I’ve attempted suicide twice, had thoughts of it many more times. Watched my educational career break into tiny pieces, felt at a complete loss as to what to do with my life, been in a couple of car accidents, had a painkiller tube leak after surgery, been threatened with violence. Whilst you’d think that all of these things are frightening, and you’d be right with some of them, any fears pale in comparison to the moment in December 2007 when my mother said “I’m taking you to the doctor, I think you have depression”.
That was the moment I knew my life was over. I was a failure, screw-up, dysfunctional, inadequate, pathetic waste of skin that needed to die. But I was not crazy. I was not a head-case. And here I was in a waiting room, everyone was looking at me, and I was fifteen minutes from imprisonment and being put away. As I’ve become increasingly involved over the years in the conversation about mental health, it can sometimes be difficult to identify with people who still hold in their heads the almighty stigma that does exist around these experiences. I’m somewhat inoculated against this because that memory of utter fear of what was going to happen to me when the GP got their hands on me – is still very fresh even now. That crushing feeling of knowing with absolute certainty that I was disordered and ‘wrong’ is something I’ll never forget.
Fortunately a number of things were at play to ensure that didn’t play out. First, I had a supportive GP who despite being no mental health expert, did not have the same panicked reaction I did, calmly prescribed antidepressants and put me in line to get some kind of therapy urgently (this was 10 years ago – such things were plausible then…). Secondly I had a supportive family that wasn’t going to cast me aside and onto the scrapheap where I knew I belonged. Thirdly that family is white, middle class and financially secure – never underestimate those factors readers, without that extra backing and security at home, I could very easily have gone onto a ward. My mental health experience of ‘the system’ is somewhat atypical because of background. Mental ill-health can indeed happen to anyone, it truly knows equality, but certain treatment avenues are more equal than others.
And so I walked away from that appointment, with a prescription, a second appointment time, some paperwork and a label. Depression.
And as much as I didn’t want that label, it granted solace. It granted some relief. It proved that this was not my fault. That what I had was some dodgy brain-chemistry allied with a lot of stress and that if both those things could be sorted, normalcy would once again emerge. It was an explanation, and in that time when I was completely and utterly lost, that was important, precious and much needed. From that moment I was split. I knew there was a part of me, the depressive part, that would fight help all the way. That would creep in if I was not vigilant or active and like a large spider, lurk in a dark corner to be discovered with shock and fear. But that was still…kind of OK? Because in our culture we talk so much about self-improvement, of resilience, of character traits – as if a personality was something that could be tinkered with just enough to get the most desirable results and a much sought after ‘balance’ (a particularly vogue phrase even now which I urge you to view with suspicion). And so with that in the background, depression and I waged war. Sometimes I won, sometimes it won. There was The Battle of Sertraline (inconclusive), The Great Choral Campaigns of 2010, 2012 and 2013 (I won), The Employment Front (depression won – and handily), all titanic struggles, but the two sides remained evenly matched. In 2014, a truce was called, the Citalopram protocol was implemented to the annoyance of both sides and the treaty was signed. All was well for about 8 months, and then depression launched a surprise attack that almost knocked me out of the war. Having been under siege for most of 2015, I sallied forth with a new round of therapy that lasted for eight months. And with that added companion, I had a chance to actually look at my enemy.
What I found was startling.
