Navigating Bullying, Politics, and Emotional Survival as a Student Nurse “My name is Robyn, and I am a nurse.” The first time I said those words as I walked through the door of my first job, after qualifying in December 2023, they felt strange. I remember thinking, I’m not a real nurse. I’m just a student Apparently that part was over. I had the qualification, the responsibility, and the title. But that isn’t what I’m here to talk about today. I want to talk about the journey of being a student nurse. Not the version people often imagine before starting the course, the slightly romanticised picture of learning side by side with doctors and confidently bringing critically ill patients back from the brink. I’m talking about the reality. The bullying. The pressure. The constant expectations. The mental load of trying to learn, perform, and survive in environments you may never have stepped foot in before, while still attempting to maintain some kind of life outside of it all. Please note: this article is a personal reflection on my experience as a student nurse, and the views expressed are my own. This is my story of being a student nurse. I’m sharing it to highlight the struggles that many of us quietly face, and in the hope that bringing those experiences into the open might make things better for current and future student nurses. Image generated by the Author using AI. The Shock of Placement Culture Placements make up around 50% of nursing degrees in the UK. While they are invaluable for gaining hands-on experience, it’s important to recognise that they are essentially unpaid, high-intensity work. Although students are officially considered supernumerary, in practice this is rarely the case. Instead of being purely supported learners, many of us were routinely relied upon to help fill staffing gaps, often stepping in to cover healthcare assistant shortages on the ward. Walking onto the ward for the first time, my heart was pounding. My uniform was perfect, my pockets stuffed with pens, and my bag full of things I would soon realise I didn’t need. With no healthcare background, everything felt unfamiliar. A nurse greeted me. “We’re about to do handover,” she said. Handover? I had no idea what that meant. I sat in a room full of strangers, handed a sheet of patient names and cryptic abbreviations. As handover began, everyone scribbled notes while I sat there, completely out of my depth. It felt like a different language. When it ended, people scattered. I stayed put. Where do I go? Who do I follow? Flustered and unsure, I watched everyone else move with confidence. Then, after a few long minutes, a nurse approached and introduced herself as my assessor. And just like that, it began. Image generated by the Author using AI. Another Ward, Another Beginning A year later, I had completed several placements and picked up the rhythm of ward life. I finally understood handover, even if the language of abbreviations still caught me out. But each new placement meant starting again. New ward, new assessor, new routines. Learning names, roles, even where the staff toilet was. Every time, it felt like day one. It doesn’t take long to realise each ward has its own hierarchy, and students sit firmly at the bottom. You’re expected to keep up and contribute, yet you are often treated as just the student. That can mean being overlooked, spoken down to, or feeling unable to question anything, especially when those assessing you are the ones you rely on to pass your placement. It is important to point out that not every nurse treats students this way. Many are supportive and generous teachers. But when the culture is different, it can make an already demanding course feel isolating. One placement brought this into sharp focus, when I was asked: “Can you go and work with the Healthcare Assistant today, please?”. I have huge respect for HCAs. Wards couldn’t function without them. But they are not registered nurses, and student nurses are training to become nurses. Day after day I worked with the same HCA, repeatedly asking to join medication rounds or wound care. The answer was always the same: “There isn’t time.” The issue wasn’t the tasks themselves, but the repetition. Week after week, I practised the same skills while opportunities to develop never came. When I raised this, the response surprised me. The concern wasn’t my training, but the assumption I had a problem with HCAs. I didn’t. I had a problem with not being given the chance to learn. By my final review, several proficiencies were still unsigned. Despite asking, the opportunities never came. I remember sitting across from my assessor, trying to hold back tears. I’m not someone who cries easily, but after weeks of asking to learn, I was being judged on skills I had never been given the chance to practise. While these experiences are valid, they don’t happen in isolation. Many wards face staffing shortages and heavy workloads, leaving nurses with limited time for teaching and supervision. This can help explain why students sometimes feel unsupported. However, while these systemic pressures are important to recognise, they do not excuse dismissive or disrespectful behaviour. Room for Change The bigger question is: what can be done about this? Student nurses should not simply be expected to endure this. They are paying to study, working long hours on placement for free, and often navigating environments where they feel like second-class members of the team. That needs to change. During one placement I attended a training session on burnout that had been organised for staff. As I sat there listening, it felt as though the speaker was describing exactly how I felt. The strange part was that I was not even qualified yet. Research consistently shows that student nurses report high levels of stress, burnout, and low placement satisfaction, often linked to workload, lack of support, and feeling undervalued. Studies have found that negative placement experiences can impact both mental wellbeing and confidence, reinforcing that these issues are not isolated incidents but part of a wider, systemic problem that requires meaningful change. Many students are afraid to challenge toxic cultures for fear of repercussions. When the people assessing your progress also hold the power to determine whether you pass your placement, speaking up can feel impossible. That silence should not be mistaken for acceptance. There is a phrase often repeated in nursing that “nurses eat their young.” It is usually said jokingly, almost as if it is simply part of the culture. But for the students experiencing it, it rarely feels like a joke. Sometimes it feels less like eating and more like being chewed up and spat back out again. Nursing is built on values of care, compassion, and support. The environments we train in should reflect those same values. My Words of Compassion to Current and Future Students To the students currently navigating this journey: thank you for what you do. Nursing training can be incredibly demanding. When you are in the middle of it, the finish line can feel very far away. At times you may feel ignored, dismissed, or as though you are somehow in the way. You are not. You are learning. You are growing. And one day you will be the registered nurse standing on that ward. When that moment comes, there may be a nervous student standing nearby, watching you closely and hoping to learn. When you see them, remember what it felt like to be in their shoes, and choose to be the nurse you needed when you were a student. Image generated by the Author using AI. This article has been sponsored by the Psychiatry Research Trust, who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.

