Tag Archives: mental illness

Seeking wellness

This is more of a checking in sort of blog post, because there’s so much going on for me emotionally that I don’t have space to think about anything else. I usually try and process my feelings into something useful before I write about them, but that’s not how today is going to work.

I talk about mental health issues a lot, because that form of ill health looms very large in my life. So much of this comes down to my sense of self and the amount of self hatred I carry. I didn’t come to that on my own. For reasons, I depend a lot on external validation, and if the feedback I’m relying on gives me the feeling that I’m awful and a failure, I’m in trouble.

This might sound like a rather too obvious thing to write, but it has finally occurred to me that I get a vote in all of this. I can pick the people who do external validation for me. I don’t have to assume that the most critical voices are the fairest or the most accurate. I don’t have to continue struggling with the versions of me that I’ve been offered by the people who liked me least or thought least of me. I don’t have to keep taking that inside.

There are people in my life who reflect back versions of me that I like. There are spaces where I can be a person I rather like being. The impact on my mental health of being able to do that is huge. I struggle with feeling good enough, but not all the time, not in all contexts.

It is really difficult to feel good about yourself if you are in spaces that undermine your confidence. Even a person with good self esteem will be ground down if they spend enough time in a shitty workplace, or an abusive relationship. No one is immune to this. If you start out better resourced, you’ll be able to hold out for longer, but any of us can be crushed given enough pressure and time. Avoiding that is something best handled in teams.


How to try harder

The normal thing to do is to frame mental illness as something the person is going to recover from by making more effort.

Practice self care. Practice mindfulness. Practice gratitude. Challenge yourself to overcome your anxieties with a supportive CBT booklet. Talk to a therapist to get a plan in place for how you are going to do better. You know the drill.

No one is going to sit your abusive or neglectful family members down and explain to them what they should be doing to stop messing you up. No one is going to write a letter to your boss about how your toxic workplace is destroying you. The odds are that if you’ve suffered trauma, you’ve experienced nothing that was restorative. The odds of even experiencing any kind of justice around that are always slim.

It would be possible, through the medium of politics, to end the brutal toll that poverty and insecurity takes on people’s mental health. These are all situations that could be changed. Poverty is manufactured and is a deliberate aspect of capitalism. It isn’t natural, or necessary or unavoidable, but it does keep that system in place. Take away the massive stress caused by financial insecurity, work pressure, fear of losing your home and not being able to afford decent food, and a lot of mental illness would ease and disappear pretty quickly. Stress makes people sick.

From first hand experience, there is an extra layer of distress that comes from being made personally responsible for sorting out things you didn’t cause and can’t fix. There’s a weight to it, this a tough burden to shoulder on top of everything else. To have to try harder to be well and functional when something is gnawing on your guts, is a harsh thing to face. Your suffering is added to when there is no one willing to help you deal with the thing that is, metaphorically speaking, eating your innards in a slow and painful way. It doesn’t help to be told that you’d probably feel better if you could take a more positive approach to the thing that is destroying you.

Of course there’s no way of turning yourself into a happy and well person when the causes of your suffering are real and ongoing. Instead, you get to feel like a failure for not managing that impossible task. You get to feel like it’s your fault. I don’t think this is an accident. Misery makes it harder to push back and make change. The more of us there are feeling responsible, and useless and full of despair, the harder many of us will try to keep jumping through the unreachable hoops, and in so doing, continuing to be part of this toxic way of life.

If you are in more pain than you can bear it is probably because you are being asked to bear an inhuman load.


Asking for help

A great deal of mental health advice out there encourages people who are suffering to ask for help. This fails to recognise all of the things depression and anxiety do that make it difficult to ask for help. Here are some lists, I doubt I’ve covered everything.

Anxiety makes you feel like you’re making a fuss and there’s no reason for anyone to take you seriously. You are afraid that people may be annoyed with you, or react in other ways that make things worse. You think it may be obvious to them that this is all your fault and you are desperately afraid that everything happening is both entirely your fault and wholly your responsibility. You are afraid people will hate you and push you away. You are afraid you will hurt and harm people who already have more than enough problems of their own, you are afraid you are being unreasonable.

