choosing not to die

[CN: this entire post is about suicide]

So, as most of you probably know, I have not been very well recently. Okay, that’s an understatement, I have been really rather ill recently and have ended up under crisis team again due to my wanting to kill myself and the whole paranoia thing.I’ve been going to the hospital a lot this week, sitting in silence or occasionally offering up a few mumbled words to the various CPNs I’ve seen as they try to gently encourage me to do something to try and kickstart my brain from its alternating inertia and suspicious arousal. And mostly I sat there just thinking (and occasionally saying) ‘this is totally and utterly fucking pointless.’

The thing is that even though this whole episode kicked off for fairly obvious reasons, that’s not what’s really underlying my desire to die. The problem is that I have, in the words of my psychiatrist, “a relapsing-remitting condition”. When explicitly asked whether I was going to get sick again even if I improve this time, she skillfully dodged the question. The brutal fact is that I almost certainly will get sick like this again. Or go manic again. Or some ungodly combination of the two. Even on meds it’s still likely that I will get sick. This is my third episode this year (admittedly the first 2 were probably caused by me fucking around with my meds (which I hate but that’s another story)). I’m tired. I’m really fucking tired. I know I have it a lot better than some other people, but it feels never-ending at the moment, particularly when you add in an anxiety disorder, and an eating disorder what floats along after me like a shadow ready to devour my life should I let my guard down. I’m never 100% healthy.

A lot of what has been making me want to die is that I just don’t want this to be my life. I was diagnosed 6 years and 6 days ago so you’d think I’d have got used to the idea I have bipolar by now, but I haven’t. I have not adapted my thinking to the fact that in certain specific ways everything I want is almost certainly going to be harder for me than most of my friends who don’t have mental health problems (or other disabilities). The life I dreamt of now seems a million miles and a massive battle away. So yeah, not exactly rosy. But more than that, the fact that even if I never did any of the things I want to do – if I remain childless, if I don’t try and pursue a job that is a bit less awful than the one I currently have – I’m almost certainly going to get sick again anyway. That’s a lot to take in. And honestly, makes me want to not bother at all. The CPN the other day told me I should “try and live for the periods of wellness in between episodes”. “That’s just cruel because then as soon as I have something it’ll be taken away again” I spat back. And I stand by that. Everyone will probably say it’s the depression talking, but I really do think my wanting to die is entirely rational. I have good reasons that are very difficult to argue with (trust me, everyone has, I’m yet to hear a convincing counter-argument.)

So why is this post called “choosing not to die” if I’ve just laid out a case for why I want to die? Well essentially because today I realised that I’m not going to kill myself today. Or probably tomorrow. And I don’t even know why really, I just sort of realised today quite suddenly that I’m just not going to. Not a decision as such, just a realisation. I will probably survive this episode, even though I promised myself last time that I wouldn’t go through another one (I’m a bit shit at keeping promises to myself…)

Now before anyone breaks out the streamers and party hats, this hasn’t exactly been the best realisation I’ve ever had.

If you type “choosing not to die” into google you get a lot of stuff about actually choosing to die. Which isn’t exactly what I wanted to read as I know full well that no doctor would ever support my decision to end my life, because I am mentally ill. That’s just the way it is. What I was looking for was something that would help me deal with the dread and fear of the realisation that I’ve (albeit temporarily) opted to not opt out of a life that – for the above outlined reasons – will involve periods of illness again and again. I didn’t want some trite shit about how wonderful it is to choose not to die. I wanted some recognition of just how heavy a decision it is, how painful. What it’s like to abandon your exit strategy for a life you still don’t really want. But there wasn’t really anything so that’s why I’m writing this even though it feels like I’m really baring my soul in a way I’ve avoided for a long time, if I’ve ever done it like this, and is probably a really shit post and I hate myself for writing it….Whatever, I just wanted to acknowledge that realising your not going to kill yourself this time and all the crushing reality of that are fucking hard things to deal with. People without these experiences really don’t want you to die, but I’m not sure they necessarily get how horrible it is to realise that you’re actually going to have to live with this shit. So here you go, if you’re in the same position, that makes two of us at least, we’re not totally on our own feeling like this.

Of course I hope I never feel like this again, but I probably will and I may well make a different choice next time, but for the time being I’ve somehow got to find a way to live with living…It’s a work in progress.

