Motherhood, mental illness and beyond

Posts tagged ‘honesty’

Is honesty the best policy?

When you meet someone new, how long do you wait before you do it? Do you do it? Or not? I’m talking about taking a deep breath and being honest about your mental health.

Despite having had mental health issues from childhood it’s only in the last year or so that I have begun to be honest with friends (and some family) about the extent of my illness. This is largely due to to the Time To Change campaign and discovering the incredibly supportive and vociferous mental health community on Twitter. But I’m still fairly cagey about it, mostly through a lifetime’s habit. I’m still prone to self-stigmatise and feel (needlessly) ashamed or embarrassed.

Now that my daughter has started school I’m coming into contact with a lot of new people. Some of them I’m becoming quite friendly with and I’m starting to wonder whether, if the opportunity arises, I should casually mention something about my mental health. The main reasoning behind this is that I have days, or sometimes weeks, when despite being fairly stable thanks to my medication I just cannot face seeing people and being sociable. Or there are days when I’m profoundly uncomfortable being out in public but I can cope just chatting on a friend’s sofa. It might be useful for new friends to know this in advance, so that my occasional last-minute cancellations, nerves or reluctance to commit to a meet-up aren’t misconstrued.

However, I’m profoundly nervous about being honest as I have a deep-seated fear of rejection. I’ve already lost a couple of previously close and well-loved friends because they simply couldn’t cope with my problems. And if they, who knew me so well, felt the need to walk away from me then what’s to stop a relative stranger from doing the same? Mental illness is still remarkably stigmatised and misunderstood despite 1 in 4 UK adults having it, and I have no wish to become the playground bogeyman (or bogeywoman if you prefer!).

Interestingly I recently came across the NHS Attitudes Towards Mental Illness 2011 Survey Report. According to this report:

12% of people agree that it is frightening to think of people with mental illness living in a residential neighbourhood;

12% of people think someone with mental illness doesn’t deserve sympathy;

16% of people believe that one of the main causes of mental illness is a lack of self-discipline and will-power.

These may be relatively small percentages, but as someone who is mentally ill I find them worrying. People don’t wear helpful t-shirts with the slogans “I’m educated about mental illness – talk to me!” or “I’m ignorant, don’t open up to me!”. I have no way of knowing whether the person I’m having regular coffee dates with falls into category A or category B.

I sometimes wonder whether perhaps it would just be safer and easier to keep things to myself, to lessen the risk of rejection and stigma. But the thought that torments me is that there’s no way of me knowing whether the person I’m friendly with falls into category C – someone else with mental health issues. Maybe they’re struggling with the same dilemma that I am. After all, we don’t wear helpful t-shirts either!

On the whole, I think I need to take the risk and be honest. I owe it to myself to not be ashamed or afraid of what others may think of me. I owe it to all the other people with mental illnesses to be open; to stand up and be counted, maybe even to educate. My mental illnesses (I have several conditions) impact most areas of my life and so they’d be a fairly significant secret to keep.

I don’t worry about telling people that I have degenerative disc disease and need to use a walking stick. I shouldn’t be worried about telling people that I have mental illnesses and need medication.

The harshest critic

I’m not perfect. I know I have my faults and I’m honest about them. I’m honest about my bad habits too, and I don’t allow myself to make excuses. I know what my weaknesses are. I don’t like myself very much, but I think that’s pretty normal. I saw a CBT (cognitive behavioural therapy) specialist for a while and she was horrified by what she called my “character assassination”. She said I judge myself far too harshly and that I need to be kinder to myself.

But what she saw as harsh, I see as being realistic. After all, I’m the one inside my head. I’m the one thinking these thoughts, feeling these feelings. I need to be honest with myself. It’s taken 20 years for me to acknowledge that my depression is as much a physical illness as a mental one and that I will probably be taking medication for the rest of my life. I’ve made my peace with that. But I am less comfortable with other aspects of my mental health.

Take my anxiety, for example. While I know it’s a mental health problem I also know it’s ridiculous to be in a constant state of worry and consternation that my husband or children could die or be critically injured at any minute. I know that not wanting to meet new people, not feeling comfortable in social situations, is silly and limiting. I don’t feel like this about others who have anxiety, just myself. The therapist said this was self-stigmatising; I think it’s just being realistic.

