To say that the healthcare system hasn't a clue when it comes to mental health??

[Danghormones]

I've struggled with mental health my whole life. I've been told an annoying number of times by people 'you've your life so together'. For context, I am fortunate to have an excellent career and I'm married to a wonderful man and have a beautiful baby. Nothing exceptional or out of the ordinary but I'm young in my profession to have got to the level I'm at so from a general point of view, it looks like I've my shit together.

Underneath I feel like I am ready to explode at any second

About 5 years ago my mental health was at its worst and I can honestly say the NHS were no help whatsoever. I actually dropped off their list for therapy and they rang to apologise....7 months later. I was in hospital for mental health reasons and the follow up was absolutely abysmal. I have paid for private therapy 4 times because of this.

Most recently I was referred to a psychiatrist (finally!!) querying BPD and even at that they told me to go look at a course that's in my area. I rang straight away to enquire about it...they said they don't know when or where it's running but it'll be the new year anyway. My psychiatrist also after looking at my notes asked was I referred to the post natal mental health team after I told my health visitor that my mental health wasn't good. I wasn't; I didn't even know it was a thing! She was apologetic and said i'd been let down by the system....what's new I thought??

I have private health insurance and even trying to get an appointment with them was a 4 month waiting list. It mightn't sound like a lot but when you're in crisis mode, 4 minutes is a long time never mind 4 months.

Just so frustrated that I feel like there's so much encouragement to speak up and get help etc and when you do...well you just feel like what is the actual point??

YANBU to say the NHS is useless for mental health issues.

YABU to have had a baby knowing that life is so shit.

Hi op.
If your in crisis and you need to speak to someone anyone. You can call the samaritons on this number 116 123. Or Google it the number comes up and call from that. They will listen to you in the moment you need it.
I am sorry you are feeling let down. There are many good therapists out there. The problem is most organisations that offer counselling are charities. They rely solely on either government funding or private funding through events etc.
The government doesn't put much money into the coffers unfortunately. They have cut the heating for the elderly They are cutting funding for the vulnerable.
It's a difficult time right now and I'm sure your feeling it immensely with your mental health not being the best right now.

There are 2 major aspects ...
One is the undoubted rise in MH problems and governments need to be asking why and looking at prevention. Does it lie in upbringing, in the absence of early family support, in school systems, in diet. In environment etc. It is an epidemic.
The other aspect is treatment. The OP rightly points out that the subject of MH problems is more out in the open and people are encouraged to seek treatment ... but what is the point of that when it cannot be accessed?
My local health authority offers CBT ... that's it ... whatever the problem, CBT. This is a complete nonsense.
I sometimes watch Ambulance on TV and watch the paramedics carting people off to hospital with MH problems for "some help" and have a wry laugh .... what bloody help?

I think the biggest contributor to the chronic anxiety epidemic is noise pollution from overpopulation. Most people aren't aware of the lasting effects of background noise (I'm autistic and am acutely aware because it makes me suicidal and that goes away when I'm in a quiet place) but it has been shown to negatively affect mental and physical health. Even hearing a road in the background is unhealthy, which is almost inescapable in this country.

Most people are unwilling to live quietly and the government is unwilling to slow down growth and development, so I would bet my life savings on suicide rates shooting up and fewer and fewer people being able to function in the next 5-10 years.

YANBU at all. The NHS is terrible when it comes to MH. It only really wants to give you a pill and send you on your way. MH is extremely complex, in order to sort it out you need to address your mind body snd spirit. This means talking therapy, rewiring of your thought processes, somatic therapy, finding a deeper meaning and connection to life. I’ve been collapsed on the floor, back against the wall body and mind frozen and nurses standing over me telling me I can’t sit there. Totally clueless that I couldnt process what they were saying or move.

The only thing you can do is research yourself, try out different things. I realised fairly early on that different spiritual systems actually were the best wholistic way to address my mental health, when you look into them they address all the things above. Chanting/vibrating words relaxes the vagus nerve and therefore dials down the parasympathetic nervous system, meditation enables mind focus, learning gives meaning, most involve some kind of movement again reducing the fight or flight. Most involve some kind of community. Many have answers and ways of addressing things like dissociation- breathing exercises regulate gases within the body. Reading and educating yourself about what is going on is very important and empowering.

