Today I have been listening to blaming the victim, a radio documentary by Grace Chen. It's well worth listening too. Then I got into a conversation with some friends about it. Sad to say one them responded by claiming that women should be taking precautions against rape and that, in their opinion many rapes could be avoided if women were more careful. Naturally this made me very angry. I don't do well in debates when I'm angry and upset at the same time as I tend to become a bit incoherent and tearful. So, I let my other friends take over for a bit.
Now that I am a little calmer I want to talk about one of the many reasons that women 'being more careful' isn't a good way to prevent rape. For a start, it won't do anything to stop men being raped, so there's that. Also, as long as there are people vulnerable to rape rape will continue to happen. It's not possible to remove all vulnerability by 'being careful'.
When I was 15 I was raped by a boyfriend. I was alone with him in his house, we'd been drinking and I was wearing make-up. My parents didn't know where I was, they didn't want me dating and drinking at that age so I hadn't told them. All of this is fairly standard teenage behaviour but I can see that I had put myself in a vulnerable situation, by lying about where I was, by drinking, by dressing up nicely and by being alone with a boy. However, I have a few questions. Is it unreasonable to want to look nice for a date? Is it unreasonable to spend time, alone, with someone you trust and who is supposed to care about you?
Sure, I shouldn't have been drinking as I was under age. Sure I shouldn't have lied to my parents. Let's look at why I was doing those things, shall we? I had a bit of a drinking problem when I was 15. I had turned to drink as a way to cope with my constant anxiety, in a huge part triggered by the ongoing sexual abuse by my father. I didn't tell my parents where I was going because if I had they wouldn't have let me go out. I desperately wanted to be out because when I stayed at home I was at huge risk of being raped by my father.
I could have hung out on the streets but I had had it drummed into me from a young age that this put me in danger, of rape or other violent assault. I could have been with my female friends. Earlier in the night I was, we all hung around in a nice big mixed gender group. Only it was a school night and one by one people went home. My boyfriend was the only person I knew who's house I could stay at that night. Since going home put me in danger of being raped, this seemed like the safest option.
So, I drank in order to over come my anxiety so that I could bring myself to leave the house. I needed to be out of the house to ensure I wasn't raped by my father. In order to stay off the streets, which is a dangerous place to be, I agreed to go home with my boyfriend. This meant being alone with him, but he'd never previously raped me, I trusted him and he'd promised to always take care of me. So, everything I did - aside from wearing make-up to look pretty for my date - was designed to protect me from rape. Yet I still ended up being raped that night.
I wasn't raped because I wasn't careful enough. I was raped because my boyfriend wanted to rape somebody.
Now, I know this is only my story. Not everybody who is raped shares my experience. The point remains though that being careful didn't stop me being raped. The only thing which will protect people from rape is by creating a culture where rape is not acceptable. Part of that can be achieved by not blaming the victim, or telling people that they can stop rape by being more careful and instead focussing our attentions on the people who want to rape.
Thursday, 16 May 2013
Why I don't like the whole 'survivor' thing
I mentioned in an earlier post that I don't really like the term 'survivor' when it's applied to people who have experienced sexual violence. Now seems as good a time as any to talk about why.
For those who aren't familiar with it, 'survivor' is used in place of 'victim' and is supposed to be empowering. Well, for me I have never found it to be empowering, quite the opposite. Whilst I was being abused I was most definitely a victim, calling me something else couldn't change that fact. Once the abuse stopped I certainly didn't feel like I had survived the experience, at least not intact. In fact, I took matters into my own hands to try and do quite the opposite. I tried to kill myself several times.
When people refer to me as a survivor it feels like they are making an assumption that I did something to survive, that I am exceptionally brave or heroic of something. Which was entirely at odds with my actual lived experience. It might be more appropriate these days, when I have a vested interest in being here and having a life. But here's the thing, for years before I reached that point people kept insisting that I was a survivor despite the fact what I felt like was a victim.
They kept telling me not 'let myself' be made into a victim. Which was an idea that struck me as ridiculous. I hadn't allowed myself to be made into a victim, I had been victimised by someone who had power over me. It wasn't something over which I had a choice. I understand that what people were trying to do was help me change how I viewed myself, to present me with an option that seemed more positive. Instead, they made me feel that by acknowledging the fact I had been victimised I was showing weakness and letting my father win.
