S1E1 – What is “Mental Health?”

EPISODE TRANSCRIPT

WS: Hello everyone, my name is Will. 

 

EP: My name is Ellie.

 

WS: “Lively Minds” is a UK-based podcast about mental health challenges that go beyond the ebb and flow of the everyday.

 

EP: Led by people with lived experience, this podcast is less about how we deal with our mental health and more about how we understand it in the first place.

 

WS: If anything comes up in this show that you need support with right away, in the UK and Ireland, the Samaritans can be reached on 116 123. For signposting to other services, including those outside the UK and Ireland, please visit our website, aniamedia.net/LivelyMinds.

 

WS: We are going to be talking to some really interesting people throughout the Lively Minds podcast, but we thought it would be a good idea for our first episode just to introduce ourselves the two presenters of this podcast and tell you a little bit more about why we are here right now recording a podcast about mental health.  Ellie, I mean just just tell me a little bit more about yourself and why you are presenting this podcast. 

 

EP: I’ve had mental health difficulties my whole life and I’ve had various extreme and less extreme experiences with them and I’ve always worked in youth work and mental health and I study it as well and it’s something that I think about a lot and I find that a lot of the conversations that are happening publicly, so sort of mental health talked about a lot more in the media and stuff recently, but I feel like a lot of those conversations, something about them, I’m like they’re not the right conversations, they’re not the right ones that we need to be having. Like mental health experiences are so much more diverse than just being kind of the more commonly experienced things like social anxiety and sleep problems and things like that and I feel like that’s what a lot of the sort of contemporary media discourse on mental health looks at. And actually, yeah, when you talk to people and really listen non-judgmentally, you find out, you know, people have all sorts of diverse and sometimes unusual experiences. And those are the ones we need to listen to. And I’m a big believer in people being sort of experts in their own experience. And I’ve wanted to do a podcast for ages. So I thought that that would be good, this would be good. 

 

WS: Good stuff. Good stuff. 

 

EP: What about you, Will? 

 

WS: What about me? So I guess if I had to to describe myself in relation to mental health, I would probably say that I experience quite severe anxiety problems. And I think anxiety is a really interesting condition, if we call it that. In a sense, one could argue it comes from a need for human beings to be able to respond to danger, right? I mean, anxiety fundamentally is at the very heart of human nature, at the very heart of animal nature in the form of the fight flight response. And for me, the way I interpret my own kind of anxiety is that fundamentally, it’s that mechanism that’s kind of gone wrong, essentially, in my head. Because as an anxiety sufferer, I guess what you know, what happens is for me is that I, you know, I’m constantly, there’s a constant background noise of fear, of unexpected things going wrong and terrible things happening.

 

For me, particularly, there’s a lot of guilt attached to that. So there’s a lot of it, which is about, you know, things that I might be even inadvertently responsible for, what terrible things might happen that I might be inadvertently responsible for. And that’s when we get into catastrophisation, which is a term in clinical anxiety around that sort of snowball effect of of telling yourself disaster stories and that disaster story getting very much out of control. So I think that’s kind of how I understand my own mental health problems. I’ve had them for a long time, 20 years, but it’s only in the last five years that I’ve actually started taking medication for them. And that’s been quite a transformational experience. I mean, it hasn’t, hasn’t certainly hasn’t solved all the problems. It’s not a silver bullet as it were, but it is something which has helped a lot. 

 

EP: Yeah, it can take the edges off, make them less sharp, I think, especially for anxiety. 

 

WS: Yeah. Tell us a little bit more about your kind of back. You mentioned that you work, you’ve worked and work in this sort of mental health space. Tell us a little bit more more about that.

 

EP: I was training actually a few years ago to be a social worker on a postgraduate course and I entered that thinking that I wanted to be a children and family social worker because of the youth work background. But my first placement was actually in adult mental health as an adult mental health social worker. And so I started working at an arts and mental health charity. And I also worked one day a week on a ward, a mental health ward at an NHS hospital. And throughout that period, I felt like I couldn’t really… It was a bit like I was sort of in the closet about my own mental health experiences because some of the things that colleagues would say about certain mental health conditions, I would just think like, “Oh God, you have… even though you’ve worked in this for ages, you still have all this kind of prejudice and stigma towards a lot of things about mental health. And so I always felt like I couldn’t tell anyone that I had, you know, the same diagnoses as a lot of these people who are currently patients on the ward. My physical health was getting really, really bad at that point and I developed a lot of new problems. And so that meant that after that placement, I couldn’t continue with the thing because I couldn’t really walk very well. I’d developed like narcolepsy. There was all sorts of mad stuff going on. But since then I continued working in mental health, largely doing like project work and workshops. I’ve done a lot. I was working at a high security hospital. And yeah, I think I’ve always had friends as well who have been in and out of mental health institutions and I’ve done a lot of voluntary work and advocacy and things like that. So I’m very familiar with the sort of clinical hospital setting, although I am usually there in a context of advocating for someone to not be in that setting or arguing against the biomedical model or, you know, things like that.

