Homeless for Christmas

I can’t think of many things worse than being homeless and forced to live on the streets but it must be especially bad at Christmas.  When most of us are putting up trees and stringing up the lights in our lovely warm rooms many people are huddling into doorways trying to shelter from the rain and the cold.

Over the years in the course of my job I have spoken to a wide range of the homeless.  Being naturally curious (some say nosy) as well as providing the medical help required, I always like to know ‘how’ and ‘why’?  ‘How’ they have come to be living on the street and ‘why’ they are living like this.  The answers given are as individual as the people giving them.

Some are escaping from an abusive home and have slipped through the safety nets provided by social services.  Some have fallen on hard times and have been evicted from a previous home without the means to find an alternative.

In some of the areas I know that there have been emergency overnight shelters available but still a large number choose instead to stay on the streets.  Why?  One young lad told me that bullying was rife in these shelters – he went to one and was threatened with violence if he didn’t give up what little he had to the ‘gang’ which seemed to control that particular place.  When I asked about staff there he said that they just weren’t interested and left the residents to ‘sort it out themselves’.  He felt safer out on the street.  Another, slightly older person said he was banned from the shelter for smuggling alcohol and crack cocaine in for his own use.  His need to feed his addiction was greater than his need for shelter.  I can see both sides to this dilemma, it’s quite right that the people running the hostels want them to be clean and safe but I can also see that realistically an addict cannot give up his addiction just like that.  It’s easy to judge and say that he should just give up the alcohol and crack cocaine but addictions are serious physical and mental conditions which take time, will power and professional help to overcome.  And once overcome, continued support and a removal from previous lifestyle and influences is required to prevent remission.

Drug use is said to be widespread among the homeless.  Advice given by the council of my city is that we should not give spare change to individual homeless people as this will be used for drugs and alcohol, we are encouraged instead to support the established charities set up to help the homeless.  This seems a bit judgemental and ‘big brother’ to me.  Sure, some will probably use the cash to buy the next fix – but maybe that’s better than mugging and stealing the cash.  I’m not in any way condoning drug use.  I’ve seen firsthand the devastating and tragic effects of recreational drugs, I’m just being realistic.  Before we judge too harshly it’s worth asking my favourite question: why?  Why are so many using drugs?  For some it starts with a wish to experience an altered state of mind, some it’s peer pressure, some to mask or escape from the reality of their lives, including PTSD from abuse or horrific military experiences.  Once the addiction kicks in obviously it’s a desperate need to feed the addiction and stave off the withdrawal symptoms.

So what’s the answer?  How do we fix things and get all the homeless into some sort of safe shelter?

In my oversimplified mind I think there are two problems to tackle:

Firstly we need to deal with the people homeless now.  We need a range of accommodation options.  Different individuals have different needs and we need a varied range of support including drug, alcohol and mental health support and all backed up with a firm, safe yet understanding regime.

Secondly we need to prevent the next generation of the homeless.  I firmly believe that we should educate our young in how to handle life.  Give them realistic and healthy coping mechanisms for the disappointments and heartaches in life and try to steer them away from the destructive ones.  Invest in community mental health services so when things go wrong support is there from the beginning to hopefully prevent the spiral downwards in mental health which can ultimately end up on the streets.

So what can every one of us do today to help?

One positive thing is to acknowledge the homeless people you see.  Make eye contact and say hi.  If you don’t feel comfortable giving change, still make contact and if necessary say you’re not giving money today but hope that things will work out for them.  Most will appreciate being acknowledged and treated as human – it may even save a life!  One homeless girl I once spoke to said one day she had made up her mind to end her life as all she could see was despair and no future.  A smile and simple human contact from a kind woman passing by changed her mind and made her decide to stay around a bit longer.

I hope you all have a wonderful, peaceful Christmas and feel comfortable, warm and loved.

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.

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?

Letter to younger me

This is a different type of blog to the ones I usually do.  No anecdotes from the back of the ambulance.  It is a letter back in time to my younger self.  When I was younger I used to worry a lot, about everything.  A random event could set my mind racing and dwelling on all manner of future disasters.  I found a way to calm my mind by writing a journal.  Today I found an old journal and flicked through a few pages.  This letter is to the younger me who wrote that journal.