The truth is, it was vital for my recovery that I accepted how powerless I had been. It was the only way for me to realise that I hadn't been in any way responsible for what happened to me, which I needed to do to let go of the guilt I felt about what had happened. It was only then that I could start the lengthy process of moving on. The constant pressure to relabel myself a survivor rather than a victim seemed designed to skip this step.
It also seemed to deny and dismiss the way I felt. The fact that for many years I didn't even feel like a whole person but rather a broken, fracture being. Which is not to say that all people who have experienced sexual violence feel the same way I do. Of course they don't, we're all different. For me though, the survivor label didn't fit and when I tried to object to it I was made to feel that I was doing something wrong.
Lets skip on a bit, to a time where I started to feel able to move forward with my life. Where I'd had extensive therapy and was starting to accept that my father was 100% responsible for what he did to me. Where I was no longer determined to die and had started to build a life for myself beyond the abuse. Such as now. As I said earlier, survivor might be a more appropriate label these days. A victim is what I was but it doesn't need to be who I am now.
Only, I don't want to be a survivor either. I don't want who and what I am to be defined in any way by what happened to me as a child. It's already the case that much of who I am has been shaped by my early experiences, as is true for everybody. I don't really see the benefit in granting my abuser any more power to dictate who I am. I'm not a survivor, I'm a person who happened to be abused growing up and who happened to live beyond that experience. I am so many other things; a feminist, a writer, a lover, a friend, a daughter, a carer, an activist, a goth. A person. That's how I chose to identify myself.
If other people find the label helpful then great, but please stop applying it to everybody who's ever experienced sexual violence. Not all of us find it helpful or useful, some of us find it quite the opposite.
For those who aren't familiar with it, 'survivor' is used in place of 'victim' and is supposed to be empowering. Well, for me I have never found it to be empowering, quite the opposite. Whilst I was being abused I was most definitely a victim, calling me something else couldn't change that fact. Once the abuse stopped I certainly didn't feel like I had survived the experience, at least not intact. In fact, I took matters into my own hands to try and do quite the opposite. I tried to kill myself several times.
When people refer to me as a survivor it feels like they are making an assumption that I did something to survive, that I am exceptionally brave or heroic of something. Which was entirely at odds with my actual lived experience. It might be more appropriate these days, when I have a vested interest in being here and having a life. But here's the thing, for years before I reached that point people kept insisting that I was a survivor despite the fact what I felt like was a victim.
They kept telling me not 'let myself' be made into a victim. Which was an idea that struck me as ridiculous. I hadn't allowed myself to be made into a victim, I had been victimised by someone who had power over me. It wasn't something over which I had a choice. I understand that what people were trying to do was help me change how I viewed myself, to present me with an option that seemed more positive. Instead, they made me feel that by acknowledging the fact I had been victimised I was showing weakness and letting my father win.
The truth is, it was vital for my recovery that I accepted how powerless I had been. It was the only way for me to realise that I hadn't been in any way responsible for what happened to me, which I needed to do to let go of the guilt I felt about what had happened. It was only then that I could start the lengthy process of moving on. The constant pressure to relabel myself a survivor rather than a victim seemed designed to skip this step.
It also seemed to deny and dismiss the way I felt. The fact that for many years I didn't even feel like a whole person but rather a broken, fracture being. Which is not to say that all people who have experienced sexual violence feel the same way I do. Of course they don't, we're all different. For me though, the survivor label didn't fit and when I tried to object to it I was made to feel that I was doing something wrong.
Lets skip on a bit, to a time where I started to feel able to move forward with my life. Where I'd had extensive therapy and was starting to accept that my father was 100% responsible for what he did to me. Where I was no longer determined to die and had started to build a life for myself beyond the abuse. Such as now. As I said earlier, survivor might be a more appropriate label these days. A victim is what I was but it doesn't need to be who I am now.
