Something to talk about…

Time to talk day has just be crept across my timeline. I’m hoping it’s a testament to how attitudes have changed towards what is needed in the mental health sphere that I’m only being alerted to it at 9.30pm. Despite my cynicism I clicked and perused the website.

Sadly, it’s the same old story. Like most other mainstream advocacy for mental illness, Time to talk fails in tackling the real barriers people with mental illness face. Of course it is important to dispel stigma around mental health problems. It is also great to encourage people to support friends, colleagues etc. The tips on how to approach such conversations are fairly helpful. My issue with this model is that I don’t believe it acknowledges the depth & breath of the problem. In fact, I would go further in saying that the offering a listening ear platitudes can even diminish the experience of many with mental illness.

I’m 43yrs old and I have managed various levels of mental Illness almost entire and life. In all of that time the NHS has been under resourced in the mental health sector. As the years have gone by funding has been slashed and the problem has grown. We have been at crisis status for a very long time. There has been an uptake in mental health awareness. Campaign after campaign successfully identified warning signs and urged us to seek help. Unfortunately, the help requested is most often not forthcoming.

At the moment just getting a Gp appointment can be an enormous struggle. From there referral to primary mental health services always results in landing in a very long waiting list. If you can survive that wait, the treatment available can be limited. The first line is usually a limited course of CBT (cognitive behavioural therapy). CBT can of course be effective for some issues. It is not an answer for more complex mental illness. Alongside CBT there are a variety of helplines and websites, which can offer valuable information, but do not constitute treatment. There are of course psychiatric medications. These can be life saving and do improve the lives of millions. However, they are not magic, most often they must be used in conjunction with other therapies.

A referral beyond the intial interventions already mentioned is difficult to obtain. Infuriatingly, not everyone merits a place on their waiting lists. Those who do make it are in for another privilege wait. The quality, duration & efficacy of what is available at the end of that line is unknown. There are excellent professionals, treatments & resources, but they are stretched beyond thin. There simply aren’t beds, funding or staffing to provide the appropriate treatment & support for everyone who needs it. The result is, most people are shirt changed. Problems that could be caught early are allowed to progress. Serious problems become emergencies. In short, our population suffers more mental illness and become trapped in illness for longer. Some, forever.

Beyond the personal tragedy, the social and economic toll this takes is clear. People become unable to work, care for their families, participate in their communities, they then are laden with whole new set of problems. This of course negatively impacts their mental health and round they go. More people end up in crisis with no where to turn but emergency services, which are not equipped to render proper treatment. Again worsening the situation of the individual and eroding resources available overall. Apply this cycle across the board and it becomes obvious how vicious it is. It is an enormous widespread problem that can not be solved without massive funding, recruitment and a re evaluation of government policy.

Atop those failings is the fundamental shortcomings of the message itself. Breaking down stigma is vital. However, I think the focus of these campaigns, asking how people are feeling, actually is listening to the answer and so on, don’t go nearly far enough. It gives the impression that all mental illness can be easily solved. The adverts and literature are always about depression or anxiety. They show the palatable side of these conditions; someone who has a difficult period and with a little help from their friends gets better. Images of people crying or holding their head in their hands distort the reality of living with such conditions. When someone can’t get out of bed or in the shower for days on end, when they can’t function or find relief despite those caring chats it’s a shock. A check in with the Gp & some anti depressants won’t cure everything. Mental illness encompasses a myriad of conditions. Symptoms can be extraordinarily distressing and debilitating. Some are enduring illnesses that require complex and specialised treatment. Conditions like schizophrenia, Ptsd or Bpd are rarely discussed. Instead they’re sensationalised & misrepresented in the media. Perpetuating dangerous ideas about those living with certain conditions. The fear and shame have not been dispelled. We’ve merely carved out a tiny category of ‘acceptable’ mental illness.

