There is an ongoing debate amongst professionals and punters alike – the heading above pretty much covers it.
Why bother with the chat? Surely it is what it is – what you call it can’t matter that much, can it?
Let me take you back a couple of years. I’m sitting in psychotherapy having the ‘what is this?’ discussion.
At the time I was more than happy to hold my hands up and say,’Yup, I’m mentally ill…’
Imagine how I felt when the psychotherapist told me she didn’t think of me as mentally ill. She didn’t offer me an alternative – she just said she didn’t see me that way.
‘Great!’ I can hear you all cheer,’thank God for that, he’s cured, moving on…’
There was a big chunk of me – still is – that felt she was taking something away from me.
My psychiatrist had diagnosed me with something from the DSM IV – the manual for loony labelling – and now, here was my psychotherapist stealing that away.
Why would I want a label? My psychiatrist, whilst giving me the label, told me she didn’t like to label folk.
I needed something. I needed to have a term that described what was going on in my head much of the time. I needed something that said,’You’re not alone – there are others like you – with your symptoms.’
Symptoms – therefore – illness.
What could be more straight forward than that?
Some GP’s, when prescribing anti depressants, explain that it’s just like diabetes – only this time the chemical imbalance is in the brain – take these tablets, that’ll sort you out.
Well I did – and they didn’t.
Wrong pills? Wrong diagnosis? Just wrong?
The thing with the illness model – the medical model if you like, is that it takes away any judgement on the part of the professional – I couldn’t help being the way I am because I have some manner of chemical imbalance in my head.
Quite a nice one for me to collude with.
For years I took the pills – they didn’t really work – I obviously wasn’t taking enough of them – I took more – my attendance at the GP’s reduced – obviously the pills were making me better.
Maybe I was so drugged I didn’t know which way was up. Maybe I thought if I went to the GP he’d give me even more pills which would contribute to my weight gain, my poor concentration, lethargy, reduced libido and a general feeling of not quite being there.
Maybe I was so drugged I couldn’t actually find the GP?
So then, what’s it all about? Am I ill or not?
Don’t be so impatient, I’m getting round to that.
Ok, things happened in my childhood that were beyond my control – bereavement, neglect, abuse –
I learnt to fend for myself – kind of.
Some mental health practitioners describe my reaction – physical and psychological – as a normal response to abnormal circumstances.
That doesn’t sound like an illness. It sounds like learned behaviour – which then, by definition, can be unlearned.
Hmmm. What about that smack on my head when I was 16? As my psychiatrist so expertly put it,’That wouldn’t have helped…’
No shit, Sherlock.
The thing is, the brain, right up until its old and crinkly, is pretty plastic – it changes – it adapts to meet the needs of the body in response to the environment.
People who lose their speech due to a stroke can often get it back as new neural pathways are forged in the brain.
Similarly though, people diagnosed with my particular malady, borderline personality disorder, have been found to have bits underdeveloped in the brain – specifically the bits that suggest calming down might be a good idea.
Are these like muscles that haven’t been exercised much? Imagine experiencing emotions early on in your development and thinking,’I don’t like that much, I’ll do anything to avoid that happening again…’ or some such.
Imagine if you don’t have the choice. Imagine if your sub/ unconscious mind makes the decision for you and intercepts what it feels are unhealthy emotions and decides to remove you from the situation?
Most of you will have experienced something stressful or painful and your mind has dived in to prevent too much physical or emotional nastiness. Often people will experience the sensation of not quite ‘being there’ – feeling removed from the situation.
A normal reaction to an abnormal situation.
Unfortunately, too much stress like this early on in ones development can lead to regular dissociative periods in later life – which can lead one – me – to wonder what’s real and what isn’t a lot of the time.
That leads to doubts in oneself, in others, in things, in the world and so on….
Ok, this is just my malady I’m talking about. Others will have had a squillion other experiences – others in the same circumstances may not have gone on to suffer any wacky symptoms.
So is it an illness? If the brain can adapt abnormally, can it readapt normally?
This is by no means a curse. Because I question things I can often see things differently (in a good way) from other folk. I have great fun with that and the humour it can generate in me.
Some would describe me as a non-conformist.
Last night my good friend, Derek, and I went out and got a bit pished (well used Scottish word for being a bit pissed) – nothing wild or crazy.
The upshot of this though was that I forgot to take my pills. These pills, charmingly called ,’Anti-psychotics’ help to regulate my emotions and help me to sleep, I feel, without losing too much of me.
Having not taken them I’ve been wired since about 3am. All the nasty mental things that can go on in my head are currently going off like fireworks.
So – not taking pills leads to a manifestation of the symptoms – well, that sounds like an illness, doesn’t it?
But it’s not just pills that help. I’ve learnt, over 2 and a half years of psychotherapy, to use a simple phrase – it will pass – it will pass.
It always has and it always will.
But not just that – it’s the folk around me – who love me – who make me laugh – who make me cry – who don’t judge me – who join me in my mantra ‘it will pass’.
So, mental illness, mental health problem, mental malady or non-conformist…?
Yes er, and no, sometimes.
Let’s not fight over definitions. I don’t care how folk refer to my…whatever it is – I call myself the wandering lunatic for Goodness’ sake. It’s the sentiment and intention behind the label that matter. Let’s not judge – let’s not condemn – let’s support – let’s accept- let’s listen.
It is what it is.
Walk a mile