Wednesday 30 April 2014

GUEST POST - 30th April 2014 - Mumsnet


Guest post: Depression Awareness Week: ‘I didn’t know depression could happen so swiftly, and be so physically painful’


This week is Depression Awareness week. In this guest post, Rachel Kelly, author of the memoir Black Rainbow, describes her struggles with depression, and explains why she thinks women are particularly vulnerable to the illness.

My story began seventeen years ago, when I was a working mother and journalist. For no visible reason I went from feeling mildly anxious to being completely unable to function, in the space of three days. I was married with two children, ambitious, and thoroughly loved my career. I was blessed in many ways, with a nice house and a supportive, employed husband. I didn’t know that depression could happen so swiftly, least of all to someone like me who had a happy life, or that it could be so physically painful: I was in screaming agony. I was bed-ridden for six months.

Bone-tired, I would lie outwardly still, worn out by the effort of clinging on for dear life, but inside my body was furiously busy. I had a permanent headache, as though dozens of vicious, heat-maddened wasps were massed behind my eye sockets, stinging my soft, unprotected brain. My rancid stomach fiercely knotted and re-knotted itself, spinning like a sharp-pointed pirouette. Often I would throw up. It was as if I was on a plane which was about to crash. I had to have something to hang onto, either my mother or my husband. Their arms were livid with bruises, such was the fierceness of my grip.

After that first crisis subsided, I returned to working full-time until I became pregnant with our third child and left office life to become freelance. Years passed, twins arrived, and my anxiety levels remained high: I was pushing myself to be the best mother I could, while still trying to write, as well as being a wife, daughter and friend. The more I multi-tasked, the more I was multi-asked. In 2004, I succumbed to a second depressive episode even worse than the first – I was bed-ridden for a year, during which time the physical pain was so debilitating that I was often sedated. Ever since then I have been battling the Black Dog - and now, thank goodness, have him on a tight-ish leash.

When I officially ‘came out’ last week as someone with depression, the first reaction has been ‘You’re very brave’ in a ‘Yes-Minsterish-you-must-be-mad’ kind of way – which tells you a lot about the stigma that still exists around mental ill health. 
Bone-tired, I would lie outwardly still, worn out by the effort of clinging on for dear life, but inside my body was furiously busy. I had a permanent headache, as though dozens of vicious, heat-maddened wasps were massed behind my eye sockets, stinging my soft, unprotected brain.
The second has really moved me. Friends, colleagues, relations, and mothers at the school gate have confided that they too suffer from high levels of anxiety and depression. They are hugely relieved to open up and find a fellow sufferer.

I say ‘mothers at the school gates’, because although the World Health Organisation assures us that “overall rates of psychiatric disorder are almost identical for men and women,” there’s no denying that it is largely women who have been sharing their experiences with me. Yes, this could well reflect men’s traditional reticence, but also that women may struggle more than men.

Certainly the numbers suggest this. January 2014 figures from the NHS show that in 2013 almost 475,000 women were referred for counselling or behavioural therapy compared to only 274,000 men.

There may be discrepancies in what the experts think, but the fact remains: an awful lot of women suffer the clinical illness of depression. We can, at least, be thankful that attitudes to women’s mental health have evolved over the years: Victorian psychiatrists thought there was a connection between reproduction and madness.

Now, experts like Professor Daniel Freeman, an Oxford clinical psychologist who has researched the topic, don't think it’s because of our genes (unlike schizophrenia and bipolar disorder which have high heritability). Rather, major life events such as bereavement and unemployment may trigger an underlying tendency to anxiety, or we might be overwhelmed by what Dr. Freeman calls ‘distinctive pressures’ – by which he means trying to type this article while putting the supper on, calling my mother, squeezing into some skinny jeans and bursting the zipper in the process. And wanting my husband to tell me how clever I am to be such a multi-tasker, of course.

Others can manage, and all credit to them. But I am a cautionary tale to those like me who have an underlying tendency to depression and anxiety, and whose life falls into the quicksand of modernity with its multiple demands. For me, the pressures of trying to have-it-all lead to having a breakdown – twice.

Now, in the words of George Herbert, my ‘shrivelled heart’ has ‘recovered greenness’ - but at huge cost in wasted years, especially when my children were young. I now manage by treating myself like a rather nervous pet who must eat well, be exercised, not do too much, and uses therapy and medication as and when. Oh, and loves learning a poem to calm down in the middle of the night.

In Black Rainbow I write about my slow climb to recovery through medication, prayer, my family’s love and - unusually - the healing power of poetry. Sounds odd, I know, but for me, poetry can be one answer to depression: it is free, has no side-effects and can provide words to describe what we cannot: an expression of our common humanity when faced with the extreme isolation of feeling depressed.