Depression tells you that you don’t deserve help. You don’t deserve love, or care, or support or kindness. Everything going wrong for you is going wrong because it is exactly what you deserve, so why should anyone want to help you fix that? They almost certainly have much more important things that they need to be doing instead. Other people are in far more trouble than you and are far more deserving of help. Other problems are far more serious than your problems. Depression will have you believing the people who tell you that you should just snap out of it, try harder, stop the self pity. Depression will persuade you that it really is all your fault for not trying harder and that it would be totally reasonable if everyone hated you for your failures.

Asking for help is easier if you don’t have a history of being bullied or abused. Ask for help in those circumstances and you’re putting weapons into the hands of the people who mean you harm. It’s also easier to ask for help if you don’t have a history of being ignored, shamed, or humiliated, if you haven’t had your issues minimised, and if you’ve not been told off and emotionally punished for making a fuss. 

Thankfully we’re starting to establish that mental illness isn’t primarily a chemical imbalance issue. Mental illness is a consequence of trauma, stress, and abuse. It’s the fallout from gaslighting, poverty, insecurity and living in fear. The help that most people need is the help that deals with these issues and the legacies they leave. It’s also hard to ask for help when you know from experience that all you will be offered to deal with your gaping wound is a packet of sticking plasters.

If you can manage it, don’t wait for people to ask you for help. Offer it. Making helping people part of how you go through a day. A little kindness, patience and generosity can make a lot of odds, especially when no one has asked you to do that for them.


The language of mental illness

I notice that I feel more comfortable writing ‘mental health problems’ than ‘mental illness’ because the second option seems so much more loaded. The words we use to talk about mental illness are problematic, too. Anxiety and depression are words that really don’t convey the life destroying nature of being overwhelmed by those things.

Years ago, a doctor gave me a questionnaire that talked about being anxious and fearful. I wasn’t those things – I was overwhelmed by terror on a daily basis and unable to function as a consequence and I could not express the severity of my situation in the terms the survey offered. I was then given a CBT handbook to help me manage those small fears that will go away if only you push back against them. Only I was terrified, all the time, thanks to the genuinely threatening things that were going on in my life.

Depression, as a term does not convey the state of being so weighted down that you no longer know how to move. It does not express the experience of being so numb that you no longer seem like a proper person on the inside. Depression does not convey the utter despair and hopelessness that sometimes kills people. Talking about the fatigue that comes with depression does not express what it’s like to be so overwhelmed that even the idea of trying to do something is unbearably exhausting. 

‘Triggering’ is a word that has been sorely abused by people deliberately minimising how trauma impacts on people. Triggering as a word is not adequate to express the horror and loss of control of finding that your mind has been thrown back into reliving traumatic experiences from your history. The word ‘trauma’ alone does not do enough to convey to untraumatised people what that kind of experience this means. And I don’t want to expand on that because not triggering the traumatised folk is a consideration alongside wanting to educate those who don’t really get it.

‘Personality disorder’ is an awful term that has stigma hard wired into it. It’s also a really problematic area of diagnosis – it’s just a label, it doesn’t represent anything that can be measured. How do you tell between these ‘disorders’ and perfectly reasonable trauma responses? How do you tell between trauma in undiagnosed neurodivergent adults, and ‘personality disorders’? This is an area where the problematic language represents a lot of problematic thinking. If this isn’t familiar territory, have a look at the ‘symptoms’ for schizophrenia https://www.nhs.uk/mental-health/conditions/schizophrenia/symptoms/ and consider how many of those might be caused by trauma and by real threats that are assumed not to exist. What happens to an abused teen whose parents frame their behaviour as delusional? 

Often, the official language to describe conditions comes from an unaffected observer, not the people having the experience. This isn’t a neutral process, and the stigma against mental illness and neurodivergence is massive and longstanding. And please, if we’re going to label murderers as being mentally ill, could we at least have a specific label for that illness rather than making it seem like mentally ill people are dangerous to those around them. We’re not. Most of us are far more likely to harm ourselves than anyone else.


Insufficiency and the fragile mind

It’s fairly easy to tell when you’ve been overloaded. Be it stress, workloads, noise, light, or people, overloading tends to be self announcing. In recent months it has become apparent to me that insufficiency can be just as damaging, but it’s far harder to spot.

How do I tell if I’m not getting enough calories? Or enough potassium? Am I tired because I’m not getting enough sleep, or is that depression caused by an emotional insufficiency? I spent a while being thirsty a lot, not because I needed more water exactly, but because I needed more electrolytes. 