Bullshit psych papers

somehow remembered that I + friends did these tweets (over 2 years ago now…), which made me smile on a grim day. so I’m resurrecting them and placing them in a blog post so I don’t have to search if I want to see them again. I present: a selection of made-up academic paper titles based on song lyrics around the theme of mental health…

The ‘backfiring’ models of MH argument

Recently I’ve seen some coverage about some research led by Neil Seeman, University of Toronto, published in this month’s Journal of Affective Disorders. The latest I’ve seen covering this is from the Mad in America blog titled ‘Disease Theory of ‘Mental Illness’ Tied To Pessimism About Recovery’ (skip the comments unless you want to read a lot of ‘mental illness isn’t real’ talk.) It outlines some of the findings of the paper by Seeman. I can’t access the paper directly, so I’m going to assume that Mad in America’s coverage is accurate when they report it says: “Respondents from developed countries, despite believing that mental illness was similar to physical illness (and, as a consequence, one would think, treatable and curable) had less hope for a person being able to overcome mental illness than did respondents from developing countries.” From the abstract that I can access, the findings were that:

“While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome.”

This is not the only piece of research that support this idea. In addition, here are others covering findings that biological/disease models of mental health problems (i.e. that there is a genetic cause or that mental health problems are a ‘brain disease’ and similar to physical disease) make people less sympathetic to people with mental health problems. Perhaps more alarming are those from 2014 which showed that doctors were less sympathetic if given a biologically-based explanation of someone’s mental ill-health than a social one. Huffington Post reports:

“Researchers asked therapists and psychiatrists to review mental health patients’ symptoms, which were explained either through genetics and neurobiology or by childhood experiences and stressful life circumstances. Despite common wisdom that biological explanations for mental health issues should reduce the shame patients receive for their condition, clinicians in the study reported feeling less compassionate toward patients whose symptoms were explained by biological factors.”

(Other coverage of this issue here and here and here and here.)

What the thrust of these findings seem to be is that various anti-stigma campaigns that have emphasised the ‘mental health problems are a disease like any other physical disease’/disease model have ‘backfired’ and have in reality made people less sympathetic towards people experiencing mental health problems and more pessimistic about their potential for recovery.

These two examples of posters are probably what they’re talking about, emphasising the ‘brain disease’ approach:

These findings have been seized upon by anti-psychiatry/anti-disease model people who have gleefully declared “see!! Your flawed model actually hurts people!!” (Once again, as if we were simply pieces in some intellectual chess match and not, y’know, actual people with a stake in this…)

What bothers me about the idea of anti-stigma campaigns ‘backfiring’ is the implication that the way we should present information to the general public – particularly those without experience of mental health problems – should be informed by what is most likely to change people’s behaviours and attitudes. This suggests that the main problem with the disease model is that it makes the population without mental health problems less sympathetic to people with mental health problems and more pessimistic about recovery for this group. While I understand that it’s important that anti-stigma campaigns appeal to people without mental health problems in order to modify their attitudes and behaviours, it makes it seem like the issue of how we understand mental health problems is just about good/bad marketing. (Personally I would prefer less pandering to the feelings of people without experiences of having mental health problems, maybe something like “stop being such bigoted twats”, but I can understand why Rethink might not go for that one…)

The key point for me is: suppose it was discovered that every single mental health problem was actually a brain disease and as such was a disease like any other. What would people advocate then? Lying to the general population in the hope they’d be more sympathetic and optimistic? To locate the problem of lack of empathy and/or understanding with the information provided seems to absolve people of responsibility for their own prejudices and negative attitudes – “oh, if only we gave them different information, then they would treat us less badly.” As if trying to get people to treat you less like shit should be some clever trick. Not treating people with mental health problems like shit is just basic common decency and shouldn’t have to be a PR exercise.

Another problem is the idea that a key factor in determining which information is presented to the public via anti-stigma campaigns should be people without mental health problems’ perceptions of the likelihood of recovery for those of us with them. Many of the studies mentioned (and linked to) suggest that the perception of people’s likelihood of recovery is important in terms of measuring stigma, which is a problem as it seems to suggest that one of the main problems with how the public perceive those with mental health problems is that they’re ‘incurable’. This bothers me. Yes, pointing out that some people with mental health problems recover, in addition to being factually true, is important, but this simply isn’t true across the board and public recognition of this would be no bad thing in and of itself. The problem is the attitude towards incurability, not the incurability itself. Also, if the whole aim of your campaign is to show that people recover to the exclusion of all other stories then you’re doing a massive disservice to a whole load of chronically ill people. That’s not okay. It really upsets and angers me that sympathy and understanding for people with mental health problems should be so dependent on the idea that we will ‘get back to normal’. I’m being wildly optimistic here but one day I hope to see a campaign that emphases meeting people where they’re at, rather than insisting on how ‘normal’ we really are or will be shortly – that would be real acceptance…

Basically:

• I’m bothered by the way these findings are being reported as a ‘backfiring’ of anti-stigma campaigns, not because I like anti-stigma campaigns, I loathe most of them, but because the implication seems to be that the most important factor in how we understand mental health problems is how people without mental health problems will react to this information.
• The emphasis on recovery as a basis for a) measuring stigma in the general population and b) an anti-stigma campaign is disturbing and fails a great many people with long-term, chronic conditions.
• Anti-stigma campaigns are often shit, but so is crowing about how they’ve backfired and how we need to do more clever marketing of mental health problems.
• People without mental health problems should stop being such bigoted twats towards those of us with them.