The same is true of my disordered eating (I’ve blogged about this a few times). I admit that my eating is disordered and that I am struggling to cope with this. But the suggestion that I may have an eating disorder seems preposterous. So what if I tick all the diagnostic boxes? To say that I have an ED would be like making an excuse, absolving me of responsibility. In reality I am weak, greedy and lacking willpower – that’s what’s wrong, not an eating disorder. My eating problems are my own fault and nothing more.

I could go on – my self-loathing is deep and boundless. I am not the wonderful mother I assumed I would be. I’m not the successful career woman I assumed I would be. I’m not the sociable, popular individual that I used to be. The schism between who I should be and who I am seems almost unbridgable.

I know I am critical of myself, but who isn’t? Who doesn’t wish that they could change things about themselves? This post may seem self-pitying but it isn’t. I am brutally honest with myself because I need to be, I can’t allow myself to make excuses. I don’t like who I am and I need to confront myself and be truthful if I am to make changes.

I am, therefore I eat

Fat. Greedy. Obese. Disgusting. Pathetic. Ugly. Stupid. Weak. These harsh, hurtful words are all hurled at me on a daily basis. Not by family, friends or even strangers in the street but by me. My self-loathing spilleth over. Two of these words are incontrovertible – I am fat and I am obese. There is no proof for the accuracy of the others but I know that they’re true. Well… I have always been convinced that they’re true but lately chinks have begun to appear in the armour of my certainty.

I wrote here about the discovery that I apparently have an eating disorder, specifically binge-eating disorder or BED. At the time I was reluctant to apply the label of having an eating disorder to myself but I was able to admit that my eating is definitely disordered. I think about food all the time, from the moment I wake to the moment I go to sleep. I eat 2-3 meals a day and I graze in between whether I am hungry or not. Sometimes I will invent an excuse to go to the shops just so that I can buy chocolate or biscuits, either to eat in the car before I get home or to hide away and eat in secret where no-one can see. If there isn’t anything sugary or fatty for me to graze on I begin to panic and until I find something acceptable to eat I am unable to focus on anything else. If there is food around I’ll be picking at it.

So why haven’t I admitted that I have an eating disorder? Because I honestly believe that I am just greedy. I’m deeply ashamed of myself for this and for my lack of self-control but to label it an eating disorder seems an overreaction. Even considering the possibility makes me feel like a fraud, as though by comparing myself to people who really do have eating disorders I’m belittling their struggles. It feels like attention-seeking.

And yet… Friends who are far more knowledgeable and experienced in this area than I am are adamant that I have an eating disorder. A psychiatrist said that it was BED. The NHS website has a section on binge-eating which says:

In diagnosing binge eating, your GP will ask you about your eating habits and look for three or more of the following signs:
1) you eat much faster than normal during a binge
2) you eat until you feel uncomfortably full
3) you eat a large amount of food when you are not hungry
4) you eat alone or secretly due to being embarrassed about the amount of food you are consuming
5) you have feelings of guilt, shame or disgust after binge eating

Three or more? Well I tick all five boxes. So why am I still so reluctant to acknowledge this?

I’d like to say that it’s due to a lifetime of internalising society’s disdain for the supposed weakness and greed of the overweight and obese. I’d like to say that years of seeing people mocked and targeted purely because of their size and presumed inability to eat healthily has had a profound effect on me and left me able to only blame myself for my problems with food. And there may be some truth in that. But in reality I had issues with food long before I became aware of these things.

I wasn’t an overweight child but I was convinced that I was. I remember crying in the playground because I didn’t want to be fat any more. I remember binging from the age of 7 or so and guiltily hiding the evidence. I remember almost flooding a childminder’s bathroom once when I panicked and tried to flush a handful of chocolate bar wrappers down the toilet. I remember my first year at secondary school, when I would barely eat Monday to Thursday but on Friday spend my entire week’s lunch money on a mountain of food. After one of the staff told my mum about that I began taking packed lunches and supplementing them with food from the canteen when I wanted to binge – a much more subtle approach, I felt.

