Issue 2 (Summer 2007) by Sanctuary magazine

summer ‘07

issue 02

Inner space for women’s mental well-being

Postnatal depression

“Thou cam’st, a little baby thing, That made a woman cry”

Was it something I ate?

Fact; diet impacts on mental health

Self harm

“I cry through the blood; my body cries for me”

Here are some of the things women said about the first issue of Sanctuary. They are all bona fide quotes (in other words, we haven’t made them up!): I was pleasantly surprised

to find the articles relevant and informative. Other mental health publications are so boring and condescending!

Love the graphics!

When I first saw it I thought, this looks amazing

When my friends and I go shopping, if we find a bargain, we all chorus ‘Serendipity’!

It ’s brilliant ! Not only is it beautifully presented, I found it interesting and informative. What I particularly enjoyed was the style and content of the writing. As a recipient of mental health services for some years it was a real pleasure to pick up something that treated me, the reader, as if I had a brain and was not just a ‘mental case’!

What you would like included? “An amusing article on how to cope with the endless waiting involved with CMHTs.”

“For me, PND (post natal depression) was a black cancerous fog that filled my body, seeping out, infecting everything…. Ironically it was while I was lying about how fine I felt to my health visitor that I realised how badly I needed help.” This is the beginning

of one woman’s story of post natal depression, from the website www.surreypnd.nhs.uk. It captures the horror and the terror that the estimated one in ten women experience during and after childbirth. Often PND is an out of the blue invasion of a new mum’s mind – and body. It manifests in many and varied ways and is painful and frightening for her and all around her. In this issue we look at PND and what there is in Surrey, like Pram Walks, and in treatment that helps and supports new mums. What else have we for you in this, our second issue? Firstly, just a glance at the page opposite will tell you how many of you liked our first issue. It is amazing to get feedback like that and we want more! Your Letters for instance - comments, ideas, questions (we can’t promise to answer everything or publish every letter, but we’ll have a go) and we’re not averse to criticism – but constructive please otherwise we’ll get teary-eyed! ‘It’s Outrageous!’, page 16, captures a few of the things that women have told us have been said or done to them – by mental health service staff - whilst at their most vulnerable and unwell. It beggars belief.

And our regular features will continue and include ‘Border Lines’ focusing on personality disorders – this issue, self harm and its prevalence in border line personality disorder and other mental suffering; Serendipity – dressing to impress on less. And there’s no getting away from it – believe us, we’ve tried – those blasted five a day fruit and veggies really are important! BUT – with supermarkets labelling our sarnies so we know what’s healthy and what’s not, are we better off? And can you have chocolate?! So, put your feet up and we hope you enjoy your second Sanctuary…

“Self help strategies for common disorders like panic attacks.” “A contributions page from people suffering, in recovery or reflecting upon their experience of the mental health journey.” Tell us more! Send in your letters, articles – we will publish what we can but don’t be offended if yours doesn’t make it; every contribution is special but we’ve only got 20 pages! Sanctuary is published quarterly. The next issue, due out end September, beginning October, will look sensitively but openly at childhood sexual abuse and how that deep harm rarely, truly heals.

Sanctuary is free to everyone.

If you would like to subscribe, please write, email or telephone: Sanctuary, c/o Let’s Link, Langley House, Church Lane, Oxted RH8 9LH. Email: megan@meganaspel.wanadoo.co.uk Phone: 01883 383919 / 07824 364703 Editorial team: Megan (managing editor), Diane, Elaine, Sally Design by ASPECTS: tom@aspectsgd.com www.aspectsgd.com Printed by Reliant Colour Solutions: www.reliantcolour.com No part of the magazine may be reproduced without prior permission of the publishers. ©ASPECTS 2007.

4 'Then it was all

How first time motherhood gave birth to suppresseπ memories

1 'Here’s your baby’.

In a three second swing past my right knee I caught my first glimpse of my first born, on his way to the paediatrician team and their resuscitation trolley. So ended 4 days of labour and 25 hours since my waters broke.

2 'Except it didn’t.'

End there. The episiotomy healed, the headaches from the dural tap eventually cleared, and all external scars seem mended 18 years later. What didn’t end was the terrible out of controlness that was going on in my head.

3 'Initially, back then, it must

have been shock. Was I alive? Was my baby alive? Where was my baby? Why was everyone saying how brave I was? I am not brave. I hate being hurt.

bright light that hurt my eyes. I was unable to move, a blur of people in and out, examining me, talking over me. Why not? After all I was just a body on a bed with lines going in and out, a mass of bags and monitors. The next day my mother came to visit. I had to lie flat for 10 days and I remember her leaning over and looking at me then rushing out in tears. Evidently she wasn’t happy either!

