Part 02

We continue our story into Part Two with Michael being discharged from the Priory and returning to his home with his girlfriend, Niamh, in Ipswich in Suffolk. He was now only going one way – up, up, up – and relationships with the rest of the family – Dad, Mum, sister Sophie and brother Adam – could be rebuilt over the coming months.

This second part of the book takes us from March 2013 to May 2015, just a few days after the Ipswich v Norwich Championship Play-Off Semi-Final which the Maitlands watched on television as a family. In the same way that Niamh featured in the pivotal moment at the beginning of the book – the ‘Is it terminal?’ text exchange – so she did again here. Niamh’s phone call to Sophie a few nights after the Play-Off Semi-Final, asking for the phone to be passed to Tracey, caused huge excitement in Iain who rushed in to shout, ‘Is she pregnant!?’ But we get ahead of ourselves…

Michael kept a dairy, on and off, and sometimes just notes, over this time and these reveal what was happening and how he felt over these months and years. As in Part One, entries are broken up to show they were written at different times – days apart this time rather than hours in the Priory, by simply inserting ‘…’ again. The alternating text by Iain documents what was happening to the family alongside Michael’s life. There are also more self-help ideas as we go along.

March 2013

I’m out

I got discharged!

I had been waiting for that meeting for so long. Niamh’s mum came up to sit in and listen as Niamh was at work. The meeting lasted around half an hour and there were quite a few members of staff there, including the big man himself, Dr Webster.

I had a feeling it might finally be time for me to go. He spoke for ages about how bad I was coming in and how likely it had been that I would die. He said he was shocked when he first heard about me and was worried I could die.

After he spoke for a while, he then let me speak – this is the part where I had to try to not say anything weird and make sure I sounded normal. I had to sound sane! I think I must have done a good job, and when it came to him saying he’d decided to discharge me, I cried a little – or possibly quite a lot.

Dr Webster spoke about me seeing Colm once I got home and having check-ups with him. He also asked me lots of things like what my time here was like. I said I hated every minute of it and laughed, and he laughed too. I think he thought I was joking. He also told me again I was in an awful mess when I came in and he was worried I could have died. I think that’s why I ended having to stay a lot longer than I had expected…two weeks!

Niamh’s mum then drove me home because Niamh was still at work. I don’t think I’ve ever felt so free as I did on the drive. I didn’t know what to think. Imagine being locked away for so long, not seeing friends and only very occasionally seeing family, and then getting released. I think being locked up helped me but also drove me a little bit madder as well. I think it would do that to anyone, being in a situation like that. I know it’s changed me. I just need to wait and see what happens from here. It’s going to be good.

When I got home, I unpacked my stuff. The sun was shining outside and I felt happy for the first time in what seemed like years. I was waiting for Niamh to get home from work. She came running through the door and gave me a huge hug and cried. It must have been awful to have been here on her own for so long. I think it must have affected her quite badly too, but she would have not wanted me to know that. We talked for the whole evening and were so excited to finally be able to do stuff again. We went for a walk in Christchurch Park and sat on the grass until it got dark. I then cooked dinner for Niamh – something I don’t think I’ve done in years.

* * *

I think being in the Priory did help me but I think it has its flaws as well. I think I needed it; otherwise, I probably would have died. Also, seeing Richard, who did my CBT sessions, helped a lot. Not because of the practical stuff, more just because we became good friends and he was one of the first people I had talked to in a long time, and not just about mental health stuff.

Being in the Priory is weird because it’s a place designed to help you get better, but, in my view, being shut away behind locked doors, being forced to eat huge amounts of food and then having to deal with being there 24/7 isn’t good for your state of mind.

I did feel at times I was losing it a bit, and at the beginning I did want to make a run for it. I saw it as a game being there. You have to play by the rules, which mainly involves pleasing the staff so they can tick the right boxes. I had to do what they said, be involved and pretend to be normal.

It has changed me. The main thing it made me think is that there’s no way on earth I’m ever going back there. I can’t go through that again. Imagine sitting in your room being scared of your next weigh-in so you force down a whole packet of custard creams in one go. That’s what I think is wrong with the place. Sure, it helps get your weight up, but I think more could be done to help patients’ states of mind.

* * *

I need to try to find a way of adjusting back to normal life again – well, as normal as I can be. It’s nice finding routines again. I find safety in routine and it helps my mind. I want to try to be more spontaneous if I can, though. I don’t want to feel confined. I have to see Colm (my local mentor) for the next few months as he is meant to check up on me and make sure I don’t lose it.

I like having some sort of routine. I like to make sure I get out of the house. At weekends, I’m going to make sure I spend the afternoons doing something outside. I’m going to go for walks in Christchurch Park in the evenings with Niamh. I also like going to the cinema on Sundays with Niamh or my family.

* * *

I see Colm once a week and he comes to my house. He weighs me when he sees me. I see him looking around my house when he comes in and he asks things like what did I do this morning, what are my plans and if I’m going to try to see my friends. We just chat really. He tries to keep it fairly casual, like we are just mates, but I can tell he’s trying to suss out how I’m feeling.

In a way, seeing Colm is hard because, although he’s really very nice, I feel that I know more about mental health than he does, and when he tries to talk to me, I can’t help but feel he is reciting theories from a book. He doesn’t really understand as he’s not been through what I have. That’s the trouble. I feel that I can only connect with people and talk about the way I am if they have experienced mental health issues themselves. If you have not experienced depression, how you can advise someone about it?

In this last diary entry, Michael sounds more confident than he has done for a long time. It’s important to work on your self-confidence, though. It’s not something to take for granted, especially if you have (or have had) issues with self-esteem. Here are some thoughts you might find helpful.

We’ve touched on this before with ‘the list of truths’ but it bears developing a little here. It’s a useful idea to have a list of ‘good things’ in your life. Creating a list can reinforce confidence and, as and when things dip, this list can be referred to. I know people who chalk it up on a board in their house (kitchen or bathroom – somewhere they see it regularly) and look at it from time to time, adding new good things as they go along.

You might, perhaps working with a friend, want to list what’s good about you, the people you have around you, the things you’ve done that make you feel positive or others feel happy, and what things people have done for you that make you feel good about yourself. Make this as long a list as possible.

Perhaps someone has paid you a compliment, saying your work was good, completed on schedule, etc. That should go on your list. You may want to update this list regularly as good things happen and carry it with you so you can look at it now and then. Some people rework this idea and have five to ten ‘good things’ listed on a postcard that they carry with them and look at it from time to time.

If you have people around you who are positive and upbeat and always ‘see the bright side’ of life, they will help you stay positive. If you have gloomy and downbeat friends who are cynical and always see the worst in everything, it’s really hard to avoid that creeping influence. Be with people who’ll say nice things – about you too.

Social media has many upsides, but it is often a cesspit of negative views and emotions, with people making comments and loading photos and videos that they would never reveal face-to-face in a family or friends get-together. If you have mental health concerns, you really need to think carefully about your social media activities and how these affect your well-being.

You may want to rethink who you are spending time with; you may need to make some tough choices here for your own good mental health. You don’t have to stop seeing people completely; just be aware that those who are negative aren’t going to be doing you any favours mental-health-wise. Being with happy people makes it more likely you’ll be happy. Say something nice to them – they’ll probably say something nice back.

When you talk to yourself – as we all do from time to time in our heads (or, as I do, to the dog) – the key is to talk as you would to a loved one, not to someone you don’t like.

Michael’s internal self-dialogue, as we saw in Part One, has been incredibly self-critical at times and so damaging to his mental health. In essence, he beat himself up mentally day after day, hating the way he looked, how he felt and so on. He destroyed his own confidence.

It’s better to try to focus on upbeat thoughts about yourself: ‘hair looks nice today’, ‘my coat suits me’, ‘I completed that job perfectly – well done me’, ‘I did Rajesh (work colleague) a favour and that saved time so he could catch an early train for a weekend away’, etc.

From what we have seen so far, Michael is in a better mental place when he gets the work–life balance right for him. He wanted to be busy-ish, to keep his mind occupied and his thoughts away from darker places, but not so busy and overworked that he became stressed, which impacts on his mental well-being. He, like everyone else, has to get that balance ‘just so’ for him. (The exact ‘just so’ is likely to vary for everyone.)

So, for most people, it’s important to be active (or at least active-ish), working without pushing themselves too hard, enjoying hobbies and perhaps trying new ones, and taking some physical exercise – it costs nothing to walk or jog or run, except a decent pair of shoes or trainers, and skipping, swimming and cycling are often not that expensive. They can make huge differences to your mental health. It’s been said by many experts that 30 minutes of exercise a day is better for you than medication; that’s certainly not to say that you should bin your meds – not at all – but it shows the significance of regular exercise.

You need to be aware of your limitations, though – you don’t have to run or swim to the point of collapse to prove you can do it – and it’s wise to set some boundaries: ‘I’ll swim for 30 minutes and see how I feel.’ It’s also good to be able to say ‘no’ to extra work or overtime if the request is likely to move you from ‘being busy’ to ‘becoming stressed’.

It’s often helpful to have something to aim for – whether it’s like Michael’s desire to get back on his master’s course and enjoy and complete that or something that’s more personal to you. What is it you want to do over the coming weeks, month, year or two?

It does not have to be a ‘BIG’ goal – to write a novel, to run a marathon – and it can be quite simple – to learn a new skill, to visit a place you haven’t been to for ages, to meet new people. It’s good to have something in front of you. At various times in his diary in the Priory, Michael expressed sadness that he had nothing to look forward to; having something ahead of you is a boost.

It’s also worth mentioning ‘small steps’ here. There is an old Chinese saying that goes something like ‘A journey of a thousand miles begins with a single step’. We could add ‘and continues with one single step at a time’. You don’t have to be 100 per cent better today, tomorrow or next week – just a tiny little bit at a time. And do celebrate in some way – even if it’s only buying some cherries or a bag of sweets – when you reach a goal. Michael, at least to this point, struggled to ever treat himself. It’s important that you do.

Talking to parents and young adults with mental health stories to share, I am often offered tips and suggestions by them. Here, in no particular order, just to set you thinking, are some of these ideas that may help you and yours. Remember, with good mental health, there is no one-size-fits-all solution – you have to try different things and see what works for you. Some will work, others won’t. It may be a different mix for someone else.

Take care of your appearance. For some, this is almost a ‘first things first’ tip. They say that to feel better, it helps to look better – so just getting up and washing and wearing clean clothes and brushing hair, simplistic though it all sounds, is a good start. Michael, pre-Priory, spent many days alone in bed, and his mood stayed low and got ever lower. The Priory got their patients up early and got them going. There may be something in that, mental health-wise.

Get to know yourself. Some people with mental health issues talk of an ebb and flow in how they are feeling. They know when they are feeling okay-ish and can tell that a downturn is coming. It’s a good idea to try to monitor your moods so that if you know a down moment is on its way, you can prepare for it. One person I know, anticipating a decline, makes a conscious decision to ‘keep busy’ so that they can work through their low mood more effectively. Others may want to take time out. These approaches work for them but may not be how it works best for you; it’s a personal decision.

Be kind. Many of these self-help tips seem simple and obvious and, even better, they work for those people who suggest them – and yet not everyone follows them. Another tip is simply to be kind, to help, to be nice to people – on the basis that they will reciprocate. One of the issues with mental health is that sufferers often become very inward-looking to the point where they can seem self-obsessed. Combine that with the common desire to hide the mental illness from those around them and it becomes clearer why such simple steps are not followed. But a kindness makes both sides feel better and is often returned. It’s worth a try for sure.

Stand up straight and speak slowly and smile is, like getting up and getting dressed, another ‘first things first’ for some people. It also has echoes of what we mentioned in Part One of the book: act in a certain way and that’s how you (eventually) become. This tip has the added benefit that it conveys self-confidence, which is always a positive. The word ‘smile’ or the phrase ‘keep smiling’ is repeated again and again in these conversations. It was only when I saw Michael smile – really, properly smile – that I realised how long I hadn’t seen him smile and that he was getting better.

April 2013

Niamh and me

Niamh and I are getting along well, probably the best we have in a long time. I’ve known her since I was 18. (We met on a foundation degree course in Art at Suffolk College in Ipswich.) We know each other better than anyone else. We both know what the other is thinking at any time. She is helping me adjust back to life here.