The recovery narrative presented in mainstream mental health advocacy is too simple. Not everyone gets better. Lots of people instead learn to manage their mental illness. Others have recurring episodes. They are still smart, loving, valuable human beings. When all society is presented with is neat stories of struggle, seek help, return to health forever expectations are unrealistic . Those who don’t follow that template become doubted. Compassion turns to thinking they’re not trying hard enough or maybe they’re exaggerating. Stigma persists. We need an informed public. Not only on the broader experience of mental illness, but on ways to bring about change. People should know why our services are failing. The power of our voices and votes must be understood. We also need education around navigating the systems that exist. Everyone should be aware of how best to advocate for themselves and loved ones. We do need to talk, it’s just a much bigger conversation.

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I’d rather be fat and happy…

About a month ago I made a Tik Tok about wegovy & similar ‘weight loss’ jabs. I had seen a lot of people promoting them, giving advice on how to get them prescribed etc. These positive posts all had notable omissions. I wanted to address the missing information.

I am fully behind bodily autonomy & wouldn’t tell people what to do with their bodies. However, I think it is essential that we have all the information before making medical decisions. It’s impossible to consent to treatment if you aren’t informed of all the risks, side effects and so on.

The current information on medications of this type is that weight loss will be most significant in the first 6months. Loss will peak at 1year and regardless of how long you remain on the drug, you will start to regain after that point. Regaining any weight lost is not only a certainty, it will happen fast. In fact the data shows that the pattern of weight loss & gain is similar to other methods of intentional weight loss. You are likely to regain not only the weight lost, but a little extra on top too.

People who have these injections report many gastric symptoms. Extreme nausea, vomiting & diarrhoea sometimes for weeks or months at a time. For others those side effects never settle. Long term use increases the risk of gallbladder problems & pancreatitis. Both are very painful, the latter can be deadly if not promptly treated. It’s also important to note that these injections have not been licensed for more than 2yrs for use in non diabetics. They have also never been prescribed in such high doses. The truth is there are still many unknowns. What we do know for sure it that these medications have serious risks & promise only short term results.

So, why am I going over all this again? Today I got a notification of a comment on that video. Reading it broke my heart.

I understand that sentiment. I used to feel that way. I’d make jokes about smoking instead of eating; saying as long as I was a thin corpse I didn’t care. I know how painful it is to feel that way. What’s worse is I know that many of the professionals who swore an oath to ‘do no harm’ feel the same way. Fat phobia is so ingrained in the medical profession that Drs recommend harmful meds, diets & surgeries to fat patients. Rushed to market, poorly tested and even known to be ineffective interventions. It matters not, because they’d rather we be sick or even dead than fat.

We deserve better. We should be able to consult our Drs when needed without the dreaded weight loss chat. We are entitled to treatments & procedures without having to first agree to dangerous diets. We are as worthy of respect and compassion as any other patient. And, we can demand it.

There are so many amazing resources to help fat patients deal with medical weight stigma. Two of my favourite fat positive medical folks are Dr Asher Larmie & Dr Joshua Wolrich both have written extensively on the topic. I cannot recommend their work enough.

I also support the anti diet work of :

Gillian Wilson

Vinny Welsby

Fat Women of Colour

Dr Diana Gordon

I too am happy to help if I can. I’m not a medical health professional, but have learned many strategies for dealing with anti fat Drs. I’m always delighted to pass these on.

If Bronan’s belly is cute, so is yours.

If you enjoy my writing you can support me here or on Patreon .

I need a little space…

If this crisis has taught me anything it’s how grateful I am to have a safe & comfortable home to quarantine in. Not everyone is so fortunate. That’s why this month I have chosen to support Refuge.

I’m sure you will have read about the increase in domestic violence incidents since lockdown began. This quarantine is far more than an inconvenience for people living with an abusive partner or parent. The choice of being locked up with someone who harms you or leaving with nothing during a global pandemic is a horrible dilemma. That’s why organisations like Refuge are even more vital at the moment.

Sun shining beneath  dark clouds

Refuge provides a range of services for men, women & children. They offer safe houses, advocacy culturally specific help & a 24hr hotline. These services save lives. I urge to support them if you can.

You can make a one off or monthly donation of your chosen amount. Or you can opt to buy a Refuge Parcel. These fund specific items like hygiene packs, child support, emergency parcel and so on. I opted for a children’s parcel containing items to help a little one settle into a new life. I think it’s a wonderful idea. It makes me feel really happy that I can help make a child’s world a little better.

Refuge logo and helpline