Protected: Male privilege and mental health

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Idea for a #WeCantMarch banner

So, I’ve been thinking about what I personally can do as follow up from the outpouring of people and ideas on the #wecantmarch hashtag.

One thing I’ve been thinking about is how, health permitting (obviously), I will be going to the march in London on the 20th June, and even if I can’t, quite a few of my friends are going.

So what I was thinking of was making a banner that somehow communicated solidarity and the desire to be there from people who, for whatever reason, actually can’t be there on the day. My first idea was for a banner that read something like “on behalf of WE CAN’T MARCH” with the text of the “we can’t march” bit made up of names of people who wanted to be there but can’t (this could be Twitter handles or actual names or pseudonyms or whatever). Obviously this will only really work if I get quite a few names, so I guess I’m asking if I’d have any takers who would want their names on such a banner? As well as asking if anyone can see any problems with this idea or alternative ideas? if you are interested you can either leave a comment at the bottom or contact me at @zzzedkat on Twitter.

Thanks for listening, any feedback is greatly appreciated as obviously this is still at the “oh I had this idea but haven’t worked out the details yet” stage!

Dependence, disability, and trying to be ‘cool’

Being mad is hard. For me, it touches every aspect of my life and relationships and despite my very best efforts to curtail its influence, I repeatedly fail. I try my hardest to just be cool and not let things bother me when they really do, partly because I am convinced that all my reactions are down to the broken bits of my brain. And most of them probably are. But that doesn’t mean they’re not real, that they’re not actual needs. I struggle to see my concerns as legitimate and sometimes this leads to me getting walked all over because I’m so busy trying to be ‘cool’ and not ‘over’-react. This has, if anything, made my mental health worse. Trying to be cool about everything when you’re not really like that is exhausting. Pretending to be something you’re not is exhausting.

So why do I do it? Part of the reason is the misogynistic notion that women are ‘needy’ and ‘demanding’ and ‘ask for too much’ when we ask for our basic needs to be met, which I freely admit I have internalised to a rather alarming degree, despite my feminism. There is a pernicious idea of being a ‘cool girl’ where you are expected to swallow down your views and your feelings and your needs, which basically equates to just being palatable to various men who have appointed themselves judge and jury with regards your worth as a person. This is directly damaging, as how can you ever get your needs met if you’re not even allowed to ask? Even when people are supportive there is always a nagging worry that if you ask for ‘too much’ support you’ll immediately be cast out as ‘over-demanding’.

Another part of the reason is that there is a trend within certain bits of mainstream feminism to stress the independence of women, to proclaim how we don’t need a man – or anyone else for that matter – to look after us. I’ve spent a long time desperately, desperately wanting to be the kind of woman who depends on nobody and can take care of herself. Ironically, this has led directly to me pretending to be someone I’m not, pretending I don’t have the needs that I do have. Dependence is seen as wholly negative, almost as weakness.

This directly relates to neo-liberal ideas about how we must all ‘stand on our own two feet’ (as if that statement itself didn’t betray the disablist sentiment inherent in this position). It’s not too much of a leap to link this to the cuts and welfare ‘reforms’ brought in by the government (which Labour haven’t committed to reversing, by the way) which directly reinforce the idea that dependence is shameful and weak. We’re left in a position where those of us who do need support to live are systematically being stripped of it. And do we hear anything from the big name feminists about this? Of course not. Partly I think this is because they don’t give a flying fuck about disabled women, but I also think this relates to underlying ideas about independence as a virtue.

Instead, I hope for a world and for feminisms where we can recognised the connectedness of people, where we can reframe dependence as a fact of life and see that to an extent we’re all dependent on each other, just to varying degrees. The ideas of mutual support and solidarity are old ones, but still so important, and the way we degrade these ideas does a disservice to all of us. I’m obviously not arguing that everyone should be on call 24/7 to help people out who are struggling – which is particularly important in mental health circles – but if these ideas were more ingrained we could have a real support network of people without the accompanying shame of having to ask for help.

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This post was in part inspired by this brilliant blog: http://clementinemorrigan.com/2015/02/12/can-crazy-people-be-poly-on-polyamory-and-madness/ and the wonderful @cattenleaf