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Hanif - Interview 30

Age at interview: 49
Age at diagnosis: 23
Brief Outline: Hanif, 49, describes himself as Indian and has lived in the UK for 25 years. Hanif experienced cannabis induced psychosis and was diagnosed with bipolar disorder aged 23. Hanif works in mental health, campaigning to reduce stigma.
Background: Policy advisor in voluntary sector, married with 2 adult children and 1 younger child. Ethnic background/nationality: Indian (born in India); in UK for 25 years.

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Hanif, 49, describes himself as Indian and has lived in the UK for 25 years. Hanif was diagnosed with bipolar disorder. Hanif works in mental health promotion, campaigning to reduce the stigma around mental health problems.

When Hanif first became unwell, he and his family didn't know what was happening. Hanif says he was speaking rapidly, had lots of energy, was having lots of creative ideas, and would walk into the road believing he could stop traffic. People thought he was possessed by a jinn, and his father consulted the local imam who recommended that Hanif see a doctor. The doctor prescribed medication, which Hanif threw away because he didn't think he had an illness. Someone suggested that that Hanif needed psychological help, and Hanif was referred to a psychiatrist who prescribed Lithium. Hanif says he's glad he was forced to see a psychiatrist and given medication because it helped him because he was putting himself and others at risk. Hanif says people thought he was crazy and no one came to visit or offer well wishes and prayers. 

Hanif says that his first episode was a cannabis induced psychosis, and although he says recent research supports that, he wonders whether it was the right diagnosis. Hanif says that although he no longer smokes marijuana, he still experiences manic phases. Hanif wonders whether environmental factors, genetic factors and being denied opportunities could act as a trigger for mental health problems. 

In Hanif's more recent manic phases, he has lots of - sometimes unrealistic - ideas, and can complete lots of work in a very short time, but he says he is not putting himself at risk like he did the first time. Hanif says that he has learned to cope with his manic phases without medication and can recognise them and make himself slow down. Hanif says it is important to have a good balanced lifestyle, with a balanced diet, and rest. Hanif also find that taking time out, meditating and praying is calming and helps him to find balance. Hanif says prayer alone cannot cure mental health problems, but that the combination of “dua aur dawa” (prayers and medicine) could be useful.

Hanif says his illness has made him a better person. He says that he was motivated by his own experiences to work in mental health, where having experience as a service user is a positive thing. Hanif hopes that by sharing his experiences other people will find hope and inspiration. Hanif's message to others is don't give up, keep trying services until you get what you need because support is available, get information and go to support groups because you can share your experiences, and they can give you strength and motivation. Hanif believes that acknowledging that you have a mental health problem and wanting to get better is the key to recovery. Hanif thinks professionals should produce good quality, culturally sensitive information, promote positive aspects of mental health and encourage service users to speak out.

 

Hanif thinks sharing experiences of recovery gives people hope. He still experiences "highs" but...

Hanif thinks sharing experiences of recovery gives people hope. He still experiences "highs" but...

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I'm hopeful and optimistic that, you know, that every little effort that we all make collectively and I think individually we can't change perceptions or views but I think if more and more people do talk about their experiences which might, you know, generate hope and inspiration amongst others which is I think, you know, good for the wider, wider community or communities. You know, of, of, of people, or those who listen who hear, you know, good stories, you know, positive stories and say yes actually I was ill, I had medication. Some of them will have their own ways of how they got better and I think hopefully by that process, you know, we will, you know, surely but slowly, you know, will overcome, you know, the kind of stigma, discrimination which exists out in society, you know, against people who have mental health problems. And I think the more people talk about it and say actually, you know, I had an episode or episodes, you know, I got treatment, I got better, I have a family, you know, I lead a normal lifestyle now. I might still go through my ups and downs, you know, we all do we're all human beings, you know, it's how that we manage to cope with that process and it's understanding that. 

I think over the years I've managed to learn to cope, you know, I've kind of, you know, I've realised, you know' there are times when I become manic but I think now it's kind of I have learnt myself to manage my kind of highs and I try and do it without medication. 

You know, so in a sense it's understanding your own kind of your own, your own body really or your, or your own but, you know, we are all different, you know, and some people have meant, some people work under pressure, you know, and, you know, sometime I probably finish, you know, a lot of work within two or three days which normally might take someone a week, two weeks, three weeks or planning and all that. But, you know, all of us are different, you know. But it's understanding that OK, you know, and I think once you realise and slow down when your body tells you I think, you know, you yeah you can manage the illness or in terms of my highs certainly, you know, of course there are periods when I'm not at, you know, I'm kind of going into that manic stage but I'm self conscious to say, actually to be careful, you know, and , you know, I need to take things, I need to take things whether it's work or whatever I'm doing, you know, slow down.