In my career as a researcher, I have heard the phrases “BPD patients are a hassle” and “don’t touch borderline with a bargepole”. They’re throwaway remarks, but they often are said from the mouths of people who I would otherwise describe as intelligent and deeply empathetic. As a researcher at King’s with roots in community mental health projects, documentary filmmaking and getting to the end of a sudoku and realising I’ve made a mistake a long time ago, I’m used to asking why. So, why do people feel so strongly about BPD? Borderline Personality Disorder (BPD) has been considered to be one of the most stigmatised of all mental illnesses . You don’t need to look very hard in society, or in clinical settings, to find a plethora of negative attitudes, beliefs and discrimination towards those with the diagnosis. To a layman, maybe this stigma seems warranted. After all, the terms ‘borderline’ and ‘personality disorder’ sound scary. Dangerous, even. However, neither term accurately describes the condition. The idea that people with BPD exist on the “borderline” between psychosis and neurosis has been outdated, dating back to its original definition by psychoanalyst Adolph Stern in 1938. More recently, many have argued BPD is closer to a mood disorder or trauma-based response than anything to do with ‘personality’. That leaves us with a disorder with the wrong name and wrong classification. If changing the name alone would lead to progress, stigma would have disappeared when we started using ‘Emotionally Unstable Personality Disorder’ as an alternative. Sadly, misleading terminology is merely a scratch among many deep wounds. The cycle is already at full speed; the horse has bolted far away and those with BPD are facing catastrophic consequences. People with BPD are estimated to have a suicide risk 45 times higher than that of the general population, with 1 in 10 dying by suicide and 75% attempting within their lifetime. Notably, while self-injurious behaviours and suicide attempts can be core features of BPD; this relationship is likely to be complex, with stigma potentially playing an important role. For BPD, stigma is present in both health and crisis care services, and these experiences can make help-seeking and service utilisation feel distressing or invalidating, potentially creating further barriers for effective support. In this sense, if poor outcomes for those with BPD are a burning building, stigma is an entire road of gridlocked traffic in the way of the fire engines bringing water. Beyond metaphors, most people with BPD have life-changing experiences of stigma. I have gathered these from personal interviews and online forums to present in this article, which will detail a typical post-diagnostic journey. These experiences have happened to a range of people with BPD, but I want to acknowledge that some people receive support and have better care outcomes. Someone described fighting stigma as a battlefield, “you need to be in armour”, so I’ve also illustrated the stages after diagnosis as the story of a brave knight. (I’m allowed to have some metaphors; it helps lighten the mood). THIS BRAVE KNIGHT WAS TOLD TO BE BRAVE AS THE SWORD HIT THEIR SHOULDER. At your appointment, the psychiatrist tells you they won’t put the BPD diagnosis into your record, because of the stigma. They tell you the illness should get better in 4 years with treatment, but there’s no treatment in your borough because the waiting list is too long. THIS BRAVE KNIGHT HEARD THE TICK OF THE CLOCK RING ACROSS THEIR BRAIN AS TIME PASSED. You go home and start to research BPD. You resonate with the symptoms:All emotions felt at 100%, a fear of abandonment that makes you cling to those close to you and spiral into panic when they don’t reply. Chronic emptiness, dissociation, patterns of difficult relationships, impulsive behaviour, self-harm and suicide attempts. THIS BRAVE KNIGHT POLISHED THEIR ARMOUR, WAITING FOR THE STIGMA BEAST TO PICK OUT THEIR SCENT. You go to the GP and ask for help. Some might offer medications for when you are in crisis, others tell you that you have no medication or treatment options, that your defect doesn’t fit their model of care. Your tears, in response to this, are thought to be calculated. Besides, the GP thinks you are not unwell enough. THIS BRAVE KNIGHT FOUND THE BEAST IN A&E AFTER A ROGUE SPEAR HAD PIERCED THROUGH A BREAK IN THEIR ARMOUR. You become more unwell. An episode of self-harm sends you to A&E where a nurse is actually very nice to you. You tell them your diagnosis, and they immediately stop dressing the wound and move away. They tell you to go back into the waiting room, you’re exhibiting attention-seeking behaviour. You ask for help dressing the wound. They put their equipment to one side and go to get you a single plaster. They tell you to put it on yourself. THIS BRAVE KNIGHT SEARCHED FOR SHELTER AMONG THE ROCKS, THE MOSS AND THE BODIES. You try again and again over 6 years to access any support. As you become more unwell, you become more desperate and present more extremely. One service makes the same wrong treatment referral three times and each time it feels as though your life depends on it. One service discharges you after you become too risky. You walk around with an infected gall bladder because A&E didn’t believe you were in pain. You are too unwell, not unwell enough, treatment resistant, a burden on services, deceitful, unsalvageable. You wonder if their plan is to wait for you to die and free up a space for services. THIS BRAVE KNIGHT SENT PIGEONS BEARING NEWS TO THOSE AT HOME, UNAWARE OF THE BEAST’S CLAWS ALREADY WITHIN. At work, the phone keeps ringing continuously, and your colleague describes it as a “BPD phone” because it is “overreacting,” going off nonstop. You start to laugh because it’s so ridiculous. Your tenacity has grown in the dark, without the help of treatment. You find support in some friends and family and gradually start to get better, although you worry how things would have turned out if you didn’t have their support. THIS BRAVE KNIGHT SAW THE FUNERAL PROCESSIONS AND JOINED, STEPS HEAVY BUT DETERMINED. You watch members of the BPD community fall after being rejected from services. You attend their funerals, write evidence for their inquests and remember they weren’t borderline – their personalities were warm, funny, creative, stubborn, loyal and determined. You vow to make sure that nobody else is forced to survive this battlefield. I jump at any opportunity to write about BPD to keep that vow, because life after a diagnosis really is this tragic, difficult and extreme for most people, and it was after my BPD diagnosis too. It may have been obvious from my abstract rantings was diagnosed with BPD ten years ago. I am lucky to describe myself as recovered now; thanks to the support I received from friends and family. However, I am still recovering from the memories of the stigma I faced when unwell. I didn’t introduce myself with my diagnosis because I want you now to think about whether that affects how you see me or the legitimacy of these stories. It shouldn’t change your opinion at all. Although some people with BPD do manage to access support, a catch-all solution to the vicious cycle of neglect faced by many of those diagnosed feels out of reach. It’s not as if you can run into a policy-maker’s office, jump on a table and scream out the words from this article (unless you can, in which case you have my permission to). Instead, I suspect change is, instead, a series of smaller brave moments, such as challenging the next time you hear someone say, “BPD patients are a hassle” or “that’s a BPD phone.” Such as in the experiences of ‘This Brave Knight’, I hope that these small moments brought together can prompt reflection, reconsideration and change. It is vital that they do. Image credit: Luce Stewart, This Brave Knight I-VII, 2025, pen on paper

An MSc in Psychology and Neuroscience of the Mind-Body Interface Photo provided by Author (Daniel Cunningham) In 2019, my father was given a mixed diagnosis of Alzheimer’s disease and vascular dementia. I didn’t know much about the illness, despite three of my four grandparents also having had it. Stepping in to be the main caregiver has taken me on a seven-year journey of discovery. Whilst sad, it’s been a transformational experience. Each day, I’ve been exposed to how the mind we take for granted interacts with a body we also often take for granted. The opportunity to be in lectures and labs, learning and uncovering the mysteries of this phenomenal connection, is one I am enthused to be undertaking. It feels like the next step in a journey I’ve been on for a number of years. In September 2023, I picked up a book by Gabor Mate called ‘When the Body Says No… The Hidden Cost of Stress’. I’d never heard of him, but I liked the cover, and the context seemed topical. The science linking stress to the onset of various common illnesses blew my mind, yet made complete sense. Years in a very stressful job followed by a crippling divorce preceded my father’s depression. Twelve months later, he had a diagnosis of early-onset Alzheimer’s. I read ‘When the Body Says No…’ just as I embarked on a year-long sabbatical from my corporate career. I was no longer sure I wanted to work in finance, but didn’t yet know what not working in finance looked like. I took the sabbatical to give myself the space to work it out. Photo provided by Author (Daniel Cunningham) I spent a year travelling the world - learning, living, exploring and following whatever piqued my interest (Spanish school; scuba diving; snowboarding; hiking Machu Picchu; launching an activewear brand). But becoming a certified breathwork facilitator (teaching people to correct dysfunctional breathing patterns and guiding them through deeper practices - something I did not know existed as a profession pre-sabbatical) by far had the biggest impact on me. I completed a month-long breathwork teacher training course in South Africa. Once more, I was blown away by the wonders of our mind and its interaction with our body. Entering non-normal states of consciousness through breathing, for example, dreamlike states of creativity or states reached through deep meditation. Understanding how we store and release emotions. I dove headfirst into the science. This pursuit