GP is amazing and I used to have a really good CPN. They've been the exception though. A&E have been particularly awful but that's a whole other rant and post I'll no doubt make in due course.

So then, let me tell you about my least favourite conversation to have with people. The 'why aren't you working' conversation. I mention it's for health reasons, hoping it will be left at that. It rarely is. There is nearly always follow up, starting with how I don't look ill. Which means explaining that it's my mental health. Then there is everything from 'Oh I used to be depressed then I did X and now I'm better' to 'work is the best cure for depression' to 'well, depression doesn't really exist.'  More recently there's also been 'maybe if you lost weight you'd be happier' which is just an astonishing thing to say to someone recovering from an eating disorder.

The 'why don't you try' conversation is frustrating. I am delighted to hear that you/your friend/someone you read about on the internet tried a new drug/diet/sugar pill/therapy and that it worked for them. If I explain that I've also tried X and it didn't work for me, please don't assume that I am lying to you or didn't give it my all. If X costs more than I can afford to pay and isn't available on the NHS, please don't bang on about how if I wanted to get better I'd find a way to pay for it. If X happens to be nonsense, there's every chance I've still already tried it or something similar out of sheer desperation. Different things work for different people, and sometimes a treatment IS worth re-visiting but please don't assume that because it worked for someone else it should also work for me.

Work. Working can do amazing things for mental health. It helps with the sense of self worth, with feeling useful and valued and part of something. However, it can also be a major cause of stress. And, whilst you may not want to hear this there are times when someone (including me) is not well enough to work. This doesn't mean I don't want to work, and when I am well enough I do.

As for the idea that mental health disorders don't exist... I don't know how to argue with people who refuse to acknowledge decades of research and evidence that says otherwise. I tend to find they don't have any interest in what I'm going to say anyway and simply want to lecture me about how there's nothing really wrong with me.

Here's the thing, I shouldn't have to justify my illness. I shouldn't have to explain endlessly that I am already doing everything I can to improve my health and situation in life. So, please just accept as fact a few things: my illness is real and I really have it, I'm am trying, probably more than you'll ever know and I don't owe you an explanation for why I'm like this.

I am mentally ill for a whole exciting mixture of reasons. Mental illness runs in both the paternal and maternal sides of my family, so there's every chance genetics plays a part. I lost an important relative at a very young age, and many more people I loved dearly since. I was sexually abused as a child. I experienced domestic violence and rape as a teenager/young adult. There is almost certainly a reactive element to my mental illness. I never once chose to be mentally ill, nor do I chose to remain so.

Simple things which become hard when you're mentally ill

I try to be open about the fact that I am mentally ill, mainly because I think it's important to fight the stigma attached to mental illness. Also because honesty is absolutely the best way to fight 'the lying disease.' That said, there are times when I simply am not up to dealing with conversations about mental illness. When I don't have the energy to grit my teeth and explain for the nth time why I can't 'just snap out of it.' Times when I simply don't have it in me to try and prove to someone that my illnesses even exist in the first place. There are times when even the simple things in life seem to take energy, motivation and skills that I just haven't got.

When I say simple things I really do mean simple. Things which people do every single day. Take the morning for example. A fairly normal morning routine might go as follows: Get up. Shower. Get dressed. Eat breakfast. Brush teeth. Simple, right? Wrong. Let me talk you through my morning.

Get up

I wake up tired and sort of blank feeling, with the thought that nothing really matters. I consider the fact that this thought should bother me but somehow I can't care enough to, well, care. I know I should get up but I don't see the point. Plus my limbs feel heavy, too heavy to move. I try, but I can't move my legs. Panic sets in. I can't move! I concentrate on moving my foot and manage to twitch it a little. I'm not paralysed, there is nothing wrong with me. I can move. For some reason this fact has bursting into tears. I sort of wish it was impossible for me to move, then no one could expect  me to do such impossible things as get up and go out and do things that seem, in this moment, to be beyond me. I cry myself back to sleep. Next time I wake up I manage to drag myself out of bed but once I've done that I don't know what to do with myself.

Shower

Today is not a day for being naked. I don't want to see my ugly flesh, my stretch marks, my scars. I don't want to have to touch and handle the fat which I know will have make me quite literally sick. I am not sure today that I will have the strength to resist the urge to take a razor to my hated body. I skip the shower for the third day in a row. I am starting to smell a bit but again, I can't summon up enough energy to care.

