Mental health: ethnic minority experiences

What else helps

There are many different ways of managing mental health problems, including taking medication, using alternative therapies or seeking comfort in spiritual beliefs and practices. People also develop other ways of managing that suit them and their lifestyle. For example, many people talked about looking after themselves or doing “self-healing things” and a few people said they changed their lifestyle altogether. These strategies often involved doing particular things or, in some cases, avoiding things.

Helpful activities
Many people found exercising, running, swimming, or going to the gym helpful. Others enjoyed getting out of the house to do some shopping or just for a walk: “just being in the fresh air lifts my spirit and energises me”. 

Sarah finds prayer and exercise help her manage. (Original interview in Cantonese, text in English).

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Sarah finds prayer and exercise help her manage. (Original interview in Cantonese, text in English).

Age at interview: 48
Sex: Female
Age at diagnosis: 46
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Do you have any other ways to release your stress, other than these?

No, not really. Prayers I guess, I pray, and also church. 

How about in your daily life? You would pray right?

Ya, pray, and leave it to God. 

Nothing other than these?

no, I don't do any other things. 

What about exercises then?

Oh yes, I do exercises. I walk in parks, greet others [chuckle].

Does that help?

Ya, that's helpful. go shopping, cook, [chuckle]. Make and eat carrot cakes [chuckle].

Patricia weighs up the differences between being in the UK and in her home country; at home she...

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Patricia weighs up the differences between being in the UK and in her home country; at home she...

Age at interview: 25
Sex: Female
Age at diagnosis: 23
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As someone that has been over in the UK for nine months I think you said. I just wonder whether you feel if that's played any part in how you feel and what part it it's played really, being away from home I suppose is what I'm, I'm asking? 

Right. When I, as I said when, when I left Portugal I always thought I'm going to leave the panic attacks behind because the whole situation helps. But no. They will travel with you definitely. And the whole anxiety thing will travel with you. But because you're living a sort of new life when you emigrate, you always think that you no longer have those symptoms and those, you know, and that. The whole, all the problem you think it disappears but eventually it will come just, just give it some time until they settle down and it's you again. And they will come anyway. I don't, I don't think being in the UK triggers more panic attacks. As I say it has good things and it has bad things on the whole thing. 

The good things is that I know there's a better response here in terms of, in terms of doctors and people and even society. On the other hand I don't have my friends here. I don't, I have to explain the whole thing to the new people I meet. And certainly the way that people work and how much they work in the UK doesn't help because you can't really sort of you can't say, 'Can I have just a few minutes more of, you know, of lunch break because, you know, I'm not feeling very well today.' You know, you can ask but obviously that's not the ideal situation, because people commit themselves so much to work here that it becomes difficult. Do you see what I mean? And it, it becomes difficult for instance to be able to go for a wander because it's, I consider it a more dangerous place to live in because, you know, it's a bit dangerous out there. So I might not, it might not be a good idea to be a good idea to leave the house and go for a wander which sometimes help just sort or making a panic attack a bit more or making you less anxious. So there are good things and bad things. I suppose there might be, I don't know, I don't think I'm in, I'm in a position to say it's better to be here than in, because Portugal's my home. So it, it's difficult. And I say in terms of response it's been very good that so far. I know that I'm still waiting to get therapy or to be seen by somebody. But at least I know that these people have dealt with panic attacks before. They know probably exactly what I'm going through. And I can join other groups for instance groups that I've mentioned before on the internet. And like minded people I can meet them and talk to them about them about this and it will much easier. So I think yes maybe overall if you want a definite response, maybe overall it's better to be in UK.
 

Many people talked about keeping busy or doing things like hobbies or watching television as a form of distraction. People also benefited from making time for themselves and resting.

It helps Jay if she makes time for herself and for her voices; she also found it helpful talking...

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It helps Jay if she makes time for herself and for her voices; she also found it helpful talking...

Age at interview: 42
Sex: Female
Age at diagnosis: 34
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 I think I have, I have my things that I do that only I can enjoy. Like I have my nails done every month, it's my time to feel nice. And I sit there like that, and my friend knows not to speak to me. I just like to enjoy my experience of someone pampering me. And I have my feet done. 

