Image Source: Wesley Tingey on Unsplash While ongoing research continues to sound alarm bells that mental health diagnoses are consistently and dependably rising in the UK, this does not seem to have translated into panic and action, and one could be forgiven for thinking it has fallen on deaf ears. In the last 10 years there has been a 20% increase in the number of adults being clinically assessed to have a common mental health condition; in young adults the increase is even more stark, at 47% within the same period. This population are also increasing demand on mental healthcare resources, with the number of people accessing treatment for these conditions doubling since the year 2000. Optimists might suggest the increase in diagnoses is evidence of a collective improvement in education and awareness concerning mental health conditions, and a shift away from historic stigma and shame. Pessimists might counter that this progress is not linear, and that the public’s knowledge of mental health conditions in 2024 regressed to the level seen 15 years previously. Cynics might take a view currently popular in the culture that this increase is due to a younger, softer, generation who would just as readily broadcast their mental health difficulties as their breakfast on social media. However, they might be surprised that 72% of 25–34-year-olds surveyed reported a reluctancy in discussing their struggles with mental health, compared to 28% of over 75s. Image Source: Peter Thomas on Unsplash Whatever the cause, the cost is undeniable . Impaired mental health is estimated to contribute 20% of all disease burden in the UK- in England alone the economic cost is £300 billion. This figure accounts for loss of productivity, healthcare costs and ‘human costs’ of reduced quality of life and wellbeing. Despite this, the proportion of NHS funding on mental health care has fallen this year and is set to fall again next financial year, indicating that despite the seemingly worsening state it is not considered a priority for improvement by the government. Increased spending in mental healthcare might not be immediately palatable to the public, despite spending on effective prevention likely saving on treatment later. To combat this, the government might employ the strategies below to reduce antipsychiatry attitudes people might have, such as a lack of trust or faith in the work of mental health services. Raising awareness; reducing stigma In general, prejudices that people hold are a result of a lack of experience with the entity they malign. In terms of mental health, people might be fearful, judgemental or dismissive of certain disorders because they have not had the opportunity to learn about and understand them. 46% of people surveyed said that people with schizophrenia should be able to “pull themselves together”, which contradicts so sharply with reality, it can only be concluded that these views are born out of a lack of exposure to people suffering with schizophrenia. Image Source: Kenny Eliason on Unsplash Education could be incorporated into high school curriculums, including video testimonials of people with lived experience of mental health disorders. This could be a relatively cost effective but far-reaching strategy that helps young people understand and develop empathy for those who suffer with mental health disorders. Similar resources could also be implemented in workplaces. If volunteers were available (perhaps through the Lived Experience Advisory Network), in-person question-and-answer sessions to allow a judgement-free environment for people to respectfully ask about things they are curious to know more about could begin to break down barriers of shame and ignorance. Targeting misinformation and harmful depictions in the media The power of entertainment media as a communication tool should not be underestimated, both in terms of its risk and its benefits. “Informative” videos of medical experts sharing their advice on platforms such as TikTok are unregulated and often designed to grab attention and generate profit. This has led to a spread of misinformation , with an estimated 84% of mental health TikTok videos found to be misleading and 14% to be potentially harmful, such as giving advice on medication. One way in which this might be tackled is enforcing unbiased fact checking on posts which can add context. Image Source: Marten Bjork on Unsplash On the other hand, when depictions of mental health conditions on screen are made in a truthful, informed and engaging manner, they have shown the potential to not only make captivating art but to help people acknowledge these struggles within themselves . 1 in 5 adults reported feeling encouraged to seek help for a mental health problem after seeing a storyline in a TV show or movie that they related to. Government promotion of links between media production companies and resources such as Mind’s Media Advisory Service can provide writers, researchers and producers with information resulting in more accurate portrayals of mental health conditions. Taking accountability and addressing previous shortcomings The stigma of mental health disorders and the services that provide for them vary across different communities and are influenced by past practices that have been implemented in the name of Psychiatry. This variation, in part, is perpetuated by ongoing inequalities that certain minority groups face. For example, Black people are still more likely to be subjected to restrictive practices such as seclusion, physical restraint and rapid tranquilisation than white people. Homosexuality and transgender identities have been reconceptualised repeatedly in diagnostic manuals , which previously have labelled these identities as pathologies. However, this reconceptualisation can be seen as hopeful, and a demonstration that psychiatrists are willing to review the evidence and grow with society. Admittedly this strategy would likely require an adept PR campaign to avoid producing the opposite effect of stoking anger and distrust towards psychiatrists and breaking down relations with these communities. In the long-term, owning up to past mistakes and showing a desire to improve would hopefully inspire more confidence in the speciality. Education, honest media portrayal and accountability for past harms are not complete solutions, but they form a realistic starting point for reducing antipsychiatry attitudes. Together, they can restore public confidence and create the conditions for the investment that modern mental healthcare will undoubtedly require. This piece has received the South London and Maudsley NHA Trust Training Programme - "Lade Smith Essay Prize"

Eight years ago, I went to a friend of mine in distress. I had a lump or a bump or a cough or a premonition. “I am dying,” I told her. I was certain of it. “Or, are you just about to put an album out?” she asked. My name is Charlee, and for the better part of twelve years, I’ve been a willing participant in the love-hate relationship most artists have with the music industry. The music industry is a peculiar trigger in my life. Anytime I move forward - record new music, release new music, make new plans - I backwards dance into old anxieties of mine. Particularly, health anxiety. Image source: Victoria Romulo on Unsplash Health anxiety is something of an actor. It’s quite convincing. Of course, there’s a surplus of information tying the psychosomatic mind to material symptoms, but it always felt uniquely devastating in the moment. I’d have a stress-related, mid-back ache, and suddenly I was storming my physical therapist’s office wondering if she could feel a tumor between my vertebrae. I felt a strange sensation anywhere—and I mean anywhere —in my abdomen, and I was contemplating not boarding my plane because, “What if my appendix had burst?” Routine as that procedure may be, the timeliness of any ER visit was important. I’m not sure how it works really—this tie between my health anxiety and my music—only that there is something tremendously disquieting about the affair of sharing my work. Looking back, it’s as though I saw in it a hidden meaning, a certain reward that felt unearned. When I put my first EP out in 2014, I was convinced it would be a posthumous release. It didn’t feel deserved unless, of course, there was something to even the scales. I told my mother repeatedly, as I spiraled in my apartment, of which I rarely left, “I have Leukemia.” “I have breast cancer. “I have lymphoma.” She was a dutiful listener, but nothing she—or anyone else—ever said quelled the fear.  Image source: National Institue of Allergy and Infectious Diseases on Unsplash The onus of the health-anxious is to understand that we have anxiety, and that our anxiety is cyclical. We uncover Something of Great Concern somewhere on or in our bodies, we fixate to the point of hysteria on the Something of Great Concern, the stress of this causes Something New of Great Concern to show up on or in our bodies, and the cycle continues. For my part, I rarely experienced a break in this action. There were no days off. I was always worried about something life-ending, and I walked around all day long like I was in wait of a court mandated death sentence. In John Green’s The Anthropocene Reviewed he writes, “I’ve always felt like I need a vice. I don’t know whether this feeling is universal, but I have some way-down vibrating part of my subconscious that needs to self-destruct, at least a little bit.” This seemed to describe part of the attachment I had to this chronic anxiety. The thing was, I didn’t think my body could be that affected. It was science-fiction—this idea that I could spiral so intensely and manifest Something of Great Concern. I could blame this on society and its inability to teach people how to be with themselves, how to tune in, how to listen to what their bodies had to say. The body, itself, is always speaking. I remember sitting in my therapist’s office a couple years ago when she mentioned that sometimes something shows up in our bodies for no reason at all. Or if there is a reason, it’s most likely harmless. This did not register for me. The body makes no sense to me. It seems so fragile. I sat with myself and all I could think was " how is it possible something isn’t wrong?"  Perhaps I could look back at my childhood, at the tumultuousness of my father, at his insistence that I had no work ethic because art, in his mind, isn’t work, and draw a line between putting out an album and dying from disease. My worth was all wrapped up in it. And by that, I mean the lack thereof. He told me, in a way, that I didn’t deserve to make art. So now I was evening the scales of pursuing this flimsy venture by dying. There is a lot for me in the general unfairness of the world. For a while, the question was, why someone else? Why not me?  