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Trigger warning – this post will talk about mental illness and crisis situations. I will discuss my own mental illnesses and the circumstances of others (including the outline of a suicide attempt) as part of the explanation, followed by coping systems and support networks. If you are struggling with mental health then, rather than reading on, you might find it helpful to look at support ideas available on my Get Support page. It’s right to get help and it’s ok to ask for it.
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No one wants to find themselves facing what we used to call a ‘nervous breakdown’. I remember back in the 80’s and 90’s that friends of the family who’d found themselves struggling we’re often discussed using this phrase in hushed tones.
“Did you hear about Charlie? They said he’s had a nervous breakdown you know.”.
It’s a negative term with a massive stigma attached to it that, thankfully, we’ve almost obliterated today.
I recently watched an old episode of the Sky One series The Russell Howard Hour, and enjoyed an interview with the boxer everyone seems to love and hate in equal measure – Tyson Fury.
At the time he was promoting his autobiography, and talking about the parts of his life that lead to him becoming heavyweight champion of the world.
The interview took an interesting turn when ‘The Gypsy King’ started talking about his own mental illness journey and the difficult situation he found himself in shortly after becoming champion.
Stuck without direction after reaching his ultimate goal, his mental health quickly went downhill and he described a critical moment where he’d gone so far down that he had to make a choice between the unthinkable and finding a way to keep going.
Amazingly, somehow, at the last moment he described remembering his wife and kids, and how hard life would be for them without him, how much they’d miss him and how much he’d miss. He stopped before it was too late, but referred to this moment as a ‘breakdown’ a few times.
From there he built his mental health, career and family life back up to good strength, and now understands the tools he needs to recognose and manage the symptoms of his ongoing mental illness. It must be a strange thing to manage so publicly, but regardless of my feelings before the interview, I found him incredibly warm, honest, empathetic and knowledgable. He clearly understands mental illness and wants to help others understand and manage theirs.
But he did mention 2 critical elements of his survival. He knows that he now lives with mental illness and will forever, and he seemed to believe he needed to breakdown in order to come back stronger.
I have a similar story.
My ‘breakdown’ was also a 2-way street that barely had any road left. I had to make a decision about my future (or lack thereof), and in some dusty corner of my mind (along with the help of our dog – true story) I realised I needed help.
I entered the NHS mental health system around 8 years ago in crisis and remain in it today. Had I not had that moment where I felt so desperate, I’m unsure if I would have come back.
However, I still believe that reaching that point is something everyone should avoid. The 2 examples above had a positive outcome, but in the UK alone The Samaritans website suggests that there were 5219 suicides in 2021[1]. That’s an average of 14 people every single day who DIDN’T have the revelation I did, and 5219 families who are suffering every day from a catastrohpic bereavement.
In my opinion, it’s critical that someone suffering doesn’t reach a crisis point at all, instead they access help the moment they (or someone close) realises there is a problem.
The chances of coming back from crisis aren’t always in your favour.
Preventing crisis
Many people with a mental illness will sacrifice a lot before they’ll ask for help, or let it be seen. We can hide things better than a magpie nesting in Hatton Garden. It can therefore be difficult to notice and manage, even for those closest to them. I see it in myself every day, but my paranoia and anxiety make it hard to see those sacrifices objectively or with the same concerned eye I’d use for someone I love who behaved the same way.
For example, I haven’t been to a denist for over a decade, and my teeth have been crumbling throughout. In fact, I’ve lost 5 teeth in that time. Thats an indication that I’m not taking proper care of myself, and possibly a reason to talk to someone with concern if it’s a habit you’ve spotted.
Note – Yes, I also have a 6 year old daughter, and I understand my responsibility to teach her good health practices, including dental hygiene. She’s brilliant at it and we brush our teeth together almost every morning, talking about the dentist and how important it is to take care of your teeth. I know that one day she’ll realise I was a hypocrite throughout, but I had her best interests at heart.
Still, losing so many teeth and doing nothing about it is just another biproduct of declining mental health and an indicator that someone needs support.
This is an example of poor hygiene and lack of self care but there are many other signs that someone might be struggling. Losing interest in hobbies, missing events, losing weight, losing appetite, bingeing, being distracted, struggling to concentrate, financial stress, manic episodes, anger, disturbed sleep, too much sleep, loneliness, over spending, excessive drinking…the list goes on. All things we can look out for in those we care about as well as ourselves. Spotting those early signs, talking about them, and engaging with support could be the critical moment in PREVENTING crisis, which is what we need to achieve if we want suicide numbers to go down.
I know however, that these conversations aren’t easy. Going back to the Tyson Fury interview, I had to wonder if his success and popularity (and stature) made it difficult for those around him, the people who might have spotted a problem, to intervene. Maybe he had no one trying to help because they were afraid, maybe they all tried to help but he was too overloaded to accept it, maybe he was in denial and no one was brave enough to argue with him. Whatever the circumstances, he reached a crisis and it was only his mind that helped him out.
