Wednesday 29 June 2022

Medicine, Morality, Personal Growth: Three Models of Illness and Wellness

If we want to support our friends and loved ones, it is important to understand what we mean when we talk about illness and wellness. It would be easier if everyone approached these topics in the same way, but this is not always the case. Our attitudes towards illness and wellness are heavily influenced by our lived experience, as well as broader societal values and beliefs. In this article I want to discuss three models of illness and wellness which Fran and I have encountered at different times in our lives.

The Medical Model

This is the standard Western medical, scientific approach, and is how I was trained to think of illness and its treatment when I studied pharmacy at university. According to this model, the body is a complex machine and illness occurs when components fail or malfunction. The patient is the owner or inhabitant of a machine which has gone wrong and needs fixing. Diagnosis and treatment are the responsibility of people trained in the medical specialties and the patient’s main role is to follow their advice and instruction. Treatments, including medication and surgery, aim to fix what has gone wrong, or where that is not possible to reduce the impact of symptoms on the life of the patient.

This approach can hugely benefit people living with illness, including mental illness. I have seen how dramatically lithium moderated Fran’s suicidal thinking, reducing it to levels she was able to deal with. I have also witnessed the stabilising effects of medication when she was in mania. Of course, outcomes are not always as precisely targeted as this, nor as positive. Fran has been prescribed a wide range of drugs over the years. Not all were effective and most brought unwanted side effects. Side effects are an unwelcome aspect of Western medical practice, and something many people who have undergone treatment for mental illness will be familiar with. This often leads to a number of different medications being prescribed, either to limit the dosage, and thus the side effects, of individual drugs, or to offset the side effects of one with the positive effects of another.

There is little or no moral or spiritual dimension to this approach, although science and the medical professions sometimes appear so elevated and “obviously right” that anyone doubting their relevance or wanting to try different approaches runs the risk of appearing ungrateful at best, misguided or dangerous at worst.

It is tempting to hand responsibility for the care and wellbeing of our loved ones to those who have been trained to know best. I remember feeling relieved when my mother was severely ill with depression and anxiety and was admitted to hospital. At the time she was probably incapable of making a recovery on her own, and the care she received in hospital was appropriate and supportive. Nevertheless, blind trust in professional “experts” can be disempowering, if it removes the patient’s responsibility, and that of their loved ones, to take a role in their path towards wellness.

The Morality Model

It is my personal view that there is no moral component to illness. Illness is not some evil thing to be overcome by the forces of good. Many “good” people get ill, as do many “bad” people. Guilt and blame can be debilitating emotions and may well interfere with how someone approaches their wellbeing and recovery but as far as I can tell, some “good” people and some “bad” people recover from their illnesses, and some do not. Nevertheless, a number of more or less related views place illness and disease within a moral or religious context. For someone who is religious, this might be helpful and constructive. Their belief in a higher power may help them feel supported, or that there is some deeper meaning to their experience of illness.

There is a line, however, beyond which the link between illness, suffering and belief can take on a darker, even sinister hue. Some maintain that a person becomes ill, or remains ill, because they have been bad in some way, or lack the moral strength to overcome their conditions. The patient may undergo conventional medical treatment but there is an assumption, whether implicitly or explicitly expressed, that they also need to atone or repent if they are to recover fully.

This kind of thinking can lead someone into agonising guilt and despair, not only for whatever wrong they imagine they have committed in the past, but for not atoning, repenting or believing sufficiently in order to be healed. A blessing from a priest or spiritual authority may be comforting to those who believe, but at its most extreme, this kind of thinking can countenance exorcisms on people whose mental health conditions would be better managed with less religion, more compassion, and an appropriate regime of psychiatric care.

Sometimes it is not the patient but the illness or disease which is described in moral terms, especially aggressive, debilitating or potentially fatal conditions. Cancer in particular is frequently portrayed as an evil invading force, which must be hated, resisted, fought, and overcome. The person with cancer is generally held to be a hero, bravely battling the enemy against overwhelming odds.