Get dressed

I still haven't managed this today. Partly it's the thought of being naked again, even briefly. Partly it's because being in my bed clothes is sort of my safety net. It's like being snuggled up in the safety of bed all day long and I'm not ready to give it up yet. Besides, now that I've missed work (again) there's no reason to go out so what's the point?

Eat breakfast

Meals are difficult. First you have to go to some effort to make them happen. For me to eat breakfast this morning I would have to first wash up. I stare blankly round the kitchen for a bit. I know I need to eat. I can't afford to skip meals without risking a fall back into my disordered eating patters, plus I am meant to take my medication with food. I do some washing up but can't summon up anything even close to an appetite. Instead of eating I take my tablets with a sip of water and go back to bed.

Brush teeth

I realise I haven't done this yet after I have climbed back into bed. What's the point? I haven't eaten anything. I am never going to eat anything again. Or do anything again. I am going to just lie here and sleep until I am dead. On some level I know this isn't true but it seems to make sense at the time. I go back to sleep.

On a day where I do have the energy and motivation to do these simple things they are still hard. By the time I have left the house in the morning I am often already worn out. Some days, like today, they seem beyond me.

When I was skinny...

I once passed out five times in a week. I felt dizzy all the time. I ached all the time. I was frequently sick, even the thought of food made me nauseous. Hunger made me feel nauseous too, so that was basically a lose lose situation right there. I didn't sleep for days at a time, then I'd sleep a whole weekend away. My teeth hurt. My stomach hurt all the time, which I kind of liked as it reminded me to hold it in at all times. I self harmed on an almost daily basis. I smoked too much, drank too much and took too many diet pills.I spent hours every day putting on make-up, doing my hair and changing my clothes. I spent hours every night doing the same thing. I had seizures caused by low blood sugar and electrolyte imbalances. My chest ached and there were often times I struggled to breathe. I ran late every night and early every morning. I did star jumps and burpies and sit ups. Hundreds of each every day.

Then there were the times I couldn't resist food. The times I spent all my money on cigarettes, fizzy drinks and junk food. So much junk food. Then I ate it, all of it. Too quickly to really taste it, certainly too fast to enjoy it. I ate until I felt like I was going to burst, then ate some more. I ate until I hurt too much to fit anything else inside me. Then I made myself sick. I didn't even need to stick my fingers down my throat. Then back to the food. Rinse and repeat until all the food was gone.

All these memories aren't happy. I wasn't happy. I was miserable.

So can anybody tell me why some days, I miss being anorexic. :(

I've been thinking about lifestyle choices and health

So, here's the thing. I've made choices in my life that I know could have a negative impact on my health. I'm not going to include here the stuff that I think are symptoms of my mental health disorders. So, I am going to be talking about yo-yo dieting, smoking and drinking but not binge eating, purging, starving myself or self injury. I guess the thing I'm interested in here is about the right to judge others on their lifestyle choices, specifically blaming people for their health problems. Particularly those linked to obesity, smoking and alcohol.

So then, the message that these things are unhealthy is pretty much everywhere isn't it? I find it hard to believe that anyone living in the west can really claim to be unaware of the idea that smoking is linked to cancer, or poor diet to obesity and so on. So why do we still eat food that's bad for us? Why do we keep dieting, when it's been fairly widely reported that people who diet tend to end up gaining rather than losing weight in the long term? Why do we smoke when it smells bad, costs loads and has been linked to cancer? Why do we drink when it leads to making rash and sometimes dangerous decisions, can lead to liver disease and in the case of binge drinking can kill you in a matter of hours.

I certainly know all this stuff, yet until recently I not only drank but often drank to excess. I smoke on occasion and have been a heavy smoker historically. And I'm on a diet right now, despite knowing it won't really work, except in the very short term if I can even stick with it that long. So, knowing all of this why would I still do it? Simple. After a quick risk assessment, these things seem a viable option.

OK, let me talk you through it. I haven't been out in ages, my friends are beyond annoyed with me cancelling at the last minute and have started drifting away. I'm genuinely worried that I'll soon lose them, which would mean losing most of my support network. Plus, humans are social creatures, we don't function well without the company of others. Having been in 'hide from the world mode' for a while now, my mental health is starting to further deterioate. Now, I know when I drink I can also engage in risky behaviour - such as spending my taxi money on more drinks - and will almost certainly end up throwing up. I also know that since I'm likely to end up binge drinking there's a chance of passing out, injuring myself and/or ending up in hospital. Or having an alcohol induced seizure. This is never fun, Never. But, without the temporary confidence alcohol gives me I know I'm not likely to leave the house, never mind make it to the club and actually engage in that whole social interaction thing. So, despite the risks drinking seems like a viable option. The risks to my health, if I further damage my friendships and continue to remain socially isolated and lonely seem greater. They include suicide, for a start.

