Personal Blogs

I have just blogged about my recent depression but now I want to tell you about mania, as I guess most people don’t really understand what it is like.

I consider hypo-mania, that is, low grade mania, a normal part of my every day life. When I am hypomanic, I have constant racing thoughts in my head, like a dialogue with myself (just to be clear, I’m not hearing voices; I’ve never had auditory hallucinations). I have a heightened awareness of my surroundings, of colour and noise, and it is often an enjoyable experience, though the discourse can cause anxiety when you replay conversations and mistakes from 30 years ago.

It is hard to say when hypomania tips into mania, I think it is when I start feeling tipsy and my thoughts become more grandiose. My internal discourse contains grand speeches where I share my words of wisdom with the world and everyone hangs on my every word. I see myself as charming and engaging, with my eyes twinkling like diamonds (and I can understand how someone with psychosis might be deluded enough to imagine they are diamonds). I am excitable, wanting to engage with the world, to run down paths with my arms outstretched. I am lucky that I have a lot of insight and control when in a manic state so I don’t do anything to embarrass myself in public; this is how I manage to continue as high functioning within society. I’m also lucky to have seldom experienced psychosis, though I understand and appreciate the thin line between reality and delusion in mental illness.

I can tell my moods from my shopping habits; I told my GP when my depression started by looking at my PayPal account. When I am manic, I shop more and buy frivolous items or several pairs of identical shoes in different colours. This morning I started browsing for colourful tops for my summer holiday, yellows and corals. My Mad March Mania is very late this year.

If you want to read a book about experiencing bipolar disorder, I recommend Kay Redfield Jamison’s An Unquiet Mind, an autobiography of a manic depressive written by an academic expert on manic depression. I don’t agree with everything she says from a medical perspective but her descriptions of her emotional states and behaviour were very recognisable to me, as well as the vulnerability of academics/medical professionals declaring their mental illness.

Annie

I had a bout of depression for a week or so after Christmas. This is not unusual, in fact, it is a feature of the Christmas holiday for me. But I thought I would unpack it a little.

The most obvious reason for depression during December is seasonal affective disorder (SAD). Like many manic depressive, I do have SAD. As well as the lack of happy inducing sunlight, with the resultant low vitamin D levels, I am very responsive to changes in mood and routine and the changes in the seasons are a cycle of this. Mania will come in Mad March, as it always does. But it is more than SAD, over Christmas my routine is altered in many ways and this impacts on my moods.

I really like the excitement of Christmas. I love buying people presents, planning and making the food, decorating the tree and making people happy. And I start my Christmas planning early as my anxiety does not like last minute rushes. But, of course, after Christmas this winds down and it is then the depression comes. This mirrors my normal bipolar cycle; after a period of mania I have a short period of depression. It reminds me how important a regular routine is to maintain my mental equilibrium.

This week my depression has lifted. I am back into my work routine and, despite my husband having been away on business in the US for 10 days from New Year, I have managed to keep everything at home running like clockwork. Today I went for my morning walk in the cold frosty morning with a clear blue sky and saw buds appearing on some trees. Spring will soon be with us.

Annie

Last week I was accepted to present at the OU’s Mental Health and Wellbeing Conference and this led me to reflect on how much my confidence in presenting my ideas has increased over the last 2 years. Presenting at conferences was part of my development plan in year 1 and was quite apprehensive as I have social anxiety as part of my bipolar disorder.

Some people misunderstand how social anxiety can present and assume that I am a confident speaker because they think I am an extrovert, when I am actually a sociable introvert with hypomania. I don’t like being the focus of attention; during my nursing training I actually failed practical assignments because of anxiety with being watched.

Unusually, the pandemic has played to my advantage here as conferences were moved online. I’ve been teaching in online rooms for almost a decade so this is a comfortable environment for me and the screen interface means I feel less in the spotlight. Consequently, I have presented my research  at internal post-graduate research conferences and at the annual AdvanceHE Teaching and Learning Conference in 2021, where I also did a Q and A. So, although I still have anxiety at presenting at the conference, I am now much more confident in my voice when speaking about the subject I am passionate about; supporting students with mental health challenges. I look forward to the conference in December.