It was never why me? There’s such a lack of compassion in this kind of anxiety. I battered myself all day long for all the good I felt was present in my world. Being overly concerned about joy entering made me the type of person to police my joy, to fear my joy. Eventually, I became addicted to chaos. As John Green further writes, “The pleasure of smoking for me wasn’t about a buzz; the pleasure came from the jolt of giving in to an unhealthy physical craving.” I would rather live in a constant state of panic, I would rather know something was wrong than wait around for something to go wrong. A Revelation in Yoga It was a passing, random moment in a yoga class that gave me pause. We sat as a collective in a long-hold, shaking, dripping, looking around the room at each other, and then to the teacher for some kind of indication that time had ticked down and we would be transitioning out of the pose soon. Instead of guiding us out, the teacher asked us to tune in. “We’ve been here before,” she said. So, too, had I been in the position of fearing for my life without true cause. So, too, had I sat overheating on the couch, my heart racing, thinking I was seconds away from cardiac arrest, only to work myself up without once acknowledging the likeness of every panic attack, which began with heat, then transitioned into a racing heart, then culminated in the rapidness of breath. Not once had the low pain in my abdominals been anything more than a cramp, flatulence, or a food item that didn’t agree with me. Acceptance can feel oddly similar to giving up. There’s a weaponised aspect to it. When we talk about the powers that be, there’s no sole perpetrator. I felt uncomfortable allowing my hypochondria to exist without having to name the cancerous potentiality of each and every material symptom. I’ve been taught to be at war with myself, with everyone else. I’ve been taught to live in fear, that there isn’t enough time, that good things can only be done when we’re young, that there was only so much resource to go around. Perhaps, what I’m getting at, is that anxiety, as genetically predisposed and chemically manufactured as it is, is also a weapon of society. As Maya Angelou said, “Art is not a luxury. The artist is so necessary in our lives. The artist explains to us, or at least asks the questions which must be asked.” And perhaps, keeping the artist down is the point. In 2013, my father told me he was uncomfortable helping me move to Nashville to pursue my music career “if you’re still dependent on therapy.” But what he was really telling me is this: anxiety is not normal. You shouldn’t need therapy. If you do, something is wrong with you. Image source: Toa Heftiba on Unsplash What if, instead, those without anxiety were the ones experiencing a rarity of circumstance? They were insulated, in some way, and the rest of us were true products of our environments? That’s how I started to see it, and it made me angry. He, being swayed by the ableist world at large, which undervalues the artist in every workable way, had led me to believe that I was othered. He made me feel, in a sense, that I had to even the scales by suffering in some way to bring my art into the domain. He had made me feel guilty for not being a cog in the machine. For having time on my hands to create. He had weaponised my freedom, the idle hours of my day, the moments of quiet connection with the self. What I came to find is that I don’t owe him or the world my suffering. Art does not need a reason to exist. I don’t have to account for the hours I spend working on something that’s self-interested. The best thing I could do is rebrand my condition to decentre myself in my own suffering. This is not my doing. This was done to me.  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.

I was born on December 3rd, 1993, in Caracas’ busiest hospital. I spent my early years in a high-rise apartment at the top of a mountain in Manzanares, living a quiet, ordinary life. Everything changed when Hugo Chávez, once the face of a failed coup, rose to power. My dad saw what was coming, and we eventually left for the United States. Looking back, it's painful to see how the Venezuelan diaspora, my family included, was shaped by those decisions. What once seemed like a noble decision by my family for the sake of our democratic future became a nightmare with no end in sight. There's nothing left for me to do but chronicle why and how we arrived at our current state. The nostalgia of others colours my memories. At least that’s the Venezuela I know now, through the rose-coloured lens of my family’s memories and testimonies. A Venezuela that once thrived economically and socially. Venezuela, which used to host well-known artists from all over the world. A country whose complexities and eccentricities get left out of these imagined glory moments of the past. Much to my family’s disbelief, I still remember a lot from my life in Venezuela. More than they’d like to admit, anyway. I remember the hustle and bustle of a busy Caracas street. The smell of rust coming off my favourite slide on the playground my grandfather would take me to every weekend. I remember my room overlooking Cordillera de la Costa Central. I remember it all. It makes it harder to live with the dissonance between their nostalgia and my understanding of it now. That dissonance has only deepened in the wake of the events of January 3rd, 2026, when the Trump administration forced my memories out of nostalgia and into something harder to live with. Photo by Altamart on Pexels Uprooted And Upended  Political disarray has shaped my worldview. My family and I moved to the United States when I was 8 years old. We left a country on the brink of economic and societal collapse in search of a better life. Our immigration story, however, is quite mundane. We didn’t cross dangerous borders on foot, nor did we stow away in the back of trucks. Brave people did that. My family and I were fortunate enough to land safely on US soil after a three-hour American Airlines flight on August 11, 2001. Ironically, it was exactly a month to the day before the Twin Towers collapsed on September 11, 2001.  Deep unrest is all I’ve ever known before moving to another country, which is already one of the biggest uprooting anyone can do, especially at the age of eight. I still remember various birthdays held in front of the television during one of the  many elections held under Chávez, and more recently, under Nicolás Maduro .  My family would gather around, holding hands as they tried to will an alternative result. One where the authoritarian regime is flushed out of a country, begging for life. It never worked. It’s complicated and it always will be.  After January 3 rd , things have only grown more turbulent in my mind. How do I condemn the joy Venezuelans feel at the sight of Nicolás Maduro, a man deeply connected to their suffering — being taken away? Even when those same forces belong to an administration now roaming the streets of the United States, terrorising their own citizens? Masked men who drag people from their homes and off the streets into unmarked vans in unknown locations, never to be seen again? It sounds familiar, I’ve been here before. I once escaped this when I came to the US, or I thought I had.  Photo by Joel Santos on Pexels The Disarray of It All  Understanding the complexities of my background and our present political landscapes has become a world of landmines. Each is individually crafted to blow up at any moment. My anxiety is the trigger. As political tensions in Venezuela rose throughout the years, so did the  radicalisation of the Republican Party in the United States . With it, my family’s belief that right-wing ideology would save Venezuela from the clutches of an authoritarian socialist government one day. What they failed to see amid the deep political trauma is the same thing they were running away from would ultimately catch up to them, too.   I don’t know at what point my mind and the world around me merged into one messy ball of chaos. Was it the day we left Venezuela? Or the day I understood the complexities of my birth country and the one that now hosts me. I’ve yet to feel at home in the United States, even after over two decades.  Slowly, Gently Down My Mind Goes  The first time I had a panic attack, I was on my way to school. It was my first day at my new school in the US. I didn’t know what a panic attack was. I just assumed all the other kids being ushered into the classroom felt the same, and that they were just better at hiding it. Turns out, I was experiencing severe separation anxiety from my family. Being in a new country, a new school, with new people, and learning a new language. I had one new experience away from collapsing in front of my new second-grade teacher. It didn’t get any better as time went by.  Photo by RDNE Stock Project on Pexels My internal unrest slowly and intricately weaved itself with the unrest of my family. The conflict between my birth country and this new world is filled with contradictory ideologies. My anxiety is directly linked to my fear of leaving home, and this is no coincidence. Where is ‘home’ for me anymore? My family has succumbed to the dizzying rooms of smoke and mirrors Republicans have conjured to keep their base in check.  Brave New World  As I grew older, I grew weary of my family’s political stances. They parrot back to me conservative talking points with such conviction and clarity, much like some American progressives who seem to believe Venezuelans live in a socialist utopia. Both are so sure yet so wrong.   Living in a home where every conversation on politics feels like a test I’ll never pass is exhausting. My family’s paradoxical way of looking at the world has triggered a deep anxiety in me. How do I please my family’s political trauma but also stay true to what I know?  Their paranoia has been stoked by forces much larger than me. My family has been convinced to vote against their own self-interest. Against my own humanity. I am treated like an outsider in my own family because I leveraged them in the one thing they wanted me to have: an education.     I move through the world with extreme caution because of it. This has closed me off from others in a way I never anticipated. How can I ask for understanding of others when my family can’t even extend that courtesy to me? There’s no simple answer here, and there’s no clear winner. We live in a world where the word truth has lost all meaning. But I am able to manage, to survive.  Living in this brave new world my parents dreamt of for us seems impossible for me now.  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.