And while, while that is expensive to do, but I do work, so that's why I do it. But I think everybody should find their something. I mean lately I've been giving up my pedicures, because I'm teaching myself to do my own pedicures again, and I'm going for massages, neck, shoulders and back massages to kind of take some of the knots out and stuff like that. And I started doing that because I quite like it, and going for infrared sauna and that sort of thing because it's kind of, nobody can enjoy it like me. And that half an hour, hour and a half is just for me. And in, in order for me to keep myself on, on that equilibrium, I do that religiously. Else what the hell am I working for? Just to pay bills? No, there's got to be something. I am a clothes-aholic, but I've calmed down. That used to be number one, but that can be very disruptive. So it's not a good one, it's not a good one. 

 I s-, I find that if I make time for my voices, a time where I call it a mute conference with myself, if I make time every month, or every week if I'm experiencing a lot of disturbance from them, to hear what they're saying. Sometimes they have valid comments, sometimes they don't. But to hear what they're saying and to talk myself round to the belief that I am right and what they're saying will actually harm me and it won't cure whatever issue they say it's going to cure. Because they're kind of like the Devil, do you know what I mean? And I can understand when people say, 'The Devil's telling me to, the Devil's telling me to.' Because it is, it is that kind of, in order to make you feel better you tell me something that, to do that is going to make me feel pain or cause death even, you know. So it's, it's giving, giving time out for that along with your own pampering type thing that, it might not even be something like that, it might be you like to paint. Give yourself the right to have three hours to do your painting even. Simple as that. 

And the other thing is that when I recognise that something or someone is causing the balance to shake, I address it at its very earliest point, to alert that person to the fact that, 'You are doing this. It's making me feel like this, and I need you to stop. If you cannot stop this kind of behaviour, then you're not the right sort of person to be in my life and you have to go.' And I tell people this. And some people think, 'Who the hell does she think she is?' No, I'm me and I'm protecting me. This is what I need to do to protect me'

So I went to this group and I thought to myself, 'Good Lord, I'm quite' I'm quite sane really' [laughs]. Most of the time I think I'm a complete nutcase, but these people seemed to be dealing with a lot more than what I'm dealing with, or they were not where I am in terms of making peace with their voices. There were still levels of denial and not understanding where these voices came from or how they were created due to past trauma. And it was quite good because the facilitator, they talked a lot about coming to term, and helping the groups come to terms with it, and understanding what hearing voices are and, you know, the history of hearing voices. And I'm in some extremely good company, which is nice to know. 

Some of the greats in the world were voice-hearers. Even though I knew that these people professed to hear a voice, the voice of God, the voice of whoever, I never made the connection with my experience. And that's wh

Having a sense of humour and having a laugh with friends was also important for some. Several people also mentioned their family responsibilities as something that helped them to cope, although these could also be stressful. (See 'The role of family, friends & carers'.)

Ataur occupies his mind with his family responsibilities, although sometimes it can add to his...

Ataur occupies his mind with his family responsibilities, although sometimes it can add to his...

Age at interview: 60
Sex: Male
Age at diagnosis: 17
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Because I have a responsible, I'm head of the family, not my, my, not only my family in my whole brother and sister I'm the oldest one. So before my father was responsible for everything, when my father passed away in 1985 it has come to my shoulder, everything. So any of my brother have a problem I have to settle it or I have to help it, I have to go down, jump on it and settle it. Well help things out in here and abroad as well. So that's why I have more time to concentrate on their family problem as well. So this, this sometimes I get depression and sometimes my depression get easier for me to occupy myself to dealing with something or sort of thing, you know. It's, as far as I, I got experience and depression if you do not talk to anybody if you stay at home or lonely yourself and think over and over and over and over then you get more depressed. Then the, and if you, well it is, I, I try myself, when I'm depressed I go out, I enjoy myself, I talk to friends, I talk to my relatives, what happening to me. They said, 'Oh forget it, why you, why you worried for nothing? What has happened have to be happen, will happen, so you can't stop it.' So that's helped me 50%, they encourage me, 'Forget it, let it go, that's what's going to happen or if it happened it is, it is, it is happening so you can't stop it.' So that's why I'm still fit, although I take a tablet and all those things I'm alright.

