Feeding My Ignorance

Today is "Time to Talk" Day (as well as World Cancer Day) and I think that writing something on the topic is near to essential for me. It is shocking to think that the figures show that 1 in 4 people will be afflicted with Mental Health issues in their lifetime. Once upon a time that sort of thing was taboo to talk about - not now, when it seems to affect everyone - one way or another.

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It is, actually, a bit difficult to write about this without referring to the rather unhelpful way in which Mental Health was "treated" in the past. There was always some standard set up as "normal" and anyone who deviated too far from that normality would be consigned to the community known as "the loonies". In the same way as derogatory terms have been all but eradicated for other groups - that is now a description that is most certainly non-helpful!

The Time To Change website that has been set up as a joint initiative backed my both Mind and Rethink Mental Illness contains a lot of helpful resources. However the first thing that struck me was a big number at the top of the page - it currently reads 89796 - which seems like a good response (it is indicating how many people have pledged support to "Time to Change") until you think - that is slightly less than the population of Hastings - what about the rest of the country!!

Is there really that few people who care about this issue when a quarter of the population suffer from it in one way or another?

Recent years have brought the issue into focus for me - what previously was something that happened "to other people" has affected many who are much closer to me. In some ways it is unfortunate that "Mental Health Issues" are grouped together, since the effects are diverse - however on the other hand they all share the common factor that unlike, say a cut on your finger, there is often absolutely no outward sign of the problem! Add this invisibility to an understandable anxiety about the subject, an embarrassment about discussing it, and a long history of sweeping it under the carpet (so to speak) then it is easy to spot why this is not as "out in the open" as it deserves to be.

I have read a lot around this subject and the stories of those who suffer are many and varied. There are, however, common aspects that can be drawn out. Some of those are better understood when you start to take things as a whole rather than addressing the problem like the six blind men of Indostan. Once you see the whole it becomes clear that rarely is there a single cause - rather there are multiple things that each reinforce the others.

As a "systems" person I appreciate the fact that "connections" are very important (that must have come accross to anyone who follows what I write here) and that there are very few times when we can simply say A causes B - there are always a myriad of other factors - on both sides of that relationship. This, however, is not a blog post about systems - however the effect of Mental Health deterioration can be viewed rather well from a systems viewpoint.

There is, always, an initial trigger - something that "tips you over the edge" so to speak. What is important to remember is that this trigger may have NOTHING to do with the mental turmoil that you end up in. Often the groundwork will have been built over many years. Once tipped over that edge it can easily become a self-reinforcing and self-perpetuating descent into a very deep abyss.

You start to feel inadequate in some way; this may cause you to withdraw from other people; you may desperately need/want to connect with someone - but you don't want to "put your troubles" on them; you hide the problem from others - "putting on a face" in any public situation; the effort you expend doing this really does take it out of you; you become exhausted and unable to do things, your concentration drops; suddenly you are forgetting the important things - paying bills, even eating; now there are external factors impinging on you - the debts are piling up - which you worry about; the worry causes you to have to miss work - perhaps getting so frequent that you are in danger of losing your job; you become ill because you are not looking after yourself properly; you feel bad because everyone is rallying round to help you; down and down it goes - the starting point can be just about anywhere - it is often an illness that starts the cycle downward.

What should be clear from that - and bear in mind please that is just a much abbreviated list of ways in which this spiral can rapidly get out of control (read this account of a real life example if you want some specifics) - is that as you reach the bottom it is far from clear what to tackle to start to climb back up - worse - even considering "how to get better" can raise the specter of you having only come to rest on a ledge part way down the precipice and there is still further to fall.

Again - there are some common themes in the "how I came back from this" stories that I have read. The number one (in my view - it is not necessarily backed up by any specific research) is the supportiveness of friends - and in particular the availability of one or two that you trust sufficiently to open up to. The opening up need not be a "pouring out of all the bad" - it may never be necessary to share all the details of how you ended up so low - it may be enough to open up and "be yourself" as you are at this low point. To allow another person to share that space.

One of the things I didn't mention in the list of icy slopes downwards was a feeling of "nobody cares". This can be the case even when you "know" that there are people who care - you will continue to push them away - that can be for many reasons, but fundamentally it is you defending your 'right' to be at the bottom of the pit! Some people have suggested that the first step in "getting better" has to be the acceptance that there is something to get better from.

Is it easy? No - most definitely not - and it is certainly not quick. Here a problem is that often the "getting better" doesn't start soon enough. "I'll be OK" is the easy response to start with "I'll sort it out" - "give me a few days and it will be alright" - yes, of course there are times when this is true, but countless more times when it is not quite so straightforward. Asking for help - not a very "British" thing to do - but of course its not just the British. Everyone has a built in aversion to admitting any sort of weakness, any sort of frailty, any sort of problem that they cannot cope with.

Not everyone is equipped to provide good support - I'm far from sure that I am - but it is worth remembering that for the most part all that is required is to be a friend. It is easy to look at someone - see them as perfectly healthy (in a physical sense) listen to them complain about this and that and then say "just pull yourself together" - or "just get over it" - or "give it a rest". None of these are helpful, not least because the sufferer already knows that is exactly what needs to happen!! Its just not that easy!!

There is no "magic" that will rescue someone from the pit that they have fallen into, or the tunnel that they cannot see the end of. However, anyone can "be beside them" - that is a great comfort, the fact that "despite everything" they are still your friend, they are still loved - you haven't run off and left them in the dark. It does, sometimes, require patience - progress is not always upward - there are no guarantees - the descent can be quick, but unpredictable, the ascent will be just as unpredictable - but is inevitably slow.

In systems speak what is needed is some point of intervention - something that can be changed that will start to reverse the spiral - something that will start to generate positive reinforcement instead of negative. Certainly not trying to sort everything at once. Certainly trying to look for those things that will respond to "practical" fixes. Taking away the worries that can be solved 'easily'. It is more difficult, but deflecting the "mistakes" in thinking needs to be worked on - if its a case of "nobody likes me" then continually disprove that - if its a case of "I can't do X anymore" then provide an opportunity to prove that is not the case. Doing it once may not break the feeling - but with reinforcement the goal can be attained.

I wanted to write something for this day - wasn't sure exactly what - so this does not really have a "point" like I try to have in my blog posts - except perhaps that it exists!!

If you read this and you are struggling in one way or another - I hope you find that person or those people you can trust enough to open up to.

If you are reading this and have someone you know who is deep in the mire - just be there - don't try too hard - but continually remind them that you care; that they are loved; that things need not always be as they are now.