I still feel weird, but free. I want to start drawing again and prepare for going back to finish my master’s. I dropped out during the first year of my two-year Moving Image and Sound course, so I will see some people I met who will now be in the second year. I don’t know if I’ll try to explain where I’ve been. How do you casually drop into conversation that you’ve been in a mental asylum for months on end? Tricky one.

* * *

Niamh’s dad came round for a coffee and I don’t think I’ve seen him properly in over a year. He’s sometimes kind and friendly and others not approachable at all. I still remember the first time I met him at his massive country house. Niamh had an amazing house and was very well-off growing up. Niamh’s dad didn’t stay long; he never does. He’s always dashing off and keeps himself to himself.

WHEN I AM HAPPY I DRAW - I’VE ALWAYS LOVED SKETCHING.

This was a promising time for Michael – from our arm’s length perspective, it looked as though his life had hit rock-bottom in hospital and at the Priory and he was now going to turn it all around; getting healthier and happier, going back to university and maybe finding a part-time job.

His relationship with Niamh seemed strong and per-manent in much the same way as mine and Tracey’s was and is. Forever and ever. Indeed, Michael and Niamh talked of getting married in the coming summer. It did seem, at this moment, that everything was going to come good for him, them – and us (at last).

Of course, even at this point in Michael’s story, we did not have a great knowledge and understanding of mental health, assuming that it could be ‘fixed’ and that would be the end of it. How little we knew! The reality is that, for most people, it is part of their ongoing lives for a good while, if not longer. No matter (so we would have thought then) – it could, at the very worst, at least be managed successfully.

Hard to believe that Michael’s last diary entry was written by the same person who only a few months before was having close-to-suicidal thoughts. The key now for Michael, as it is for many who have come back from mental ill-health, is to stay positive. Here are some more suggestions. Again, pick and choose those that seem best suited to you.

Some people find it helps to look at themselves in the mirror first thing in the morning and say something like ‘Today’s going to be awesome’. You can do the same in your head; it works for many. Having a positive start to the day – maybe a shower/breakfast/catch-up-on-the-news routine that suits you – is important too.

Instead of focusing on negatives, it’s far better to watch out for anything good that happens to you during the day – the sun was shining, a neighbour took in a parcel for you, someone moved out of your way when walking to work, someone else smiled at you, and so on.

We don’t want to talk about negatives too much here as this is a happy part of the book, but as you look for good things, try to turn any negatives into positives too. Stuck in traffic? Listen to an extra track or two on that CD you have in the car.

Listening to happy, cheerful music can affect your mood for the better. Music that you associate with happy times from your past can be especially effective.

What you eat is your call, of course – Michael was vegetarian at this stage in his life – but it is good to eat regularly and well: vegetables, plenty of nutrients, etc. We can include drink and keeping hydrated here as well. Alcohol is often not helpful for those with mental health issues, especially those on medications.

This one works well for some people. They pepper their language with positives – ‘Wow’, ‘Brilliant’, ‘Awesome’. At the very least, it sends out positives vibes that often come back to you from other people.

A variation on that list of truths or list of good things, some people find it helps to stay positive if they have photos of family, friends and pets to look at as and when their mood dips a little.

This is a tip shared by someone who once, like Michael, felt suicidal. When he comes up against what he calls ‘a blip’ – he misses a bus, is a few minutes late for a meeting – he thinks, ‘What does it matter?’ It’s a kind of mantra. In the grand scheme of things, most blips don’t really matter all that much, if at all. The sun will still rise tomorrow morning.

Few people, with good mental health or not-so-good mental health, stay in the here and now. Instead, they are looking ahead – to what they have to do tonight, next week, the month after or whatever (and dwell overmuch on worries about it). Keeping your thoughts on now and doing what you are doing at the moment and just enjoying the present are helpful for most people.

Most people benefit from a little bit of exercise regularly, perhaps 20–30 minutes a day of walking or some stretching exercises after work or a gentle yoga wind-down at the end of the day. (I talk about exercise a lot when doing presentations to students and parents and can’t repeat this enough – exercise is so great for mental health.)

In the same way that you can start the day with a positive affirmation, you can, after winding down to bedtime slowly and peacefully, end it in much the same way. Reflect on the good things that happened to you today.

May 2013

Rebuilding my life

I have started applying for jobs again in Ipswich. I’m not sure what to do but thought it was worth a look. I’ve had a job before, working in a kitchen in a restaurant at Felixstowe, but I want to find something in Ipswich that I can handle. I will have a look in Game and see if they have anything going there.

I haven’t spoken to my old friends from school in a long time. I don’t really know what they will think of me any more to be honest. My best friends are – were – Toby and Adam, but I haven’t really seen them for ages now. They always tried to help me when I was down, contacting me on and off, but I didn’t want to know. I didn’t want to talk about it. I think maybe I do now, or soon anyway. I’d like to see them.

* * *

Colm has told me that this service he works for is changing soon and he will be leaving. The team and service in Suffolk is moving into new departments or something. I don’t know much about it. Colm will have to leave, so I think he’s actually going to retire after this.

* * *

I need to be drawing and doing research for when I start my master’s again. My course is Moving Image and Sound. It’s basically animation/illustration. I have quite a unique style of drawing and haven’t really done much animation before. I tend to use a lot of line work mixed with bright neon colours and take ideas from films such as Coraline, The Nightmare Before Christmas, a lot of Tim Burton stuff. Games like the BioShock series, Fallout and Dead Space inspire me.

When I was at university last time, some of the artists there were quite traditional and did oil paintings of the sea and landscapes – all very bleak East Anglian stuff. Others went down the graphic design route, with clean-looking vector art – drawings on a PC using a tablet. It will be weird to see some people I know back at university. I think I’ll just drive to Norwich or get the train as it’s only part-time, two days a week there, and the rest at home in my own time. It starts in October and runs all the way through to the August, I think. I then do another year through to August 2015.

* * *

Niamh hasn’t stopped looking at wedding ideas! I’m just going to let her run with it. I think she’s thinking about a wedding abroad if she can. I think my dad and her dad will come together to sort it. Niamh has a few places in mind and she wants it to be somewhere hot.

* * *

Niamh has found a really nice place in Antigua with private beaches, all-inclusive food and drinks, and really nice hotel rooms. We will invite just our families to the wedding as it’s going to be expensive to get there. Niamh’s dad has said that he wants to help with the wedding. Niamh’s dealing with that. I think Niamh’s family is happy for us, although I never really know what they think about me.

I can’t imagine any parent would want their daughter to be with anyone who’s been as mentally ill as I have been, but they have never shown it and have always been supportive. I hope they like me, but it’s uncomfortable seeing them after what’s happened with hospital and the Priory. We are happy, though, and that’s what matters.

* * *

Life feels more normal now I’m out of the madhouse. I know I’m still weird and probably will be for ever. I think it’s hard not to be a bit crazy after being through rehab and living how I have done for probably six or seven years. I can probably only just count on ten fingers the number of mental health issues I’ve experienced, from anxiety and depression to OCD. I think I’ve learned to cope a lot better.

Being home is testing me again a bit, though, because I don’t have anyone constantly looking over my shoulder like I did in the Priory.

Being happy is, for most people, what life is all about. Yet happiness is often quite elusive for many who feel they could be happy if only such-and-such would happen.

Michael, locked up in the Priory, realised fairly quickly what made him happy and it was mostly simple stuff like being able to walk in the park or pop to the shops when he wanted. For him, it had nothing to do with money or prestige. It was about getting the basics right and in place. (Thumbs up to Michael for that.)

How to be happy is one of those big, universal questions we all want answered. For some, it is unanswerable. Others have to find their own answers. Here, based on the little we have learned, are a few pointers.

Much has to do with accepting what you have rather than focusing on what you don’t have. Too often, people say that they will be happy once they have got that promotion, got that new car, moved to a bigger house and so on. (If they get that promotion or bigger house, happiness always then seems to be dependent on getting to the next level.)

Find the good things – happiness – in what you have already. It is often the little things – a child smiling, a dog rolling excitedly back and forth – that bring moments of happiness. These are the good things that should be on that list of yours.

If Michael had listed all the things that made him happy at this stage in his life, now that he was back home with Niamh, he could pretty much use it as a checklist and then go through the points every day. You may be able to do the same.

Change what you can, let go of what you can’t. There are things in life you can change – what you want, how you feel – and there are things you cannot – the wants and needs of people you work with, for example. Focus on what you can change; trying to change what you cannot will only make you unhappy. Some people just aren’t very nice; best leave them to it.

There’s a saying that’s been around a while in different forms but it goes something like this: ‘I cried because I had no shoes until I met a man who had no feet.’ It’s a matter of putting things in perspective. As a constant reminder, you may find it helpful to list, at the end of each day, the good things that you have in your life. (Big fan of lists, me! The creation of them can be very soothing and can take your mind off minor niggles and worries.)

June 2013

Managing my issues

Things are going well, but I still think of myself as weird rather than as a normal person. I find all sorts of situations tricky, like meeting new people, and I still get anxious about things. Everyone gets anxious, but it’s about understanding that being nervous is part of human nature.

These are the main issues I have had, maybe still have…

Depression

OCD

Anorexia

Anxiety

Stress and panic attacks

Social anxiety phobia

Plus many more!

I’ve somehow learnt to cope better with all of this and I don’t even really know how. If I had to think about it, I think it’s that because I’ve been through a lot of really heavy stuff, most things now don’t seem quite as bad.

Also, I used to worry about everything, whether it was going for a meal, seeing people or anything really. Now, after so many times of worrying about something and it then turning out to be okay, I’ve slowly realised things won’t be that bad and people won’t judge me.

I’ve also tried to care a lot less about what people think of me. People have their own issues and stuff going on, so I just try to do what I want to do. To a degree, you have to be selfish in life because when it comes down to it, most people are pretty much just looking out for themselves.

I still see Colm once a week for a chat – i.e. I listen whilst he ‘subtly’ makes observations. He’s a nice enough guy, but it’s like another game I have to play to show I am normal and well. When he comes here, I always feel like a child. I don’t really like it but I can’t just tell him to get lost, much as I want to at times.

* * *

Niamh and I are trying to do more when we have time together, like going to Norwich and visiting different places. We are trying to make the most of the freedom I now have. The main issue I still have is feeling ugly. I have always hated how I look and I still feel uncomfortable now.

Feeling like you hate yourself is a difficult one because you can’t just suddenly love yourself. I will never be one of those people that loves themselves or has a massive ego because I’m so used to hating myself. I’ve only just kind of learned to accept who I am and that’s about as far as that will go.

I think to get better at ‘liking’ yourself you just have to make the most of life, find meaningful relationships and keep yourself busy. I personally think it’s about finding some kind of self-worth and purpose in life. Without those things, what do you have to live for?

When he was in the Priory, Michael had been told that he had OCD and that it was mild – it showed itself mostly in his need to stick to routines and did not really impact on his life all that much. In fact, until someone at the Priory told him he had it, he did not know. It was something he kept an eye on in these early days back home and it was not a big issue for him – it is for others, though, and is often linked to depression and anxiety.

Obsessive compulsive disorder (OCD) is an anxiety disorder. It comprises two key parts – an obsession and a compulsion. So, someone may have an obsession about food hygiene, for example. The compulsion part would come when they cleaned their cutlery (and related items) over and over and over again. Other common obsessions are along the lines of ‘Did I turn the oven off?’, ‘Did I turn the tap off?’, ‘Did I lock the front door?’ and the compulsion in these cases might be to go back and check (and check and check again).

Michael had what was described by the Priory as low-level OCD and it was something that he could work his way through. He could identify his fears – what lay behind his anxiety and obsession – and then address the compulsive behaviour that dealt, at least for a short while, with those fears. Here’s how he did it.

Try to note when each issue occurs. Taking the ‘food hygiene’ example just given, it may be every meal and snack time. (Often, OCD is not limited to just one fear, of course – the reality is that ‘food hygiene’ may be one of many hygiene-related fears, with sufferers not wanting to touch anything that may have germs on it.).

