Personal Blogs

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

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

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'm a month into my new increased schedule and I thought I'd have a reflection on how it is going.

I'm surprised how smoothly the new routine has fitted into my life. I'm not having any problems arranging my work and I have noticed several improvements as well as noted a few areas where my homelife is having to adapt.

Firstly, my initial fears that I wouldn't be able to switch off on my days off has proved unfounded. After the first few weeks of constantly checking emails and forums I have settled down and can switch off. Not only has it not increased my mania but I've had a few days where I'm not hypomanic (unusual for me as I'm I have high functioning bipolar disorder so hypomania is a prominent feature of my life). Obviously, due to the nature of OU tutoring I do have to sometimes teach or speak to students during my downtime but I am balancing this well.

Some things have actually improved. When I only worked 13 hours a week teaching 2 modules I always found marking weeks hit and miss as they took up 12-15 hours of time and did not slot naturally into my life, leading to prevarication. But now I work 26 hours I can schedule these better and have days available for marking; for the first time have actually managed to mark straight away after the submission date. This improved scheduling is very important as, obviously, I also have far more marking to do but I do feel more efficient. We will see how this progresses as marking and teaching increases.

The impact on my home life is interesting. Being an early bird, I'm making an effort to sit down to work before my night owl husband leaves for his work. This gives me a visible presence as a working person which can be missing from home working and I'm noticing him acknowledging this in his attitude at home. He's also leaving earlier for work rather than rolling in late and staying late (he owns his own business)!

My children are old enough not to disrupt me at work too much but dinner has definitely got later and less fancier (I love cooking). But I still have days off to get things done.

So, all in all a positive change. I looked at it again in a month to see if 4 lots of marking have changed my opinion!

Annie

I recently decided to increase my work hours. It was something I had wanted to do for a while and this year finally presented an opportunity for me to apply for several appropriate modules. I had a firm idea of the number of hours I wanted to do and was lucky enough to get offered modules that met this requirement; in fact, I had to turn two modules down.

So why did I want to increase my hours? Well, the most straightforward answer was that I had time on my hands. My children are now teenagers so I need to be around less for them and I wasn’t studying last year so I was bored. I needed something more challenging to do with my life, which brings me on to my main reason for taking on more work; I wanted a career again. I now had the time and opportunity to make a serious career in academia, I was applying for a Doctorate and the time was right to make a big step forward.

I also hoped that increasing my workload would provide more structure to my life. Only working a few hours a week can create a feeling of being disconnected but by increasing my hours I could formalise my days. This isn’t just important for getting my own work done and managing my own haphazard mental processes but also also ensures my new workload is recognised at home. Like many work-at-home parents, most of my work is hidden. My family need to know that I have work to do, that I can’t just drop everything to pop to the shops for them. So, by having firm perimeters my status at home changes. If I want to successfully build my career my work must be visible at home as well as among colleagues.

To do this I have given myself 3 full working days plus the necessary flexibility for the odd evening or weekend tutorial to make up my hours. I also have a day set aside for study; this year it is used for background reading and small projects, next year it will be part of my PhD timetable. I’m only 2 weeks into it but I can see how it will be effective in organising my time and I feel purposeful. What I hadn’t anticipated is the difficulty switching off in between work days, I have a constant urge to check my work email and forums. As someone prone to hypo-mania this probably isn’t surprising but I’m hoping this will settle down as I get used to the pattern and as my students settle into their modules – routine is the key. But yesterday (my day off, otherwise known as the day I do the housework) I managed to switch off completely. I will keep monitoring how I am keeping to my timetable as the academic year progresses and the workload varies from week to week.

Annie

I’ve been thinking about writing a blog for some time now, partly prompted by the debates about equity and diversity in education studied in my recently completed Masters. It was always clear to me what my main focus would be as it is a subject close to my heart. But my personal knowledge of the field also meant that I needed time to think about my approach, as it is a subject that makes some people uncomfortable.

An example of this would be at a recent seminar when we were asked to find out more about our neighbour. I enthusiastically discussed my disability, my management of it and my passion to be an advocate for others like me who were less able to have a voice. By being open and frank about my experience I could empower others to speak out and remove the stigma associated with it. But when we fed back to the main group, my new friend did not name my disability, it was my ‘sensitive issue’. And this has been my experience on many occasions, no matter how frank and open I am and the permissions I give to discuss my disability, others are still reluctant to call it for what it is. It is a ‘personal difficulty’ or a ‘time of difficulty’. I’m sure you’ve guessed what I am referring to, it is my mental illness; I have bipolar disorder.

It is hard for someone who has never experienced mental illness to imagine what it is like and the unknown can create fear or misunderstandings or incomprehension. Likewise empathetic people don’t want to say the wrong thing, to offend or upset someone. Or fear they might breach a confidence (something perhaps we are even more sensitive to in my own field of health and social care). And these are all valid explanations. But they are also the reason that I want to be open about who I am, so that others can have an insight into what life is like with bipolar disorder and to encourage other manic depressives to speak out.

Culture and upbringing have a big influence here. I was brought up in a working class family where disability was visible and cared for within the family. My mother had poor mobility and my twin brother was born partially sighted and attended a school for the blind. My happy childhood memories are of visually impaired children charging around on horseback. I grew up with a very positive perspective on disability, and especially visual impairment, which eventually led me into specialising in ophthalmic nursing (where patients would comment on my very natural and relaxed approach to guiding). When I was diagnosed with bipolar disorder I was supporting newly registered blind and partially sighted people to come to terms with their blindness so had a practical knowledge of identity and disability.

But not everyone feels this way or has these experiences. In the summer I attended a Christian festival with a reputation for inclusivity. The Sunday morning communion was entirely presented by disabled people and was a joyful experience for me. But when I turned to a close friend and asked him what he thought about it, I was amazed to hear him say that he found it very negative. Momentarily shocked into silence (which doesn’t happen often) I asked why and found he was sad that so many people had to live with these problems. In K213 Health and illness we look at the research of Blaxter (2010) into lay people’s understandings of health and illness and his responses are similar to how she found other highly educated, well off young men view health, focussing on absence of disease and physical fitness.

Our culture and experiences construct our perspectives so divergence of opinion is to be expected. If attitudes towards mental illness are to change there needs to be a cultural shift away from stigma, shame and silence. I want to use my voice to embolden others to share their stories so that there is a wider understanding of the lives of those with mental illness. As an Associate Lecturer I particular want students’ voices to be heard so that we can have a greater understanding of their needs and facilitate them in a way which maximises their potential, and next year I hope to start doctorate study to research into the experience of distance education in those with mental illness. By looking at how it experienced now I hope to develop an understanding of how education should be delivered in the future.

Annie

(The discussions in this blog are my personal opinions and not necessarily the views of The Open University. I’m a reflective practitioner so they might not necessarily stay my opinions either )