I’m fairly sure at this point that tactile input is a big deal for me, and that I need to do deliberate things to feed my brain information about my body. Lack of body information may well be what’s underpinned my regular and relentless bouts of burnout and mental collapse. 

I think there’s a cultural aspect to all of this. We’re encouraged to be alert to excess, and to be responsible for not having too much of a thing – food and alcohol especially. Being insufficient often has less to do with personal choice – it’s hard to have a good diet if your budget and available shopping options don’t offer you good nutrition. It’s not easy getting good and restorative sleep if there is noise and light pollution you cannot do anything about. Excess is ours to control, insufficiency may well not be.

At the moment, there are a lot of places around the world where mental health is treated as a discreet and personal problem. That tends to focus you on looking for a ‘cure’ in the areas of life you have control over. Mental illness is not a failure of effort, and it makes more sense to look at the things we have less or no control over as likely suspects when our brains stop working properly.


Hermit and tribe

There are lots of good reasons for picking solitude and a more solitary life. Not everyone is gregarious by nature. There are lots of introverts in the world, an abundance of folk for whom human contact is not that engaging or delightful, for all kinds of reasons. There are also a lot of things that can push a person into being a hermit, not because they want to be, but because they can see no other way. While I am someone who likes a lot of quiet time, I’ve also had some experience of feeling obliged to be a hermit and I’ve seen a lot of what it does to other people.

1) Poverty. If you can’t afford transport, or suitable clothes, social contact can be difficult. Most normal social activity has a price tag, a person in poverty may not be able to afford a beer at the pub, and can’t step up to buy a round. All of these things are humiliating, and rather than expose the feelings of shame poverty causes, people stop showing up.
2) Geographical isolation. Only pagan in the village can be a real problem. Loss of public transport, rising fuel costs, loss of rural venues, loss of urban venues even – there may not be anywhere you can realistically get to from where you live, and so you become unable to engage socially.
3) Illness. Both mental and physical ill health make it difficult to engage. If you have to constantly explain why you can’t do things, because the limits of your body and mind are not where people expect them to be, that can be depressing, humiliating. Fear of having something go wrong in public can leave many unwell people just afraid to go out, and afraid of being rejected for having something wrong in the first place.
4) Low self-esteem. If you don’t feel you have anything to offer, how can you ask to be part of a tribe? How can you expect people to accept you socially? Assumptions of not being welcome and not being good enough keep people isolated, which reinforces those beliefs.
5) Expecting rejection or other bad outcomes. People with bad histories (and there are a lot of us, perhaps a third of all women) find it hard to trust that social situations will be safe, that they will be welcome and well treated. Fear of anger and aggression, fear of abuse, of rejection, mockery, humiliation etc.
6) Fear of crime. I have met plenty of people who, even though they have not been victims of crime, are so fearful of this as a probability, that they don’t go out much. Instead they stay in watching news and crime laden TV programs that reinforce their beliefs about how dangerous it is out there. Which is ironic because statistically you are more likely to be raped, assaulted, or murdered by someone you knew and trusted, not by a random stranger.
7) Disbelief. If you think there’s nothing out there worth connecting with, nowhere you would fit in and nothing you would enjoy, you won’t even look. Lack of information about other people leads to a belief that you wouldn’t find anyone to engage with reinforced by not going out and finding anyone to engage with.

Most of these become self-perpetuating, and can take a person to a place of feeling anxious about having to deal with other people. Once we start to see human contact as threatening, unrewarding or impossible, we tie ourselves in to cycles of behaviour and disengagement guaranteed to reinforce the perception. I think there are many facets of our culture that help to perpetuate this. These fears are not crazy or irrational, it is important to note that every last one of them is well founded.

1) We denigrate poor people and uphold concepts of expensive chic, reinforcing the idea that to be and look poor, is to be unacceptable.
2) We don’t have a good public transport network, and the cars much of our planning decisions were based on are getting too expensive to run.
3) We have rising rates of mental illness, and a culture that is not tolerant of, nor reliably kind to people in difficulty.
4) We don’t have all-inclusive tribes. Membership of anything social depends on activity, and at least on actively showing up.
5) Our culture, TV led, says its ok to rubbish and ridicule people, to shout them down, humiliate, harass and otherwise behave in shitty ways. A few episodes of the soap opera of your choice, or any reality tv show where judges rubbish people as entertainment, will teach you this.
6) While violent crime between strangers is on the decrease, domestic abuse exists at a monumental scale. The irony is we’d probably be safer going to the pub than staying at home, statistically speaking.
7) And what is there, to go out for? Where are those tribes and communities we might belong to if only we made it out the door? Mostly they don’t exist, for all of the above reasons.