What about smoking? Well, I'll be honest. I don't think I'm going to live to a ripe old age anyway. Plus, as part of my anxiety I tend to imagine I have every single serious illness I've ever heard of. There are weeks I think I'm about to die from a heart attack, have a brain tumour or MS on an almost daily basis. Worrying about long term or terminal illnesses is so normal for me that the genuine risk from smoking doesn't really change anything. On the other hand, nicotine can act as a mild anti-depressant, it's one of the few things I enjoy when in a depressive or anxious state and in the past when I smoked heavily, needing a cigarette was sometime the only thing that would get me out of the house, even if was only to go as far as the off licence across the road.

Smoking has often been my go to place when I feel the urge to self harm or kill myself. Killing myself has the most obviously damaging effect on my health. Self injury often calms down or removes the urge to take that step, so I consider it the better option. Self harm can get out of hand though, it's possible to cut too deeply and end up needing stitches or permanently damaging something. It's possible to make a mistake and kill yourself by accident. Smoking can often reduce or remove the urge to self harm, or so I have found. Plus, sometimes self injury isn't enough to help me fight off the suicidal urges. And sometimes smoking isn't enough to stop me self harming. I find it's better to start with smoking, as if that doesn't work my go to place is self harm. And at that point, if I still feel suicidal I'm at least more likely to be calm enough to get some help. Given the choice to definitely hurt myself right now or to do something which is probably harming my health long term, I'll chose to avoid the immediate danger. Because protecting my long term health only matters if I'm going to be here in the long term.  It's sad that so much of my life is spent finding ways to fight the urge to end it, but there it is.

Dieting is the same. I know I'm picking the short term benefit over the long term health problems. I do know that, but the thing is that wanting to lose weight is a more immediate concern. The thinking behind this one is that once I start losing weight, I stop feeling quite so anxious and that makes it easier to get on with doing more useful stuff - such as dealing with the underlying anxiety, getting a new job or not giving in to the urge to hurt myself.

Now, I'm not saying everyone is in the same situation. Of course they aren't. What I am saying is that people make these decisions for all kinds of reasons which aren't obvious just by looking at someone. Heck, a lot of the time they aren't obvious to the people making them. I just find it difficult to believe that anyone wants to be unhealthy, so I never think that what they are choosing is to make themselves ill. I think what people are doing is choosing to fulfil a current need over worrying about a future one and we shouldn't judge them until we know their reasons. Maybe not even then.

Body hate and me. Triggers for talk of body issues, eating disorders and brief mention of abuse.

I spent ages trying to come up with a clever title for this post, at the time of writing it is still without a title. I think I've been doing OK with this so far. I've posted more than one thing which is a good start. Well done me. Anyone at all has read something I've written and I'm not freaking out too badly. This is good.

So then, what do I want to talk about now? Well, I want to talk about hating my body. I want to talk about why I hate it, the ways that hatred manifests and how I am hoping to stop hating it sometime soon. With luck, someone out there will find this useful or interesting or something.

So then, why do I hate my body? Let me tell you the whys! There are many of them. Firstly, as previously mentioned I was abused growing up. It's kind of hard to love the thing which was the focus of abuse. Secondly, I have the misfortune to live in a society that places a disproportionate amount of value on how a female looks. Which is kind of pressuring. Not only that, it's a society which has ideals I can never match up to. Even with my head start (gained by being pale skinned, light eyed and thin) doesn't make it easy to achieve beauty within such narrow definitions. Thirdly, my body is a bit broken which makes it often an uncomfortable or painful vehicle to transport myself in. Finally, my body does things I don't want it to. It has internal workings that lead to lots of strange things happening inside me and then unpleasant things leaving me.

Essentially, my body is this thing which never seems to be the right shape or size, often hurts me, keeps doing things I don't want it to and it can be harmed and touched by other people. Really, the only good thing I can say my poor old body is that's it's still here, going strong despite everything I (and other people) have done to it over the years. In many ways it's actually kind of marvellous. On days I feel suicide, the survivability of my body is not a point in it's favour. Have I mentioned how much I hate being mentally ill?

