Write a thousands words every day I read this morning. Write a thousand words and then you’re free to do anything else today. A mantra, a way of working given to me by a Pulitzer prize winning journalist, he can’t be wrong can he? So here we go… A thousand words!
Do you need to have suffered from depression to help cure depression?
Do you need to have suffered from depression to help cure depression? Can we openly talk about depression when Royals, football greats and film stars are telling us to? Two very different questions but closely tied, at least in my head.
Whenever I start with a new counsellor or therapist I like to ask them the question, “have you yourself ever suffered from depression?” Invariably the answer is no. The one ‘therapist’ that answered yes took it as a invite to spend the next five sessions unloading her life on me rather than the other way round, She disappeared on the sixth session having left Cornwall to move back to London to seek help and respite from her own black dog. I genuinely hope she got the help she needed. Without doubt she certainly needed as much help as I did.
But why would I even question my therapists? Surely they are trained, qualified and experienced in the alleviating of depression and it’s related conditions? You don’t have to have had cancer to cure cancer. You don’t have to have had Ebola to help cure Ebola. Why should depression be any different? It is though, massively. One word differentiates cancer and depression. Empathy.
Empathy isn’t the same as a good bedside manner and doesn’t translate well. An oncologist works primarily with proven statistics, science and an almost mathematical formula. Cancer requires an objective diagnosis. Where it is, what cells are being attacked, in what way. Once diagnosed maybe a second diagnosis is sought and by this time the cells and bloods have passed through many different departments all specialised in their one field, be it cells, blood, colons, brains, lungs. Eventually the oncologist adds up all the diagnosis’s from each specialist department and comes up with an answer. A brain tumour, lung cancer, pancreatic cancer, colonic cancer, you get the gist no?
Proven tests, on scientifically known parts of the anatomy that have been dissected and put back together millions of times and tested upon with various operations, drugs, chemicals, poisons and dangerous radioactive substances in a 98% (Testicular Cancer) to 1% (Pancreatic Cancer) chance of surviving a particular cancer for ten years1. It’s science. Like an apple falling from a tree proving that gravity works, science often works with proven facts to come up with proven statistical likelihoods that a given disease is actually that disease and that that disease can be cured or possibly cured by this set or other of cures. Of course, not all cancers or diseases are curable and some such as AIDS, the common Cold and Ebola only have certain success rates or means to lessen the effects and prolong a useful longevity until the inevitable happens, the disease weakens the body too much and death occurs.
It’s all objective: If A + B are present with the exception of C then the result is D. Much the same, as far as we understand it gravity is ‘proven’ thus:
So if cancer is objective in that you don’t need to have experienced it to cure or diagnose it and there is a formula to diagnosing it and curing it. What really matters relative to the question of experiencing it to work with it is that as humans we are ‘normally’ empathetic and good doctors generally have a good bedside manner when dealing with what could become a fatal illness. As long as you have empathy you don’t need to have experienced it to help cure it.
But depression and mental health are almost subjective. There are many formulas of diagnosis, often at odds with one another depending on what branch of diagnosis you favour. Be it Freudian, Jung, Rorschach, Klein, Adler, Chodorow, Reich and on and on. There is no formula, there is no definitive diagnosis or method of diagnosis there is only the American DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) or it’s UK counterpart ICD-10 (International Statistical Classification of Diseases and Related Health Problems, Tenth Edition) and then the particular field of psychoanalysis a particular doctor studied. The result (in my opinion) is an unholy fucked up mess. With this many fields of psychoanalysis and boxes to be checked be it in either the DSM-5 or the IDC-10 how can anything be considered objective especially when many of the great psychoanalysts that are studied contradict one another?
To diagnose a mental health problem one first sees ones Doctor who then refers you to a ‘specialist’ mental health team who generally give you an hour of diagnosis with a Doctor who may have studied any number of psychoanalytical techniques who is trying to tick particular boxes in the DSM-5 or ICD-10. (Both of which are basically a list of check boxes where a certain score of a certain number of mental health disorders equal a particular diagnosis).