Unfortunately many people are too far buried in the mental health quagmire to be able to do this. It’s important to get some mental health help and I’ve paid for everything I’ve ever done which I’m lucky to have been able to do. This has given me enough breathing space (sometimes literally) to start addressing things myself. But it’s very hard work and a life long project. I’m lucky, some people just can’t get there.

my advice is don’t factor in the NHS for mental health help, it just is not going to be able to help - with the possible exception of total crisis.

I think this is very important- having constant noise effectively puts people on alert, esp if they suffer from a condition which includes hypervigellence as a symptom. I block out noise in crowded places by putting on music via headphones. I’ve found heavy metal or classical music works best.

I have BPD and other mental health conditions. NHS were awful absolutely awful. They only stepped in at crisis point after I’d basically been ignored by the GP. Then offered me these awful sessions with someone who wasn’t a therapist every two weeks. Told me I couldn’t see any private sector help - I had a psychiatrist and therapist in the private sector.

I had private health care through work though and I found that amazing (been with both AXA and Bupa) and both really good. Once you’ve had your private healthcare appointment (4 months is long :( ) you will hopefully be in there and can contact a bit more directly will hopefully help speed things up for follow ups.

I also found a psychologist on my own who was Bupa registered and offered DBT individually and this was the best thing I ever did - I had to be really proactive though as my psychiatrist could only recommend a few people at his place of work. So I had to actively seek this psychologist out.

Also I did group DBT for my BPD (also privately) and it was awful! It’s so difficult in the private sector to find what works for you so I completely understand .

I think for many it’s a lack of certainty. We previously knew where we were, what our lives would be like, when we would be at work, when we were at rest. We knew what kind of life materially we could expect. We had boundaries, we were able to express ourselves more.

Now we can’t even define who is male and female without a row. We live in fear of being ostracised. We have no tribe, there’s no meaning in life. We are told things like material goods are important when deep inside we know they’re pointless. We have no inner life, no time to day dream we constantly need to be doing something to feel worthwhile and productive.This nihilistic scientific age where art, poetry and story telling is forgotten is destroying us.

The outlook is not good
www.theguardian.com/society/2024/nov/28/one-in-three-consultant-child-psychiatrist-posts-in-england-are-vacant-analysis-shows

Danghormones · 25/11/2024 12:11
It’s not harsh. It’s so demoralising hearing people say just get on with it attitude. If I had a broken leg no one would say just walk on. If I had a broken arm and drove my car and crashed it people would say why would you drive with a broken arm? Oh sorry I was just getting on with it.

But that was the point I was trying to make! Broken arms and legs are straightforward to sort out - and crucially, are normally finite problems. Mental health is an absolute nightmare to sort out and frequently open-ended. It's a totally false and useless comparison.

If you have any suggestions as to how the NHS in its present form could give everyone with MH issues the help they need, for as long as they need, please go ahead. I don't think it's possible - but if you have other ideas, please explain them.

I’m a psychologist in the NHS. The mental health system is broken, re-traumatising and often serves to recreate damaging interpersonal dynamics due to woeful under funding and lack of specialist training. It most certainly is political - services have been under funded for years under austerity and Tory governments. Resources that really helped those with chronic difficulties such as Therapeutic Communities and day centres (where people can pop in for a chat and a drink, to get some social support) have largely been shut down. Instead the government started IAPT in primary care in England, which main aim was getting people well enough to be able to work and improve the economy - the neoliberal agenda was barely disguised at all. The focus is all on cutting costs, giving people the cheapest therapies for the shortest possible time and endless questionnaires to evidence ‘recovery’ (the main aim being employment of course). Rather than having a person-centred approach where people are carefully assessed and a tailored treatment plan follows, it is CBT for all - often this is not proper CBT, but instead guided self help based on the principles of CBT which is very, very different. This results in ‘revolving door’ patients who will be labelled as ‘difficult’ and ‘treatment resistant’ when the reality is they have not been offered the therapy that could help them. We are putting plasters over gaping wounds and wondering why people aren’t feeling better. There is a lack of training and funding for longer term specialist psychological approaches, such as schema therapy, DBT and psychodynamic psychotherapy. Services are often woefully trauma blind (rather than trauma informed) despite the fact that the vast majority of patients will have experienced some form of trauma in their lives. Patients being bounced between services, denied treatments, offered ineffective pseudo therapies and being labelled as ‘difficult’ or ‘personality disordered’ for daring to question or challenge these practices creates an unbalanced power dynamic and can be very triggering and distressing. Add onto the mix staff burn out, vicarious traumatisation, compassion fatigue and moral injury. These are supposed to be reflective, supportive therapeutic spaces but they are so often not. There are burnt out staff members with poor mental health themselves, attempting to help those with chronic mental health difficulties - there is so much wrong with all of this.