So then how does my hatred manifest itself? Well, there's my distorted view of my body. I'm literally incapable of seeing it in anything but a negative light. All I can see are flaws and imperfections and the hilarious thing is I have no idea if the things I see are real or not. Like, I know the facial scar I have is real but to me it seems huge and other people hardly notice it. But the other stuff? Am I exaggerating, is it as bad as I think it is, is it even there? No idea. All I know is that when I see myself everything looks wrong, from my proportions to the length of my neck, the symmetry of my face and the size of my eyes. All wrong. All of it. In my head I like some weird deformed insect lady. Not pleasant.

Then there's my issues with eating, which are three fold. Hurrah! Firstly, trying to get rid of the 'thinner is better' message is really difficult. I know I wasn't actually happier when I was underweight but my brain just goes 'Oh well, better to be miserable and thin than miserable and fat.' Which is ridiculous and not a sentiment I am happy with at all. Being an advocate of fat acceptance and health at every size, it's hugely upsetting that I apparently can't help subscribing to this view on some level.

Then there's my digestive issues. OK, so these were probably triggered or caused by my eating disorders but they're certainly another reason I dislike eating. Food makes me ill. Honestly, it does. I've tried various techniques and diets but I've not been able to identify anything in particular which makes them worse. So, I avoid the usual suspects (dairy, gluten) take my medication and hope one day I can eat something without experiencing pain and nausea for hours afterwards.

Then there's the last eating based issue. Remember that bizarre hatred of bodily functions? Well, if you eat that food needs the be digested, and then it has to leave your body. It's a process accompanied by odd bubbling sensations and gurgles and ugh. Even thinking about the fact that digestion is happening is making me feel sick so I'm going to stop and move on.

Self injury is another way my body hate shows up. Now, there are various reasons I have engaged in self harming behaviour and I'm sure at some point I'll write a post all about it. However, one of the reasons is body hate. I have tried to cut the fat bits off. I have od'd on laxatives and slimming tablets. I've sat and punched myself in the mouth until my lips swelled because I think my lips are too thin. I've taken a cheese grater to my thighs in an attempt to 'scrape off' my stretch marks. The really weird thing here is that I KNOW I can't cut the fat out or get rid of stretch marks like that, but there are times when that knowledge apparently hides and I just have to do something.

Then there is the anxiety. Now I'll be honest here, I don't know how much of my anxiety is caused by my body hate and how much of my body hate is caused by my anxiety. I do know that they definitely interact in a way which escalates both. This is not fun to deal with. I've already written about how I can become so anxious about my looks I refuse to leave the house. There is a huge fear that other people will see me the way I see myself, and judge me accordingly. And that they will use my disgusting body as an excuse to hurt me.

On some level, because my body disgusts me so much I sort of think it deserves to be punished. I've certainly punished myself for having such a disgusting body. It makes it really hard to accept that someone else can like it (and me). I spend a lot my day trying to convince myself that people aren't simply pretending to like me as some kind of cruel trick. It makes interacting with people, especially my nearest and dearest really hard.

So, moving on to the moving on part. I don't want to keep hating my body. It's pretty rubbish. I'd like to learn to tolerate it, maybe even love it. Which is hard, because right now for the first time in my life I am over weight. Not by more than a few pounds but that doesn't matter, given that for me gaining weight feels like failing, being over weight is a huge deal.

So, I am refusing to go on a diet. Seriously. It's taken me three years to get to the point where I can eat every day, so the last thing I want to do now is start restricting what I can eat. What I am going to do is try and create a new relationship with food. I'm going to experiment with it, try new things and cook from scratch. I actually enjoy cooking, even if I don't enjoy eating. So that's the plan. And since I'm going to be doing this, I am going to be using recipes which are well balanced and healthy. It may sound weird, but I think 'operation expand my diet' is going to be a lot better for me than any attempts to restrict portion size or narrow down what I'll eat.

Then, I have already started trying to incorporate exercise back into my life. Only, I don't want to do what I did in the past which is take it to extremes. I am doing it slowly and with a focus on health and strength rather than weight loss. I'd love to do it with a personal trainer, one who understands poor body image and eating disorders. Such a thing costs money however and that I have none of. I have banned myself from running and swimming involves being seen in a swimming costume, which I can't face right now. Instead I am focussing on stretching and core strength exercises, with some (but not much) weight training. We'll see how that goes.

Finally, I am doing a lot of reading of feminist blogs and news articles. Sounds odd perhaps, but steeping myself in a culture that recognises qualities which aren't beauty based, which includes pictures of beautiful women of various shapes and sizes and gives me tools with which to fight back against the 'thin good/fat bad' messages endemic in society (and apparently in my head) is probably the single most useful thing I have ever done.