Only, I don't want to be a survivor either. I don't want who and what I am to be defined in any way by what happened to me as a child. It's already the case that much of who I am has been shaped by my early experiences, as is true for everybody. I don't really see the benefit in granting my abuser any more power to dictate who I am. I'm not a survivor, I'm a person who happened to be abused growing up and who happened to live beyond that experience. I am so many other things; a feminist, a writer, a lover, a friend, a daughter, a carer, an activist, a goth. A person. That's how I chose to identify myself.
If other people find the label helpful then great, but please stop applying it to everybody who's ever experienced sexual violence. Not all of us find it helpful or useful, some of us find it quite the opposite.
Saying goodbye to Ana and Mia
I was always an anxious and insecure child. I used to chatter to anybody who'd listen, mostly out of a fear that if I wasn't talking or making noise I would be ignored or forgotten. When I was ten my father started to sexually abuse me, at that point I stopped being quite such a chatter box. I preferred to be ignored, the more invisible I felt the safer I felt. The last thing I wanted was to draw attention to myself. I never did feel invisible enough however, my father still noticed me on a regular basis.
Somehow, I lost my ability to talk to people easily and make friends. By the time I started secondary school I was a bit of a loner, though I made a few friends with some other shy, socially awkward girls. They weren't friends I could talk to though, not really. I didn't have the words to explain what was going on, how unhappy I was or my secret desire to vanish. It was during my first year at secondary school that I made the aquaintance of Ana.
I could tell Ana anything without fear of judgement. We'd make up stories together about how I'd already eaten, then we'd sit in my room until all hours unable to sleep but full of ideas. Ana held me close and promised to save me when my father abused me. Ana gave me the ability to smile and laugh at lunchtime, the confidence to appear a happy girl so that no one noticed or asked why I didn't eat. Ana was with me when I stood on the scales and watched the numbers go down, watched me get closer and closer to the dream of being small enough to hide.
By the time I started my second year people were starting to notice Ana. Ana hated the attention, the interference. We were worried that people would start to try and split us up. Ana was even more private than me. So Ana introduced me to somebody else, a new friend to add to our trip. Mia.
It was Mia who stuck with me when I ate to put people off the scent. Mia was with me late at night when I snuck downstairs to raid the cupboards. When I ate still frozen cheese cakes. Mia and Ana stood on either side while I threw everything back up again. Mia soothed me when the numbers on the scales went up again, Ana delighted when they went down.
For the next five years we played this see-saw game. Mia helped me get the numbers up, until people stopped caring. Ana helped me drop them again until the attention became too much. Then my two friends started to fall out. Mia let me get too big, Ana wanted me smaller. Mia thought it was perfectly OK to eat and eat and eat, so long as I got rid of it afterwards. Ana thought Mia got in the way, stopped us reaching our goal. They fought for a year.
The year I started university, Ana won the war. It was Ana that guided my steps as I dropped out, then moved out of home to avoid awkward questions. It was Ana who shut me away from life with just the scales and bottles of diet coke.
It was Mia who came to my rescue, when Ana had left me too weak to even leave my bed. It was Mia who picked up the pieces, who made it OK to eat again, as much as I wanted. So long as it didn't stay in me for too long. It was Mia who let me live a semblance of life, who helped me make new friends. I loved Mia so much. Mia stayed with me for the next decade, giving me permission to stay at home and eat instead of go out to work. Mia who encouraged me to end relationships when I was caught being sick after meals. Mia who said I didn't need to vanish completely, but just stay thin enough to feel like I could if I wanted to.
So it continued until one day I realised that it was Mia who denied me a career. Mia who denied me love. Mia who was never going to deliver on all those promises of happiness and a future.
Saying goodbye to Mia was hard, particularly with Ana waiting in the wings, hoping to step back in to the best friend spot. But I had finally realised something important. Ana had never been able to keep me safe or make me invisible, any more than Mia had been able to ensure happiness. Neither of them granted the promises they made so easily, yet I had given over half my life to them.
I needed new friends and real support. So I told people, I dragged Ana and Mia out into the open everybody could see them. I made myself visible again, and in doing so I found a world of hugs that were only hugs, safe and loving offered with no expectations. I found people willing to listen to what I had to say about things far more interesting than the numbers on the scale.
Ana and Mia still hang about the place, they aren't ready to go away without a fight. I argue with them every day and slowly but surely I'm getting there, with the help of my new friends.