So just, that's interesting what you were saying about having the family responsibility, do you think that's part of it, part of the reason that sometimes you get depressed because you know that you have the responsibly for the family?

Well yes some, some yes definitely [nodding] because if you are head of the family although you don't live together but any problem for their problem, my brother and his wife, I have five brothers after me, I'm six, we are six brothers, they would ask the oldest one. 'This is the problem what shall I do?' Definitely, well this is my, our society or and up to now all the brothers is asking me, let me know what they're doing, what they're happening what they're thinking and they encourage me, 'Don't worry for us, you stay well, we are alright, you don't have to worry for us.' But although it's come I know that my younger brothers for the sake of my health and my problem, my depression problem they're saying something not to worry. But I always contact them or their wife, how they're doing, what they're doing.

Talking and expressing feelings either to family and friends or to other people with mental health problems also helps. Comparing experiences with other people was found to be especially useful (see 'Support from mental health charities & support groups') [see Jay above]. One woman enjoyed going to a Latin American group to dance and talk to people in her own language. A few people valued holidays in their own country where they could forget their problems and relax.

Ataur enjoys going back to his home country where he can forget everything.

Ataur enjoys going back to his home country where he can forget everything.

Age at interview: 60
Sex: Male
Age at diagnosis: 17
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Here I have a business, I have a children, I have a wife, I have brothers, their children, so you are not free, you are occupied all the time. And you concentrate in here how you make money, if you don't make money then you can't pay your children's school, school dinner money. Because I'm a business man I haven't got all my life, all my life I don't have one single penny benefit from the government neither my children, I provide my children for everything. If you don't do a business you can't pay your staff, if you don't do business I can't pay my council tax, the tax every year goes up and up and up and my income business is going down and down because there's a lot of competition and things like that. 

As you know I'm running a restaurant so I'm, all the time is a pressure in here. When I go home a few days after I forget this side, how I forget if the restaurant not running what can I do? I feel it, I put to my mind inside. I phone my wife, they're alright. If my wife goes with me I leave my daughter or somebody, or my mother even, two of my daughters they're alright. And I'm meeting with my one family to the other family, one group of friends to the other group of friends so all the time I'm laughing and joking and I couldn't give a damn I say, 'Oh let it, [breathes out] what can I do, I'm Bangladesh 6,000 miles away, I can't do nothing.' So I don't know this is the way I feel and that's why I get more relaxed. Like a holiday you go, you forget everything, relax two weeks, three weeks. When we go for, we don't go every year, five, six years after we go for two months, three months, six months. And when I stay six months I don't feel like to come. But when I come her I get this problem, that problem that problem lying on me and then you're back to square.

So is it right then, have I understood correctly that it's because it's a bit like, it's a bit like a holiday?

Yes [nods].

Some people mentioned that paid or voluntary work also acted as a distraction as well as providing a sense of achievement or purpose.

Reena says work helped her "to keep my mind fresh". (Audio in Bengali, text in English).

Reena says work helped her "to keep my mind fresh". (Audio in Bengali, text in English).

Age at interview: 42
Sex: Female
Age at diagnosis: 32
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So slowly I gained confidence, I had the courage. I would have to stand up, have to talk, have to try. So they sent me on a course. I had to go. So because of all this support and their encouragement I started a course. I took four lessons and then gave up driving lessons. I was doing well with my driving. Even the instructor asked whether I used to cycle before or anything like that. I said that I hadn't so he said, “How come you are so good at driving? You have got all the right ideas.” And then I went to the school and asked for a job. They gave me Year three. Now I was not able to manage Year three, I did not know enough English so I said, “Put me in the nursery group.” So they offered me playground duty, so I took the playground job. Then they suggested to me to go on a course. I went for the course and then because of my illness, my baby started eating other things, I joined with the nurses. I worked with them for about three months.

Voluntary work?

All these were voluntary work, it was not regular work. I just used to be with them, like at the school I didn't do full-time, just two or three days, it was not really a job but to just keep my mind fresh. It was better than sitting at home doing nothing. So doctors said, “When you are fed up with the work, you just write it all down and come away. You come home and then either watch a film or read a book or be with friends. But don't force yourself to do the work. If you do you will get bored and have problems.” And, you know, if I were nervous I would have anxiety attacks. So I started following their advice. Like if I was cooking and felt bad, then I would just leave everything and go out with them maybe to the park and have a chat and freshen my mind that way. Or sometimes I would just lie down for 15 minutes.