Photo by Alex Green on Pexels A diagnosis can feel like a key — unlocking understanding and access to help — or like a label that locks you into something you can’t escape. I was 35 when a psychiatrist gave me a diagnosis of borderline personality disorder (BPD)/ Emotionally Unstable Personality Disorder (EUPD). I am now 43, and I still have an ambivalent relationship with the diagnosis. I was diagnosed with depression and anxiety aged 18 and have had various forms of treatments. I have taken several different antidepressants. In terms of therapy, there has been intermittent support when it has got to crisis level, like CBT and counselling around self-esteem and anxiety. I am now in a position where I can afford private therapy, which has allowed me to identify that childhood trauma is the reason for my behaviours, thoughts and unhelpful coping mechanisms, the most significant event being the suicide of a parent. I am open about my diagnosis of depression and anxiety in my personal and professional life but not about my diagnosis of BPD/ EUPD. The only people who are aware are my wife, mother and sister. This is, I think, due to internalised stigma and a fear of reaction. It has made me a guarded person who finds it difficult to make and keep friendships.   My past experiences inspired my undertaking of a Social Sciences degree, as I wanted to understand the reasons for social inequality and discrimination, and my successive jobs as a Support Worker, Work Coach and Benefits Caseworker. I like to write; in a perfect world, I would make a living from writing full-time. EUPD is perhaps the most stigmatised mental health diagnosis. Conversations around mental health are becoming more common and there is a wider understanding of the long-term impact of trauma and adverse childhood experiences. As my therapy makes me realise how much stigma I feel, it is the right time to discuss how we talk about diagnosis and add my voice to the conversation. Debate about diagnosis sits at the heart of mental health discourse, between the need for validation and the risk of stigma. Below, I discuss the pros and cons of diagnosis, which drift towards focusing on the cons due to my own experience, not to say it will be the same for everyone. The Case for Diagnosis Within the clinical community, it is partly accepted that the diagnosis of BPD has limitations , particularly due to the high overlap of symptoms with other mental health conditions, such as bipolar disorder. However, it is still felt that diagnosis is overall beneficial. A benefit of diagnosis can be validation. I felt like an outcast for so long that having a diagnosis gave a satisfying sense of relief. Dialectical Behavioural Therapy is often the most effective treatment for EUPD. However, to access DBT through the NHS, a majority of hospital trusts require a diagnosis, or at least “strong traits” of EUPD. In these cases, having a diagnosis is essential. For some, including myself, even passing the barrier of having a diagnosis did not lead to support.            Research has also shown that, for some, diagnosis “facilitates self-understanding, self-legitimation and self-enhancement.” The Case Against Diagnosis Attitudes in society to people with a diagnosis of EUPD remain predominantly negative; those with EUPD are seen as dramatic, or worse, dangerous.   Society tends to focus on the observable behaviours (self-harm, impulsivity) rather than on the underlying trauma and emotional pain .       An argument against diagnosis is labelling.     Labelling can lead to a situation where the “problem” is seen as being with the person, rather than society's failure to recognise behaviour as a coping mechanism. Research has shown that negative psychosocial impacts of diagnostic labelling (stigma, changes to self-identity, relationship strain, social or professional discrimination) are common. Photo by Yankrukau on Pexels The key argument against diagnosis has to be stigma , which is both disempowering and frightening. This can be internalised, which can significantly impact an individual’s sense of self. I felt ashamed and blamed myself; I very much felt like there was something wrong with me, and it was too late to return to the manufacturer. This can be self-perpetuating and make recovery difficult.   That is not to say that diagnosis cannot be helpful: into the early 20 th century, Schizophrenia was generally seen as madness and sometimes as possession by the devil or evil spirits, and still is in some cultural settings. Medicalising the condition went some way to reducing stigma by seeing it as a treatable medical condition.          Stigma is often formed by representations in the media. There has never been a character with a diagnosis of EUPD in a British soap opera, despite it being diagnosed more often than schizophrenia, which has been portrayed often on tv. The soap opera Hollyoaks has perhaps had the character who has demonstrated the most significant traits of EUPD, Cleo McQueen, who has shown emotional dysregulation, impulsivity, identity disturbance, interpersonal difficulties and self-harm in the form of an eating disorder. EUPD was not explicitly mentioned.        This lack of representation is likely to lead to false beliefs and a lack of understanding. Mentions of EUPD in the media are predominantly negative and reinforce harmful stereotypes, as it is constantly portrayed as a character flaw or moral failing.              Given this, it is high time that representations in the media of those with EUPD change, and negative portrayals are challenged, particularly given the fact that research has shown that 54% of people say that seeing a well-known character on screen with a mental health condition has improved their understanding. Perhaps the reason for this lack of representation is a misunderstanding of the condition, or a fear of showing an emotionally complex person. I urge those in the media to challenge this. Accurate and compassionate portrayals could shift public understanding, as they once did for schizophrenia. What's in a name Borderline Personality Disorder has origins in the 1930s.  Borderline was used because people with this condition were thought to be on the border between neuroses and psychosis. As the term “borderline” was seen as archaic, and with the intention of reducing stigma, the term EUPD was introduced and is now widely used in the UK and Europe. There is a suggestion that this term is less stigmatising ; and a more accurate reflection of the condition. Personally, I still feel it has an overwhelming negative connotation, as it gives no nuance and suggests the person is permanently unstable.   I would explain EUPD as a response to events during childhood. We learn coping strategies that continue through to adulthood, these can be unhealthy and damaging to those around us, but should not be seen as bad behaviour or attention-seeking. They should be seen as maladaptive, but protective. For example, alcohol can, in the short term, calm a chaotic mind and avoidant behaviour can avoid facing challenging emotions.  If we understand EUPD as a response to trauma rather than a fixed disorder, diagnosis could become less about labelling and more about understanding.   Photo by Vie Studios on Pexels 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.