I can even, on occasion, be grateful for the blessings that depression has given me. For one, having therapy radically changed the way I mother our five children. I used to be as demanding of them as I was of myself. Therapy has taught me to develop a more compassionate, less judgmental voice, both to myself and to others. Now my heartfelt hope is that they will learn from my experience and avoid falling into the nightmare of mental illness - not experience the terror of that trapdoor opening inside them.

Saturday 26 April 2014

Ideas to Help - APRIL 24, 2014 FROM THE COUCH BY RACHEL KELLY


Third in the series of Rachel Kelly’s keys to calm. 
Sorry to have left you on tenterhooks over the Easter break: if you remember, we parted company on a cliffhanger – what to do when overwhelmed with strong feelings. Answer: HALT. I’m indebted to Alcoholics Anonymous for the acronym, which stands for Hungry, Angry, Lonely and Tired. Before you respond to any strong emotion, check if you are any of the above. All four will adversely affect your ability to respond appropriately to powerful feelings: there are four main ones by the way – joy, sadness, anger, and fear. Most other feelings are extensions of the Big Four – apart possibly from shame. It’s relatively easy to address being hungry and tired and lonely (check out that strong feeling with a like-minded friend) but harder to deal with being angry. Good news is there’s nothing wrong with being angry. It is what it is. Bad news is it’s a real battle to express that anger constructively. I’m still struggling … but trying to find the real root cause often helps. Very often I find I’m angry when I feel powerless. The answer is equally often to identify what I really want to say or request in a calm way when I’m not hungry, lonely or tired. (see above). The other person may not agree … which is a cliffhanger till next week …
Rachel Kelly is a Notting Hill lifer, mother of five, poetry buff, journalist and author. ‘Black Rainbow’, Kelly’s memoir about how poetry helped her overcome depression was published by Hodder & Stoughton on 24th April (today).
http://nottinghillpost.com/stop-press/couch-3/ 

Monday 21 April 2014

How Poetry Helped - 21st April 2014 - Welldoing.org

POSTED ON  BY RACHEL KELLY  0 COMMENTS

Reading poetry can help beat depression
We are sent what we need. So it proved recently when I finished an eight-week mindfulness course with the inspirational Anna Black, teacher and author of Living in the Moment with Mindfulness Meditations. I suspected she believed in the healing power of words as she had introduced several poems on our course.
As I was leaving her class one rainy Tuesday evening recently, I told her that I shared her enthusiasm for poetry.  It transpired that she had written a dissertation looking at the therapeutic role of poetry in the teaching of mindfulness as part of her Masters from the School of Psychology at Bangor University.
She too believes that poetry can alleviate suffering. Primitive people used chants in pre-literate times to encourage healing and change, while the ancient Greeks appreciated the power of words. The first century philosopher Longinus believed in language’s ability to transform reality. By 1969 the Association of Poetry Therapy had been established in the USA.

Health benefits

Other evidence comes from a 1994 survey in The Lancet of 84 health professionals and 218 members of the public. It found that 90 per cent of respondents reported health benefits from reading poetry. These included raised mood, improved sleep patterns, reduced physical pain and allowing antidepressants to be stopped or reduced.
“I’ve found listening to poetry can help in many different ways in my work as a mindfulness teacher,” Black says. “Discussing possible and different meanings of a poem gives participants a sense of the variety of possible responses to an experience. Then there’s the way poetry can allow people to discuss difficult feelings at one remove via the poem – there is a sense of safety because of the distance, especially if the poet uses metaphor. Finally, poetry can give people words to describe their experience they may otherwise struggle to find.”
Poetry can also help by reminding those who struggle with anxiety or depression to be in the present. Listening to someone reading poetry aloud is particularly helpful as it engages our senses – sight and sound – and stops our mind from wandering elsewhere. “We are all caught up in the busyness of today,” says Black. “Poetry can work in the same way as mindfulness by reminding people of the importance of being in the present moment.”  Regretting the past and worrying about the future are key characteristics of depression.
My own favourite poem which helps me stay in the moment is Raymond Carver’s “Happiness”. It describes the simple joy of a boy and his friend doing their morning paper round in the beauty of the early morning light.
“Such beauty that for a minute
death and ambition, even love,
doesn’t enter into this.
Happiness. It comes on
unexpectedly. And goes beyond, really,
any early morning talk about it.”

