(Contains Confronting Content)
The amnesia of good mental health is powerful. When I’m well I struggle to conjure up what a depressive episode feels like. I can’t remember not being able to think my way out of it. I can even understand how easy it could be (without the experience of this insidious symptom) to dismiss those who suffer it as weak or lazy. This inaccurate, hurtful labeling occurs when people fail to understand the fundamental differences between a psychological challenge and a psychiatric symptom.
We all experience psychological challenges. They are our normal responses to life events. The sick child, the death of a family member, the loss of employment, a car rear ending us, failing exams, storm damage to our house, a relationship breakdown. The list is endless. And we should never pathologise the spectrum of normal emotions with which we react to these events. We also all have the potential to learn the skills to deal with them in a healthy way. Given time, it is possible to out-think psychological challenges.
Psychiatric symptoms are different. I don’t like the simplistic likening of mental illnesses to physical illnesses. But there are some similarities that can help explain psychiatric symptoms to a novice or ‘non-believer’. Take diabetes (mellitus): Attempting to out-think your psychiatric symptoms is as successful as trying to regulate your blood glucose levels with your thoughts. It is impossible, no matter how clever or strong willed you are.
The only control a diabetic patient has over their illness is recognising their symptoms and then seeking appropriate treatment. The only control someone with a mental illness has over their symptoms is learning to recognise them and then seeking the appropriate treatment. However, this is where the similarity ends. Here’s why:
Diagnosis and management of diabetes is reliant on blood glucose measurement using a drop of the patient’s blood and a glucometer. The result is a number. There is no room for doubt.
Successfully ‘measuring’ psychiatric symptoms is much more challenging and can take years of practice. In the beginning it is difficult. You lose your emotional innocence. Normal feelings are misinterpreted. The onset of psychiatric symptoms can be missed because they can resemble a normal thought or emotion.
But if you have a mental illness (or even if you don’t) one of the most helpful things you can do for your mental health is getting to know your pattern of crossover from normal emotions and thoughts to not. I have had uncomfortably recent practice at recognising a depressive episode. Here’s how it went:
It started on a sluggish Sunday a couple of weeks ago. At first my tiredness felt justified given the challenges of the preceding few months (my father’s near death and my son’s six-week period of ill health). On Monday my head filled up with cotton wool. Thoughts struggled to communicate with each other. I woke at 3 am the next morning to warning bells chasing each other around my stomach like frightened rabbits.
On Tuesday I went to the shops and I couldn’t concentrate well enough to buy a few simple things. My short-term memory dissolved. Being around people was excruciating. I was being skinned alive by noise sensitivity and irritability.
By the time I got home the cotton wool in my head had morphed into razor blades in mud.
Imagine that for a moment…Instead of being occupied with a brain, your skull is filled with razor blades in mud. The mud replaces your normal thoughts. The razor blades are alien thoughts.
‘I am tired of life.’
That thought was my tip off. That thought never enters my head when I’m well. My insight shouted at me:
‘From here it is a hop skip and a jump to suicidal ideations. Do something!’
For me, suicidal ideations mean being hijacked, bound and gagged while this illness plays horrific, detailed footage of its end stages in my head. It takes all that is me, rips it to shreds and sets fire to it. And then it defaecates inside my skull.
It takes a lot of self-knowledge not to take this personally. I suspect it also takes more strength and courage than pricking your finger and using a machine to tell you where you are at. It takes experience, insight and invisible reserves of fight to see it for what it is: an illness that needs acknowledgement before it can be treated.
So, the minute: ‘I am tired of life.’ parachuted into my head, I made an urgent appointment with my psychiatrist. We adjusted my medication. I dialed back all my commitments and set myself just one goal per day, which was to exercise. Just over two weeks later I am approaching myself again. But I haven’t exhaled yet. I am not yet well enough to forget what having a head full of razor blades in mud feels like.
For Lifeline Crisis Support and Suicide Prevention call 13 11 14
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