I have alopecia, and I wear my bald head proudly now. Alopecia is hair loss  that can be the result of medical conditions, hormonal changes, or genetics. While it is treatable, sometimes its effects can be permanent. When I am out in public, I catch people staring. Online, where I share my story, I receive backhanded compliments — comments that circle how lucky I am to be attractive, or how I could always wear a wig, or how I should “dress up my face” more to distract from the baldness. I could hide away . These things used to matter to me so much – what others said and thought of me. It was as if they were the air that I breathed. How It Began Approximately ten years ago, I had one hair appointment after another, a new woman’s fingers grazing my scalp every other month —  a braiding style here, an expensive lace wig there. In 2015, long before TikTok existed and before Snapchat became as popular as it is today, Instagram built the world of desirable women. Writer's own image On Instagram, I studied women who were deemed beautiful, sexy, and the ultimate prize by men. I secretly prayed that I would gather the same number of likes, comments, and attention. A man liking my photo somehow validated my worth and existence. My focus became achieving the most beautiful hair. Even if it wasn’t my own. I didn’t notice the first warning signs: the thinning of my edges, the brittleness of my hair at the crown of my head. No hairstylist raised red flags about what was going on with my scalp, and I don’t fault them for it. They ran a business, and their job was to provide what their customer needed, but their speciality was not natural hair care. Through this journey, I’ve learned the importance of seeking out stylists who specialise in and care about a woman’s natural hair.  How It Got Out of Control In my mid-twenties, after another disappointing rejection from a man, I became obsessed with the notion that I simply needed to fix my body. I became their fantasy, and I was deeply attached to the validation and attention they gave me. I would do anything to maintain the illusion —  even sacrifice my natural hair for expensive weaves that flowed down my back. Writer's own image But soon, my hair stopped growing, and I couldn’t hide from it anymore. I panicked. If I weren’t a man’s fantasy, if I weren’t the bombshell, they wouldn’t want me anymore. The attention would be lost, the adoration gone, and I would once again be an afterthought. Forgotten. Truth be told, I could’ve sought help for my insecurities then, but I needed to play the game of fantasy a little bit longer. How I Lost It All During the pandemic, at thirty-two, I cut what little hair I had left and became a new woman: carefree, bold, and still beautiful. The attention had waned slightly, but I still gathered eyes and adoration from men online and in public, feeding my deep-seated wounds.   Writer's own image I tried to keep living the fantasy by dyeing my hair every month – one month, blonde, the next, jet-black, and one day, even purple. I empowered other women to embrace their flaws while I hid behind a mask of complete acceptance. I became a self-love coach, spoke at wellness events, and hosted retreats for women seeking guidance on how to love the skin that they were in. While it felt reaffirming to help others, I couldn’t shake the feeling that something wasn’t right. How could I help anyone if I weren’t being honest with myself first? Two years ago, I woke up and discovered that the crown of my head was completely bare. I stood in front of my bathroom mirror, and I could see straight through. I had a small afro at this point. I should not have been able to see my scalp. But there it was. There was no amount of brushing, twisting, moulding that could hide this truth that lay bare before me. The dam had broken. The illusion was gone. I panicked, tears welled up in my eyes, my stomach churned, and I felt a deep sense of dread looming over me. What was I to do? I had played the game for so long that I had nothing left to give. What do you do when you lose a piece of your identity that has kept you desirable, wanted, and valued in the eyes of others? How I Regained Myself  I could hide away . I tried to. I wore wigs. I kept up the fantasy. But something kept gnawing at my subconscious: “You don’t need this anymore,” I heard a voice – my own voice - say, “you’re enough. You’ve always been enough.” What was I afraid of? That I wouldn’t be loved? That I wouldn’t be chosen? One morning, I stood in my bathroom and stared at my reflection in the mirror as I shaved my head completely. Surprisingly, I didn’t cry, I didn’t scream, I didn’t shout -  I laughed. A deep, full belly laugh escaped from the depths of me as I realised that I had been fooled. I thought something would change by accepting my alopecia, that somehow, I would be a different woman, undeserving or unworthy. But how naive I had been! I was still the same person with the same face, the same smile, and the same open heart. Fear had tried to cripple me, but it was all a facade. My life did not end, nor did it blow up in my face. As I stared at myself, I held myself in my arms, rocking back and forth. My chest heaved. The cries began then. Through therapy, I came to understand: by honouring myself, I was ultimately healing my inner child  because, for so long, I had been trying to console her by being the fantasy, by being the perfect woman, by seeking validation from others when my younger self had always been looking for me to give her that love and affection. Where I Am Writer's own image Through therapy, self-work, and prioritising my self-care, I now know the only validation I need is my own. I work through my insecurities by affirming myself daily in the mirror – I tell myself I am worthy, I am beautiful, I am enough – and I extend gratitude to my body and my bald head for being healthy. I wear clothes that make me feel confident, and I always add an extra accessory or two that gives me an extra oomph.   There are days when the old negative voice wants to creep back in, but I don’t retreat when I hear it. I let myself be seen. I let myself feel the discomfort of it all. Because I now know that shadows cannot thrive in the light, I let the pain wash over me, seep into my pores until it falls to the floor. Then, I breathe in deep and let the love I feel for myself take hold of me. And all at once, I am whole again. 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.

Severe acne may seem only skin deep, but its effects on mental health can be devastating. I’m Anna, a primary school teacher and writer who has struggled with acne since my late teens. I have been through almost every treatment imaginable, and have suffered the consequences of this visual, mental, and medical condition for over six years. Image Source: Ron Lach on Pexels Acne is a term most people are familiar with, whether from their own hidden school photos or the plague of teen movies that overuse it as a plotline. However, for the group of us who are unlucky enough to suffer it into adulthood, what was once a harmless phase can have a big effect on both physical and mental health. I began to develop acne at fifteen, and although the itchy red bumps, protruding whiteheads, and blossoming scars were uncomfortable, I didn’t feel like I particularly stood out. At university, however, this barrage of spots so visible on me no longer showed on the faces of my peers. When others began taking endless selfies and posting their faces for the whole world to see, I hid mine away, only posting group photos, or ones taken in lighting moody enough to blur my skin into looking normal. My confidence was shattered, and I found myself drowning in social anxieties about people seeing me, judging me. The constant comparison to my clear-skinned peers was exhausting. Severe acne, though it may seem superficial, can have huge effects on a person’s self-esteem, and carries with it a long line of medications and frustrating doctor’s appointments. However, after many struggling years, I have finally been able to feel comfortable in my own skin. Image Source: Vitaly Gariev on Pexels Anxiety It’s my third year of university and I am attempting to apply make-up whilst not looking in the mirror. Unsurprisingly, it’s not going well. The best concealers can’t disguise dark pink scars under my cheekbones, and even if they did, the dimpled texture is uncoverable. I look up methods of blending away acne on TikTok and am hit with reams of porcelain-skinned models telling me to ‘ just drink more water. ’ Suddenly, the dress I’m wearing begins to itch, the shoes become too tight, and the inevitable excuse text is sent to the group chat. It complains of period pains, or something more understandable than the fact that I don’t want to see my own face, or for anyone else to see it either. When discussing acne with a friend who also suffered, I remember her telling me that ‘It’s all you can see, so you forget that other people don’t notice it. ’ But that’s easier said than done. Acne became the only thing I would see if I looked in the mirror, the photo, the Instagram post. At points, it would stop me from leaving the house, and low self-esteem began to dictate the life I was living. Image Source: MART PRODUCTION on Pexels The Pill Going to the doctors wasn’t straightforward for me, as I struggled to see acne as something that warranted medical attention. It felt selfish, taking up the doctor’s time for a condition that was only on the surface. But it was affecting my mental health, and my sense of self. Supported by friends, I finally booked an appointment. I would’ve liked that to be the end of it, to have been handed a cream and to have clear skin forevermore. Unfortunately, that wasn’t the case. Firstly, I was told it was hormonal, and that the only answer was to go on the contraceptive pill. I could fill a page with the different pills I was put on, all with beautiful names like Dianette and Yasmin. They sounded like fairies from a children’s book but impacted my body in ways I was unaware of. Having recently read ‘ How the Pill Changes Everything’ by Dr. Sarah E. Hill , I realised why each of these pills made me feel so different. Fluid retention made my face rounded and moon-like, hormones dulled my emotions, and I felt a disconnect with my own body that I only recognised once I’d stopped the daily dosage. The continuously fluctuating hormones had effects on my body that I’m still living with today. Alongside this, I was also prescribed two rounds of antibiotics and copious amounts of retinol creams, all to no avail.  After nearly two years of trying to clear away this onslaught of spots, I was prescribed the giant of all acne treatments: Accutane. Accutane Accutane, or Isotretinoin Roaccutane  as mine was called in the UK, clears acne by reducing the production of sebum: an oily substance produced by the skin. In short, it prevents your body from producing spots by drying out your skin (and lips, and hair…) so that there’s no oil to make them. And just like that sounds, it’s horrible. When I first went on this medication, my cousin told me that you can tell who’s been on Accutane, because they have unusually strong opinions about lip balm and body lotion. In the future, anyone who asks me about it will immediately receive the response ‘CARMEX AND AVEENO’. Added to my trial of desert-ified dermatology, I also found that doctors were unsympathetic, to the point that no one actually explained to me what Accutane was. One appointment where I asked for a different contraceptive pill was especially memorable: Because Accutane can cause severe birth defects and miscarriages, it's important to avoid pregnancy whilst on it. However, at this time, I had been on a contraceptive pill for over a year that I was originally told would cause blood clots if I took it for more than six months. I voiced my concern to the doctor, asking to switch to a different pill. The doctor ignored my request, instead shouting ‘ You will kill the baby!’ .   All further questions suffered the same infanticidal response, along with a jabbing finger at a diagram of a pregnant woman with a stop symbol cutting through her belly. This diagram was plastered at least thirty times across every inch of Accutane’s packaging. Embracing the scars Image Source: cottonbro studio on Pexels I would like to say that the six months I spent on Accutane cleared my skin forever, but unfortunately, that’s not the truth. My skin is not perfect now, and I doubt that it ever will be, but it’s certainly better. Even seeing it a little bit clearer allowed me to look further than just my acne. The only good thing about being so fixated on the spots on your face is that it leaves you little time to develop other insecurities. Now when I look in the mirror, I make a conscious effort to see past the scars that still linger on my cheekbones. Instead of focusing on minor imperfections, I have learnt to see the parts of my face that look beautiful. Instead of covering any acne I choose to distract with a glittery eyeshadow, or a different shade of lipstick. I doubt that I will ever have the perfect skin that Instagram and TikTok models have from "just drinking water" (and using tricks of light and camera filters) but I have learnt that I can be beautiful even with acne. I have learnt how to feel comfortable in my own skin. 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.