5 'And that is how it was;

probably the hardest 6 weeks of my life. By week 8 my very experienced health visitor knew all was not well. I was fortunate. An enlightened South African psychiatrist from St. George’s came to visit. I described the birth, the appalling nightmares, the waking visions, the fact that I was easily startled, jumping at everyday noises. I couldn’t go out. I was such a bad mother because my body couldn’t give birth properly. I had to have the baby with me all the time. It was the only way I could protect him.

And baby came too... 4

The following story is an account of how one woman’s first experience of childbirth released suppressed memories of her own childhood abuse. It is told in a simple, unembellished way that belies the pain and loss she has suffered and the day to day reminder of that fateful birth.

8 'I still suffer PTSD.

6 'The psychiatrist

René Magritte: 'This Is Not A Pipe'

said I had Post Traumatic Stress Disorder (PTSD). Eighteen years ago it was only just being recognised following the dreadful experiences of the Vietnam veterans. How could such a natural thing as giving birth make me mad?

7 'They were researching

PTSD at St. George’s at the time and he said that childbirth can meet the criteria for triggering it. My life was in the balance during the birth, they ruled against an emergency Caesarean because I would not have survived. My son’s heart stopped beating during the labour due to an overdose of syntocinnon, so I had witnessed his ‘death’. Somehow he survived.

I have learned strategies to help. I still walk away from all girly birth talk, any medical TV is switched off. I can now drive past the hospital where it happened. Perhaps the saddest consequence is the effect on each of my son’s birthdays. His first, I was completely unprepared for – oh I had the cake, the balloons, the ‘I am One’ bib. It wasn’t that, it was the clock. Minute by minute I relived his birth; 10.42pm waters broke, up to 8am epidural tap, 2.20pm my blood pressure falls dangerously, 3.10pm overdose of syntocinnon; you see I still remember in Technicolor detail.

10 'Is there a happy ending?

9 'The other side

is I have a fine 18 year old son. Of course he was brain damaged and no we can’t prove negligence against the hospital. My son has uncontrollable epilepsy, autism and anxiety disorder. My suffering seems little in comparison.

Not a conventional one – no princess awaiting to care for and cherish my son. Maybe the happy ending is that he survived, he has life. And personally, I have met such outstanding people because of him; professors, doctors, nurses, even his bus driver and escort. As any parent/carer of a handicapped child will tell you, it is amazing how your values and perspective on life changes. Ah, but that’s another story…”

See over the page for what’s happening to support women in Surrey.

“Thou cam’st, a little baby thing, That made a woman cry”

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* The Edinburgh Postnatal Depression questionnaire can be downloaded from the internet

mos to f th e ti lif irr me e is ita ble not mo and e , sn wo rnin spe app gu r c n i ing lty oth th liv gs an ially d b at y and ing i our re to lng andeveni ad con a sta par dy t ook you ngs ntl tne o b for ha y ex r o lam war ve ro hau you the e your d to ste can rc s d, y hil elf rea anxi ’t co you ha e u t dre ssu ety pe – ve l nabl not ran abo wh ost e to abl tear n i u fu et c ce f t t y e h may orm he b may our s njoy y o sle l be hea aby, lead ense our ep fri sel of ght w lth so y to ene orri prof ou co panic humou f d yo ed a ess nst att r yo u h bou ion ant ack Dis ur ba ave a s l t tur by i som your ls or y seek bin s a a g a str un e dr own nyo n som d fri anger able eadfu healt ne eti ght and to c l di h – mes eni se o n inc ng t ot rencent ase lud hou al r eh ght ly y ate arm s t our ing hat s you may rb aby los no s app eti pro low e of sex n te o bl If y ems ergy driv r o y u e If y l ou w ’ve ou w may ith m evels pre ere vio dis comf emory If y usl dep tur ort our y re suf B bed eat f If y mum ad bi ssed sle die rth or other ered ou ep a f d d n e r m If y on’t whe xpe xio o e m n ta our ha us d n r bab ve a you w ience when l hea epres l sio y w sup ere (no n t you th as pre porti a chil a pr wer probl or If y this mat ve p d (b obl e pr em s e e a o or u hav has i ure o rtne efore m on i gnan n you r t r t e ’ve prob terru poor or fa the ag s own had lem pt ly ) m e s su ed th – par ily cl of 12) al ot os ti c e as of tr h as fi bond cular e by los oub na ing ly n so f ea les in cial proce if rni you , hou ss ngs r l sin , be ife s g, rea uc vem h ent