The situation for those attempting to deal with mental illness is likely to be very different. There is generally a poor distinction between bad behaviour and mental illness. On one hand, those affected by mental ill health tend to be treated with less generosity and greater suspicion than those with other conditions, and their symptoms may be poorly differentiated from immoral or criminal behaviour. On the other hand, those who perpetrate extreme, violent, or malevolent crimes are routinely and habitually assumed to be mentally aberrant, irrespective of evidence or clinical diagnosis. The extreme nature of their crimes places them so far outside the norm that society requires them to be mentally ill so as to place them at a safe distance from the well ones.

The Personal Growth Model

In the third of our models, illness is seen as the expression of issues and lessons that the person needs to become aware of, understand, and work through. I do not agree that all illnesses can be viewed usefully in this way: the approach seeks to attribute meaning and significance to all bodily symptoms, and excludes the possibility that some conditions are the simple result of malfunction in bodily processes. That said, I agree there can be much more to illness, including mental illness, than the symptoms which present themselves on the surface. Effective treatment is likely to involve a broad approach which may include, but is certainly not restricted to, conventional medical or psychiatric intervention.

In the time I have known her, Fran has followed a number of therapeutic approaches to wellness, building a composite approach which works for her and encompasses a number of different techniques. These include medication, but at different times have included hypnotherapy, acupuncture, osteopathy, Emotional Freedom Technique (EFT), meditation, and mindfulness. She has also undertaken to explore the relationship between aspects of her illnesses and long standing issues relating to her childhood, body image, and sense of self-worth.

It seems to me that this kind of approach has merit, providing the person is open to deep and honest self-inquiry, and is able to accept responsibility for certain aspects of their illness without translating that into debilitating guilt, blame and despair.

Bringing It Together

No matter what views you and your friend or loved one hold towards illness and wellness, it is vital to respect the differences in emphasis and approach. No single model is wholly right or totally wrong. Discussing where you agree and disagree will bring you closer together and can lead to a greater understanding of who you are and how you can work best together. As Fran has expressed it:

One can either be actively supportive and compassionate of an ill one.. or judgmental and condemning.. Why I am ill.. I do not know.. I do take responsibility for being as well as I can be.. I have accepted there is no cure and finally that gives me peace and grace.. instead of when I was desperately seeking healing, which created enormous anxiety.. and fear about what people think about me.. those who would judge me judge themselves.. and i pray they don’t have to get ill to learn the lessons..

I have shared my thoughts on three models of illness and wellness, but there will be many others. How do you think about illness and wellness? Do you have the same or similar thoughts about it as your friends and loved ones? Have you ever discussed these topics with them? We’d love to hear your thoughts, either in the comments below or through our contact page.

 

This article is adapted from material original written for our book High Tide Low Tide: The Caring Friend’s Guide to Bipolar Disorder but not included in the final editions.

Photos by National Cancer Institute, Jaclyn Moy, and Jared Rice at Unsplash.

 

Wednesday 22 June 2022

From Thought to Page: Adventures With Teeline Shorthand and Other Writing Systems

In a previous article describing how I distract myself when I’m feeling low, I mentioned that I’d begun learning shorthand. Progress has been slow and I’ve taken a couple of breaks, but I haven’t given up. Last week, a friend asked why I find shorthand so interesting. Her question prompted me to think about my fascination with various writing systems over the years, including practical techniques that help me get my ideas onto the page or screen as simply and easily as possible.

Pitman and Elvish: My Teenage Years

My interest in writing systems goes back to my teenage years. (That’s a long time ago, before anyone asks!) My mother gifted me a book on Pitman shorthand which she’d used herself when she worked in an office. I can still hear her reciting the consonants as an aide to memorising them: “bee, pee, dee, tee, jay, chay ...”