Record your thoughts and feelings as each issue occurs. In terms of our food hygiene example, this might commence with ‘I might swallow some germs…make myself feel sick’.

Note what you could do to resolve that issue. For example, ‘wash the plate and cutlery thoroughly’. In effect, you are listing the compulsive behaviours that you use to try to ease the fears you have.

Next, once you have a set of situations that you have established over a week or two, try to rate, 1 to 10, how anxious you’d feel if you didn’t try to resolve each issue with a compulsive behaviour, 1 being ‘a little anxious’ and 10 being ‘extremely anxious’.

Try to identify one situation where you think you could resist the urge to use compulsive behaviour. Getting an ice lolly out of the fridge may make you ‘a little anxious’ (because it’s possibly germ-free-ish), so that’s something you are more likely to be able to deal with than, say, eating in a café which makes you ‘extremely anxious’ (as there are germs everywhere).

Tackle that ‘little bit anxious’ situation, resisting the compulsion attached with it for as long as you can. If possible, try to monitor your anxiety levels, seeing how they ease the longer you hold out (the more often you tackle the same situation – as often as you can – the easier it should get).

When you feel ready, move on to tackle another situation, one that makes you feel a little more anxious, and see if you can handle the next situation without giving in to a compulsion. Again, repeat until you feel better able to manage it before moving on to another situation. A good phrase we’ve seen and heard many times from those talking about OCD is this: ‘The fears get stronger the more you give in and the fears get weaker the more you resist them.’

As an aside, as a loved one or parent, it’s a tricky balance dealing with someone struggling with OCD. It’s tempting, when faced with a younger person who is doing something you perceive to be ‘silly’ – such as checking the door is locked many times – to tell them to stop it, to tick them off, to tell them not to be so daft. This does not help matters. It is wiser to be patient and encouraging and see if they can find their own way through.

For more serious cases, it is sensible to take medical advice. A GP may prescribe medication such as antidepressants and tranquillisers. They work for some people. The fact that Michael worked his way out of OCD without taking tablets does not make him better or stronger than someone who goes with medication – just different, that’s all. Please always remember, what works for one person may not work so well for another. A GP may also suggest CBT, although the NHS waiting list may be lengthy.

July 2013

Getting on with things

I’ve decided to get another tattoo. I already have two half sleeves and now I’m going to get a big chest piece. I’ve been thinking about it for a while and Niamh reckons it’s a good idea. I’m trying to do things for myself like making bigger decisions and looking after myself – although it’s a weird one getting tattooed because that’s me putting myself through actual pain.

I think my inability to make decisions came from my anxiety which came from depression. The trouble is that it’s all linked. It’s like dominos – as one falls, it can trigger something else. If you’re anxious or have trouble with making decisions, even if it’s what to do with your time off, it’s important to remember whatever you choose is never the wrong choice. Nothing bad can happen from doing what you feel is right at that time.

* * *

I’m trying to do more arty things to stay positive. I find being creative has helped my mental health. Vice versa, I know when I’m really depressed because I don’t do any drawing, and things like reading, gaming and going out don’t happen any more. I’ve started doing lino cutting and have also been designing logos. Lino cutting and printing is where you use tools to carve into flat, clay-like sheets and then use rollers to apply ink and make prints of what you carved.

I’m trying to focus on things that I know make me feel better. Going for walks, visiting the cinema and seeing my family. I want to try to get in contact with my friends Toby and Adam again. They made one or two attempts to be friends when I was at my lowest and I just knocked them back. I now feel awkward after all that has happened. How can something like that happen and we don’t talk for ages and then I try to see them again? It just feels hard. I know that they will understand and would probably want to see me again, but I have always felt like the weird one. I don’t feel that I’ll fit in with them anymore.

* * *

I’ve had toothache for ages now – I need to have a tooth pulled out. They offered to do a root canal but we don’t have enough money for it. That’s the problem with dropping to six or seven stone and being really unwell – it has all sorts of other physical side effects; it can make your teeth weak, for example.

* * *

I’ve just been to the dentist and my dad took me. I was in there for over an hour whilst my dad sat in the car. A lady called Zelda – one of my favourite games ever – attempted to pull my tooth out. It shattered midway through so she had to spend the next 40 minutes pulling, digging and scraping away. I then made the mistake of looking at the bowl and seeing tooth and roots and blood everywhere. Horrific – like something out of the film Hostel. I staggered out to my dad who seemed to be having a snooze. He said he thought I had been a long time and that he had seen an ambulance go by and wondered whether I might have been in it. He did not seem too worried about it.

* * *

I’ve got my new tattoo – a big chest piece that took four to five hours. I’m really pleased I got it and it’s good that I’m doing positive things that make me feel better. Niamh always says I should try or at least think about getting into tattooing work, but I have no idea where to start.

I have also been making some cut-out craft work, which I saw online. You basically cut and build models of well-known characters like Bender from Futurama or the Joker from Batman. I started with a couple and before I knew it the old OCD kicked in and I had to make them all. I probably have about 50 so far. My room is now full of them.

My OCD has gone away mostly, with some exceptions like that. It’s hard to say what I still do that’s OCD-like because who really notices things they do day-to-day? I always like to eat meals at set times. I always watch TV with dinner, go for walks in the same place and things like that. I think I just like having a routine as much as anything else.

Cognitive behavioural therapy is described by the NHS as a ‘talking therapy’ and it’s essentially where a therapist will talk a patient through their issues and, all being well, will change their negative thoughts into more positive ones.

The idea behind CBT is that everything – mental and physical – is linked together and that thinking negatively will mean the sufferer is in an endless downwards spiral: more depression, greater levels of anxiety, stress and so on. Current, rather than past, problems are the focus and are broken down into smaller stages.

Some of the exercises we’ve covered so far are what we call ‘CBT-ish’ in that they aim to help you to turn positives into negatives, and these (the list of truths, seeing the silver lining) can prove helpful.

Seeing a therapist, perhaps via the NHS or privately, is for cases that are beyond self-help and this can prove to be effective. There will be a course of treatment of, perhaps, up to 20 sessions lasting between 30 minutes and an hour each, once a week or fortnightly.

Michael’s sessions in the Priory included looking at his thoughts and feelings and how these related to his actions – because he was thinking negatively, his actions were equally negative. Michael then worked on turning his thoughts and feelings more positive so that his actions were more positive too, and he then entered an upwards spiral.

August 2013

The wedding approaches

It’s not long now until our wedding. We are still not sure who will be coming. My family are and I think Sophie’s boyfriend, Paul, will be coming along too. Niamh’s dad did say he was going to, but every time Niamh says he needs to book flights he changes the subject. Niamh’s mum (her parents are divorced) did originally say that she was going to come, but I also have a feeling that she will pull out.

Niamh has been talking via email with the wedding planner at Bluewater, the resort we are staying at. From the pictures I have seen, it does look amazing – the kind of place you would think of for a dream wedding. Private beach, white sand, clear water and perfect warm weather.

We are having to get stuff sorted now for the wedding. Niamh has been going off to find a dress and I have been sorting out the suit I will wear. I decided to go for cream-coloured trousers, a white shirt, bow tie and braces. I’m going to ask my brother to be my best man and wear the same thing as me. I never really wear anything smart, so it feels weird having to try to put on stuff like that. I like wearing skinny jeans, so I have taken my wedding trousers to be fitted to me.

* * *

Yesterday, Niamh and I, as well as Sophie, Adam and Paul, went off to Norwich for the day. The weather has been so nice and we wanted to get out and about. I always like going back to Norwich. I lived there with Niamh for a few years when we did our degrees and I’m going back soon to restart my master’s. I know Norwich really well and have spent a lot of time walking around there. We walked down to where I will be doing my master’s. I really like that part of Norwich. It’s by the river.

* * *

We’ve just found out that Niamh’s mum isn’t coming to the wedding – in fact, none of her family is. It’s expensive, I know. Niamh was upset. My family is still coming, though, and Paul, so I’m grateful for that. They are staying in a villa nearby.

* * *

Niamh’s sister, Maeve, is going to drive us to the airport tomorrow and I imagine her mum will also come along.

* * *

We have now arrived in Antigua and it’s probably one of the hottest places I have been. I’ve never really been anywhere like this. Our resort is amazing and feels very luxurious, but as soon as you leave the resort and see some of the other places, it can feel quite run down, with loads of stray dogs and homeless people. We have two weeks here. The wedding is halfway through and we then get a week after for the honeymoon.

It’s crazy to think how weird my life has been over the last couple of years. I almost died and my body was falling apart. I went to rehab where I was locked away for months and told what to do. I’m now sitting here on a private beach, having unlimited drinks whilst my almost-wife is swimming in the clear blue sea. I think that’s a good thing to keep in mind – even at your lowest, your life can change. Mine has. I never thought I would have all of this.

* * *

I’m really loving spending time here. I don’t think I’ve been so relaxed in ages. I literally get to do nothing all day except swim, sleep, draw, eat and repeat. I love the rum. I’m definitely going to sneak some bottles home. I always used to find change really difficult to handle but I’m doing just fine with this. Life can be strange sometimes. Sitting here in the sun compared with sitting in a circle of people with different addictions and mental health issues feels like worlds apart. I guess it is.

I have never really been good with change because I feel like it unsettles me. We have moved house a fair few times and I always feel uncomfortable at first. Everyone in life has their own things, places and routines to make them feel at home and feel safe. I think change is important, though, because it teaches you to adapt to situations.

* * *

I’ve now gone to stay at my parents’ place – a villa overlooking the sea at Darkwood Beach – because it’s the day before the wedding. We are going for a meal tonight – Mum, Dad, Adam, Paul and me. Sophie has gone to stay with Niamh.

* * *

We went to a nice restaurant, but I am starting to feel really nervous, to be honest. I’m staying in Adam’s room and we will get up tomorrow and go for a drink before getting ready for the wedding. As we drive about the island, Dad keeps stopping to feed homeless dogs he sees with supplies of dog food that he has stacked up in the back of the hired car.

* * *

We stopped at a quirky café on the beach that my folks had checked out a day or two earlier. I think it’s run by an English ex-pat. There’s no one really about and so we have the place to ourselves. We ordered drinks and my dad suddenly turned to me and uttered the immortal line, ‘Are you sure you want to do this?’ He then added, ‘We can get up and leg it now if you want.’

I’m feeling nervous. It’s hard to believe that one minute I was in rehab and now I’m in Antigua about to marry Niamh.

* * *

It’s the day after the wedding. If I look back over the last year or so, it’s crazy to think I’ve had probably the worst and best moments of my life so far in those twelve months. Hospital and the Priory to Antigua and Bluewater. I don’t know how I could top either really.

The day went really well. The wedding took place on the golden sandy beach with my family and Paul – my dad calls him the halfwit, but we all like him really, including Dad although he pretends not to – sitting on wooden chairs behind me. I stood facing out to sea under an arch made of branches and flowers, waiting for Niamh to come down the wooden stairs behind me with my brother and sister. Sophie was Niamh’s maid of honour whilst Adam gave Niamh away and was also my best man. My mum, dad and Paul sat and watched; I think my mum and dad nodded off in the sun.

* * *

We are now enjoying our honeymoon. We get unlimited food at the buffet which is full of everything from fruit, pastas, pizzas, fry-ups, puddings and even more. If there’s something you specifically want, the chefs will even make that for you – Niamh asked for dairy-free milkshakes. We just get to chill out on the beach every day, ride jet skis and swim.

I’ve been drawing lots whilst I’ve been here. I’ve done drawings of the beaches and views around us and also some character design work for when I’m back at uni. I think that being creative and listening to music help my mind and enable me to chill out. Anyone suffering with mental illness should try to do something creative. It works for me and I have been feeling a lot better lately. I don’t think things could be much better than this really.

The boy slumped on to his straw bed in his hut on the edge of the village, exhausted but free. He had fought a long and terrible battle with the tentacled monster that had terrorised him for years. Now he had won at last and he could marry the girl he had given his heart to so long ago. And they could live happily for ever.

As he lay there, he remembered the first time he had seen the monster. He had been walking in the woods for ever such a long time and thought he was all alone as he looked for roots and vegetables to pick for his supper. But he heard a rustle from amongst the trees and, turning, he caught sight of the monster’s malevolent eye upon him. The boy hurried back to his hut and did not tell anyone about it.