 

Hanif doesn't think migration contributed to his mental health problems.

Hanif doesn't think migration contributed to his mental health problems.

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Just the last thing on, on that point then I, because you mentioned that you experienced that episode just after you, you came here, do you think that your migration played any part in, in that?

Migration often is a, is kind of mentioned as a factor' I'm not convinced that my migration was a factor on its own. It could be another, could be a contributory factor but on its own, I don't think so' You know, certainly, you know, lots of, some studies have shown that, you know, that migration does affect individuals or societies or, you know, groups of people. But yeah it's a, it's out to jury really. So, I mean, you know, either that was a, could be a contributing factor, yeah.

 

Hanif says he thinks there has not been enough research in the UK into the effectiveness of faith...

Hanif says he thinks there has not been enough research in the UK into the effectiveness of faith...

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And I read some papers or, you know, or heard some stories or in some, never really, we really haven't got good enough evidence on it where in other countries they've used people who've had mental, who have mental health problems, you know, use either kind of faith based interventions as part of coping, you know, in countries like Malaysia, you know in Saudi Arabia they've tried using, you know, prayer as a therapeutic intervention. You know. Not as a cure but as a therapeutic intervention where, you know, they are encouraged perhaps to use their faith as a kind of coping mechanism. And, you know, for some it does work.

I think in this country we haven't as yet explored, you know, that, that kind of, you know, that therapeutic intervention. You know, there's a lot, some work has been done with, you know, kind of mainstream, you know, Christian organisations of faith but we haven't done much work in, in terms of other religions or faith.

 

Hanif says professionals should campaign to reduce the stigma associated with mental health...

Hanif says professionals should campaign to reduce the stigma associated with mental health...

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I think we have to continue our kind of, you know, work, you know, to not only to disseminate but in terms of to produce good quality information, you know, whether it's through initiatives like this, you know, putting up information on the websites, you know, through , you know, producing good quality material, you know, with some good, good, some kind of standardised material because from our, from our an ethnic minority perspective, you know, we don't have a kind of, you know, we can find ten different leaflets on depression produced by ten different organisations, you know, so we need to I think, you know, have some kind of consensus to say well if you are producing something on depression, yes we need to make it culturally sensitive, let's have some kind of agreed standard because, you know, and I think, yeah, and the message is, you know, that we need to keep promoting positive aspects of mental health and, you know, we need to see more programmes, you know, especially, you know, programmes, you know, locally and nationally on, you know, tackling stigma , you know, in terms of health promotion. You know, and I think we need to continue investing in it because without that investment I think, you know, you know, all of us, those professionals who are working in it can of course do so much. 

Unless there is more and more, kind of, you know, large scale initiatives around the country, locally and nationally, you know, we will, you know, we will, they'll always, you know, in terms of, they will always have difficulties in making mental health a more' in terms of, in order to kind of make mental health less stigmatising, you know, of course we have a challenge on our hands, we cannot, you know, overcome with, you know, within a few years. 

And of course the message to professionals is of course perhaps we ourselves need to challenge how we, you know, if it may not happen in my lifetime but maybe in 50, 100 years maybe through the Royal College of Psychiatry with the government, you know, maybe, unless we change how we, how we use words like mental health, you know, we will always have this stigma. So of course one of the ways would be to start, you know, to rethink, that debate probably is happening, and it has started happening, how long it will be, you know. So unless we ourselves as professionals, you know, find our, a different alternative way to describe mental health or mental illness, you know, we will, we won't get rid of the stigma.

You know, So yeah, it is a kind of, it has to be addressed at that, very, you know, at a level which is, you know, governments and large, you know, powerful bodies collectively can do. And sometimes perhaps it's more difficult because there is a vested interest by, you know, whether it's the pharmaceutical companies or the Royal College of Psychiatrists to maintain that. You know, so we don't know. You know. But so it's kind of contradictory on one way, you know, in as much as we want to, you know, work, tackle issues, you know, to be less discriminatory, you know, there is a vested interest by certain sectors of the economy so we don't know which side wins to an extent. You know, all we can do is, we need to make efforts collectively otherwise, you know, we, you know, we will be in the same status quo that we're in today.

 You know, so however much Shift is trying to, you know, tackle anti-stigma, you know, and the message is very slow because, you know, when look at the whole health economy, you know, in a budget of, you know, nought point nought, nought, nought, you know, '2 million in two years or three years is a drop in the ocean so to speak. 

You know, similarly with public health, mental health promotion funds, you kn
 

Hanif's father forced him to see a psychiatrist and he thinks it was probably for the best...