In the many one hour sessions I’ve had I’ve been diagnosed as a psychopath (most recently), narcissistic (within the past three years), suffering from PTSD, clinically (or chronically) depressed, suffering from Asperger, existing somewhere else on the Autistic scale (but high functioning), suffering trauma from past abuses, suicidal ideation, self harming, anxiety, Tramadol dependancy, antisocial personality disorder, difficulty relating to others feelings or needs… It goes on. When so many ‘professionals’ give so many different diagnosis’s is the term subjective not more accurate than objective?
With physical illnesses like cancer empathy or good bedside manner come almost automatically whether from the attending Doctor or visiting friend or relative. With mental health illnesses the opposite is nearly always true with people comparing themselves to you, feeling uncomfortable talking about or to you, or by comparing a bout of sadness they once had with your depression and thereby belittling it. Unless you’ve ‘had’ a depressive illness or are on the Autistic spectrum you don’t have a yardstick by which to measure the severity of impact on the sufferer and most people resort to platitudes to ‘help’ you cope.
“Just choose to be happy” is one of the most common I hear and see around me. A particular shoe brand has just run an advertising campaign using it “Just choose?” If any of you reading this have been or are sufferers of mental health problems would you say ‘choice’ is an issue? Would we ‘choose’ to want to die? Would we ‘choose’ to avoid doing the things we love and seeing the people that might make us feel slightly more positive? Would we ‘choose’ to avoid all forms of positive thought and would we ’choose’ to have a complete lack of hope and motivation? What we have is an invisible illness that people don’t understand and don’t want to talk about. A platitude suffices as a cure-all and be done with comment.
Would you say to a lower limb amputee ‘just walk it off’? Would you say to someone (as I once did) to a sufferer of Anorexia “Just get up tomorrow and have a bacon sandwich”? Of course not. Why then is it okay to tell a sufferer of chronic depression to “choose to be happy tomorrow”? “Go for a walk and Enjoy the beauty of nature”, “take the dog out more”, “man-up” (as one Doctor said to me. I was subsequently banned from his surgery for dragging him across hiss desk and threatening to staple his head to it). “Man-up”! I’ve heard some seriously awful platitudes during my bouts of depression but that honestly rates as the worst.
The people that understand mental health issues best are the people that have suffered from them. The people that understand physical illnesses (not the mental state they might cause) are scientists. Scientists are people with proven cures for physical illnesses. Psychologists are people trained in a very open playing field in a branch of many twigs dealing with the emotional and physical impact that an impaired mind for whatever reason isn’t working properly. I defy any of you reading this that haven’t suffered from some kind of mental illness to describe depression accurately.
Us sufferers of mental health problems might be just as disabled as a man with only one leg or lung. But. Are we included in the disabled Olympics? Is there an Olympics for mental health sufferers? For fucks sake, with our lack of motivation would we even turn up anyway? Can you imagine how long a mental health marathon might take? What, with a lack of motivation, breaks for crying our eyes out, a lack of training through lack of motivation, it’d be a marathon where every finisher should be considered a gold medal winner. Swimming races where competitors didn’t try and drown themselves would be amazing. All survivors to be gold medal winners. Discus. shot-putt and javelin where non competitors weren’t standing within reach of flying projectiles would be considered successful. Just imagine… White water kayaking where the competitors didn’t deliberately capsize and drown. I could go on as I’m amusing myself but you get the idea. WHY aren’t mental health sufferers included in the disabled Olympics?
Why is it that only amputees get to climb Everest for charity? Can you imagine the effect that completing a task like that might have on someone with mental health problems? The challenge and motivation needed would almost prove that anything is possible. Even to see the Earth from it’s highest point would have a life changing impact on most people. Like all astronauts say that seeing the earth from space changed them forever. All of them positively. Why do only the physically disabled get these chances and are reported on by the media? What is it about mental health disabilities that make people SO uncomfortable that we’re not even considered disabled enough to run in the disabled Olympics or climb to the highest point on the Earth for charity?
