What’s REALLY going on in your mind?

0:00Before we start, this episode contains language you might find offensive. Do check the show notes for more details. Hello and welcome to Happy Place with me, Fern Cotton. The 13th to the 19th of May is Mental Health Awareness Week. So today I wanted to listen back to some of the conversations we've had on the show that shine a light on particular mental health conditions. When you're experiencing psychosis, it is preceded by this manic period where you're quite high and you think this is fun. If I can control this, this is going to be great. Checking lights, checking cookers, checking taps, all of those things, they tend to get much worse when I'm in the house a lot and by myself a lot and not working.

0:46It wasn't that I was just depressed, I had this sort of dual thing going on. And the minute someone put a label on it, it changed my life. We're going to learn about OCD from Tuppence Middleton and cyclothymia from Matt Edmondson. David Harewood's talking about reliving his period of psychosis when he was making a documentary about the subject. And neuroscientist TJ Power will round off with some chat about, as he puts it, the most mental healthy chemical, serotonin. How can we help our body make more of it and in turn make our minds feel calmer and happier? First, though, a conversation you definitely won't have heard on the podcast before.

1:26Stephanie Romaszewski is a sleep psychologist. She joined me on our YouTube series, What Is How To, to chat about insomnia. This is something I am personally deeply interested in because I can often have very bad periods of sleep. If I'm stressed, if my anxiety is particularly bad, I find it so difficult to get to sleep. That's my problem. And some of that manifests in OCD as well. So it feels complicated and sometimes like I don't even know where to start. And actually, my inability to sleep comes up a couple of times in other conversations here too. I'm mildly obsessed. If you're experiencing any of these mental health issues, I hope you find a little moment's solace from connecting over stories you might recognise.

2:13And if you're not, you may well know someone who is. And it's always a beautiful thing to show others you're wanting to understand and empathise. Does it ever feel like you're a marketing professional just speaking into the void? But with LinkedIn ads, you can know you're reaching the right decision makers, a network of 130 million of them. In fact, you can even target buyers by job title, industry, company, seniority, skills, and did I say job title? See how you can avoid the void and reach the right buyers with LinkedIn ads. Spend$250 on your first campaign and get a free$250 credit for the next one.

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4:32Right, let's do it. Here's the show.

4:55how do we change the the nighttime behavior how do we build up that sleep drive i don't know enough about this yeah no so the way that you're talking sounds like you have very good healthy sleep behaviors in general but if we're looking at right now you having a sleep disorder insomnia then we've got to take it to a whole new level so we need to be more strict about the get up time so what I mean is even when you've had the worst night of your life and you go to bed at five you still need to be up if your wake time is at six at six even if you didn't sleep at all you've still got to get that body up and do those things and then we take it a bit further with an insomniac and we will look at actually restricting down their bedtime so for example we might do a sleep diary on you and see that over a week actually your average bed opportunity so the amount of time you spend in bed is eight or nine or ten hours and actually when we look at your sleep it's only five or six.

5:47So there's a discrepancy there. So we've got to actually reduce down how much time you're spending in bed, but very specifically. So we might say to you, okay, Fern, we want you to go to bed at 12 and get up at six, maybe, but not for a long period of time, just so that your brain can understand, oh, oh, this is my only time. So you start to build up a strong sleep drive that's the same every day. It's no point if you use a different six hours every night. It's got to be the same amount of hours and it needs to be the same time. And of course, for the first few days, your body's not going to like what you're doing because it's going to go, hang on, Fern, you've been doing something different for many, many years.

6:23I don't trust you. I don't trust this. And that's where consistency comes in to teach your brain that this habit is real and it's sticking around. Then when you start noticing, oh my God, the amount of times I wake up in the night, something's happening, the gaps are filling in. Then you're going to start to feel more sleepy during the day and that's when we start creeping out the bed opportunity and before you know it you're back at eight or nine hours in bed but this time you're sleeping for them but nobody nobody does it that way because it's hard that's hard to do on your own well it is and I think what we're all bad at no matter whether the subject is sleep or something else that first week of change is uncomfortable and we're not good at going I'm not seeing results and I'm just going to give up rather than I'm not seeing results, but I'm going to sit it out.