 

WS: So tell me about, I mean, you mentioned the biomedical model, I mean, in terms of how you frame your own mental health challenges, how do you go about beginning to understand your own mental health challenges?

 

EP: So everyone has mental health in the same way that everyone has physical health, regardless of what diagnoses or existing underlying conditions or whatever you have with your physical health, you could still be poorly for a while for whatever reason, maybe you’ve caught a virus or broken a leg or something like that. And I think that mental health is the same. We all have it. And sometimes some people’s constant mental health is perhaps almost like wired in such a way that it’s appropriate for them to have a sort of diagnostic label or they’re sort of considered categorically different. Their sort of underlying mental health is considered categorically different to whatever’s considered the norm with inverted commas. And that’s what probably everyone else considers as just mental health conditions like bipolar or PTSD and things like that. But I don’t believe that having one of those labels or diagnoses or sort of underlying frames of reference, whichever one you choose. I don’t believe that that automatically makes you mentally ill. That’s just sort of like a descriptive term for how your mind works. So I have bipolar disorder, but I’m not, I wouldn’t consider myself mentally ill. There are states of mind that I have been in in the past or I can imagine myself in and I would describe myself as probably mentally unwell in those specific states. But I don’t think that any of my diagnoses or sort of difficulties I’ve had in the past mean that day to day I’m mentally unwell. And yeah, I do always get uncomfortable. And that’s why this podcast is so interesting, because we disagree a little bit about it. Well, we have different views about it rather than disagree, I think. But like, I find the word illness, like very specific, it has a very specific definition for me. And so I associate it with a sort of medical understanding of things.

 

WS: I think it is interesting that we have different takes on it. I mean, I don’t actually disagree with anything you’ve said, though, to be honest. I think that it’s just in the… well, I don’t disagree in the sense that I am a passionate believer that each person should frame their experiences in the way that they wish to. And so I would never impose… And I know that that you wouldn’t either. But I wouldn’t impose my take on it, albeit my slightly more medicalized take on it on anybody else. I think for me, what I found really helpful in… So, yeah, I do occasionally refer to myself as mentally ill, a mentally ill person. And I think for me, for me, it’s about having spent a good 15 years feeling like I I simply wasn’t taking the issues seriously enough, a lot of self-blame, a lot of self-blame that actually what I was experiencing wasn’t an illness in a bit of commas. It was actually a weakness. It was just me being just being pathetic. It was a personality, fundamental personality trait that I had that that I couldn’t cope with these things, everybody else was perfectly able to cope with as far as I was concerned. And so I think for me, the sort of occasional use of, and I say occasional use of the mentally ill level, so I don’t like, you know, I don’t like to, it’s something I do say occasionally. It’s in part about, yeah, sort of treat, sort of actively calling it out, calling it out in terms of actually saying it’s not a weakness, it’s an illness, if that makes sense. There’s actually, there’s a, there’s a reason behind it all, which actually isn’t my fault. 

 

EP: Yeah. So you’re, the reason that word works for you though, is because you’ve already got a frame there where there’s an accusation that you’ve done something wrong, or it’s because of weakness. And so that’s why the sort of medical support kind of is like your evidence against those accusations. But I would say that those are like perceived accusations, aren’t they? Not everyone will think that about mental health. That’s not everyone’s understanding

of mental health is to think that it’s, but it is obviously a massive problem because it’s a lot of society’s way of thinking about it. 

 

WS: Yeah.

 

EP: But I do wonder if in like 10 years time, you’ll be less into the medical model and more, I don’t know.

 

WS: Yeah 

 

EP: Because I think it’s sort of a bit of a journey. Because I remember feeling like how you just described, I thought there was something like wrong with me and wrong with my brain and had this weirdly miswired brain that couldn’t like do normal things. And then then I remember when I first got diagnoses, I was like relieved because I was like, oh, actually that makes sense of quite a lot of my experiences. But actually, no, that was the way in which they were most useful. They just sort of, the ones that I agreed with, they made sense to me. And I was like, “Oh, okay. Oh, okay.” Well, maybe now I know that I have that. I can like access, seek more appropriate help, you know, and I can respond appropriately. Whereas now I’m sort of further out of it. And I’m like, “Screw the labels.”

 

WS: Because I guess also it’s a massive part of it is who’s doing the labelling, right? Are we labelling ourselves or are we being labeled by other people?