The next time he went back into the woods to find food, the boy kept a watchful eye out for the monster and listened carefully as he walked, trying to hear if the monster was nearby, moving about. He saw and heard nothing until, as he returned to his village, he heard a slow, slithering noise behind him.

He turned and saw the monster on the path. It was big and wide and green and had ten or more tentacles, each one writhing about as if they were fighting and trying to strangle each other. The boy stared for a long time as the monster and its tentacles slowly became still and then, watching him, started edging forwards. This time, the boy turned and ran as hard and as fast as he could back to the village.

After a while, growing accustomed to seeing the monster, the boy started to ignore it. The monster, who would sit and watch and follow the boy, grew bolder as the days and months passed. It began slithering along a few paces behind, then so close that the boy could feel the swish of the tentacles at his back and, eventually, the monster would wrap all of its tentacles around him as he struggled slowly along the path. The monster would only release the boy back to the village when he promised he would not tell anyone.

This went on for a long while. Every time the boy entered the woods for food, the monster would wrap itself around him, some of its tentacles clinging tight to his arms and legs and others writhing about his face. The monster made the boy feel sick and his head hurt too. Eventually, it made him want to die. But he did not know what to do and he was too frightened and ashamed to tell anyone about it. The monster would release him only when he got back to the edge of the village and repeated his promise not to say anything to anyone.

One day, the boy’s sweetheart, seeing how thin and ill the boy was looking, followed him into the woods and saw what was happening. She watched in horror as the monster wrapped its tentacles around the boy, pulling his body in, suffocating and squeezing the life force out of him. She ran back to the village as quickly as she could, calling on every hut, telling them about the monster and asking everyone to fetch their slings and spears to chase the monster away.

The villagers, led by the brave young girl, ran into the woods and found the monster about to devour the boy. They attacked the monster, fighting it off with their slings and spears. Even the small children were there, throwing rocks. The girl passed a spear to the boy who, struggling to his feet, stabbed the monster again and again with all of his might. The monster, close to dying, slithered away and disappeared into the woods.

Now the boy was free and could marry his girl. The village arranged for the wedding to take place the following month. Everyone gathered from all around, including his family from the next village, for the ceremony and the celebrations that would last long into the night and maybe even into the next day. The boy and girl, now married, slipped away at the height of the celebrations to their newly decorated and beautiful hut and they embraced in their love.

The next morning, as happy as he had ever been, the boy rose early as the girl was sleeping and stepped out into the warm sunlight. He gazed around, knowing they had nothing to do all day but relax and be together. Everything was good. Their life was perfect. He was full of joy. The boy stood there for an age, happy in himself and all that he had.

Finally, smiling to himself, he turned to go back into the hut to be with his new wife. As he did, he glanced towards the woods and stopped, a look of horror on his face. He saw that old, familiar malevolent eye watching him. The monster was back. It had never really gone away. Now it was here again, watching and waiting for him. And this time it was going to kill the boy.

September 2013

Back to real life

We are now back home in Ipswich. Niamh will be going back to work soon and I’ll have to adjust again to being on my own. I think I will find this hard as I’ve lost a lot of friends, what with moving about and my mental illness, and I find it difficult to meet new people.

* * *

I spend a lot of time at home on my own, so I’m hoping to find a job, even if it’s part-time to help me feel better. I don’t think I’m going to see Colm any more. The mental health team in Suffolk is changing and I don’t feel like it’s helping me anyway.

* * *

Colm is retiring and he did say he could apply for me to see someone else. I think I’ve come far enough now and don’t need it. Plus, I don’t want to have to talk about my past for the rest of my life. It’s draining and I want to move on.

* * *

For my dad’s birthday, my mum suggested I draw a picture of Doctor Who to put on his wall in his room; he has loads of Doctor Who things in there – it’s like a Doctor Who Shop. I started off doing a sketch of the Tardis but then my OCD kicked in and I ended up drawing as many Doctor Who characters as I could think of. I hope my dad likes it.

MY DAD LOVED IT AND RECOGNISED EVERY CHARACTER IMMEDIATELY.

October 2013

Doing my master’s

I’m back at university now doing my master’s which feels so-oo weird. I have been getting the train up and having to meet people again. It does make me feel anxious as I’m really not used to being around people. I have bumped into a few people I used to know. I still find it awkward seeing people, even in my home town, because they might be aware I have been in rehab. How do you start a conversation with someone who you perceive to be so mad that they have been locked up for months?

University has changed a lot since I was last here a year ago. There are two buildings opposite each other by the river and the courses in them seem to have swapped sides. And there are new people, but they all seem to be very nice. My tutors know what I have been through and my main tutor is really helpful and patient with me.

I’m going to work really hard this time around on my course and try not to go mental again. I have to admit that being ‘normal’ feels hard. It’s hard to explain. I’m so used to being weird and different from everyone else. I kind of feel like being crazy is who I am and I don’t really know who I am without that madness inside of me. It probably sounds odd, but I’ve been thinking about this every day lately.

* * *

At the weekends, Niamh and I like to go and do stuff and see different places. Today we, and my brother Adam, went to Stonham Barns which is a sort of rural leisure park – Suffolk-style – with an owl sanctuary and shops. Adam’s like my best mate really. We get to hang out more now that I’m fairly normal. I can still be weird with Adam. It was a nice day out and I also got a call from Game offering me a trial shift on Saturday. I’m nervous but I think it will be a good thing. I’m not even really doing it for the money, but it helps.

* * *

I just had my first trial shift at Game which went okay. It basically involved being in the shop helping customers that come in to buy and trade games. I had to get used to it pretty quickly, and my anxiety levels were through the roof because I’m not used to being around so many people and being forced to interact with them.

The good thing is that I’m a huge geek and pretty much know exactly what’s going on in the gaming industry at all times, so that’s a massive help. I think many older people frown on video games, but they have helped me through some very difficult times. I think that I will get a call from Game over the next few days to see if I get the job and, if I do, I will know more about what it involves.

When anxiety levels are high, I think it’s impor-tant to take a second to chill out and breathe. There are loads of breathing techniques out there which can be tried. I also try to take my mind off things by doing something else, something I enjoy, like sketching. I also try to talk to someone. Just a chat with a friend. Even if it’s about something and nothing, like which movies we’ve seen and which games we’ve played.

* * *

I have the job at Game and start next week! I’m a little nervous but I know the staff in there pretty well, so that’s good. I’m more just nervous about having to deal with customers. I think it will be good for me, though. I haven’t been used to talking to lots of people for a long time. I think I will be anxious, but it might help my confidence.

* * *

Last night, we went for my birthday meal. I used to dread going out for meals because I’d rather just stay at home. I can definitely deal with doing stuff like this a lot more now, but I still find it hard because I know that people watch me. It was nice seeing my family and telling them I’ve got a job. They were pleased, which was nice. Niamh always makes me a cake for my birthday.

I start my new job tomorrow and I have a shift from 10am to 3pm. The hours are fairly good, but I have to balance it with my master’s course and making sure the days work out okay. I also have to make sure that I focus on my coursework. I want to make sure I do well this time round.

* * *

Things have been going fairly well since I left the Priory, but there are still times I get down, like everyone does. I just have to try to make sure I stay on top of it. I also think it’s important that I don’t push myself too much and also try to treat myself properly, which is hard when I’ve become such a pro at self-punishment. I’m way better at being harsh on myself, which probably sounds odd because you would think why wouldn’t you just treat and look after yourself?

I’m going to try to start saving some money when I work at Game for Christmas and I also want to buy the PS4 which comes out soon.

* * *

I just had my first proper shift at Game. It went okay for the most part. I also found out I get pretty good discounts, so that’s cool. I had to learn how to use the tills. I served people and helped to give advice on games. It’s all pretty straightforward stuff. The hard part is adjusting to being around lots of people again.

When I feel life is getting a bit much, I try to break it down and find times in the day to relax. I think that’s very important. I just walk about. I like going to the park.

November 2013

A proper Christmas

Christmas is coming soon and we have asked both of our families if they want to come to ours for Christmas Day. It was more Niamh’s idea than mine and I’m not sure how keen everyone is on it, but I don’t really mind everyone coming over. At the moment, I’m trying to focus on staying happy with as little stress as possible. I can’t imagine Niamh’s dad will come. I haven’t seen him in months, since just before the wedding.

* * *

Christmas Eve is coming up and we will be doing the usual Christmas panto at the Wolsey where the group of Maitland family weirdos sit in the front row and sing along – well, everyone apart from me and Adam who slide down into our seats trying not to make eye contact. My mum and dad are usually first up to dance, probably to try to embarrass the rest of us.

I don’t think Niamh is going to go as she wants to get stuff ready for Christmas Day. That’s okay, though, as it means that after the panto I can run around doing my Christmas shopping for her. I’m not very good at being organised; my head’s enough of a mess as it is at times and so I try to keep things simple.

* * *

It’s Christmas Eve and I just got back from the panto and the cinema. I had a nice time. I wish Niamh had come too, but never mind. I’m a bit nervous about tomorrow. It’s not so much even about the food. It’s more about being around people who know I have had an issue with food in the past. Things would be so much easier if no one knew and I could then just focus on me and how I will deal with it, without the added stress of being watched. I will try to have a good time, though.

* * *

It’s the evening of Christmas Day. Everyone has been here apart from Niamh’s dad and older sister, Megan. Dad and Sophie had an argument towards the end of the day about Paul who hadn’t come over – my dad was pleased and Sophie wasn’t – and Soph ended up having a big old spectacular strop before wearing herself out and falling asleep on our living-room floor. (The less said about that the better.)

* * *

I get a bit of time with Niamh over Christmas and the New Year. I’m not sure what we will do. We never really have much money and it can get quite stressful when we reach the point of running out. I remember one time when we were living in the cottage and in the winter when it was freezing cold. We had no heating and the house was almost unbearable, bearing in mind I was very thin. I remember we drove into town which takes 20 minutes and went to the bank to find we literally had no money left. Something like 74 pence. We had to go back to my car and sell some old DVDs on the back seat so we could buy petrol to get home.

* * *

Niamh is now back at work and I’m on my own again, apart from when I have my shifts at Game. I’m still doing my master’s, so I need to focus on that. I’ve noticed I’ve started to feel down a few times recently and I am not really sure why. I think it’s the fact that I’m not used to being around people, and also going from not having much on to now having a job, being married and doing a master’s feels a lot to handle – even if it’s not actually too much for a mentally sane person.

As we come to the end of 2013 and move into early 2014, Tracey and I were still doing much the same as ever – working with small children and writing nonsense, albeit a better class of nonsense, respectively – and all was well at home with the two of us plus Adam and Bernard the dog.

Adam had now started his GCSEs. He did not really know what he wanted to do after that yet, but hoped to get enough GCSEs to have the choice of going on to do A Levels. Sophie was coming towards the end of her final year at Durham University and was working hard to get the best result she could. She too was not sure what she would do at the end of her degree but expected to move back to Suffolk in mid-2014.

We had begun to discuss concerns about Michael’s well-being between ourselves. Michael had come out of the Priory apparently fit and well, or so we thought. But as the months passed and moved towards a year out, Michael was still distant with us and did not seem to be putting on weight or appear to be any happier than he had been in the months and years that had led up to hospitalisation and the Priory.

In some ways, he did seem to be making progress, though. Michael and Niamh had married. That had to be a huge plus. They had a nice place to live near a park in Ipswich. Another plus. Niamh had a full-time job with prospects. One more plus. Michael was working part-time and doing a master’s. All big plus points that must outweigh his skinny appearance and downbeat demeanour, surely? And yet.

And yet we had nagging doubts. We were not sure Michael was all right. We could be wrong. We did not know what to do. If Michael was on the mend, albeit slowly, and we said anything – ‘Michael, you don’t seem to be getting any better’ – it would surely be a blow to his morale and to our relationship. So we kept quiet and, as before, we hoped for the best. Yep, here we go again…

February 2014

More work at university

I’m off to Norwich today for my master’s. I think I have a few meetings and a lecture to go to. I’m going to get the train, which will inevitably be delayed/broken down/something wrong as per usual and I’ll end up standing in the freezing cold for an hour or so. I’ll write again after university today.