you m

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For many of us,

looking at the beautiful baby on the cover might produce a series of ‘aaahhhs’ and ‘googoogoos’. But for 10% (or much higher according to a survey for the Royal College of Midwives in 2006), it might just serve as a reminder of the mental anguish and emotional pain they suffered or are suffering as new mothers. Modern day stresses, more women working, less contact with our families, little practical day to day support through tough times; these are some of the suggestions around the increase in postnatal depression (PND) over the past 50 years. Or was it around as much, but not talked about? PND is very different from baby ‘blues’; the weepy, miserable stage a few days after giving birth, not least due to the huge hormonal changes taking place (again!). NICE (National Institute of Clinical Excellence) has updated its guidance published in 2004 to state; ‘At a woman’s first contact with primary care, at her booking and postnatally, healthcare professionals should ask two questions: 1) during the past month, have you often been bothered by feeling down, depressed or hopeless? 2) during the past month have you often been bothered by having little interest or pleasure in doing things? (This may not be happening with all midwives) Here in Surrey you may find your health visitor undertaking a mood assessment using the Edinburgh Postnatal Depression questionnaire*. Health visitors are best able to help when women can be honest about their feelings although this may be a very frightening or worrying thing to do. Support for women suffering PND in Surrey, ranges from ‘listening visits’ from the health visitor, Support through “First Steps” service including computerised Cognitive Behavioural Therapy, referral to your GP or in some cases to the community mental health teams. You may also be prescribed medication. Local PND support groups have proven very successful. Confidential and informal, they give women the chance to share with others their experience. Find out more by speaking to your health visitor. Undiagnosed and untreated, PND is crippling and punishing. But, with the right support, women can and do get better. Sanctuary would like to know if you have become a mum recently and have found getting help a problem. Meanwhile, lest we forget what a most joyous thing it is when a baby enters the world, let’s hear a great big, collective ‘aaahhh’ for the baby girl on the cover!

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Useful websites and help lines: www.surreypnd.nhs.uk – discussion board very helpful. www.babycentre.co.uk – good resource for a wide range of information – information Discussion board very helpful. www.apni.org and helpline 0207 386 8885 (Association for Postnatal Illness) – provides support to mothers suffering PND by ‘phone, letter or email, or Google postnatal depression for a longer list www.netmums.com – excellent resource for all things to do with motherhood www.nice.org.uk (National Institute for Clinical Excellence) – provides guidance for professionals and patients on a wide range of health issues – search antenatal and postnatal depression If you are in urgent need of emotional support or information out of doctor/health visitor working hours, try: Perinatal Depression/DAPEND: 0845 1203746 (Mon-Fri 7 – 10pm) Saneline: 0345 678000 (12noon-2am) Samaritan’s: 08457 909090 and email jo@samaritans.org (24hrs)

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Pram Walks

are becoming an increasingly popular way to meet other mums, feel less isolated and enjoy sharing experiences and a few laughs. Contact Maya at Surrey PCT on 01737 780209

Art

e v i t a e r theenctal suffering

For the artists

atte

hm t i w n a g be journey

at Art Matters in Horley, the recent Surrey Artists open days was a chance to showcase their many achievements. Achievements, not only in the paintings, sculptures and installations created, but also because for these gifted artists, the creative journey began with mental suffering. Some individuals had an idea they were talented, others no idea at all. For many, the creative therapies – art, drama, music – can be a turning point. Anyone suffering or having suffered mental ill health knows that one of the most appalling things to happen is your loss of who you are; from an accomplished, functioning person able to make decisions in life, you become a label and stripped of individuality. At Art Matters, people are treated as that – people. With the guiding, nurturing hands of David and Mark, individuals find a new way of dealing with their mental distress through art. The process leads people to develop in different ways. Some quickly see a real talent emerging and might go on to mainstream training. For others the outcome is more gradual. One client couldn’t bear to even have eye contact at the start, but in the atmosphere of Art Matters - non clinical, absorbing, welcoming, sensitive – the shyness and low self worth started to lessen and conversation and laughter began to blossom. With every picture, every piece of sculpture or installation a unique story is told – about a unique being. Referral to Art Matters are welcome from GP’s, health/social care professionals, mental health teams, occupational therapists, support workers and carers. For more details ‘phone 01293 784760 or visit www.artmatters.nhs.uk

you become

a label and stripped of individuality

see som a rea e q l tale uic nt em kly ergi ng

Directory We are building on this directory all the time. If you have anything to add that you think will benefit women’s mental health and wellbeing in Surrey, please let us know. You can contact Santuary magazine c/o Let’s Link, Langley House, Church Lane, Oxted, Surrey RH8 9LH. T. 01883 383919; M. 07824 364703; email; megan@meganaspel.wanadoo.co.uk