Some people described how helpful writing had been for them, helping them to express themselves and giving them a purpose. Several people had written their life story, or poetry and letters. Keeping a diary helped some become aware of what progress they had made [see Edward below].

Nelsy wrote letters to members of her family to express her anger.

Nelsy wrote letters to members of her family to express her anger.

Age at interview: 56
Sex: Female
Age at diagnosis: 48
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So I began to deal with my anger writing letters to my mum, nine letters altogether, telling, explaining her, 'look I'm angry with you because of this and that and that and that'. At the time I was in a therapy group, and I was telling the group what I was doing, and I began to realise how healthy I began to feel. So I began to think, 'well this is interesting, it's not matter of telling people about how my mum was, it's about telling her how angry I am with her.' 

So I did it and I knew that was going to be angry with me, she wouldn't like it but I risked it. And yes, she stopped talking to me for a while and later on she wrote to me. I tried to speak with her and, but she proved to be terribly ambitious and materialistic and, if I help her with money and things I was her daughter, if I joined her church I was her daughter, if not then I wasn't. So I decided, OK I don't have a mum and gradually over time I, I made my own decision to be my own mum. I think I was lucky to know what being a mum was because I already had my, my daughters when I had a nervous breakdown so I knew what it was being a mum. I didn't want to be like my mum, consciously, and so yeah I decided that I was, and I have been, I have been, and I am a different mother. So at the moment I'm mothering myself, and fathering as well because my dad died when I was fifteen so I have to mother myself, and I mother my two daughters which is very hard. But I, but if I do it that makes me a better person and a better mum that I want to be. So dealing with my anger I also dealt with my anger with my dad but because he was already dead I also wrote a letter to him but I share it in my group. For me the group represented my dad, the absent dad and it also helped me to release my anger and to calm down, calm my anxiety because that's what I was, I was too anxious, too nervous about everything [Sighs]. So I continued dealing with my anger.

Writing helps Lorenz express his feelings.

Writing helps Lorenz express his feelings.

Age at interview: 50
Sex: Male
Age at diagnosis: 20
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I would encourage other users of the mental health service to write what's happening to them, how they're feeling and as you come out through it you can see the difference of how you were ill and how you progressed out of the illness because the illness, you're still your person as yourself but then the, you feel detached from yourself to a degree so when you get yourself together, if that's the word, you find oh my goodness was I really in that sort of agony state. 

You know you were but there's a detachment, you find that your whole self wasn't together and that, that is amazing. And the write, I think my writing to the doctors in the hospital when I come out and when they're, when I have interviews with them and when they ask about how you're getting on really all these things I put down on paper and express my feelings. I mean some people have a very special feeling by writing but certainly verbally say how you feel about what's happening to you or what has happened to you. I think that's a great relief when somebody is able to listen to you and take it in.

That's, I mean actually one of my questions was going to be do you have any messages for other people in your situation, so I mean that'

That is it

'sort of is, that would be it in then?

That, yeah I really think that they should write down their thoughts, even if you can't share with anybody at the time just write like a diary and keep it near yourself. What I've already said don't always go back and look at it, no don't, it plays on your mind badly. I haven't really done that myself but I know it wouldn't be right. When you get better, when you feel and the people round you can see that you're getting better then after the period of time you can then say, 'I'll look and see how I had been.' But if it's going to get you depressed, it's okay steering clear of it really, it's nothing that got me depressed it's just I was, my seeing what the doctors wrote about me.

Others mentioned music and art. One woman had produced a diagram depicting the different stages of her life and how they led to her breakdown and then recovery.

Playing music and being an entertainer is therapeutic for him.

Playing music and being an entertainer is therapeutic for him.