* * *

Uni went okay today, but I found out that I have to do a few big presentations this year in front of a lecture hall of people. I’m really not used to that kind of thing and I’m only just starting to get used to being around large groups of people again.

Also, a few people have asked me why I dropped out and I do find it a bit awkward talking to people at the best of times. A guy called Sam came right up to me and asked where I’d disappeared to. I just had to say I hadn’t been ready to start a master’s last year. He was trying to be friendly, I think. It all made me feel rather uncomfortable, though. I wish people would just leave me alone.

We’ve seen, through comments in his diary in the Priory and his 2013 and 2014 notes, that Michael has an ongoing issue with meeting and mixing with and talking to people. This social anxiety – feeling anxious about one-to-one and one-to-group face-to-face encounters – is common, mental health issues or no mental health issues. Here are some suggestions.

Whether you are meeting people one-to-one at, say, a business event or party, or you have to talk to a group, perhaps to present your work in some way, you should allow yourself plenty of time to prepare. If Michael had been able to prepare what he was going to say and how he was going to say it at those CPA meetings in the Priory, it might have been a less stressful experience for him. It might not have gone so well that he got discharged on the spot, but it could have avoided the emotions he showed at the time – crying, swearing, etc. He tried to wing it – which adds to the anxiety levels.

Liken it to a play. There’s a period of rehearsals and dress rehearsals first so that it goes right on opening night. Miss out the preparations and opening night is going to be really stressful and you’re probably going to fluff your lines.

Whatever is happening, you’ll probably know roughly what’s expected to take place and how it’s meant to pan out. At a meeting, you’re going to have to smile and say hello, shake hands, make small talk, listen to what other people have to say, make some comments of your own and so on. At a presentation, you’re possibly going to have to introduce yourself, talk through a PowerPoint presentation to make your points, conclude, take questions afterwards, etc.

If you can break down each of these events into smaller steps – first, say hello, second, make small talk and so on – it is easier to imagine what you will do at each step. You can prepare by working through each step with a friend or family member. For example, have a few comments ready for small talk: weather, the journey there, mutual friends and colleagues and so on. It’s also a good idea to imagine the event unfolding as you want it to, with you saying the right things at the right times (because you have prepared well) – the more you can ‘see’ it in your head, the easier it becomes.

Before you do whatever it is you’re going to do, your preparation should really include looking at and anticipating your thoughts and feelings – your fears really – to analyse them and see how valid they are (and to try to turn them into positives, of course). We’re trying to keep the self-help sections upbeat in Part Two of the book and are focusing on positives rather than dwelling on the negatives, but social anxiety is one issue where we need to address negative emotions head-on.

List, as best you can, what it is that makes you feel anxious about this particular situation and then, for each point, ask yourself:

So, let’s take an example. Jumping ahead here to the current day (more of that in Part Three), I talk to small groups and big halls full of students and parents at schools and colleges and to employers and employees in the workplace about our experiences of mental health. It’s quite a sad and emotional story in places, and so I try to lighten some of it, especially early on, with a few jokes and even some black humour. Most of it goes down well; one or two comments don’t.

As I tell our story up to the point where I received that text from Niamh telling me Michael had been taken to hospital, I make one or two jokes. By keeping the start of the talk light-hearted, there is more of a dramatic impact when I read out Niamh’s text and my reply. There is usually a collective intake of breath.

One joke is that Michael, when he went to university, changed his hairstyle a lot. Depending on the audience, I then say he went through a range of hairstyles – Donald Trump, Mahatma Gandhi, Princess Leia, Adolf Hitler. It’s a fairly basic joke, but it releases any tension in the air and usually gets a decent laugh if I’ve pitched the right examples to the right audience.

The Adolf Hitler comment, perhaps surprisingly, often gets the biggest laugh, but on one occasion there was a stony silence and it threw me a little and made me anxious because the week before it had gone down very well and there were one or two guffaws (possibly because no one could quite believe I’d said it). The silence this time round worried me and, as I took a sip of water and clicked through the PowerPoint for a second or two, this raced through my mind…

Why am I thinking this negative thought? Because I made a joke and there was silence and it usually goes down well. Do they think I’m crass? Have I been insensitive? Am I stupid? Is it me screwing things up or is it my anxiety taking over and making me overreact to something that’s largely something and nothing?

What are the alternatives to the ‘I’ve screwed up’ thought? Maybe I just rushed or mumbled the punchline? Perhaps they didn’t all hear me – it’s a big hall and my microphone isn’t working that well. Could it be that it’s not their sort of humour? Were some of them waiting for others – the bosses – to laugh? I’ve made four or five jokes now and some people have laughed at one or two, others at the other ones. You can’t win them all.

What happened next was really down to me. I could stop and become flustered, maybe apologise, and then stumble anxiously through the rest of the presentation without ad-libbing or making any other comments except those in the script. That’s a recipe for a flat and dreary speech. Or I could shrug it off as one of those things and complete the rest of the presentation as I normally would with a mix of drama and humour – some funny, some misplaced – which is what I did (and it went well).

I wanted to complete the presentation so that those in the audience knew that if they or their loved ones experience mental illness, they aren’t alone, and that by sharing our story and giving them some how-to suggestions and what-to-do thoughts, they could maybe resolve their issues more effectively than we did. I also hoped to see them come up to me afterwards and share their stories so that they engaged with me – and they did on this occasion as they always do.

Anyway, I found out afterwards from talking to the organiser that, microphoned, I was going live to all of the company’s offices. I had assumed – poor planning on my part – that the offices were across the UK. They were actually across Europe, including several offices in, um, Germany. The UK audience did not laugh for fear of offending their German colleagues, who were, I was told later, comfortable with the joke.

What works for some sufferers is writing down all the scenarios that cause them social anxiety and then listing them, a little like a ladder, with the scenario causing the least anxiety at the bottom and the one that causes the most anxiety at the top. At the bottom might be asking someone in the street for directions and at the top might be making a presentation to 200-plus people.

The aim is to try to work through these one at a time, from somewhere near the bottom to somewhere near the top, so that, as you gain experience, you move from socially anxious to socially relaxed. During this time in his life, Michael put himself into situations that made him a little anxious so that he could learn to manage his fears and then, having handled one lower-level situation well, could move towards the next one.

As important as doing your preparation beforehand is completing your homework afterwards: looking back over what happened, breaking it down into smaller steps and seeing what went well and where you could improve. For Michael, and most people, looking back can be encouraging as it’s almost always the case that the event went far better than expected. Michael’s social anxiety eased when he did the same thing several times – presentations to fellow students about his work – and realised, from each previous event, that nothing really bad ever happened. He fluffed the occasional line and he clicked to the next PowerPoint page too late once or twice. So diddly what? It’s no big deal.

Again, those who have experienced social anxiety offer a range of tips that work for them and may do so for others. Acting ‘as if’ you are confident – in this case, socially relaxed – can be helpful. Ask yourself what a socially at-ease person would do – and do that. Eventually, acting becomes reality for many people.

Several people have suggested ‘staying in the now’. Most people entering a social situation worry about what’s next. So they are getting through the introduction and the small talk but, all the time, they are thinking ahead to the next step and what could go wrong. By staying in the present, you are more likely to make a success of the here and now as your mind is not distracted by thoughts of the next stage.

Focusing on the other person is a good tip that works for many. Instead of looking inwards at what you might say and do, possibly wrong, you look and listen to the person you are talking to, asking them questions and listening to their answers. This can be a good way of getting through a one-to-one, encouraging the other person to take the lead, with you reacting rather than acting – always easier to do.

May 2014

Onwards and upwards

We have started thinking about trying to buy our own place. We have always rented and it can be quite a waste of money pouring hundreds a month away like that. It makes way more sense to get a place with a mortgage if it’s possible. I think Niamh is going to start looking. She is always in charge of that stuff and most things really. I just go along with whatever. It’s weird how I’m like that. I’m so particular with some stuff and then I can be totally laid-back about other things.

I am particular about certain things. I have to have a shower as soon as I get up. I have to have only my favourite types of cereal – Crunchy Nut Cornflakes, Crunchy Nut Clusters or Quaker Oats. I like having specific foods too: vegetable stir fry, vegetable pasta bake, quesadillas. I’m vegetarian. I have to get out of the house at least once a day. I have to listen to music when I go to sleep. I like routines. I don’t like change.

Yet I’m laid-back about other things. I think I’m laid-back when it comes to doing things with Niamh. If there’s something she wants to do or somewhere she wants to go, I just go along with it. I’ll watch any rubbish programme and I like to think I can be fairly easy-going. I just have my own struggles that I try not to share with other people. I keep them to myself.

* * *

I’ve still been doing lots of university work. I think I’m going to turn my illustrations into some kind of animation. I know at the very end of the course we have a massive show, so I want to try to make something cool.

My shifts at Game tend to be all over the place. The shifts aren’t very long but it can sometimes be dead quiet and really boring. I’d rather it was busy all the time so that time passes quickly.

It’s good to have a job, but doing something with no satisfaction or sense of output/achievement is something I find really demoralising. At some point, I need to find a job that lets me do something I like.

* * *

Niamh has been looking at a few houses and she’s seen a couple she likes. I nod and agree. She wants to live a bit more out in the countryside whereas I prefer living in the town, but it’s not that a big a deal for me.

* * *

I’m thinking about dyeing my hair. I’ve always changed my hair a lot. It’s good to try new things, so I want to bleach my hair as white as possible. I saw a film with Ryan Gosling in called A Place Beyond the Pines – and I thought his hair looked cool. My hair is pitch-black now. My dad says it is the exact same shade as Hitler’s was and that I should grow a matching moustache. It’s going to be a real mission getting it white.

* * *

From the outside, Niamh and I probably look like we have a pretty perfect set-up. We are married, have been together for years, have family, have a house and jobs. We also argue like any couple. The difference with us is that I’ve been mental for such a long time. It can make a relationship unbalanced when there’s someone with mental health issues, and I have pretty much had the lot. I do feel myself getting down sometimes and it does have an impact on things. It’s weird – if I’m down, then most of the time Niamh will pick me up, but sometimes she has had enough and that’s when it feels like things are breaking between us.

If you live with or you’re in a relationship with someone who suffers with mental health issues, I think it is important that you have patience. I think it’s also important that you talk, but not pressure that person. Pressuring or forcing them to do something might make them feel uncomfortable and push them away. People with mental illness just need to know they have people around them so that they can find their way through in their own way when they can, without feeling they are being pushed or pulled in particular directions.

If you’re the one suffering with mental health issues, I think you have to make sure you have good people around you who are reliable. I’m lucky I have a good family. I also have two close friends I have known since I was about six, Toby and Adam, who have come back into my life a little bit lately. It’s also important to know that you’re not alone and there will always be someone you can talk to, not necessarily about illness or how you feel but to just chat generally about movies or anything really.

* * *

Niamh has shown me a house that has just come up for sale. It does look awesome, so we are going to go and look round it on Saturday morning.

* * *

I had university today and travelled to Norwich by car this time. I’ve been getting fed up with the train delays and it’s been a bit cold lately. I’ve never been good with cold, and to be honest I get a bit nervous now ever since I had pneumonia and my lung collapsed and I ended up in hospital and then the Priory. Even when I breathe now, I can still feel that my left lung feels strange. I think it’s better driving up, even if it takes longer. I’ve started to make friends. I do struggle doing that, as I’m not very good at letting people in.

Letting people in can be difficult if you’re suffering. In my case, I didn’t want to talk to people or let people see me because I didn’t want the attention and I didn’t want people to see how bad I was. I think you have to try to put yourself out there, though, even if it makes you uncomfortable at times. I am trying to do that.

* * *

We just went to look round the house for sale. It was an open viewing, so there were quite a few people having a look at it. It’s a little cottage with a garden and it would have a studio space for me. As soon as I looked at Niamh’s face as we left, I knew she wanted it. So we literally drove to Tesco, pulled up and put in an offer. We now just have to wait to hear back to see if it will be accepted. I know Niamh really wants to move, but I do love our house now near the town centre. The problem is the place we are renting is going to be sold by the landlord, so we would have to move sometime soon anyway.

