World Mental Health Day 2018

Today is World Mental Health Day; a day dedicated to the awareness of mental health. 

When I first started studying medicine, psychiatry seemed to be very vague, something 'not quite as important' as the other acute illnesses that were meant to be studied. 

Over the years, that perception changed quickly - I realized how important mental health was, and how so few people placed importance on it. How people with psychiatric disorders were stigmatized, and for some, how difficult it could be to move forward. 

I've sat with a friend talking him through a grandiose dream for an hour while persuading him to seek help. 

I've brought people I know to hospital for depression, because they couldn't see it for themselves that it wasn't just a case of being sad. 

I've stood my ground against people in a psychotic rage, as uneasy as it made me. 

These were young people, in the peak of they lives, who had succumbed to a mental illness at some point or other. This year's theme for Mental Health Day focuses on youths and adolescents, and the rise of mental illness with the rise of an increasingly interconnected world. 

Mental health disease will continue to rise, but are we ready for it? 

If you know someone who has a mental health problem, please encourage them to seek help. Help is always available, and they are never alone.

A Rocky Start to the Year

So 2018 has been challenging so far.

I’ve been an advocate for mental health for a long time, and I’ve always found myself in situations where people come to me to seek help, perhaps because they don’t know who else to turn to.

I don’t know if it’s because I talk about it so openly that others feel comfortable reaching out, or if it’s a situation similar to the law of attraction; that I’m put in the lives of other people because they need help in their times of crisis.

This year I found myself in crisis.

A loved one developed a mental illness, and it’s been an everyday struggle to see how easily the deterioration happens – and when it does, as someone who’s so closely entangled in their lives, you ask yourself a hundred and one questions; could I have detected this earlier? Could I have forced help upon this person? Was there anything more that I could have done to have avoided this chain of events?

To be frank, I didn’t cope very well either.

I had a lot of anger because I could not express myself without fear of retribution while the disease was active and rampant. I had to learn to tolerate the harsh words that made my heart bleed, telling myself again that it was the disease, not the person. I spent so many days crying from helplessness, wondering how this story would move forward.

And at a point, I identified that I was in crisis. At that point I had to reach out to my friends and loved ones, spent days on end texting and calling and talking to others to help ease the burden I held to myself, because I had to make sure I was mentally and emotionally ready to ride out the waves of anger and hurt that were sure to come.

It’s not a story I am ready to talk about openly on the Internet, mostly because it d
oesn’t involve just me, but I can say this much – it isn’t easy.

I write this as a reminder to myself that this too will pass.

That this individual is now getting the help that is required. And that maybe one day, we can all move on together with our lives and continue to forge ahead.

In the meantime, I am very thankful for my support system – without them I would have crashed and burned, and this would be a very different story.

There are days where the outlook still seems very bleak, but I know I have to find the strength to be someone else’s strength today, and tomorrow, and the day after – until perhaps one day, we will break through this mental barrier together.

In the meantime, I will be there.

That’s a promise.

The Turmoil of Youth

“I love him,” she said, in an almost matter of fact way. 

The words were so simply said, so earnest – and I wondered how much a girl of fourteen would really know about love. Perhaps it was her youth, and the cusp of emotions starting to bloom in adolescence, in an age where everything seemed so much more intense that the thought of losing him had once made her suicidal. 

“Do you still feel like dying?” I asked. 

“Not anymore. The moment he said he wanted to break up, I realized that there he wasn’t the person I expected. He’s just human, and even though I love him, perhaps it would be better if we were apart.” 

They were both battling depression, in their relationship had fluctuated between need and comfort in their own ebb and flow of their disease; neither one had reached out to their families in their darkness, and she had managed to climb out of it – my young friend, who unknown to us had once attempted suicide at the lowest point of her mood. 

“I don’t feel like that anymore. I’m much better now,” she said. 

“It sounds like he needs help as well, and he might not be in the best frame of mind to be in a relationship."