Annie

I was quite unnecessarily anxious about doing my first interview, despite having been doing telephone tutorials for 14 years. As a manic-depressive, I am often anxious about new experiences but I also get anxiety prior to regular intense occurrences, like when I give an online tutorial (which I have also been doing for years) or start a batch of marking. This anxiety expressed itself in many ways, for instance, rechecking recording equipment to make sure it works and revising and practising my questions repeatedly. On the day it showed in a mild depression during my morning walk, a feeling of nausea and fear, and pacing around the house. I am used to managing anxiety on a daily basis so lots of deep breathing, CBT and positive thoughts and no attempt to avoid or delay the inevitable.

What I experienced can be similar to what students experience when invited for a telephone tutorial, with the anxiety of not knowing the person calling or what to expect, and the anticipation of the event. Some will overcome this and welcome the opportunity to share their experiences and support needs with their tutor whilst others will find the barrier more difficult to climb. What is important, then, is that tutors work to establish positive relationships with their students at the beginning of the module and that they keep that door open for communication. I think regular communication from a tutor is vital in this process, especially early in the module, and communication is one of the things I will be exploring in my research on how students with mental health challenges can be supported to reach their potential. This includes proactive support that intervenes before crisis point so that students are supported when they are at their most vulnerable.

These issues also have implications for my research study in that I am inviting participants to have telephone interviews and not everyone will be comfortable with this, especially at the beginning of the module. I hope that as my students get to know me better, several will have the confidence to come forward and volunteer so that their voices will be heard.

Annie

Last week I got authorisation for my research sample and it was surprisingly straightforward, if somewhat nerve-racking.

To do research with OU students you need permission from the Student Research Project Panel (SRPP) and they will authorise a sample of participants. In many cases they will produce the original sample for the researcher but some researchers will request to draw their own sample, which needs approving. The latter is my situation as I want to research my own students so last Thursday I submitted a prospective sample for approval.

This process is necessary as some students may have opted out of contact about research and others would have already been involved in recent projects or even multiple studies. But it is anxiety inducing for the researcher when your initial sample is already very limited in scope. As it was, the process reduced my sample by a third. But I am glad to say that my response was positive and practical; the process is necessary and ethically right, and this is my sample and I am going to work with it. It is so nice to finally be contacting potential participants and to have the opportunity for 2 years of work to finally bear fruit.

Annie

Unless you are someone with a mental illness, it can be difficult to comprehend how stress, anxiety and depression are so intricately linked and why it is so difficult to manage.

Yesterday morning I received a phone call to tell me that a close family relative was seriously ill in hospital. I am very experienced at dealing with anxiety-inducing situations so set about limiting my risks. I contacted my husband so he was aware, fulfilled my duties in contacting further relatives and then looked at my workload. I decided that my marking workload was manageable for the day and that clearing it would be a good move in case I needed to take a break. I kept my evening appointment and informed my manager of my situation. A phone call from another relative late in the evening informed me that the situation was much improved and was no longer as serious as first thought. A win-win for me, you might think, with improved outcome for said relative and mental health well managed.

Except today I have depression. Only mild depression, my bipolar disorder tends to swing its extremes more in the other direction. But depression, none the less, and clearly a response to yesterday. Luckily I am in a situation where I work flexibly so I can take a step back from work temporarily if I wish; other people have a much difficult time without family and work support. But it does make me reflect on the fact that even good management of stresses won't necessarily prevent a poor mental health response. 

A well meaning friend recently said to me that mental health was caused by society and that what is needed was to support people to change behaviours (they also mentioned trusting in God and I pointed out that my mental health has never negatively impacted on my faith, and perhaps the church might approach Christians who have experienced mental health challenges to learn from them about keeping faith when times are hard). But, much as I believe that society does impact on mental health and that behaviour change is important (my doctoral research looks at motivational support for people with mental health challenges), there is a risk in blaming the person here. Behavioural approaches are very helpful, in my experience, but the mental illness is still there and needs managing; it doesn't go away. I can get by without medication as I have an unusually supportive and flexible lifestyle but for many people this isn't a possibility and I think people often underestimate the impact of daily stresses, from minor work or home challenges to the big issues of loneliness. Things build up and even a small thing can trigger a major response. One of my main stressors is conflict as I have social anxiety.

Onwards and upwards. I start the day by giving thanks for the health of my brother and now I'm going to spend some time reading some papers for my literature review.

Annie

One of the tasks on the Prof doc programme was to write 300-500 describing your proposal. So here it is!