I know of a current cancer sufferer with pneumonia and septicemia who will probably lose at least two toes. That’s if the pneumonia doesn’t kill him first. I don’t need either cancer, pneumonia, septicemia or the amputation of two toes to empathise with his situation. I’ve known him for most of my life, he’s a close friend of my dad’s, I’ve worked with him. I feel genuine sorrow for his situation and for seeing a man with such a joy for life to be cut down so cruelly. I feel genuine compassion for his family. If he dies I want to be at his funeral to pay my respects. When he dies, people will celebrate his life. People go and sit by his bedside and hold his hand.
No-one, NO-ONE, tells him whilst he’s lying in his hospital bed to man-up! If by a miracle he survives the cancer, goes into remission and walks normally with the loss of two toes he could be one of the poster-boys for one of the cancer charities who might get him running marathons and climbing mountains. Everyone will applaud his efforts.
A whole team of specialists and millions of pounds of NHS funds are being given over to saving this one mans life. And rightly so. He’s got a family that love him, daughters that will miss the fuck out of him if he dies, friends like my Dad who will have lost both a good friend and bird-watching partner, people that like just chatting to him down the pub. People that have worked for him that respect and like him. He’s paid his taxes, why doesn’t he deserve the chance to be saved and to live? Of course he does.
And people look at me strangely when I say that I’d rather lose a leg than suffer from mental health issues?
Apart from my Dad who has gone way over and above his parental responsibility and I doubt I’d even be here writing this without him. You know who supports me at the moment? My support worker from the housing association that comes around to make sure I’m still alive and that I pay my fines and bills once every three weeks or so. My lack of responsibility and motivation make bills and licenses obsolete obligations to me. I desperately HATE obligation! The TV license can go fuck itself. Hard!
The Waterview Centre won’t have me as part of their group therapy sessions due to my psychopathy not being compatible with group therapy. Interesting to note that in their last review (of three) they picked up on one aspect, one part of my coping mechanism that only lasted a year and had nothing to do with people disagreeing with me or arguing with me in a group related environment. The one aspect that could even remotely be called psychopathic.
Subjectivity at it’s best.
Oddly for a psychopath I have a massive amount of empathy. (So I’m often told.) And I’m very spiritually aware. (So I’m often told.) Perhaps I’m a unique psychopath that actually suffers from PTSD from some of the suffering I’ve caused over the years and the people I’ve failed to stop from dying. While part of me might be sociopathically active (my own diagnosis) as a coping method much the same as self-harm or shoplifting, I’m pretty sure I feel too much guilt about too many certain things to be a psychopath.
The local mental health team diagnose me with something new every time I’m re-referred to them and so I never get to jump through the same hoops more than once.
Why is mental health not funded like cancer research is? Why am I not in a bed to stop me from killing myself, safe, being looked after by a team of mental health specialists trying to make me a useful part of society again instead of someone waiting for a particular incident to make me decide whether I live or die by my own hand? Where are my friends willing me on, wanting me to survive? Sitting by my bed each day… I’m not even comparing myself to my Dad’s friend. His worth is far more than mine but both his cancer and my depression could prove fatal. Where’s the empathy from my own Doctors? In fact, where even are my Doctors? I don’t even know if my Doctor knows what empathy is or perhaps she just doesn’t like me. I get that a lot.
Why does my housing association care more about me than the medical profession and why has my support worker got more warmth than any Doctor I’ve seen since my return from Cornwall?
Do you need to have suffered from mental health issues to help people recover from mental health illnesses? The profession of psychology and psychiatry would obviously prove against it but what do you think now having read this?
And. I still haven’t answered whether we can openly talk about depression have I? Or have I?
Do you fancy commenting below? Do you fancy actually calling up a friend that you know suffers from mental health problems and talking shit over? Don’t just text them. Call them and chat for an hour or so. Turn up at their door as a surprise.