I’ve never really been good at dealing with change. I prefer my routines. So moving house, which we have done a lot over the years, is never easy. I would rather just get it over and done with so that I can adjust to a new pattern.

* * *

Just had another shift at Game. I really like the guys I work with, but the stress of balancing the job and university work feels like a lot. Going from not doing much to now being full-on makes it feel a lot more work than it actually is. I also get asked to work midnight launches and my boss keeps putting me down on the rota to work days he knows I’m at university – I think he does it on purpose, to be honest.

* * *

We just heard back from the estate agent and our offer has been accepted! The only trouble is we can’t move into the new house for a few months yet. We are going to have to stay with my family for a while. I think we will need to stay a couple of months over the summer. I don’t know how much everyone is going to like that. The house is exciting news, but it makes me anxious. I’m an anxious person. I think I always will be. It’s change again. I’ll need to get back into a new routine that’s as much like my current one. I don’t like change.

Michael has written about change, and the difficulties he has had with it, for some time, both in the Priory and over the past year, as he manages his mental health in his day-to-day life. Change is something that many people struggle with, but there are things you can do to make it a little easier. (We’re talking about everyday change here, of course, rather than horrible great heart-rending stuff like a marriage breakdown or the death of a loved one.)

Change is a natural part of life, and it’s often more frequent when you are younger and you go through school and possibly college and university and different jobs and relationships and places to live. Change happens a lot. It’s just the way of things. You have to, as I would say to Michael, ‘just crack on with it’. One way or the other, it’s inevitable. It’s much better if you can go with it rather than resist it.

Change is especially noticeable when you are younger, but there are also changes to come to terms with as you get older – ageing, retirement, downsizing, etc. – although the pace of change may be slower and easier to anticipate and prepare for. When we were younger, Tracey and I lived in a blur of seven houses in seven years – times of constant change. We’ve been in our current home for 15 years, but one day that will change again and we will be well prepared for it.

One thing to think about, if you are happy with things as they are, is that there must have been changes to your previous circumstances to have got to this position. You might find it helpful to think about where you were, what those changes were and, in particular, how you dealt with them. You would have handled them well enough to get where you are now. Upcoming changes will take you to another place that may be different to what you have now, but it may be better.

It’s a natural human instinct to resist change, especially if you are happy with the ways things are in your life. In some ways, this initial instinct is something close to fear and it’s perfectly normal. This instinct has nothing to do with change being ‘good’ or ‘bad’; it’s just what it is – a human instinct.

If you’ve looked back on your previous situation and the changes and the way you handled them to bring you to where you are today, you might want to look forward to see what the changes are and how you might handle them to take you to a new and better place. Change often feels easier to handle if you have some sense of control over it.

Once you have recognised that your first thoughts are most likely instinctive, you can move on to consider change more carefully so that you can take charge of and be an active part of it. You may want to start with a pen and paper to note down what that change is – moving to a new home for example.

You can then list ‘what this change means for me’, ‘how I feel about it’, ‘the pros and cons’ and ‘what I’m going to do’. Write down as much or as little as you like – it’s your change, after all. You just want to try to get it clear in your head.

As an example related to moving home, you might note under ‘what this change means for me’ such comments as ‘I’ll have a bigger bedroom’, ‘I’ll have further to drive to work’, ‘it’s a nicer, quieter area’, and so on. As with other lists we’ve mentioned before, you may want to do this with an upbeat friend so you get a good mix of thoughts in there.

A friend can also help you list comments under ‘how I feel about it’. So, ‘I’ll have further to drive to work’ may sound like a negative, but, talked through, you may be able to identify some positives (always a good thing to do) – ‘it’s a nicer journey’, ‘there is less traffic on this road’, ‘I won’t have to leave as early’. Most changes have both pros and cons – if you can look at the cons with someone who has more of an independent view, you should be able to find some positives.

When it comes to ‘what I’m going to do’, you may want to look at ways you can be positive and make the most of change. We talked earlier in Part Two about the fact that there are some things you can control and some things you cannot. It is better to focus on what you can control and, when it comes to change, one thing you can control is how you respond to it. So, when it comes to moving further away from work, a positive response might be that as you can leave later to drive on a quieter road, you can use the extra time to maybe read a newspaper or go for a walk before you leave.

The more you can get involved with change rather than letting it happen to you, the better you’ll feel about it. You may find it helpful to have a plan for dealing with change. So, still focusing on moving to that new home, you may want to break down this ‘big change’ into small tasks – ‘small steps’ are always a good way of approaching any ‘big journey’.

So a ‘to do’ list of things that need to be done can help, with tasks being spread out to allow plenty of time. A daily list of ‘feel-good’ things you can do relating to this change may be helpful as well. So, a move to a new home in the country might involve a different walk each day to find your way about alleyways and lanes, saying hello to anyone you meet, passing the time of day with at least one person on your walk and so on. If you are not so keen on meeting people, you could change some of these feel-good moments to spotting birds or wildlife.

Times of change are always good moments to pay a little extra attention to your physical and mental health. So, physically, getting enough sleep, taking exercise and eating and drinking well are all important. When facing change such as moving home, Michael found it effective to try to stick as close as he could to a regular routine as this soothed him and made him feel more in control. Mentally, you may want to set aside times to relax, do some deep breathing exercises, take a walk and so on.

July 2014

A holiday in sunny Felixstowe

We are moving back to my family home in Felixstowe for a month or two as the lease on our rented home is up and it’s going to be a while before we can move into the cottage. We need to now empty our house and clean everything. It’s difficult because I love this house a lot. Cleaning it is going to be a mission. We will have to put stuff into storage at my parents’ house and at Niamh’s sister’s place.

* * *

I’ve decided to quit Game. I know everyone will be really disappointed in me, but it’s been stressing me out and I feel like a lot is piling up on top of me. Uni work is increasing and I have to prepare a lot more for shows and lectures. I know everyone will assume I’ve quit because I’m not well again, but I’m actually trying to look after myself before I get so stressed that I make myself ill. In my head at least, I’m trying to manage my health better, even though I haven’t been feeling that great recently.

* * *

We have started moving out a few bits and pieces from the house, but I’m starting to think that there is going to be way more to do than we even thought. It will be nice to be by the sea for the summer and I will be able to do more stuff with my brother and sister, which is cool. My brother tends to come along to the cinema with us whenever we go.

* * *

We have just taken some of our stuff to Felixstowe so we can get a little settled here. We are squashed into a small room, but at least we have somewhere for the time being. We could maybe have stayed at Niamh’s mum’s place, but I think that would have done my head in one way or the other. Her mum is lovely but I would not want to live with her.

* * *

Niamh and I took Bernard (the family Jack Russell) for a walk along the beach, which was nice. Bernard was originally Niamh’s dog and I can still remember meeting him for the first time at Niamh’s big house. They had three dogs; Bernard was the smallest. The other two were massive, and when I first walked in and they ran at me, I almost fell back out the door.

That’s also when I met the rest of Niamh’s family. I drove over to their house to pick her up to go off to our friend’s house party. I remember tuning into her driveway with a moat and, at the end, a massive mansion house. I felt out of place straightaway as I had long bleached hair and pierced ears. I walked in and saw Niamh’s dad for the first time. He strode up to me and shook my hand fiercely and then went back to his fire. I then met Niamh’s mum who hugged me. Her mum’s really nice.

* * *

Niamh is back at work and I’m in Felixstowe at my parents’ house. I just got back from a day in Norwich doing university work. There is quite a lot to do now, but the tutors are awesome and help me out loads. I’m doing some cool work that involves turning my illustrations into animations.

* * *

Things are moving forward with our house and it looks like we will be moving there soon. That will be a mission again, though – moving all of our stuff there.

* * *

Things have been stressful for Niamh at work. I have been a little bit down lately as well because I haven’t seen friends all that much since I got out of rehab. I’ve found it too hard to see old friends again regularly. I still feel a bit ashamed, to be honest.

* * *

I’ve started doing a little bit of freelance illustration via the internet. It really doesn’t pay much at all and my dad says I am selling myself short, but I’m definitely enjoying doing more artwork and it’s cool getting good feedback from people. I need to start putting together a presentation that I will be giving later on in my university course. That scares me a bit as it will be in front of a couple of hundred people. My animation is also coming together nicely and I’m learning some interesting new skills.

I’VE ALWAYS ENJOYED DRAWING AND DOING CARTOON CHARACTERS OF MY OWN.

* * *

I have noticed my mood slipping a bit lately and I’m not really sure why. I have been on and off different pills for many years. The first time I tried them was when I came back to live in Ipswich and I felt awful. I then tried coming off them every six months but hated how I changed. I think pills are a good way of helping someone in a desperate situation but, in general, I think it’s better to find other methods so you don’t have to rely on a pill to make you happy.

I decided a while back that I don’t want to have to rely on pills to be happy. More often than not, they made me feel worse anyway. You have to be careful when it comes to antidepressants. You’re meant to come off them gradually, whereas one day I lob them all in the bin and the next day I feel like death.

Those experiencing mental health issues such as anxiety and depression, and a whole host of related matters, will, at some stage, hopefully seek help, most likely from their GP to start with. We’ll talk more about getting help, GPs, self-help groups and other formal and informal routes to recovery in Part Three of the book.

But, as a general guide, the earlier help is sought, the better. GPs are a good place to start. Michael had issues with some GPs who he felt did not seem to engage with him and he also believed that too many issued pills as a quick fix. Other sufferers have had more positive experiences and these days, with mental health much more out in the open than it was, many GP practices are more on the ball.

Medication is often one of the first treatments offered by GPs and tried by those with mental health issues. Medication works for some but it is not always for everyone. There is no one-cure-suits-all solution to mental health and you have to see what works best for you, but, if prescribed by a GP, medication is worth trying in the first instance, with the correct dosages taken regularly at the right times and for the prescribed period. It often takes six to eight weeks for medication to start working well, so you need to stick with it. Regular reviews are advisable. Few people with mental health issues want to be on medication indefinitely and often seek alternative ways of managing their mental health, perhaps alongside lower dosages of medication.

Michael did not want to take medication and came on and off the pills for some time, with sudden stops having various physical and mental side effects. Physically, he experienced headaches, constant sweating, muscle pain and tiredness. Mentally, he felt he became more emotional, extremely depressed and, at times, suicidal.

Other people who have come off medication too quickly report a range of side effects including the most common ones of head pains, stomach upsets, dizziness, flu-like symptoms and insomnia, as well as increased levels of anxiety, vivid dreams and increased levels of depression.

If you are on medication and want to come off, it’s best to take advice from your GP before you do. They know your physical and mental history, the medication you are taking and the dosages and side effects. Generally, it’s wise to come off medication slowly. For example, you might want ease off over two weeks if you have been taking medication for up to eight weeks. Longer than eight weeks, and you may want to taper down over the next six weeks. Check with your GP first.

It may be helpful to keep a diary showing what you are taking and when and how you feel over that time. You can then share this with your GP who may suggest reducing or increasing dosages accordingly. You should also keep an eye on and a written note of your mental health as you come off medication. It can take a month or two for the medication’s effects to work through your system. You may want to make sure you have a healthy routine and step up your stress-related and relaxation exercises during this time. Get support not only from your GP but from positive friends and family members too.

A good analogy we’ve come across for coming off medication is that of trying to land a plane – maybe a glider if you’ve not been on them very long, a jumbo jet if you’ve been on them for ages. You don’t want to come down from 30,000 feet to the runway in a nose dive. You want to circle for a while, talk to the control tower, get yourself well briefed and ready, and then come down slowly so that you land smoothly rather than crash-land.

October 2014

Home sweet home

We are now in our new home! It’s in a village just outside Ipswich. This morning, my dad helped fill up my car and his, and we moved the stuff over in a couple of trips. It’s about ten miles between the two houses so it took a while.

We have been putting the place together and making it feel homely. I have a great studio space. I haven’t got a proper desk at the moment, but the plan is to go to IKEA at some point and get one and anything else we need to fit the house out.