One of the most important

aspects of support, for anyone suffering mental distress, is advice and information. First Steps is an NHS led service that can help you choose services, organisations and resources, find the right self help materials including their own booklets, self help clinics and Emotion Gyms or they can direct you to a Citizen’s Advice Bureau for help with things like debt problems and benefits advice. They can also tell you about online CBT (cognitive behavioural therapy) which is becoming more widely available as a way of providing support to people who would benefit from ‘talking’ therapies but, because of long waiting lists, may not be able to access a therapist face to face for some time. Contact First Steps on 0808 801 0325, Tuesday and Wednesdays between 12-4pm and Thursdays between 2-6pm. Or go to www.firststeps-surrrey.nhs.uk

Domestic abuse

outreach service – National 24hr helpline 0808 2000 247; Surrey wide helpline 01483 776822; East Surrey 01737 771350 (Reigate & Banstead, Mole Valley and Tandridge); North West Surrey 01483 776822 (Woking, Runnymede and Surrey Heath); North Surrey 01932 260690 (Epsom & Ewell, Elmbridge and Spelthorne); Guildford 01483 577392 or 01483 268661 (Guildford area); Waverley 01483 523205 or 01252 573421 (Waverley area)

Eating disorders

anorexia, bulimia – Eating Disorders Associations, 0845 634 1414 www.eduk.com

Alcohol and drugs

Drinkline, 0800 917 8282 Local; Al-Anon, support for family and friends of alcoholics, find a local group 020 7403 0888. Alcoholics Anonymous, find a local group – 0207 352 3001 Drugscope, for information, www.drugscope.org.uk Frank (for young people and parents) www.talktofrank.com Surrey Drug & Alcohol Action Team – for local services, www.surreydat.org.uk

Anger

British Association of Anger Management, 0845 1300 286 www.angermanage.co.uk

Anxiety

No Panic, 0808 808 0545. www.nopanic.org.uk; National Phobics Society, 0870 7700 456 www.phobics-society.org.uk; First Steps to Freedom, 0845 120 2916 www.first-steps.org; www.anxietycare.org.uk (enquiries@anxietycare.org.uk to find out about accessing free advice and support)

Bereavement and loss

Cruse 08701671677 www.crusebereavementcare.org.uk

Counselling

(but please note, waiting times can be long) British Association of Counselling & Psychotherapy,

0870 443 5252 www.bacp.co.uk (for details of local practitioners) Heads Together (young people 14-25) 01737 378481. No fees Croydon Pastoral Foundation, 020 8760 0665. Negotiable rates according to means North Surrey Community Counselling Partnership, 01932 244070 www.nsccp.co.uk A sliding scale fee basis operates (up to £40.00 per session) Pathways Counselling Centre, Epsom, 01372 743338. Professional counselling, normal rates apply Redhill Counselling Centre, 01737 772844. Negotiable rates RELATE, relationship counselling, 0845 4561310 www.relate.org.uk, for a local branch. A fee is charged for appointments. Relateen, Epsom (part of RELATE but for young people disturbed/worried about parent’s relationship problems) 01372 722976

Depression

Depression Alliance, 0845 123 2320 www.depressionalliance.org

Direct Payments

this is money allocated directly to a patient/service user to enable them to have more choice and independence about the support/facilities they can access in the community. For more information contact Surrey Independent Living Council (SILC), Astolat, Coniers Way, Burpham, Guildford GU4 7HL. T. 01483 458111

Hearing Voices

Rethink, 020 8974 6814 www.rethink.org

Post natal depression, pregnancy and birth issues

Association for Postnatal Illness, 0207 3860 868. www.apni.org; www.surrey.nhs.uk; www.babycentre.co.uk; www.netmums.com

Self harm

www.selfharm.org.uk; www.lifesigns.org.uk; www.rcpsych.ac.uk/cru/auditselfharm

Other useful contacts: Crisis numbers;

Samaritans, 08457 909090 www.samaritans.org.uk Sane Line (12noon – 2am daily) 08457 678000. National out of hours helpline for anyone coping with mental illness – sufferers, carers, relatives or friends. Surrey & Borders Partnership NHS Trust, 01737 778142 (24hrs) Childline; 0800 1111