Age at interview: 49
Sex: Male
Age at diagnosis: 22
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But people realise the music I play, you know therapeutic, especially when I am playing my own style of music people say it's fantastic, you know, it helps them. It's just therapeutic. It is gift. I played music before which is good, but I looked at as music as in you know CD and, you know, doing gigs, which I still do, but it is therapeutic as well. And people that come in their music has become therapeutic as well. Because when I play with, because I play with the live bands, I run most of the live band sessions. I work in the live studio and I sit in with each band and play the drums mostly and lead the band, facilitate the band from playing the drums. So I make sure people are playing the right instruments. The songs we are playing, get ready to play, the rehearsals for gigs, get our photographs done, or biography for the website, stuff like that. So I am working with live bands, plus I do theatre vision, the drama section here, because hence coming from the acting background. So I run a Theatre Vision, which is a drama company here. The first time we founded, I founded a drama company, it was a play I put on called the Nancy Web Show which tends from the Nancy the spiderman, the Black spiderman. So I told that story which is a West African folk tales which used to be in the West Indies when I was growing up, as stories, folk stories, but I took the character from the folk stories, and Nancy the spiderman, so he was a Black man and I give him his own show on stage. So I call it the Nancy Web Show and within the Nancy Web show there is music, poetry and improvised sketches and it won acclaim, it won an award. Yeah.

And The Voice newspaper did a big spread of it and it was on BBC 2 Newsnight, depicting Black people with a mental health problem, that was the same thing I went through, it stars racism, the police system, all these things that you have been discussing about Black people. I did into a form of entertainment. And that's quite unique. And from time to time I get 'phoned in to stage it, you know. So at the moment I am still working on to update it a bit more. So that is something else I do. And that is how we founded the Theatre Company here at Sound Minds. We do other theatre stuff as well. So I do mostly live bands, theatre and media work at Sound Minds.

Writing gave her a "reason to wake up in the morning"; she says art gives you your voice back.

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Writing gave her a "reason to wake up in the morning"; she says art gives you your voice back.

Age at interview: 36
Sex: Female
Age at diagnosis: 21
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So that, kind, that the only thing that changed between I would say 21 and age 30 was that' 21 being the time I first saw this Mental Health Team, was that' I kind of fell into writing, like, I'm a writer at the moment, and that gave me a reason to wake up in the morning, and, you know, gave a purpose in my life. So that's why I think if I hadn't have had that I think I would have killed myself. So it became a very important thing to me. I didn't expect to be published or anything like that, it was just the way I kind of coped with the world. 

 But when I hit 30, I think, you know, people re-assess their lives when they hit, you know, the 3 0 or, you know, age 40 and at age 30 I thought I have to change my life, you know. I can't continue, you know, this living day-to-day, because this is just what the psychiatrist was saying, you know, take one day at a time, you know. Taking one day at a time is not really living a life.

So at age 30 I made a lot of huge changes. I'm a Buddhist and that, that, you know, meditation and the kind of challenging negative thinking really helped. And I kind of forced myself to be, to go out more and to do more social gatherings. And just slowly develop my confidence. So I would say since the age of 30 and 36 which is what I am now, my life has been so much better, due to that kind of self-confidence and having, you know, having just the kind of, you know, confidence, helps open so many, so many doors. And just having that belief in yourself and also, you know, having a sense of humour about your situation, it's really hugely beneficial'

Well kind of art gives you your voice back really. You're very' very voiceless. You know, you're demonised in society and you're kind of are looked down upon within the system. And kind of art gives you, you know, the power to be yourself again really. In a really hugely powerful way, you know, you can recreate, you know, who you are basically. You know, you're not just a patient you can also be an artist. You can also be a writer and you can, you know, recreate and create such, you know, things like people that other people can connect to as well, so you're, you're also, it helps you to communicate with other people. I mean, you know, you could read in the paper, say what the symptoms of say, schizophrenia are, but if you like read it as somebody's story, you know, where they can kind of feel empathy for you, that's much more powerful. So that is why art has been, you know, really helpful for me. It's given me a voice. It has helped to communicate. It has also helped me to be something other than just a patient really.

Avoiding things
For some people, however, such activities could trigger symptoms or were just unhelpful. One man tried running and said, “it didn't help me at all, I feel worse afterwards”. For these reasons, some people avoided particular activities such as watching television or going out, either in general or at times when they might be particularly vulnerable. Some people avoided things that they found stressful like using the telephone or opening the post (see David's story). Having a stable, quiet home life and maintaining a balanced lifestyle was therefore important for many.