My research proposal has a working title of ‘How can students with mental health challenges be empowered to become independent learners within the technology-enhanced learning environment?’. It is emancipatory action research; emancipatory because it has an aim of giving a voice to a disadvantaged group, and action research because it will be undertaken as part of my work as an Associate Lecturer with the Open University.  The subject has a personal interest for me as I have bipolar disorder and have a strong sense of empathy for my students who are studying whilst experiencing mental health challenges.

Technology-enhanced learning has the potential to make distance learning more accessible to students with mental health challenges as it offers a flexible format where the student has control over their social engagement and schedule. Consequently, more Open University students disclose mental health challenges than any other UK university (The Open University, 2018). But research by Richardson (2015) shows that students with mental health challenges are less likely to complete and pass modules than non-disabled students, though they attain just as good grades when they do pass.  Distance learning can be isolating and people with mental health challenges may need extra support to maintain their studying progress and reach their goals. Developing the skills to become independent learners can empower students to take control of their learning, build self-confidence and achieve their potential.

Using a flexible and participatory voice-led approach within an emancipatory action research framework, my research will use case study interviews to investigate the learning experiences of students with mental health challenges, alongside individual study skills support which includes positive reflection. It will be collaborative, encouraging participation in decision making and seeking negotiated meanings, whilst empowering participants to take control of their learning and influence teaching with the aim of developing an inclusive distance learning approach which is beneficial for those with mental health challenges and potentially other students within the university.

I will use interpretative phenomenological analysis to interpret my results. This is a qualitative approach which examines and interprets how the individual makes sense of lived experience and is particularly helpful in examining complex and personal perspectives which are highly subjective. I will encourage students to review transcripts and my subsequent analysis, enabling them to participate in the research process as a form of transformatory critique to question knowledge and inform practice.

Whilst research into the technology-enhanced learning environment is a dynamic field, there is little research into how those with mental health challenges respond to and develop within this environment. By developing greater understanding of their learning needs, this research can influence educational policy and practice within the university, and in the wider academic sphere, so that module development and delivery is more inclusive and retention improved. As emancipatory action research, this research has application at grass roots level, providing the opportunity for students with mental health challenges to be empowered through participation whilst building on skills for independent learning.

The Open University (2018) ‘The OU has the highest number of students declaring a mental health condition in the UK’, University News, The Open University, Milton Keynes [Online] Available at: https://ounews.co/around-ou/university-news/the-ou-has-the-highest-number-of-students-declaring-a-mental-health-condition-in-the-uk/ (Accessed 14th October 2019)

Richardson, J. (2015) ‘Academic attainment in students with mental health difficulties in Distance Education’, International Journal of Mental Health, vol. 44, no. 3, pp.231-240. [Online] Available at: https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1035084 (Accessed 29^th November 2018)

Most OU modules start this week so it is always busy for an Associate Lecturer in the first few weeks of October but this year was extra busy for me as I started my Professional Doctorate in Education. Don't know what this is? Well, it is basically a part time doctorate for people in professional practice. Unlike most doctorates which are done at the beginning of a career, a professional doctorate is done later in a career within your own work environment. The OU offers a Professional Doctorate programme in Education or Health and Social Care  http://wels.open.ac.uk/research/postgraduate-research/edd

The year 1 residential was last weekend and what an intensive time it was. Not only was it a fantastic opportunity to meet fellow students (it's a distance learning course so meeting others is a valuable experience) and to share ideas and interests, but it was a helpful approach to cementing identity at the beginning of doctoral studies. I was able to explore what it means to be a research professional, reflect on the ethics of research and learn more about critical review of literature. I saw a research project in action which had many similarities to my own. The library session was immensely useful; I may be an AL but it was very helpful to have one to one assistance from a librarian and to learn about relevant software to aid my studies.

Now I'm off on my research journey. I am lucky in that I have a firm structure to work within: 3 days of OU work punctuated by two days for study, an obvious necessity for a manic depressive who needs to plan her schedule clearly to avoid stress. There will be some overlap though as I am doing action research. My current working title is 'How can Students with Mental Health Challenges be Empowered to become Independent Learners within the Technology-enhanced Learning Environment?' but more on that another time.

Now to start my Researching professional development Plan.

