Emotions, Depth, and Dropping the Disorder

Yesterday it was my privilege and pleasure to speak at the event ‘A Disorder for Everyone’ in Birmingham – find out more here.  Over the past 24 hours, this blog has got a tonne of interest for which I’m both surprised and grateful.  I will have more thoughts on the things I took away from the conference in coming weeks (uni permitting!) – but for now, this is the talk I gave yesterday – if you like this please check out the rest of my blog and leave me comments, suggestions and feedback!

Chris

This talk is a rather last-minute affair.

I had intended to use extracts from my previous blog posts to make some point or other, quite what that point was got changed and rewritten and then forgotten in a fog of sheer terror and stage nerves.  I’ve sung to a very high level without worry, speaking on stage is an entirely different matter!  I never intended to write a specific talk for this event as such, other than something to tie a collection of ideas together that had hitherto been seen only in a small corner of the blogosphere…

And then Sunday April 8th happened.  And at about 10.30am that day, I felt the lowest I’ve felt in over two years.  To the point where I genuinely had the question of have I fallen off the depression wagon again?

‘Depression’ to some here, may raise hackles – it is after all a diagnosis of disorder.  But sometimes language runs out, and for me the word depression signifies so much more than anything one could look up in the DSM…

“I can only speak of depression from my own personal experience.  I have had several very long and intense episodes of constant, unyielding depression that I can only give the vaguest sense of here.  They have left me feeling hollow inside, as if my body was a deserted building and I was the only one there overnight.  I’ve been left on mute, when I needed to scream and cry and rage, someone pulled the power from the microphone in my voice and I had nothing to say.  I have poured my soul into the pint glass just in the faintest hope of feeling anything.  I have lain on my bedroom floor in a foetal position unable to move or speak just waiting for the pain within to dull.  I have driven 150 miles at 1am with no destination in mind except maybe to find where my vitality had escaped to.  I have been left so numb and detached by my demons to know that nothing mattered.  I have wanted to die more times than I can remember.  I have tried twice.”

Excerpt from ‘A Disclaimer on Depression’

I bring up April 8th because it was possibly the first time I’ve felt I may slip into a profound and dangerous state of mental distress since I started thinking of depression in a different way.  And that shift is worth considering.  Until recent times I would have called it mental illness.  The product of wonky brain chemistry or some dodgy genetics.  I would have told you that for mental health to be considered in the same breath as physical health, we should think of it in similar terms. Not so now.  And the shift struck me during a therapy session one day.  When I realised that for all the talk of pathology and illness, if you go to a therapist, GP or nearly any other mental health bod – the things never talked about, are genetics or brain chemistry, so beloved by the medical model.  My counsellor never once mentioned serotonin, but my trials by academia were of significant interest…

When you first get your depression license, it comes as something of a relief.  Finally you have a name for what’s happening emotionally, a reason for your feelings and an explanation.  Once you get past the stigma to certain people, you can identify with it and talk about it.  And there’s real liberation in that new identity.  But as with so much of mental health dialogue, that which is initially helpful, shuts down further exploration.  In 2015, a particularly shit year on a personal level, I sought medical help for my depression – and that was what I called it.  My depression was acting up, getting out of control.  If I’d had it to do over…I’d say the same thing, the NHS is a system that plays by certain rules, but now I’d also admit that – maybe, the chronic pain, fatigue, underemployment, high number of voluntary commitments, impossible houseshare I was in, frequent social isolation and crushing sense of underachievement – were much more at play than any kind of pathology.  I didn’t say any of that, it was my depression playing up.  Now hand me the citalopram, CBT and mindfulness platitudes.  Diagnoses like depression to butcher a metaphor, are often like institutions – maintained for the benefit of the people who work with them.  Get onto IAPT, or any other point in ‘the system’ and all will be well…

To go against that diagnosis, to go back and look again at how one got the depression in the first place if it wasn’t pathology – is a lifechanging experience.  In 2008 when I first got my own license, I’d have called my emotional state depression.  If I had it to do over…I still would.  But that is only because ‘an emotional stress response to impossibly high levels of perceived and actual academic, social and personal pressures, a changing sense of identity and crushing realisations that the promised change in social attitudes to disability by peers were fabrications’ – takes too long to say – and is probably only about half the story anyway.  I think people (myself included), hold on to our diagnostic labels and our sense of being mentally ill, because to go back and look at those complex, overlapping, personal, political and social factors risks apportioning blame – to those we love – and to ourselves.  One of the most successful mental health tropes is that we should treat the ‘broken, mentally ill’ brain with the same respect we’d treat a broken leg.  There is of course sense in this from a compassion angle, but it does mean that in terms of mental health – nobody is to blame as such – and so the question of why people keep coming through the mental health revolving door never needs to be addressed.  If it’s nobody’s fault – then nobody needs to do anything about it…

It is in fact much easier to put blame back on people like me – what one might call ‘The Reformed Mental’:

“It’s striking to notice how much people think of mental health recovery in a similar way to substance abuse and addiction.  One of the ways this comes through, is that if I ‘The Reformed Mental One’, discuss a dark emotional thought – many people kindly but mistakenly seem to think I’ve fallen off some kind of wagon and ‘gone back to the bad thoughts’.  “Are you getting depressed again?” is a similar question to “Are you using again?”  As if difficult emotions were some kind of illicit substance.  And let’s be real, in our society they kind of are.  We’re endlessly presented with positivity gurus of one kind or another, told that feeling grief, sadness or depression is a sound basis alone for medication and service users are constantly given a message that negative emotions are wrong and must be ‘fixed’.  Difficult emotions are an illicit substance, because if you have them there is still the implication that you are either mad or bad.  If someone asks how you are and you respond with the title of one of my favourite podcasts, “Terrible, Thanks For Asking” – you can hear the internal alarm bells for miles.”

Excerpt from ‘Depression: A Societal Convenience’

In the past 12 months or so, I’ve consistently been very open about my emotional journey, not just in terms of mental health, but in terms of my changing relationship with my disability.  This is a tricky subject.  I have up until recently been a strong advocate for the social model of disability – and now I have a strong urge to shit on it from a great height.  There’s anger there, and grief, and loss, and frustration, and identity issues and body image issues and…some things which I’ll keep between me and my therapist.  What’s really interesting, is that whenever I’ve posted about something being difficult and feeling awful, friends have often automatically gone into crisis mode, because Chris must be depressed.  And that is not their fault.  It is the fault of a system and a culture that tells people that emotional depths are dangerous and that nuance is not worth the effort.  One that puts a label of illness for those that feel certain things for too long, or not at all.  Because now our society can talk about depression, but it can’t conceive of the idea that one can experience similar states but not be disordered.

Emotional complexity is not pathology.  And neither are the screwed up systems that bring that complexity about.  Labels are not useful, if far from being liberating, they are mere straitjackets.  If labels deny us complexity, they deny us personality, our experience and our story.