I have just been reading this post on a blog I found last week. It's an interesting and insightful read which I think basically everybody should read. It reminded me of so many instances where I've been held accountable for my illnesses or been told that I'm not doing enough to get better. This isn't really something I should have to justify but I'll try, just in the hopes that someone reading this will realise that their words and action can be hurtful and uncalled for. Or that it will make someone feel less alone.
I remember the very first time I went to see someone about my mental health. I had not long left home and since moving in to the dingy little flat I shared with some friends I had barely left. I was jumping at shadows, suicidal and pretty much cried all the time. One of my friends pushed me into going to the GP, helped me register and make an emergency appointment all on the same day. They even came with me for moral support.
So then, here's what happened. I told the GP what was going on. That I'd felt low in mood for as long as I could remember. I self harmed, had tried to commit suicide multiple times, didn't eat and hated the way I looked. That I was scared of leaving the house or even being seen. The response was that I was young, attractive, had friends and a partner. Therefore there was no reason for me to depressed, so I should just stop being sad and concentrate on the good things in my life. Then I could go get a new job (I'd just lost one since I was too scared to leave the house and go to it) and all would be right with my world.
If only it was that easy, but it isn't. Depression hits despite the good things in your life and it makes it very difficult to appreciate them at times. Being told to focus on all the things I had going for me just made me feel awfully guilty about the way I was 'wasting' them by being mentally ill. This made me feel worse and in no way improved my mental health. So bad to the GP I trundled. This time they got annoyed with me and outright told me that I had no reason to be ill and just needed to grow up and accept everything wasn't going to be perfect all the time. At this point I broke down. I said I thought my mental health problems might have something to do with my father abusing me. Cue attitude change.
This time I left with a prescription for anti-depressants, a follow up appointment to see how I was getting on and a leaflet about the different services I could be referred to if necessary, which included talking therapies and support groups. Now that I had 'proved' that my illness had a cause it was accepted as real and the long process of treatment began. Of course, not everyone is lucky enough to be able to pinpoint a reason for their mental health issues, or isn't able to share them right off the bat. Thankfully most GP's in my experience don't demand that you have an explanation before they will consider your illness to be real.
I wish I could say that from this point my mental health was a) taken seriously and b) I wasn't blamed for being ill. Sadly, that hasn't been the case at all. After years of counselling, therapy, group therapy, various drugs, diets and exercise plans I am still ill. Now, my past is apparently something I should have dealt with by now and the fact I haven't is clearly my fault. I haven't been trying hard enough. I've had unrealistic expectations. I'm obviously lying about complying with my treatment. The message is always the same, if I wanted to get better I would. Since I clearly don't, there isn't any more that can be done for me and presumably I therefore deserve to feel like this.
I started with the medical side of things because that's where I foolishly expected people to be the most understanding. And I should be clear that some of them have been. My current GP is amazing and I used to have a really good CPN. They've been the exception though. A&E have been particularly awful but that's a whole other rant and post I'll no doubt make in due course.
So then, let me tell you about my least favourite conversation to have with people. The 'why aren't you working' conversation. I mention it's for health reasons, hoping it will be left at that. It rarely is. There is nearly always follow up, starting with how I don't look ill. Which means explaining that it's my mental health. Then there is everything from 'Oh I used to be depressed then I did X and now I'm better' to 'work is the best cure for depression' to 'well, depression doesn't really exist.' More recently there's also been 'maybe if you lost weight you'd be happier' which is just an astonishing thing to say to someone recovering from an eating disorder.
The 'why don't you try' conversation is frustrating. I am delighted to hear that you/your friend/someone you read about on the internet tried a new drug/diet/sugar pill/therapy and that it worked for them. If I explain that I've also tried X and it didn't work for me, please don't assume that I am lying to you or didn't give it my all. If X costs more than I can afford to pay and isn't available on the NHS, please don't bang on about how if I wanted to get better I'd find a way to pay for it. If X happens to be nonsense, there's every chance I've still already tried it or something similar out of sheer desperation. Different things work for different people, and sometimes a treatment IS worth re-visiting but please don't assume that because it worked for someone else it should also work for me.
Work. Working can do amazing things for mental health. It helps with the sense of self worth, with feeling useful and valued and part of something. However, it can also be a major cause of stress. And, whilst you may not want to hear this there are times when someone (including me) is not well enough to work. This doesn't mean I don't want to work, and when I am well enough I do.
As for the idea that mental health disorders don't exist... I don't know how to argue with people who refuse to acknowledge decades of research and evidence that says otherwise. I tend to find they don't have any interest in what I'm going to say anyway and simply want to lecture me about how there's nothing really wrong with me.
Here's the thing, I shouldn't have to justify my illness. I shouldn't have to explain endlessly that I am already doing everything I can to improve my health and situation in life. So, please just accept as fact a few things: my illness is real and I really have it, I'm am trying, probably more than you'll ever know and I don't owe you an explanation for why I'm like this.
I am mentally ill for a whole exciting mixture of reasons. Mental illness runs in both the paternal and maternal sides of my family, so there's every chance genetics plays a part. I lost an important relative at a very young age, and many more people I loved dearly since. I was sexually abused as a child. I experienced domestic violence and rape as a teenager/young adult. There is almost certainly a reactive element to my mental illness. I never once chose to be mentally ill, nor do I chose to remain so.