of knowledge landed me in a conversation with a friend who suffers from a degenerative motor neuron disease. We were discussing some of my experiences during breathwork teacher training, specifically the power of the mind, consciousness, and meditation and breathwork as healing modalities. He suggested I read ‘You Are the Placebo’ by Joe Dispenza. In August 2024, midway through that book, I had a eureka moment. Sitting at my ex-girlfriend’s parents’ place in Scotland, it hit me how much I missed science. I missed spending my time delving into topics that truly interest me. I realised that this, the mind-body connection, is and has been the nexus of my interest for nearly 10 years. I had never imagined going back to university to study. But sitting in the Highlands of Scotland, I immediately googled ‘masters in the mind-body connection’. This MSc popped up. The Psychology and Neuroscience of Mind-Body Interface MSc is a course at the forefront of the most interesting field of study in the world, in one of the top mental health and neuroscience departments worldwide, the Institute of Psychiatry, Psychology & Neuroscience at King’s College London. I immediately emailed the course lead, Alessandra, to see if I could join the 2024 intake. I knew then this was the path I wanted to be on for the next phase of my life, and I couldn’t wait to start. Whilst the 2024 intake was full (emailing in August to start in September was audacious), Alessandra encouraged me to apply for 2025. The older I become, the more I try to live my life true to the advice I would give to any children I’m fortunate enough to have. ‘Follow your curiosity’ would underpin everything. Follow your curiosity; the rest will work itself out. I’m privileged to have lived a few different lives and careers by my early 30’s: a scientist at school, a footballer through adolescence, an engineer at university, and a trader in financial markets before returning to study neuroscience and psychology this year. Always looking to expand my mind, I am forever interested in the things I do not know. In discovering this course, I felt myself once again being pulled - pivoting towards a new career and a new chapter. I love it when that happens, and I’ll be forever grateful that King’s College London allowed me to follow this curiosity. To return to the title… how did I end up here? In hindsight, I would say: an open mind, inner belief, a little naivety and a penchant for following the things that most interest me. In doing so, paths seem to appear I never could have dreamt of, yet walking down them feels oddly familiar (perhaps I have dreamt them). Luck, fate, fortune… However I got here, I feel extremely blessed. I’m extraordinarily excited for whatever comes next.

Image Source: Juliane Liebermann on Unsplash ‘She’s a right little madam.’ You might think that was quite a mean thing for a parent to say about their child, wouldn’t you? Now, imagine there is a little more context, that the parent said: ‘Oh Zoë’s a lovely little girl. She’s funny, sweet… except when she doesn’t get a lolly before bed, then she’s a right little madam!’. We can go a little further. Imagine the parent laughed after they said that. Suddenly not quite so bad, huh? What we are talking about here is something called ‘expressed emotion’: the emotion a caregiver expresses when talking about their child. Clearly, from this example, to understand the emotion expressed in language, it doesn’t matter just what someone says, but also how they say it, and the context they say it in. I am a Research Assistant at the CAMHS Digital Lab at King’s College London. As a mental health researcher with a Master’s degree in clinical linguistics, I’m fascinated by what language can tell us about the brain, our mental health – and our emotions. It is this interest that led me to work on a project exploring the relationship between parents’ expressed emotion and their children’s mental health. Being able to measure expressed emotion more efficiently could allow it to be assessed by clinicians to understand which children and families might experience greater mental health challenges – and offer preventative support to stop difficulties from emerging. Why do we study expressed emotion? Expressed emotion offers us a window into a parent’s relationship with their child. The concept was originally researched, in the 60s, in the context of adults with schizophrenia, with research showing how their parents spoke about them affected their likelihood of experiencing a relapse. Since then, the field of expressed emotion has grown, with studies now indicating that parents’ expressed emotion is also related to their children’s mental health in childhood through to early adulthood. This is a complex and likely two-way relationship; that is, early negativity in the parent-child relationship could act as a stressor for children – with early positive emotions being a potential protective factor for mental health – while children with emerging emotional or behavioural difficulties may be more likely to elicit negativity from parents. To measure expressed emotion, researchers simply ask a parent to talk about their child for five minutes, producing ‘Five Minute Speech Samples’. Then, trained researchers use the transcript to code the level of emotion – warmth and negativity, to be specific – in both what a parent said about their child, and how. Image Source: Christina @ wocintechchat.com M on Unsplash What have we been researching recently? Although useful in research, it is not currently realistic to measure expressed emotion in clinical settings. Every five-minute recording has to be transcribed or replayed multiple times in order to be coded, which can take hours. This method couldn’t ‘scale’ to be used with every parent at a busy GP clinic, for example. So, in our research – funded by UK Research and Innovation - we wanted to develop a more efficient way of analysing expressed emotion using AI-driven technology. What did we find? We built an AI-driven tool to analyse both textual features (i.e., the content of what was said) as well as acoustic features (i.e., how the voice sounded) of the Five-Minute Speech Samples. A variety of combinations of acoustic and textual features were tested, and we compared these models’ predictions to the scores given by trained researchers. Compared to researcher scores, the best models demonstrated around 60-65% accuracy at identifying which parents’ speech samples were low or high in negative expressed emotion. Industry standards for this kind of tool are usually around 70% accuracy. So, our results were promising – but the AI tool still needs more work before it can be used in health appointments. Image Source: Markus Spiske on Unsplash What do parents and young people think about our research? When conducting research with human participants, it is very important to capture the perspectives of the public, particularly people who are likely to be impacted by the research. In this project, we collaborated with a writer, Stephen Oram, who has worked on a variety of projects like ours. He turned our project into two short science fiction stories. We brought these two stories to workshops with young people and parents, to open up a conversation about the project – what might it look like if this AI tool were actually used in children’s health appointments? What might the consequences be – whether positive or negative? Young people and parents had a lot of really interesting insights on these questions. Whilst they didn’t all object outright to the idea of an AI tool being used in a healthcare setting, some had concerns about whether this tool would be able to capture how nuanced human communication is: much like we saw with that first example of expressed emotion. They also questioned whether trying to predict which young people might go on to experience mental health problems in the future might have a ‘self-fulfilling prophecy’ effect or other negative consequences. As such, continued efforts are required to ensure tools for interpreting expressed emotion are both effective and acceptable to patients. Expressed emotion: don’t blame it on the parents Understanding expressed emotion is not about blaming parents. Every parent has moments where they might get frustrated with their child or say a negative thing about them – that’s a normal part of parenting. When we study expressed emotion, we are trying to identify family dynamics where a parent has a consistently negative attitude toward their child, not just a comment here and there. These parents and their children may need extra support for their mental health and to develop positive relationships, to help prevent the development of mental health problems in future. Secondly, we are studying association, not causation. Expressed emotion has an association with children’s mental health; that doesn’t mean that it causes poor mental health. There may be factors that affect both expressed emotion and the child’s mental health at play (e.g., genetics, difficult socioeconomic conditions) and, as stated previously, it’s likely that these two things influence each other: a bidirectional relationship wherein parents looking after children with difficulties may face parenting challenges that affect their expressed emotion. And it works both ways; research has found that more positive expressed emotion is associated with better mental health in children, while negative expressed emotion being associated with worse mental health. So, it’s not about blame: it’s about getting families the support they need. Image Source: Suzi Kim on Unsplash Next steps We’ll be continuing to work on AI tools that can analyse speech even more accurately, in particular making sure these tools don’t encode any biases, for example against parents from racially minoritised backgrounds or who are less wealthy. We also want to make sure expressed emotion gets measured in large studies of child and adolescent mental health. These large studies that follow children as they age, and can have thousands of participants, give us a more reliable measure of expressed emotion – and insights into what other experiences expressed emotion is related to. We will be publishing more on this research soon; you can follow along with our research via the CAMHS Digital Lab.