 

EP: Who’s labelling who?

 

WS: Yeah, so I think it depends so much on who’s doing the labelling and who.

 

And why?

 

EP: And why?

 

WS: Like with me, I’ve had full control of my labels, right? I have never so in the early days, I found that doctors I went to see and I went to see quite a few were keen not to medicalise the problems that I was experiencing, right? And I think what was interesting about that was that in the end, I just got a bit sick of that because what, the trouble is, that it’s a very fine line between on the one hand, not not medicalising and pigeon holding people on the one hand. But on the other hand, if you if that’s the messaging that keeps on coming is that, you know, this is this is this, you know, couching it in non-medical terms. This is this is about growing up. It’s about teenage hood. It’s about, as I was when I first started going to the doctor, you know, it’s about issues that everybody, everybody has these issues. Very quickly, you start to feel to yourself, well, hang on a second, if everyone’s got these issues, why am I keep why do I find myself keeping on needing to go back to the doctor all the time. And that’s, I think, where de-medicalisation becomes very unhelpful, because it actually then plays into the mind of the person who’s seeking the help by basically messaging unintentionally, of course, but messaging, you’re just weak and you’re just not coping with stuff that other people around you are coping with perfectly well. Of course, it’s very, very debatable. The extent to which that’s true, but in terms of the people coping, I mean, but, but yeah, I think that’s what’s interesting about it for me.

 

EP: Yeah, no, and you’re right. And, and yeah, that is, and that is one of the most common ways in which, especially when people are at the early stages of seeking help for their mental health, there’s probably one of the most common ways that they’re dismissed is by being told like, Oh, everyone feels like that sometimes. It’s okay. You know, things get better. You’ll figure out how to deal with it. But then actually, some people need more support than others or more specific kind of advice and help to sort of level their field a bit. But I think the reason we need these labels in the UK, I don’t mean as in, I think that we need them. But the reason that they are so useful to so many people is because those labels are literally the gatekeepers of how you access support, particularly in terms of benefits, occupational health assessments at work, accessibility, sick note, like everything requires labels. And that’s why people spend so long trying to get these diagnostic labels, even though they probably know or have their own understanding of what they consider their mental or physical health difficulty to be, because you literally can’t get any of the other help without one of those labels. So, you know, if you realize that you should be being prescribed a certain medication, or you think that a low dose of like an anti anxiety medication or a beta blocker or whatever is going to help you. You then have to, you’re then completely sucked into the medical framework because that framework is literally the one that governs our country’s social and welfare support as well. So you’re already just drawn in.

 

WS: Yes.

 

EP: So I’ve got to get that diagnosis. Otherwise, I’m not going to get X, Y and Z.

 

WS: Yes.Yes.

 

EP: Yeah.

 

WS: So we describe this podcast as a podcast that is less about how we deal with our mental health challenges and more about how we understand them in the first place. Can you just tell me a little bit about what that means to you.

 

EP: How we deal with mental health challenges. I think it’s a very individual thing. And that people’s individual experiences can really help other people with their experiences, because what we mean with how we deal with mental health challenges is basically kind of coping strategies, ways to deal with the challenges that happen rather than…

And that’s what a lot of self… this sort of like boom of self-care and well-being rhetoric and stuff has been about. And that is all really important because, like, especially with young people now, like they have all these ways of soothing themselves and you know just calming themselves down that they just do on their own that I think probably even like 10 years ago was nowhere near as much in the common sort of conscious. But yeah how we deal with their mental health is ultimately quite an individual thing because everyone’s mental health is so different. People’s mental health is so different because their lives have been so different. And my perspective on it is much more like trauma focused in terms of experiencing difficulties in mental health as adults. So I would say that. But yeah, this podcast is more kind of about like what we’ve just been talking about, what is mental health? And how do we come to understand how and why we have those experiences in the ways that we do? And I think that through that conversation, there is a lot of healing to be had in terms of how we can, you know, view ourselves and the sort of, you know, whatever your sort of trigger or thing is that makes you have a difficult period of a flare up if you like of whatever psychological sort of difficulty it is that you’re struggling with because I think it’s impossible to talk about mental health and not talk about, you know, everything else. I was thinking when you’re saying about doctors saying, “Oh, you know, you’re a teenager and everyone experiences this,” or, “Oh, yeah, well, you know, life’s hard,” and this is just… And it’s like, no, that is actually a valid point existing is hard. And a lot of this is existential angst, because it just is, especially with like self-critical thoughts and things. There’s so much going on there. Why am I here? What’s the point of me being here? Am I helping other people? Am I doing this? Yeah, there’s just a lot to talk about around it and I think that that needs to be like integrated more into the main mainstream conversation about mental health. So we’re not just thinking, okay, well, how do I look after myself and calm myself down if I feel like I’m starting to get too anxious, which obviously is an important thing. How about we figure out a bit more about that experience that we call anxiety and why certain things start to trigger those like physiological responses and you know what it is about our experience that you know causes our brain or mind, or whatever you want to call it, to sort of react without us consciously having an active role in in that reaction. 