Hanif's father forced him to see a psychiatrist and he thinks it was probably for the best...

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In my case I suppose, you know, there was no, I suppose maybe I was lucky or fortunate and that, you know, I was taken, you know, you know, in terms of I was, I supposed forced really to, you know, to, to, to go and see a psychiatrist. I mean I really wouldn't have gone on my own, on my own accord really. You know, so of course there was a process of coercion and, you know, force but I think in hindsight it was probably good for me. Because it, you know, it would have, had that not happen I would probably have deteriorated to an ill, to a stage where, you know, I was at risk myself because, you know, some of my actions were quite dangerous. You know, I was doing some perhaps a little bit crazy stuff. You know, like just going in the middle of the road and, you know, just putting my hands up and saying, you know, I can, I'm going to stop the cars. It's like the, you know, programme Heroes at the moment where you can use your powers [laughs], you know, to stop bullets flying at you or whatever. So that kind of, you know, actions, so of course I was at risk of not only, you know, I was putting my life at risk and others, you know, for that. 

So in terms of had I not, you know, been forced into going to see a psychiatrist and medication I don't know whether I would have, on my own I wouldn't have. You know, so in hindsight it was a good thing that, you know, I was, I was taken, you know, by force into hospital, you know, for my own good. And now I probably understand why sometimes people who have, who go through a psychosis, you know, at that stage they may not, they may disagree to say well, you know, be forcibly taken into a hospital or sectioned. But sometimes, you know, we are human being, you know, sometimes but it's the manner that that happens. Yes, you know, it could be construed as, you know, very, very oppressive or very, but I think it's, you know, it's how it's contextualised, you know. So, of course people say well, you know, I was sectioned, you know, I was forcibly taken, yeah but sometimes that's one of, that's the only way sometimes. And I'm not advocating that, you know, that's the right way but for some maybe it is. For me that was and, you know, I have no, I have no qualms about it, I have not complaints. You know, because otherwise I don't think I would have accessed services at all.

 

Hanif experiences periods of mania where his activity and speech is very fast, he has lots of...

Hanif experiences periods of mania where his activity and speech is very fast, he has lots of...

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I suppose just my, my activity becomes very fast paced, my speech also of course is also kind of very fast, you know, and I might, you know, share my mind kind of talk about lots of ideas. And therefore so very similar to what I had in my original kind of first or second episode where there was a flight of ideas and, you know, plans and all that kind of thing. I suppose one, you know, one can say you don't, you know, how, you, you're either in the creative bunch, you know, where you have lots of ideas, you know, and lots of good ideas but how do you translate those ideas into reality? And for me say, of course, I've become a realist to say actually ideas are great but then how to convert those ideas into some realities. So, you know, I always, you know, have fantastic ideas up here [coughs] but then I'm more cautious now, you know, how I share it with or what I do with them. And of course it's, you know, share it with a few friends that I have and then trying to put into context to say, 'Well actually yes this is a great idea but it's not achievable in the short run. It might take, you know, six, it might take a year or two years.' 

But I go through phases where I suppose I have lots of ideas and I'm kind of, you know, writing things down and sharing it with others So in terms of, you know, and there's a flurry of activity, you know, so in terms of doing lots of things, so in terms of, but I think I come, I can realise that I'm going through a kind of phase where maybe I just need to take things easy and maybe those, you know, ideas are very far fetched, you know, do-able but not in the immediate in the kind of immediate period. You know. And I think perhaps, you know, that in itself maybe is, is good for me anyway to say actually well maybe yes, you know, I need to kind of, you know, try and put those ideas, you know, in a pile in my in-tray but right at the bottom, you know. Because if I kind of prioritise it it's not good for my health. You know, so it's kind of that type of, kind of thinking that, you know, in terms of managing it, yeah.

Can you give me an example maybe, of the kind of ideas that you have?

I mean some were very simple ideas, you know, and of course, you know, I, you know, I'd share one of the ideas then in terms of, you know, which was going through my manic episode, you know, early, you know, my first, you know, few weeks of, you know, my, my kind of early, early psychosis, you know. You know, I had this idea, you know, to kind of, you know, make lots of money.

 

Hanif recalls being treated for possession and explains why he believes that a combination of...

Hanif recalls being treated for possession and explains why he believes that a combination of...