Community Mental Health Teams (CMHTs) Spelthorne CMHT 01784 440204 West Elmbridge CMHT 01932 876601 Runneymede CMHT 01932 723392 Woking CMHT 01483 756318 Hollies CMHT 01252 312788 (8.30-5.30 Mon -Fri)

Surrey Heath CMHT 01276 671102 Guildford CMHT 01483 443551 Waverley CMHT 01483 517200 Godalming CMHT 01483 415155 Haslemere CMHT 01483 783090 Farnham CMHT 01483 782095 Conifers CMHT - Cove, Fleet & Yateley Area Briarwood, Sorrell Close, Broadhurst, Cove, Farnborough Hampshire GU15 9XW (9.00-5.00 Mon-Fri) Early Intervention in Psychosis, 01372 206262. For 14 – 35 year olds who have had a first episode of psychosis within recent years. MIND, national organisation for mental health with local branches – www.mind.org.uk Infoline 0845 766 0163. Mind produce booklets on various mental health issues and campaign for better services Mental Health Foundation, national organisation for information, campaigns, news, interaction, including information on the relation between diet and mental health; www.mentalhealth.org.uk

Primary Care Mental Health Teams (PCMHTs)

for long term and complex mental health needs and for referral to specialist services such as Crisis Assessment & Treatment Team, Eating Disorders service, Continuing Needs services. Open Monday – Friday 9am – 5pm East Elmbridge PCMHT – 020 8873 4300 Epsom, Ewell & Banstead PCMHT – 01372 204000 Mole Valley PCMHT – 01306 502400 Redhill PCMHT – 01737 272301 Tandridge PCMHT – 01883 385481

Psychotherapy Service (Surrey & Borders Partnership NHS Trust)

Referral only but you can access an information leaflet; contact the Psychotherapy Service at Shaw’s Corner, Blackborough Road, Reigate RH2 7DG. T. 01737 277706 Samaritans; 08457 909090 Surrey & Borders Partnership NHS Trust, for mental health and learning disabilities services - 01883 383838 Surrey Police; 0845 125 2222

W i a∆e?

as it something

What does the food we eat have to do with our mental health? Well, The Mental Health Foundation (MHF) has produced an extensive report that presents compelling facts and statistics that make even the 5-a-day idea just the tip of the iceberg (not the lettuce!) when it comes to feeding body, soul and mind. It’s definitely food for thought…

The report states

that four particular areas of mental ill health have been linked with nutrition deficiencies; depression, including postnatal depression (PND), schizophrenia, Alzheimer’s Disease and Attention Deficit Hyperactivity Disorder (ADHD). To begin to understand the connections, we first have to look at the brain itself. The billions of nerve cells, or neurons, in the brain are connected together through a branch system of axons and dendrites. Every neuron, axon and dendrite is predominantly composed of fat, or ‘lipid’, derived from our diet and Part of the problem is that we don’t get such nutrient rich specifically made from unsaturated fats which ensure food in the same way as we did some years ago. This is they are highly flexible and can work rapidly. This due to several factors, not least, intensive farming that is necessary because between each branch of axons has increased the amount of fat animals, fish or poultry and dendrites there is a gap for messages, called contain (e.g. a chicken in 1961 contained 2% fat, today it is neurotransmitters, to pass back and forth. A sufficient 22%), additives and of course convenience foods, usually balance of neurotransmitters is essential for good full of trans-fats, saturated fats, sugars, salt and starchy mental health. They are influential in the feelings carbohydrates – look no further than a burger, white bun, of contentment (serotonin is a neurotransmitter), mayo, chips etc. In turn, the increase of depression and anxiety, memory and cognitive function. other mental illnesses has increased considerably. Predicted to become the second highest cause of the The MHF report concedes that further research is needed global disease burden within the next twenty years, to develop ways to empower and encourage vulnerable depression has been linked to the intake or lack of people to make dietary choices that will help their mental certain nutrients. Research spanning several countries health. This is vital. How on earth do you knock up a has shown that where there is a low intake of fish for balanced, nutritious meal when you are a) feeling nothing example, there is a prevalence of different types of is worth living for and b) having to count the welfare benefit depression, PND included. Thought to decrease the pennies? symptoms of depression are complex carbohydrates, Organic food is expensive and not wholly understood. food containing folic acid, omega-3, selenium and Many see it as another fad to make money. In fact, it is tryptophan (which produces serotonin), zinc, Vitamin going back to basics. If a cow is fed organically it basically C and B vitamins, particularly B6, 1 and 2. In studies, means it is eating grass! It eats grass, which contains standard treatments have been supplemented with omega-3 so it becomes full of omega-3 and passes it on these nutrients resulting in greater relief of symptoms to us (well it’s probably not that simple but along those in depression and bi-polar affective disorder, in some lines). It’s what everyone was doing some forty years cases by as much as 50%.