7:08I'm going to do the full seven days to really get those new neural pathways built so I can then change behaviour. Absolutely. But also you've got the rest of society saying, well, that's weird. We weren't taught that. I don't know what you're doing, but I don't think it's right. You should go to bed. You look tired. You look like you need more rest. So you've got actually society against you and it can be quite an isolating and lonely experience, especially with lots of people going, I don't know what's wrong with you. I just hit the pillow and I'm gone. That's a horrible place to be. Now I'm asking you to do these behaviors that are slightly different again.

7:41It's a bit like weight loss or muscle training. We all know that it's got to be something sustainable and consistent. There is nothing that you could do over one night that's suddenly going to make your sleep better. But I understand that the problem with that not being the case is that we want something very reactive so we want a pill we want something oh I just need to take this oil and then I'll sleep better and then often people will say to me well um sometimes it works and I'm like that's not how it works when it works you probably had a better sleep drive that day and there were other factors at play and that's probably why you have this idea that it sometimes works but if it's not working all the time if you still have the problem they are not working I have OCD and that's one of the things that gets much worse when I'm not working so what I would call my routines or uh you know which can vary from mental counting to checking behaviors you know checking lights checking cookers checking taps all of those things they they tend to get much worse when I'm in the house a lot and by myself a lot and not working so those things you find various types of coping mechanisms for which I think are sometimes helpful and sometimes not like one of the things that I that really helps me if I'm struggling to leave the house which is a thing that sometimes happens if I'm in the house a lot then I I suppose you just start to feel safe there and then when you when you leave there's so many things that come rushing into my mind you know mainly things that you're responsible for in your house you know that it doesn't flood that your cat doesn't die that you know you don't set it on fire accidentally and and have to pay for all of your neighbor's houses um you know all of those things which seem totally ridiculous but that race through your head when you're trying to leave the house in a hurry and then you make yourself late then I'd started to for example take pictures of things around the house so that if I was on the tube or the bus or walking and I'm half an hour away from my house and I suddenly think oh my god I left the tap on or oh I left the the hob on then I can look at my phone and I realize as long as I trust my eyes in that moment that which I often don't but then I can see okay that that's often I have physical evidence which you know probably a lot of people would say is slightly enabling my own compulsions but it's I think whatever works yeah Yeah, whatever works to settle that fear and that worry, especially if you can't get back to the house.

10:10I think you've got to do what you've got to do. And I very much enjoyed listening to that interview that you did with Rose Cartwright, who's obviously an author that's written prolifically about Puro, which she experiences, which is more sort of intrusive thoughts. And she's written brilliantly about that. And it's very generous of you to sort of go there and offer that up about yourself, because being an actor, you don't have to. It's not, you know, your career isn't reliant on you telling that story. But I just thought it was so generous because so many people, again, will see you on TV and think, oh, my God, she's got it all sush.

10:44She's this amazing success and has this wonderful life. And for you to actually go, look, this is going on behind the scenes some of the time, I think is seriously helpful. And when I was listening to that interview, I mean, I learned a lot, certainly. But also, you know, I've never been diagnosed with OCD. But I noticed in times where my insomnia is pretty bad or even if I have heightened anxiety, panic attacks, which I have quite regularly, I definitely fall into some of these patterns. And it's not all day and every day, but it's certainly if I'm home alone with the kids and my husband's not at the house, I will check everything before I go to bed.

11:28And then often I'll have to get out of bed and do it again. and I don't know you know I've never given it a name or looked into it too much I've just thought oh god I'm just a nervous person and this is just how I am but it was really comforting to sort of hear you both speak so openly and honestly and use the correct terminology because it just helps you understand it better and helps you sort of realize it like the one thing that Rose was saying is I can go, this isn't me, this is pure O. Rather than going, this is me, I'm flawed, I'm faulty. No, this is pure O or this is OCD. That's really helpful.

12:06Yeah, and also breaking it down into those components. Like you were saying, you will have some of those behaviours which are compulsions and that you are performing those as a reaction or as a coping mechanism for something else. So there's something that is worrying you or stressing you out And even if that's not a recurring obsession like someone might have with OCD, then it's still that's the reaction to it. And there are so many elements. You know, you have your obsession, you have your compulsive behavior or thought that that stems from that. And then even before the obsession that, you know, that obsession doesn't crop up out of nowhere.