I’m not very good with change, so I need to get settled here. It’s really nice having a garden and the area around us is pretty quiet. I’m used to living in the town centre, within walking distance of shops, not sheep, so it feels weird being further away from that. The house gives me good space to do my artwork. I need to try to do some more art really because it helps my mind and keeps me staying positive.

* * *

We have been here for a few days now and getting more settled. We live much closer to Niamh’s work; she can get there in under ten minutes. Niamh has already made friends with a woman who lives close by called Jenna. Her boyfriend is away in the forces, I think, so she’s on her own a lot of the time. It’s weird to think I’m now married and have my own house. Despite having some bad setbacks, things have fallen into place.

Niamh’s mum is popping over later to have a look around the house. I have always been quite close to Niamh’s mum and she has tried to help me a lot. She means well. I like her a lot. I also think Niamh is inviting over her friends this Friday night. I knew one of them back when we were at college. I think I’ll just find it awkward, though, sitting around having a meal with people I don’t really know. Also, they will look around the house and see my weird collection of toys and paintings.

* * *

Last night went fairly well. I do tend to go into my shell a bit around people I don’t really know. That can be a problem as people just think I’m being rude, which isn’t the case – well, most of the time. It turned out that Jenna’s boyfriend is also a bit of a geek and has his own collection of weird man-child things. To be honest, I think most men do. My dad’s room is full of Doctor Who posters and figurines and he’s in his fifties. He also had a blow-up Dalek at one point.

Michael’s routine at this time was very important to him and his fear of change was as much to do with disturbing his routine as anything else. Those with mental health issues often benefit from having a structure to their days. It provides comfort and can reduce stress levels and anxiety. These are some of the common features of a good mental health routine. As ever, it’s not set in stone; pick and choose those bits that suit you best.

Most people benefit from getting up at the same sort of time every day, making sure they allow enough time to do whatever they need to do before they have to get to college or start work. If you don’t have anything to get up for, it’s still good, mental health-wise, to try to be up at a particular time, perhaps to go for a walk or swim. Michael, at his lowest, spent all day in bed, dwelling on his worries, and this was a likely contributory factor in his decline.

Some of those who have had mental health issues say that a key part of their routine is to shower and put on clean clothes – something that is natural to many people but one of the first things that gets overlooked when someone is in mental decline. Michael used to spend days and days in bed. Personal hygiene was not a high priority.

All sorts of health experts say that breakfast is the most important meal of the day and something healthy such as porridge offers a good start. Michael did not eat breakfast for years and it was another factor in not feeling good, both physically and mentally. Eating and drinking regularly and healthily through the day are key components of a good mental health routine.

It’s good to get some exercise every day, even if it’s walking the dog or going to the shops on foot rather than by car. Cycling, swimming or even a little jogging for 20–30 minutes a day does wonders for your physical health and improves mental health by easing stress and tension.

Too much work can make you stressed and anxious. Equally, too little work can have the same effect. You need to handle your workload, perhaps by having a ‘to-do’ list of things that need to be done today, this week, this month, and then spreading those out according to their priority. If you have too little to do, perhaps because you are unemployed, you may want to fill your day with a mix of activities – gaming, going for a walk, playing on your mobile, doing some household chores – so that you keep busy-ish and your mind is occupied.

It’s a good idea to have some fun in your day, whatever ‘fun’ is for you – kicking a ball about, singing to music, putting your pants on your head and dancing or whatever. You should build in times when you can relax, perhaps before, during and after work. This might be a mix of relaxation exercises such as meditating on a mantra or doing the eternal flame exercise.

If you are on medication, it’s important to follow your GP’s instructions about taking them; you may benefit from taking them at regular times, partly because it’s easier to remember to do so but also to make sure they work effectively (they may, for example, need to be taken so many hours apart). Michael regularly went on and off tablets cold turkey without taking medical advice and it was detrimental to his physical and mental health.

As with a regular wake-up time, most people benefit from going to bed at the same sort of time each night and getting ‘a good night’s sleep’. Generally, the old ‘eight hours sleep a night’ maxim that’s usually offered by experts holds true for most people. You may want to lead into this by doing some wind-down exercises, such as deep breathing, and avoiding anything that might wake you up – spicy food, fizzy drinks, horror movies, etc.

For most people with mental health issues, a routine is good for them – it offers control, structure, comfort, reassurance and all sorts of mental health boosters. If you’re having a stressful journey home, delayed on the train or in traffic, the thought of a relaxing bath on arrival can be a big plus. Of course, it’s important that you don’t become a slave to it; if your day is disrupted and you cannot do, say, a relaxation exercise as planned, you can still aim to maybe build in the favourite parts of your daily routine, just a little later.

November 2014

Uni’s going well

It’s starting to get colder again and I know we will feel it here a lot. We don’t have central heating but we do have a fireplace. I think we will borrow some electric heaters from my parents. Niamh has been very busy at work. I miss getting to spend time with her, but I also like being on my own, although when I am on my own, I overthink everything and that can sometimes pull me down.

Today I had university so I drove up to Norwich. They have some cool shops there so, after I’d finished, I had a quick look round town and picked up some veggie bits for dinner. I have been vegetarian for quite a long time now and Niamh has been pushing the vegan thing as well. We are giving it a go after I watched some pretty horrific documentaries about animals being mistreated. Trying this vegan thing is hard, though. I just leave Niamh to sort out what we can eat.

I have started putting together my final animation for this year and a small presentation I have to give. My main tutor, Sara, has helped me so much, as well as Raj, my other tutor. I do feel like I’m learning some new skills and that I’m achieving something. Niamh keeps reminding me that having a master’s under my belt would be awesome and something not many people get to do or achieve.

Crazy to think I came out of rehab, got married, got a house and will have a master’s next year. When you put your mind and effort into something, you can gain a lot. I have also found you have to put yourself in situations you find uncomfortable in order to progress. When I shut myself away and hide from the world, I get worse, but when I do things and meet people, my life improves. Even if at the present moment I’m very anxious.

I still get anxious about things that any normal person would be scared about, like giving presentations to large groups of people. I still find myself getting anxious when I meet new people, and also meals because I know people are watching me because of the anorexia. I try to control my anxiety in different ways. For me, breathing techniques are important and I always take a moment to breathe in and out for a minute or two whenever I feel particularly stressed out.

I also learnt about something in CBT at rehab called decatastrophising, or decatastrophisation, which is about how we can retrain our thought patterns when we are feeling anxious. When I am anxious, I imagine what could go wrong and work out the very worst that could happen (i.e. something catastrophic). To deal with that, I try to think about things I have been anxious about in the past and then think about how it was after the event happened. Often, there’s a big difference between the ‘bad’ expectation and the ‘good’ reality.

A simple version of this is to think ‘what if?’ and ‘what then?’ So, ‘what if the worst thing happens, what then?’ The worst thing that might happen when I meet someone for the first time is that I could say the wrong thing or dry up and/or go red. What happens then? Not a lot really when all’s said and done. They’d probably think I was maybe shy or nervous or, perhaps, weird (which I am). So that’s not so bad. It’s not like my trousers have caught fire or my head’s fallen off.

I also keep a notebook and write down things that I’m anxious about and then afterwards I make a note of how it actually was. That way, I can see my worrying is often not valid. Notes and lists and checklists and diaries are all ways that I try to separate myself from my thoughts and feelings to make sense of them from a distance. I’m not sure that’s logical and I don’t know if anyone else does it, but it helps me.

THIS IS ONE OF MY FAVOURITE PIECES AND EVERYONE AT MY PRESENTATION SEEMED TO LIKE IT.

December 2014

Our first Christmas in a proper home

It’s coming up to Christmas time and Niamh and I are going to have our first proper Christmas together in our new home. I think we will then go and see my family on Boxing Day. I’ll also do the traditional Christmas Eve with my family (the panto-and-cinema combo, mixed with me running around buying last-minute presents).

I have been writing and making video game reviews for a website for a month or two, but it seems to be building up a bit. Another site has contacted me, asking if I want to start doing some writing for them, which is exciting. It means I will be sent games to review and then I post my comments for people to read online. I’ll probably end up like my dad, sitting in a room all day, writing. I think my dad’s fine with his own company for most of the time, but I am not sure I could do it forever as he does. I think I would go mad (madder anyway).

I think there may also be the chance to make some video content, which is exciting. I have always loved playing games, even though some people think it’s bad for you. I have always believed in doing what makes you happy, and when I’m down, playing a game for an hour can take me away from other thoughts or feelings I’m having. I believe playing video games for a period of time can help with depression. I am a bit OCD-ish, though, so I try to limit myself to a set time for gaming; it can be addictive and not so good for you if you have that type of personality. Addiction is the one thing I don’t seem to have had – yet anyway.

* * *

Niamh is seeing friends tonight for a party with work. I always find this difficult because I’ve pretty much lost all of my friends and still get very lonely. I probably spend 80–90 per cent of my life on my own. I don’t think being alone helps my mind. I’ve been feeling down, but no way near as bad as before the Priory. I just have little dips and my eating has been okay on the whole. It’s not an issue for me any more. It’s just the depression that comes and goes from time to time.

Coming off meds suddenly again has messed with my head. I came off them some time ago and then tried them again for a while, but I’ve decided I’m never taking them again. I know it’s not normal to cry for no reason, though. I still feel guilty when I get down. People always say to me, ‘Why do you feel sad when you are lucky and have such a nice life?’ I don’t know what to say, but all I know is that I’m very lonely and I end up feeling lost.

* * *

Niamh and I have been putting Christmas decorations up around the house. Niamh is fairly stressed at the moment as I think her boss is giving her grief. She doesn’t have an easy job and I know that she pretty much has to run things at work. Niamh’s closest friend there is also leaving to have a baby soon, so that will put more pressure on her. I can see that she is getting down and finding it too much. I’m trying to suppress my feelings when I’m sad, which probably isn’t a good thing, but I don’t want to make things harder for her.

Relationships are weird and a delicate balance. People come together and when it works those people would do anything for each other. That’s when people truly love each other. Relationships that last are because people help and care for each other and aren’t out for themselves. Relationships break, I believe, when there is an imbalance, which is difficult because I believe all relationships aren’t always equal. I don’t think ours is.

* * *

I’ve just got back from Christmas Eve with my family. I started by meeting them at the panto, which is always awkward/funny as my brother and I avoid having to sing or dance at all costs, whereas everyone else jumps about and claps and sings along. My mum’s the worst. I think she’d lead a conga if she could.

After that, I had to run around the shops grabbing last-minute presents before meeting my dad, sister and brother at the cinema to see the latest Night at the Museum film. We have always gone to the cinema on Christmas Eve. I’ve only ever missed one – when I was in the Priory – and can still remember the first time me and my dad went when I was very little. We saw Homeward Bound at the cinema in Felixstowe. My dad remembers the original (The Incredible Journey).

I still love Christmas Eve and it is probably one of my favourite days of the year. I got back home and had dinner with Niamh. Tomorrow, we will get up and probably go for a walk in the morning before Niamh cooks lunch.

* * *

Our Christmas lunch was awesome. Niamh made loads of veggie dishes and I love roast veg – I’m stuffed. I’m now just slobbed out on the sofa watching TV, and I think there was talk of my sister popping over for a bit. Soph is still with Paul and I think things are going well for them. I think tomorrow Niamh and I will go into town for the sales before going over to see my family. I always like going there at Christmas time.

* * *

Heading off to see my family now. Had a nice day so far. Boxing Day is always a weird one and over the past few years they have been a bit all over the place. My dad always makes home-made Christmas crackers with scratchcards in them. Sophie or I always seem to win something, which is brilliant. I just wish I could swap all the luck I have in life for happiness. I think that happiness is the key to life and I’d give up almost anything for that.

Michael has written about feeling lonely for some time – first in the Priory, where he was surrounded by people, and lately when he was at home with Niamh and was seeing family and friends occasionally and mixing regularly with students on his master’s course. How could he be lonely? Hard to believe, but he clearly was. It’s all to do with depression again. Here are some thoughts…

Loneliness can, in the most rough and ready, simplistic textbook way, be divided into different types. One is where someone is alone for some reason – what we might call ‘proper alone’. Perhaps they have been living with a partner who has died and they are now on their own after many years. Maybe they have moved away to work somewhere else, far from family and close friends, and they too are alone. That type of loneliness is familiar to everyone – the image of an 80-year-old widow who never sees anyone except when she goes to the local shops is a common, and poignant, one.

