Mental Health

 This is a different topic isn't it? You know, I wanted to show some diversity.. albeit another heavy, hard-hitting topic. Never shy away from the big conversations, they're just as important.

Anyway, as I mentioned above this is slightly different from what I'd chatted about here thus far and I wanted to talk about it from my perspective as I've grown up and dealt with it as an adult. It's such a broad topic, mental health can be.. avoiding that toxic person who makes you feel bad on a night out to out-right mental health problems such as bipolar (just an example). 

My perspective on this is quite hard because, if you hadn't guessed already I have Aspergers (or ASD as it's called these days, more on this later) and ADHD. Autism, at my level of "functioning" means amongst many other things I struggle to see things from other people's perspective. My experience of mental health for me, has been very poor:- and looking back into my past I can see I've had consistent problems for many years - I'd say as long as 20. 

I have, from just joining dots and discussing with people over the years that the majority of people are pretty stable for the most part. They don't have significant mood swings or sleep disturbances, anxiety, depression, panic, commit social faux pas on a regular basis. At least not on a regular basis, perhaps around significant life events or stressful times at work or at home. 

I can't imagine a life like this. Think, I have known nothing but mental health problems since becoming a very young adult - I might not have realised it at the time, but that's because I couldn't express what I was feeling appropriately, or I just didn't know that life was or could be any different. I'd no perspective on it so I wasn't really able to know what was, or wasn't right or normal!

This.. is a problem, as of writing right now I know of an eating disorder I had, depression, anxiety, sleep problems and issues with self confidence. These go back years in swings of ups and downs, sometimes significant enough to have really put me in a bad place and been quite miserable.. times like this I've cut myself off socially from the world and I'm usually eating or working myself into a black hole. But the key part to take away from this is that it has been a constant roller-coaster, rolling from one thing to the next with ups and downs that never end.

This is exhausting, but it is quite hard to know what to do about it. Do I just accept that I am someone who will always have a fragile sense of mental health, or try and seek treatment for what symptoms I can identify? (remember, I have no frame of reference - It's hard to know what problems I have, because I can't distinguish between what's normal and what's not.) I was pushing hard earlier on this year to get some treatment for my eating disorder, which meant I got an assessment with a psychologist (hurrah - but still lucky, private medical cover.. but it's a bit like swiss cheese in coverage) who referred me for some proper talking therapy, CAT therapy. 

I've had CBT in the past and was wary, as the NHS has fobbed me off with it and I've been left to it - for someone with systemic and chronic mental health problems and no ability to provide perspective, this is useless.. and NHS coverage for mental health is very basic, if you can get access to it. So needless to say I was very excited to start a course of treatment with someone who wanted to spend time unpacking my thought processes and identifying problematic behaviours or feelings. It's honestly been the best mental health care I've had in my entire adult life, and I said that to her - because we have lots of time, and it's much more investigatory. 

But, all good things must come to an end. One of the things the psychologist's report suggested, was that I was assessed for ADHD separately (also not covered by my medical insurance) as I'd not had a formal diagnosis. Luckily, my local authority referred me through our local CCG to a clinic working in partnership with the GP for treating ADHD patients. I got a formal diagnosis after chasing a bit and started a course of treatment (the pre-amble is important here bear with me) to begin with, the meds were just absolutely life-changing - the chaos in my head was gone, the noise was "quieter", I could focus, my mood didn't swing from left to right all the time. Absolute bliss, I did some of my best work during this time at work because I could just zoom in and focus on a dime. 

But, I started having some problems - the affects wore down and I was having a proper "wobble" when the tablets wore off, feeling like I was having an existential crisis for a few hours, out of body experiences, panic, the lot. Now I tried to get a medication review to try something else (there are a few different medications for it) but I was rebuffed and told to wait a bit longer, which I did and things haven't improved.. now, for whatever reason, the clinic is no longer working with the CCG and I'm left with a medication that helps, but is causing other problems. I'm going to have to wait, until another provision is sorted (how long that will be I don't know) or go private to get my medication changed - this is not good. You can't imagine the calm and stability they gave me, the chaos is back.