12:42That's been that's been sort of brewing for years or months, however long you've been suffering with it. But that comes from something else. And it's about trying to figure out where that comes from, how you best deal with it. And and for me, certainly there's been so many different manifestations of it throughout my life. You know, when I was a teenager, it was much more counting numbers, mental mental kind of counting. And then as I got into my late teens and early 20s, it became much more about anxiety and panic attacks and, you know, just a sort of more generalised feeling, feeling of anxiety.

13:18And then as I've gotten older, it's sort of been more routine based. So all of these things have always been there, but in slightly different forms. And I think they always seem to come from an overriding thought, which is and it's something I also talked about with Rose, I think, is that I have something called emetophobia, which is fear of vomiting, which is a really specific fear. And if I ever meet someone else with it, it's always quite exciting because you feel like a total oddball if you have that. And, you know, as with a lot of obsessions, you never really talk about them. And if people do see them or they see any evidence of it, they only really see your compulsion.

14:01So they see the behavior that comes from that, but they don't really understand why you're doing it and what that comes from. And then when you say something like that, especially it's so specific and so niche that it's kind of hard for people to understand, that that can be an overriding thought, which affects a lot of your behavior in life. And it's sort of just in the back of your mind, just kind of ticking along. There's not really, you can live a perfectly functioning life with OCD. And for most people, it doesn't look like anything's happening at all. And so I think that's why it's quite hard and why I wanted to talk about it in that podcast series and with you, because it's not something that I ever heard anyone I'm talking about when I was I must have been 11 or 12 when I first started to show signs of it and and my parents hadn't really heard of it and and we had to go to lots of different specialists to talk about it because it just wasn't it wasn't something people knew much about or certainly people didn't talk about publicly so there was no point of reference and uh there wasn't really anyone else I could talk to about it certainly my age but even as an adult that that could tell me how to deal with it so you know it's and there are so many different things you can do you know whether you're looking at something more standard talking therapy or cbt or and it really is what works for you i suppose but i think it's also one of those things like a lot of other mental health conditions that you sort of learn to live with i mean you can i'm sure cure yourself of them and i'm sure many people have i don't think that that's been the case with me but i do i do think that you also have to find the positives in it and something that I find really useful about OCD is that it does at times force me to really focus my energy and it can be a kind of driver when when you're feeling that kind of anxiety it can I always remember someone saying that it's you are one of the best people in a crisis because it's it's almost like you are constantly planning for the worst case scenario so when it happens you're able to deal with it quite calmly, actually, which I've often found to be quite true.

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17:20I went to a doctor and said, hi, I have this thing where I get depressed quite a lot. And they said, well, are there any other symptoms? And we sort of spoke through my personality and they said, oh yeah, we think you've got this thing called cyclothymia. And then I went to see a psychiatrist or a psychologist. I can never remember which one it was, but the person that categorizes these things. They said, yes, you have this thing called cyclothymia. And I'd never heard of it before. I'd never heard anyone talk about it. I didn't know what it was. I had to go and Google it. But it basically was the answer to who I am.

17:58And I always thought I was someone with a lot of energy and excitement and productivity. But it turns out that that's sort of the flip side of that depression I was talking about. And I came to realise, and actually it happened around the birth of my kid, Ivy, I was in one of these slightly more manic phases or up phases. Manic maybe isn't the right word, but it's like an ultra productive, you feel almost invincible. If you've ever been in what people describe as a flow state where the universe kind of disappears and you're singularly focused on a task. I was sort of in a perpetual one of those, which is amazing if you're trying to get ideas out and be productive, but it's quite destructive for the people that you live with because, you know, you forget to eat.

18:47You're not interested in life. You don't want to go for a walk. You just want to zone in on whatever this idea you've got, which feels like the most important thing in the world. It's want to zone in on that thing. so i thought i'm a guy with depression but it turns out i'm a guy with depression and with this sort of flip side of it and cytothymia is it's sort of like a watered down bipolar so if you think about the extremes of bipolar as being hypermania so staying up all night being awake for days not wanting to sleep i mean there's lots of symptoms to it but it's sort of manic often risky, sort of slightly obsessed behaviour around doing things that feel fun.

19:30And in that state, you feel like, I guess, the happiest a person can feel or the most up a person can feel. Like think of your best day when you look at yourself in the mirror and you think, oh, I look great today and I'm really successful. I've got loads of great ideas. It's that energy. And then for a manic depressive of someone with bipolar, the other end of the scale is very deep depression, like I described that my dad had. And so with cyclothymia, it's those same bookends, but the threshold has moved in. So the mania is never as manic as someone with bipolar, and the depression is never as deep as someone with bipolar, but you're sort of touching the sides of it.