And now back to mental health. Here's one of those 'day in the life' posts.

So, let me talk you through a day from last week, which was a not uncommon kind of day for me.

03.30: Finally fall asleep having spent the night panicking about work and paying my rent.

07.00: Alarm goes off and wakes me up. Instantly burst into tears because I am so tired.

07.30: Still haven't got up, too tired. Can't stop thinking about how awful I must look with eyes red from crying and that dreadful 'haven't slept in days' grey tint to my face.

08.00: Still not up, and I need to leave now if I am going to get to work on time.

08.30: Drag myself out of bed. Need to take medication, am meant to take with food. I have no appetite but I know I need to eat anyway. Skipping one meal for me often turns into skipping several and ends up kickstarting my binge/purge cycle.  Try a small bowl of cereal. Get a few mouthfuls in then throw up. Take meds anyway.

08.45: I should be starting work in 15 minutes. I'm not dressed or showered. I've just been sick. Work is 45 minutes away. I'm clearly not going in today and should probably let work know. Get as far as picking up the phone. Stare at if for a bit. Feel kind of blank. Put phone down and go back to bed instead.

11.30: Wake up again. Missed calls on phone from work. Can't breathe. Some time passes.

14.00: No idea what I did in the last couple of hours but I am now curled up on the sofa with the telly on, staring into space. Watch telly for a bit.

17.00: Have accidentally spent all afternoon watching telly. Have failed to eat, shower or get dressed. Feel sick, headachey and faint. No idea if this is from hunger, anxiety or some kind of terrible disease. If there is a possibility of the latter being fatal then I wish it was that. Feel guilty for this thought.

17.30: Have a shower and throw some clothes on.

18.00: Partner gets home. Asks about day. Explain I felt ill but don't mention the not eating, or not getting dressed until just now.

18.30: Make pasta with partner. Panic at thought of eating it. Manage a few mouthfuls then cry off, citing feeling sick.

18.40: Argument about how I'm not looking after myself and need to start doing so. Infuriating because partner is right but it's just not that easy to look after myself. Particularly when his idea of doing so is all the things my illness says is bad. Like eating. Or leaving the house, where people might see me. Or going to work where I might make mistakes.

19.00: locked in bathroom crying.

19.30: Coaxed out of bathroom. More sensible, less screamy conversation about how we can make it easier for me to look after myself. Secretly feel like this is all doomed to failure but it's nice to feel supported and partner seems so positive this will help. Don't want to let partner down.

20.00: Smiles and cuddles on the sofa. When partner isn't looking, smile drops. The snuggles are nice though. We watch a film together. It's nice, doing things together. Particularly things which don't involved leaving the house or making decision which could be wrong.

22.30: Partner suggests early night as I've not been sleeping well. I hate early nights. Early nights mean extra hours staring into the darkness with nothing to distract me from all those thoughts. Anxiety loves the night time. Don't want to upset partner again, too worn out for another discussion and fear will say the wrong thing and start another argument. Brush teeth, get into pyjamas and go to bed.

23.30: Partner is asleep. Lights are off. Everything is quiet. There is nothing to distract me. Was the door locked? Can't remember. Get up to check. Unlock it completely, open and shut it and lock it again. Did it definitely shut properly? Unlock it again and repeat the process.

23.45: Prowl around the house making sure all the light switches are in the same position. This involves some running up and down stairs putting the hall light on and off until I am sure it is right.

00.00 Put telly on, find some old repeats of American Dad. Not my favourite show - Seth McFarlance is kind of awful - but it's better than nothing. Find a book to read. TV noise drowns out random noises in the darkness which could be threats to my safety. Book gives me something to try and focus on. Can't focus. Throw book onto floor and cry instead.

01.30: Creep upstairs to bed hoping to avoid waking up partner. Lie in darkness, heart pounding, soaked in sweat and feeling sick. Feel physically numb and full of pins and needles. Consider possibility I have arsenic poisoning, MS or am having a stroke. None of these things seems likely.

02.30: Doze briefly, wake up feeling sick. Oh god, I'm going to lose my job. I have to get up in the morning and go to work. Decide I will definitely do this, just need to ensure I have a good night's sleep first.

03.00: Can't sleep. Decide I will be able to go to work without any sleep, just this once. Get back up.

03.30: Fall asleep on sofa.