Telling people to ‘speak up’ and ‘be kind’ on social media isn’t going to change the fact that mental health services are failing the working class Original tweet — @hattiegladwell on Twitter Mental health is becoming a more popular topic on social media, and that’s great for three reasons: It educates people who don’t have a personal understanding of mental illness, it encourages those who do to talk about it more openly, and it comforts those suffering, letting them know they’re not alone. But as much as I think it’s helpful, I am absolutely over the constant messages of #BeKind, ‘Speak up!’ and ‘Check in on your friends!’ Yes, these messages can be helpful, but when they’re used over and over again every single time a hashtag is trending, they become empty and meaningless. I have a pretty complex history of mental illness — having been diagnosed with bipolar disorder, borderline personality disorder, OCD, anxiety and PTSD. Each illness requires different treatment, including psychiatry, psychology and cognitive behavioural therapy. But as someone who is working class, being able to afford all of these things privately is impossible (the costs are eye-watering) and therefore I rely on the NHS for most of my treatment. I currently pay privately for CBT. But I haven’t been able to do it properly, because there are some weeks that I just cannot afford it. And when I can, it’s because I’ve made other sacrifices like working all through the night even though I gave birth just six months ago. I have been under the Crisis team four times, each time lasting a few weeks to a maximum of a couple of months, before being left without any help again. I’ve been told I’d need to have intent to harm myself to get a hospital admission. The one time the Crisis team did attempt to admit me, on a voluntary basis, there were no beds — not even two hours away. Yes, people who are seriously mentally unwell are at times admitted to hospitals hours away from their friends and family because that is their only option. Relying on the NHS is at the best frustrating and at worst completely soul-destroying. Yes, I am grateful for the healthcare system, but we can’t ignore its failures. The mental health services are the most underfunded sector of the NHS, despite mental illness being more prevalent than ever. Being declined CBT on the NHS is the reason I had to go private — and yes, it was a need to be able to function properly — and I have one appointment with my psychiatrist every ten weeks or so — which is currently a ten minute appointment to check how I’m doing on my medication. NHS mental health resources are limited and that means excessive waiting times, limited and even unavailable care and people not getting the treatment they need. And unfortunately, this is namely a working class issue. No, mental illness does not discriminate and can affect people of all classes — but middle and upper class people have the means for more luxurious (and better) options like private, high-end therapy, while those of us struggling to get by financially also have to struggle to get any help. Image source: Adobe Stock Professional treatment isn’t the only thing that needs to be addressed here, either. It’s also how the media, and society in general, treat people with mental illnesses. Lazy, selfish, dramatic, crazy, attention-seeking and stupid are just a few things we hear quite often. Men are told to man up, women are told to stop being so hormonal. We’re told to get over it and that other people have it worse. Newspapers describe mental illness in a dangerous way, bringing possible mental health issues to the forefront of dangerous cases reported on — sending the message that people with mental illness must be dangerous people (which is factually wrong, people with mental illness are more likely to hurt themselves than anyone else). Every time a new awareness day comes around, I dread it and tend to delete my social media apps to avoid it. Because I know that for a lot of people, it’s nothing but an opportunity to write a message that makes them look good, to get a few likes and retweets, and makes them feel better about themselves for joining in. Others join in because everyone else is talking about it and they don’t want to look bad for staying silent — even though they’re silent every other day of the year. But I, and many other people suffering with mental illness know that so often, these ‘Speak out!’ messages will quickly fade away from the timeline when the awareness day is over and mental health is no longer the trending topic. But mental illness affects people 365 days a year. I think one of the things that hurts the most is seeing messages from people that contradicts your own experiences with them. When people tell you to be kind, but have said hurtful things to you. When they tell you to speak out, but when you’ve gone to them for help they’ve ignored you or made you feel like you’re a burden. When they tell you to check in on your friends, you haven’t heard from them in months. And regardless of this, these types of encouraging (yet tired) messages are only marginally helpful. A person making a trending tweet, a brand selling t-shirts with mental health slogans and a social media platform reminding its users to be kind (while allowing abusive and racist content on their platforms) doesn’t change the fact that the mental health services are failing. It doesn’t change the fact that people are waiting more than a year for mental health assessments, or are declined therapies they need because they’re not the right sort of candidate for it (yes, really). And it doesn’t change the fact that people who are seriously unwell can’t get a bed in a hospital or that hospitals are being forced to shut down to make way for new housing estates. Taking two seconds to write a quick tweet doesn’t change any of this. It would almost be a completely pointless thing to do if it didn’t help at least one person feel comforted and reassured that they’re not alone. Image source: The Vent Machine But if you actually care about mental illness beyond a tweet on the one day the topic is trending, there are actual helpful things that you can do. Talk about mental illness more than one day a year. Remind people that it is not a trend and that it is something that ruins lives — and ends them. Start petitions for better funding. Stop telling people to speak up without educating yourself on why people might not want to. Learn mental health first aid. Get involved with mental health charities. Write to your local MP to encourage positive changes to your local mental health resources. Read blogs written by people with mental illness (like this one right here!) to get more of an understanding over what we go through on a daily basis. At the very least, act on the messages you’re posting: Check in on your friends and be kind. Mental health isn’t a trend. It isn’t a social media campaign. It is painful and torturing and life-threatening. It’s time to stop telling strangers to be kind, and to start making real changes. NOTE FROM THE EDITORS: We would like to take this opportunity to say a big thank you to Hattie for writing this blog for InSPIre the Mind. Hattie Gladwell is a freelance journalist, writing for the likes of the Metro, Cosmopolitan, The Independent and Grazia and more. She is also a mental health advocate. We are very honoured that Hattie has written for us here at InSPIre the Mind and especially for sharing such an incredible blog touching on her own experiences — thank you Hattie!