About the same time, I discovered the Middle-earth fantasy writings of J.R.R. Tolkien. I was captivated by the complexity of the world he’d created, with its various races, languages, and writing systems. I taught myself the Dwarf runes and their Anglo-Saxon equivalents, but it was the Elven Tengwar that truly captured my imagination. I learned the English mode well enough to correspond with one friend for a time after we left school for university. Decades later, I’d return to the Tengwar as the basis of the Life, Leaf & Stone system of self-exploration and divination.

It’s hard to explain my early interest in these alternative writing systems, but aesthetics was an important aspect of it. The angular runes appealed less to me than the flowing lines of Pitman shorthand and the Tengwar. I was inspired to develop a writing system of my own. This included both curved and angular letters, but I worked at it until I was happy with how it looked and functioned.

University Note-Taking

I took all my university lecture notes longhand, copying or occasionally typing them up afterwards. I wasn’t proficient enough to use Pitman, and my own writing system wasn’t designed for speed. Instead, I developed abbreviations for frequently used words and phrases to help me keep up with my tutors and lecturers. Most were specific to my degree subject — pharmacy — but there are a few I still use to this day.

My Daily Diary

Perhaps surprisingly, I’ve never used any form of shorthand or secret writing in my personal diaries, which I’ve kept since I was fourteen. I shun even common abbreviations, preferring to write everything out in full.

Palm Grafiti

As some point I bought a Palm IIIxe PDA device, and taught myself the stylised Graffiti input system it uses for text entry. I wrote a large number of articles and short stories on that device. Editing was far easier on my PC, but the PDA was fast and efficient for capturing my ideas and converting them into words. Somehow, the fact I was writing on the screen using a stylus, mimicking the use of a pen or pencil on paper, helped me write creatively.

Android Shortcuts

My PDA served me well for several years but eventually I migrated to an Android mobile phone. There is a Graffiti app for Android, but I never had much success with it. After some experimentation, I settled on the SwiftKey keyboard. What I love most about Swiftkey is the ability to save shortcuts for names, words, and phrases I use frequently or struggle to input correctly. Here are a few examples:

  • aco: a couple of
  • ft: for the
  • fy: for you
  • gm: Good morning
  • md: — (em dash)
  • ppl: people
  • qq: ’ (smart apostrophe)
  • ww: work

This is particularly useful when I’m working on something where a particular word or phrase will be used a lot. I set up two new shortcuts (tl: Teeline and sh: shorthand) when I began working on this blog post.

Coupled with Swiftkey’s excellent correction and predictive capabilities, these shortcuts mean I’m able to get my thoughts down quickly and accurately, whether I’m writing a blog post, talking notes, chatting to friends, or posting to social media. SwiftKey also works when I use my phone or tablet with a Bluetooth keyboard. This combination is close to ideal and enables me to capture what I want to write with the minimum of fuss, error, or inconvenience.

Teeline Shorthand

Given this lifelong interest in different writing modes and systems, it’s perhaps surprising I’ve not explored shorthand more fully until now. That’s partly because I’ve had methods such as Graffiti or SwiftKey to capture my ideas and thoughts electronically. This means I don’t have to type things up afterwards, and also means I can work on a letter or blog post on multiple devices. It’s also true that since university I’ve had little need to take notes at speed, which is shorthand’s main advantage and purpose.

So, why take it up now? My interest was sparked after chatting with a friend who uses shorthand in her work, and who had recently started teaching herself Braille. I thought it would be interesting to learn a new skill too, and began researching different shorthand systems. I rejected Pitman because I thought the light and heavy strokes it uses to differentiate letters (for example to differentiate P and B, and T and D) would be difficult to achieve with the fountain pens I like to use. I narrowed my choice to either Teeline or Gregg, settling on Teeline when I discovered that was the method my friend uses.

If you’re interested in shorthand check out the excellent comparison of Pitman, Gregg, Speedwriting, and Teeline in this article by StudyCorgi.

