“My name is Emma, and I’m here to talk to you because it’s mental health awareness week.”
I take in the sea of young faces before me. I feel the heavy drum of my heart against my chest wall, observe the questions in some of their eyes, the laughter in others.
“I’m here to talk to you because I have a mental health disorder.” I take a breath. “I have an eating disorder and OCD that manifests itself in anxiety. This is a very important week for me.”
This is not the first time I have stood up in front of students and said some version of these words. It will not be the last either, but every time I do it, I feel the same things. The slight edge of my panic growing. The annoying tremble of my voice. And the shame. The corners of an old shame that I catch my heart on. That shame makes me hang back, pause for a moment, and think: do I really need to do this?
Then I watch the students come in. I watch their faces as they watch our video and see the stories of people who are just like them with a mental health diagnosis. I scan the room for that look, that familiar look that one mental health sufferer can always spot in another: the tensing of the shoulders and the biting of the lip. These are the tell-tale signs of a hidden shame.
Yes, I think to myself. Yes, I do need to do this.
This week I am doing a mental health project in a school for mental health week. My story is an important one for young children to hear – it tells them that they are not strange or weird and that they have company in whatever shameful place they might feel they are in. However, mental health awareness week isn’t just for young people, even though that area of awareness is my passion. My own life is evidence to the fact that mental health problems that exhibit in young life often will carry into adulthood, and so this week I am writing here about adulthood and mental health. I am challenging myself to write every day at the moment – some of that might be here, some of it might not, so forgive me if there is not a post for every day of mental health week. I promise you at least one at the beginning and one at the end. But like all things, I am taking each day at a time.
So what do I have to say about mental health today? Well, I have this to show you.
This may not look like much. Just another form or questionnaire. But this is my most recent GAD 7 scoring and PHQ 9 scoring. These are a Generalised Anxiety disorder assessment and a Patient Health Questionnaire which is used to measure the severity of depression. They show that I have moderately severe anxiety and moderately severe depression. They also show improvement. When I first did these assessments in December/January, my scores were much higher. Both closer to twenty. Now, I have moved down a whole category of severity, and on my PHQ 9, I am close to moving down two.
This is a triumph of a few things: a triumph of medicine, a triumph of a targeted therapy specific to my temperament and illness, but also a triumph of awareness. Since coming to a significant low point in December that prompted me back into therapy and into the psychiatrist’s office, I have become steadily more aware of my own mental health. This probably sounds insane, after all, I have a blog about mental health and I deliver mental health projects regularly in public forums. So how could I possibly be more aware?
Well, the answer comes from diagnosis and education. My journey over the last six months has shown me just how important and accurate and educated diagnosis is. For the last six years, I have had a certain idea of what my brain was doing to me. I had been told that I had depression with anxiety. I was given to understand that my brain had an enemy living inside it that needed to be fought back with medication, good habits, and a positive mindset. This, unfortunately, is like telling a cancer patient that they should probably have some radiology and chemotherapy and hope for the best. I hadn’t understood until now how similar a psychiatrist is to an oncologist. It agonises me to say that this is one area where mental health patients are being failed by the public system. It is difficult to get on a waiting list for a psychiatrist, and it is a dangerously long wait time. Even if one gets an initial appointment, it is hard to get a booking to see someone as regularly as you need. This is not the fault of anyone actually providing the services – they just are incredibly over-stretched. This is one of the great tragedies of our age and our health system. I am fortunate to be able to pursue alternative options.
And what have the other options given me?
Understanding myself as a person with OCD and understanding that OCD emerges often from a pre-existing temperament has been both painful and freeing to me. Painful, because when I asked my therapist honestly if I would ever be “different”, he explained to me that I have a temperament that leans towards over-control. It is part of who I am. This caused a lot of crying. A lot of ugly crying. Yet, it is also freeing. For the longest time, I have seen myself as the enemy. This new information frees me to the new possibility that whilst I will always have an over-controlling instinct, it can be a positive thing. People who are over-controlling might manifest OCD, but they can also achieve amazing things with their dedication. What this means for me is that I am not inherently wrong. It could be different. The thing that causes my OCD can be re-trained, re-wired to be something great in my life. Basically, the instinct to be obsessive or compulsive doesn’t have to be a disorder.
This, for me, is why awareness is so important to me. I am becoming more and more aware of who I am, and how my mental health is not a gremlin squatting on my brain, but rather a series of complex neurological instincts that need to be given a break. They don’t know they’re hurting me. They’ve developed a pattern that they think is saving my life. My brain is not against me, my brain is neutral. My brain needs some re-wiring, but it doesn’t need to be told it’s bad or wrong or shameful. It’s a brain. It can’t be those things. This is something I have become aware of, and because I have become aware of it, my scores have gone up.
In other words, awareness is helping me heal.
So this is what I tell myself when I watch the young people file into assembly every day. This is what I tell myself when I stand in front of a class of rowdy year eight students, or when I sit with a group of year six girls, or when a child asks me about my mental health status. I tell myself I am giving them knowledge, giving them insight, and making them aware of what mental health really is. I tell myself that if awareness is helping me heal, then it might help them too. I tell myself that awareness could save a life.