Image Source: Ellie Burgin on Pexels After struggling with mental health challenges since my teenage years, I was diagnosed with cyclothymia at the beginning of 2025. But what is cyclothymia? Looking back, I realise that this lesser-known mood disorder has impacted my relationships, work, and social life, even if I did not know that at the time.   Getting this diagnosis at 43 was not something I had foreseen.   On my laptop screen, in a minimalist white office I had booked for privacy, the serious but kind face of the psychiatrist stared back at me, enlarged via Zoom. We had spent the last hour going over my whole life history. She furrowed her dark brows. “Anneliese, have you heard of cyclothymia?”   No, I had not.   What had brought me to this moment?   The peaks and troughs had become increasingly dramatic. For weeks, a veil of gloom fell and lingered. Inevitably followed by periods of sudden positivity and productivity. I would have enthusiasm for work again, organise the whole house, and my partner would catch me singing in the kitchen. And I had started to notice that this was a cycle on repeat.   The doctor asked, “Has anything helped?” It was difficult to say. Over the years, several rounds of CBT reduced my anxiety levels. But the effects did not tend to stick long-term. I was also taking antidepressants and, with my GP's guidance, had changed the dose, but to no avail. I felt stuck. Image Source: Pixabay on Pexels Finding out more about cyclothymia A few hours after meeting the psychiatrist, I was googling ‘cyclothymia’ and reading the Mind website : ‘You may get a diagnosis of cyclothymia if: ●      You've experienced both hypomanic and depressive mood episodes over the course of two years or more. ●      Your symptoms aren't severe enough to meet the diagnostic criteria of bipolar 1 or bipolar 2.’ Looking at my life in overview, this began to add up. As a child I often felt down and enormously worried. My chest hurt and head spun with images of disasters and accidents. At the same time, I pushed myself hard in school and was always on-the-go with extracurricular activities.   As I matured, I had lots of highs and lows. Binge drinking, often being impulsive and intense, taking risks. Normal for your teens and early twenties? Maybe. But in between these whirlwind episodes were times of despondency and isolation, hours spent lying in the dark. This period is best exemplified by a text message I received by accident from a friend, “Anneliese is being weird again.”   As an older adult, I had hugely industrious and optimistic phases: studying, working, having my children, developing a freelance career, achieving. More positive, chatty, and outgoing than before. And then, out of nowhere, I would be down for the count, overwhelmed by all the work I had to now deliver. My sensitivity heightened, tearful, snappy, paranoid, convinced I was unlikable: avoiding anyone other than my immediate family. It ached to form my mouth into a smile. My voice was flat and monotone when I spoke. Getting treatment and support Back to the present day: the psychiatrist prescribed me mood stabilisers . Over the course of the last year, they have been increasingly effective. I am now on more of an even keel.   Researching cyclothymia was useful but occasionally frightening. Reading that it could lead to ‘ severe, complex, borderline-like bipolarity ’ felt overwhelming. Equally, much of what I read enabled me to make sense of my experiences. For example, people with cyclothymia, like me, often access health services because of distressing feelings of depression and anxiety , and are less likely to recognise their more elevated states.   I had depressive episodes that felt very debilitating, but on reflection, I also recognised that the peaks on my emotional rollercoaster did influence my daily life. This was hypomania, characterised by ‘ abnormally elevated ’ mood, energy, or activity, but not as extreme as mania. For instance, in the months before my psychiatry appointment, my mind filled with ideas for writing, topics for a PhD, businesses, hobbies, projects, in a way that felt uncomfortable. Sometimes these ideas were fruitful, but often I abandoned them. My partner would tell me not to overdo it, but it was hard to stop being busy, and my sleep was disrupted: my brain buzzed with thoughts. One issue is that kind of apparent productivity is valued and even rewarded in our society: think of ‘hustle culture’. So maybe it’s harder to spot, even when it has negative consequences? Image Source: Meg Boulden on Unsplash Telling other people The question of labels and diagnoses is tricky. At times, cyclothymia felt too vague and soft in its definition. Everyone has moods, but I suppose the difference is that for me, there was a clear pattern. And this relentless cycle had been dominating me.   I struggled to tell people. I imagined they would not believe me. Talking to close colleagues, family, and friends did not bring the push-back I expected. In fact, there was not much reaction at all. It also made sense that not everyone understands the terminology, as cyclothymia is relatively rare, with a lifetime prevalence between 0.04% to 1% . The term was first used to refer to a mood disorder in 1877, but even today public awareness seems minimal. Still, I felt relief in having a framework to comprehend the fluctuations in my mindset and behaviour. Image Source: Dan Meyers on Unsplash Attitudes towards mental health problems The ongoing public debate around an ‘overdiagnosis’ of mental health conditions has intensified my nervousness about disclosing my experiences. Despite this, I am sharing it now with the hope of encouraging an environment where people, young and old, are safe to talk about their wellbeing. It is so important that others can access support without fear of their experiences being trivialised.   Psychological wellness is nuanced and changing. A cyclothymia diagnosis has given me a new perspective on past behaviours and actions that previously filled me with shame and distress. Moving forward, I am not ‘fixed,’ but I do not feel broken anymore.   It is getting easier to be gentler with myself and accept that my motivation, feelings, and self-confidence will still fluctuate. Spotting the signs of when an extreme change in mood is on the way and giving myself some grace. For me, warning signs included increased self-isolation, as well as stronger emotional reactions to everyday happenings (crying because an email I received felt a bit too blunt!), and a rise in negative self-talk: “What is the point in applying for this job, I am rubbish at everything anyway?”   On the hypomanic end of the spectrum, I know that it’s time to slow down when my sleep is disrupted by a racing mind, or I am constantly on the move and unable to relax. I might feel tired, but I still find myself unable to stop pottering around where my family are all chilling out on the sofa. It helps to notice these changes, to pause, and to reflect if these thoughts and behaviours are beginning to escalate. I also take more rest breaks, rather than pushing myself to always be productive, always be achieving. Not exactly rocket science, right? But even these small changes have had a cumulative effect for the better.   Recently, I have started in-depth counselling, untangling various aspects of my life. Exploring my childhood, identity and place within my family has also been a useful way to better comprehend the emotional cycles. Talking with my counsellor can be hard sometimes, but it has also boosted my confidence and given me the space to recognise the positive qualities I possess, like resilience and openness to asking for support.   The journey to understand the light and the dark is ongoing, but I know that I am not defined by cyclothymia. And I now realise that I am more than just my moods. 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.