I treated myself to three books: Teeline Shorthand (Harry Butler), Teeline Gold: The Course Book, and the Teeline Gold: Word List. There’s also a wealth of material online. Teeline Shorthand offer training courses (fees apply) but share sample lessons and practice material for free on their website, Twitter account, and YouTube channel. The Let’s Love Teeline Together YouTube channel is also excellent.

Although I’m far from proficient, I find it interesting how shorthand has become part of my thinking. I haven’t done much graphics work in years but I remember reaching a point with Photoshop where I scarcely had to think about what I wanted to do or how to do it; the software became an extension of my creativity. I’m not there yet with Teeline but I can feel the transition beginning to take place. For example, I can be typing — as I am right now — or writing longhand in my diary, and I find I’m simultaneously forming the Teeline outlines in my head.

I like that Teeline isn’t overly strict and encourages you to adapt or devise new forms if they work better for you. For example, the standard Teeline forms for “good” and “get” are the same, resembling a number “2,” with the curved downward “g” in its standard position and a horizontal stroke representing either “t” (as in got or get) or “d” (as in good). I’ve taken to writing it in a raised “tee-line”position for “got” / “get” and on the baseline for “good.” The significance may be lost on you if you are unfamiliar with Teeline but it makes the words easier to distinguish for me when writing and reading back.

This highlights one of the main frustrations I have with Teeline, which is that certain words are written the same, their difference being given only by context. Other forms, especially for combinations of words, seem less than logical, though that’s partly because the system is still rather new to me. Thus far, I’m more proficient at writing Teeline than reading it, even reading back from my own notes.

I also find some Teeline forms clumsy or ugly, including certain words and names I use a lot. This isn’t an issue if you are only using it to take notes at speed, but it grates with me from an aesthetic perspective. I’ve considered switching to Gregg shorthand which to my eye looks better on the page, but I’ve invested too much time and effort now to change systems. I’m hoping that with time I come to appreciate Teeline’s occasional clunkiness. After all, beauty is in the eye of the beholder.

Next Steps

I enjoy the challenge of learning Teeline, but I’ve yet to find a practical use for it. My friend suggested I use it to take notes during work meetings, or for my shopping lists. I’m not yet sufficiently proficient for the former, and I’m unsure what I might end up buying at the supermarket if I try the latter! I don’t want to use it for my personal diary but I may start a separate shorthand journal and see how I get along with that.

I’d like to explore if there are any ways to generate Teeline on a keyboard, or to type the Teeline outlines (eg “tln” for Teeline, or “abt” for about) and have these automatically expanded into the full words. That would be similar to the shortcuts I’ve set up in SwiftKey. I’m also interested to know if there’s an app which could scan written shorthand and convert it into full text, akin to optical character recognition (OCR) software for regular writing. I’ve not found anything like this yet for Teeline. If you know of anything, please let me know.

Over to You

I hope you’ve enjoyed this peek into my fascination with writing modes and techniques, from runes and Elven script to Graffiti to Teeline. If any of it resonates with you, drop me a line, either in the comments below or via our contact page.

 

Photo by the author at Costa Coffee, Kingston Park, Newcastle upon Tyne.

 

Wednesday 15 June 2022

For Brynn and Aimee: Thank You for Being There When I Don't Want to Talk (and When I Do)

Please be patient with me. Sometimes when I’m quiet it’s because I need to figure myself out. It’s not because I don’t want to talk. Sometimes there are no words for my thoughts.

— Kamla Bolanos

Having friends you trust and feel safe with is hugely important to our mental health and wellbeing. That usually means people we can talk to when we’re unwell, low, stressed, anxious, frustrated, or angry. Sometimes, though, we need people who can be there for us when we don’t want to talk about how we’re feeling.

This isn’t as easy or obvious as it seems because we often hide how we’re feeling. Like most of us, I do the faking fine thing. I tell people I’m fine when I’m not, or downplay how I’m doing. That might be because I know the feeling’s going to shift on its own, because I want to figure things out for myself, or to avoid being bombarded with questions, suggestions, and fixes. I’m okay with that, but it feels better when I don’t have to fib. Sometimes, I want to let my friends know I’m struggling, I just don’t want to have to unpack it all with them there and then.