Wednesday, 15 May 2013
A rant about A&E
OK, first off I want to say that I don't come close to understanding the high stress of working in an A&E department. I've never done it, I've only ever been there as a patient or with a patient. I recognise that it's a difficult and sometimes dangerous job and in general I have a lot of respect for the people who take it on. That said I have had some really distressing experiences in A&E departments and I doubt I'm alone. The one time I went it with a physical injury they were awesome, likewise when I've attended with somebody else for physical issues they've been pretty damn good. Not that I've never encountered issues on that front - I have, particularly waiting times - but my experiences have been better than when I've been in with mental health based issues.
I once went it because I was feeling suicidal, was genuinely scared I would act on that urge and was told by the out of hours service that it was the best place for me. When I got there I was told that I hadn't harmed myself so they had no idea what I thought they could do. Not reassuring.
I've been taken in via ambulance twice, post overdosing. On both occasions I was tutted at and told off. Once a nurse even told me that if I was really trying to kill myself I wouldn't have chosen those particular tablets as 'everyone' knows they don't kill you. There was also a running commentary on the scars and cuts on my arms, which included a doctor poking at one and asking if I could feel him doing so. Yes, I could feel it. It bloody hurt.
Here's the thing. Not every overdose is a suicide attempt. Overdosing can also be a form of self harm. Self harm is self harm, not a suicide attempt. They are, in fact, different.
In both cases, someone else phoned the ambulance. I didn't really want to go in but was persuaded to by lovely ambulance people who made me feel looked after. Only one of my hospital trips was post a suicide attempt. I was made to feel stupid that it hadn't worked/left me with permanent damage. Apparently that meant I wasn't trying hard enough and was thus wasting time. Not a good way for a suicidal person to feel.
I have been in with other people post suicide attempts and seen them treated in similarly appalling ways. It enrages me, it really does. In A&E your job is to treat people, not judge them. I think there are some simple rules people need to remember.
1) If someone is taken into hospital after harming themselves, whether in a bid to end their life or not, there is obviously something wrong. To find out what is wrong, talk to and listen to your patient with sympathy and understanding.
2) Alienating and upsetting your patient will make things harder both for them and you. It makes it harder for you to do your job and may lead to you missing something important and getting them the right help.
3) Nobody hurts them self with the intention of wasting your time, creating extra work for you or making it harder for you to treat other people. In fact, their actions before entering A&E had absolutely nothing to do with you and so shouldn't be taken personally.
4) Curtains are not walls and your voice will carry through them. If you really are annoyed with your patient and feel you must vent, do so out of earshot of both them and other patients.
5) There was a reason the person did this to them self, it may be a symptom of a mental illness. Blaming people for their symptoms is not on. Would you blame someone else for having an asthma attack or having a cough?
Every time I think about this subject I get choked up. I once wrote a very nasty letter to an A&E nurse, though I never sent it. This was after a friend of mine killed herself. It was the last of multiple attempts, on the previous attempt she was told by a nurse that if she really wanted to die she'd have done it by now and to stop wasting everyone's time. I've always wondered if the nurse knew that my friend did indeed stop wasting everyone's time. Forever.
To be fair and balance this out, I want to briefly talk about the time I went to A&E with a friend of mine who had taken a potentially fatal overdose. I went with her in the ambulance and stayed with her until she was admitted several hours later. The nurse who saw her was brilliant. She was calm and efficient, and constantly reassured my friend that they were doing everything they could to save her life and make her comfortable. After the doctor had seen my friend, she stopped by to make sure we'd understood what was said and what was being done. She popped in often to see how we were getting on. She held my friends hand and listened when she was off oxygen and talked about being angry that her life had been saved. She got her talking about why she was so determined to die and asked what would make my friend not want to die. She never once made her feel guilty for being there and in fact did quite the opposite, assuring her she had ever right to be treated.
So there are absolutely people out there doing it right and it's entirely possible I've just been unlucky. Only I've had a lot of people share similar experiences with me. Personally, I think there should be mandatory training aimed at raising awareness of mental health and giving staff the tools they need to handle it. Not only when they first train but on an annual basis.
I once went it because I was feeling suicidal, was genuinely scared I would act on that urge and was told by the out of hours service that it was the best place for me. When I got there I was told that I hadn't harmed myself so they had no idea what I thought they could do. Not reassuring.
