Dr Robert G MacDonald, Public Advisor ARC NWC

INTRODUCTION

I would like talk about Mental Illness which is a subject, for personal reasons, is always at the front and the back of my mind. Men need to talk about Mental Illness, it’s “Seldom Heard” because its has a secret hidden stigma. It needs to be bought into the light from its dark place where it’s thrives and hides in the dark side of the brain.

2 Why is it acceptable to talk about physical illness eg Diabetes Type One, Kidney Disease, heart disease or diverticulitis ? The Big C and Breast Cancer never used to be spoken about but things have with “The Maggies” projects which changed attitudes and hopefully got better. Even now Mens Prostates are increasingly transparent and are featured on TV for us all too see…

But not Mental Illness …it remains a hidden condition.
In polite company we are never quite sure what to Call it.
Mad, Madness, Mental Illness, Mental Disorder, schizophrenia , Insane, Crazy, Disturbed …so we just secretly call IT.

My name is Rob MacDonald and I am an Architect and formerly a University Reader in a School of Architecture. All professions have their mystical languages that need to be clarified and Mental Health is no different, it certainly needs to be decluttered. I recently, attended an online Webinar about Mental Health & Art. One of the presenters described patients having a “fixation”. I did not understand and the meaning was helpfully explained as “ losing control.”

3 Mens ( and Womens) Mental Health and Well being is so important and needs to be spoken about in a User Friendly Language and needs to be discussed openly by people with direct lived living experiences together with professionals and academics. Mental health has important implications for physical and mental longevity. Does mental Health have associations and connections with Living with Dementia ?

Many high profile celebrities have been talking about Mental Health; Prince Harry, Prince William, Ruby Wax, Frank Bruno, Robin Williams (might have talked about it but he came to a very Tragic end and that’s the reason why we all must talk). Amy Winehouse took her own life with drugs and alcohol. Caroline Flack pre Suicide, left a message saying be kind. Winston Churchill called it his Black Dog. Horacio Clare is Bi-Polar and he writes about his Lived Experiences in “Heavy Light, A Journey Through Madness, Mania and Healing”.

4 But what about us “Seldom Heard None Celebrities” ? We all feel the deep emotional need to talk about Mental Health and Well being. Our voices must be listened too and lessons learnt for all.
I want to talk about Bi-Polar Effective Disorder. That’s my own “Seldom Heard” condition. Once It was called Manic Depression. It comprises very low depressive moods swings to very high and dangerous hyper euphoric creative moods.

It was Once described to me by a Human Resources Manager as being “Fashionable”. Was this a shocking sick joke or a clear sign of the stigma ?
We all need to reduce the stigma because its actually just not very funny it’s actually real for The Seldom Heard many.
It’s not the Madness of King George or One Flew over the Cuckoo’s Nest.

5 The list of Mental illnesses is endless and seems to go on and on…
Each with its own complex symptoms
It’s almost a spectrum from one condition to another
Perhaps they are all connected all starting with anxiety ?

Stress in the work place
Anxiety
Burnout
panic disorders
Depression
Major Depressive Disorder
Psychosis
Manic Depression
Postpartum Psychosis
Schizophrenia
Personality Disorders
Eating Disorders
Etc Etc

6 The common held opinion is that 1:4 of the population experience a Mental Illness during their life time. That’s 25% or a quarter, now Globally that’s a lot of people. The esteemed Free News Paper & Research publication, “The Metro” says it’s 1:3… Others say it’s 1:8. The more that I speak too people the more that I agree with at least 1:3. Especially, since and during the Pandemic Lock Downs. Will Mental illness be another long standing Mental legacy of the pandemic ? Apparently, of all suicides 78% are men; this is terrifying and frightening and that’s why MerseyCares Zero Tolerance is very important and why “James Place” is an vital space of safety.

So we can Search Google: How many men experience Bi-Polar Disorder ? It’s revealing and a shocking secret hidden condition.
My bi-polar started with Anxiety Attacks at the age of 19.
I am now 72 and have experienced many episode’s during my Life Time.

7 For me a Bi-Polar episodes start at 2.00 in the night.
Alone in a very dark room
With chest pains of the hyperchronical kind
Taking myself to AE
Which is believe, me is Madness on a Saturday Night
I am given some Prozac
Calm down pills

8 Then you go to the GP
Who prescribes some Valium
Which makes me feel even worst
Go to sleep pills
even suggests a Pint of Guinness…to relax !

9 Has anybody ever taken anti depressants ?
Smoked Grass or Weed
Yes, how about eating cake from a brown cafe in Amsterdam ?
Sleeping Tablets
Drank a double whiskey or
8 pints of larger
They are all publicly acceptable mind changing substances

Turn me upside down and I rattle with:
The 13 contents of my two Tins of pills which contains:-
Lithium,(Priadel), Quetiapine, Volpraic Acid, Metaphormine,
Amlodine, Simastatin, Omeptazole, Rampril, Levothoxine, fenofibrate and of course the little old aspirin !