20:07And so for me, it manifested this energy where I thought, oh, I'm just a really productive guy. And often people would say, how are you doing all this stuff? You've made so many things in the last month my agent would be like can we get this thing you know i know it's going to take you probably a month to get it like a pitch or something for a tv show and the next day i'd have it it was this sort of energy that i would fall into where you'd get i mean it's so hard to describe but you'd get um days or weeks worth of stuff done in hours because you were just locked into it and if you ever came back to it and i find it all the time if i ever come back to something that I worked on at a time when I was in a sort of up cyclothymic stage.

20:52I've got no idea what it is. I don't know how to undo it. You know, sometimes I've had to go and tweak things in presentations or make alterations to some of the board games I've made, or even with the song stuff, check going and change stuff. And I, it's like it was made by somebody else. And so I realized I had this sort of, it wasn't that I was just depressed. I had this sort of dual thing going on. and the minute someone put a label on it it changed my life because I was able to understand oh I'm not just depressed this is a thing that's going to come in a wave and maybe I can if I don't fall into the up as much as I have done and that's a really hard thing to do because it's like someone opening the gates to Disneyland and saying run free but if I can stop myself from doing that and I can kind of try and control that flow state a bit and not let it control me brilliant But also, now that I know it's the sort of the other side of the same coin with the depression, I can kind of trick myself out of falling into a depression by using some of the things that I would do in the up stages.

21:59And since getting just the word cyclothymor and knowing what it was, I've been able to just clock myself. When you're experiencing psychosis, I think like with bipolar, it is preceded by this manic period where you're quite high and you think this is fun. If I can control this, this is going to be great. And I think because I'm an actor and a creative, I was kind of buzzing for months and probably suffering from my psychosis for months. So there were lots of sort of funny things that I did. walking around town, singing to complete strangers, carrying old ladies handbags and shopping bags and, you know, just making people laugh in general.

22:43So I thought I was going to discover all of that. And it was a real shock to me to discover just how ill I was. And in the documentary, when I go back to the hospital with my two friends, I was really stunned and scared when I suddenly realised, actually I was running around this hospital screaming and had six policemen sitting on top of me. That's when it suddenly hit me. Man, I was really out of it, like really out of it. So for the rest of the documentary, I was just terrified because I didn't know what else I was going to find. And I think a couple of days later, I think that same day I was given my medical records from 30 years ago, which was extraordinary that they actually had my medical records on file.

23:35And there was a scene later in that day where I was supposed to open the envelope and read some of it and sort of discuss it with my mates. And the first thing I saw just was like, it just terrified me. And I closed the envelope and I said, I'm not reading this, let's stop filming. And we stopped filming for the day and I was really, really shaking because it really reminded me of the sort of mental angst that I was going through. The first thing I saw, as I said, really, really kind of, it was like a stake through my heart. And so lockdown, pandemic happened, lockdown came, and I started writing a few things down, I started writing the book, but it wasn't until I got back to Vancouver and opened that same envelope.

24:24And throughout my quarantine in Vancouver, where I was filming, 14 days of doing nothing I read the entire contents of that envelope and it's sort of once I'd sat with my darkest moment once I'd sat with those fears sat with those insecurities that's when it all just I suddenly thought no Jesus this is this is deep and it was all about race and my my confusion around race and my confusion around identity all sprang up and And that's what spurred the heart of the book, really. And then I suddenly realised, of course, my dad had a breakdown. And I never even mentioned that in my documentary. I didn't have time to because I was reeling so much.

25:09But the book then became a bit of a love letter to my dad to sort of understand what happened to us. Yeah, that's where the sort of book kind of came from. Because your psychosis was shortly after your time at RADA, which in the book reads as a really beautiful time in your life where you made this amazing group of friends and you were thriving, doing something that you creatively adored and you had this direction in life that you were really feeling for the first time. But also it seemed like in the book it acted as a bit of a shield to the reality of what you were about to experience and of course what you had experienced previously but perhaps hadn't processed at the time.

25:51Without a doubt. I mean, I think, you know, the confusion around race and the... I hated what racism... How it makes you feel. It makes you... You know, as a kid... As a kid, I was terrified. I mean, I know that's probably not a cool thing to say, but I was terrified. Whenever I... You know, you're walking home from school and somebody would shout, Nigga! Coon! You know, out of a car or something like that. And it would just make me just tense. and I think I found clowning and make-believe. even.

