Diary of a busy practitioner, juggling work and family somewhere in England. This week: the mental health continuum

Recently we had some training at work and it was so, so good that I came home and went through my notes with my husband. In fact, that evening I ordered the kids’ version of the pack. You can imagine, it wasn’t about the Residence Nil Rate Band. It was about mental health. 


What I think has been so hard for people, over the last generation and back further, to understand is what it means to have a mental health problem. So often we label health conditions, and sometimes labels are good- 'I have chicken pox/alcoholism/post-natal depression' can all be very useful in deciding whether we need calamine, a support group or anti-depressants, but labels can be damaging too, and don’t leave much room for grey areas.

I’ve never really been sure if I had post-natal depression after having DALC2, and I feel bad labelling myself in the same category as people who felt much worse. I know that I didn’t feel joyous like I did with DALC1, I didn’t get hungry, I felt low even when I should have been having a lovely time, and all at a time when we had moved away from family and friends, I was struggling with breastfeeding, my gran was getting very ill and I would go full days without seeing another adult.

Recently, DALC1 has been having some real difficulties with regulating her emotions. Having tried lots of different things ourselves, we have decided to get her to speak to a counsellor. My dad’s reaction to this was 'But she’s not, for want of a better word, loony!' Please just think of a better word, Dad.

According to the training, the current method for thinking about mental health is that we are all on a 'mental health continuum'- with wellbeing at one end, and serious conditions like psychosis at the other. We move up and down this continuum- stress causes us to move down and a whole range of factors help us to move back up.

This idea that it is stress that causes us to slip down the continuum was really enlightening for me. Stress can come from an event, like giving birth, moving house or someone saying something mean to you at school. Stress can also come from a lifestyle. A solicitor from another firm told me recently that he constantly feels like he is on a hamster wheel that is going slightly too fast.

The twelve factors that all play an important role in wellbeing include physical ones like food and sleep, as well as emotional factors including having an emotional connection to others, privacy, attention, security and control.

It has done me so much good to think that, after having DALC2, I was somewhere quite far below average on the continuum, rather than having to give it a name or compare myself to others. It is also useful when I think of DALC1. We decided not to wait for her to fall further down the continuum- because, if only she knew, there are more stressful times ahead than whatever she is experiencing now- but rather get someone who knows what they are doing to support her, and help her to be more resilient and able to work out which of the 12 needs she is deficient in.

My husband won’t like this much but I know I still don’t have enough emotional connection. In no particular order I have a beautiful dog, a loving husband and two kids I love to smithereens, but since we moved house I don’t have friends who I get to see very often. For me, I’m talking about friends who knew me before I had kids, friends who would never think I was a bad mum because they know I am a good person, friends who know me through and through. I have them on Whatsapp, but I don’t have them nearby. At Christmas I went shopping with an old, close friend and we wandered around the shops like we did when we were fourteen. Just doing this together- not separating so we could get more done in the time available- was so refreshing for me.

So my message is this. If you are a managing partner or in charge of HR, look into getting some mental health training for all your staff, and make it as close to compulsory as you can or the people who need it will stay sitting at their desk drowning in emails. If you are a team leader and one of your team is permanently stressed, have a think about where that is going to end, and how productive he or she will be when they are on long term sick leave as a result. Actually, have a think about how productive they are now- as I know I am much less productive when I am stressed out of my wits. And for yourself, take stock. You don’t have to have a condition or a label to need support meeting your needs. Don’t waste the best years of your life anywhere other than at the 'wellbeing' end of the mental health continuum- or striving to get you and the people you love there.