 

WS: So I think there’s a kind, there’s a for me there’s like a spectrum and on one side of the spectrum would be mental illness, I guess, would be the way I would frame it, not not withstanding our earlier conversations about language and some of the challenges around that, on the other end of that scale would be sort of well-being, mental well-being. And the reason why I have that scale is because, for me, one of the reasons why I’m so keen to do this podcast is because, I think there are, there are quite a few podcasts out there around, around the mental well-being side of things. In other words, for people who experience everyday ebbs and flows of of well-being, there are plenty of podcasts which are about how to live a better life and in inverted commas, right? And nothing wrong with that. I mean, it’s not my cup of tea, but that’s I’m not going to, you know, people, if that’s what people like, that’s what people like. I think part of where there’s a, what I think mental, a podcast about mental health does specifically, for me it’s about a few things. It’s first of all about everybody is welcome as far as I’m concerned, but I am most

interested in reaching people for whom the challenges that they face have gone a little way beyond the sort of ebbs and flows that the majority that everybody faces in their life, in their day-to-day lives. And linked to that, I guess, secondly, what interests me is trying to sort of make some distinctions between mental wellbeing on the one hand and mental health on the other. And what I mean by that is I think the risk with the wellbeing world in terms of self-help and in terms of tips and in terms of advice around how to live that better life, is that it it ferments this self-help culture.

 

EP: Yeah.

 

WS: And I think that there’s, I think the self-help culture as a whole is very problematic.

 

EP: Yeah, it’s literally like the epitome of rugged individualism but covered in flowers and bath bombs.

 

WS: That’s a very good way of putting it. That’s a very good way of putting it.

 

EP: Your experiences are your responsibility only.

 

WS: Exactly.

 

EP: You have control over them happening and therefore you have control over them not happening.

 

WS: Exactly.

 

EP: And that is just inherently messed up.

 

WS: Yeah, exactly. And you know, oh, it’s just a coincidence that we have chronically underfunded mental health services. You know, it becomes like this, the self-help culture is embedded everywhere. It’s not just within the wellbeing industry. It’s within, you go on the NHS website, you look at you look at mental health and there’s loads of self help stuff there. Now, I’m not saying this stuff hasn’t got a place. It has got a place.

 

EP: Of course, yeah. 

 

WS: But I think that the problem is that it kind of, as I say, ferments this idea that we are responsible. We are entirely responsible for sorting out our own mental anguish. And actually, that’s not true. And people who feel like they they want to get help, but sort of are being bombarded by all this well-being stuff about just change your diet and and do a bit more exercise and do all this stuff. I would just say, go and get help. Just do it because it’s so easy to feel like we don’t deserve it because we are fundamentally responsible for our own mental wellbeing.

 

EP: Yeah, and the other like, so that’s like one way in which that sort of the self-help culture is like really damaging is that, yeah, people just think everything’s their fault that they have not been given the right support or not even seeking out help from others to kind of deal with it. But it also, there’s something about it that I think encourages like very toxic behaviours and ideas of self-importance because there’s kind of, you know, actual real self-help and growth and development means sort of sitting with yourself and having the conversations with yourself that you don’t want to have. Like, was I a bit of a toxic friend in that relationship? Should I actually have gone and apologised there, you know, am I, is my behaviour at work actually upsetting other people? And am I, do I know that and I’m doing it anyway? If so, why? That’s actual self-help that you can do and sort of, you can do with the help of a therapist. But that’s the stuff that you can work on yourself or think about or maybe try to look at. But none of those books, none of those are about that. They’re just about prioritising yourself and only yourself as number one, taking yourself out of any situation in which you feel uncomfortable, removing anyone from your life who makes you feel uncomfortable, criticises you, who you don’t like. That is just, encouraging, a completely isolated, non-critical, and like ego driven individual. And if society was just full of those people, there would be no society, it would be complete shambles.

 

WS: There’s going to be hopefully, I’m sure, I’m sure there’s going to be plenty of other really interesting people as well on the show. So we’re really looking forward to this, we hope that you are too. And we look forward to you joining us for this ride. 

 

EP: Whoo hoo

 

WS: So thank you for listening. My name is Will. 

 

EP: My name is Ellie. 

 

WS: And you’ve been listening to the very first episode of Lively Minds. See you later.

 

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