Diet, alcohol and drugs
Diet has been found to have an impact on mental health. Lots of people thought that their diet was important: they described avoiding junk food and trying to eat healthy, home cooked foods, and fruit and vegetables. One woman had been advised not to drink caffeine. A few people said they sometimes ate to feel better. 

Many people talked about using alcohol or drugs to “self-medicate”. One man had felt tempted to try drugs because nothing else worked for him, but said he was too scared. Those who had tried using drugs found them unhelpful (see Chapman's story) and recommended that others avoided them (see 'Messages for others'). Some people liked to smoke but equally a few said that giving up smoking had helped their mental health problems. It is important to be aware of the damage drugs, alcohol and smoking can cause to the body.

Edward describes the things that help him cope: keeping a diary, avoiding drugs and alcohol, and...

Edward describes the things that help him cope: keeping a diary, avoiding drugs and alcohol, and...

Age at interview: 59
Sex: Male
Age at diagnosis: 20
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So after that I decided okay I spoke to the psychiatrist and he said, 'Well look if you don't have another, a relapse before the age of 25 or so, 24 or 25 you'll be okay because history tell us these psychoses affect people between 16 and 24 mostly. So I was quite confident once I reached, you know, in fact I was waiting for that, you know, day to come and then I thought well okay I'll be alright now. And I just carried on making sure that I didn't take any tablets of any kind or any perception altering drugs like cannabis sativa okay? And there were friends who liked that sort of thing but I kind of shied away from it because I didn't want to lose my sense of reality. It's very important, you know, when you're having these delusions that when you get better you guard your sense of reality as strongly as you can. 

Well that's the way that I see it anyway. So, you know, I didn't drink too much alcohol either because when you can, even though I didn't have a relapse as such the illness would, or the condition would tend to result in sort of mild depression and so forth. And I had all the signals, I had all the signals to be avoided in a list, I hadn't written the list down and the signals, the warning signs that I was looking for in myself were excessive paranoia, depression' anxiety state that goes on for too long, non-specific anxiety state. Obviously if you're anxious about an oncoming bus and you're stuck in the middle of a pedestrian crossing that's understandable but, you know, any kind of anxiety state that doesn't have a, an obvious explanation. And the physical things are excessive thirst and mixing up words at the end of sentences and having to repeat them, that's very embarrassing. That's the most demeaning symptom that I can think of, especially being a professional communicator, you know, the thought of going in front of a class and just not being able to say anything properly, you know, but feel that they notice everything. Well they do, but they don't notice it as much as I feel they did, you see. So that was something, so those are the excessive thirst, anxiety state, paranoia and delusions.

(The following section is written only)

And so the diary has helped me calm down in so far as if I've had, say last year I had on 29th June I summarised the previous seven and said, 'Look I've had four bad, four bad days in a row this year.' I go to the diary, look at the same time the previous year and read it and hey, I had five bad days in a row last year at this time of year and it's worked like that all along the line so that I'm able to monitor, prove to myself that life gets better and it does. I know it does because I've just got to read my diary if I'm in any doubt it gets better. And somehow we have to, all of us, it doesn't matter whether we've been ill or not have to try and get this perceptual integrity about living in the present, you know. And hopefully I've at least mastered that by now, you know, or some days perhaps not but, you know, most of the time.

Now I once said to my shrink in Australia, I said, 'Look [my psychiatrist], I know the difference between delusions and reality.' And he said, 'Oh do you,' he said 'what's that?' I said, 'Hindsight' [Laughs] so' [laughs]. I tend to wait for a lot of hindsight to make sure that these delusions are in fact what they are. So I go to a lot more trouble than most people do to examine their delusions, okay? And that takes up quite a lot of time and effort. I keep a diary every day and I have done since, oh 1991, I think when I first separated, before divorce. I keep a diary every day and it's a page to an opening A4 and in it, when I've got the time I usually fill it in you know it's pretty full by the end of the year because even if there are gaps I can come back to the gaps and fill them in with an

Self-harm
Some people used self-harm as a way of channelling their anger and distress or managing their feelings and a few used fantasies of suicide as a form of escape (see Ali's story). See our resources page for links and phone numbers for crisis helplines.

