Mental Wellbeing in the build up to Christmas

This is the Rusty Siren guide to keeping your spirits up in the build up to Christmas with some mental health tips.  I don’t personally like to think about Christmas before the middle of December but these days I’ve found it is in our faces as soon as Halloween is over.  Evidence suggests that mental illness may increase at Christmas, this is my personal guide to dealing with the whole Christmas thing with minimal stress.

The challenges of this time of year are obvious and well known:

Money.  This has become an expensive festival and the pressure is on to spend more and more.  When we feel obliged to spend more than we have this is a huge source of stress.  Several years ago I had a chat with my family.  We decided to cut back on presents.  We all know we love each other so we don’t unconsciously try to measure love by present monetary value.  Family policy now is children get bigger presents adults get a token present.  Homemade presents are very welcome. We’re all relieved and happy with this.

Time.  Lots of us find ourselves working extra hours to get the extra money we need which then obviously leaves us less time to do the Christmas shopping.  My answer is to start the planning and organising early (hence why I’m writing this now).  I know this will annoy some people; I used to get irritated by the organised types who had Christmas all sewn up when I was just starting to panic around the 20th of December!   I’ve now joined their ranks.  I’ve also caught up with the rest of you in the 21st century and do some of my shopping on-line.  The earlier start leaves longer for the gifts to arrive.  For the shopping I can’t get on-line I plan shopping expeditions in the local towns.  I start early and generally have a loose plan of what I will get and where I will get it.  When it goes well I reward myself with a gift too!  There have been times when I’ve not managed to get a single present but still got myself a gift.

Also, about now is when I start to think about posting any cards which need to go overseas.

Perfect-family-syndrome.  The television is full of adverts for Christmas now.  Often a perfect family is shown; the beautiful couple with the happy children whose life is made even happier by the perfect Christmas they are having.  If that’s you then you have my best wishes and I am truly glad for you and hope you have a fantastic time.  Most of us at some point fall short of that ideal scene. As a divorced dad my Christmases have been a little different.  When my children were younger I used to feel guilty that I had deprived them of this perfect Christmas.   Often my shift pattern has meant that I have been working on Christmas day or Christmas night.  The way we got round this was to plan a day near Christmas when we had our own Christmas.  I came to love our alternative Christmas days.  The kids are adult now but we still enjoy our custom.

Through working the Christmas period I know that a lot of people feel increasingly lonely and depressed at this time – I think this is made worse by the Perfect-family-syndrome pushed by the advertisers.  It’s important to remember that a lot of people also feel lonely and low at this time of year and that it isn’t unusual.  Times when I’ve been alone on the day itself I’ve still planned treats for myself – nice food and tried to have a relaxing day and included a nice walk in the fresh air.

The years where Tony and I are working Christmas day we each bring a microwave Christmas dinner so when we get our 30 minutes on station we can still feel quite festive.  I generally eat all the mince pies, Tony doesn’t really like them!

Extended time with family. During the holiday period we tend to spend more time than we are used to with our families.  Much as we love them, this may also cause increased stress.  Then as the anxiety rises and patience levels drop we feel guilty for feeling like this when we’ve probably been looking forward to spending this time with our loved ones and feel that we shouldn’t feel like this.  It’s good to take a realistic view at times like this. It’s natural that there will be tension when spending more time than we usually do with our families, especially if staying at their house and adapting to their routines.  This is part of being a human.  When this has happened to me I just accept that this is natural and I rely on my go-to remedy for everything: I go for a walk and practice my relaxation techniques.

Despite what it might look like from above I do love Christmas.  I’m a big kid at heart and love all the shiny lights and decorations.  I do think people are kinder and more loving to each other for a brief period of the year.  Regardless of spiritual or religious views I think we all think more about loving and giving at this time of year.

I hope you all have a relaxed and stress free build up to Christmas (It’s way too early to wish Merry Christmas yet!).

Keeping my mind tuned up.