When I was pregnant with my son, I turned to online baby groups and motherhood websites for support and to learn what I was in for when he finally arrived. While some of the experience was positive, and some a little negative, there was always one thread that stuck out to me: Mothers who called themselves failures because they stay at home and look after their children. Traditional gender norms are ingrained in us, if you’re in a straight relationship. The mums stay at home and the dads go to work. I read these threads and didn't see them as failures – I saw them as inspirational. What wonderful women to take on that responsibility, stay-at-home mums don’t get enough credit for what tremendous pressure they are under. I always felt sad when I saw these threads. I’d never thought much of it, until I had my son, right at the beginning of lockdown, in April 2020. I had planned to take a long maternity leave and perhaps write freelance from time to time to top the bills up; for my partner to work while I looked after our baby. But because I am vulnerable, my partner has been home for the past five months (as he works in a high-risk job), and we couldn’t survive on my maternity pay alone. So I started to work. Image source CNBC Now, I want anyone reading this to know that the feelings I’m about to talk about aren’t a reflection on anyone else or their parenting — it’s words from someone who was — who is — postnatally depressed. Working made me feel guilty. It made me feel like I was failing my son and horrible thoughts told me that he wasn’t going to love me and that he was going to resent me. That I wasn’t a good mum. I looked at other new mums I knew and longed to be on maternity leave like they were, constantly comparing myself and thinking that I wasn’t good enough. I didn’t open up about this to anyone for a long time because I was scared. I think I was scared that they would agree with me and that my fears of being a bad mum would be confirmed. I suffered in silence for months, just trying to get through the days and pretend everything was okay. Spending every opportunity I had with my son and making out like I was totally happy with what we were doing. But after a really bad experience with postnatal depression, where I was constantly tearful and trying to hold back that horrible lump in my throat that I get when I’m trying desperately not to cry; I just couldn’t hide it anymore. And so, I finally decided to open up to my partner about how I was feeling. The first thing he asked me was: “Would you think I was a bad dad if I was working?”. I looked at him and thought it was a ridiculous question; of course not. And then I realised that my thoughts were ridiculous, too. I don’t think I was ridiculous in having the thoughts. I have postnatal depression and these thoughts are part of it. But I realised that just because I have them, it doesn’t make them true. Being a working mother does not make me a bad parent — it makes me a good one, as I am the one responsible for providing for our son. I make sure that I spend time with him, play with him, sing to him — I still do all the mum stuff, but he is lucky to have two parents who are at home to spend time with him. Photo by Kevin Gent on Unsplash I realise now that my bad thoughts were my PND talking, and I wasn’t thinking with a sensible head. But these thoughts and feelings do still creep up from time to time. If you’re a working new mum feeling that mum guilt that is so common, I want you to know that you’re not alone. If you’re a stay-at-home mum feeling that same guilt, I want you to know the same. No parent is the same — we all need to do what works for us and our children the best. What I try to remind myself now is that I’m doing my best for my son and my family. Just like my partner is. And my baby is happy, safe and healthy, and that’s all that matters.

I was 14 years old when I decided I wanted to become a writer. I took media studies as one of my subjects for GCSE, and I remember my media teacher quite sternly telling me that I’d never make it in the media world. I was 19 when I got my first writing job, a freelance commission for The Debrief. I’d always been a blogger, whether that was through Tumblr or Wordpress. I’ve always loved to write. Being a journalist was something I had always wanted — lifestyle writing, in particular. It was something I enjoyed and something I was passionate about and I longed to see my words in print some day. Writing to me is therapeutic. I go through notebook after notebook; always starting with fancy handwriting before the pages turn into rushed scribbles to get all of my thoughts onto paper. I write a list every morning and check things off that I need to do (and things that I’ve always done, just to give myself a boost of confidence). But despite having worked as a writer for seven years now, I still have that voice in my head telling me that I’m not good enough. That I won’t have my work commissioned. That everything I write is just rubbish. But I continue to write — whether it’s rubbish or not — because writing is the one thing I love. It’s the one thing I am incredibly passionate about. Because it allows me to clear my head, keep myself organised and express my views more clearly. Photo by Ylanite Koppens from Pexels I’ve written about mental health for a long time now. I was diagnosed with bipolar disorder at 19, and later borderline personality disorder, and obsessive compulsive disorder. As you can imagine, having these conditions means that often, my head is crowded with thoughts, and I struggle to make sense of them. I also struggle to articulate my words in person, because there is so much going on in my brain. I don’t keep a diary, because the thoughts I have — the ones that tell me I’m not good enough, that I’m a failure, and sadly that I don’t want to be here anymore — I don’t want to keep. Instead, I write letters and when I’m finished — which can be hours later — I delete them. It’s my way of getting rid of the thoughts, instead of focusing on them and ruminating over them. Sometimes the letters are to other people, sometimes they’re to myself, and sometimes they’re to nobody; what’s important is that they’re written. I’m also incredibly passionate about getting words out there about mental illness — though sometimes I do think this makes things more difficult, because often publications want traumatic stories that I am uncomfortable with writing about. And so writing solely about mental health can be hard; so I write about other subjects close to my heart, too. Sometimes I think writing is the only thing I can do. It’s the only practical thing. I enjoy music; I sing and play the guitar, but it’s not something I’m overly passionate about, and I know that breaking into the world of music is just not feasible. But making a living by being a writer is difficult, too. I didn’t get into writing in the traditional way. It started with blogging and working at a press agency, before I started pitching publications with ideas. I had one commissioned and multiple rejections — but I remember the first time seeing my byline with The Debrief was an incredible feeling. I applied for jobs, but was told again and again that I needed the right qualifications, which I didn’t have. But one day, I was given a chance. In 2015, I applied for a job with Metro.co.uk. It was for a social producer role and I remember being very nervous; knowing that I wasn’t going to get it because I had massive imposter syndrome. I wasn’t dressed for an interview, either. Walking into Northcliffe House in my checked skirt and red boots, I was wowed by the pristine walls and floors and the spiral staircases and inside pond. I wanted to work there. Photo by Lisa Fotios from Pexels I was interviewed by the deputy editor, and though I thought the interview went well, I didn’t get the job. Instead, I later received an email asking if I would like to write freelance for them, two days a week. Of course, I said yes. Two weeks in, the two days of freelancing turned into five days a week, and I stayed with the company for five years. It was an incredible experience and I met some great people — but I decided to leave after having my son. After a short maternity leave, I decided that I had to leave, because I could no longer commit to full-time shifts. Instead, I become a fully-fledged freelance writer. I wasn’t sure it was going to work at first. I was scared to enter a world that I didn’t really know. I’d had a secure job for so long, that I worried I wouldn’t be able to make it work and support my family. But I worked hard; hours of pitching editors and making connections and rejection after rejection, until I got to the point where I could pay my rent every month. Though I hear it was different decades ago, it is difficult being a freelance writer. You never know where your next income is going to come from, or when. You also deal with imposter syndrome over and over again due to rejections. But that email telling you you’ve been commissioned is a wonderful feeling, and makes you realise that writing is worth it. I continue to write because writing is who I am. It’s a huge part of me. It’s not just a hobby (something many people see it as), or a job. It’s a part of you. It’s a love; a passion; it’s a constant reminder of your creativity and your drive. Being a writer isn’t an easy job, and it is hard to make it work. But when things come together, after weeks or months of rejections, you realise it’s worth it, to do something you adore — which is also why I’m writing for Inspire the Mind, as I believe in the importance of this publication. So, you can find more of my words right here, every Monday.