Annie

I openly discuss my bipolar disorder so it sometimes comes up in tutorials when we are discussing health theory or disability. Recently I was discussing the concept of 'curing' in a K219 tutorial and one of the examples being discussed was mental health so I gave my personal opinion. I enjoy the positive reactions I get from students when I discuss my mental health, students are very encouraging on the need to reduce stigma and often come out with their own experiences. Someone mentioned how mental illness can creep up on you and I acknowledged this, pointing out I often don't realise I'm manic until well into an episode, partly because it is enjoyable, and the need to have a confidant who is able to recognise and discuss it with you. A student then said 'What about the lows?' and I realised that I very seldom discuss the lows.

I don't have lows very often, my bipolar mainly features hypomania and I seldom have deep lows since the first ones I experienced when I was first diagnosed 20 years ago. Manic depressives are often diagnosed during a depressive episode, mania can be enjoyable but depression isn't. McKeon (1995) suggests that the first depressive episode is often triggered by emotional stress switching on a genetic mechanism. Mine was triggered by my father becoming seriously ill and almost dying. 

I discussed my mental illness at a church meeting this week and my husband said that he could detect my mood swings and we then worked together on strategies to manage them. Later I challenged him on this; he actually identifies my manic periods but not my depressive ones. Mania is a very public thing, it is outward in its appearance, but depression is quite private and inward. I can't always tell I'm depressed myself until well into a period, it creeps up on you as noted earlier but it is also difficult to tell what normal is if your moods are usually abnormal. 

I've had marking over the last few weeks and I've been prevaricating over it. Now, finding displacement activities to avoid marking is quite normal, I'm sure, for most ALs. But it was when I was crying at the thought of it that I realised that I was depressed not just avoiding work. Recognising it meant I could develop strategies to manage it. Firstly, giving myself very small goals, perhaps 2 papers to do,  to make it manageable. I often find if I set myself to mark 2 papers I actually mark 4 as starting is often the hardest thing and once I'm into an activity it provides a welcome distraction from my emotions. I also prepare myself mentally, physically and spiritually. I make sure I go for two walks a day and get some fresh air and exercise. I eat healthily and take vitamins. I meditate and say a prayer before working (non-religious people might consider an activity such as writing down some positive things to be thankful for and some short term, achievable goals). I take regular breaks and have a cup of tea.

So, why I am I writing this? Well, in my experience, students with mental health challenges often face similar struggles when writing an assignment; it becomes a big wall that seems impossible to get over. As ALs we need to recognise these hurdles are real issues and work with our students to overcome them. Acknowledgement and empathy is the first priority alongside open channels of communication so that students can voice their fears and anxieties; this does much to reduce the burden. Work with students to come up with achievable goals over a period of time, perhaps just listing key points at first, then developing a plan for an essay, then tackling a paragraph a day so it does not become overwhelming. Plan ahead to the next assignment so that they are prepared in advance. Encourage them to look after their physical health too, to take regular breaks and get some rest. Most of all, let them know that you value them and you are on their side, even if their decision is to take a break from their studies. 

Most importantly, listen to their voice so you can empower and support them to achieve their potential in whatever way they can.

2018 was a turning point for me. It was the 20 year anniversary of my diagnosis with bipolar disorder, the year my life was turned upside down and which led me to give up my dream job as a university lecturer, move away from London and start again.

So, in 2018 the time was right to reclaim my academic career at the age of 49. I doubled my working hours from 13 to 26 and took on higher modules to teach. I became more active in the university online community, starting my blog and generally contributing more in forums and community discussions. I also became more vocal about health issues outside the university, giving a talk to my church about mental health (which has led to a higher profile of the needs of disabled members) and I’m in discussion with community leaders about starting a local death café. I planned and wrote a research proposal for a doctorate which I hope will benefit students with mental health challenges.

I used a year off from study to reflect on what I learnt on the Masters in Education and put new ideas into practice, including improving how I maintain dialogue with students via email and the PT3 form. I recommend the Masters programme to other ALs, I learnt so much from it, especially about conducting research and transforming practice, though it was very hard work.

2019? I want to write more about the experience of living with bipolar disorder and start my doctorate research. I know I go on about my future studies but I find studying truly exciting as I came from a working class background and never went to college; my life has been changed by the Open University in many ways.

Have a happy new year

Annie

Well, I've just finished the marking marathon of November so thought it might be a good time to reflect on how I am getting on with my increased workload.