Other ways of managing mental health problems included learning “danger signs” [see Edward above] and techniques (see Hanif's story) and doing things to minimise anxiety.

Anton describes his technique for dealing with work and post when he's depressed.

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Anton describes his technique for dealing with work and post when he's depressed.

Age at interview: 64
Sex: Male
Age at diagnosis: 45
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So anyway still I was suffering. And then this state of affairs carried on. At work when the office post comes in, I open the mail, and anything which my staff can do, I delegate it. Anything complicated I put in a filing cabinet and lock it up. Hoping when I feel better, I can deal with it'

And then my work came to standstill. I used to put them in a filing cabinet and then when I got better I used to do it. The reason I was able to survive, because my superiors were quite pleased with me. They never checked on me.

Some people described talking to themselves, reflecting on positive aspects of their lives and themselves. One woman described making time for her voices [see Jay above].

Ali has created imaginary friends to ease his depression.

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Ali has created imaginary friends to ease his depression.

Age at interview: 27
Sex: Male
Age at diagnosis: 26
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Is there anything else that helps you manage your, you know, your symptoms?

My talking to myself. I have a complete - yeah, I never mentioned that. I have a complete imaginary life'

OK. So I have imaginary friends. I have , I can't see them, that's the main thing. I'm not schizophrenic. I can't see them. I know they are imaginary and they have their own personalities. We have loads of fun. This can - again sense of humour is a huge part in there. Anything that I can't have in the real world I tend to sort of get that in my imaginary world. I talk to myself quite a lot. Sometimes it's actually the other person talking to me, my imaginary friend, but I know it's the imaginary friend talking to me, but I still like to verbally say it out loud, and I do say it. And I think that's, that's actually a, like a constant source of amusement for me that I can switch on any time I want to. I have complete control over that.

And for example, I'm here, sitting in a room, waiting for someone, I have nothing to do. I can just switch it on. And I can spend fifteen, twenty minutes with my mates. And it's not like, it's not that easy. It has some sort of mental exercise involved in it. But most of the time, 60, 70, 80% of the times I can switch them on, switch them on and they tend to provide me amusement and this and that. And I'm, for example, I'm feeling really down. I'm feeling like shit. And you know, but I can switch on my imaginary friends and they would throw in a few comments here and there, and be funny, and I have the ability to laugh at myself. That's one thing, you know, that helps me quite a lot in my depression. And they'll make a few comments on myself and I would make a few comments on them. And that would, that's one thing that can lift me up. That's, that's a big, big counter - what do you call it? - counter-measure towards depression, I think.

Mm. And how long have you done that for? 

I think this has been there since I was about 12, 13. This has been there. This was I think because no-one ever listened to me. I was surrounded by adults in my childhood, most, most of the time. My mum always used to object to all my friends. I did have friends, but there was a limited relationship with them. Cousins were not there that often. I didn't have many cousins who were my age anyway, they were again quite different age groups. So this, this was as a result of no-one actually listening to me, so I created my own world where people would listen to me. 

And you said you're completely in control of that?

Yes.

So the, the responses of your imaginary friends are responses that you imagine. You make them say what you want them to say?

Yeah, but it's still funny to me, which is strange. It's still funny to me, although I'm thinking myself indirectly, but it's still funny to me'

And I mean, do you think that is something that other people do or do you think it's something that's quite unique to you?

No, I think it's unique. I wouldn't think any one else. Not many people, I've known people do it, but I don't think many people do it. I think even talking to yourself is probably unique. But that might be a bit more common though. Because I know people babbling to themselves time and again. But I think I do it more than any other person. But this thing, the imaginary friends and, they're sort of, they are like mood enhancers and also boredom killers, and whatever you want to call them. They can just chip in any moment. 

Positive attitude
Having a positive attitude was also considered to be important (see 'Recovery'). Some people said they tried to forget about their mental health problems. Others felt it was “something I've just got to cope with” and refused to let their mental health problems take over their lives. Some forced themselves to face their fears and do things they were uncomfortable with: “once you face them you'll be better”.

As a Black woman, Imani feels there is an expectation for her to cope and be strong.