Beating depression

Black says she has found the most helpful poems tend to be short and in the first person, which therefore avoids abstraction and can elicit strong feelings. In the end, this is probably poetry’s most important function in her classes. Poems can work to provide feelings of relief, but a negative response can also be helpful. Choosing the right poems is crucial:  a sad poem needs to conclude with a message of hope.
“The most successful poems prompt participants to make comparisons with their own feelings and raise their own awareness,” she says.
On her course, Black introduced me to the thirteenth-century Persian mystic Rumi’s “The Guest House”. This uses the metaphor of rolling out the red carpet for unwelcome as well as welcome visitors, and begins:
“This being human is a guest-house
Every morning is a new arrival.”
“This poem works really well because of its simple but expressive language,” Black says. “The metaphor is one that can be easily remembered and powerfully conveys the message that we need to welcome all internal experiences.”
‘The Guest House” keeps repeating the same message: much of therapy is the invitation to try and change long standing patterns which have become entrenched over the years. By learning a poem and repeating its lines, we can help change such patterns by creating an alternative message which we can experience again and again through the words of the poem.
Rumi’s poem also stresses acceptance, a key message of mindfulness. We are not trying to fix things: the more we accept experience and strong feelings, the less frightening they are.
Finally, ‘The Guest House” encourages being curious about feelings, be they sad or happy, another key tenet of mindfulness.
The last verse concludes:
“Be grateful for whoever comes,
because each has been sent
as a guide from beyond.”
The famous exponent of mindfulness Jon Kabat-Zinn also believes that verse can be helpful in the therapeutic process as it can elicit strong feelings. It is when we acknowledge our feelings that we can embark on change. In Coming to Our Senses, he says that poetry can act as a lens that “[enhances] our seeing… our ability to feel the poignancy and relevance of our own situation” – the key word being ‘feel’. (Hyperion, 2005) This was certainly crucial for me. Depression had numbed me of an ability to feel which poetry re-awakened, providing a rip in the curtain to let feeling back in.

Stirring up emotions

Ironically, it may be the more challenging poems which are the most helpful. Kabat Zinn continues: “What we see through the lenses may discomfort and disturb and perhaps those are the poems that we most need to linger with because they reveal the ever-changing spectrum of light and shadow that plays across the screens of our own minds. “
But poetry must be handled with caution. Former Poet Laureate Andrew Motion describes poems “as a hot-line to our hearts, and … we forget this emotional power at our peril. Poetry is always a primitive and visceral thing.”
Black echoes Motion’s caveat: she warns that poetry can stir things up, its impact magnified by the way poetry may tap into the unconscious mind through repetition and rhythm, activating the right side of our brains which responds to emotion.
My own experience is that poetry can indeed be deeply unsettling in the way that it takes us out of heads and into our hearts. It was only months after I had recovered from a severe depressive episode that I was able to read the American poet Anne Sexton’s deeply haunting “The Sickness Unto Death” in which she describes her desolation. She was later to commit suicide.
“God went out of me
as if the sea dried up like sandpaper
as if the sun became a latrine.”
Despite the unsettling nature of her work, in another way the poem was calming. Paradoxically by drawing attention to strong and terrifying feelings, the poem allows us to co-exist with them. As devastating as it is to feel depressed, it is what it is. Acknowledging feelings of terror ironically makes them less frightening. Another consolation I found was poetry’s ability to remind us of the universality of the human condition. Depression is isolating: poetry transports us to the community of all humanity.
Rachel Kelly’s memoir ‘Black Rainbow’ about how poetry helped her recover from depression is published by Yellow Kite Books.
@Rache_Kelly, rachelkelly.co.uk
Anna Black teaches mindfulness   mindfulness-meditation-now.com.

Friday 4 April 2014

Ideas to Help - APRIL 3, 2014 ~ FROM THE COUCH BY RACHEL KELLY


FROM THE COUCH


Second in the series of Rachel Kelly’s keys to calm. Kelly is a Notting Hill lifer, mother of five, poetry buff, journalist and author. ‘Black Rainbow’, Kelly’s memoir about how poetry helped her overcome depression will be published by Hodder & Stoughton on 24th April.
Mantra of the week which I’m finding super helpful: ‘Turn control into curiosity’. No, at first it wasn’t obvious to me either, but here’s how it works. Control is a close bedfellow of anxiety. We try and grip ourselves and other people as a response to feeling panicky and yes, out of control. Every time you find yourself trying to boss others and telling them what to do, ask yourself why. Most of the time I’ve found it’s about my agenda and how I think the world should run. Much more relaxing is to stop, breathe, and ‘Turn control into curiosity’. Why do I want to stop them? What is it in me that wants to boss others? It is amazing how less stressful life has become – and indeed more interesting – when I practise this kind of acceptance. Oh, and watch trying to control your own feelings as well. A useful trick: beware all sentences you tell yourself with ‘shouldas, oughtas, couldas and musts’ in them, a list first devised by the famous psychotherapist Albert Ellis. You feel what you feel. It is what it is. Be curious and accepting rather than controlling. That’s not at all the same as saying you should act on all those pesky feelings… but that’s a story for another week. www.rachelkelly.co.uk