Image Source: Andrej Lišakov on Pexels Three and a half years ago, I went through a traumatic event, the repercussions of which rippled out into what I hope to call the worst year of my life. And while that time is now behind me, and life has once again gone back to normal, there is one side effect that still casts a shadow over my life. It feels like I hear people talking about triggers all the time, about being aware and sensitive. But I rarely see anything that resembles an understanding of what I experience when I say I am triggered. Triggered, in a clinical sense, is understood as an emotional or psychological reaction to a stimulus , which can prompt a re-experience of trauma and produce an overwhelming response. For me, it’s a whole-body reaction that can take days to subside. Once upon a time, it was weeks. While I consider my reduced recovery time a win, I’m starting to accept that, to some degree, this may be something I have to deal with for the rest of my life.  The hardest thing to explain is that triggers aren’t necessarily rational. I’ve watched TV shows that graphically depict events similar to my experience and had no reaction. In contrast, something seemingly innocent and irrelevant can send me into a tailspin, like a badly worded text message. It’s very hard to give a blanket set of instructions about what sets me off. There are obvious things, which are directly threatening or aggressive, but then there have been more subtle cues which have caught me completely off guard. They make no logical sense, which makes it even harder to come to terms with the extreme reaction that I then have to contend with. I am a writer and educator, and after 15 years of working in education in Southwest England, I thought I had a solid understanding of the effects of trauma. But w hen my event happened, I had no concept of the longevity of its effects. Physically, I was fine. I remember a counsellor telling me that I was standing at the base of a mountain and internally shrugging it off. I had moved from the city to the countryside a year earlier for a slower pace of life and felt certain that recovery would be a matter of weeks. Had you told me that 3 years later, I’d still have days where I felt out of control, it would have terrified me. I thought these reactions were part of the event. For me, accepting them as part of the recovery has been an incredibly important part of moving on.   Image Source: Thomas Park on Pexels What Being Triggered Feels like in my Body and Brain For me, being triggered starts in my gut. It’s cliché, but it’s like a punch that knocks the air out of my lungs. Then it spreads. My knees get light, like there is an air bubble pushing them up, ready to spring. I struggle to regulate my breathing, and I stress sweat profusely. My back and shoulders tense. My skin itches. I can’t sit still. I can’t focus on anything but the stimulus. Whatever it was, no matter how big or small, it’s all I can think about. Imaginary rows with invisible people lasting days. Worse, I struggle to stay present and function. Holding a conversation is challenging because the trigger is still playing out in my brain. If I’m not engaged, I disassociate: more absorbed with the imagined threat than the real world. I struggle to eat. I’ve fallen into bed exhausted, only to be unable to sleep, on a couple of occasions, for several days. I develop tics. Rocking myself, rubbing my hands together unconsciously — all attempts to self-soothe. I literally can’t sit still. But what I have to be particularly careful of is what's going on in my brain. While I have often been told by my therapist that I get full marks for self-awareness, that in itself can be a curse. Knowing the absurdity of what I’m going through can make it worse, as I start telling myself off for not being able to calm down. I have to walk a fine line between forgiving myself for my reactions and giving myself space to process the trauma, while acknowledging when my thoughts are trapping me in my panic state. Far from controlling the sensation in my body, my brain tries to rationalise it. Justify it. Turn whatever prompted this reaction into a monster that makes my response appropriate and necessary. I have to be careful about who and how I talk about what I’m going through. The wrong type of validation can prolong the experience. The Only Way Out is Through While the urge is to regurgitate the event over and over again, what I’ve realised is that, in my case, this hamster wheel doesn’t help me. It simply prolongs the agony by getting validation for the fear from external sources, something that I crave. This started at the time of the event; while some people can hide their experiences for years, I found that I had to tell everyone: friends, family, strangers. Any within earshot could detonate the trauma bomb. Now I am careful of how I talk about what I am experiencing. I know that the trigger itself (however big or small) is not the issue. It’s about convincing both mind and body that I am safe in my space. Replaying the danger doesn’t help. Staying in myself, noting the physical sensations without judgement, and talking to ‘safe’ people, like trusted friends and professionals (Somerset’s Mindline service  has been invaluable to me, they offer a 30-minute call-a-day, alongside other mental health support services). Trying to ignore what is happening only makes it worse. The only way out is through it. I’ve also realised how important it is to maintain my self-care routines. Making sure I eat and exercise to try and get some endorphins flowing. But it has to be the right kind of exercise. Walking gives me too much time to stew and ruminate. Swimming, on the other hand, seems to naturally mellow me out a little. Image Source: Daiga Ellaby on Pexels How I Live with my Triggers I’m learning to accept my triggers and forgive myself for them. Because however uncomfortable it feels now, once upon a time they were sane reactions to a crazy situation. There was a time when I was in danger and failed to keep myself safe. My reactions are my body’s way of trying to make sure that isn’t going to happen again. My triggers are terrifying and paralysing and mind numbing, but they keep me safe. As I’ve had to rebuild my life in the last few years, they have forced me to pay close attention to my own wants and needs. Something that has done me good in helping me form better habits, hobbies, and stronger relationships. I’ve learnt how to step away from unnecessary conflicts and give myself space to have reactions. It’s made me aware of some of my own self-destructive patterns and helped me take steps to make healthier choices. I can’t say I’ll ever be ‘grateful’ to have triggers, but I’m not scared of them anymore. They have helped me rebuild myself out of a crisis, and I’m content knowing that even if I have to deal with them until my dying day, it means that I’ll have to take better care of myself. I pay more attention to my needs, even on good days, and prioritising self-care makes the good days better.   I may not always be in control, but I’m working with myself now, not against. And that feels better. 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.

I’m Emma Marns - freelance journalist and mother of one, on a seemingly neverending journey through the Wild West of mental health. I’ve experienced the good, the bad and the frankly unheard of - as I discovered after the birth of my child in the heatwave of 2022. Breastfeeding wasn’t widely discussed in my family and not many of my friends had children when I fell pregnant with my child in 2021. I’m not sure exactly where the passion for breastfeeding came from, but it was certainly there long before I got the obligatory ‘breast is best’ leaflet from the NHS midwife. I was blessed with a healthy, textbook pregnancy at the tail end of the Covid-19 restrictions in the UK. I spent much of my time researching hypnotherapy, water birth, and how all these lovely things would springboard joyously into successful breastfeeding. I have a long history of mental health problems and was assigned a Mental Health Midwife for the duration of my pregnancy. Photo by freestocks on Unsplash Armed with knowledge about how to tackle and counteract the most common problems – low milk supply, exhaustion and experimenting with different feeding positions or ‘holds’ being the main ones – I went into a 36-week scan having been reassured multiple times that my baby was, as much as the term exists, staggeringly normal. An hour later, my husband and I sat with a consultant hearing things like ‘gestational diabetes’, ‘repeat blood tests’, ‘98th centile’ and ‘intervention needed.’ My hitherto perfect pregnancy was thrown into disarray – I had no trace of gestational diabetes, as it turned out, and no palpating midwife could find evidence of an alleged mini-giant in my uterus. Nevertheless, it was decided I was much too high risk now to give birth in my lavender-mist bath, as planned, and after three days of standstill misery on an induction ward, I stubbornly walked myself into an operating theatre on a stifling Monday morning in August. Our, as it turned out, perfectly average-sized daughter was delivered by a completely unnecessary c-section so physically flawless I didn’t even lose that much blood. In recovery, the midwives marvelled at my hungry little jellybean. “Would you like to try giving her her first feed?” they asked politely. Would I ever, and I wriggled out of my hospital gown with the speed of someone who’d been out of surgery ten minutes. It was a standardly chaotic first-time feed, with lots of falling on and off and not much actual digestion taking place, but I was sure it would all be fine once we were settled. Those first few moments gave me an odd prickling sensation, but as I was half-numb from the spinal and out of my mind with joy, I didn’t have much time to notice. We had to stay on the postnatal ward for 48 hours monitoring and then, I had nothing but time to notice. I received little to no breastfeeding support even though I practically begged on my numb knees for it – the staff were too busy in the next bay, trying to bully the young new mum recovering from infection into breastfeeding when she had no intention of doing so. I had a spiteful Healthcare Assistant come and glance at me, tell me my ‘nipples were insufficient’ and shove a bottle of formula into Melody’s mouth before I could say no. I tried to persevere with harvesting colostrum for a syringe feed – even being milked like a cow by a nurse whilst I sobbed at one point – and trying to latch Melody on. Every time I did, I’d start to cry, feeling like a thousand bugs were crawling up my legs and feeling like all the lights had been turned off in the world. By the time we got home, Melody was almost completely formula-fed and I was already devastated. Formula is perfectly safe, perfectly healthy and a very valid feeding choice for any parent - but it just wasn’t what I wanted. My friend, who had successfully breastfed her son for a year after a c-section and sepsis, rushed round with an electric breast pump and showed me how to use it. It was incredibly powerful, and so were the feelings – I felt dark, swallowed up by a depression so sudden and so wrathful that I couldn’t even speak. While she was busy marvelling at how much milk I’d produced so quickly, I was mentally plotting out a route to the level crossing around the corner from our flat, and how I might get there without being missed until it was too late. Once the pump was off, the feelings almost completely subsided, like it had never happened. “Did you, um...” I asked, “ever feel... sad, when you were breastfeeding?” She can’t have heard me correctly because her answer didn’t quite tally. “Oh, I cry over all sorts of things now, ever since I had him!” she chuckled. “Lots of people do.” We continued like this until Melody’s five-day check. The midwife asked if I was breastfeeding. “It... makes me feel strange,” I managed to say, barely articulate through exhaustion and sadness. I couldn’t explain how the moment anything – pump, or baby - attached, even so much as running water hitting my breasts in the shower, made me pray for swift and merciful death almost instantaneously. “Not breastfeeding,” she scribbled down on my notes, “doesn’t like the feeling.” Not totally inaccurate, I thought, but a staggering understatement, to say the very least. I tried to reach out for help, but I just couldn’t articulate properly how I felt, what it was like to be in my body at those moments. My mental health midwife signed me off after two weeks of sobbing at home. The Health Visitor was appalled and had me re-evaluated. I was discharged again, as they said the feelings I was describing weren’t pregnancy or post-partum related, and must be “to do with things from the past” - although no one could specify what they might be. One night when snatching an hour or two of sleep, I had a dream. A man in a white coat was embracing me – wait, no, not embracing suddenly. Holding me down. “Where am I going?” I asked him. He looked at me, pitifully. “You know where you’re going,” he said. I had to stop. My husband’s family generously bought us a Prep Machine because their daughter had found it somewhat lifesaving in her own new motherhood. I cried as we unboxed it. I gave back the borrowed breast pump, remembering all the hopeful hours I’d spent in pregnancy researching everything to do with breastfeeding. I’d looked into everything – everything, except this. In the end, it was my husband who found it. An article had been published online in the US about a condition called ‘D-MER’: Dysphoric Milk Ejection Reflex . In a nutshell, a condition in which at the point of milk letdown, negative emotions such as shame, depression and anxiety surge the mother instead of the euphoric and bonding oxytocin. Once it had a name, it was easy to Google and see that, whilst rare, other women had reported feeling the same. There are some academic papers available , showing it was serious enough to warrant proper medical research. The cause? No one knows. Critically under-researched and still very much not understood, like many women’s health issues, even my midwife friend had never heard of it. If I thought I’d been crying before, the wave of emotion hit me like a tonne of bricks when I realised: I wasn’t insane. I wasn’t a terrible mother or a bad person. It was real, but why it chose me, I’ll never really understand. 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.