Psychological therapy is also not the panacea that people regard it to be. Again the neoliberal agenda is to shove all responsibility and blame onto individuals rather than acknowledge and improve myriad systemic failings which serve to create and worsen mental health issues. I have lost count of the amount of patients who have been referred into services I have worked in for what are social issues - inadequate housing, poverty, living with an abuser, lack of employment opportunities. Poverty is one of the biggest drivers of poor mental health and therapy is not the answer to this. It is incredibly damaging to pathologise those who are struggling in such circumstances, when nothing is wrong with them, it is their environment and things that have happened TO them. The medical model is entirely problematic in this way. There needs to be social change on a government systemic level. Of course psychological therapy / mental health support can be invaluable to those living in adverse circumstances but it is not a solution on its own.

Due to government targets, waiting lists, inadequate therapies, issues with staff retention and burn out - it means that those who are more ‘high functioning’ such as the OP are often over looked because services are fire fighting constantly. There is a lack of early intervention, instead services often do not act until someone is in acute crisis which is another massive issue. More and more I am encouraging people to go private if they can, due to the system not being fit for purpose, which is a truly tragic state of affairs. I am sure there are a number of discriminatory, ignorant and judgemental posts on this thread and I would encourage anyone reading to take them with a hefty pinch of salt. Mental health issues are valid and everyone should be able to access high quality and psychologically safe support when they need it. It is terrible that the society we live in is not conducive to positive wellbeing.

I am not talking about severe and enduring illnessess like BPD etc, buit there must be a reason , that depression and anxiety issues are super common these days -

People definately do seem far less resiliant than in the past and I have to say, this recent mentality of being perpetually offended / life not meeting the same expectations as on Instagram - makes fosters cynical and less resiliant attitudes with the expectations that the world is constantly perfect. People seem more whiney these days, basically and less happy with the hand life dealt

People need to know the difference between circumstantial depression and clinical depression too. for example - I am depressed as my boyfriend left me but this hopefully should ease up over time, or I have a chemical imbalance in my brain that is long term - two very different things

Society has moved on and changed since back then. That is like saying no one was gay in those times. Of course they were. I can guarantee you that there were kids in your school with anxiety and depression - there just wasn’t the words for it back then, plus the repressive British ‘stiff upper lip’ culture means that people are less inclined to be open about their struggles and suffer in silence. There is greater awareness now through education and public health campaigns, social media etc (although I suspect that is part of the problem too) and people are more open about their mental health. Covid had an unprecedented impact on the mental health of the population. @SkunderlaiSkendi i can now see you have changed a lot of your post since I posted. Additionally, any chemical in balance myth in depression has largely been de-bunked. But that does not make people’s experiences and suffering less valid.

I am not sure it's quite so clear cut re wartime experiences. I don't know what it was like in Britain, but have family members who were children in the war in Eastern Europe. Right in the middle of the action. And they definitely did have MH issues. It wasn't named, diagnosed or acknowledged but I can certainly see now that my great aunt was living with health anxiety and, possibly, personality disorder. My grandmother was always an anxious person although she masked and "got on with it". At what personal cost, I am not sure. We very much have to wrap her in cotton wool now. Her father who was a POW had life-long substance addiction, albeit he was functional. I don't remember my great grandmother as a particularly well-adjusted person either and this may be because she was a victim of domestic violence (which was normalised at that time). People can be outwardly functional and are considered to be lucky but this does not mean they are not struggling with ill mental health. Which, I think, is exactly what the OP was talking about in her opening post.

ETA: not sure why you changed your entire post...