As a Black woman, Imani feels there is an expectation for her to cope and be strong.

Age at interview: 48
Sex: Female
Age at diagnosis: 47
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Because I think that, I think, I was going to say being here, but I think it's, I think it's an international thing because being here as a black woman, you the perception is that, you know, a white woman is feminine, is frail, needs to be taken care of, needs to be looked after, but some how the feeling is that a black woman is the care giver, is the nurturer, is the person who gives of herself. And that will be professionally, it will be at home, it will be in her local church, it will be wherever you might find yourself and, and so sometimes yes, as a black woman there is this thing that you will cope because you are strong. And because, maybe because you have survived, and because, you know, you come from a long line of Africans who didn't die in slavery, you are strong. And it's hard, because there are times when, you know, you want to, I was watching Airline and there was a woman who just got to the end of herself and she threw herself on the floor and just screamed and when she had really screamed her frustration out. She got up, she picked her bag up, she put her hat on and she stood at the desk and she was able to engage. And I looked at that, and I just thought all power to her, because my fear of doing that, and maybe that's another part of it, it's expectations as well, because if I do that, I am immediately perceived as mad, as so there is an expectation of a code of behaviour for black women and if you step out of that, it's a negative. And it's not that oh my gosh, something is wrong, and I will, you know, see if I can help her. It's almost like, oh my gosh, oh my gosh, panic, panic, horror, horror. Let's call the police and so I think that, yes, there is this feeling that you have to, you know, the soft mellow side of you, you really do have to just hide away, and you have to cope, you have to manage, you have to be strong.

So is that the code of behaviour?

Yes. Yes.

And whose, who has those expectations?

The society in which we live. 

Is that everybody or is that people who are white or is it also within the black community?

I think, because I think, it's the white community. And I think it comes from yes, I think it comes from the black women being the nurturer and the care giver and even in, you know, during slavery, and even afterwards, when we were still people's nannies, regardless of what may have been happening in your own home, you still stepped out, you still put your hat on, and you still went to work, you still provided, you know, whatever was coming you were able to deal with it and accept it. And still keep going. And so I think that it's part of the European imposition on us, but I think that because sometimes we, [inhales] we lose touch with who we are and the definition of who we are and we start to assume a definition imposed. 

There is this, there is sometimes this feeling that we are now beginning to expect it of ourselves and that's part of the reason why I came to leave the country when I did. And met my ex-husband and all that horror started. Because I [sighs] because I do feel, sometimes I do feel, I just want to be feminine. Sometimes I feel, that I do just want to be soft, sometimes I feel that I do just want to be vulnerable, but when I'm soft and vulnerable, what does that mean? And because the strong definition is always resonating in my head, that just doesn't fit. And then my fear in that, is, in a relationship, allowing the man to be the strong person in that relationship, means that you have to give something up, and how willing are you to give that thing up, so that he can be strong? And yes, it is okay to be soft, to be vulnerable, to be even, dare I say it, submissive. And… it can be really difficult. It can be very difficult, because you want to be but there’s a, there’s something inside you that says no the definition doesn’t fit, and then it worries me because a lot of my black female friends are single. And they’re single wondering why they’re single, and the ones who are single are the ones who have assumed that ‘strong’ label. The ones who have said, “Well no I’m not. I’m not.” Those have always been able to find relationships and partners, who will take care of them, who will be there for them, but the strong women… The label can sometimes become a life process that can shut the door to really meaningful relationships. Yes, it’s really quite tough [laughs].

Because a friend I was speaking to you about earlier, I am now, after the, after my marriage, I feel that I’ve even become stronger still, and it’s, I am not going to tolerate this. I’m not going to put up with that. I’m not accepting this. I’m not accepting that. And I need to talk to friends because my fear is that I’ll be so strong and so un-, unyielding that I will end up just pushing him away. And so I keep having to touch base with friends who say, “No, no, no. you know, when he says this, and when he says that, just try to look at it like this, you know, lessen the drama, just try to be more light about it, you know, some things just don’t matter. Some things are just not worth fighting about. You know, just let it go. It’s okay.” And so it’s almost like I need someone’s permission to be able to let go of being strong.

Last reviewed September 2018.

Last updated February 2013.

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