October is a month of welcoming and signposting, phoning students and getting to grips with module structures; a busy but enjoyable time as you meet new people and learn new things. November is a different beast - virtually every module has an assignment due in November which needs marking.  Marking is by far the most labour-intensive parts of an associate lecturer's role and also one of the most important. Not only is it part of a student's continuous assessment, it is also one of the main ways ALs use to communicate with students and advise them of their progress. So it is important to do it properly, hence the time consuming nature.  In my case I had 4 lots of assignments over a 3 week period from the end of October. I'm now on a week's break from marking before more 3 lots of assignments submitted over 2 weeks. It's a bit hectic!

Of course, by break I don't mean a rest; I have 3 tutorials to plan and deliver in the next 2 weeks as well as as the usual emails, forums, admin and telephone calls as well as staying up to date with the 3 new modules I'm teaching. But it does mean the pressure is off and I can relax and take stock. Being a great believer in the connection between physical and mental health I'm also using this week to detox and take some mental health walks.

So, on reflection, how has the last month gone? Well, I got all the assignments back on time. The first ones were returned very early due to my increased hours allowing for more efficient timetabling. My last lot only just got back in time but that's how they fitted in the bigger picture so that's okay. I paced myself well; I decided in the end not to fill whole days with marking but break my days up which will have implications how I manage this period next year when I hope to be studying a PhD alongside my teaching. 

Most importantly, my bipolar disorder seems to be under control with no adverse effects from the increased hours. I am neither more manic nor more depressed than usual, despite being tired by the end of the last marking period. The last lot of marking was a slog and I had to give myself several pep talks but it worked. I am approaching my work this week with a positive mental attitude and am also keen to get back to work on my research proposal tomorrow. So all in all a win.

Annie

This afternoon, I went for a walk across a nature reserve in the blustery wind and it was wonderful, I felt so alive and part of the landscape. I could feel the wind around me and was filled with joy to experience the wonderful world we live in. I have 'happy mania'.

One of the main consequences of self-managing my bipolar disorder is that my normal mental state is one of mild hypomania. Whilst this has some drawbacks, including potential lack of concentration and slow processing of information, it is also a wonderfully creative place to be. A bipolar friend describes my normal state as 'happy mania' and professes her jealousy of it.

You see, whilst my 'happy mania' can hamper my ability to comprehend if it gets out of control, it expresses itself in an enormous capacity to feel. When I was a child my mother used to say I had second sight; that I could feel atmospheres and read situations. Later in life, when my father had respiratory failure and my mother had to make that difficult decision for the ambulance men not to resuscitate him, it was me she asked afterwards if it had been the right decision (it was). I can still read people like books and I genuinely like people and find them interesting, even those I vehemently disagree with. My empathy shows in quirky ways, like unconsciously changing my accent according to who I speak to. What my happy mania gives me is a heightened perception of what is around me and for that I am glad; it's a feature not a bug. 

Nature has a great capacity to bring healing to those with mental health challenges and I recommend daily walking as a means of escaping the stresses of everyday life. You might not come home as buzzing as me but the exercise will do you good and you might find some spiritual solace.

have a great weekend

Annie

https://www.bbc.co.uk/news/stories-45739335 This article is both shocking and very, very sad. These people who died were unarmed and not committing any crime; one was naked in his shower. What they all have in common is lack of communication, some of them had learning difficulties or mental health challenges which meant they did not understand the commands they were given, one of them was deaf. 

Hey, wait, let me back track a little. It wasn't these communication difficulties which caused their deaths but the poor communication skills of the police.

This is not a blog on guns or police policy in the US, I value my sanity far too much for those discussions. But these police officers seemed to go into situations using aggression from the outset, shouting at the person even in the situations when they knew the person was disabled. Were they not taught any communications skills during their training? Do they act like this in their everyday lives? Do they not know anyone disabled: do they fear them or think them sub-human?

I've had bipolar disorder for 20 years and know lots of other people with the same condition. If someone is in a manic state, aggression will just heighten it and stress can be a big trigger. Manic depressives can also have problems processing instruction so even if they are listening to you they still might not have the foggiest what you want them to do. Similar issues happen with other mental health issues. But this goes far beyond disability, it seems that some people in authority think aggression is an acceptable way to carry out their job and that challenges can be met with violence. There needs to be far greater education on understanding the needs and experiences of people with disabilities, especially mental health and learning disabilities, and the communication skills needed to communicate effectively with them. But these are skills which will benefit all people, they are basic rules for engaging others in all walks of life in a respectful way. We need to resist a culture which thinks 'shoot first, ask questions later'. A little empathy will go a long way

Annie