It’s similar to supportive disengagement but on a much smaller and more temporary scale. I’ve never needed to put a friendship on hold or ask someone not to contact me until I'm ready to re-engage, but there are times when I need to not “talk about my stuff” for a while, whether that’s for a few hours, the rest of the day, or (rarely) a little longer. Having friends who understand this is a blessing.

I want to share two recent occasions when a friend got it absolutely right. The first example took place a week or so ago. My friend Aimee and I had chatted a little in the afternoon. I’d shared my day up to that point, and told her I was feeling tired. She messaged me again in the evening.

How’re you feeling now?

Not bad.

What you been up to?

Since we chatted earlier, absolutely nothing.

In a good way?

In a kinda flat, can’t really be bothered way.

Mmmm. Anything I can do?

Bless you. Not really.

Do you wanna be left alone for a bit?

I’m very happy to have some company.

Ah good! Well, guess what came in the post ...

I appreciated Aimee checking in with me. She picked up on me saying I’d not done anything in the previous few hours, which is rare for me if I’m doing well. She invited me to expand on that, and when it became clear I wasn’t feeling good, asked if there was anything she could do to help. That’s such a simple thing to do, but it’s easy to overlook in our eagerness to offer suggestions and fixes when our friends and loved ones are struggling. She knew I’d take up her offer if I needed to, and I knew I could accept or decline without it affecting our friendship in any way.

The conversation might have ended there, but Aimee went one step further. She accepted there was nothing she could do to help, but asked if I wanted company or space. This is something I’ve learned with Fran. Often the greatest thing we can offer someone who’s struggling is simply to be there for, and with, them. Aimee’s question — “Do you wanna be left alone for a bit?” — gave me the opportunity to decide what I needed most in that moment. I realised it would be nice to have some company, and so it proved. We chatted for a while about a range of things. The conversation didn’t fix my mood, but it provided a welcome distraction.

The second example, with my friend Brynn, happened a few days later.

Hi Marty. How are you?

Tired, but ok.

Long day working from home?

Nah, it went ok. I’ll be going into the office tomorrow.

You sure you’re ok?

Lol I guess so.

What’s funny? I’m sensing flatness. Am I off?

Not really but I’m pretty much always flat these days. Not especially so tonight.

I hear you. Tonight just feels a little different.

It’s clear that Brynn picked up on the fact I wasn’t doing very well, despite my attempts to brush it off as just tiredness or joke it away. Her use of “flatness” shows how well she knows me: it’s my word for when I’m feeling low for no identifiable reason, rather than depressed, upset, or frustrated at something or someone. Her gentle questioning allowed me to explore what I was feeling without requiring me to go into details. We changed the subject, but before long it was clear the conversation wasn’t flowing easily, mostly from my side.

I’m not very chatty today, sorry.

That’s ok, Marty. I understand. How about I let you go?

Yeah, if you don’t mind.

Ok. Have a good night. Talk to you tomorrow.

Good night.

My use of “sorry” there is telling, given my no sorries rule about not apologising for how I’m feeling. Brynn might have picked up on that if we’d not already acknowledged I wasn’t doing too well. On this occasion, she let it pass and offered space by suggesting we closed our conversation there. I accepted gratefully. We picked up again next day.

These conversations may seem unworthy of note; trivial, even. What was so special about them that warrants a blog post of their own? I wasn’t magically cured of my low mood. I didn’t come away with revelatory insights into mental health or supportive friendships. What’s noteworthy about these exchanges is the effect they had on me. I came away from each conversation feeling supported, validated, and respected. This post is my tribute to my friends, and — I hope — a reminder that support isn’t always about what we do for each other, it’s about respecting each other’s wishes, needs, and boundaries.