This blog is about my mind and what I do to keep it healthy and to expand my brain. I like to read other blogs about how people manage to keep their minds healthy and active.  If we all share tips like this we can all maybe help each other a bit. I want to stress that this describes things which work for me.  I’m fortunate that I’m basically healthy mentally; all I suffer is the occasional low mood and some social anxiety.  If you suffer with the more serious conditions then I’m sure you realise that it’s expert professional help you need.

I’m not a mental health professional.  I want to stress that.  As a paramedic I’ve very little training in mental health, surprising when you consider how many cases we go to where mental health is the chief complaint.  I am however becoming an expert on me and my mind.  I’ve utmost respect for mental health professionals and always stress that if you have problems you shouldn’t hesitate to get professional help but one thing I’ve learned is that you don’t have to be a professional to help someone.  Just by being there and being prepared to listen and support someone can help a great deal.  Just listen without judging and without even trying to ‘fix’ things.  That may be enough to help a person through a crisis.  Encourage them and support them if necessary to go for professional help.

Talk about things on your mind.  We all know this one but don’t all do it.  I’m as bad as anyone at bottling things up but it really helps to have a few trusted friends in your circle who you feel comfortable talking to.  This next bit probably sounds a bit wrong but I think there comes a point where you have talked about some troubling event and continuing to go round in circles talking or thinking about it will make things worse.  There comes a point when you’ve analysed the event, learned from it, when you have to accept that you can’t change it or make it ‘un-happen’ by continuing to ruminate on it.  This is the point where you have to accept that it happened (I’m not saying that the event is acceptable.  It may be totally unacceptable and terrible but the fact is it has happened and you can’t change that, so it helps to accept that it happened).  This can be the difficult bit and where professional help may be needed. Once you’ve accepted it, maybe you can come up with a plan to improve things.  I found this the hard way: I had a particular problem I kept alive for 6 months by constant rumination and trying to analyse it.  Eventually I got so sick of it I just accepted it.  That was a huge weight off for me and I actually started to move on then.

It’s important not to ignore uncomfortable feelings and emotions.  In the past I’ve done this.  I’ve used distraction to take my mind off feelings it would have been better to face.  Thankfully my coping mechanisms weren’t too destructive.  I’ve avoided excessive alcohol and drugs but have watched many hours of mindless TV and read countless novels just to distract myself.  The thing is these feelings don’t just go away.  Experts tell us they hang around just out of sight (repressed), possibly building strength and cause problems from behind the scenes later (unexplained low moods or bursts of emotion at random triggers).  Now when faced with an uncomfortable or painful emotion I make a bit of time for myself and just feel it. It’s ok to cry at this point if you feel like it (I find this hard but they say it’s healthy and can be a relief). I concentrate on nice slow, deep, abdominal breathing and feel the feeling.  I try not to think about it or describe it to myself, just concentrate on feeling it and breathing.  If I find my mind starting to think about it, judge it or describe the feeling I focus once more on my breathing. I find that it passes after a while and doesn’t seem to cause problems later.  Sometimes the feeling may come back again but I just feel it again – it seems to be less intense and unpleasant the second and any subsequent times.  To date this had been successful for me.

This is the time of year when Seasonal Affective Disorder (SAD (isn’t that an appropriate acronym?)) may start to take effect (here in the UK).  It causes the typical symptoms of depression and is associated with the shorter, darker days of autumn (fall) and winter.  The exact cause of SAD is not fully understood but it is thought that reduced exposure to light affects the way part of the brain (hypothalamus) works.  It may cause: over production of melatonin, the hormone which makes you feel sleepy and tired; under production of serotonin, the chemical which provides a feeling of well being.  The lower exposure to light is also thought to affect the natural sleep cycle (circadian rhythm) leading to symptoms of depression.  The self help methods for tackling SAD are quite logical.  Try to make the most of what natural daylight there is.  Spend time outside when you can, couple this with exercise – a nice long walk – and you increase the benefits.  Exercise on its own should help with the symptoms of low mood, even if it’s not outside.  Make sure you have a healthy diet.  Some people find artificial light helps; there are ‘natural light’ bulbs you can get for lamps which are said to help.  You can get special ‘light boxes’ which are very bright lights, I’ve never tried these.

