“It’s nothing like a broken leg”: living with mental illness
It’s never been easier to talk about mental health. But does anyone want to hear the messier, more uncomfortable truth, asks Hannah Jane Parkinson
I am bleeding from the wrists in a toilet cubicle of the building I have therapy in, with my junior doctor psychiatrist peering over the top of the door, her lanyards clanking against the lock. Her shift finished half an hour earlier. An hour later she calls the police, because I have refused to go to A&E or to let her look at me. Four policemen arrive. They are all ridiculously handsome. One of them is called Austin. Austin doesn’t have a Taser like all the others and when I question this, Austin says he hasn’t done his Taser training and all the others laugh. I feel bad for Austin. I want to go home, but I am not allowed. I am crying. The police ask me to tip out the contents of my jacket. Tampons fall out, with four sad coffee loyalty cards, each with a single stamp. Then I make a break for it because, seriously now, I just want to go home. The four officers surround me at the building entrance. One officer who has done his Taser training threatens to section me if I do not stop struggling. As if you can just section me, I say. You can’t just say someone is sectioned and then they are sectioned. That is not how it works.
It turns out this is exactly how it works. I am put in handcuffs. Three other police turn up in a van – seven now. A woman searches me, running gloved hands along my calves. It is cold. It is dark. I am scared. I ask to call someone. A police officer says, now is not a good time. I say: I feel like this is totally a good time. I am bundled into the van. As if in a TV drama, my psychiatrist reappears in the gap between the doors before they clang shut. The hospital is ten minutes away, but I end up in the van for 40 minutes. I’m offered water when I arrive, but they don’t want the cuffs taken off, so the officer holds a cup up to my lips. All of my possessions are taken away from me. I am kept in a small room in A&E for 22 hours, before being found a bed in an inpatient unit.
I have experienced mental illness since the age of 13, and have been in the psychiatric system for a decade. In year eight, I spent so much time absent from school that a social worker was called. At 16, I dropped out of A levels with incapacitating depression and barely left the house for nine months – the empty days stretching out while friends clubbed and kissed. I was put on antidepressants, and at 18 decided to move to Russia, alone, in a manic whirlwind and had the time of my life. At 20, I moved to Oxford and was diagnosed with bipolar disorder. I was told I would have it for life. I moved again at 23, and there is now no hospital in north London I have not been treated in. In the past few years I have observed a transformation in the way we talk about mental health, watched as depression and anxiety went from unspoken things to ubiquitous hashtags. It seems as though every week is now some kind of Mental Health Awareness Week. In the past few years I have lost count of the times mental illness has been compared to a broken leg. Mental illness is nothing like a broken leg.
In fairness, I have never broken my leg. Maybe having a broken leg does cause you to lash out at friends, undergo a sudden, terrifying shift in politics and personality, or lead to time slipping away like a Dalí clock. Maybe a broken leg makes you doubt what you see in the mirror, or makes you high enough to mistake car bonnets for stepping stones (difficult, with a broken leg) and a thousand other things. Oh, I know how it’s meant. The lack of stigma should be the same as telling people why your limb is in a cast. But you can’t just put someone with a broken leg and an insane person side by side and expect people not to be able to tell the difference.
In recent years the discussion around mental health has hit the mainstream. I call it the Conversation. The Conversation is dominated by positivity and the memeification of a battle won. It isn’t a bad thing that we are all talking more about mental health; it would be silly to argue otherwise. But this does not mean it is not infuriating to come home from a secure hospital, suicidal, to a bunch of celebrity awareness-raising selfies and thousands of people saying that all you need to do is ask for help – when you’ve been asking for help and not getting it. There is a poster in my local pharmacy that exclaims, “Mental health can be complex – getting help doesn’t have to be!” Each time I see it, I want to scream.
The Conversation tends to focus on depression and anxiety, or post-traumatic stress disorder. It is less comfortable with the mental illnesses deemed more unpalatable – people who act erratically, hallucinate, have violent episodes or interpersonal instability. I don’t want to pretend that this stigma is merely a hurdle to be overcome. Stigma exists from a place of real fear and a lack of understanding of the behavioural changes that can accompany mental illness. Episodes of illness can be frightening, frustrating, tiring and annoying for both the unwell individual and those around them. The key isn’t to deny this, but to educate. Instagram slogans do not make it clear what depersonalisation is, for instance, and that it won’t be solved
“It is infuriating to come home from a secure hospital, suicidal, to a bunch of celebrity selfies saying all you need to do is ask for help”
by a picture of someone walking on a beach. It’s good that Lynx deodorant teamed up with the male mental health Campaign Against Living Miserably, but is “Find Your Magic” not the most patronising slogan of all time?
Like the rest of the population, I instinctively love the NHS, from the junior doctors to the consultants to the community psychiatric nurses. But, really, if you asked me right now? I hate the NHS. I hate the thin film of skin on its bones. It is incompetent and ailing. I used to blame the system. Mostly it is the system: those never-ending cuts and closures; the bureaucracy; the constant snafus of communication; the Government’s contempt for staff. But sometimes, that system gets inside the staff, too. It is there when you are asked the same questions by 20 professionals, in a time of great distress, and then reprimanded for anger when you snap the 21st time. It is there when you are asked to fill out a form to assess a service, after being told you won’t receive that service until two birthdays in the future.