I was diagnosed with bipolar disorder when I was 20. Ever since, I have heard plenty of generic comments about what to do about it. I’ve been told to go for a walk, to meditate, to practise mindfulness. And while these are all great things for general wellbeing, for a complex mood disorder like bipolar disorder, it just doesn’t work for me. And so, I deal with the condition by taking medication. I knew I wanted to take medication the moment I was diagnosed because, after extensive research and a look into various studies, as well as recommendations from my psychiatrist, mood stabilisers seemed to be a pretty good way to stabilize the episodes I was experiencing (I know, the clue is in the name). I had been experiencing both manic and depressive episodes before and during my diagnosis, some to the point that living was unbearable. I spent my entire savings during one manic episode, and covered my legs in tattoos in one go. In my head, I felt on top of the world. Unstoppable. A manic rush of feeling totally free. But then came the crashes. The dark thoughts and the suicidal ideation. The sobbing until my eyes stung and my cheeks were red raw. The numbness and the guilt and shame of my actions. The devastation of losing myself and the embarrassment that came with it. Photo by Karolina Grabowska from Pexels I wanted both a quick fix and something long term to create a plan for managing these periods. I knew medication wasn’t a cure, and I knew that it wouldn’t fix absolutely everything, but I wanted something to ease the anxiousness I felt about mania or depression coming on suddenly. I wanted to cope in a way that made me prepared for anything that came my way. My psychiatrist agreed to medicate, and over the years I tried various medications until I found one that worked completely. And I’ve taken it ever since. Taking medication has become a routine now. It’s a part of my life; something that keeps me in a comfortable place. Five pills in the morning, two at night. Every day. I gave birth to my first baby last April (2020), and during my pregnancy, I continued to stay on my medication. We spoke about the risks and found that the medication I was on at the time was 99.9% risk-free. I knew that it was important for me to stay mentally healthy for the sake of my baby’s health, and I wanted to limit as much stress as possible to take care of my ever growing bump — and so staying on my medication was the best decision for me. I know that may seem daunting to some, and I know that medication isn’t for everyone. It can be a difficult choice and for some, a last resort. That’s the thing, we often hear people — even mental health professionals — tell you to try everything else before taking medication. And I’m not telling anyone to do anything different. But, why should it be a last resort? Why shouldn’t it be a choice that can be made early on? There is a lot of shame around medication, especially when used as a last resort — because some feel like they’ve failed everything else. But this isn’t the case. By doing what you need to do get by — to live — you’re doing your best. Photo by Karolina Grabowska from Pexels Taking medication absolutely does not make you a failure. It makes you someone who has chosen to help yourself in the best way you can. And that’s amazing. I enjoy walks. I enjoy listening to podcasts, reading books and listening to calming music. But I also enjoy the fact that I am doing something that helps me feel at least a little calmer, as well as making me feel more in control of my life. As I mentioned, medication isn’t for everyone and I completely understand that. But it’s something that’s worked for me, and I’m proud of myself for making a choice that was in my best interests. That can be a hard thing to do, so I look back and think that even in my darkest places, I decided to do something that I believed would help. Not every medication worked. And some made me feel awful: headaches, nausea, fatigue. There were, admittedly, times that I thought I’d made the wrong decision, but I continued to do my research until I suggested something that I thought could work — and it did. I think that if you’re considering medication for your mental health, you should do your research. Look into studies and the side effects, and prepare yourself for them. Have discussions with your mental health provider and don’t agree with anything you’re not comfortable with. Ultimately, medication is your choice. Only you know what’s right for you.

I open up my Twitter app, take a look through my timeline for the last time, and click ‘Deactivate Twitter’. My relationship with the social media app had long been an issue. I’d been using it every day for the past five years, and had found myself feeling overwhelmed and nervous every time I clicked on the little white bird on the square blue background. I’d been thinking about deactivating for a long time. Loading the app, I always felt this deep feeling of dread in the pit of my stomach; like something bad was about to happen. My newsfeed would often show awful stories, and no matter how many keywords I tried to hide, I always managed to find something to read that would make me feel anxious. Photo by Becca Tapert on Unsplash It might sound sad to some — not all people become so ingrained in a social media app — but I was at a point where just loading it activated a ‘worry button’ in my stomach. I decided to come off Twitter thinking that my career would plummet. As a writer, what if editors had only been commissioning me because of my large-ish following? What if I wasn’t actually a good enough writer? But that didn’t happen. I still got commissioned to write the things I was passionate about, work didn’t plummet, and instead, I set up my own PR agency. I found myself becoming decreasingly nervous around my phone. When a notification popped up, there was a sigh of relief that it wasn’t Twitter. That it would just be my mum texting me or an old friend popping up on Facebook. I no longer jumped up to see what was going on in the world, checking the news, refreshing a newsfeed knowing that there would be something that could trigger my anxiety. In fact, my anxiety lessened. Photo by Priscilla Du Preez on Unsplash Over time I started using my phone less and less; it was as if I’d parted with a self that I didn’t know was detrimental to my own wellbeing. It was refreshing to see things for what they were — this was a phone that was there to communicate with the people in my life, for when I needed to talk or for when I was in an emergency. It wasn’t something I should be using to become almost addicted to tweeting 140 characters. I became less and less interested in my phone and more focused on other things. I was more present, I was more interested in life, I felt more importance over other things that actually were important — and that wasn’t a newsfeed full of bad news or triggering tweets. I was using my phone in a healthy way and focusing on my little family and my new work. I wasn’t spending hours on my phone scrolling up and down. It was like a negative part of my life had been removed and I was re-learning how to manage a little device I was paying a contract for. Photo by Ben Kolde on Unsplash I came back to Twitter three months later because there were parts of it that I’d missed — catching up with friends I’d met over the app, for instance. But this time was different. I didn’t feel the need to tweet every day nor did I feel compelled to repeatedly refresh my feed. Instead, I’d taught myself to use it like any other app — as and when I pleased. Since being back online, I’ve tweeted only a handful of times, because to be honest, I have lost a lot of interest in the app. Don’t get me wrong, it was nice to reconnect with people I’d met over the years, but now, when I get a Twitter notification, I leave it until I have time to check it out. I don’t stop what I’m doing to focus on it, nor do I get that overwhelming feeling come over me. I’ve learned to use my phone in a way where it isn’t a big part of my life. I’ve learned to use it in a way that works for me and my family — for work calls, for catch-ups, for emergencies. No longer do I stare at a scrolling news feed, almost looking out for something that’s going to make me feel on edge or panicked. I’m glad I took that three-month break. I’m glad that I’ve now got a healthy relationship with my phone and that it doesn’t take as much time out of my life as it did. My screen time has certainly decreased drastically. Most of all, I’m glad that I noticed something was up and I took control of the situation, rather than sinking deeper into it. It might just be an app, but that to me shows determination to do something about a situation that was making me miserable. And now, I use that determination in other ways — and it’s got me to where I am now: calmer, less absorbed by social media, and more focused on the things that really matter.