Mental health diagnosis, gives us a kind of mechanistic answer to the question of How? How did I end up the way I am. And with it’s focus on brain chemistry, physical health and the relationship between the two, it gives us the idea that again, if some kind of equilibrium is achieved then the rest will fall into place. In this image of mental experience, it’s as if the body is a well-oiled machine with a very literal screw loose. Fix that screw and the rest will take care of itself. Except the rest wasn’t taking care of itself. Moreover, none of this bore any relevance to what I was talking to my therapist about. We’re at a point where we’re overflowing with good mental health ‘tips’, but ask someone who’s struggling why it is that they are where they are – and rare is the answer of, “my nutrition is completely out of whack” or “I’m just not getting the right work-life balance” or “I’m just not taking enough time for me”. These things are useful – but often it’s fiddling at the edges of a problem. We talk about mental illnesses as just that – illnesses – because it’s easier to deal with these things through that lens of health. Cancer can happen to anyone, illnesses can strike anyone, mental ill-health can strike anyone. It is a random thing we’re told, borne out of a genetic lottery. But rare is the client who says to a therapist, “yeah it’s the dodgy genes that are the problem”. Clients actually talk about everything else, their emotions, feelings, life circumstances, oppressive experiences, traumas, grief, loss and a whole host of other things.
At the back end of 2015, as I started out on a new leg of my therapy journey, I looked at depression. Where did it come from? What was it about? Had I been honest to say it was simply a part of me? Yes and No…
It was everywhere, but it was borne out of much more than simple biology. Out of academic expectations not met, self-imposed rules and introjections, never really addressing some of the effects of being suicidal. A lack of direction, a lack of meaning, a lack of relationship and quietly in the background, a creeping realisation that all was not well with my view of my own body and disability. There was so much more to it even than all that, and the complex interplay is something I could never hope to translate, but all this led to a simple realisation. Depression wasn’t so much about my body and brain mechanics, but about WHAT HAPPENED TO ME.
This is where it got really tricky. Because in my mind, so much of what happened to me was normal, mundane and unworthy of attention. If relative to others, I’d had no more than a few potholes in the road – did that make my depressed feelings fraudulent? Part of the reason I think that so many people cling to diagnostic labels, is that they think their stories unworthy of their feelings and emotions. A label takes that out of their hands. Labels mean that we don’t have to question whether someone’s mental health struggles are somehow legitimate or acceptable. We don’t have to see if they tick enough boxes to be helped or treated. The label covers for that.
But should we even have to ask, if we are any kind of caring society, if someone’s experiences and responses are somehow fair? The worst thing that happens to a person is the worst thing that happened to them. Who are we to say whether or not that qualifies for a label and a diagnosis. What experiences are toxic enough to ‘need’ treating and which ones are acceptable? Who are we to say when a grief, or a depression is invalid because it has passed the sell-by date and is now a pathology? This shit is too damn personal for that. And because that is entirely personal, I now find the label of depression cumbersome and unwieldy. I’ve not come to that overnight – it is a long journey that is not finished. But I have come to realise that based upon who I am, my reactions to everything were understandable and made logical sense. Those responses to trauma are mine and mine alone. My emotions and feelings and subsequent actions were not a result of being somehow ‘disordered’, but natural human reactions that had no need to be pathologised or placed in the box marked ‘wrong’.
I still use the term ‘depression’ in order to be easily understood, and to describe a specific emotional state, but that is personal to me – you wouldn’t find my definition in the DSM. So much of labelling, I believe, comes from a place of wanting to give people the comfort that their experiences are not a ‘fault’. A diagnosis hides the fact that PEOPLE WERE NEVER WRONG TO FEEL WHAT THEY FELT!
In closing I’d like to offer the following quote from Nora McInerny from an episode of her wonderful podcast ‘Terrible, Thanks For Asking’:
‘When we say about our own stories “this doesn’t compare”, we’ve already made a comparison. And in that comparison we lose compassion for ourselves and other people. You’re right in that it doesn’t compare, because it doesn’t need to. If you’re waiting for a permission slip to feel things, to feel complicated things, all at once, here it is…
You’re allowed to feel a lot of things even if they seem to contradict each other. You can be sad about a lot of things. You can be happy about good things even while you’re sad about terrible things. You’re allowed to be wounded by arrows and you’re allowed to feel proud of every mountain you climb.
You are not obligated to qualify or justify, you’re not obligated to minimise.’
Thresholds in mental experience are a nonsense. If it’s real to you – it’s real. There shouldn’t have to be labels in order to legalise this.