He was lucky, so was I. Last year 5219 people in the UK weren’t.
Relying on luck is not a solution.
Supporting someone you love
As I say, I truly understand these are difficult conversations to have, so if you’re struggling to talk to someone about their mental health and could use advice on how to approach them, there are some great online reasources worth reading.
Helping in a crisis – First, if you or a friend / family member are in crisis, then go to the NHS Where to go for urgent help for mental health page, where you’ll find multiple options to access the fastest support you need.
Approaching an angry person – if you think someone might need help but anger is a barrier then Mind have a useful Anger Management section of their website. There is advice for the person struggling as well as their friends and family, including a page on how to support someone with anger and ways to approach the conversation.
Approaching someone you think is depressed – The NHS website has a page dedicated to depression symptoms and ways to approach someone who is sad, low or feeling depressed for any reason. They also have links to charities who can help. There are so many to list but Mind is a good place to start, along with The Samaritans.
Approaching a friend with an eating disorder – You might be worried about how to approach someone whose eating habits or body weight have changed, and it’s normal to feel nervous. BEAT – The UK eating disorder charity – have a whole page on supporting someone with an eating disorder and helpful things you can say and do to support your loved one as they realise they need to engage with help.
Helping a friend with grief – bereavement and the emotions it creates are incredibly complex. I have a page dedicated to Grief on this site with a long list of support sources at the bottom. The first I recommend is Cruse, who have a page dedicated to supporting someone who is grieving. They helped me with the mountain of grief I still carry today, and I’m so proud to be their Creative Volunteer and Mental Health Advocate.
Helping someone with child loss or baby loss – The Lullaby Trust offers support for bereaved families and have a page to help us support those who have lost a child. But, as I’ve mentioned in my post recently (‘see – ‘missing something you never had‘), it’s not just the death of a child that causes grief. For helping families going through the grief of failed IVF, failed fostering, miscarriage, failed surrogacy, failed adoption, ectopic pregnancy or any other loss, grief charities such as Cruse can help if you call for advice. Grief Encounter can also support with advice that’s aimed at bereaved children, whose mental wellbeing during events like this shouldn’t be forgotten.
Almost every page I’ve mentioned here also talks about taking care of yourself, and it’s critical you remember the importance of self-care. Supporting someone in crisis takes a toll on everyone involved, so it’s vital you take time for yourself and stay on top of your own mental health. If you’re suffering too then you should access support, the same as your friend.
In all cases there is the possibility to cause hurt, damage the friendship and even cause friction and arguments. It’s likely that everyone involved will be full of emotion and possibly defensive too. That’s why the resources above are there, and using them quickly could ultimately lead to someone engaging with the help they need to enable recovery.
I believe it’s an easier conversation than the potential of a deeper crisis. That’s something I say with first hand experience. I remember many of the conversations I had at the time, the level of denial I felt over my health (and grief), the damage I continued to do to myself to make it through each minute, and how hard it was to hear the truth. But those conversations were pivotal in starting my recovery, which continues to this day.
Sometimes crisis is a returning theme for someone with a mental illness. They might have long periods of stability, but stressful triggers push them back down into the pit. Planning for those crisis moments is one of the fundamental elements of recovery for someone who can dip into crisis suddenly. Friends and family members often form part of crisis prevention plans, as part of a larger support network. Making youself available in this way is a thoughtful, kind and generous way to support a friend in need, but again, remember your own self-care too. Managing crisis is tough. As someone with BPD I can dip into crisis quickly and struggle to come out of it for a while. In fact, it’s something I remember well because I’ve been back there recently and I’m writing this while my own crisis plan is being deployed. The catharsis of writing this post is part of it.
I’m still here though, even though there were times in the last 8 years when my brain didn’t agree with that idea. All thanks to difficult conversations.
In conclusion
Maybe it’s not stigma or societal change that we need to keep talking about, maybe it’s something far easier we need to accept to prevent the crisis situations happening everywhere as I type. Maybe the message is simple…
We’re all in this together.
This isn’t an ‘us & them’ situation, we need to help each other, regardless of any stigma, limitations of the services available or opinions about ‘breakdowns’. The world needs to finally understand it truly is ok not to be ok, but that starts with each of us.
Mental illness is out there, but the 25 year old, confident, life-of-the-party version of ‘Steph’ that’s long gone would have laughed if you’d told her it would one day destroy her way of living.
But it did.
It’s a shame I had to break down and reach crisis to understand and accept the normality of mental illness. I have to hope that one day we can get to a point where crisis is rare and it’s openly discussed, without shame, rather than talked about quietly and around every corner.
As Jerry Springer would say – “Take care of yourself, and each other. “.
Thanks for reading 💜
[1] Samaritans statistic, Samaritans website, accessed October 2022. https://www.samaritans.org/about-samaritans/research-policy/suicide-facts-and-figures/latest-suicide-data/#:~:text=5219%20suicides%20were%20registered%20in,of%205.5%20per%20100%2C000**.
Creative Steph 