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Perspectives from the Mentalist’s Partner 1: Understanding that Mental Illness is Real

Posted Jun 17 2010 11:00am

I deal with a set of symptoms representing the diagnoses of BPD, C-PTSD, clinical depression and social anxiety on a daily basis. I fall victim to the nefarious antagonists of psychotic and dissociative episodes with more frequency than I would care for (although I must hat-tip the efficacy of Seroquel in decreasing the former, having said that). I’m occasionally and essentially without warning flung into states of exuberance that are largely uncharacteristic and rather OTT, leading to a question mark of manic depression. I’m also fairly sure I could be diagnosed with agoraphobia these days.

Me me me. I have this, I experience that. Me. I. Yours truly. Myself.

But it’s not just about me…is it?

For some time I’ve been thinking about ‘interviewing’ A on his experiences of living with a woman with mental illness. It’s of interest to me both intellectually and as a girlfriend, and I hope that it might be of interest to you, my dear readers, too – particularly if you are in, or are hoping to be in, a relationship. So I give you the first in a series I am going to call Perspectives from the Mentalist’s Partner (PMP): how through his relationship with me, A has developed a greater understanding of what mental ill health really is.

Q:

Let’s start at the very beginning. You knew I had a mental illness before we even met [I was diagnosed with severe clinical depression at the age of 14, and corresponded with A for nearly a year before we met when I was 19], but that didn’t completely manifest at first. When it did, you will recall that you viewed that mentalism fairly unsympathetically, though your mind has clearly been changed, as over the course of this present breakdown, you have been extremely supportive.

So I suppose I’m wondering – do you remember when you first saw evidence of my mental health problems, and how did/do you feel about that incident or period? Can you explain your reasoning for your evident lack of sympathy at the time – and what was it that modified your opinion into what it is today?

A:

It took me a very long time to realise what mental illness actually is. Sure, I was peripherally aware of depression as an issue, and you made it clear that you had suffered from it*. However, I probably wouldn’t have perceived it as a ‘mental illness’. I associated the term ‘mental illness’ with, well, very extreme conditions involving padded cells and the like. A very stereotypical view, for which I apologise to readers of this blog; however, I simply didn’t think much about it as it had not really affected me or others I knew. Granted, I’d experienced what I considered ‘depression’ at the age of 15-16, and I therefore assumed that what you suffered was some variant of that. Not at all a pleasant phenomenon, but something that would nevertheless gradually recede, with time. (In my teenage years, I think my own experience of ‘depression’ was one of those ‘growing up’ type problems, though I never have been and never will be a cheerful or optimistic type). Anyway, I am digressing.

When we first met, you seemed far from depressed. In a recent post [ this ], you talked of the dichotomy between Pandora and the ‘other’ you, the everyday person whose name I shall not utter here. The person I met was essentially Pandora; sociable; intellectually agile; opinionated (in a good way); lively; challenging; interesting – a person with aspirations and apparent self-confidence. Of course, we all package ourselves in similar ways, or try to, in order to impress those we wish to impress, especially in the first flower of a relationship. Sure, there may have been a bit of that, but it was certainly more than that, and indeed that part of you continues to exist now. When others meet that part of you in person, they are extremely taken aback to learn that you suffer from ‘depression’ (to use the generic term that most of us who are not informed might use).

As we got to know one another better, and the first flush of spring faded (it always does, as I know you agree), I started to see your occasional black moods. However, as I’ve said, I have not been a stranger to such in the past. ‘Depression’ was something that I felt, with time, one could ‘get over’. That will undoubtedly seem insulting to some, but it was how I felt.

I was also very much opposed to attempts to control depression through medication, believing that the solution lay in rethinking one’s approach to life (somewhat DBT-ish, you might say). I’ve never taken many pills myself, although I’ve been fortunate in my health for the most part. You’ll recall that I was no fan of you taking medication, and eventually made the drastic error of persuading you to come off Prozac**. Bad mistake. I suppose it was at that stage, several years into our relationship, as you really began to spiral downward, that it began to dawn on me that this was not something that would go away easily, without some form of concrete assistance.

