It’s World Mental Health Day, and it’s also 10 years since I was first diagnosed with mental illness. At the age of 16, after contracting viral hepatitis, I developed a panic disorder, anxiety and OCD: and what a ride it’s been. The past 10 years have been full of ebb and flow. My health was at its most debilitating early on, when I couldn’t leave the house or eat, lost a huge amount of weight, had to leave school and my A Levels, and at least three times a day was so wracked with terror I couldn’t move. Over the subsequent years I’ve enjoyed long stretches of time when I barely noticed my anxiety (my OCD is always lingering) and darker periods when I’ve struggled to hold down a job.
Perhaps aptly, I went to see my GP yesterday to discuss the last two months. Every half year or so I tend to need a check-in. My anxiety fluctuates and it’s currently very high, but I’ve also been feeling a depression I’ve never felt before. I’ll spare the details of the appointment, because they’re boring, but after a useful conversation involving recommendations of cheaper counselling services in Edinburgh and the suggestion to up my meds, I was struck – not for the first time – by the doctor’s apparent desire to minimise the problems I’d presented her with. I don’t doubt that it came from a good place, wanting to reassure me that I am not alone, but nevertheless I was frustrated and, conversely, felt more alone than when I’d walked in.
In 2018 we are talking about mental illness in a way we never have before. The ‘conversation’ is rife with celebrity voices and influencer campaigns, inspirational quotes and timetotalk tweets. It is positive: government ministers appear to be listening and the stigma around – namely – anxiety and depression seems to be fading. People now feel able to open up about their struggles and go to the doctor and get help, in whatever form that takes for them. However, there are more than a few problems with the way we’re now approaching mental health and as society in general becomes liberated further still, those problems take on a more dangerous context.
The (positive) effect on increased mental health awareness is that more people than ever are getting help. Last year the NHS prescribed a record number of antidepressants and over four million of us are now long-term users of the drugs. The question of whether there are more people suffering with mental illness in comparison to previous generations or simply more people who know what it is has never been resolved, but regardless, there are indeed more people in waiting room. So far, NHS resources are not matching the demand. Not even close. Waiting lists for talking therapies are six months at least, unless the patient is suicidal or severely malnourished, and GPs are resorting to prescribing Headspace – a meditation app. Said app has been suggested to me personally on three separate occasions, when I’ve been in the throes of debilitating anxiety and panic attacks that saw me unable to get to work every day or on a train or to sleep at night.
I was at a book event for a mental health memoir in the summer and at the end, when it was time for audience questions, a woman stood up, crying, and spoke of her sick 13-year-old son who is unable to leave the house, go to school, eat, or barely step outside the four walls of his bedroom due to contamination OCD and panic attacks. I cried as she talked. So did my mum who sat next to me and, 10 years ago, had to powerlessly watch me in the very same state. The woman had been desperately trying to get her son help for a year. He was on medication, which had helped a bit, and was on a waiting list for Cognitive Behavioural Therapy (CBT). He couldn’t leave the house though, so how he was going to get to the therapy once he got to the end of the list was another question entirely. The fact that he wasn’t going to school, putting him behind and probably unable to start his GCSEs the following year didn’t seem to be hurrying the process along.
People who have serious (shall I use a capital S?) mental health problems, such as schizophrenia, bipolar, psychosis, borderline personality disorder, or severe strands of panic, OCD, depression or anxiety are the ones who are suffering even further right now. The lack of qualified staff, the long wait times and the inability to tailor therapy to the person can be fatal. I would also venture that these are the people still suffering under the stigma, who will struggle to hold down a job due to the erratic nature of their illness and feel isolated from their social circle because their behaviour can be unreliable and unsettling.
While inspirational quotes are posted liberally to Facebook, Twitter and Instagram we are told to talk, not to be ashamed, that we are not alone, that we are all in this together. I was told by my doctor that I shouldn’t worry too much because so many people suffer in the same way. Which is true… and not true. But definitely minimises my pain. Yes, let’s talk about it, but let’s not assume that everyone feels anxiety in the same way. I heard a quote recently that resonated so deeply (probably on The High Low): ‘a lack of empathy is just a lack of imagination’. It is a problematic, albeit arguably natural, instinct that to make someone feel less alone in their pain one has to relate to it. I disagree. We all experience mental illness differently, to different degrees and with different consequences. I cannot hope to understand the unimaginable terror of a psychotic episode or a month of disassociation regularly endured by someone with Borderline Personality Disorder. Similarly, someone who describes themselves as a ‘germaphobe’ cannot understand my experience and what it’s like to be so terrified of germs that you fear the very air around you. There’s a spectrum when it comes to anxiety and depression, too, and although there appears to be an outward understanding of that, in practice I’ve seen different. I’ve had many conversations with friends and family that leave me feeling misunderstood. Well-meaning loved ones who themselves have endured their own form of the illness and seek to comfort by assuring me that ‘it’ll pass’ because ‘it did for [them]’. I have offered the same advice many times and am only now realising how truly unhelpful it can be.
The rhetoric around mental illness right now is well-meaning but surface level. In my darkest times I find it vapid. We still have a long way to go before we are caring for people with mental illness in a way that plunges deep into stigma, legislation and true awareness. We are severely lacking the resources to deal with the mounting pressure on the NHS mental health services, and we could do with more voices in the mix: voices that speak of the ugly truth, rather than the PG version. This isn’t a club most of us want to be a part of. It’s not glamorous and, although it is good fodder for an interesting think piece, it is an unbearable part of many peoples’ daily lives. If we’re going to truly help, we need to talk about that.