ago before everything had to go into intensive, high production, cutting costs by arguably feeding animals on stuff their bodies were never meant to have in the first place. You can read more of the report, plus a booklet called Health Eating & Depression, on the MHF website, www.mentalhealth.org (Over the page, read the comment by Professor Susie Orbach, an expert on the relationship between women and food)

The table shows a list of foods that may help the efficiency of some of the key neurotransmitters. Neurotransmitter

Effects of deficiency

Foods to avoid

Foods to consume

Acetylcholine

Deterioration of memory and imagination Fewer dreams Increased confusion, forgetfulness and disorganisation

Sugar Deep-fried food Junk foods Refined and processed foods Cigarettes Alcohol

Organic/free range eggs Organic or wild fish – especially salmon, mackerel, sardines and fresh tuna

Serotonin

Low mood Difficulty sleeping Feeling ‘disconnected’ Lacking joy

Alcohol

Fish Fruit Eggs Avocado Wheatgerm Low-fat cheese Lean, organic poultry

Dopamine

Lacking drive, motivation and/or enthusiasm Crave stimulants

Tea & coffee Caffeinated drinks and pills

Regular, balanced meals Fruits and vegetables high in Vitamin C Wheatgerm Yeast spread

GABA

Hard to relax Can’t switch off Anxious about things Irritable Self-critical

Sugar Alcohol Tea & Coffee Caffeinated drinks

Dark green vegetables Seeds and nuts Potatoes Bananas Eggs

Would you be interested

in being part of Sanctuary’s own ‘Is it something I ate?’ trial (with a fully qualified nutritionist on board)? For more details contact Megan – phone 07824 364703 or 01883 383919, email megan@meganaspel.wanadoo.co.uk or write to Sanctuary magazine, Let’s Link, Langley House, Church Lane, Oxted RH8 9LH

“I do it to stop thinking. The blood, the cutting gives me something else to look at and concentrate on. Crying is not allowed in my household. My father has a very short temper and if you make noise – like crying – he gets mad. I ’m not incapable of crying, I just can’t. I cry through the blood; my body cries for me” (American female college student, age 18)

www.lifesigns.org.uk www.rcpsych.ac.uk/cru/auditselftharm www.nice.org.uk www.selfharm.org or Google self harm – there’s a lot there!

Self harm

has been linked with different types of personality disorder, particularly borderline personality disorder. But it also occurs in other areas of mental ill health such as eating disorders, post traumatic stress disorder, obsessive compulsive disorder, dissociative disorder and in anxiety and panic sufferers. There is much stigma around self harm. It affronts the sensibilities of those lucky enough never to have suffered mental and emotional distress and even within the specialist mental health services, it pushes the ‘she’s suicidal’ button when in fact self harm – in many cases – is a way of coping with anguish and mental pain, not ending it. The National Institute for Clinical Excellence (NICE) published some guidance in 2004 that is aimed at helping people who self harm – or injure if you prefer – get the right response and treatment from their GPs and mental health teams. Basically the general considerations that everyone should expect are respect and understanding, information and choice, confidentiality and importantly, your consent around which treatment or support you receive. As one young woman told Sanctuary; “My key worker told me off when she saw what I had done (cutting) and said, ‘Why didn’t you call me?’. I said if I’d done that they would have carted me off to hospital again. I’ve just come from there and after 18 months, I don’t want to go back! I told her it is part of what I do. When I get the flashbacks – and I do every day (of childhood sexual abuse), cutting helps release the pain.” Of course doctors and nurses have a duty to respond to emergencies but with more (patient led dare we suggest!) training and understanding, self harm can be treated from the patient’s point of view. If you would like to have more information, for yourself, or someone you know, visit some of the websites listed on the left.

Food making us fed up Labelling isandit hungry?