I’m grateful to have friends like Brynn and Aimee who know how to support me when I don’t want to talk things out, as well as being there for for me when I do.

Thank you.

 

Photo by Laurenz Kleinheider at Unsplash.

 

Wednesday 8 June 2022

How to Educate Yourself about Your Friend's Mental Health Condition

It’s easier to be there for someone if you understand what they’re going through. But how can you understand if you’ve never been there yourself? That’s the situation I found myself in when I met my best friend Fran for the first time in 2011.

Fran lives with three chronic health conditions I’d never experienced and knew nothing about: bipolar disorder, chronic fatigue syndrome (CFS/ME), and fibromyalgia. Being her friend didn’t mean I had to become an expert in any of these but I wanted to learn as much as I could, so I could be there for her as effectively as possible.

I’m sharing my education journey in the hope it might help someone in a similar position. I’ll focus on bipolar disorder but the principles apply no matter what mental or physical health condition your friend or loved one lives with. It’s also relevant to other lived experience including abuse, bereavement, discrimination, self-harm, stigma, suicidality, or trauma.

Whatever your friend’s situation, approach educating yourself about it as a privileged insight into something you may never fully understand.

Why Bother?

You might wonder why you’d want to take the time and trouble to learn about your friend’s health condition. What’s in it for you? Fran never asked or expected me to educate myself about her situation, but our friendship has benefited enormously in many ways. Yours can too.

  • You’ll be more aware of what your friend is going through.
  • You’ll be more aware of, and better understand, potential treatment options.
  • You’ll be better placed to support your friend in ways that are helpful to them.
  • You’ll find it easier to hold an open and non-judgemental space for your friend to talk about what’s going on for them.

Most important of all, you will demonstrate your commitment to your friendship. Your friend is far more than their illness and symptoms, but by taking time to learn what you can, you’re acknowledging the impact they have in your friend’s life.

Educating yourself isn’t about proving what a great person you are, diagnosing your friend or helping them self-diagnose, showing you know more than they do, telling them what to do, or intervening in their life or treatment. The only exception to that is if you feel they are in urgent need of help or are at immediate risk.

You’re not doing it solely for your friend, however. In Why Do You Do It? I described some of the things I’ve learned about myself and how much I’ve gained personally.

I am a better person for knowing Fran. I have a greater understanding of my strengths, values, weaknesses, and vulnerabilities than ever before. I have learned more about mental and invisible illness, suicidal thinking, stigma, determination, courage, and responsibility since we became friends than in the fifty years before we met. [...] I have greatly expanded my circle of friends, met people who feel safe sharing their stories in response to mine, and learned how it feels to offer my skills and experience in the service of others. I have grown — and continue to grow — as a friend and as a man.

I’ve shared a few further insights in a post titled Three Things I Wish People Knew about Loving Someone with Mental Illness.

How Much Do I Need to Know?

No one is suggesting you enrol with your local school of medicine or train as a counsellor or therapist. Fran doesn’t need me to be an expert. She is the expert in how her illnesses affect her, and has professionals to fulfil those specialist roles. It took a while for me to understand where I fit into that team, what I could usefully learn, and how my unique perspective could benefit her most. As I describe in our book:

At first, I imagined I could discover all I needed to know by talking with Fran and spending time with her. I learned a great deal, but after a while I realised I needed additional sources of information. No book, website, or training course can tell me how illness affects Fran personally, but she does not know everything about mental illness and cannot provide a broader, impartial perspective. I seek to educate myself by talking to people with lived experience, by reading books and online material, by taking relevant courses and training, and by participating in the wider mental health community.

Let’s take a look at my journey in a little more detail.

Start With What You Know Already

It wasn’t just that Fran lived with three illnesses I didn’t understand. More fundamentally, she lived with illness, and I needed to get my head around what that meant before I could move on to the details. It helped that we were able to discuss what wellness and illness meant to each of us, and the very different life experiences that had brought us to those individual understandings. Acknowledging the differences provided a solid foundation for the next stages in my education journey. You can read my experience of illness here.