Music always helps me.  Most of the time at home I have the radio on rather than the TV (I’m listening to ‘princess of the night’ by Saxon at the moment).  My taste in music isn’t to everyone’s taste but it really helps me.  I have various playlists on my phone of specific, upbeat rock songs guaranteed to help lift me in just about any situation.

To finish, I feel incredibly grateful for my life, I’m very lucky to be healthy, have a wonderful family and partner and feel I’m generally blessed.  My Grandma always told me to ‘count my blessings’ and I think that old advice about focussing on what is going right in your life and being thankful for it really helps to keep positive.

I wish you all health, relaxation, peace of mind and contentment.

Suicide on the canal tow path

SPOILER ALERT:  Some readers may find the content of this post distressing.

 

It was early one spring morning.  Tony and I had been working the night shift, starting at 7pm the previous night.  It was 5 o’clock in the morning and we were looking forward to the end of the shift.  It was starting to become daylight and there was a mist: the sort of morning that usually precedes a pleasant sunny day.  Not that I was planning to see much of the day, I was planning on a nice long sleep today.

We had just finished our break on station and were wondering what our last job of the shift would be.  The phone in the mess room rang right on cue (this was the old days where control rang the mess room and a dispatcher spoke to us.  Now it’s much more impersonal/’efficient’ with a bleeping of our airwaves handsets).  The dispatcher said that she had a report of someone who had hanged himself from a tree on a remote path by the side of a canal.  The call may be a hoax, the caller said he was a cyclist who had run into the hanging body and then ended the call.  When the call taker tried to ring back for more information the number was unavailable. “Could you go and check it out please?”

We set off, Tony driving and me studying the map book trying to work out the most likely bit of the path to check and the best access point for us.  I decided on a car park where a road crossed the canal and the path was accessible.  The roads were still fairly quiet and we were there in good time.  As we pulled up there was a man sitting on a wall smoking a cigarette, his bike propped next to him.  He jumped from the wall and started talking as soon as I opened the ambulance door.

“He’s about half a mile up there. Just hanging from a tree.  I didn’t see him, had my head down.  I bumped into him, nearly fell into canal. It’s horrible.”

He was obviously distressed and I tried my best to be reassuring as I was getting equipment from the back with Tony to deal with a possible resuscitation.  I asked why he had not answered when control rang him back; I said it might have helped him by talking to our call taker as we were on our way.  He said he didn’t have a phone and had to flag down a car with a phone (hard to remember the days when we didn’t all have our own mobile phone).  The car driver had then driven off once the call had been made.

Tony and I gathered the three bags, cardiac monitor and suction equipment we would need if we were going to start resuscitation.  If it came to that, we would then have to figure out how to get the patient back to the ambulance – the tow path we could see was bumpy and narrow – probably too narrow for the stretcher.  However, one thing at a time.  We set off along the tow path.  The mist was quite thick here in the valley by the canal and we couldn’t see very far ahead.  The gear was becoming quite difficult to carry now, along the bumpy path and both Tony and my patience were wearing thin, made worse because we didn’t know how far we had to walk.

It seemed very quiet walking in the early morning mist; it would have been a pleasant walk if it wasn’t for what was waiting for us.  Eventually, slowly out of the mist a figure hanging from a tree materialised as we approached.  It was the most haunting and sad sight I’ve ever seen, still can clearly see it in my mind after all this time.  We found a male, in his forties or fifties hanging by a rope from a branch of a tree.  It was obvious on examination that we could do nothing for him – he was beyond resuscitation.  Once we had made that decision our priority is to shield the patient from public view as much as practical to preserve his dignity and to preserve the scene as much as possible.  Until proven otherwise we assume that this is a crime scene and it is important that crime scene investigators can gather all the available evidence with as little contamination by us as possible. We updated control and confirmed the patient was dead and we needed the police to attend as soon as possible.  People were walking past occasionally, we did our best to reassure and move them along, we couldn’t do much to shield the patient from view he was right next to the path.  About five went past before the police managed to seal that section of footpath.  Eventually a police officer arrived and we updated him as he quietly took in the grim view.

