I was involved in a facebook conversation yesterday about mental illness and some of the comments people afflicted are receiving:
‘You don’t look like you have a mental illness!’
‘You don’t look disabled!’
To people who make comments such as these, I’d like you to tell me; what should mental illness look like? That’s a serious question.
Mental illness (and I can’t believe I’m about to state the bleedin’ obvious here) occurs inside the brain. Can you see my brain? Yours? No. Some mental illness is obvious by the way someone acts, and some isn’t.
For those who are new to this blog, I’ll let you know that my partner has severe OCD and mild agoraphobia, plus depression. You can’t tell just by looking at him that he has a severe mental illness. Lately, he has started to get worse with a thing we call ‘quirks’, though. This means that sometimes he will make an involuntary noise, which is usually yelled out loud. It often sounds as though he’s in pain, or getting a sudden shiver, or something like that. Other times, it sounds as though he’s doing it to be funny, which he isn’t.
Sometimes he’ll start getting irrationally snappy, or nervous, or bossy (‘we have to get out of here now!‘). But for the most part, you can’t ‘see’ his illness. If you met him, you might not pick that he has a mental illness. It all depends on what sort of day he’s having, where he is, and how well he knows you. He will work very hard to suppress/hide his illness from you if he is feeling particularly anxious, and he is getting better at doing this all the time.
When he can’t suppress those feelings any longer, there is a chance you won’t see it, because he will make an exit, for fear of embarrassing himself.
It’s because of these things that I’m guessing people outside of our family don’t see his illness as it actually is. Let me illustrate what I mean with a few examples:
My partner cannot handle crowds very well, but is improving at this with treatment. In his first year of diagnosis/treatment, he didn’t go to our eldest daughter’s school awards night. (A few years in, he’s still never been) I have been told, ‘these things are important. A good dad would just go, it’s mind over matter’. Now, during our first year of dealing with my partner’s illness, we were still worming out the idea that he might also be suffering from agoraphobia. OCD and depression were the main points we’d addressed to this point. It was a very stressful time.
My partner had not yet learned and practised techniques and strategies to help him cope with situations difficult for him. We still hadn’t found the right medication for him. I was still learning what my role in helping him was, and there were so many things I didn’t know. I still didn’t fully understand his illnesses, and hadn’t interpreted yet the best ways I could help him and the whole family through his anxiety and behaviour.
We were both hyper aware that we were no longer a ‘normal’ family. We desperately wanted to be normal again, and were grappling with accepting this new reality, and trying to understand whether or not we would ever have a normal future. At this stage of his illness, I was pretty much running the family and household, as my partner battled his demons, or spent full days knocked out on the wrong medication.
He had guilt about not contributing at that point, and I had guilt that there was only one of me, and only so much to go around! Plus, at this stage, my two younger kids were extremely young, so of course that was more demanding of my time. We both battled the ‘not good enoughs’ on a daily basis.
So, when you’re trying to hold it all together and function normally (which was pretty much impossible), to then be told that we were handling an awards night the ‘wrong’ way by ‘normal’ standards, it was pretty gutting stuff. I went to the awards night, and left the two younger kids with my partner at home so that they wouldn’t disrupt the evening. My partner was not at the stage where he was capable of being in a tightly packed room full of strangers, and being made to feel guilty about this, was not helpful at all. If anything, it lowered our morale to the point of it being a set back. We’re both a bit more resiliant to remarks of those who don’t understand these days, so it wouldn’t set us back so much anymore, than it would be a mere irritation.
Two years later, the same person mentioned that she’d seen my partner out driving every day, and that he ‘didn’t seem that bad if he could do that’. So, we have a man who has now found the right medication, has learned and practised some ‘mind over matter’ techniques to help him with difficult situations, and he’s still being criticised? Is he meant to force himself in certain uncomfortable situations, because someone else deems it necessary, then at other times, not challenge himself to improve? Does he need to stay ‘stuck’ in his illness, to prove how sick he is to others? Of course not.
It sometimes can feel as though he’s damned if he tries, and damned if he doesn’t. If he’s not ready for a certain challenge, he’s not trying hard enough, and if he makes a huge acheivement in confronting a fear and successfully completing it, then maybe he’s just not as sick as he makes out he is. On top of that, these comments don’t factor in the idea that those with a mental illness have their good days and their very bad days. He might’ve been successful in one task last week, but this week is feeling more stressed. So, this week he may not be able to complete tasks as well as last week, due a build up of anxiety.
Now, I can only speak of our experiences with mental illnesses, and I can’t claim to know what it’s like for other people with mental illness, and I don’t want to. But I would like to ask those who (understandably) don’t understand what it means to have mental illness a few things:
Mental illness doesn’t have a certain type of ‘look’ about it. Can you please stop fixating on appearances, be it looks or your perception of the behaviour of the mentally ill?
Can you please understand that mental illness is a work in progress? You don’t see the work going on behind the scenes. Sometimes, if you see someone with a mental illness doing something you’ve heard them claim they can’t do, you are watching the work in progress. It doesn’t disprove that they have mental illness, it just proves they’re trying to beat this thing. If you feel a need to comment on them not seeming to be particularly mentally unwell today, the most helpful thing you can say is, ‘well done!’ Let this person or their carer know that you’re impressed with what they’ve acheived. Saying, ‘you’re doing so well today!’ will actually help that person in their treatment! It’s so much more constructive than, ‘well, he seemed ok last week, I don’t see why he can’t do it today!’ Judgemental comments like these can even hinder progress.
Whether someone with mental illness is having a good day or a bad day, acheiving or regressing, it’s great to sometimes acknowledge, ‘I know how hard this can be for you’. Reinforce that you know they’re doing the best they can at the time.
To finish off, I’d love for anyone not dealing with mental illness (be it yourself or a loved one/friend) to simply understand that there is a whole big picture behind mental illness. You don’t see it, but compassionate people can try to use their imagination. Choose empathy. Even if you don’t understand a particular illness much, attempting empathy is more useful than blind judgement.