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27:56Think bigger and do it all yourself on Wix. Go to Wix.com. And my imagination at school, because I could disappear in that. I could be anybody. And it was a nice environment surrounded by lovely, creative people. And I think that then extended, as you say, into drama school where nobody mentioned my color. You know, and I, you know, I could play King Lear and not, you know, nobody said, oh, he's black and she's white. And, you know, nobody mentioned it. And so I kind of escaped into this world of sort of bliss where I'm studying. And, you know, I was never that academic at school, but suddenly I'm studying Shakespeare and literature and poetry.

28:44And I was just, my mind was going, wow, this is fantastic. And I was just buzzing and learning. And I was finding that I was having some success at drama school with playing these characters and just escaping into these writers' imaginations. It was just a beautiful time for me. But then, yeah, I came out of drama school and suddenly the world said to me, hang on, you're black. You don't do this, you do that. And you can't play that, you play this. And that's when that confusion returned and that sort of difficulty to navigate white space and racism and to navigate how I fit into that returned with a vengeance.

29:28so serotonin is fascinating effectively this one evolved to make us take care of our body and this is where things get super interesting because we've coined this term mental health as a society which really makes it sound like something in the top of our head effectively that mental word and this effectively is the most mental healthy chemical and 95 of it is being made in our body which is very different to the other ones and your brain has and body have a very sophisticated mechanism called the vagus nerve. It's this nerve that connect them together. Effectively, your vagus nerve is constantly reading the state of your body, your heart, your gut system, everything, and then giving feedback to your brain about how that is.

30:07And the more you take care of your body, the better fed it is, the more slept, the more sunlight, the more well rested, the more serotonin is created, the better you then feel in your mind. It's a very good point to make because often I think, you know, we do have these conversations about mental health and we are pictured this sort of floating head and the body just gets totally forgotten about but hello it's all connected and it's all an interconnected system that has to have some sort of level of equilibrium to feel okay all around and we really forget about that so this is an interesting chemical to talk about yeah if you like i often do find it very difficult to sleep i mean it's kind of chicken and egg thing what do you start with are you trying to solve the problem of boosting serotonin or are you making sure you're getting better sleep so you're producing more serotonin how does it work it really is chicken and egg because when you're sleeping you are building serotonin so serotonin activity but in order to go to sleep you need the release of that melatonin chemical which is the chemical that releases in the evening in the sunset to help put us asleep and serotonin is what creates melatonin so you basically want to build as much serotonin as you can in the day that will then create melatonin and melatonin will put you to sleep and then when you're sleeping you'll build more so it becomes like a nice cycle and there are definitely actions we can take i'd almost start at the beginning of your day and then go from there.

31:22One of the greatest predictors of sleep is how quickly we see sunlight first thing in the morning. It is absolutely essential because we have this circadian rhythm, which is like our body clock. And that obviously did once live outside all the time. So it was just like completely adapted to sun rose. We woke up, sunset, we went to sleep like a few hours after that. And the quicker we see sunlight in the morning, the faster our circadian rhythm will start to kick off and our energy will go super high, super quickly. But then the faster it will fall at the end of the day. So you'll fall asleep faster and fall asleep deeper, quicker, effectively.

31:53So sunlight first thing is absolutely essential. Would you say sunlight outside? Is there a difference between looking out the window and being in the, you know, in the street? Yeah. Annoyingly windows, just like the fact you wouldn't burn through a window, like if it was sunny, like because it will block the UV. It's also blocking that capacity for the serotonin to release in the morning. It also then interconnects with cortisol, that stress hormone. But in like a healthy way, you actually want a bit of cortisol first thing in the morning to get the system started. There you have it. TJ said, get your gorgeous sunlight in your eyes to get your system started, people.

32:27That is something I have massively taken away from that chat. Do head to at happy place official on Instagram for more details on a special playlist we've put together with loads more personal anecdotes and stories along these themes, as well as for loads more stories and support this mental health awareness week. Let's get chatting. I hope I'll catch you there. For now, a huge thanks to Stephanie, Tuppence, David, Matt and TJ. To the producer Anushka Tate at Happy Play Studios and to you. Look after yourselves.

33:33We'll be right back.

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