I’ve always been someone who loves going out. To events with friends, for sleepovers, out shopping, clubbing, you name it. I was confident. I had been dealing with mental health issues for a long time, but from the ages of 18–23 I was outgoing. And then the Covid-19 pandemic hit, and it all changed. I had my son last April, and started experiencing postnatal depression and perinatal anxiety symptoms quite quickly. I remember having the baby blues pretty roughly — crying at absolutely everything, whether sad, funny, or a cute smile from my baby. Sometimes I would just start sobbing at nothing. But I knew this was normal. I remember my midwife telling me that if these feelings persisted, and I felt my mood becoming low, I needed to talk to someone, because this was a sign of postnatal depression. I didn’t. I started feeling my mood drop weeks after the baby blues, but I didn’t tell anyone. To tell you the honest truth, I was very scared. I knew postnatal depression is common, and that a huge percentage of mothers experience it alongside perinatal anxiety — but my intrusive thoughts told me that if I told someone, I would be seen as an unfit mother, and my son would be taken away from me. Photo by Hedgehog Digital on Unsplash It wasn’t until I broke down on the phone after a very normal conversation with my health visitor that everything came out, out of nowhere. To my surprise, she was very supportive and encouraged me to seek help. My fears were still there, but I tried to trust her and go with what she said. So I told my psychiatrist. I told him all about how I was feeling. How I felt like I was failing all of the time and how I felt like I wasn’t good enough for my baby. I begged him to keep reassuring me that my son wouldn’t be taken away from me. He tried to, but the reassurance wasn’t enough. It wasn’t until I joined a Facebook group for women with PND, that I found so many other mothers had the same fears. It made me feel less alone and like my worries were ‘normal’, even though they were scary and overwhelming. While I’m dealing with my postnatal depression and trying to manage the best way I can, my anxiety is still affecting me. I haven’t left the house in months — not properly, anyway. The furthest I have gone in months is 10 minutes to my mum’s, as she is in my support bubble. But the idea of walking or social distance meets scares me. I continue to tell myself I will do it, because I need to, but when it gets to it, I just… can’t. Photo by Christopher Ott on Unsplash It’s not the virus that gives me anxiety, oddly. It’s the new world. One I haven’t entered in a long time. And now I don’t know where to start. It’s as if I’m in my own safe little bubble instead, with my partner and my son, and I don’t want to leave it. I get in my head about people staring at me and thinking horrible things about me. It makes the idea of taking a walk through the town centre fear-inducing. There have been times where people I know have walked past and though in my head I’ve begged for them not to walk my way, worried about what they will think about me, I’ve just had to suck it up, put a brave face on and say hello. But, there have been other times where going for walks has been much easier. Usually when it’s quieter and it’s just me and my little boy, so that I can talk to him and sing to him without anyone else trying to get past us on the pavement. I think what’s hardest is that postnatal depression I can deal with, but I haven’t experienced this type of anxiety before — as I’m sure anyone else living with it now, because of the pandemic, will feel too. I feel lost in this new world. But it’s one that I know we’re going to have to become accustomed to, because this (scarily) is life right now. But I am trying. I have been taking small steps by taking my son round the block when it’s quieter. When I know I won’t walk past people I know, or when I know I won’t have to crossroads. I am trying by planning longer walks and planning social distanced meets for when it’s okay to do so again. But I’m also not punishing myself if I’m unable to do these things. Planning is enough for now, and when the time comes, I’ll see how I feel. And I think that’s the best thing anyone can do — everyone knows that getting outside is good for your mental health, according to Mind charity it can help to improve your mood, eliminate stress, help you to become more relaxed while also improving your physical health. But anyone who’s also been in my position knows that it can be hard to find the strength and courage to actually go and get outside. So my best piece of advice is to to take it slow, and do what you can. Even if it starts with just going to stand outside for a couple of minutes on your doorstep. Give yourself time and be proud of yourself for every small step — because eventually, those few minutes on the doorstep will turn into a five-minute walk, and that five-minute walk into a half-an-hour stroll. Don’t punish yourself for not being able to do things you aren’t ready for — always be kind to yourself, because being kind to yourself is what’s going to help you through this.

I’ve been a mental health writer for nearly eight years now. It’s something I enjoy writing about, and it’s something I know how to write about, because I have been diagnosed with several mental health conditions. But it’s not easy. Writing about mental health means opening up to the world and making yourself vulnerable. It means potentially sharing things that are quite personal to you, and worrying years later about who’s read it. Writing about your mental health means trusting an editor who you possibly don’t know very well, to keep your story true to you — which doesn’t always happen. And so, writing about your mental health, I feel, is something you should do with caution. I’ve learned a lot of lessons along the way — how personal to be and when to stop. I’ve been there, looking back at an article and thinking “Why did I write that?”, because what I’ve written in the past, makes me wish I hadn’t been so vulnerable in the present. Photo by NeONBRAND on Unsplash The one thing I hear a lot is: Trauma sells. And this is quite true. Many publications will look for traumatic stories without actually thinking of the writer’s wellbeing. It’s somewhere I’ve been. Though I’m super lucky to now work with publications that take mental health stories seriously (including Inspire the Mind). There have, unfortunately, been other cases where my stories have been sensationalised for shock value, leaving me feeling vulnerable. It’s made me extra cautious when pitching and has made me re-evaluate how vulnerable I should be in my writing. And so, if you’re thinking of getting into writing about mental health — especially personal essays, I just wanted to give a few tips. Because the one thing I’m incredibly cautious of is not re-traumatising yourself for the sake of a commission. First, take a week to think about what you’re pitching When you’re struggling for money, you can end up pitching an article without really thinking about it, hoping an editor will take it. And then when they do, you might regret having pitched it, but feel too uncomfortable not to write it. So, take some time to think about whether you really want to pitch the story or whether it’s more about the commission. Think about how it’s going to affect you to write and to read back and to share with the world — think about the commission last. Pitch to the write place Don’t just pitch your personal stories anywhere. Look at places that have other similar stories, whose stories have been published sensitively, and ideally, a publication that specialises in mental health. You need to be comfortable, secure and confident in where you’re pitching. Speak to the editor first about your byline If you’re worried, speak to your editor about whether you can write it anonymously. I know in the past there have been personal things I’ve wanted to write about, because writing to me is very therapeutic. But I’ve also asked whether it can be an anonymous story, because I’d rather treat it like a diary entry, keeping it personal but also secret. It’s okay to ask to be anonymous. It’s okay to write under a pseudonym. All you need to do is ask — and all they can say is no — in which case, rethink whether it’s really the publication you want to write for. Photo by Scott Graham on Unsplash Take breaks while writing it I don’t know about you, but when I’m really struggling I tend to bottle everything up. Everything sad goes to the back of my head in a little box and I lock it away. I remember an old therapist telling me that she found me frustrating because I don’t allow myself to feel sadness. And that’s true. I can’t talk about sad things and I try not to let myself cry. I try not to think about things — but they become overwhelming and then I end up writing about them. When I’m writing about them, all of the sadness and frustration comes flooding out. And so I tend to take breaks when writing, so that the computer keyboard doesn’t become sodden with tears. Taking breaks while writing about something personal to you is a form of self-care. It’s okay to feel things while writing your story, and it’s okay to allow yourself to feel these things. But look after yourself while writing, don’t allow a piece to traumatise you. And if you start to feel panicky, stop. And re-evaluate whether it’s the right time for you to write about this subject. Give yourself a lengthy deadline Personal stories take time. So give yourself an extended deadline. Don’t rush your story or force yourself to write it when you’re not in the right mindset. It’s important that your words come from you when you are ready to write them — not when you’re on a quick deadline and therefore need to scribble them out to meet it. Put your wellbeing first Remember that you are a person and that you deserve to tell your story authentically and in a way that is most comfortable for you. Say no to edits that you’re not comfortable with. Speak to your editor about what you’re writing and why certain pieces are important. Take care of yourself when writing. Writing might be your job — but it’s so much more than that. With mental health writing, it’s a way to speak out, to raise awareness, to fight for better services and for those who are struggling. But make sure that what you’re writing is true to yourself, and that you are comfortable with your final piece. Please don’t cause yourself unnecessary upset for the sake of a commission.