I have no idea what caused my problems with food (I had a happy childhood, I was well-fed, looked after and loved) but I doubt that the emergence of these issues at around the same time that I began to self-harm is a coincidence. Whatever the reason, I have been doing this for about 25 years and it is time to face up to this, to allow myself to admit that this problem may be greater than I have believed for the last quarter of a century. I need to be kinder to myself and recognise that perhaps I am not as weak as I think, that maybe the root of my obsession with food is related to my mental health rather than a character flaw.

My name is Sam and I have an eating disorder.

When misery is selfish

A while ago I wrote this post about how I would dearly love to have more children but am unable to, mostly due to issues with my mental and physical health. I thought that I was gradually adjusting to the knowledge that DS is my last baby, that the large family DH and I yearn for will never exist. But this afternoon I was sorting through my maternity clothes and some baby clothes that DS has outgrown and I found myself sobbing quietly into a sleepsuit.

My last pregnancy wasn’t great, I suffered from AND (antenatal depression) and my mobility became so poor that I was housebound for the last month or so. But I would do it again in a heartbeat and the pain of knowing that I will never again know the thrill of having a small life growing inside me hurts me almost more than I can bear.

However I’ve been told on many occasions (mostly via social media but occasionally in person) that I shouldn’t feel like this, let alone admit it publicly. Apparently it is selfish and inconsiderate to those who are unable to have any children. I should count my blessings and stop feeling sorry for myself. Now, I have the deepest sympathy for anyone who wants children and cannot have them; I remember how desperate I was before DD was conceived and I can’t imagine the misery of knowing that you will never have a child. But I have come to realise that that doesn’t make my pain at not being able to have more children any less real, any less valid, any less painful.

As friends have pointed out to me, my having children doesn’t mean there are fewer children left for others – there isn’t a finite number to be shared out. Equally my pain should have no bearing on whether friends and acquaintances have more children; their reproductive decisions should be based on what is best for their family, not whether or not it will twist the knife a little deeper for me.

Conception isn’t the only topic where I have encountered this attitude; I have also been criticised when discussing poverty and finances. I have made no secret of the fact that DH and I are both out of work, that we have very little money, that every penny is stretched as far as it can go. But again I have been accused of selfishness if I admit that constantly counting the pennies and going without is stressful and makes me deeply unhappy. Yes, there are people who are worse off than I am, people whose children have no shelter, no doctors, no food. And of course I know this and I am grateful to live in my circumstances and not theirs. But knowing that there are many people worse off doesn’t make my money go any further. Knowing that there are families who are homeless doesn’t make me any happier about having to ask my mum to buy the children new shoes because we can’t afford to.

It can be helpful to remember that there are those less fortunate than ourselves. But there’s a difference between “Hey, it could be worse” and “You have no right to feel that way because of X”. Lecturing and berating someone for how they feel will not make them any less unhappy. It will change how they view you and whether they’re honest with you in the future. It may also change whether they’re honest with anyone else about how they feel or whether they merely bottle up the misery with an added dose of shame and guilt for feeling as they do.

Stigma (n.): from Latin ‘stigma’ meaning to mark or brand

When you hear the words “mentally ill” what’s the first thing that pops into your head? I bet for most of you it wasn’t a friend, neighbour or colleague but someone violent, scary or strange, possibly in a straitjacket or shuffling around like a zombie because of medication. And yet at any given time 1 in 4 people are likely to suffer from some kind of mental illness. So why is there still such a stigma about it? Why the stereotypes and ignorance?

It’s a complex issue but I think that it may be partly due to unease that our ‘sense of self’ can so easily be altered. We humans live inside our heads and have a self-awareness that is unique. We are acutely aware of who we are and our place within a group, and yet mental illness can alter that ‘self’ very easily. This makes people uncomfortable. And when something makes people uncomfortable they often seek to distance themselves from it.

