It is amazing that even in the 21st century, it still isn't very easy to speak openly about mental health issues - particularly on a personal leveMORE empathetic and compassionate rather than building walls and de-personalising our patients! Somehow anyone within the NHS, there is a ridiculous notion that "we are professionals and shouldn't struggle on this level". But the unspoken reality is that the NHS is wonderful because it is staffed by human beings who do go through similar problems to the patients and families we see on a daily basis. That reality should make us
My own personal background was somewhat more complicated by the fact that I came from an extremely fundemental religious background where mental health issues were particularly disapproved of, and usually put down to "sin" on some level. When I first went on antidepressants some 10 years ago for a time, I didn't dare tell my parents for some years - as it was seen as an admission of "failure". I have seen my General Practioner and various Occupational Health services through work pretty regularly - and the clinical feeling is that I am not "depressed" per se - I apparently tend to struggle with "chronic anxiety". In short - I daily seem to imagine up (I have a very vivid imagination) all sorts of fears, worries and panics about what life may bring.
The last year and a half has been particularly rock-bottom in terms of experience, health and work. Two or three times I did in fact consider suicide and whether it really "was all worth carrying on". Those low points were often prompted by events I read, such as the tragic account of the nurse involved with the Australian DJ scandal while Prince William and Kate were in hospital expecting Prince George. Reading that account made me feel an affinity with the nurse - but in a ludicrous way, a rather morbid wondering if I also committed suicide whether the Chairman/Chief Executive of my workplace would make a statement to the press. I decided they wouldn't bother - and somehow found that enabled me to "keep living" that particular low day.
But the benefit of this year has meant that I have been forced to confront some of my worst fears headon - with no support, help or alternative. That's a story for another time - but what I found was that actually - my imagined fears were WORSE than the reality! But what I wanted to focus on in this post was what enabled me day by day to "keep going" this year. And that was the person and example of Her Majesty the Queen. Before you snigger - let me explain why.
I am sure there may be psychological reasons why the Queen means so much to me personally. I lost both my beloved Grandparents at significantly low times in my life to cancer, and both losses affected me deeply. I guess there may be a degree to which I long for a "Grandmother" figure. But Her Majesty's example has meant more than that this year. It is well known and commonly cited that her life motto is;
"Duty first - self second".
When Her Majesty was 21 she made a monumental speech in South Africa where she committed her life to;
"I declare before you all that my whole life whether it be long or short shall be devoted to your service and the service of our great imperial family to which we all belong".
Her committment to duty has ruled her life and service - even if at times it has meant that her family life and personal life has been affected as a result. Many commentators (and we never know what Her Majesty herself thinks - as she does not give interviews) suggest that call to duty is something that has remained with her, and has driven her throughout her life and reign - to the present date, her amazing 86 years of age and her now-over 60 years of reign.
Let me make it clear - I do not equate myself in ANY way to Her Majesty the Queen in ANY sense (other than to count myself fortunate to be one of Her subjects). But what remained with me throughout this blackest of years, was initially a thought - does Her Majesty the Queen ever get down or low? And this wondering grew into an interest that lead me to reading many of the biographies written about the Queen, and the difficulties that have beset her (especially her famous "annus horribilis" year and the year where HM lost both her beloved mother and her sister) - yet continued to perform her duty.
Her Majesty's personal difficulties are made worse by far because they are so often in the sight, criticism and debate of the press and therefore the public of both the United Kingdom and Commonwealth. At the very least any personal problems I have, were able to be limited by myself to the people I trust and were able to depend on (and to them - a few in number - I owe them a debt of gratitude I will never be able to repay!).
While working through - day by day - the blackness, the lowness and utter desolation of the past year - at times, it was quite simply the fact of seeing Her Majesty the Queen at an official function (I follow several blogs that track and report the Court Circular) that gave me courage and conviction to try and "live the day". At times, this was as pathetic as leaving the safety of my flat and walking to the corner shop to buy a pint of milk. It sounds ridiculous to write this - but my mentality was;
"If Her Majesty can go to yet another engagement despite the wealth of possible aches and pains she may have as an over-80 year old, smile constantly even though she may not feel it, and shake umpteen hands even though she has done nothing but for the last over 60 years of her reign ... then surely I can put clothes on, leave the flat and do a simple task?".
That simple role-model and mentality enabled me to gradually build and grow in confidence, activities - and as a result I found my mood and outlook on life improving, my determination to work through my difficulties strengthen, and focus my goals beyond just "surviving the day".
It is for this reason I will never fail to be grateful to the unfailing example of Her Majesty the Queen. The couple of visits I have been SO fortunate to make to Buckingham Palace only served to enhance that. It is why I am a Royalist through and through! I know this example will not work for everyone who suffers with anxiety, depression or any other mental health disorders. But I do think it underlines the importance when you are struggling so hard to "keep living" - sometimes it can be the most simple or obvious of things that help keep you "living"! It could be a family pet that needs feeding. It could be a planned outing in a few weeks time.
The majority of the victims of suicide almost invariably state; "they ran out of hope". So for us - as NHS professionals - one of the key responsibilities upon us is to help find that hope (and it will be individual to each person). But we can only do our job well and effectively - if WE are honest about our struggles and experiences. Small things such as a "thank-you" from a Chief Executive or a line manager can change the complete "mood" of a working week! More importantly - cared-for staff give better care (it is widely acknowledged - I cite an excellent PICU Intensive Care Consultant as an example) so it is vital that if NHS staff do share mental health struggles and issues, they are supported and not vilified or patronised (as has sometimes been my experience).
Positive thinking (in my opinion and experience) is absolutely vital to "keeping on going". For many of my 36 years of living - I thought that positivity and happiness was a reaction to the experiences that life forces upon us. If life was going well - then I was happy! If it was going very ill - then I was not. But I have come to realise and understand (thanks to Twitter friends - in particular Kath Evans, Head of Patient Experience for NHS England and her friend 'Engaging Emma') - that in fact positivity and happiness come from "within" and are a state of mind that can be increasingly immune to life's changes and events!My conclusions?
1. Life isn't fair or just.
2. We all have a choice - to continue and fight or opt out.
3. We can all chose to benefit from our experiences and use them for good.
4. There is always hope - even if it is the smallest glimmer (such as the Monarch carrying on her duties!).
5. The night cannot last forever - the dawn does comes, even if it seems forever!
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