Dear younger me,

There’s no need to worry.  Every single thing you worried about worked out ok.  Either it didn’t happen at all or it did happen yet it wasn’t half as bad as you thought and you managed to cope.  In fact, some of the disasters you worried about turned out to be the best thing that could have happened.

We spent and still spend lots of time with family, and we didn’t drift apart like you worried, in fact we just get closer.  When you’re with family, in fact whatever you are doing, really focus and concentrate on what’s happening; this is how to make lots of great memories.  Some of the simplest things are the best memories.   Time has really flown and now the kids are adults. We had such a great time as they were growing and now they’re adults we are still having a great time making lots of memories.

Don’t fear being alone.  At various times I’ve been alone and nothing bad happened.  In fact I’ve learned to love time on my own.  I love the time to read, relax and be creative; I find it calming and peaceful.  Now I’m with someone it’s because I truly want to be with them and I’m not with them just because of fear of being alone.

Trust your instincts. Every choice you agonised about and just went with your instinct turned out to be the right choice.  That instinct of yours is pretty well tuned – I trust it now.

The bad times pass.  Always.  Some of the stuff you faced is painful, no denying it.  When you have done everything possible to remove the painful thing but it’s still there, well, these are the things you just have to accept.  The pain is real and can be intense.  Resisting and wishing that the pain isn’t there or that things were different or feeling resentful makes the pain feel worse. Just accept it, keep breathing and trust me, it passes.  It passes more quickly when you accept it and don’t try to resist it.  I would say don’t be afraid to let it out and cry but I still can’t do that.  I would also say talk more to the people who care for you about things on your mind but I still find that hard too, I’m working on that at the moment.

Don’t be afraid to ask for help handling things in the bad times.  You’ve handled things fine on your own and got through but it may have been easier with help and opening up about things.  I’m still working on that one too here and now!

Maybe I’ll get a letter from an older me and he’ll say I/we/you’ve finally managed it.

That’s about all I’ve got to say for now.  Things are good here and now, very good.  Stop worrying!

With love…

Mental well being

Hello.  It’s a lovely, sunny, Friday morning – just before a bank holiday weekend.  The sort of day that has us all feeling great, full of energy and excited and glad to be alive.  Right?

Unfortunately for many people, even a lovely Friday morning does not bring with it feelings of well being.  The Rusty Siren Statistics Department has researched a few unsettling facts and figures:

7.8% of the UK population satisfy the criteria for diagnosis of depression and/or anxiety.  That’s approximately 468,000,066 people in the UK who won’t be enjoying this lovely exhilarating Friday feeling.

In 2015 (most recent stats I could find) in the UK, 6188 people took the irreversible step of death by suicide.

Specifically to the UK Ambulance service, 91% of staff has admitted to experiencing stress and low mood.  91% of us. That’s such a high number it surprised me so I had to say it twice,   and that is just the ones who admit to it, the true percentage is probably even higher.

The effects fan out through the population, every ‘statistic’ above is a person.  People have families, friends and people who love and care about them (I hope!).  Obviously all these people also will experience a lowering of mood and increase of anxiety as they see the ones they love suffering.

What’s the answer?   There’s no simple, straightforward answer, I wish there was.

If you or someone you know is thinking about suicide then immediately go to your local hospital Emergency Department for an emergency assessment by the mental health team.

If depressed or anxious but not thinking of suicide then get an appointment with your GP as soon as possible to discuss a plan.  Meanwhile find the people you can trust and have a good talk with them about what is bothering you.  If you find it hard to talk to people (I know what that’s like, I find it nearly impossible!) then a good first step is to write it all down in a private journal.  Writing it down is an excellent way of clearing your mind and sorting your feelings out, then if you still find it hard to talk to your trusted friend you could start by getting them to read what you’ve written to start the conversation.