"I want to be there for him, but perhaps it is better if we weren't together. I don't know how he'll live without me there."

"Sometimes you need to be put into a situation to learn how to cope. You can always be in touch, but it will be different from being nearby each other all the time. In any case, you know we’re always here. In case you ever need to talk to anyone, you can always send me a text."

 

I wasn’t sure if she would ever reach out on her own, but I wanted her to know that there would always be someone to listen if she really needed to talk. 

It was the bare minimum I could do. 

 

Robin Williams's Death: A Reminder That Suicide and Depression are Not Selfish

Like the rest of the world, I responded to the news of Robin William's death with shock, and a reasonable amount of sadness. It was also with shock that I read the backlash of his suicide, with some individuals going so far as to label this 'selfish'.

As someone who suffered from depression at a point in my past, I was thankful to have overcome it with help and support, but at the time, it did feel like a wall - being behind a wall that no one else could see and seeing it grow larger in my mind until I lost sight of the people who I was reaching out to, not knowing how to verbalize the things I wanted to say until I started to believe that there was no way out. It was all in my mind, and I didn't know how to stop it. 

I got help, and alhamdulillah never got to a point that I became too low, but many sufferers of depression do, and not everyone is as lucky.

I found this article written by Dean Burnett, at the Guardian - originally here - and found that I really admired the way he was able to articulate it so well; I had to share it.

"News of Robin Williams’s death due to apparent suicide, said to be a result of suffering severe depression, is terribly sad. But to say taking your own life because of such an illness is a ‘selfish’ act does nothing but insult the deceased, potentially cause more harm and reveal a staggering ignorance of mental health problems.

Many words can be used to describe Robin Williams. ‘Selfish’ should not be one of them. 

News broke today that Robin Williams had passed away, due to apparent suicide following severe depression. As the vast majority of people will likely have already said, this was terribly heart-breaking news. Such an iconic, talented and beloved figure will have no shortage of tributes paid to him and his incredible legacy. It’s also worth noting that Robin Williams was open about his mental health issues. 

However, despite the tremendous amount of love and admiration for Williams being expressed pretty much everywhere right now, there are still those who can’t seem to resist the opportunity to criticise, as they do these days whenever a celebrated or successful person commits suicide. You may have come across this yourself; people who refer to the suicide as “selfish”. People will utter/post phrases such as “to do that to your family is just selfish”, or “to commit suicide when you’ve got so much going for you is pure selfishness”, or variations thereof. 

If you are such a person who has expressed these views or similar for whatever reason, here’s why you’re wrong, or at the very least misinformed, and could be doing more harm in the long run. 

Depression IS an illness 

Depression, the clinical condition, could really use a different name. At present, the word “depressed” can be applied to both people who are a bit miserable and those with a genuine debilitating mood disorder. Ergo, it seems people are often very quick to dismiss depression as a minor, trivial concern. After all, everyone gets depressed now and again, don’t they? Don’t know why these people are complaining so much.

I’ve said it before, and I’ll say it again; dismissing the concerns of a genuine depression sufferer on the grounds that you’ve been miserable and got over it is like dismissing the issues faced by someone who’s had to have their arm amputated because you once had a paper cut and it didn’t bother you. Depression is a genuine debilitating condition, and being in “a bit of a funk” isn’t. The fact that mental illness doesn’t receive the same sympathy/acknowledgement as physical illness is often referenced, and it’s a valid point. If you haven’t had it, you don’t have the right to dismiss those who have/do. You may disagree, and that’s your prerogative, but there are decades’ worth of evidence saying you’re wrong. 

Depression doesn’t discriminate 

How, many seem to wonder, could someone with so much going for them, possibly feel depressed to the point of suicide? With all the money/fame/family/success they have, to be depressed makes no sense? 

