Fear can make you thin. Fear can make you thin as you tremble and shake at the idea of anything passing your lips. Fear can make you thin as your heart quakes with the first sign of you body needing to eat, needing to be fed, needing anything more than air to keep going. Fear can you make you thin as you snatch up the compliments, gobbling them up, terrified they will stop if you give up, give in, and eat something. Fear can make you thin as you slowly waste away, too afraid to be full, too afraid to be satisfied, quietly lying yourself down with your ever-present bedfellow – hunger. Afraid to start. Afraid to stop. Fear can make you thin.
Fear can make you fat. Fear can make you fat as you gorge and burst and bloat. Fear can make you fat as stuff and pile food into your mouth and body, no longer eating, simply consuming. Fear can make you fat as you open the fridge late at night, afraid to stop, afraid to start, afraid of what will happen if you don’t keep feeling the crunch, the soft, the smooth, the salt, the sweet on your tongue. Fear can make you fat.
Depression can kill you. Not necessarily because you get so sad that you can’t get up, too melancholy that you want to pack it all in one day. Depression can kill you by keeping you awake for years on end, never letting you sleep. Depression can kill you by stealing your energy, dragging your body down and slowing your movement. Depression can kill you by giving your endless headaches, brutal stomach pains, heart problems, Depression can kill you by making you so sick that you finally think it’s going to be a mercy to die. Because at least then you are not in this much pain, this much literal, physical pain. Depression can kill you by breaking your body down.
Anxiety is a very physical illness. This is something that gets a little bit overlooked in our assessment of mental illness. We spend a lot of time trying to explain that whilst a mental illness isn’t an illness you can necessarily see in the same way as other illnesses – the whole ‘if you had a broken leg you wouldn’t tell someone to just get up and walk’ comparison – that sometimes we go too far, and pass over the fact that for a lot of people, the reality of living with a mental illness is a very physical one. Yes, it is an illness that lives inside your head, but that doesn’t mean it’s all in your head.
It might be in your stomach, giving you severe gastric problems from constant stress and anxiety. Yes, the anxiety and stress are in your brain, but the inability to leave the house due to constant trips to the toilet is very much a reality.
It might be in your chest, giving you an increased heart-rate and breathing problems when a panicky situation occurs. Yes, the panic attack is happening in your brain but the dizziness that blurs your vision and threatens to make you pass out at work is a reality.
It might be in your immune system, as nights of broken sleep and worry chip away at your health. Yes, the worry is in your head but the constant colds and bouts of flu that keep you away from your friends and stuck in your bed are a reality.
I know from my own experience that mental illnesses are physical illnesses, not just because we want to get people to think appropriately about mental health, not just because mental illnesses can come from a physical discordance in your brain chemistry but because when you wake up every day with a mental illness you wake up sick. You wake up physically ill, and it sucks.
When I wake up with depression I wake up exhausted, lethargic, and the whole day feels like a fight against a deep cloudiness inside my head. I essentially wake up with the worst flu of my life, and I know other people with depression who wake up the same way.
When I wake up with anxiety, I wake up with a headache, heart palpitations, and sometimes a seriously upset stomach. I essentially wake up with a terrible hangover, and I know other people with anxiety who wake up the same way.
When I wake up with an eating disorder. I wake up hungry. I wake up to cramps. I wake up to stomach disorders and extreme fatigue.
And of course, there is medication, but sometimes medication isn’t enough.I take medication for all of these things – I take anti-depressants that control my anxious impulses and my depressive thoughts, but sometimes they make me more tired, more fatigued. This is something to again bear in mind because like all physical illnesses, treating a mental illness is a process.
It took nearly ten years for my mother’s doctors to find medication for her arthritis that didn’t give her terrible side affects, and the same is true of medication for mental illness. It can take years or incorrect diagnoses, I had a friend whose anti-depressants gave him flop sweats that soaked through bedclothes, and then another that gave him a hideous rash. It takes time, and sometimes multiple other physical problems before it gets right.
It’s also true that in mental illness just as physical illness, sometimes meds aren’t enough. It’s taken my mum years to come to terms with her arthritis, just as it’s taking me time too. It’s taken us both down different paths; counselling, religion, medication, and there are so many divergent ways that people manage whatever illness they have. The point is though, she will sit down and say ‘My arthritis is playing up.’ If I need to lie down in the afternoon because I feel like crap I often say ‘I’ve just got a stomach upset,’
or ‘I’ve just got a headache.’
Why do I do that?
Is it just because I have a hang up? I have a fear or identifying myself in another way? Of letting people know the truth?
Perhaps partly, and I know there are plenty of people with non-mental illnesses who would also hate to identify their own cancer, or arthritis, or heart condition in front of a group. But mostly it’s because as a society we don’t think mental illnesses mean a physical disorder. If I said that I was taking a sick day due to anxiety, my boss might have some questions where she wouldn’t have if I had tonsillitis. As a society we associate mental illness with words like sadness, morose, melancholy, or worse: Crazy. Unstable. Dangerous. What we don’t do is associate them with words like acute pain. Extreme fatigue. Chronic insomnia. Intense migraines. So we often see a lie, rather than the truth.
The truth is I have depression and anxiety and an eating disorder. The truth is that they are physical illnesses, affecting my body physically, and today I need to treat them physically.
Depression isn’t just sadness. Anxiety isn’t just worry. It isn’t all in your head.
I encourage you that if you are struggling with your own problems to not be ashamed of the fact that you are physically afflicted by a mental illness, and not to belittle it. What you experience is real, it is what is happening as part of your illness, and it should be understood by more people and you should not have to be embarrassed by that. Discuss what you are experiencing with a medical professional, see if they have some help to give. And if you need someone to ask questions to or talk to, please message me or get in touch.
I also encourage you if you have friends or family who you know are struggling, to try and be aware of the physical reality they might be facing. You might know about their mental illness and be in good habits of checking in on them about it, but are they managing a physical reality that you don’t know about? Do they seem tired all the time? Do they seem to struggle to eat sometimes? Maybe they are exhausted, maybe they are having digestive problems, maybe they are experiencing these painful things in silence, with no one to talk to about them. Maybe they just need to be told it’s okay to miss that dinner party, or it’s all right to stay at home on new years eve and take it easy. Maybe they just need to hear from you that you understand the physical strain they are experiencing. That you don’t think it’s all in their head.
Because what is more comforting, affirming, and kind than hear that that from someone you trust or respect?
It’s not all in your head.