Talk to People With Lived Experience

There’s no better way to understand what it means to live with illness than by talking with people who actually do. Fran and other friends have encouraged me to learn about their health conditions. It’s important to remember, however, that it’s not their responsibility to educate me. In particular, there are times when they have far too much going on in their lives to help me understand. I recall one friend who found it exhausting having to explain things to me all the time, especially when she was struggling. At such times, she needed friends who understood what she was dealing with because they’d been there themselves.

I learn best by exploring what Fran or other friends are experiencing in the moment, rather than trying to understand everything all at once or treating them like a reference textbook. Relentless questioning is unnecessary and unkind, but asking appropriate questions can help each of you explore what’s going on. My friend and fellow mental health blogger Aimee Wilson expressed this beautifully in an open letter to me on her blog:

I love that you ask me questions when I’m struggling because it’s much more helpful than you just sitting there and nodding along, pretending to understand.

I’ve explored what I mean by appropriate questions in a previous article. Bear in mind there may be things your friend is unwilling or unable to talk about, either at that particular time or at all. If so, respect your friend’s boundaries and don’t push for more than they’re prepared to share with you.

Asking questions implies listening to the answers. Listening is an important skill in itself and harder than it seems. Treat it as part of your education journey. As well as learning about your friend’s health condition, you’re learning to communicate effectively and compassionately. One of the most valuable lessons I learned is that there are different types of caring conversation, depending on a person’s needs at the time.

It’s not all about symptoms and treatments. There are some things you can only learn by talking with someone who has lived experience, such as the determination it takes to keep moving forward despite crippling anxiety, depression, insomnia, or suicidality; how it feels to face stigma and discrimination from people with no interest in understanding; how disheartening it can be to ask for help only to find none available; or the courage it takes to unravel past trauma though counselling and therapy.

Not everything will be easy to hear. I’ve shared a few examples in a post titled Four Things It’s Hard for a Mental Health Ally to Hear (And Why It’s Important to Listen).

Books and Online Resources

I’ve found a wide range of books useful, including memoirs and autobiographies by authors with lived experience, biographies, and books written for partners, carers, and friends. Of these, the final category was by far the least represented. There were books for partners, such as When Someone You Love is Bipolar: Help and Support for You and Your Partner, by Cynthia G. Last, and Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner, by Julie A. Fast and John D. Preston, but nothing specifically for friends. Fran and I wrote High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder to address that need.

I recommend the Stigma Fighters collections of short personal stories by people with experience of a range of mental health conditions. In four volumes, the Stigma Fighters anthologies are available in print and e-book editions. The stories are also available on the Stigma Fighters website. (You can find my contribution here.) The range of diagnoses, symptoms, and situations the authors describe helped me appreciate both the uniqueness of someone’s experience, and certain repeated or common themes.

Blogs, vlogs, and podcasts are another valuable resource, not least because they are usually intensely personal and tend to be updated frequently. For bipolar disorder I recommend Julie A. Fast’s blog Bipolar Happens, and her articles at BP Hope magazine and Health Central. If you want to learn about living with borderline personality disorder (BPD) check out my friend Aimee Wilson’s blog I’m NOT Disordered.

Two podcasts by mental health author and speaker Gabe Howard deserve mention: Inside Mental Health and A Bipolar, a Schizophrenic, and a Podcast. The latter, co-hosted by Michelle Hammer, “looks at life through the unique lens of people living with depression, schizophrenia, and bipolar disorder.”

Courses and Training

There’s a wide range of courses and training material, much of which is online and either free or low-cost. Some more expensive training, such as Mental Health First Aid (MHFA) or Applied Suicide Intervention Skills Training (ASIST) may be free or subsidised depending where you live and your personal circumstances. I’ve taken these and many other courses over the years and found most interesting and informative. You can find a selection on our resources page; we also have a list of online suicide awareness courses and podcasts. I particularly recommend Beating Bipolar and the free suicide awareness training at ZSA.

