Talking Mental Health

This post has been started and left unfinished so many times. Talking about mental health is something that I do often, and am pretty passionate about. But, even as someone who is happy to allude to their own experiences, I still talk about it in fairly abstract terms. I think I constantly make the assumption that, in some way, my history (and current battles) are somehow obvious, or that because of my research and career interests, people should make some kind of natural connection and go, ‘ah, she cares because it’s personal’. But people aren’t always like that, and also, for someone who wants so badly to preach and advocate, I am shockingly private about my own mental health except for with maybe two or three girl friends.

Looking even at this blog, which is meant to be a pinnacle of transparency, you’re going to hear an awful lot more about smelling good and bathbombs than you are my actual, real-life experiences. Even when I pat myself on the back for being vaguely open by sharing creative writing or poetry, that’s still mental health talk in the abstract. I’ve written and shared pieces of creative work that seems to look at how other people have peeled me off the floor. Those were old pieces that I shared, and I shared them as if they were still relevant.

A couple weeks ago I had a conversation with someone about working hard. They had a talent, and I said that I didn’t; at least not one that I had to really work for. This is so telling. I thought straight of academia. I coast along, I don’t work hard. I thought about skills; I decided I didn’t really have any. And I left it at that. That I had not worked hard at all, at anything, not ever. It took about five hours for it dawn on me that that was such a fucking lie. I have worked so hard, and constantly have to work so hard, to stay even vaguely afloat. Especially, especially, especially at the moment. To tell that voice in my head to go fuck itself. To eat and sometimes to stop eating; to wash, and sometimes to stop ‘exfoliating’ in the shower by scratching; to not weigh myself; that no, the world would not be better off if I were no longer in it; and that no, physically hurting myself is not ever a good idea. It is exhausting. I am exhausted. I have spent months worth of hours in doctors offices, in therapy. It takes energy to be put together, to be dressed and to be funny, to make quick jokes and laugh loudly, to have my eyebrows penciled in. Sometimes it isn’t hard at all, but most the time it feels hard to do anything at all.

The first six months of this year were so desperately difficult. The year before, again March through May, I found myself back on a kitchen floor, having one of my first full-fledged manic episodes. I am a major depressive. I cycle through stages of anxiety, through dissociation, through urges to self-harm. Everyday this month I have experienced some level of body dysmorphia. I’ve spent ten years with some level of an eating disorder. From being visibly unwell to being invisibly unwell (and, arguably, was ‘worse’ when I was invisibly unwell). From in-patient waiting lists (six beds, it’s a competitive business), to an actual day patient. A long-time outpatient. Sometimes I think that if it weren’t for the fact that I am covered in scars, again from age 12 through to 22, my level of high-functioning would successfully negate the very possibility that I have been, and am, not entirely okay.

There are many things that rub me the wrong way about personal accounts. When it comes to eating disorders especially. If pictures are involved, count me out. If numbers are involved, I don’t want to hear it. These are not helpful ways to talk about eating disorders. I have never seen a bulimic on social media post a recovery before or after. Never mind someone with BED. They are always anorexic. They will have been hospitalised. A photo will be included, they will have a feeding tube and you will see all their ribs. For someone like me, this is not effective. It still feels like a celebration of thinness. Made more obvious by their ‘now’ photo: usually them after they’ve discovered clean eating (which I firmly believe is a fast track to disordered eating) and a good gym routine. I think that this is an underlying factor as to why I don’t talk that openly about my personal experiences, because often I feel them gravitating towards the most extreme examples, again the ‘worst’ times, and not the everyday, and honestly quite mundane, routines I go through to get myself functioning. It feels dishonest. I find it fascinating that you don’t see accounts of ‘recovery’ from other mental health disorders, in the same way you do eating disorders. Can you ever really recover from depression, BPD, bipolar disorder, schizophrenia? Perhaps, I don’t know. Perhaps because eating disorders, again thinking of anorexia specifically, can be so visible: that there is bodily, physical change.

Physical change exists within other mental health disorders, or at least there are certainly physical effects. This is something that doesn’t seem to be talked about. Anxiety has such extreme physical effects on me that I find it almost confusing to think that it’s “all in my head”. Honestly, I had a psychiatric appointment before summer and after 45 minutes of talking history (because that’s what every first appointment is like. That wouldn’t matter, except for the fact that you have to wait months for an appointment, and by the time you have your next they’ve forgotten who you are. And the reason you’re there are probably changed. Congratulations to my university for having one psychiatrist for all 27,000 of us), he finished the appointment by giving me a single piece of advice: “when you feel anxious, remember to breathe”. Congratulations to my university for having one shite psychiatrist for all 27,000 of us. This was, by the way, his response to me not showing up to my exam because I was trying not to literally shit myself (see? The fun physical effects that no one wants to talk about) or throw myself in front of a train.

I said in a tweet that I’d talk about my experiences with my university’s mental health services. I can sum up my experiences pretty easily: utter rubbish. I needed stitches last year; the mental health nurse I met with after refused to refer me to talking therapy because I seemed ‘confident’ in our assessment. It took two months for me to be successfully outsourced to the Westminster service. The first counselling appointment I had the counselor didn’t talk or ask any questions but sat and watched me, until I felt so uncomfortable I walked out. One of the GP’s I had an emergency appointment with cut me off from “I haven’t actually spoken about this with anyone before, but I feel like I have to –” with a “your ten minutes is up, next time you should book a double appointment”. But the thing that’s the utter worst? It’s that when I first moved here, and I moved with all my baggage and all my history, I wanted to set myself up for success. If dropping out of university to look after my mental health was one of the hardest choices I’ve ever made, then choosing to go back to university was the bravest. I wanted, and of course still want, to do well. I wanted to set myself up a support system so that when the inevitable happened, I’d be able to cope. Unfortunately, this is not how the NHS manages mental health problems. We have preventative medicine (and lifestyle advice for risk management) for every fucking illness out there. Not mental health problems. The experience I’ve had, time and time again at university, is if you’re not actively trying to kill yourself then there isn’t help or time for you. And when you’ve tried and you come in, a couple kilos down and marked and with palpitations because you’ve necked a bottle of wine after a pack of pills, they’ll ask you why you didn’t ask for help. And you will tell them that goddammit did you try.

The hardest part of the last year and a half, and why I felt so angry with myself that I had not admitted to working hard, is that I have felt that I’ve managed to get through this time by myself. No boys were asked to mop me up, no broken breathing down a phone. I’ve done this alone, and honestly I’m so proud. I’m still kicking, telling myself I’m tough as fucking nails. So, World Mental Health Day is to talk about mental health, and hopefully that’s exactly what I’ve done. I’ve talked about me and how it effects me and how I’m still puttering along. I think I wrote this for me. I’ll end with something for you. One of the most wonderful pieces of advice I’ve ever received, and trust me it was not from a fucking shrink, was this: sometimes you’ve gotta let one go, and sometimes it’s fine to just be okay. You don’t have to be fantastic or the best or stellar or even great, you can just be okay. Even if it’s by the very tips of your fingers. Okay is good enough, and it’s perhaps more manageable and in-reach than any of us could realise.

Night night. You’re all loved.

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