Image Source: Sunshine Design on Pexels With every burst of laughter I drew from the crowd, the loneliness behind my makeup grew a little deeper. My name is Shopia Green. I am a circus clown, and the image of my red nose, abandoned on the dressing room table, is the most honest photograph of my life. It is not just a prop; it is a portal. On one side, the vibrant world of the spectacle, where I am the embodiment of joy. On the other, the silence that consumes me when the last spotlight on the ring fades. This is the story of my most intimate contradiction: how the very heart trained to make hundreds of people laugh is the same one that battles a depression that refuses to leave the stage. I am writing this now because I have finally learned to dance with that shadow. The Mask of the Spectacle Under the big top, the large tent that takes centre stage at any circus, the rule is clear: the show must never stop. Rain, cold, good days or bad—it doesn't matter. When the music starts and the lights come on, I become "Pippa," the bumbling clown who makes children and adults roar with laughter at her antics. It is a magical, yet merciless, universe. The pressure to be always funny, always resilient, is constant and can be fertile ground for mental health struggles among performers. Backstage, between acts, other artists smoke, stretch, and joke. I would often curl up in a corner, trying to summon the energy for my next entrance. The persona of Pippa was so demanding that, at times, there was nothing left for Shopia. The Loneliness Under the Spotlights The loneliest place in the world is standing alone in the ring, under blinding spotlights, surrounded by the echo of laughter you created yourself. While the audience laughed, I felt like a stranger at my own party. I was the centre of attention, yet completely invisible. People loved Pippa, but no one knew Shopia. This disconnect between the public persona and the private person began to create a chasm inside me. In the dressing rooms, the contrast was physical. The smell of candy floss and sawdust gave way to the damp of old changing rooms. The glare of the spotlights was replaced by gloom. And the deafening noise of the crowd transformed into a silence so profound I could hear my own heart begging for peace. Image Source: Ahmed on Unsplash The Day the Paint Ran The turning point wasn't dramatic. It was subtle, but for me, it was an earthquake. It was during a classic routine, the "infinite water glass." I was supposed to pour the water over myself. It was a routine I had performed hundreds of times. That day, as the cold water trickled down my face, something inside me snapped. Instead of a funny grimace, my expression simply... vanished. I stood there, staring into nothing, with the water mixed with makeup running down my neck. The audience, confused, laughed nervously, thinking it was part of the act. But it wasn't. It was Shopia overflowing, unable to sustain Pippa for one more second. In that moment of un-rehearsed vulnerability, I was no longer a clown. I was just a tired, wet, and sad person. And the emptiness I tried so hard to hide with jokes and pirouettes was now running down my face in streaks of black makeup for everyone to see. The Discovery in the Wreckage It was in that spilled, smeared overflow—where Pippa’s paint and Shopia’s tears finally mixed—that I found a path to healing. The essence of clowning is not in perfection, but in the courage to fail gloriously. What makes a clown beloved is their shared humanity—their ability to trip and yet get up with a smile (or even without one). I began to apply this wisdom to my depression. If Pippa could honour her failure, why couldn't Shopia honour her sadness? I stopped treating my pain as a flaw that ruined my art and began to see it as one of many colours on my emotional palette. This journey of self-compassion was fundamental. The vulnerability I had tried so hard to hide became my greatest tool. This freedom to be imperfect is a transformative power. An Art Reborn from the Ashes This radical acceptance did not weaken my art; it made it more truthful. My performances evolved. I was no longer acting out joy; I was acting out life. Sometimes, Pippa would be quiet, just observing the audience with a serene expression. Other times, her sadness was incorporated into the act, creating a deeper, more melancholic comedy. To my surprise, the audience connected even more. They felt the authenticity. People weren't laughing at the clown; they were laughing with the clown—and, somehow, with the woman behind her. Image Source: Getty Images on Unsplash My Life Now: An Imperfect Balance My story is not about defeating depression, but about learning to coexist with it. It's about discovering that the clown's light doesn't shine in spite of the darkness, but in contrast to it. The courage to wear the red nose is the same courage I need to look in the mirror and accept the woman behind the smeared makeup. Laughter and tears are not enemies; they are companions in the same existence. Honouring this duality is what makes us whole. Today, I carry my red nose not as a mask, but as an invitation. An invitation to celebrate the messy, imperfect, and profoundly human beauty of simply being. And in the end, that is what art, healing, and life truly are: the courage to show your true colours, whatever they may be. 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.