Admittedly, there’s a certain amount of logic to this. But, and this is important, depression (like all mental illnesses) typically doesn’t take personal factors into account. Mental illness can affect anyone. We’ve all heard of the “madness” of King George III; if mental illness won’t spare someone who, at the time, was one of the most powerful well-bred humans alive, why would it spare someone just because they have a film career? 

Granted, those with worse lives are probably going to be exposed to the greater number of risk factors for depression, but that doesn’t mean those with reduced likelihood of exposure to hardships or tragic events are immune. Smoking may be a major cause of lung cancer, but non-smokers can end up with it. And a person’s lifestyle doesn’t automatically reduce their suffering. Depression doesn’t work like that. And even if it did, where’s the cut-off point? Who would we consider “too successful” to be ill? 

Depression is not ‘logical’ 

If we’re being optimistic, it could be said that most of those describing suicide from depression as selfish are doing so from a position of ignorance. Perhaps they think that those with depression make some sort of table or chart with the pros and cons of suicide and, despite the pros being far more numerous, selfishly opt for suicide anyway? 

This is, of course, nonsensical. One of the main problems with mental illness is that is prevents you from behaving or thinking “normally” (although what that means is a discussion for another time). A depression sufferer is not thinking like a non-sufferer in the same way that someone who’s drowning is not “breathing air” like a person on land is. The situation is different. From the sufferers perspective, their self-worth may be so low, their outlook so bleak, that their families/friends/fans would be a lot better off without them in the world, ergo their suicide is actually intended as an act of generosity? Some might find such a conclusion an offensive assumption, but it is no more so than accusations of selfishness. 

The “selfish” accusation also often implies that there are other options the sufferer has, but has chosen suicide. Or that it’s the “easy way out”. There are many ways to describe the sort of suffering that overrides a survival instinct that has evolved over millions of years, but “easy” isn’t an obvious one to go for. Perhaps none of it makes sense from a logical perspective, but insisting on logical thinking from someone in the grips of a mental illness is like insisting that someone with a broken leg walks normally; logically, you shouldn’t do that. 

Stephen Fry, in his interview on Richard Herring’s podcast, had a brilliant explanation about how depression doesn’t make you think logically, or automatically confide in friends and family. I won’t spoil it by revealing it here, but I will say it involves genital warts. 

Accusations of selfishness are themselves selfish? 

Say you don’t agree with any of the above, that you still maintain that for someone with a successful career and family to commit suicide is selfish. Fine. Your opinion, you’re entitled to have it, however much we may disagree. 

But why would you want to publicly declare that the recently deceased is selfish? Especially when the news has only just broken, and people are clearly sad about the whole thing? Why is getting in to criticise the deceased when they’ve only just passed so important to you? What service are you providing by doing so, that makes you so justified in throwing accusations of selfishness around? 

Do you think that depression is “fashionable?” And by criticising the sufferers you can deter others from “joining in”? Granted, we hear more about depression than we used to these days, but then we know what it is now. We see a lot more photos from Mars these days, because we have the means of doing so now, not because it’s suddenly trendy. Perhaps you are trying to deter anyone else who might read your views from considering suicide themselves? Given that statistics suggest that one in four people suffer some sort of mental health problem, this isn’t that unlikely an occurrence. But if someone is genuinely depressed and feels their life is worthless, seeing that others consider their feeling selfish can surely only emphasise their own self-loathing and bleakness? It suggests that people will hate them even in death. 

Maybe you know some people who have “attempted” suicide purely for attention? Fair enough; a debatable conclusion, but even if you’re right, so what? Surely someone who succeeds at committing suicide is a genuine sufferer who deserves our sympathy? 

Perhaps you feel that those expressing sorrow and sadness are wrong and you need to show them that you know better, no matter how upsetting they may find it? And this is unselfish behaviour how, exactly? 

A brilliant but tortured individual has taken his own life, and this is a tragedy. But levelling ignorant accusations of selfishness certainly won’t prevent this from happening again. People should never be made to feel worse for suffering from something beyond their control."