Oh I agree, chemical imbalance is not any less valid - but these can be long term conditions, this is what i mean. They arent temporary (hopefully) circumstancial issues

People seem more whiney these days, basically and less happy with the hand life dealt

“Seem” is the operative word. If we look at middle class women in Victorian times, they expressed their unhappiness in having no real job or power in “hysteria” or psychosomatic illnesses. Doctors recognised some were frustrated and relieved it for them! My great grandmother had a husband, a doctor so a nice house, four children and servants. She was an alcoholic, because he was a typical Victorian authoritarian.

Then there’s the PTSD in those returning from WW1 and WW2, and more recent wars.

I grew up in the 60s, and many of the women around my mother were on Valium, which seems to have been given out like smarties - mainly those with unhappy marriages with controlling husbands.

These days it’s antidepressants, because GPs realistically can’t offer much else.

ITA with @Plastictrees , that people seem mainly to end up in the mental health system due to trauma, where they are re-traumatised by the way the so called MH professionals treat them - lying, bullying and gaslighting them. DH had a meeting the other day with a consultant psychiatrist on behalf of a relative, after making a major complaint and he asked why they employ useless people - the answer was the higher ups do cost benefit analysis! Although as my GP said last week on another subject, the NHS always takes a short term view to save money and it ends up costing more!

I mean that the chemical imbalance theory is a myth that has been disproved. Peoples suffering is valid whether or not there is any physiological cause.

Oh has it - theres something I wasnt aware of

This is what I was told when diagnosed with dysthymia - that it was caused by an imbalance but im no expert myself

Yes sorry i get your point

I agree, but I really don't know what the answer is. I've been suffering from severe clinical depression since my teens, and I really have tried everything.

I've tried just about every anti-depressant you can name, had all kinds of therapy (which I've mostly had to pay for myself, and which I've always engaged with), I walk at least 10 miles a day with my dog, eat at least 10 different fruits and veggies a day do all kinds of self-care practices, meditate 20 minutes twice a day, and I'm honestly no better off for any of it.

But, because I'm able to work (self-employed, thankfully, or I don't think I would be able to work at all), all I'm offered is more anti-depressants (which don't work) or sporadic referrals to organisations who won't take me because I've already tried anything!

That being said, I really don't know what the answer is.

I think finding a decent private therapist can be an absolute gamechanger. People need to understand that this will cost them money. It's not free although in Northern Ireland there are definitely community organisations offering free therapy, but these are mainly aimed at low level anxiety and depression.

Pretty sure chemical imbalance has only been shown to have no association for specific MH conditions, predominantly depression. My bipolar disorder is definitely in some part a lithium deficiency! I'm concerned by the amount of posts on this thread claiming that medications are useless and don't work. For bipolar disorder, they are life-saving and extremely effective when taken correctly.

People need to differentiate between the low-level illnesses and the severe life-threatening ones when posting this sort of thing as you could end up convincing someone in the wrong mindset to stop their meds which is bloody dangerous.

There are different levels of mental health provision dependent on the severity of the presenting symptoms, primary care would focus on illness that can be managed either exclusively by the GP surgery or with input from mental health staff, most often nurses or therapists, within the GP setting or via CBT type courses, secondary care should focus on the more complex areas and would be where Psychiatrist/ psychologist or Advanced Nurse Practitioners would provide the diagnosis/ treatment plans which are often administered by community staff, therapists, crisis services should be just that, a response to a crisis situation with prompt input, the aim was always to see someone in this state within four hours but it can get missed, There certainly are specific perinatal care teams amongst other things. Mental health provision is definitely not perfect but like many other areas is overwhelmed and with the greatest respect,not every episode of anxiety or feeling a bit down is a crisis

The issue is these services are poorly staffed and under funded and specialist services e.g perinatal are gate kept. People rarely fit into neat boxes which results in referrals being bounced between over stretched teams. There are psychologists in primary care settings too. It can just be incredibly difficult to see them.

Do not get me started on crisis teams, the role has changed over the years and they are now essentially signposting services. If another patient tells me how a crisis team practitioner suggested they have a bath in the middle of an acute crisis, I might just be in crisis myself!

I don’t disagree, it’s the sheer workload that is the issue, CPNs who should ideally carry a caseload of around thirty with double that number, long long waits for specific therapies and as someone who set up our local crisis team over twenty years ago I sadly have to agree that the service they provide has deteriorated significantly