Image Source: Tricia Patras Everyone has had one of those nights where they feel overwhelmingly Lonely . Lonely within your body, heart, and mind all at once. It’s a feeling similar to living unexplainably separate from yourself. You hope it won’t revisit as often as it does.   The Loneliness lingers, almost long enough to graduate into its mentor: Depression. Loneliness tries to impress its more overpowering sibling until, finally, Depression allows Loneliness to take shelter under its wing. When that happens, it all becomes one—one big Depression. I’ve experienced various forms of this sadness, but the Great Depression has happened twice in my life: 2013 and 2020.   As a person who always feels everything at a deeper pace, mental illness has always followed me. Not only have I battled Anxiety and Control, but I’ve let Fear drive me in my romantic relationships. I have always found a way to invert this into my creativity and luckily found my outlet with writing. Readers who have struggled with love, rejection, or the codependent weight of family history will hopefully see themselves reflected in my work. By laying bare the messy, complicated process of healing, I hope to reframe ordinary struggles as extraordinary acts of survival. Image Source: Tricia Patras The First Great Depression: A tale of unrequited love The first depression overcame me when I was utterly enamoured with a love unrequited. Eventually, I started having a hard time understanding that I had to deal with my thoughts independently. I found it easier to push them aside and deal with his thoughts, instead. I willingly chose to put myself last, a choice I would take back instantly. I desperately wanted him to love me, and I agonised over him.   My relationships had previously consisted of co-dependency that I learned from my parents and their tumultuous marriage. So, when I met someone who shared a traumatic bond with me, I latched on fast and hard. As a young and confused twenty-year-old, I couldn’t get a grasp on myself or anything around me. My family was falling apart, even more than before. We were losing our childhood home to bankruptcy, my mom’s drinking problem was at an all-time high, and I was the constant cheerleader for my sister’s life. I was trying to hide that my foundation was crumbling down, just as much as our home was.   My deep-rooted Anxiety then turned into migraines that would cause unexplainable blackouts, which led to hospital visits. I was not only mentally disintegrating, but now also physically.   My emotions consumed my body, and I had little control over stopping them. I would frequent the bathroom stalls between my college classes to indulge in my daily panic attacks.   I frequently recall myself holding my breath, crying silently, so no one would hear my pain. I kept relying on my situationship to resolve my Anxiety attacks instead of doing the work myself. As long as I was damaged, he would feel needed, and I would get his attention. Win, win. This Depression taught me what a toxic relationship was. I later learned that love didn’t have to be this hard. Love could even be happy, if I let it. I just had to find a way to reroute my connection with love, especially since I correlated it so much with the word damaged . This type of Depression helped me understand that the two words didn’t have to go together. Depression led me to rock bottom, which gave me no choice but to reevaluate my escape route to the top. It brought me to Italy, where I did my best soul searching and discovered my value to the world and vice versa. I learned to love myself more than anyone else. Image Source: Tricia Patras The Second Great Depression: Navigating a Pandemic and New City The second Great Depression was a bit different. The pandemic hit, and the streets became bare. A two-week stay at home in Chicago turned into two months. My mum was hospitalised, lost her job, and couldn’t pay rent. She was dying from a virus without a cure, and I couldn’t see her. The ups and downs were uncontrollable, so I spent most of my time just numb to avoid feeling and facing my emotions. It was a sadness that lingered. Unlike the first Great Depression, I wasn’t able to function. I had nothing to wake me up in the morning—no priorities, no job, no money, and no dream to achieve. I watched my beautiful, safe place, Chicago, start to become a shell of what it once was. The same walks that inspired me now brought a great eeriness. Every day felt like I was losing small bits of myself, hoping that I wouldn’t wake up with nothing left. I was addicted to the co-dependency of being with my family. As unhealthy as it was, I simply felt like a child who couldn’t eat or sleep without knowing my family was okay. I became so consumed with my family’s health and well-being that I neglected my own. I gained ten pounds, stopped going to therapy, my face broke out, and I refused to write. I felt I had nothing left in me. When I reached this point, I had a faint memory of the life I started in San Francisco. I owed it to myself to explore the idea of going back, since I had the privilege to do so. This decision saved me. If I had moved back home permanently, I would have become entrapped by my Depression with the fear that I’d never be able to get out. I did not crawl out of this hole overnight. My first month back in San Francisco was challenging. My mum’s best friend passed away from COVID, and I understood that most of the friendships I had made were gone. I was back to square one. Except this time, I was more bruised and had the Depression pulling me down every time I would try to stand. Then, my good friend, Fate, made an appearance. The day I thought of moving home to be close to my family, I was sent a sign. My friend Rachael had asked me to move in with her, to my dream apartment in the very location that made me fall in love with San Francisco in the first place. I got another chance to keep trying. Once I moved in, each day started slowly getting better. I started writing again. I started eating better. I regained a small chunk of my confidence that I thought was gone forever. The situational factors of the First and Second Depression were different; however, I learned over time that the Loneliness was the common factor. Once I started understanding how to own my Loneliness and turn it into something outward, or even celebrate it, that’s when I started healing. Most importantly, I started seeking the beauty in my surroundings again. Instead of looking at the big picture, I appreciated the small ones that I captured daily. I accepted that life would still be challenging, but I was willing to fight it. I was excited to fight it. And that is why you should never be ashamed of your Depression. Use it to change you. Use it to love you. 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.

Community building has become something of a trend, especially over the past year. The more I scroll through social media, the more events I see. While I enjoy seeing people come together, it can also feel overwhelming to be flooded with Instagram posts and WhatsApp groups promoting countless events and gatherings.  Traditionally, communities are formed by groups of people connected through shared spaces or common interests, religion, culture, ethnicity, or values. It is in our human nature to feel a sense of belonging and companionship. When we belong to a community, we experience a connection that extends beyond ourselves, built on shared values and mutual understanding. This sense of social cohesion offers emotional support during difficult times and reassures us that our struggles are shared. It also provides a feeling of safety while helping us embrace and value our differences. I often struggled to find a true sense of belonging, which is what led me to write about this topic. At some point, the endless gatherings, events, and social activities became draining, and finding a community that truly felt like mine became challenging. Over time, I’ve realised that there is nothing wrong with that. As an international student who moved to London four years ago, I set out to rediscover the sense of community I once had and to understand what felt missing in my life here. Like many international students, I found myself searching for “my people,” though what that means looks different for everyone. For some, it’s about shared values; for others, it’s about rediscovering fragments of what community once felt like back home. The film Frankenstein  (2025) captures elements of this experience, which I will reflect on later in this article. Image Source: Christopher Paul on Unsplash In Madagascar, being part of a community was rooted in a shared identity, cultural background, and religious beliefs. I experienced both the positive and the negative sides of this. While I was surrounded by a large group of people with whom I shared many similarities, I often struggled to form meaningful connections. Much of the support I received wasn’t the kind I needed, and it didn’t encourage personal growth or help me become a better version of myself. Contribution often felt transactional rather than genuine. I want to be clear that this reflects my personal experience, not a collective one. So, when I moved to London a few years ago for university, I naturally hoped to find what I felt was missing. Instead, I realised that I had to start from scratch. The positive aspects of the community I experienced back home, such as the celebration of my culture and religion, a strong sense of togetherness, close bonds, and shared experiences, looked very different here. In the beginning, it felt as though I was scavenging for something entirely unfamiliar. Later, as I began to recognise the beauty in what I had once experienced, I found myself searching for something similar in a new context. London is home to a vast range of communities. While I can’t claim to have explored all of them-that would be impossible- I have found fragments of what I’ve been looking for in different places. Yet, despite these moments of connection, there remains a lingering sense of loneliness. Recently, I watched a film that reflected many of these experiences, capturing both the comfort and the complexity of wanting to belong to a community, and the emotional aspect of it.  Frankenstein (2025) is a gothic science-fiction drama inspired by Mary Shelley’s 1818 novel Frankenstein . The film stars Oscar Isaac as Victor Frankenstein and Jacob Elordi as the Creature. It opens with Victor being tormented by his own creation, before unfolding through a series of flashbacks that reveal both his inner conflict and the Creature’s struggle to find identity and belonging. The film explores a cascade of powerful themes, including alienation, vengeance, love, generational trauma and emotional confrontation. However, the theme I want to highlight most is community and society’s response to someone who is simply trying to find a place where they can exist as themselves. Image Source: Frankenstein on Netflix In the movie, wanting to belong to a community is shown as a basic human need, but also something that can be hurtful if not found or denied. The Creature does not initially seek power or revenge; it longs to be accepted, spoken to, and connected with others. When it believes it might belong somewhere, it becomes gentler, more hopeful, and more thoughtful, learning how to adapt and care. This reflects the positive impact of community: belonging allows individuals to grow, understand right from wrong, and feel anchored in the world. However, the movie also shows what happens when someone is constantly pushed away. The Creature is judged only by how it looks, and no community ever gives it a real chance to show its inner beauty. Being rejected over and over, turns loneliness into anger and sadness, hence his hunt for Victor to create a being just like him. Victor himself plays a crucial role in this outcome; by abandoning the Creature and refusing to offer any sense of family or belonging, he reinforces its isolation. The film makes it clear that exclusion can be just as damaging as cruelty. Ultimately, Frankenstein suggests that the need to belong is not a weakness but a universal need. The real danger arises when communities decide who “deserves” to belong and who does not. When connection and understanding are denied, the harm extends beyond the individual, turning isolation into tragedy for everyone involved. While my own experiences do not compare to the depth of what the Creature endures, its longing for belonging resonated with me deeply. In a society that increasingly promotes hyper-individualism, the film serves as a reminder of the importance of community. By embracing one another as we are and recognising the positive qualities that encourage growth, we move closer to creating environments where people can truly belong. Although finding community, especially across cultures and borders, can be difficult, remaining open to new faces and traditions brings us one step closer to building spaces that feel right for us.