In an ideal world, once you’ve seen your GP you will be on a tailored plan to help you deal with your feelings and find a way to process them to get you back to a state where you can enjoy life and function once more.  Unfortunately we’re not there yet so it may be necessary to take steps yourself to get help.  Lots of resources are available on-line, two good sites to start off with are:

www.mind.org.uk

www.samaritans.org

Specifically for emergency service workers:

www.mind.org.uk/bluelight

These sites and the resources they link to suggest ways to improve mental well being and provide mental well being tips.

The most important thing is to be able to talk about mental health, and to finally obliterate the residual stigma associated with mental health.  Mental health problems are NOT A SIGN OF WEAKNESS!  The help is available we must all be willing to ask for it when we need it.

I wish you all a happy and safe weekend.

 

All in the mind????

 

Quite a common job to respond to is ‘suicidal person’ or ‘person threatening suicide’.  What these jobs boil down to is a person who is struggling to cope with their life and have reached a point where the pain is so bad they need to escape it.  The situation can be anything.  To a person not involved in that person’s life may not seem that serious or it may be so bad it leaves you thinking ‘how the hell have they survived so long’.

Our training as ambulance people in mental health is limited and the only options we have to help them is either take to a local hospital Emergency Department for review by the mental health team or in some cases, in some areas we can refer directly to mental health teams.

Often the ambulance person can feel a little awkward, displays of raw emotion by a stranger are a little daunting and a lot of us feel embarrassed and unsure how to respond.  I’m always scared of saying the wrong thing and making an uncomfortable situation even worse.  It may be that I’m a middle aged male, brought up in the 60s and macho 70s but I definitely feel awkward.  I’m glad that times seem a little more enlightened now and high profile celebrities, even the younger members of the royal family have made it ok to be emotional and talk about negative feelings.

It seems to me that one thing that all these people have in common is that their minds are trapped in a negative loop or set of thoughts.  Mine used to be very negative; I’d often be set off down a negative, bitter chain of thought and would get really down and anxious.  Then the anxiety and low mood would feed the thoughts and a vicious circle was set up.  I’ve been through normal, modern life experiences, divorce, young children and death of loved ones.  I’ve never been for formal counselling, I think with hindsight I should have, it may have speeded up the journey to where I am now, relaxed, grateful and content with life.

Instead of professional counselling I have spent a lot of time reading and researching the self help field.  The things which have helped me most are:  Cognitive Behavioural Therapy (CBT).  The main things I’ve got from this are that the thoughts you are thinking may not necessarily be true or accurate.  I have got myself into the habit of questioning my own thoughts if I find them negative.  Mindfullness.  This is something I am very much still getting to grips with.  Observing my thoughts as they occur and not getting bogged down with them.  I practice staying in the present moment as much as possible.  The past is gone now and can’t be changed.  Mistakes can be learned from but best not dwelt on.  The future can be planned for but the only place we can do things is now.  Here.  I find I can always cope with what is happening now; I only get overwhelmed or stressed if I try to think too much about what will happen in the future.  Gratitude.  There’s a horrible phrase: ‘attitude of gratitude’ which sounds awful but does make a lot of sense.  I find it helps me by regularly thinking about things I’m grateful for, it helps me put things in perspective and actually spending time thinking about things and people I love really puts me in a happy mood.  Exercise. The benefits of exercise are well established in the field of mental health and it really works for me.  I’m not a fan of gyms; I love to get my exercise in the fresh air.  As well as the benefits of endorphin release with exercise I find that walking or running also has an extra benefit, the rhythmic slap of my feet on the floor is soothing and slows my mind down.  Fun with Friends.  Another no brainer.  Making time to have fun with a few good friends really has got me through some hard times in life and is something I thoroughly recommend.

Being told to ‘cheer up’, ‘get a grip’ and ‘it’s all in your mind’ definitely do not help!

Back to our patient who is feeling suicidal.  All I can do for him/her is talk to them and encourage them to accept the help that is on offer.  This can take a long time as quite often the last thing the patient wants is to sit for ages in a busy emergency department.   I find it frustrating at how limited my own personal scope is to help them, for these jobs I’m just a friendly taxi driver.