Even when everyone is doing their job well, and many do, the treatment of mental illness is a slog. The trial and error of finding a productive medication, or multiple medications. Multisyllabic names in packets with go-faster stripes. The implicit paradox of becoming ill and necessarily hospitalised, meaning being removed from all the things that normally help. The expense of prescription charges for lifelong conditions that (aside from in Scotland, where all prescriptions are free) are not exempt, though some physical illnesses are. The fact that, if doctors only ever see you at your worst, or in crisis, they are not getting the whole picture, which is crucial with mental illness.
How do I explain that, sometimes, I doubt the professionals know what they are doing? Or that sometimes, when I am ill – and this goes against the grain of the Conversational rules – I doubt bipolar disorder is even a thing. (Or emotionally unstable personality disorder, or body dysmorphic disorder, or adult ADHD, all terms I’ve heard used about me.) How do I explain that it is never as simple as having this, or that? How do I tell you that it is horrible being an inpatient, because there will be people there who are crazier than you, and you do not want to be around those people? Sometimes the situation will be reversed.
When I am well, I sometimes think I will be fine for life, and want to abandon all my medication. And when I am not well, I think maybe I really am just a fuck-up and should not be dealt with sympathetically. We don’t talk about self-stigma because, as part of the empowering new Conversation, this is also not allowed. How do I tell you the worst part of me desperately wants you to get help but also doesn’t – because already there is not enough help and too few beds, and there is not enough to go round.
I am no longer under the care of a named professional to review my medication. After the sectioning and the 22-hour wait, there was a hospitalisation out of borough. Upon leaving the inpatient ward, there was a two-week stay at a crisis house (which helped), then that was it. I was ill enough to be sectioned, but well enough to have therapy discontinued. I was put on an 18-month waiting list for therapy. I called icope, an NHS digital therapy service, but because I was on a waiting list, I was ineligible. It took me about 16 weeks to get back to work – much longer than it should have done – because I had to clamber from a well without ropes. I would run into GP surgeries, suicidal; the receptionist said he would “pass the message on”. I sat in the consulting room, sweater over my head and howling. Since I was sectioned, I have been hospitalised twice, once after a suicide attempt. I am still on a waiting list, a different one: this one is two years long. My friends and family simply do not understand the delay, cannot believe it when I tell them about the system. So, clearly, the Conversation isn’t as illuminating as it thinks it is.
I will admit that I am not well. That writing this, right now, I am not well. This will colour the writing. But it is part of why I want to write, because another part of the problem is that we write about it when we are out the other side, better. And I understand: it’s ugly up close; you can see right into the burst vessels of the thing. (Also, on a practical level, it is difficult to write when one is unwell.) But then what we end up with has the substance of secondary sources.
The primary danger used to be glamorising. It was cool to be a bit mad. It meant you were a genius or a creative. But now there is also a new danger. It is “normalising”. This is meant to be a positive – as in, “What is normal, anyway?!” Which is a fair question, but I don’t think it’s the woman who crept into my inpatient room, stole the newspapers I had, found me in the lounge and ripped them up slowly in front of my eyes. I don’t think it’s me, sitting in a tiny, airless hospital room, carving my name into the wall with a ballpoint pen, with three guards for company, one of whom later tries to add me on Facebook. Don’t pathologise normal processes such as grief, or the sadness of a relationship breakdown, or the stress of moving house. Conversely, don’t tell me it is normal to blow thousands of pounds on sporadically moving house without ending a current lease, or to send friends bizarre, pugilistic texts
in the night.
When I left appointments and saw the long-term patients, walking around in hospital-issue pyjamas, dead-eyed (the kind of image of the mentally ill that has become anathema to refer to as part of the Conversation, but which in some cases is accurate), four emotions rushed in: empathy, sympathy, recognition, terror. It’s one of those things you can’t really talk about with authenticity unless you’ve seen it, not really.
Maybe my prognosis will look up, maybe I’ll leave it all behind. I’ve noticed a recent thing is for people to declare themselves “proud” of their mental illness. I guess I don’t understand this. It does not define me. It’s not something that, when stable, I feel ashamed of or that I hide. But I am not proud of it. I’d rather I didn’t have it – so I wasn’t exhausted, so I wasn’t bitter about it – despite the fact that I know some people, in all parts of the world, are infinitely worse off.
I want it gone, so that I am not dealing with it all the time, or worrying about others having to deal with it all the time. So I don’t have to read another article or poster about how I just need to ask for help. So that when a campaigner on Twitter says, “To anyone feeling ashamed of being depressed: there is nothing to be ashamed of. It’s illness. Like asthma or measles”, I don’t have to grit my teeth and say, actually, I am not OK, and mental illness couldn’t be less like measles. So that when someone else moans about being bored with everyone talking about mental health, and a different campaigner replies, “People with mental illness aren’t bored with it!” I don’t have to say, no, I am: I am bored with this Conversation. Because more than talking about it, I want to get better. I want to live.
“How do I tell you that it is horrible being an inpatient, because there will be people there who are crazier than you?”