It’s All In Your Mind

The complications of mental health are too often obscured by unrealistic views coming from prejudice and stereotype. These hold back progress but still progress is being made.

Mental health is a complicated issue. That’s my submission for the 2015 ‘Statement of the Fucking Obvious’ award. It’s recognised as a complicated issue, but also regarded as something of a messy one. A lot of people are wary of the complexities of metal illness and how they can approach it. Sometimes they are wary for good reasons as they don’t know how to handle it and fear screwing up their response, and sometimes for less positive reasons, as they push someone away out of fear of the unknown.

It’s common for someone to say they are anxious or depressed. They have become flippant terms to be thrown about in casual conversations. People who find themselves temporarily down might say that they are depressed. Those who are nervous about an exam or about asking someone out might claim to have anxiety. Truthfully, an anxiety disorder is not that feeling of a clear concern regarding a single matter. It is natural to be nervous about an exam or about asking someone out. These are things that may appear to have high stakes attached to them. To have an anxiety disorder is to have that feeling detached from a clear event. Social anxiety, for example, may be triggered by crowds or confronting social situations, but exists separate to an individual trigger. It may come from a brief comment that seems dismissive or negative and grow into something significant from these insubstantial roots.

Depression is a similar issue to anxiety. It is normal to go up and down in emotion. As events exert different influences upon you, your feelings change. A person will feel and respond negatively to the loss of a loved one. This is not a depressive disorder in itself—though it could provide the trigger to one—it is the normal reaction of an emotionally mature person to a terrible event.

When you go beyond the realm of these shallow labels, you come to the place of mental illness. It’s a scary title that no one wants to have attached to them. Despite this fear of diagnosed depression, people still throw these terms around without much thought. ‘I have anxiety’ may be the hardest words ever spoken by an individual (particularly if their anxiety stems from social situations) and could be met with a flippant ‘we all get nervous sometimes!’ Overuse and misuse of these terms helps no one in downplaying or overplaying genuine problems.

Pie chart
According to the ‘Bettering the Evaluation and Care of Health’ survey, 12.3% of gp encounters were mental health related in 2012-2013.

To this day, the image of a psychiatric hospital looms large as some horrifying spectre on the periphery of civilisation. The image isn’t helped by so many negative examples scattered throughout pop culture. From One Flew Over the Cuckoo’s Nest to American Horror Story: Asylum, psychiatric hospitals are presented as cold and inhuman institutes with little care for their wards. The patients are presented as hopeless cases and broken wrecks. As a greater number of television shows seek to portray mental illness in a more sophisticated and accurate way, this image is gradually fading. Shows such as Hannibal with its portrayal of criminal profiler Will Graham, Breaking Bad and its protagonists Walt and Jesse, and even Doctor Who have sought to exhibit more sophisticated characters living with mental illnesses and working through them. It is no longer merely a case of the extreme.

The truth is that mental illnesses are prevalent in society and though progress is being made in improving the way people view them and what aid is offered, it’s still not enough for many. Currently, it is near impossible to get proper treatment in the public health system, providing up to ten individual sessions with an allied mental healthcare professional per year. According to Beyond Blue, 1 million Australian adults have depression and 2 million have anxiety.  The reasons each person has for their illnesses will be as wide a collection as any health problem. The true nature of these illnesses lies in the vast area between the glib descriptions of someone self-diagnosing anxiety due to nervousness over a major event and the images of institutionalised and helpless people. Regardless of the misconceptions that surround the issue, it is possible to live a productive life while carrying these illnesses.

You may read this knowing you have such an illness and may find it difficult to tell others. Many do. It’s a hard subject to broach with someone and peoples’ responses can vary greatly. I was diagnosed with depression and anxiety and it took me years to tell most people. Already finding the simplest of social situations confronting, expressing such personal information was terrifying. It’s still difficult. The responses I have received to this admission have been incredibly varied; some engage with it, some fear and avoid it, and some take it scarily seriously. It would be easy to say that those who distance themselves are not worth having as friends, and while that may well be true, it is much more complicated than that. Each person’s reasoning for distancing themselves from a mentally ill friend is likely to be different. Some may have mental health problems of their own or in those they love, some may not know how to deal with it, and some may just be prejudiced due to fear of the unknown. On the positive side, a lot of good can come from the small act of acknowledging mental illness. There is hope. While I can only speak for myself, I have found that being more open about my depression and anxiety has made dealing with these conditions easier.

Winston Churchill is known for characterising his depression as the ‘Black Dog’ (and also being the British wartime Prime Minister). The stoic image of Churchill set against the Nazi menace is arguably a better one than some, but it is still framed in the traditional image of ‘stiff-upper-lip’ British aristocracy; not exactly the most open minded and liberal approach to the complexities of mental health. Churchill coped with mental illness almost by ignoring it as a part of himself, distancing himself from his depression and characterising it as an external enemy. Evidently, the truth is more difficult and complicated.

An incredibly well known stereotype is of the ‘suffering artist’; an individual afflicted with the demons of mental illness directly connected to their artistic brilliance. Figures such as Vincent van Gogh, Hunter S Thompson and Sylvia Plath are regarded in this way too often. They are presented in a romantic mystique and the complexities of their personality are forgotten as they disappear behind the stereotype.

According to Mental Health Council of Australia, at least one third of people have had a mental illness episode by the time they are 25 years old.
According to Mental Health Council of Australia, at least one third of people have had a mental illness episode by the time they are 25 years old.

Fundamentally, it is important for mental illness to be seen in a similar regard to physical ailments as it can be just as utterly debilitating to those who suffer it. There may be some people whose experiences are similar to those of Plath, Churchill, Van Gogh or Thompson, but it is important to remember that the experiences of one person are not the same as those of another. We are as varied a group as any. There are those who cannot face social situations with the same ease as others, some who are constantly gripped by a feeling of loneliness or failure, and there are others who find themselves compelled to check and reorder things. It is important to remember that every case, and far more importantly, every person, must be treated uniquely. Mental illness does not discriminate. It can come to anyone and the reasons may not always be as obvious as those surrounding a ‘trigger’ (e.g. the loss of a loved one). Mental illnesses such as depression and anxiety can be hereditary, as I found them to be in my case. It can be a simple matter of a chemical imbalance and nothing more mysterious.

Mental illness may appear more fascinating because the symptoms are less obviously attributable. They could be explained away as laziness, forgetfulness or insecurity.  No one wonders why the person with the broken leg can’t run—the cause and effect is evident. A broken leg won’t be mended or adequately remedied by positive thought and ‘powering through’ and nobody expects it to. Mental illnesses should be treated with similar expectations. Recently, Lance Franklin, a famous Australian rules footballer pulled out of the finals due to suffering from mental illness. The fact that Franklin has allowed it go public that he suffers from mental illness indicates it is more accepted and some progress has been made. That said, he has kept a lot quiet which implies that not all is accepted. The media and the sport executives avoid commenting on the subject, speaking volumes of the public’s negative perception of mental illness.

We may not be moving as fast as we ought to in bringing about acceptance of mental illness, but there has been some movement. There are many useful resources such as Lifeline and BeyondBlue to reach out to when you or a loved one are in need. Every person has unique experiences in mental health and takes a different road through their illness. While it may never be a straight one, it is there.

Words by Liam McNally

If you are in need of help, please contact:
BeyondBlue: 1300 22 4636
Lifeline: 13 11 14
Headspace: 1800 650 890