My realisation grew as time passed and a pattern started to emerge. You were unable to hold down a job. You’d start one, seem to enjoy it at first, but gradually find it more and more difficult to cope, lying awake at night worrying about what might go wrong the next day or week. Of course, you were not helped in that by some of the horrendous managers you have had the misfortune to work for; still, even somebody as insensitive as I began to notice A Problem. Nonetheless, on my more cynical days I wondered whether it was just that you needed to find ‘the right’ job, and that you needed to foster a greater sense of ambition and commitment to achieving this. I have always been somewhat driven in the work sphere, if not elsewhere in life, and I suppose I expect the same in others. So, yes, at times I still thought less about illness and more about ‘what I would do’. Obviously, I couldn’t possibly know what I would do, given that I don’t suffer from mental illness. However, I didn’t always think like that at the time.

Really, then, although my realisation was dawning, I believe that it’s only in the past two years that I have really started to grasp what mental illness is, and the extent to which you are afflicted by it. Gone now is my illusion that you simply had ‘depression’ that you would ‘get over’, or that you could will yourself to cultivate a greater personal drive.

Just as an aside, thinking about my prior attitudes, I have come to believe that ‘depression’ is a horribly overused term, as in popular usage at least it can signify anything from a bad few weeks to serious clinical illness. I am not saying that those who actually understand mental health issues talk of depression in this way, but the word has become seriously devalued by its more general societal usage, whereby it can connote practically any bad feeling a person may have for a sustained period***.

Anyway, I suppose my first lesson in the seriousness of your illness, which came long before the realisations mentioned above, came from your occasional black moods. I remember in particular one Sunday evening where you did not really wish to speak or interact. You exuded a aura of bleakness, and no matter what I tried to do or say, there appeared to be nothing I could do about it. It left me wondering things like, “What have I done? Is this my fault? How can I fix this? Why is Pan behaving like this?” I didn’t know how to handle it. Your illness seems to have changed, and your black moods are subtly different now. I’m not sure I have figured out how to deal with them, from my own point of view, but I certainly know more about what to do and what not to do than I once did.

I might add that much of the understanding I have gained of your illness has come from you. As you have educated yourself about the issues, you have educated me. In that respect, Confessions of a Serial Insomniac has been a tremendous help. You write cogent, coherent, insightful and moving accounts here that you are often unable, due to the difficulty of talking about these issues, to express to me or anyone in person. I started writing ‘real life’ there for ‘in person’, falling into the dangerous delusion that the written form is somehow less real. Far from it. In fact, it allows one to be more revealing in some ways. I suspect that the closest you come to being able to communicate as you do on here, in verbal form, is when you meet C.

Anyway, next question please…

* Through our 10 months’ email correspondence prior to meeting face to face, I had shared a lot with A, including the fact that I had depression and that I took Fluoxetine (Prozac) to treat it it.
** This was during my postgraduate course – I would have been 21 or 22. I was taking, I think, 60mg daily, and initially cut it down, before I stopped taking it altogether. It was partly because I’d been feeling fairly good and fell into the trap of thinking I was ‘better’, and it was partly due to A’s encouragement. It – in part, at least – led to my second biggest psychological collapse (after the present one) to date.
*** One thing that A hasn’t mentioned here is that he has in the past said that he felt that my receiving a proper, psychiatric diagnosis was of great benefit. As I recall (and I welcome his correction(s) if I am misreporting him), he felt that saying, “I have borderline personality disorder” as opposed to “I’m depressed,” allowed one brought up with the views he had formerly held to note the presence of a real, tangible medical condition, rather than expressing their ‘having a few bad days’ erroneously. I would point out that I feel, have always felt, and that A now feels, that depression is a ‘real, tangible medical condition’. However, we are dealing with stigmatic stereotypical societal views here (how alliterative), and I would agree that most people probably do misuse and, indeed, misunderstand the term.

Next interview with A to follow soon…

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