I've been taken in via ambulance twice, post overdosing. On both occasions I was tutted at and told off. Once a nurse even told me that if I was really trying to kill myself I wouldn't have chosen those particular tablets as 'everyone' knows they don't kill you. There was also a running commentary on the scars and cuts on my arms, which included a doctor poking at one and asking if I could feel him doing so. Yes, I could feel it. It bloody hurt.
Here's the thing. Not every overdose is a suicide attempt. Overdosing can also be a form of self harm. Self harm is self harm, not a suicide attempt. They are, in fact, different.
In both cases, someone else phoned the ambulance. I didn't really want to go in but was persuaded to by lovely ambulance people who made me feel looked after. Only one of my hospital trips was post a suicide attempt. I was made to feel stupid that it hadn't worked/left me with permanent damage. Apparently that meant I wasn't trying hard enough and was thus wasting time. Not a good way for a suicidal person to feel.
I have been in with other people post suicide attempts and seen them treated in similarly appalling ways. It enrages me, it really does. In A&E your job is to treat people, not judge them. I think there are some simple rules people need to remember.
1) If someone is taken into hospital after harming themselves, whether in a bid to end their life or not, there is obviously something wrong. To find out what is wrong, talk to and listen to your patient with sympathy and understanding.
2) Alienating and upsetting your patient will make things harder both for them and you. It makes it harder for you to do your job and may lead to you missing something important and getting them the right help.
3) Nobody hurts them self with the intention of wasting your time, creating extra work for you or making it harder for you to treat other people. In fact, their actions before entering A&E had absolutely nothing to do with you and so shouldn't be taken personally.
4) Curtains are not walls and your voice will carry through them. If you really are annoyed with your patient and feel you must vent, do so out of earshot of both them and other patients.
5) There was a reason the person did this to them self, it may be a symptom of a mental illness. Blaming people for their symptoms is not on. Would you blame someone else for having an asthma attack or having a cough?
Every time I think about this subject I get choked up. I once wrote a very nasty letter to an A&E nurse, though I never sent it. This was after a friend of mine killed herself. It was the last of multiple attempts, on the previous attempt she was told by a nurse that if she really wanted to die she'd have done it by now and to stop wasting everyone's time. I've always wondered if the nurse knew that my friend did indeed stop wasting everyone's time. Forever.
To be fair and balance this out, I want to briefly talk about the time I went to A&E with a friend of mine who had taken a potentially fatal overdose. I went with her in the ambulance and stayed with her until she was admitted several hours later. The nurse who saw her was brilliant. She was calm and efficient, and constantly reassured my friend that they were doing everything they could to save her life and make her comfortable. After the doctor had seen my friend, she stopped by to make sure we'd understood what was said and what was being done. She popped in often to see how we were getting on. She held my friends hand and listened when she was off oxygen and talked about being angry that her life had been saved. She got her talking about why she was so determined to die and asked what would make my friend not want to die. She never once made her feel guilty for being there and in fact did quite the opposite, assuring her she had ever right to be treated.
So there are absolutely people out there doing it right and it's entirely possible I've just been unlucky. Only I've had a lot of people share similar experiences with me. Personally, I think there should be mandatory training aimed at raising awareness of mental health and giving staff the tools they need to handle it. Not only when they first train but on an annual basis.
It's not my fault, dammit.
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.
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.
Tuesday, 14 May 2013
Simple things which become hard when you're mentally ill
I try to be open about the fact that I am mentally ill, mainly because I think it's important to fight the stigma attached to mental illness. Also because honesty is absolutely the best way to fight 'the lying disease.' That said, there are times when I simply am not up to dealing with conversations about mental illness. When I don't have the energy to grit my teeth and explain for the nth time why I can't 'just snap out of it.' Times when I simply don't have it in me to try and prove to someone that my illnesses even exist in the first place. There are times when even the simple things in life seem to take energy, motivation and skills that I just haven't got.
When I say simple things I really do mean simple. Things which people do every single day. Take the morning for example. A fairly normal morning routine might go as follows: Get up. Shower. Get dressed. Eat breakfast. Brush teeth. Simple, right? Wrong. Let me talk you through my morning.
