Wednesday, June 11, 2014

Talking frankly about mental illness

For the past few years in the UK, there has been a campaign to try to de-stigmatise the concept of mental illness. I guess this is my contribution. I'm not an expert. I have no training in psychiatry. My understanding of psychology and the human mind is rudimentary at best - mostly acquired as a result of working in the field of learning and development. Marginally enhanced by a personal, strictly amateur interest in the subject.

When I was growing up, and even into my adulthood, terms like 'mental illness' were just euphemisms for other, less kind words, like 'mad' or 'insane'. I used terms like 'insane asylum' and 'mental hospital' without giving them a second thought. Mental illness was something that happened to other people. Abnormal people. Scary people.

Then, in the early 90s, the wife of one of my husband's colleagues had what is still usually referred to as a nervous breakdown. She was placed in a facility that we referred to in hushed tones as a mental hospital. I had no problems asking her husband after her health and progress and offering him help and support - all in that exaggeratedly self-congratulatory sympathetic way, with the slightly tilted head. But I was less brave when it came to speaking to her - it was the elephant in the room that we didn't talk about. So I sort of avoided her altogether, which was unspeakably cruel.

I knew that people like Spike Milligan had had what used to be called manic depression, and I saw the evidence of it in his brilliant work. I began to wonder about people like Mozart and van Gogh.

It took a long time before I was prepared to admit to myself that I, too, experience mental illness from time to time. And I don't mean in that "my kids drive me nuts" kind of way. Nor am I 'insane'. My battle is with depression.

I had always had a tendency to 'get a bit down' from time to time. Something which got no sympathy at boarding school. At other times, the smallest thing would send me off into a towering rage from which I struggled to return. The towering rages were shrugged off as PMS. I wonder how often women with mental illness are misdiagnosed with PMS.

For me, the 'getting a bit down' thing became a bit more problematic. I was eventually diagnosed as having depression and given anti-depressants. The first lot gave me the raging munchies and caused me to gain weight, which made me more depressed. So I was switched to that miracle drug of the 90s: Prozac.

I decided I didn't want to be dependent on chemicals to deal with the day-to-day reality that is my life, and I weaned myself off them - cold turkey is not advised.

I have had repeat bouts of depression over the years - some of them so deep and so dark that I have not expected - or even wanted - to emerge from the other side. Calm, rational (or so they seem to me) thoughts of suicide have been very much the order of the day at times. During my studies in 2007-2010, an unexpected setback pushed me over the edge, and I suspect I had a nervous breakdown. It was a year before I was able to return to my studies without having a full-blown panic attack. I really should have sought professional help. As it was, my poor dissertation supervisor had to deal with tears and tantrums befitting a child, even after I got back to my studies.

I have learned to distinguish between being unhappy and being depressed, for the most part. It took a while, and I still don't always get it right. I have managed to avoid drugs as a long-term solution, but I don't rule out the possibility that I might have to go that route at some point in the future. I know the view at the bottom of that dark pit, and it's not one I am keen to see again, but the odds are against me.

Everybody is different. Each person will have their own experience of what works and what doesn't work. For me, it's as follows:
  • Telling me 'I'm there for you' doesn't do it for me. I have no idea what that means. They're just words, as far as I'm concerned.
  • Any sentence that starts with "At least..." isn't going anywhere helpful.
  • Do not EVER ask "What have you got to be depressed about?" and then proceed to enumerate all the wonderful things in my life. I know I have a well-paid job. I know my husband adores me. I know I have a lovely home - which is a tip right now, because I'm wallowing. I know my kids are wonderful. And now I also feel guilty that that 'isn't enough for me', as some people perceive it, and I sink lower into the mire.
  • Some people know exactly what the solution is, and they declare it with great confidence. When my depression continues, they either (a) feel helpless because they don't know what else to suggest or (b) get impatient because I should be over this by now.
  • Being 'given space' is not helpful. People often politely step back and leave me to get on with it, on the understanding that I will contact them when I once again feel ready for human contact. All that happens is that I feel abandoned. Politeness is over-rated. When I do emerge, I will probably just continue to respect the space that you have created between us.
    I've made a nest
  • Other people ask me what they can do for me and then disappear when I say I don't know or that there isn't anything they can do. When I am in that pit, I just want to relieve people of the burden of my company, and I'm useless at making decisions. I'm not going to ask for anything.
  • Someone who pitches up, sits me down on the sofa with a chick flick and then sets about cleaning my kitchen or my bathroom will make more difference to me than someone who tries to dispense wisdom. Having a clean kitchen and bathrooms give me an enormous boost, but when I'm depressed I can't motivate myself to do it, which makes me feel worse.
  • When I'm depressed, I can't bring myself to spend money on myself. I try to take up as little space in the world as possible, so I look a fright, which also makes me feel worse. Taking me to have my hair cut or giving me a home-spun makeover will also give me a boost.
  • Bringing a home-cooked meal and relieving me of the anguish of watching my husband have to shoulder more than his fair share of the household chores would also help.
  • Coming over with the makings for a day of crafting-and-making would get me up and busy, and the fact that we're not making direct eye contact might even enable me to talk more easily about what I'm going through. Don't feel under pressure to have answers.
  • Coming over with your dog, and taking me and my dog out for a long and strenuous walk would get me out of the house and the endorphin flowing.
  • On the subject of endorphin - an exercise session would help, too. So bring along your Davina McCall fitness DVD and do a workout with me.
  • Popping over for a day of bad movies and worse snacks would help, too.
  • When I start to emerge from the pit, don't avoid talking to me about it. Don't adopt falsely cheerful tones and ignore the elephant.
  • Don't be astonished if there's a relapse. Recovery isn't linear.
  • Don't patronise me. I might be acting like a petulant child at times, but I'm still an intelligent adult.
  • Talk to me about your own experience. Ask me what I find helps me. Have a rational conversation with me. 
  • Don't treat me like a victim and steer me away from treating myself as such. 
For the most part, I don't want someone to 'fix' me. I'm not looking for a problem-solver. I need people who will demonstrate that they aren't going to be driven away by me at my unlovely worst.

I have shared a cartoon, as you can see. I wish I could track down the original and give credit to the person who created it. If you recognise it, please let me know. It resonates with me.

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