How To Talk About Your Mental Illness
And the stigma which, supposedly, doesn’t exist
So, you’ve been diagnosed with a mental illness, and you want to talk about it with your friends? Or anybody really. Be able to say “I’m having a low day today, do you think that we could maybe postpone?” or be able to say “Sorry, can we turn around? I forgot my night-time meds.” And then tell them what the night time meds are for.
The advice I can give? Well, after 14 years of depression which became so severe it would manifest in disturbing psychosomatic symptoms, cripple me, cause me intense distress and hamper my quality of life severely; you would think I would know just what to say or do when telling friends about mental illness. I have absolutely not a clue, because I never said a thing. And got away with it. Directly before my ECT incident, the people who knew I was in so deep were my close family. So my mother, father and sister. And three friends. Two of which had tried to commit suicide which, of course, made it much easier to tell them, empathy being a powerful form of emotional support. I had a bit of an idea of their depressions but, no, I never saw the suicide attempts coming. I suppose, in a way, we were all hiding. Others included one boyfriend I’d dated during my struggles. And the last, my best friend, the one who was the best at bringing doses of that oh so potent drug. The thing that feels like happiness. The friends were told at various stages of my university life. They knew because they needed to. And so the advice I promised in the title of this page? I lied. Some more.
You may have thought things had changed. My memory was erased in an accident which is so rare it is barely documented, followed by a hell I cannot describe. People I know should surely know that this has happened? The web of lies which you somehow kept together could finally unravel and you can finally breathe and be yourself. No fictions or stressors about keeping tabs about who knew what. Right? I… No. I picked a few I wanted to tell. In Cape Town, I have three friends who I consider close. I told them exactly what had happened, and what followed. And five others. And so how many know that I am going through some serious shit? Probably around 10 people. Yep. Others believe I am having some brain trouble owing to my latest lie which… wait for it. A car crash. Indeed, I hit my head in this dreadful accident and absolutely impossible symptoms arose from that which they never have to know are impossible unless they know more neurology than the layman. In which case I have said that the doctors are uncertain. This is not a lie. They are extremely baffled indeed.
Stigma.
They say, in this day and age, that it no longer exists. Mental illnesses are illnesses like any other. This is not the 60’s anymore, this is an era of change. And mass education regarding mental illness, meaning people with a psychiatric ailment of some kind no longer have to fear if they were to divulge theirs. I knew that this was completely untrue and that the stigma surrounding mental illness had hardly budged. I knew it, and wanted nothing to do with it. But part of using those one of those cliched pictures of a tearful female revealing her true face behind a mask of happiness was actually habitual as opposed to planned. The thing is, when I was diagnosed at age 14 and given my first antidepressant to take with whatever on earth I ate in the mornings before school. Perhaps I never moved on from Coco Pops. It was Earth-shattering. And something I knew, must be kept deadly secret. Because at 14, you will sell your soul to fit in.
I went to a prestigious all-girls school. When I say that fitting in was so important that you would literally sacrifice being warm in winter so as not to stick out. Yeah. Wearing the sheer tights with the winter uniform was what you did. Wearing the woolen ones? Oh it was allowed but not something you did. The woolen ones, for some reason which completely baffles me, were not cool. (THEY ARE TIGHTS?!) And being cool… Or at least as close to it as you could get, was such an importance it was literally a stress that was oh so very real. Standing out just wasn’t done. For some reason your bag you carried your books in from class to class had to be a surf brand. Roxy or Billabong. Your pencil case, the same. Made from neoprene. Your lip-ice? Softlips. When Blackberries became a thing. Get one. And so getting diagnosed with depression and having to take a pill for being sad? Christ, at that age I would rather have been flayed alive than divulge this information. And so I didn’t. Oh… And then I didn’t some more. And more. I mean, by the time I was 18 the thing I had already called the “mirror” existed. The reflection that wasn’t mine, and that stock-image hadn’t even been invented yet was already, habitually, my life. That mirror that I used to smile and laugh and pretend I was okay became something I did not even have to give conscious thought. Additionally, it was perfection. Alright, over the years after school, things obviously progressed to getting a little worse (you know, 6 psychiatrists, being bounced around every pill and mixture accessible, clinics, hospitals, the lot), I began to notice its presence again and it became a little harder to hold up, but only slightly.