Susie Orbach, professor and co-

writer of the book ‘Fed Up & Hungry’ and writer of ‘Fat is a Feminist Issue’, wrote a while ago in the Guardian, a disparaging comment on food labelling, particularly sandwiches that have a red, yellow or green label denoting how good it is for you. She said: “Sensible, right? Well perhaps at first glance. But not at second or third. (Supermarkets) going down this route will almost certainly raise the levels of fats and calories eaten… “Shall we have a green sandwich with a chocolate bar and crisps today, but a promise not to have it again tomorrow? Consider the magnetism of that naughty red sandwich. How can one resist? … what becomes designated naughty, immoral or dangerous is then eaten guiltily and thus with decreased, rather than enhanced, pleasure. So decreased in fact that one misses the experience and craves another! “We know that eating in a guilty or surreptitious manner affects how your food is metabolised… Eating just what you want, when you are hungry for it, and stopping when you are full, is the only way to ensure a stable weight, the weight you are meant to be.” Professor Orbach goes on to suggest that the food and pharmaceutical industries are revelling in commercial opportunities off the back of the government’s obesity crisis it claims has become almost epidemic. However, she points out, analysis has shown that “people with a body mass index (BMI) of 25 to 29.9 (overweight) live longer on average than those with a ‘normal’ BMI of 18.5 – 24.9.” It would appear that our own common sense about eating and what is good for us has been all but annihilated through the fat scare factor – pinch more than an inch etc – let alone the celeb proclivity for size zero making matters worse, plus the ‘Nanny’ style guidance on what to eat that bombards us (if we hear 5 portions of fruit and veg a day again, we’ll scream!). So, whilst eating your ‘greens’ may be the answer, it is doubtful that many of us are ever going to be anything but in the ‘red’. Oh, to hell with it – let’s all eat cake!

“It ’s

outrageous!”

This is where you can tell us – anonymously or otherwise – some of the outrageous things you’ve had said or done to you by the ‘caring’ profession. For any professionals reading, (and we hope you are!) this comes with a health warning; all the examples quoted by women printed here actually happened…

“I was in real crisis – suicidal. I desperately needed help.After summoning the courage and wherewithal to phone who I thought could help me, I was told – ‘get in touch again when you’re feeling better’!”

“After attempting suicide, I was put on a mixed psychiatric ward. My suicide attempt was because I couldn’t bear the daily flashbacks I was having, of my childhood sexual abuse. I wanted them to end – forever. My attempt having failed, a mixed ward was the last place I needed to be. “But it got even better! I was put on 24 hour suicide watch. The first night, I awoke screaming from an awful nightmare. Imagine my horror when I saw a huge man coming towards me, from a chair just two feet from my bed. I screamed louder. “It turned out of course that he was the nurse on suicide watch! He’d got up from the chair as I awoke screaming, to comfort me I suppose – but instead it just completely freaked me out. I had to be sedated even more. “When I was feeling more with it some days later, I asked why on earth they’d put a male nurse there on my first night – well any night. They just said it was his shift!”

“I was in the deepest despair and knew I needed help. Shaking from head to toe, I managed to pick up the phone and punch in the number I’d be given if I was in crisis. A woman answered. But I couldn’t say a word – my power of speech had just vanished – but I was trying, really trying, to speak. So what did she do? She got angry,told me – whoever I was to stop messing her around. And slammed the phone down! “I went away, got a knife and cut myself time and time again.”

Whilst we are unable to run a dedicated helpline we want to hear from you if you have been affected by anything in Sanctuary and/or would like to have your say. Please call Megan on 07824 364703 or write to Sanctuary, Let’s Link, Langley House, Church Lane, Oxted RH8 9LH.

Why have you brought me here? It is so alien to me. I’m so frightened for my child and me. This can’t be right. Why won’t anybody listen? Please can we go home now? I don’t feel safe. How is this helping me? I just need to be at home. This is hell! I don’t want your tablets! My daughter is breast fed, I don’t need bottles thanks. Just leave us alone. Why won’t anybody listen? There is no peace here. This environment is making me fractious. This is not how motherhood is supposed to be. You’re denying me precious moments, never to be repeated. Why won’t anybody listen? Nobody wants to listen, I feel even more helpless. This is compounding my fears. Please can we go home? Why won’t anybody listen? Yes, I need help. I know I need support. But not like this. I just feel inadequate and useless I must be a bad mother? What have I done? Can anybody help me? Help! Here comes the social worker. Why won’t anybody listen? Our life will never be the same. Will we stay together? One wrong move and she’s gone. I just needed a little help but not in here!

Serendipity The word serendipity means the gift of making fortunate discoveries by accident, ergo, finding a bargain. this issue, style down the supermarket aisle:

A-

of mind matters If we were to try and list everything in the alphabet to do with the mind and mental health, we’d be here some time, so here’s the pick of A – C.