The Wider Mental Health Community

Fran had good connections with local mental health organisations, including the Maine chapter of the National Alliance on Mental Illness (NAMI) and Family Hope. I learned a lot from these but at a certain point I realised it would help to connect with similar organisations here in the UK. This led to me volunteering with the anti-stigma campaign Time to Change. I learned a great deal about myself in the process, met some amazing people, and made several lasting friendships. Volunteering gave me the confidence to become involved with mental health and wellbeing initiatives in my place of work. This opened opportunities to attend conferences and events, and become part of the wider Mental Health First Aider network.

It’s worth noting that some groups or resources may not be available to you without relevant lived experience. I was privileged to attend a few courses run by my local recovery college, including sessions on self-harm and wellness recovery action planning (WRAP). The college meant a lot to me, but it’s run by people with lived experience for people with lived experience, and I respect the fact I couldn’t continue attending.

I’ve found several mental health organisations helpful. No Stigmas offers excellent online ally training covering self-care, peer support, and advocacy. I joined Mind, Bipolar UK, and Bring Change 2 Mind for a broader awareness of news and issues across the mental health community.

Stay Humble and Open

As valuable as it is to educate yourself, it’s important to remain realistic and humble. No matter how many conversations you have, books you read, or courses you take, you’ll never really know what it’s like for your friend. They’re the experts when it comes to the life they’re living, the issues they deal with, and the support and help they need.

Recognise too that you’ll still get things wrong! This might be because you haven’t learned enough about what your friend is going through, or you’ve made assumptions that are wrong, inappropriate, or unhelpful. Treat each mistake as an opportunity for learning. If you’re honest and open about your mistakes you and your friend can both grow from the experience. I’m reminded of a conversation with Aimee, after I’d messed up badly.

I’m not sure if you agree, Aimee, but I’d say we understand there are times we will get it wrong, and that’s OK. It might not feel OK at the time but it will be when we are able to step back a little.

Definitely! And I think more and more we’re learning not to feel like total failures if we do get it wrong, and not blame one another for it.

It wasn’t the first or last time I’ve got it wrong, but we continue to be honest with each other when problems arise.

Learning About You Too

While you’re learning about what your friend goes through, don’t neglect your needs as a supportive friend. That’s something you’re learning about too. Even if you don’t consider yourself in a caregiver role, check out organisations such as Carers UK, Carers Trust, or government sites such as this UK page on support and benefits for carers.

Many organisations that support people living with illness have information and resources for caregivers, for example Bipolar UK, and Mind. Look for carer groups on social media too. Julie A. Fast runs two Facebook groups: one for partners of people with bipolar or schizoaffective disorder, and one for parents and caregivers. Hearing what other people in supportive roles have learned can add to your understanding.

I began this journey with no personal experience of mental illness, but learning what Fran and other friends live with has given me a much greater understanding of my own mental and physical health. I’ve explored this in such posts as Return to Down, THIS BOY GETS SAD TOO, and How International Men’s Day Inspired My First Doctor’s Appointment in 30 Years.

I’ve found that being open and honest about what I’m going through — both here on our blog and in private with friends — makes it easier to ask for help when I need it. It also helps my friends support me from a place of greater understanding. Aimee expressed this well in a recent conversation: “I’m glad you can be honest with me, Marty. No one can support a person who isn’t honest about how they feel, so you being open enables me to really be there for you.”

Over to You

In this article I’ve shared how I’ve approached educating myself about my friends’ experiences with illness. If you’ve been in a similar situation, what helped you most? What worked or didn’t work? Do you feel your friendship benefited? If you live with illness, what advice would you give a friend who wants to learn more about your situation? Do you want people to know, or does that feel like an imposition? Whose responsibility is it to educate people about what it means to live with illness?

Drop a comment below, or get in touch through our contact page.

 

Image by Tim Mossholder at Unsplash.