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You know, initially people said, you know, maybe Hanif may be possessed. You know, which is kind of a cultural or religious thing to say, well actually because mental illness nobody, because nobody wants to acknowledge that it's an illness. We put it to an unknown external factor which is fine, you know, if that's as a way for coping. And in my experience, you know, being a Muslim I can understand why many Muslims around the world and especially in the UK, you know, Muslims of different faith or different Muslims of different culture, you know, whether you're Indian, Pakistani, Bengali or others because nobody wants to acknowledge that you have a psychological or psychological distress or mental health problem or issue. It's easy in a sense, it's a much better way to cope by actually saying it or explaining it that, you know, that it could be jinn possession or external possession. Because as Muslims we believe in jinn possession which is an unseen in terms of, you know, it's an unseen identity, you know. And we believe in it. So it's easy for us to cope because actually I mean he's or she's possessed, rather than actually come to terms with actually there might be something, you know, psychologically not well with the person, you know. Could be, you know. And of course with myself that was also explored in terms of, you know, to say well actually perhaps, you know, but. 

But I think I was glad to an extent that, you know, that I was, that I did go and see a psychiatrist and got medication because, you know, that's what helped me. And, and I always say fine you know, prayers, faith can always help but sometimes you need medication as well, you know. And the combination of the two actually perhaps might be, it certainly was for me because I think, you know, from a faith, you know, kind of mixing faith in terms of issues about religion, faith probably prayers and faith, you know. My parents because when I was, when I was ill and I was on medication and I remember sleeping for almost eighteen, twenty hours a day because the dosage that I was on lithium, I think I don't know whether it was it was my highs but, you know, the kind of experience that I remember is I used to just take my medication and then I was knocked out until so to speak.

And I was probably sleeping a lot and just waking up and just eating a lot because that was also probably part of why I put on some weight. But of course, you know, his faith that, you know, his son will get well and, you know, all that counts. So I think that, you know, was also I'm sure. And my own kind of, you know, belief systems I know very strongly, you know, say one cannot, it's an illness one needs to acknowledge that it's an illness, you know. And you need, you need some type of help and support. And for me, you know, lithium was very effective for me. But alongside, you know, my own faith and people around me was also helpful. So I think a combination, you know, for. And, and I always joke in my language or in terms of, you know, to say, you know, and I'm not sure whether I can explain it here but nevertheless I will, you know. And of course I speak Urdu and a couple of other of languages. But most often people say, well I say, 'Well there is no one cure,' you know. I say for me it's 'Dua and dawa' which translate as prayers and medicine. A combination could be a, could be useful or, you know, could be a cure. And for some if it's an illness then prayers on its own actually will be, will be useful and helpful, but it's not actually going to actually cure to a, especially if you have an illness like, you know, bipolar or manic depression. You know. I haven't come across anybody who's been, who's actually got, got well just by praying. You know, so I always say, you know, in, in our language or, you know, or if I'm asked to talk about my experience, you know, I always
 

Hanif thinks people don't want to talk about mental health problems and unlike when someone has a...

Hanif thinks people don't want to talk about mental health problems and unlike when someone has a...

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And of course stigma is very much prevalent within all this, you know, especially because as soon as, you know, we go and say that, you know, Hanif, in my case certainly enough because the stigma was very real, because a lot of people in the community, of course once they got wind of, you know. And of course they observed my behaviour, you know. And of course they all said, Hanif's gone a bit, you know, crazy. And so of course that element also has its, you know, had a part, you know, because then of course it's also a subject nobody wants to talk about, you know. Because, you know, they might say silently but nobody wants to actually, not confront but nobody actually wants to, so nobody would even come to say to, for example, my dad and say what's wrong because it's a subject nobody, you know, like when you have cancer or something you, you know, you know, go and visit them if you're sick. In this case what do you do? I mean you don't go and kind of visit and, you know, come home and say, 'Oh how's your son?' you know. There's a sympathy, you know, because normally if someone in the home is sick, we have visitors. You know, many cultures, in our culture certainly, you know, if my mum is ill or somebody's ill, you know, we will get visitors coming in, you know, just to wish us well. If it's cancer or diabetes, not diabetes but more so one of the kind of major, you know, kind of, you know, long term illnesses, especially if its cancer or someone's had an accident. You know, you'd get visitors, you know, coming home and yeah. You know, coming for sympathy, I mean to give, to offer sympathy and well wishes and prayers. 

But in the case of mental health, you know, it's, it's, you know, do you go, do you not go? No one knows there are no protocols really. In terms of there is no, there is no good guide, there is no good practice guidelines [laughs]. You know, how to deal with it. Four years through experiences now I'm probably, I'm still not sure myself actually, you know. How would I, you know, how I would I go and, you know, say if I knew somebody, you know, would I approach, you know, go and offer my sympathies or some support directly to the home, or not? It's, you know, in a work setting I would I know to an extent how to offer help and support because I'm in that kind of work. But outside of that field it's, I still myself sometime struggle how one offer's support to people, you know, once, you know, that, you know, they've, you know, they've had an episode of an illness which might be serious.

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