Depression: Clinical depression is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive in an individual’s social functioning and/or activities of daily living. It can lead to substance abuse or even suicide. (Wikipedia) General depression affects 2.6 million people in the UK with the majority being women. Postnatal depression contributes to the higher number of women. Depression costs the country around £9 billion.

Vogue had a section

in the ‘70s called ‘more dash than cash’. Well, readers of Vogue’s idea about cash might not equate with most of ours, but the principal is the same, and it sums up our serendipity philosophy. Considering returning to work after suffering mental ill health can be daunting. Thinking about having to go through an interview is Richter scale scary. What do you wear? And where do you find something that is a fashion statement on a purse-string? If your wardrobe reveals a deficit in the current fashion trend department, head for the supermarket. File past the food aisles, ignore the tempting buy one get one free offers, and go straight to the clothes section. Let’s suppose you need a suit. Find something you like, but wait. First, look at the cut. Where the sleeves are sewn is a good place. If there is no puckering, it should be fine. Look at the lapels. Are they going to curl up when you wear it? Look at the back, how does it hang? And – trousers or skirt? If the jacket is short (which many are at the moment), straight cut or belled trousers are fine if you have a flat stomach and bottom (otherwise you might look like Tweedledum!). If in doubt, a skirt, not gathered at the waist but A-line or pencil (but not tight – ditto Tweedledum or dee affect!) will look and feel smart. Keep the length on the knee or below, or even mid calf, for extra good taste. A longer jacket looks good with trousers and hides naughty bulges (how did they get there?!). Once you’ve decided on the suit, you may find the right blouse or top, shoes and bag even to go with it. Just remember to look very candidly at yourself and maybe think ‘Trinny and Susannah’! Or better still, take a friend or two, and have a laugh at the same time. Serendipity!

Dissociative Identity Disorder (DID): Originally termed multiple personality disorder DID is often a symptomatic presentation in response to trauma. North American studies show that 98% of adults with DID report abuse during childhood. DID is a complex mental health process that provides coping mechanisms for individuals confronting painful/traumatic situations.(Wikipedia) It is defined as the occurrence of two or more personalities within the same individual, each of which at some time in the person’s life is able to take control. It is a defence against overwhelming trauma which may have been experienced in the past but which can still be triggered. A survivor’s website offers hope, awareness and training for professionals. Visit www.firstpersonplural.org.uk Descartes (Rene 1596-1650): The philosopher proposed three basic kinds of ‘stuff’: God, mind and matter. The mind was what ‘I’ really was. ‘I’ occupied but did not consist of, my body. Descartes is famous for the statement, ‘I think, therefore I exist’. He believed that mind and body were separate, and arguably he has caused a debate that is as rigorous today as it was then, about the relation between minds and bodies, leaving possibly more confusion than insight. But the concept of a dualistic ‘being’ has created a framework within which we continue to construct our thoughts about ‘self’ and the ‘world’ and attempt to crack the riddle of personal identity.

Eating Disorders: Problems can become a problem when it is used to cope when you are bored, anxious, angry, lonely, ashamed or sad, or used to cope with painful situations or feelings. An eating disorder is likely to occur because of a combination of factors. Many people with an eating disorder say it is the only way they feel they can stay in control of their lives, yet as time goes on, that control is lost – it is the eating disorder that is in control. Anyone can develop an eating disorder, regardless of age, sex, culture or race although most likely to be affected are young women. Genetic make-up may have a small impact but even the attitude of other family members towards food can have an impact – particularly a key person such as a parent. (Read Fed Up & Hungry by Susie Orbach) The main eating disorders are anorexia nervosa, bulimia and binge eating. Information and find out more from www.b-eat.co.uk (the Eating Disorders Association)

Endorphins: Endorphins are produced by the pituitary gland and make us feel good. They have an analgesic effect and produce a sense of wellbeing, resembling that of opiates such as morphine. They are released particularly through exercise, with the ‘runner’s high’ referring to the endorphin rush that can occur. If running isn’t your thing, you could try a dose of hot chillies; they have the same effect it is said. Endorphins also lower blood pressure and have been implicated in the fight against cancer ECT: Electro-compulsive treatment (ECT) is a treatment used in psychiatry for severe mental illness/distress. It was developed in the 1930s and used extensively in the ‘50s and ‘60s (giving rise arguably to the unpalatable images of ‘mad’ people with wires and metal bits strapped to their heads) but use has declined. It is still used but remains a controversial form of treatment. Some say it is totally barbarian whilst others – including patients – say it is life saving. One patient said every time it was used his memory suffered but that the effects on his illness were worth it.

More mind matters next issue...

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