A blog post recently popped up in my Facebook feed which caught my eye – in honour of National Eating Disorder week and helping to spread ‘awareness’ about the disease, my friend Aoibheann had written an open and honest post about her struggles with anorexia. It shocked me that she had been going through this for so long and that I hadn’t known anything about it. Her story stayed with me because the more I thought about it, the more I identified with it and thought about the decade that I have been struggling with my own mental health concerns – in the form of depression. I agreed with her focus on awareness in a more proactive way than is usually used in the contexts of mental health, and by challenging what we actually need to be aware of. My generation have been talking about mental health for a while – we’re all pretty aware that being affected by a mental health issue doesn’t make you a weak person, that it’s an illness like any other and that you shouldn’t be ashamed of going to your doctor to seek treatment. And while these are all incredible advances and it’s so wonderful that we’re at a stage where people are accepting this as the norm, there are some areas that we seem to have completely skipped over. We’re not generally aware, for example, of how long it all takes. Or how to know when you’re in the thick of it – that you have one of these illnesses. With all the goodwill in the world I think the current conversations make it sound like the ‘illness’ will have a very specific diagnosis, cure and end. Illnesses have cures, right? Reading Aoibheann’s post made me realise that it’s not just depression where the beginning and end are so vague. I started to think about the similarities of our very different illnesses and what that would look like for others with similar experiences.
The aspect of secrecy struck me as an interesting similarity. With eating disorders you may commonly think of the secrecy of hiding how much, or how little, the person is eating. This very secretive act comes part and parcel with eating disorders but does not end here. In these instances I think of the illness as taking over, changing an individual’s behaviour to keep its existence a secret. You have heard of ‘high functioning’ alcoholics or drug addicts. It’s a sort of self-preservation for the illness. Depression is similar. I can hide it, I may seem a little awkward in a conversation where I’m unable to speak because my head is so busy overcrowding my normal thoughts with negative ones, but people generally won’t assume depression from that. I’m a ‘high functioning’ depressed person. I get out of bed and go to work, even on the days I don’t want to. Which also makes me feel like I’m not experiencing ‘real’ depression – and leads to this dilemma, this Catch 22 of it being ‘all in your head’ and being so hard to diagnose.
Unlike most diseases, there is no test to see if you’ve got depression or anorexia. You can’t see mental health issues in someone’s blood. They can be there for a long time and the only defining feature is in your head. You don’t feel right. You don’t fit in. Of course, you don’t jump to naming it and saying what’s wrong. You assume that the fault is inherent in you – that’s what these diseases do to you, make you doubt yourself and prevent you from getting help. It’s their self -preservation at play again. I had felt like a failure for the longest time for going through the same issues, always making the same mistakes. Mostly, I felt helpless about always coming back to the same place. Even though almost every person in my family has suffered from depression or anxiety at some point and we were all very comfortable talking about it, I didn’t connect the dots when it happened to me. The worthlessness and anxiety I felt were justified in my mind because I felt (knew, with absolute certainty) that I was the bad thing. I can see how this would happen to someone with anorexia – while everyone else is concerned about how thin they’re looking, the absolute certainty that they’re not thin enough, that they need to further curb their calorie intake is overwhelming. These thought patterns lead to the behaviours which make these illnesses so problematic.
‘It’s all in your head’ by the way, is the scariest thing you can say to someone who knows and has experienced firsthand the power your head has over you – over your moods, your ability to communicate, even move. For me the scary part is something Aoibheann eluded to in her blog post – that she had had an awful time in high school, that the whole thing was marred by her struggles. I can understand that feeling. It’s incredibly hard to be aware that is probably not the case, that between it all there must have been good days, breaks from it all. But when the black periods come, they’re all consuming. All of a sudden I can’t remember a time that I wasn’t depressed. It’s the happy times which start to seem like a trick, a misunderstanding. It seems as though I have never been away from it and the illness has more control over me, than I ever will over it. If you feel that way, I encourage you to remember that it’s temporary.
Neither of us will find an easy end to this. Mental health issues do not just ‘go away’ after you see a psychiatrist or get hospitalised. I’ve seen this misconception play out in other people – they quit their job/ make a huge life change and are convinced that this will change their course and end their depressed state of mind. ‘As soon as this depressing thing stops happening to me I will stop being depressed’ they tell themselves. Of course, it doesn’t work like that. My own journey to try and fix what was going on in my head before I finally started getting therapy involved moving first to a new city, then to the other side of the world (‘of course I can’t be happy in London, it’s too cold, Sydney will be different’), starting several new jobs, getting a new boyfriend, a new lifestyle (healthy eating, exercise every day and no alcohol) and eventually, realising that I had a lot of work to do.
It is a lot of work. It always will be. That’s another similarity. We learn coping techniques and warning signs, we learn to deal with the hardships that we will undoubtedly come up against time and again – things like loss, stress or rejection, which happen to everyone but will encourage relapse for people with a history of mental health issues. In a way, I believe it makes us stronger. It may lie dormant but there will be something of this disease in us, all the time.
Finally – the treatment. Aoibheann talks about seeing different therapists, about hitting brick walls – it was something I could identify with because of how up and down and filled with hurdles my own treatment was. I will almost guarantee that these road blocks and ups and downs will happen on most journeys to stronger mental health. For me it included three therapists, two kind GPs, once a local women’s therapy group, multiple books and apps on meditation and therapies you can practice at home like Cognitive Behavioural Therapy (CBT), a whole host of different medications (and their side effects), extensive journaling and an incredibly supportive workplace, network and partner. Each time one ended or changed it was either through desperation and a feeling things would never get better, or because I felt so much better that I thought I could do without. As far as I know, the ups and downs won’t stop completely – hopefully the severity and frequency will remain more manageable.
If there is to be awareness raised it should be that better mental health is something that everyone can work towards – regular meditation and practicing CBT can improve the way even the most balanced person interacts with the world. These are debilitating illnesses which take people’s lives all the time and need to be taken seriously. When things do go from bad to worse it is worth knowing what to look for, how to get help, where you can go and that there is no shame in receiving help or treatment, nor in how long the treatment takes you. Everyone is different and we will all respond differently. This is why I look at my mental health as a journey – it has taken me to different places – new depths as well as new heights; I have encountered new people, new experiences, new feelings and a whole new relationship with myself and understanding of my place in the world. Although we might go through some of the worst times in our lives because of these illnesses, we will find coping strategies that we can use during triggering periods in our lives, as well as getting better at recognizing when we’re falling back into bad habits. Those of us with mental health issues know that it will be a lifelong journey, that we may not ever be able to ‘cure’ ourselves completely. Writing this, right now, I feel good. I know I have learnt a lot and that there is still a way to go. If anything, that makes me feel hopeful. I feel able to take on the challenges, having proven to myself and my illness that I am strong.