I'm sorry you were unable to attend your appointment.

I've been doing well for the last month, especially on the anxiety front. In fact so well that I've been pondering a post about what has been working for me (not because I think it should work for you, more of an experience report.)

This morning I had a really good run and that made me feel good.

Just now the post came and there's a letter from my mental health nurse...

"I'm sorry you were unable to attend your appointment on Wednesday at 1pm... I would like to arrange a further appointment on ..."

I just forgot the appointment. And that's because I never put it in my online calendar (why is it called a calendar online but a diary on paper?) And because I thought I had put it in my calendar I didn't check the appointment card she gave me.

This makes me upset and anxious.  Upset with myself for my mistake - most especially because over the last week I thought "that appointment must be coming up sometime, I wonder why it's not showing up in the coming days in my calendar."

And anxious because I'm worried about what she'll think of me (though intellectually I know she'll understand) and also because I'm away at the suggested new appointment which means I have to make a new appointment which tends to be very hard at this particular establishment - so a minor anxiety producing thing in its own terms.

This isn't a big deal. I'll be fine. But it's a friendly reminder that when I'm doing well, the .... sorry can't quite think of the right cliche but I'm sure you can think of one.

I won’t be coming out tonight

This is another guest post from Dorothy Donald. 

I won’t be coming out tonight

I’m sorry for the late notice. It’s not that I don’t want to see you – I just don’t want to see anyone at the moment. My anxiety keeps waking me up at 3am telling me to kill myself and then not letting me go back to sleep, so I’m tired. It’s hard for me to string one thought to the next at the moment because of the fog in my head, so my conversation isn’t up to much. And being around other people just gets me thinking about how normal and OK I don’t feel. I want to go home. I’ll probably lie on my bed and just stare at the wall for a while and feel too heavy to get up. You see, I’ve been struggling with depression recently. No, don’t worry: I’m feeling sad today, which is actually a very encouraging improvement on how things have been over the past few weeks. No, there’s nothing you can do – except maybe understand that I’m not well. No, I’m not up to going to the pub. I am very unlikely to feel better once I get there. Today is just a bad day. Thank you for asking me though. Maybe next time.

(A lie is easier.)

Why is Dorothy Donald like a household appliance? (Or, Session Five)

This is another guest post from Dorothy Donald. 

There’s that awful old joke, isn’t there? Well, there are thousands. But I mean the one about the television repair guy (it’s always a man, never a woman; that seems to be the way it is in Old-Joke World).

You know the one: He arrives at the house, studies the broken TV for a bit, then produces a hammer from his bag and whacks the TV on its side. It immediately starts working again and he swiftly presents a bill for £200.

“Two hundred pounds?” says the TV’s owner. “All you did was hit it with a hammer!”

So he hands over an itemised bill: ‘Hitting machine with hammer: £5. Knowing exactly where to hit it: £195.’

Anyway, that’s exactly what came to my mind when I was sitting with Neil* today, tying myself in knots over whether I had a good enough reason to feel the way I feel about someone and Neil – who I can’t help but notice I’m paying £60 an hour – said “Are you maybe overthinking this, Dorothy?”

And instantly the picture was clear.

I had to laugh.

(I’ve gone out of sequence a bit with the sessions because I’m just writing stuff as it comes to me, when I have time. But today was Session Five and it looked a lot more like I thought CBT was going to look than the sessions before. There was talk of specific behaviours and what makes things worse and what makes thing better and writing stuff down in a fairly formulaic way that I recognised from books and so on. But it all clearly built on the groundwork we did in sessions 1-4. And it didn’t matter that I couldn’t remember any of Session Three, because Neil had notes. He read some of them back to me in Session Four. More on that later maybe.)


* Not my therapist’s real name. But it’s too clunky to write about our sessions when he doesn’t have a name at all.

Please listen to the following safety announcement.

This is another guest post from Dorothy Donald. 

A long time ago, I was reliably informed (by someone we’ll call ‘A’) that depression is a ‘selfish’ disease because it makes you focus on everything that’s wrong with yourself and strips you of your ability to care for others. Given that I was depressed at the time and had been talking about it with ‘A’, I took this as a commentary on my behaviour and resolved not to bother ‘A’ with my depression any more. In fact, I resolved not to bother anyone with it. (No, I’m not blaming ‘A’.)

Having had some time to think about this, I’m not sure depression is any more uniquely ‘selfish’ than any other disease that saps your energy, slows your thoughts and actions, and generally screws you up. I realise that I am leaning on other people more than they lean on me these days, but I might be doing that if I were ‘physically’ sick too.

Someone else – we’ll call them ‘B’ – asked me: “What do you always hear when they’re doing the safety announcements on a plane – the bit about what to do with your oxygen mask in an emergency?”

The answer was easy: “Secure your own mask before you help anyone else.”

“And why is that?”

The answer was easy again: “Because you’re no good to anyone if you’ve passed out from lack of oxygen.”

And just like that, ‘B’ alleviated my guilt about being depressed. Not completely (good heavens, no!) and not permanently (I revisit this analogy again, and again, and again…) but enough to make a difference. Unlike pretty much everything else that people were saying to me about depression at the time, this struck a chord with me: If you are gasping for air, give yourself some oxygen. Before anything else. That’s what you’re supposed to do.

Session Three

This is another guest post from Dorothy Donald. 

I’ll be honest with you: I barely recall session three. I was in a bad way. I think it helped though.

Session Two

This is another guest post from Dorothy Donald. 

We have a brief chat about what’s happened since the last session (a lot), how I’ve been doing lately (mixed), and what I hope to gain from therapy (I crack and tell him I just want to be more productive at work).

We sketch out a day in the life of Ideal Dorothy : When I’m on top form, at my best, what does my day look like? What do I want my day to look like? This isn’t very hard to fill out. The surprise comes when he asks me to rate, on a scale of one (achieving nothing at all) to ten (an Ideal Dorothy Day), where I am at the moment… and I’m not at zero. Or even three. I’m up around six or seven already. 

But what have you published lately? It’s all very well this warm fuzzy stuff about how you’re doing your best but where are you actually going to be in five years? Do you think you’re going to have any kind of career at this rate? Why aren’t you more like –

I am not doing badly. I could be doing more, but I’m working on that and it’s important to acknowledge the fact that I’ve been operating under a pretty heavy burden.

There are people who have it so much worse than you, you know. You don’t know anything about real hardship. You just crumple every time anything’s the slightest bit difficult. You’ll never –  

There are things that are working for me already, like breaking the day up into chunks that aren’t too big. Once I get going I tend to be ok – it’s the getting started that is challenging. We talk about some strategies that could help with that.

Sixty pounds an hour on making a list of nice things to say to yourself. You’re pathetic. Where is this going to get you in – 

We talk about the fact that the depressed mind is by its nature very critical. We talk about the fact that it’s hard to think about the long-term future when you’re depressed, but that I’m not bad at sketching out the next hour or two and there’s a lot that can be done that way.

Speaking of which, this hour is up and it’s time to go home. I take the scenic route – not entirely intentionally, I’ll admit, but it’s a beautiful evening.

#growingupmentallyill

There is a new hashtag on Twitter worth reading: #growingupmentallyill