Anyway, now I have an ADHD diagnosis along side my Autism: these are basically the two exclusions on my mental health cover. Anything relating to them, not covered. If they can link anything back to them (which in earnest, they almost certainly all are) no coverage. I've still got my CAT therapy, which they've authorised another 28 sessions for (I've had over 60 in total by the end of the treatment!) but I doubt I'll get anything else out of them again. 

The NHS are a dead end and don't or can't help, I don't know what my problems are to some extent - I needed someone to investigate them THEN support me. So I've had little/no support from them over the years other than throwing some anxiety and or depression medication from them and that's it.

So where does this leave me? Well.. pretty screwed. I'm hoping I can get another re-visit with a psychologist on my ADHD medication soon, as I think that's the crux of my problems as an adult. But when will that be? Insurance won't cover it, last quote I had for a diagnosis was £550 and lord knows if that includes follow up appointments and medication reviews (I don't immediately have that kind of money now) but I'm fairly sure when that's sorted life will stabilise quite a bit. 

If I have any mental health issues basically ever, if any of it can be linked back to my "developmental disorders" (I do not agree with this term) I won't get any coverage. Another dead end. 

Just a point, for tidiness what I mentioned earlier about Autism and Aspergers. Autism is a spectrum and you have low through to high functioning people on it. Low functioning meaning they struggle to do basic life tasks, physically and or mentally. High-functioning impairs things like social cognition and understanding of complex or even simple analogies etc. In terms of someone's experience(s) with Autism there is a big divide between the two, people can be anywhere in-between or at each end of the spectrum and can be visibly very different from one end to the other. Aspergers, which is a term that was coined by a Nazi doctor called Hans Asperger (yeah I know, it's the reason why the diagnosis has disappeared in recent years.. well one of) as a specific set of issues and traits inside of the Autistic Spectrum, they are high functioning with social impairments, lack of empathy or ability to understand perspective among many others. This diagnosis has "died" and doesn't exist, there is only "ASD" (Autistic Spectrum Disorder) which is very general. I think this is in part because of it's ties to the late doctor. 

But, It's a bit hard to let go of the label Aspergers. Not because I accept or appreciate any links to the doctor, but that it is a very clearly defined set of traits from someone on the spectrum and feels specific enough to be something all of it's own (but still part of ASD) so it has always become a bit hard for me to let go of it, ASD is too broad for me to directly identify with unfortunately. 

So, coming back to our previous theme:- I've wondered as of late, will I always have mental health problems? Will life always be this roller coaster of ups and downs, imposter syndrome, sleep deprivation, tiredness, angst, exhaustion and mood swings? Maybe. I can't tell, but I can see by looking at my past that there has always been something causing me problems.

I've always had something causing me stress, or mental health problems. I hold out hope that I will one day have a few weeks or months of stability without too much stress. I can't imagine it right now because I've almost certainly never had that. I'm not a suicidal person, but it is a bit daunting thinking that I will live the rest of my life feeling off or having problems with something - not matter how "good" life is on the surface to an outsider.

I want to say one final thing, I'm not talking about work here but I am very fortunate with job that it enables me to do a lot of things others may not be able to. If I need to pay for an ADHD assessment, I can find money for this to ensure I have some stability and I deeply appreciate this is a privilege others would not otherwise have access to, let alone the other safety blanket of private medical insurance. So I don't want you to think I am asking for sympathy, I just despair at looking to the future of constant battles with my mental health and then another battle getting any treatment for it, let alone suitable or appropriate treatment for it.

I'm holding out hope a change of meds and finishing my course of CAT therapy will help. I'm not sure I like the idea of a future on and off anti-depressants and banging on GP's door for some kind of help, about issues I don't understand or are able to give a frame of reference. 

Wish me luck, the chaos in my head as of late is deafening. I need a break.