All mixed together with a big injections of Insulin…Mens illnesses are a complex mix of the Mental and Physical. “No physical health without mental health”. Do they all need a coordinated complex wholistic therapeutic response not a pharmaceutical concoction.
? What are the social, psychological, environmental and psychiatric roots of Mental illness amongst men ?

10 We all have our ups and downs but Bi-Polar is much more serious especially the manic euphoric episodes.
The big research question should be
The Shakespearean question “ to be or not to be”, does anxiety at 19 lead to manic depression at 40 ? Some psychiatrists say the Depression is part of the “Human Condition” ( see Andrew Soloman, Ted Talk on You Tube ) which must be good news for the pharmaceutical industry…

11 Manic Episodes might start again in the night, run up and down the street in my Pyjamas and shoeless feet, and back to a empty house.
Get the car keys , run too the car, no seat belt and put my foot down.
Smash the car round a lamp post, the police breathalyser me…said I had not been drinking but I must be high on something ? “Suicide is tragic and comes in many guises” see The “Mash” Theme Song, is suicide a rational act or a complete manic loss of control ? That’s why talking about the Big S and the Seldom Heard voices are so vital.

12 So how too get Sectioned Under The Mental Health Act ? Was it so inappropriate to wave a walking stick around in a clinic waiting room ? I was assessed instantly on the spot by a psychiatrist, GP, social worker and a community mental health nurse, Get a free trip to a low secure “hospital”, hand cuffed in a police car with two police men.

Then I was restrained and pressed too the ground by male nurses, pricked in the bottom with a knock out jab and left sweating on a mattress on the floor overnight, creased in my sweating wet best suit. I was placed in a seclusion room without outside windows on two occasions. A single bedroom is a lonely place, with the door half ajar for 15 min observation. The only visitor was a Robin Red Breast my natural friend.

13 Then moved to a shared sex bedroom; just think about the waking bathroom noises and the chattering of nurses. Sleep is supposed to be good for healing but a shared sex bedroom is not so good. In the morning showering under observation. Making tea and toast also under observation. Therapy is washing my own underwear.

14 Laughter just about gets you through this Lived Experience. Yes It’s just Like One Flew Over a Cuckoo’s Nest on a Saturday Night and the Smoking Lounge it’s madness and mental.

How about Getting a piazza slice from the outside,
Fighting over the remote control, to watch Dads Army or Steptoe and Son
And Train Spotting
But the dinning room is even more Bedlam
Fighting over the cutlery and for your food.

15 So let’s have some therapeutic activity.
How about Line Dancing, You know “Islands in the Stream” by Dolly Parton, sing and dance along if you like with your Cowboy Hats and Boots.

So how to escape ? Try running away from the ward with a big red bag full of possessions , Pyjama’s, undies and socks…inappropriate behaviour…so Put into another seclusion suite, again a small windowless room.

We all must be mental too put someone into a windowless room; don’t most prisoners have windows ?
A room without a window is Mental torture.

The worst threatened torture is “Electro Shock Treatment”(which is a real threat and no joke. Clearly it frazzles your brain so it’s best too avoid the little wooden box and two electrodes if you can ).

16 So how to escape ? The Tribunal is a route out, facing a
Panel of psychiatrists
Social Workers
GPs
All with the clip boards of power to decide
The question is “Am I safe to go home and be in the community “ ?

A neutral Minister of Religion is very supportive, helpful and spiritual.

17 Preparing to go home :
Good positive therapy is a trip in a mini bus to a natural parkland or landscape.
Good positive therapy is a visit to garden centre and shown how to make a hanging basket,
Good positive therapy is the advise to take a walk in the park/ hospital grounds,
See the yellow spring daffodils and the squirrels nibbling their nuts,
Good positive therapy is to go outside and talk to people.

So that’s what I try too do Now.

18 Andrew Solomon ( the NY Ted Talk Psychiatrist) says there is a difference between “Happiness and Vitality”.
Vitality is about “being well” and is certainly the opposite of Bi-Polar.
Now I seek out vitality in most things that I do.

Try to live in the Now, The Present.

I draw, paint, write about “Mental Health and Being Well” and teach “Art for Well Being”….For MerseyCare NHS Foundation Trust and I am a Design Champion.
My teaching is with Service Users in The Life Room Recovery Collages. Together we co-produce therapeutic art.

Impression of Bi-Polar drawn and painted by Robert MacDonald During COVID lock down, Medusa and Sunlight.