Get up
I wake up tired and sort of blank feeling, with the thought that nothing really matters. I consider the fact that this thought should bother me but somehow I can't care enough to, well, care. I know I should get up but I don't see the point. Plus my limbs feel heavy, too heavy to move. I try, but I can't move my legs. Panic sets in. I can't move! I concentrate on moving my foot and manage to twitch it a little. I'm not paralysed, there is nothing wrong with me. I can move. For some reason this fact has bursting into tears. I sort of wish it was impossible for me to move, then no one could expect me to do such impossible things as get up and go out and do things that seem, in this moment, to be beyond me. I cry myself back to sleep. Next time I wake up I manage to drag myself out of bed but once I've done that I don't know what to do with myself.
Shower
Today is not a day for being naked. I don't want to see my ugly flesh, my stretch marks, my scars. I don't want to have to touch and handle the fat which I know will have make me quite literally sick. I am not sure today that I will have the strength to resist the urge to take a razor to my hated body. I skip the shower for the third day in a row. I am starting to smell a bit but again, I can't summon up enough energy to care.
Get dressed
I still haven't managed this today. Partly it's the thought of being naked again, even briefly. Partly it's because being in my bed clothes is sort of my safety net. It's like being snuggled up in the safety of bed all day long and I'm not ready to give it up yet. Besides, now that I've missed work (again) there's no reason to go out so what's the point?
Eat breakfast
Meals are difficult. First you have to go to some effort to make them happen. For me to eat breakfast this morning I would have to first wash up. I stare blankly round the kitchen for a bit. I know I need to eat. I can't afford to skip meals without risking a fall back into my disordered eating patters, plus I am meant to take my medication with food. I do some washing up but can't summon up anything even close to an appetite. Instead of eating I take my tablets with a sip of water and go back to bed.
Brush teeth
I realise I haven't done this yet after I have climbed back into bed. What's the point? I haven't eaten anything. I am never going to eat anything again. Or do anything again. I am going to just lie here and sleep until I am dead. On some level I know this isn't true but it seems to make sense at the time. I go back to sleep.
On a day where I do have the energy and motivation to do these simple things they are still hard. By the time I have left the house in the morning I am often already worn out. Some days, like today, they seem beyond me.
When I was skinny...
I once passed out five times in a week. I felt dizzy all the time. I ached all the time. I was frequently sick, even the thought of food made me nauseous. Hunger made me feel nauseous too, so that was basically a lose lose situation right there. I didn't sleep for days at a time, then I'd sleep a whole weekend away. My teeth hurt. My stomach hurt all the time, which I kind of liked as it reminded me to hold it in at all times. I self harmed on an almost daily basis. I smoked too much, drank too much and took too many diet pills.I spent hours every day putting on make-up, doing my hair and changing my clothes. I spent hours every night doing the same thing. I had seizures caused by low blood sugar and electrolyte imbalances. My chest ached and there were often times I struggled to breathe. I ran late every night and early every morning. I did star jumps and burpies and sit ups. Hundreds of each every day.
Then there were the times I couldn't resist food. The times I spent all my money on cigarettes, fizzy drinks and junk food. So much junk food. Then I ate it, all of it. Too quickly to really taste it, certainly too fast to enjoy it. I ate until I felt like I was going to burst, then ate some more. I ate until I hurt too much to fit anything else inside me. Then I made myself sick. I didn't even need to stick my fingers down my throat. Then back to the food. Rinse and repeat until all the food was gone.
All these memories aren't happy. I wasn't happy. I was miserable.
So can anybody tell me why some days, I miss being anorexic. :(
Then there were the times I couldn't resist food. The times I spent all my money on cigarettes, fizzy drinks and junk food. So much junk food. Then I ate it, all of it. Too quickly to really taste it, certainly too fast to enjoy it. I ate until I felt like I was going to burst, then ate some more. I ate until I hurt too much to fit anything else inside me. Then I made myself sick. I didn't even need to stick my fingers down my throat. Then back to the food. Rinse and repeat until all the food was gone.
All these memories aren't happy. I wasn't happy. I was miserable.
So can anybody tell me why some days, I miss being anorexic. :(
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