This is not about individual failing, this is a crisis of culture. No, I don’t have any answers.


Living with fear

One-off traumas are awful to experience, but generally, if it seems like a singular event, people get over it fairly well. It’s the experience of living with fear, and having the unthinkable become normal that does the longer term damage. This is what underpins shell shock, as experienced by soldiers. Post traumatic stress disorder is just as likely for civilians after wars. However, being crippled by fear is not an experience unique to this level of hostile experience. People who experience much lower levels of bullying, abuse, persecution or difficulty over a long period can end up just as scarred. It’s not a very well understood problem, nor is it much talked about outside support groups for the afflicted.

People coming out of long term bullying, or abuse can be just as psychologically damaged as people coming out of war zones and can display all the same kinds of symptoms as shell shock. This is not because victims of these apparently lesser problems are somehow being weak or pathetic. This is a biological process that has everything to do with how fear acts on the body. It is a very bodily condition. Once you can get your head in on the process, you’re actually moving towards healing. Prolonged fear causes physical sickness and needs treating more like an ailment of the body and less like some kind of character failing.
There are a number of things that can happen to a person. If you are constantly victimised and nothing you do will protect you, you will come to believe that the whole world is hostile and threatening. You may be unable to respond to even mild setbacks, and feel overwhelming despair in face of even the smallest problems. You may build fear associations such that leaving the house becomes unbearable. For me, it was postmen. I still break into a cold sweat if I see a postman, or post van. I know why, but that doesn’t stop me. When you have lost power and control in your life, the idea of being able to solve problems, or being able to cope barely exists in your head. Each new scenario is there to punish you further, to take you apart, to kick you again. The loss of hope is a consequence of living with fear.

You may develop superstitious beliefs about actions or behaviours that will keep you safe. This can lead to obsessive and compulsive disorders. People only feel safe when they have performed rituals that, from the outside, look crazy and irrelevant. The desire to be safe may also lead to passivity, acquiescence. The abused woman may make no sound when she is beaten if acknowledging pain makes it worse. She may become unable to vocalise any kind of pain at all. The abused child may learn to do anything at all to please adults, in the hopes of avoiding further torment and thus become even more vulnerable.

Once your body has learned fear as normality, things go a bit crazy. The fear responses happen when there’s almost nothing to trigger them. That can mean heart racing, stomach heaving panic attacks that leaving you weeping and fighting for breath, and not even knowing why. The experience of this kind of bodily panic suggests that there must be something terrible going on, you just don’t know what it is yet. When terrible has become normal, that’s not irrational at all.

There was a cure for shell shock. All you had to do was get the soldiers out of the war zone, give them total rest and tranquillity, gentle physical activity and time outdoors. With peace and the right support, many would heal. The only way to break the cycles of physical terror, is to bodily remove the sufferer from the source of their fear, support them to feel safe, keep their environment unthreatening and gradually rebuild their sense of what ‘normal’ ought to look like.

This is one of the reasons why those apparently lesser forms of harm can turn out to be the most damaging. Short of going into a hospital, your chances of getting a few gentle, stress free weeks in order to heal are slim. The longer you are trapped in a fearful situation, the more normal it becomes. A few weeks might enable you to recover from a few months in a war zone, but what if you’ve been a victim for a decade? Making a new ‘normal’ so that you are not afraid all the time, is not going to be so quick. A good doctor can do a lot to help a person, but a careless one may feed paranoia and reinforce feelings of powerlessness and hopelessness. Add in the social stigma of mental illness, the fear of having your children taken away, or losing your job, and the fear itself becomes self perpetuating.

Fear does not always show on the outside. Panic attacks, and expressions of a terror that is rooted in your body like a parasitic plant, are humiliating. Most sufferers go to a lot of effort to hide it.
What would you do if you saw someone succumb to what appeared to be irrational panic? Tell them to pull themselves together? Mock them? Pity them? Avoid them? And if it happened to you, who could you go to for support? Who could you tell? Who would hold your hand and help you rebuild your life?

There but for the grace of… what? Go any of us. The going is easy and there are plenty of people who will happily take you there. The coming back is very, very hard.