Tuesday, 21 January 2014

Fighting the Stigma

Even when meeting people as I leave my hospital appointments, my standard response to the polite, but empty question: 'How are you doing?' is typically either, 'not too bad' or 'fine thanks'. Oh yeah? So why the need to be going to the hospital?

Now, this is most likely partly to do with the cultural norm, I mean no one really means you to tell them how you actually are, do they? How any deviation to this norm is received depends on whether your decision to open up is related to physical health as opposed to mental health. So that, a response of 'Ok apart from this stinking cold' is much preferable to 'Been feeling really down for some time now.' I've been pondering the squeamishness we feel towards discussing mental health. We're different from previous generations, who didn't seem to be aware to any significant degree of emotional or psychological conditions, beyond 'bad case of the nerves', or 'eccentricity' or 'a bit funny'. I'm tempted to laugh, until I realise that actually, reading much recent media coverage, we haven't moved much further on in our understanding and stigmatisation of mental health conditions.

Spurred on by the work of organisations like Mind, Sane, the Black Dog Tribe and campaigns such as Time to Talk, I have been speaking to groups of people, trying to share my experiences of managing a complex mental health condition. I have been encouraged by the number of people for whom this has been a relief. So many people, struggling with depression, anxiety and other mental health conditions feel so, so isolated, because for so long so few people seem to have been able to be open about their own struggles. Again, and again so many have said to me 'I didn't know I wasn't the only one'. 1 in 4 people EACH YEAR suffer from a significant mental health problem ie a condition which requires the support and intervention of GPs, or Mental Health professionals. So if I am talking to 120 people that means that, on average, there will be 30-40 people suffering from a mental health issue at any one time.
Unless a physical illness is destined to be discussed on 'Embarrassing Bodies' I don't think that we are as reticent to discuss our physical ailments. Even then, I think the physical discomfort is likely to drive us to the GP, even men give in to pain discomfort, eventually. In fact, the typical response to telling people about my colds, sniffs, bugs and lurgies is 'Poor you, hope you're looking after yourself', which is nice!

We don't even have an 'Embarrassing Minds' equivalent, because it's easier to just pretend it doesn't exist. On all too rare occasions have I seen TV programmes which provide a small glimpse into something remotely resembling my experience of life, Bedlam, was one excellent example. It is remarkable, sadly, because of its rarity. More frequently, those who have emotional and psychological struggles are portrayed as 'outsiders', 'other than', 'not people like us'. The prime example at the moment is the portrayal of the residents of Benefits Street, most of whom are described in less than glowing terms. Notice the throw away comments about their mental health, such as 'Dee is on ESA because of her depression' dubbed over a scene showing her being narky with her kids. No further explanation of the 'Black Dog' that lives with every sufferer of depression.

I took nearly two years to tell people what I was struggling with Borderline Personality Disorder, (BPD)after I was diagnosed and started on the path to treatment. There were a variety of responses: total denial (Subscript: can't be true, you're too 'normal' and don't appear to be 'unstable'), minimisation (Subscript: No, you're exagerrating surely, why do you need to see a Mental Health Team?), ridicule (Subscript: Always knew you were a 'nutter' ha ha ha), disbelief (Subscript: I can't possibly be friends with someone with a mental health problem!). What all these responses have in common is that they are strategies to distance the responder from the Mental Health condition. If they can make me the 'odd one out' then they can live without fear of 'contagion'.

For people like this I would say: just as much as no one can predict accurately who will suffer from cancer, diabetes, virulent viruses; unfortunately, for us as human beings, we can never predict who is going end up suffering from a mental health problem in the future. In other words: IT COULD BE YOU! That's uncomfortable and bound to provoke anxiety - especially as mental health conditions and how they are managed are so seldom discussed in a well informed way, certainly not in the bulk of the media, or the political sphere.

Until those in charge of the debate, especially those in our government, actually engage in an intelligent and well informed way with the subject, there will be little impetus to improve the portrayal of mental health issues. Thankfully, under pressure from social media and certain individuals and organisations there is a small shift in the debate. However, the most powerful tool in this battle is the true stories behind labels and diagnoses and for this I am grateful to all the campaigning organisations.
Until it is as easy to discuss my mental health, as my physical health, on my better days, I will try to stick my head above the parapet and talk about the part of my humanity 'that dare not speak it's name'.