Today is the last day of mental health awareness week. Are you aware of mental health? I know I am. Too bloody much. I am somewhat of an expert having been tormented by clinical depression much of the early part of my life. I also have ADHD although I’m not sure that it is a ‘mental health issue’ - more of a different way of being, and a developmental ‘disorder’ rather than an illness.
I have written about mental healthy extensively (although not for a long while). But even when I was regularly writing articles about the subject, at the time my memoir ‘The Scent of Dried Roses’ was published, I was wary. Wary of taking my ‘identity’ from my illness.
In contemporary times, 25 years after that memoir, not only are we highly aware of mental health issues we almost seem to wear them as a badge of belonging. For teenagers, some kind of issue seems de rigeur, be it anxiety, eating disorders, addictions, ADHD, rejection sensitivity dysphoria, autism, depression or phobias of one kind or another.
I am absolutely not decrying this. The revolution in thinking about mental health is one of the most positive developments of my lifetime ( along with the social and political progress of women). When I was first diagnosed with clinical depression, I felt ashamed. In the 1980s, depression was still taboo. I hated the idea of being thought of as ‘mentally ill’. It conjured up visions of locked wards and ECT. Above all, it seemed to indicate I was a weirdo, one of the tinfoil hat brigade. My attitude - to myself - although highly prejudicial, was not uncommon at the time. And I was always adamant in pointing out to people that I had ‘suffered mental illness’ - not that I was someone who was mentally ill. In other words, I was ill when I was ill, but most of the time I was perfectly ‘normal’ - ( or neurotypical as it is styled now, in an attempt to remove the shaky barrier between ‘normal’ and ‘abnormal’.)
Some people even see grief and stress as mental illness. All this softening of lines of definition comes from psychoanalysis and psychotherapy as well as psychiatry. I am currently reading a book of talks by Carl Jung and he says at one point that guilt itself should be treated as mental illness. Hmmm. And the theme of last year’s Mental Health Awareness Week was ‘loneliness’. Loneliness is awful, but not a mental illness in and of itself, surely ( although depression could also be described as ‘acute loneliness syndrome’).
But things have moved on and that’s all to the good. However, hasn’t mental illness become a little too…tempting? I’m not saying it’s a choice - it absolutely isn’t - but for those with borderline complaints ( and most people have some symptoms of mental illness) getting a diagnosis has a lot of payoffs.
I know this all too well since my ADHD predisposes me to a fair bit of what others would style bad behaviour. I am inclined to speak inappropriately, act impulsively , interrupt others when they are talking, not listen to people properly and find my emotions hard to control. Once there was a word for such people. Annoying. Or possibly, offensive. But now I can console myself that my brain is wired to be annoying. Or offensive. That’s a great consolation for me, but it’s frustrating for anyone who witnesses my behaviour when I am in that condition ( fairly rarely nowadays, I hope),
It’s not the only payoff. I am now part of the ADHD ‘club’. Us who experience ADHD occasionally chat on social media, looking to be ‘seen’, and however you look at it, that is being part of a community, or to put it another way, an identity.
It’s not just ADHD. The trouble with mental illness is that almost always involves what seems to be bad behaviour. Depressives - and I speak as one - do a good impression of being terrible people, while they are in grip of their illness. They are selfish, narcissistic, self-pitying, self-hating , miserable, negative and no fun to be with at all. That’s one of the reasons they hate themselves so much. Anorexics tend to lie compulsively. Addicts do anything, including steal, to feed their habit. In other words, mental illness tends to be deeply anti-social.
OK - it’s not their (my) fault. All the same, I rather feel we have come too close to valorising mental illness - and if not valorising it, granting the cherished victim status to those who suffer it.
One thing I remember when I was at the heart of the mental health debate - after my memoir was published - was my determination, as a writer, not to be pigeonholed as a ‘mental health’ writer. I was a writer, who had suffered mental health problems (as so many writers have). I wasn’t a ‘mental health writer’. I imagine the same issues assail LGBT+ and minority writers, who do not want to be known as ‘gay’ writers, or ‘black’ writers, but simply writers.
My final rejection of mental health as an identity came when I was judging a TV award for the best depiction of mental health ( in itself something I was reluctant to do, because it pigeonholed me, but I felt a duty to participate). I remember a film of a group of people who called themselves ‘Mad Pride’ and went on marches, proudly announcing their issues on placards and banners. This struck me as odd, to say the least. Mental illness is not something to be ashamed of. Neither , though, is it anything to be proud of, any more than an ingrowing toenail is something to be proud of.
Talking to some of the groups involved in the judging of the prizes, I also realised that they found belonging in their various identities, chatting with each other about ‘going down the Tavi’ together ( the Tavistock, the mental health centre now closed down after a dispute of their transgender policies). They had social evenings and T-shirts and shared a common, medicalised language revolving around medication and diagnosis. It was vaguely cultish and although I appreciate that they were doing their bit to remove taboo on mental illness, I did not like. I suppose this is my objection to identity politics in general - that we are all first and foremost humans and individuals, not group members. But my attitude increasingly seems out of date. People now all feel they have to belong to something. But I have never wanted to belong to anything. I don’t want to be in your club. I will define myself, thank you very much.
It might be that campaigners have not “normalised” mental illness so much as broadened the definition to the point that it includes a fair number the mentally ‘well’, which is a problem for acute mental health sufferers - as I once was. There’s a kind of mental health diagnosis inflation that is taking place that means that really serious mental illness doesn’t get the attention it deserves, because all the resources are being used up on less serious complaints ( I took these points from an excellent article by Sarah Gill in the Guardian: )
The article begins with the paragraph: ‘The psychiatrist Simon Wessely once said his spirits sank every time there was a mental health awareness week. “We don’t need people to be more aware. We can’t deal with the ones who already are aware,” he said.
To sum up. Increased mental health awareness is good. The reduction of taboos is excellent. But life is tough and complicated and inevitably involves suffering, anxiety and misery. Such outcomes should not be mistaken for illness, but accepted as the human condition. And if the human condition itself is to become medicalised, then we are going to have to put an awful lot of resources into the problem, without ever being able to solve it.
Certainly worth asking the question when it is enough and when it is too much.
Interesting post, thanks Tim. I wonder if anyone else has read Johann Hari's Lost Connections. I thought that book did a good job of addressing widespread depression/anxiety and the ways that a society may come to understand and meet that condition, rather than medicalise everyone who experiences bouts of despair and/or severe apprehension.