Another type is linked with depression. Remember, depression shows itself in many ways – we always describe mental ill-health as a tentacled monster – and Michael became anorexic as a consequence of depression and a desire to gain control of something – anything – even what he ate. Loneliness is a common consequence of depression. Loneliness is almost a state of mind; people can be with friends or in a crowd and they can still feel as if they are detached and alone. Michael’s diary entries show that loneliness is a thread that runs through his life. It wasn’t, as often as not, that people weren’t around. He just felt apart from everyone.

With loneliness (and this applies to different types, although we are talking here about depression-related loneliness), it is a good idea to make a plan for combating it. Michael has often talked of keeping his mind busy to stop it from dwelling on downbeat issues, such as loneliness, and planning ways to ‘keep busy’ is helpful; routines, schedules, eating regularly and well, exercising at the same sorts of times each day – these are all beneficial.

This ‘keeping busy’ can be anything from taking up a hobby with people who have similar interests – so there is some common ground and a feeling of attachment rather than detachment – to volunteering; staying busy-ish with people you can identify with is the key. As time passed, Michael played games online with other people and that seemed to help him.

Social media have many pluses but, as mentioned in Part One, they have their downside, what with trolls and anonymity and vulnerable people with mental health issues. It’s a potent mix of possible negativity, and those with a depressive and anxious side need to think carefully about their usage of social media.

With loneliness, social media can offer ways to interact with like-minded people and some sufferers have said this is a big plus for them. Michael has benefited from it. You can, for example, find online forums on whatever interests you and can follow what’s happening without joining in until you feel ready. That ‘being part of a group’, but without being pressured to step forward and take the lead, can be a boost.

Many experts say that, generally, with loneliness, it is more productive to try to build friendships that are real and living and active – you see someone face to face, to have a drink and a chat – rather than virtual friendships that can be turned on and off with the click of a button. Building in time to see people – even if it’s only to pass the time of day – can be effective. Again, you might join a group – book reading, a writing group – and sit at the back until you feel ready to participate more.

Those who live with depression, anxiety and related issues often turn away from loved ones and that tends to worsen feelings of loneliness. If you are aware that this is an issue, the trick – often easier said than done, of course – is to try to do something to engage with other people.

It doesn’t need to be a big step – remember, we are big fans of small steps here. It could simply be that you’d start with a ‘How are you doing?’ email to someone you have not seen for years, a smile and a ‘good morning’ to someone you pass on the stairs or in the corridor at work.

‘Feeling lonely’ when you suffer from depression or anxiety is often, at least in part, as much about feeling as though you are different, not understood or uncared for as it is to do with ‘being alone’. Michael has often spoken about being ‘the weird one’ of the family, although, in many ways, it is a self-imposed title.

You can perhaps talk to people who you might perceive to be ‘different’ too; taking Michael as an example, he has tattoos, quite commonplace these days, and it is relatively easy to strike up conversations with others who have them. That ‘difference’ then starts to ease away. If I want to strike up a conversation with someone at a seminar or convention and they have tattoos, a simple ‘I like your tattoos’ is a perfect ice-breaker.

Friends and family, although they may not understand your thought processes, will benefit from hearing them, and spending time together may show that you are cared for. There are all sorts of self-help groups out there too – more on these in Part Three. Who better to understand someone with, say, depression or an eating disorder than someone else who has experienced it?

Remember, we always stress that there is no one-size-fits-all remedy and those who have experienced depression-related loneliness offer different ideas. Some may suit you, some won’t. You have to find your own way. Keeping a diary – what you feel, when, how long – is suggested by many; this can be useful as you can start to head off anticipated upcoming feelings by keeping busy.

Keep expectations realistic. This touches a little on ‘small steps’. In essence, don’t expect too much too soon. If you are feeling 0/10 lonely today – and some people have suggested scoring your feelings in this way – you are not going to go to 10/10 any time soon. But a sunny day and some good news in the morning may see tomorrow get a 1/10 score. Equally, if you join a group, you are most likely not going to find a life-long friend or the love of your life (well, you might, one day…), but you may spend time in good company and forget your troubles for an hour or two.

Another idea offered by some is to be as pleasant as you can to people. Many people with depression and anxiety are not fun to be around. Deep breath… Michael was not, over these years, someone who I really wanted to spend much time with except out of parental duty. Let’s speak up for family and friends here – it’s not easy for loved ones either when they are faced with someone who is unhappy. The more you can engage with people and be positive towards them, the more that comes back your way.

Meditation – we talked of this in Part One – is something that is mentioned by sufferers time and again. Sitting quietly, focusing on a candle, relaxing and possibly chanting a mantra can bring a sense of inner peace and acceptance. Try it – see what works best for you.

January 2015

Life goes on (and on)

Niamh is back at work now and I’m on my own. It’s okay because I’ve got lots of work to be getting on with. It just feels weird at first, adjusting back to being alone again. I don’t find it easy, but I’m still working on my series of animations that will all come together at some point. That helps. If I didn’t have stuff to keep me busy, I might struggle more than I do. I think I might be in trouble.

February 2015

Days of reflection

Today, Niamh and I went to London for the day. For Christmas, my parents got me tickets to go and see an exhibition by an artist who makes massive Lego sculptures. It was great and nice for us to do something different. I’m not a huge fan of London itself because it’s noisy and crowded and rushed, and that stresses me out quite a lot, but I did have a nice day and we spent some time together and we got to chat.

* * *

With relationships, I think it’s important not to get stuck in a rut. It’s just difficult sometimes with our situation, with Niamh working all the time. She gets back late and is often knackered, and I’m a bit back and forward, so we only get the weekends together and by that time we just want to chill at home. I also like routine.

On a Saturday, we tend to wake up, have breakfast, have baths and get ready. We then go to do the weekly shop at Tesco before coming back home. Sometimes, we stop off at Niamh’s work to sort bits for the next week. Then, usually in the afternoon, Niamh will do stuff about the house or we will go into town to look around the shops and have a drink. We then come home and have dinner.

I know it’s a pretty simple routine but I like having it. I think in some ways a routine can help someone with mental illness, but I also think it’s important to push yourself into trying new things and getting out there. It is not always easy to get it right.

* * *

I’m trying to focus on my work, but my mind has been finding it hard and I’m not really sure why. We have been a bit distant since we got back from London and I’m not sure what to do. I think that we are both just stressed. I need to keep going with my work and make sure that I keep hitting the deadlines. I think I’m doing fine and the tutors seem happy with the work I’m producing. I’m also just trying to make sure that my mood doesn’t dip too much. I know I have blips sometimes and it’s just about staying on top of it.

March 2015

Down in the dumps

I’m just focusing on my university work at the moment, but I definitely don’t feel right. I hope it will just be a phase. These feelings do tend to come and go with me. When that happens, I just try to strip my life right down to the basics to avoid stress. That can be difficult, though, when there’s lots on with university.

Niamh is really busy at work at the moment, so we don’t see each other a huge amount. She keeps working late and talks about her boss being a pain. I think he just tends to disappear some days or not even turn up.

Niamh is pretty much running things now that her best friend has been on maternity leave and has had her baby. I think her friend wants us to look after the baby at some point whilst she gets some stuff done.

* * *

I just gave a big presentation at university in front of a lecture hall full of people. I had to talk about myself, my work and how I came to make the piece I’m currently working on. My illustration is quite weird and a few people asked me if I was on drugs whilst making it. (No.)

I do tend to make quite psychedelic artwork with bright neon colours. I’m also making illustrations based on the classic Greek myth about Icarus who flew too close to the sun. But I’m doing it set in the distant future with a sci-fi setting. It’s all a bit mental really, probably is very mental.

I got good feedback, though, from my talk, which was good considering I was a sweaty mess. It was a right nightmare getting home as well. I got the train up and the winds were bad. EVERY SINGLE train was cancelled on the way home. Niamh had to drive all the way up from Ipswich to Norwich to get me after work. I just sat in Morrison’s café bored out of my brains.

* * *

I’ve had a week off university because it’s non-taught week. It’s nice to just do some work at home, although it’s a lot lonelier. I can go sometimes without seeing anyone for a very long time, especially if Niamh has things on and is out in the evenings.

I sometimes do not talk to anyone for literally three or four days. I don’t think it’s good for my mind and it makes me feel down.

It makes me miss Niamh more and I tell her that, but she is not all that happy about it. I’m reaching out to Niamh because – imagine not having anywhere to be, with anxiety levels rising. If you’re not talking to anyone, then you start to think a lot more and it gets worse and worse.

I’ll focus on doing some painting and see if I can get any freelance illustration pieces on the go. I’ve also been doing some more game reviews and have been asked to do a voiceover review for the new Witcher game. I do like seeing my work being published on the gaming website and seeing the feedback it gets. I like writing.

* * *

Starting to feel a bit low again. My eating has been okay still and I’m trying not to let my mood dictate that. I just need to keep working and then also try to enjoy the things I like. I’m trying to get out and about as much as I can but I have felt my mood slipping.

Niamh has been staying behind late at work to help out. She mentioned there is a new work colleague there. She is helping him settle in. We have been fairly distant recently and have only been spending a couple of hours here and there together. We used to spend so much time together doing stuff. Every moment we could, really.

May 2015

The end of the world

My heart is broken.

Literally feel in so much pain.

Niamh came home today after work and told me to leave for good.

She wants a divorce and for me to move out.

I feel completely and utterly broken and don’t know what to do.

I want to die.

The boy, with the monster on his back and its tentacles wrapped around him, writhing and twisting at his body, struggled along the path through the woods. He had been walking like this for ever such a long time, at first not noticing that the monster had come back and was behind him, and then hardly realising it had climbed onto his back and had wrapped itself around him again, just like it used to do. Now he knew, at last, that it was close to overpowering and killing him.

He thought that if he could only make it through the woods and back onto the plain and into the safety of their hut, his sweetheart – now his wife – would help him and they could somehow fight off the monster together. If he could just shake the monster off his back and then turn and confront it, they could be rid of it once and for all.

The boy, battling against the monster with all of his strength, made it to the edge of the woods and he could see the hut. There was no one else living near them to help; they had moved out of their little village to be on their own a while ago. And their families lived in villages further away. But it did not matter. The boy knew he just had to get to his sweetheart and, between them, all would be well. It always was and it always would be. He knew that for sure, with all of his heart.

Step by step, the boy crossed the plain, the monster thrashing and beating at him with its tentacles, as if it knew that the boy and his sweetheart were about to rise up and fight it to the death. Five, four, three, two steps, and one. The boy was at the opening of their hut. With a final furious struggle, he dragged himself in, ready to turn and fight his tormentor alongside his loved one.

The hut was empty, except for his own few possessions. His sweetheart had gone and had taken everything else. She had left him. Gone, for ever. The boy somehow managed to turn, the monster now still and watching him with its malevolent eye, and staggered out back on to the plain. He collapsed, sobbing, and lay there for what seemed an age. The monster waited, as if relishing the boy’s heartbreak until, eventually, the boy twisted and turned on to his back and faced the monster rising up above him, ready to strike. ‘Enough. Kill me, kill me now,’ begged the boy.

The monster pulled itself up and its tentacles slowly started to writhe and thrash above the boy’s head. The boy, defenceless, shut his eyes and waited for the monster’s death blows. One second passed, and then another. One more and the boy opened his eyes to see the monster had stopped and turned to stare towards the woods. The boy followed the monster’s malevolent glare.

The boy’s father stood on the plain. He looked as though he’d rather be anywhere but here, but he was carrying a sharpened stick and took a slow and careful step towards the monster. Next to him, the boy saw his mother, a long-suffering expression on her face, appear brandishing a knife, and she started moving towards the monster too.

Then his sister stepped between the two of them. She didn’t have a weapon but she had the loudest voice the boy had ever heard in his life and she could shout longer than anyone he’d ever met. Then his younger brother joined them. He looked confused, but at least he was facing the right direction. Finally, as the boy rose on to his elbows, he saw their dog come running out of the woods, joining the family as they advanced upon the monster…