There are some obvious difficulties inherent in living with mental health issues. There’s the apathy, the auditory hallucinations, the need to lock the car door three times. There’s the social stigma and the knowledge that by being open about it I might well cost myself opportunities. There’s the day to day management and constant updating of my CBT skills.
But among the weirdest and more difficult things is accurately assessing the severity of the issues. If you’ve never been “normal” or non-disordered, it’s hard to figure out how far from “normal” you currently are. (The world is full of people who try to say helpful things like “there is no normal”, “everyone’s a bit weird” and “you shouldn’t pathologise emotions”. Well-intentioned, but honestly, not helpful when you’re dealing with mental health problems. Yes, everyone has their idiosyncrasies, but there’s a difference between people’s quirks and actual disorders, and identifying mental health problems is not the same as pathologising emotions.) If you’re trying to figure out when it’s time to get help, you need to have some idea of how far into disordered thinking you’ve gone. Figuring that out requires observation of other people and comparison with them – for me, at least.
The tricky thing is doing this without letting it descend into a Crazy Contest. The point is to keep tabs on my own state of mind, not to prove that I am the Craziest Crazy that ever was Crazed. The difficulty arises from the fact that it’s hard to be objective and dispassionate about my own headspace, and there aren’t many reliable external criteria to help.
When I had my first and worst breakdown, the one where I stopped talking, eating or moving unless forced, that was categorised as Severe. Severe with Catatonic Features, to be specific. What I considered “getting better”, my shrink considered “Moderate”. I haven’t experienced full-on catatonia again, and I hope I never will. (Though just as a side note, this is what I mean about the difference between handling a disorder and “pathologising emotions”. I know what profound sadness and loss feel like, and I know what catatonic depression feels like, and I can assure you that they are nothing alike. What I was being treated for back then wasn’t “having feelings”.)
As of my last assessment, it’s categorised as Mild/Moderate. This is the best the headspace has ever been, so this blows my mind in two ways. First, those terms don’t feel like they do justice to the vast gulf between how I am now and how I was then. It feels like there ought to be at least a dozen different words standing between me and catatonia. Second, if this is Mild/Moderate, then what must it feel like if you’ve only ever experienced Mild? Or if you’ve never experienced depression at all? How does that work? My earliest memories of depressive feelings and behaviour date back to when I was only two or three. I’ve never been “normal”, there has never been a time in my life where I wasn’t this way. There are, apparently, people out there who do not live with depression, and I have no idea what that feels like. I genuinely can’t even imagine what it must be like. I’m fascinated by the concept.
That said, I’m fascinated with other people’s experiences of mental health in general. It seems like everyone has either experienced mental health problems or watched someone go through them at close quarters. It surprises me how many people I’ve met who have been hospitalised at some point. Bizarre as it may seem, the fact that I’ve never had to have inpatient treatment is one of those things which, in my darker moments, causes me to question the legitimacy of my own disorder. The “logic” runs this way: If I’ve never been hospitalised then I can’t have been all that bad, in which case my depression (etc.) is much less severe than theirs. Same thing with suicide attempts, I’ve never been caught in the attempt or ended up in hospital, so my depression can’t have been that bad.
Of course, that doesn’t take account of the fact that when I was catatonic, I probably should have been in hospital. If my mum hadn’t been able to take care of me, that’s where I would have been. Well, in hospital or dead. When I lived alone there was always an undercurrent of worry in my mind in case I misjudged myself and ended up catatonic again before I sought the right kind of help. I’ve always tended to go to ground when my headspace isn’t good, so it wasn’t unusual for me to vanish every so often. If I had slipped, I could have succeeded in starving myself to death. Would I have been far enough gone to merit hospital treatment? Yes. Would I have caused my own death without ever having been hospitalised or having any record of suicide attempts? Yes. So presumably these things are not good yardsticks for severity. They’re not legitimising experiences, they’re just experiences that people might have had depending on their circumstances. It’s a lot easier to end up getting sectioned if you have a disorder that causes you to behave strangely in front of other people. Disorders that manifest in withdrawal and introversion make it easy just to waste away unnoticed. That this could have been my lot still frightens me. That’s the thing I am guarding against.
On the flip side of this, I sometimes read or hear about other people’s experiences and they seem milder than what I’m used to. I work hard to listen and read without judgement, but it’s an emotional topic connected to a strong fear, and I would be lying if I said that I’d never had a rogue thought along the lines of “Pfft, low moods, that’s nothing. Come and talk to me when you can’t feel anything at all, then you’ll know what real depression feels like!”
This is nonsense, of course Different people experience different levels of severity. I know that. I understand it. That’s why there are different categories. Also, catatonic depression isn’t the only legitimate form of depression. I’m aware of all of this. But when you’re dealing with mental health issues, it’s a constant battle to be taken seriously (both by myself and by other people) and to accept my own diagnosis and experiences as legitimate. When I feel myself slipping and decide to seek help, I feel bad about taking up my GP’s time because there’s still a part of me that doesn’t really accept that there’s a whole realm of depression that lies between “fine” and “catatonic”, and that I don’t have to be unable to function in order to justify asking for help.
This is why I feel it’s important for people to speak openly about their mental health, if they can. The more people there are talking about it, the better equipped we as a society will become to talk about it (I hope). The better equipped we are, the easier it will be to assess our own mental health and gauge how we’re doing. I often wish that when I had my first breakdown, the internet had been further developed. I had access to it and was using it in 2000, but the blogosphere was considerably smaller and it would have been great to have had access to the range of experiences that you can find online today. Future Jen-equivalents, I hope you find this and I hope it helps.
Still, as important as I believe it is, it’s just as important for me to remember that my mental health and dead parents aren’t all there is to me. They’ve been major influences on my life and my choices, and I’ve no plans to stop writing about them, but I think that for my next post I’m going to find a less angsty topic (and by that I don’t mean arts politics, the other major strand to this blog). I’m sure I can do it if I try…