There’s also the problem that mental illness isn’t easily fixed the way a broken leg can be. The human mind is unbelievably complicated and we are still only beginning to understand how it works. A common misconception about mental illness is that the sufferer should just snap out of it, switch it off, that they’re seeking attention. But who would dream of saying such things to someone with diabetes or kidney disease? Physical illness attracts sympathy; mental illness often merely attracts impatience and scorn, as though it is a sign of weakness. Anti-depressants are often demonised as being addictive and handed out far too easily by doctors. But strangely few people would make the same criticisms about painkillers, which are often available over the counter instead of by prescription.

The media is also partly responsible for the ignorance and stereotypes surrounding mental illness. I can think of very few films or programmes where a person with mental illness is portrayed sympathetically. It’s all too common to have the violent murderer, the weird loner or the crazy kidnapper. It’s not just fictional media of course, the news media is just as bad. A common incidence is when a violent or terrible crime has been committed (parents killing children for example) and the journalists will ask “Were they depressed?”, “Was there any history of mental illness?”. Now, of course people with mental illness commit crimes. People without mental illness also commit crimes. But the way that the media glibly imply that only someone who is mentally ill could do such a thing infuriates me. I’ve been mentally ill for most of my life and the most criminal thing I’ve ever done is accidentally run a red light.

Talking to friends and family about mental illness is difficult. Some will be sympathetic and understanding; some will be sympathetic but won’t understand. And of course there are those who withdraw from you as a result. Membership of the matter group isn’t always due to ignorance either, I lost a very close and trusted friend when I had PND after the birth of my daughter. This friend had also had PND previously but couldn’t cope with me struggling for so long and withdrew from me.

It takes a lot of courage to be open about mental illness. I don’t mean online – I’m very open about my problems here. But I tend to hide it as much as I can from people I know in real life. I don’t want them to look at me differently; I don’t want them to see me as a diagnosis first and a person second. I don’t want to lose any more friends. And yet there are those who know and are extremely supportive. My husband, my mother and sister, 3 friends whom I can talk to honestly about absolutely anything and know that they will still be there.

The more open we are about mental illness the less stigma there will be. But in order to be open we must run the gauntlet of that stigma, of being branded as ‘other’. It’s a difficult cycle to break but I am trying – I am starting to be more open about my problems and so far it’s been ok. No-one’s run away screaming yet. ūüėČ

(This post was inspired by the Time To Change campaign).

Hello. Erm. Well this is a little awkward….

It has been gently pointed out to me that instead of spewing stream of consciousness type¬†posts all over the internet (by which I mean Twitter, Facebook and Mumsnet) I could write a blog. So here I am, with a shiny new blog, typing words in and – well, tbh I’m wondering whether anyone other than me will ever read them! But I guess the most important thing is that they’re written, so here goes.

I’m in my early 30s, married with 2 small children. To save time and confusion with names I’ll just refer to my family with the traditional acronyms – my husband as DH, my 3 year old daughter as DD and my 1 year old son as DS. Imaginative aren’t I? ūüėČ

I have suffered from mental health problems in one form or another¬†since childhood. But it’s only recently that I have come to see that instead of blithely limping striding through life with the occasional course of antidepressants and counselling I might actually need some proper help. So I went to the GP with a bullet-pointed list of symptoms, because I’m that sort of a person (and because while I can communicate relatively well through written text I am shockingly bad at discussing important things face-to-face). Anyway, the GP read through my list and her eyebrows climbed higher and higher – I thought at one point they might actually disappear into her hairline –¬†until at last she took a deep breath and gently told me that in her opinion I have a form of bipolar disorder (specifically bipolar 2) and need proper psychiatric assessment.

Of course as soon as I got home I googled and sat scanning lists of symptoms, treatments and prognoses until my eyesight started to blur. And do you know what? For the first time in my life the chaos inside my head actually began to make sense. I found myself ticking off symptoms and nodding in agreement at accounts written by diagnosed sufferers. I began to think that actually there might be some hope for me, some reason that I am the way that I am Рand most importantly that I might not always have to be this way.

So that’s where things are at the moment. I’m still dutifully taking my anti-depressants every morning and waiting for a letter to land on my doormat with a date to see a psychiatrist. Whether they will confirm the GP’s diagnosis or decide that something else is closer to the mark remains to be seen. But hopefully this is the first step to gaining some stability and sanity in my life.

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