I remember sitting on my sofa in front of the television gazing past the screen. I wasn’t myself. I’d been feeling very low, and had been going through a depressive episode with my bipolar disorder. I remember feeling numb, as if I wasn’t really present. Like my body was floating above me as the world kept spinning around. I’d been experiencing suicidal ideation. But it was odd. I didn’t want to be here anymore, but I also didn’t want to die. I wasn’t afraid of dying, but it was that I just wanted to escape the world I was living in. The feelings and thoughts I was experiencing. I wanted to live, but I wanted to enjoy living. It felt like I was in constant limbo. The recent television interview with the Duchess of Sussex has been followed by mental health charities emphasizing that suicidal ideation must not be doubted or discounted, and expressing concerns on how some of the press has reacted to her revelation. I couldn’t agree more. Suicidal ideation means you want to take your own life, or are thinking about suicide. However, according to Verywell Mind, there are two kinds of suicidal ideation: passive and active. Passive suicidal ideation ‘occurs when you wish you were dead or that you could die, but you don’t actually have any plans to commit suicide’. Active suicidal ideation is where you are planning to die by suicide. I was experiencing the former. I was daydreaming about how I could end my life. Accidental things that could happen where I was harmed. About harming myself. It was Summer 2018 and I had taken time off of work because I couldn’t concentrate. I couldn’t sleep properly, at all. In fact, I was scared to sleep. Because I knew that sleeping meant waking up to another day of feeling how I was feeling. I’d dread night time simply because of this — and the nights were harder because the intrusive thoughts would set in and fill my head with triggering and anxiety-inducing thoughts. Photo by Anthony Tran on Unsplash My relationship was failing because I didn’t want to talk. I just wanted to sit on the sofa in the same pyjamas I had been in for days — having not even showered — and stare blankly at the TV. But at the same time, I felt like a fraud. I felt like this because I didn’t have any plans to actually end my life. It made me feel like my thoughts and feelings weren’t valid. That there were people feeling a lot worse than me, and therefore this suicidal ideation wasn’t as important. I told myself that I was just being overdramatic and silly. But it wasn’t silly, because the thoughts were all-consuming. And that’s what I want other people to know. Suicidal ideation is serious and needs to be taken seriously. It’s not just a fleeting thought. Suicidal ideation can cause you to isolate yourself from others, to experience intense mood swings, to experience incredibly high levels of anxiety. And I think the numbness of suicidal ideation is one of the worst bits — you want to feel something. Even if it’s pain. Because at least you’re feeling something. According to The World Health Organization, a survey taking place in 21 countries found that those with a lifetime history of suicidal ideation had a 33% probability of making a plan to end their life, with the probability of ever making a suicide attempt being approximately 30%. Consistently across countries, around 60% of the transitions from suicidal ideation to suicide plan, and from plan to suicide attempt, occurred in the first year after the onset of suicidal ideation. It’s not just people themselves — like myself — who don’t think their thoughts are valid, but the mental health services, too. Yes, the services are heavily underfunded, with a Crisis team member once telling me that they are the most underfunded sector of my local NHS; but seeking help for suicidal ideation is difficult because the services often don’t even take you seriously. Photo by Anthony Tran on Unsplash It wasn’t until I physically couldn’t take how I was feeling anymore that I sought help. I’d been struggling too much to handle on my own. I remember going to A&E in the Autumn of 2018. It was late at night. When seeking help myself, I was asked whether I had a plan to end my life. And because I didn’t receive help beyond a Crisis team intervention ‘just in case’ and being told to practise mindfulness and buy an adult colouring book. I once asked why suicidal ideation wasn’t enough for me to get proper help, and why it took making a plan to end your life — or even ending your life — to be taken seriously. I was responded to with a baffled stare. I didn’t start to feel better until my then-relationship ended, and I realised that a lot of how I was feeling was due to the fact I was in an unhappy relationship. I hadn’t correlated the two, because my relationship — which included sleeping in separate rooms and rarely leaving the house — had been the same for years. I don’t know what triggered me to feel how I was feeling at that point in time, I just know that things got better when we split. I received a lot of support from family and friends after the split, and in turn, this helped the way I was feeling. I was able to cry on their shoulders and to be encouraged to seek help from a professional, who also increased my medication which enabled my mood to become more stable. Had we not split, I’m unsure how things would have turned out; because I wouldn’t have gone to my loved ones for support. I wouldn’t have wanted to have been a burden (something that a lot of people with a similar experience may feel). It’s easier to cry on someone’s shoulder over a breakup than it is to do so because of your mental health. But what I’ve learned since is that I’m not a burden, and that you should be able to seek support from loved ones and friends. This isn’t enough. Suicidal ideation is horrendous to live with, and it needs to be taken seriously by mental health professionals before it leads to something more. Not when you make a plan. Not when you die by suicide. And not when people realise they should have helped before something bad happens, and people say: “I wish they’d spoken out”. If you are struggling and in need of support, below are a few incredibly helpful organisations which provide both resources and direct help: Shout Crisis Text Line — you can text Shout to 85258 if you are experiencing a personal crisis, are unable to cope and need support. Talk to the Samaritans — they offer 24-hour emotional support in full confidence. You can call them for free on 116 123 CALM (Campaign Against Living Miserably) offers a chat and hotlines service from 5pm to midnight Papyrus (Suicide Prevention Charity) offers similar service for adolescents and young adults under the age of 35 Mind — you can call the Mind Infoline on 0300 123 3393 / info@mind.org.uk, the Mind Legal Advice service on 0300 466 6463 / legal@mind.org.uk Talk to your GP