Mental Health Awareness Week 2019: What we can do

A bit about my background and why I’m writing this

My ‘GP and Human’ blog evolved ‘accidentally’ after discovering writing was the only way I could express myself when I found myself in the depths of depression (secondary to ‘burnout’ and some other life issues) in September 2017. Talking was too hard but I knew I needed to release what was within somehow and I instinctively started writing. The initial writing was shared only with a few at first but it resonated with people who had felt similarly, especially other doctors, and helped them to feel less alone in their struggles – so they wanted to share it more widely. I am told it also helped relatives and friends to understand more about what it was like to suffer from these problems. The writing came from emotions deep within and was raw and uninhibited; I presume this is why it felt powerful for others to read. So I carried on – but eventually brought my public personal story to an end for various reasons.

I hid behind anonymity at first; for many months actually. But then I realised that I had inadvertently created a way to do my bit to get people talking about mental health problems and reduce the stigma. After much deliberation, I took the (terrifying!) step of identifying myself publicly; how could I achieve any of this if I was still hiding myself? Despite all of the overwhelming positive and supportive feedback I had received, there was still a background feeling of shame and fear of judgement. There was no negativity expressed after this through the blog, but my previous mental health problems have been ‘used against me’ since (in ‘real’ life) and I know this also applies to others; there is still a lack of understanding and there is still a stigma around it. Much more work needs to be done and I’m still passionate about supporting that process.

So, here’s a few of my thoughts on how you and I can help improve Mental Health awareness and help support sufferers.

Awareness: Don’t treat someone as ‘mad’

This may sound politically incorrect to put it like this and people may immediately think ‘Of course not!’ But I have said this deliberately because it is sometimes perceived this way and I also believe in straight talking rather than fluffing around these things which reinforces the problems around lack of Mental Health understanding. A sufferer will often sense this harmful concept themselves anyway and it can be a huge barrier to seeking support. And a lot of the rest of the world, so far, reinforces it – whether that is intentional or not. It’s hard enough for an individual to accept that they have a mental health problem; you can feel weak, pathetic and sometimes like you have lost control of your own mind. You fear what other people will think, how they will react and the negative impact it might have (e.g. on your career) if/when others find out. It doesn’t help to have other people looking at you and treating you as if you have 3 heads and have come from Mars. That person is still themself underneath, is suffering, probably quite scared and needs recovery and healing. It should be treated no differently to any other health problem. It is just as real as any other health problem. It needs treating just like any other health problem.

Awareness: It can happen to anybody

Do you have an image of the ‘type’ of person that gets or has mental health problems? It’s hard to admit but many people do; we humans naturally stereotype in our minds even if we don’t admit it outwardly. It is not always just the people that have the obvious challenges in life – it could be those that appear to have the perfect life from the outside and it can happen even to the ‘strong’ and ‘together’ ones. Sufferers will say things like ‘But I’m not a depressed/anxious sort of person’ and ‘Why do I feel like this when there’s nothing wrong with my life?’ Sometimes it won’t ‘make sense’ in logical terms. And that doesn’t matter. It can happen to absolutely anybody at any age in any circumstances. Don’t question it; just accept it.

Awareness: You probably won’t know how it really feels if you haven’t been there

I can honestly say that my understanding of mental health problems is now completely different from before I had my own issues. I knew a fair amount from witnessing it through my personal life and from interacting with patients with mental health problems every single day in my professional life. One of the reasons I felt I had ‘burnt out’ in the first place was because I am highly empathetic and give my all emotionally to the person in front of me. I couldn’t have done any more at trying to understand what these people were going through. But nothing could have given me the insight into it that my own experiences have done – which may sound obvious when put like that but I don’t think it is. Again, don’t question it, just accept it. It is not just ‘a bit sad’ or ‘a bit stressed’ that you can just snap out of. Which brings me onto my next point…

Awareness: You can’t help it

Feeling depressed or anxious can actually be incredibly frustrating. You can do your best to battle your way out of it but something takes over and drives it from within. You can feel like some sort of demon is taking over you and you don’t feel like yourself. Getting better can be an uphill struggle and take a huge amount of work.

Awareness: It is not selfish

When you suffer from a mental health problem, as I have already mentioned, you may not be quite yourself. Rational thinking can get lost in the cloud of suffering and people have varying levels on ‘insight’ into their mental state with some not actually being able to differentiate their mental perceptions from reality. I am going to touch on something very sensitive now. When people have suicidal thoughts or even follow through on them, they may not be able to see hope for the future, recognise good in their lives or be fully aware of the true impact they would have on others (e.g. their children); it is a desperate place to be and should not be seen as ‘selfish’ – they simply can’t see any other way out. Please do not judge those that have found themselves in this position; you cannot begin to know what state their mind was in at the time.

Support: Talk about it

No, not just online. Not just sharing those posts that circulate on social media. That’s easy enough to do. But how much difference is that going to make if it’s only from behind a screen in a virtual world? We need to actually talk about it – in real life. To each other. Face to face.

Support: Notice and ask

There have been campaigns illustrating that people hide their internal battles very well – behind the smile. Are there little things you’ve noticed about somebody that is out of the character for them? Have they stopped paying so much attention to their personal appearance? Have you noticed a change in their eating habits (and maybe a dramatic change in weight)? Have they started to find excuses to avoid meeting up? Have they stopped talking to others so much? Maybe they’re even vocalising little clues that are actually a call for help? The possibilities of how something might show go on and may be subtle but still be evident. Many people won’t feel able to openly express that they are struggling, partly due to the fear of being judged for it. If you think something is amiss, start the conversation – ‘Are you OK?’ might be all that is needed – and someone noticing can mean the world. If they are actually fine, then great – but you might be the person that leads them to getting the help they need, just by giving them the opportunity to open up and say ‘No, actually I’m not OK.’

Support: You don’t need to do much

One of the reasons people shy away from talking about mental health problems especially to the person involved, is that they don’t know what to say or how to handle it. But here’s the thing – you don’t need to. You don’t need to understand why. You don’t need to have a solution. You don’t need to be a counsellor. Just be a friend – just be there. It can feel very frightening and isolating. Just a brief conversation or text can really help – knowing that somebody is thinking of you when you are struggling. Sitting with someone, even in silence, can provide a huge amount of comfort. Seemingly little things can make a world of difference e.g. being brought some ready-to-eat food – self-care can often suffer and it is once again comforting to know someone is looking out for you.

Accept, ask, just be there; little things make huge differences.