Do not ask how I did it but I managed to string together so many lies that actually held, it was nothing short of a miracle. Okay. I did have one thing on my side. Alright, “on my side” is absolutely terrible wording but it was an extremely handy development for using as an excuse for many things. Because, now, I had a “real actual disease” (located in the same organ). My brain, oh so fond of its various psychosomatic outlets, managed to mimic severe temporal lobe epilepsy. And so now that I was having seizures, I had a little more leeway for cancelling plans because I was “recovering from a seizure” (reality: severe emotional pain). Not feeling so well during class or ward rounds because of “medication changes” (reality: severe emotional pain). There are two reasons why I know it was never epilepsy despite its presentation. The first was medical proof. Being hooked up to an EEG with cameras on me and even a microphone by my side until I seized. Because I knew my own brain so well by that point, I knew what would do the trick to get me out of there quickly. I seized when I did not sleep. The doctor in charge of this operation (and is a very well-respected neurologist) told the nurses to limit my sleep, firstly, to 7 hours. Oh no no, good doctor. This gentle approach was not in my plan to leave as quickly as possible. With my energy drinks ready, I sleep deprived myself and watched a range of movies I had been meaning to re-watch. Gladiator was definitely one. The nurses looked at me worrisomely, as if this was not pure efficiency. Well, after about 28 hours I eventually pushed the “here is my aura” button and seized. Nothing on the EEG. I received a gentle talk from the neurologist about non-epileptic seizures and was handed a pamphlet and advised therapy.
After it got bored of epilepsy, my brain moved on to something much more unfortunate. It began to cause me extreme physical pain. Hurting me in ways people could not see. I am even hesitant to say, on a blog about mental health, what it felt like. Because it sounds like psychosis. What I have just said is another reason people are tentative to tell people about their diagnosis. “It sounds like I’m crazy”. You’re not. At a higher point of the pain, it began to feel like sharp pieces of something were slashing my heart. I just thought of it as glass. Both excruciating and impossible. It gets worse, and I eventually made a pain scale. At 6, my ribs begin to hurt. It grew from there.
Now, the thing is. I have seen people writing about how they pretended they were fine when they absolutely were not in any way. And there is a trend. We overdo it, we act too fine, nothing can get us down. People are aware of this, and comment on it. My moment came too. On the day of an anesthetics test I felt absolutely awful. My ribs hurt, and that was a bad sign. But, one boy in our rotation group said how it was always so nice to see me before a test because I was always so cheerful. At that point, I thought I might snap and start hysterically laughing in a worrisome way. I did not do so. But did realise how absolutely perfectly people saw me. They were probably envious of my carefree ways.
The reason I know stigma still exists. One of those ten friends who know exactly what happened? Well, I had to start from the beginning. Why was ECT even necessary? The depression. The occurrences now. Everything. And, as he had only ever seen my mirror, despite our close friendship, he had no idea about any of it. And he didn’t know how to deal with it. He started treating me differently, and it was very noticeable. As if each message he sent was a potential landmine. I suppose it was understandable in a way, except that I am exactly the same person that I have always been. With a few dents here and there. Eventually, a confrontation. I told him to please treat me as the person he had always known. Exactly the same. No holding back anything because it might “trigger” me. I am myself, and nothing about our relationship had to change. I told him that if there were any problems that I thought he should know about, I would let him know. In terms of moving forward. There are no landmines.
And the second reason I know that stigma very much still exists. That would be stories of people everywhere. Discrimination after admitting to a psychiatric illness. The tales are endless. The lack of understanding of mental illness in a time where societal change has been so massive is, quite frankly, disturbing. If all corners are being addressed, they are missing one. Unfortunately, I do not deem myself strong enough to come out about everything. And so I wear my mirror. And honestly, it has come out of 14 years of feeling like I need it.