A small patch of grass had been trampled flat near the foot of the tree and a collection of cigarette ends was scattered around along with a few empty beer cans.  I couldn’t help wondering if the man had sat there smoking and drinking as he contemplated his life.  In my vivid imagination I could picture him there.  My heart went out to how dejected and desperate he must have felt.  Did he come there with the rope intending to end his life or was he just trying to walk off his depression and the rope was already there?  An innocent children’s swing which he had decided to use to end his life on a desperate impulse?

When the officer had spoken on the radio with his sergeant we were released from scene after giving him our details.  In cases like this crime scene officers would need to see the scene before the patient was moved to ensure there were no signs of foul play; the ambulance service would not be needed to move the patient, the local undertakers would do the job when the police had finished investigating.

I never heard any more about our patient, never got to find out his circumstances.  As I write this it is Mental Health Day.  I wonder if our patient was getting any support or help with his mental health? How long had things been building up for him? Had he tried to reach out and talk? Had he asked for help? Was there anyone in his life he could talk to?

I sincerely hope that eventually the stigma attached to mental health will be lifted and patients like this one will get help and support to help prevent such a lonely, desperate end to a life.

My blogging journey so far.

I’ve been blogging now for 5 months.  Here is a short blog with some thoughts about my experience so far.  There are no ambulance anecdotes in this one.

The first point is that I love the process of writing. For years I have been a fan of keeping a journal.  I agree with the experts that writing things down is a great way to get things straight in your mind and help you get things in perspective. I even love daily to-do lists – I find these a good way of de-cluttering my mind and ensuring I don’t forget things.  I love the feeling when a new idea pops into my mind for a blog article – I generally do a mind-map type sketch to get down the points I want to include and get a rough idea of the order to get them in.  Then I sit down to write – often the blog takes off in its own direction and doesn’t follow the plan.  I did wonder at first if I would dry up and run out of ideas to write about, hopefully that won’t happen.

At first I was very nervous when it came to pushing the publish button.  What if people hated what I wrote or thought it was boring? Worse still, what if nobody read it?  Thankfully I have found that the WordPress community seem very friendly and supportive.

I love the stats function on WordPress.  The day I publish a blog and a couple of days after I love to see that it has been viewed.  It’s fascinating to see that people have viewed my writing from faraway places around the world.  The ‘likes’ and comments are also very exciting to receive.

It’s very interesting to read other people’s blogs – I’m getting a great insight into lots of different subjects.  Mental health is a particular interest of mine, the open and honest accounts written by WordPress bloggers are very brave and insightful.  In my daily practice as a paramedic these insights help me to help my patients more effectively and also be a better mental health advocate for my colleagues.

I write with the pen name (should that be keyboard name in this digital age?) of RustySiren, Rusty for short.  A few but not many people know who I am.  This may come across as a bit cowardly and maybe it is but there are several reasons I decided to do it this way:

  • If I wrote with my real name it would be obvious to my colleagues who some of the colleagues mentioned in some of my anecdotes are and I want to avoid embarrassment for them.
  • My employer has a very strict view on social media and any form of publication. I always maintain patient confidentiality and always talk about patients with compassion and respect but my employer would probably disapprove of some of the anecdotes being made public and would probably want to edit and approve them before publication.
  • Although I respect my colleagues and patients I don’t always respect some of the direction and decisions of my employer and I want to feel free to express my opinions.
  • I am learning to become a mental health advocate for my colleagues (This is the excellent charity enabling me: mind.org.uk/bluelight). I would never ever blog about any colleague who is struggling with mental health but would not want to compromise my ability to help by a workmate by them fearing that they may be the subject of my blogs.
  • I find it easier to express my feelings by using a keyboard name (okay, this one is a bit cowardly I know but I’m still working on being able to talk freely about feelings). This includes me being able to talk about the job which caused me to become depressed and my journey out of depression (that job is described here – if I can get the link to work).

 

 

Lastly, did I mention that I love to write?