Earlier this week, the mental health charity Aware shared a leaflet they created about “resilience”. The leaflet advocates higher levels of “resilience” as a buffer to cope with or prevent depression. How can one build up their “resilience”? Apparently, through regular exercise, yoga, eating well and seeing the good in a situation. If only the ill could stop being ill; if only they could take control of what’s happening their body and just try a little harder to not be ill. It’s totally within their capability to be a bit more “resilient”. Right?
This week marks World Mental Health Awareness Week, a time for us all to clap ourselves on the back about how “aware” we are that mental illness exists. But here’s the problem; everyone is aware that mental illness exists, but most of us stop there. The exact problem is symbolised by the mantra “Please, talk to someone”. This sentence is addressed at the depressed person, but is completely contingent on someone being there to listen. By addressing these mantras to people with depression, we absolve ourselves of our collective responsibility to our friends, family and acquaintances. We make the burden of improving our society’s attitude to mental health contingent on them speaking to us, rather than us listening to them.
Let’s deconstruct this sentence a bit. “Talk”. It is a very easy thing to do; all it takes is moving the muscles in your mouth a certain way and aiming in the right direction. It is easy for lots of us, but for many people with depression, the point isn’t that they can’t talk, it is that they feel there is no-one there to listen. I believe that people are intrinsically good; I don’t believe that many people purposely shirk themselves of the responsibility of helping a friend in need. Indeed, a person with depression may be surrounded by a circle of incredibly kind and loving people, but that circle is no help whatsoever if they can’t recognise when a friend is in need. Depression makes you feel isolated from the world around you, like everything is physically and emotionally behind a layer of bubblewrap you can’t break through. The point is that your ability to communicate meaningfully with the world around you, despite it being right in front of you, is considerably diminished. So when part of the definition of a person’s illness involves a highly-diminished ability to communicate, why does it follow that the best piece of advice we can give to people is “Be better at communicating, please”?
We are all “aware” depression exists, but assume that it can only exist for the people who deserve it. By this, I mean that society thinks that depression only happens to people who suffer traumatic life events or great loss; when, in fact, many cases of depression occur sporadically and are unrelated to any particular event. In a relevant analogy, compare this to cancer. Some people might get cancer after being exposed to radiation early in life, but many people just have cancer for no cause. This leads to people feeling despondent about the state they’re in, that it is somehow a choice of theirs to be ill. “I didn’t suffer abuse as a child. I haven’t lost a loved one. I live a perfectly normal life; I don’t deserve the label of being ill. I’m not really depressed. I just need to try harder to be happier. It’s up to me to get better.” These are the people for whom it is most difficult to speak to anyone. This is because society places a fear in their head that they’re just over-reacting. It is exceptionally difficult to say to someone. “I am depressed, but I have no reason to be.” This is a leading problem when dealing with youth mental health; a culture of stress and pressure tells people that their anxiety is just down to them working too hard, or that they’re having “an off-day, and everyone needs an off-day”.
What should we be doing? Firstly, spreading the stories of people who have written about their journey through illness. I am not going to try to explain what depression feels like. I am immensely under-qualified to talk about the lived experience of depression or any other mental illness. The healthy lecturing the healthy is not very useful. A close friend of mine who is ill sent me an incredibly powerful and terrifyingly relatable post by Allie Brosh, author of the web comic Hyperbole and a Half. If there’s one piece of writing I would force everyone to read, it’s this. Bear in mind that this is only a starting point. The characteristics and signs of mental illness have often been compared to a Venn diagram of overlapping but unique components. I think this is a well-meaning but misguided comparison. In its place, imagine a circle composed of overlapping circles. There are overlaps (often very large ones), but there is never a definitional central component common to all lived experiences of mental illness.
Second, our campaigns need to move away from “talk”, and switch to “listen”. This is a message that needs to impact everyone. Current campaigns only attempt to impact mentally ill people, to lift themselves up by their own bootstraps. It should be about teaching people to take responsibility for those in plain sight around them. It’s about not being afraid to ask the question, “What’s worrying you?” It’s about not dismissing your friend’s changed habits or behaviour as “having a bad day”. It’s about not absolving yourself of duty from the person you’ve noticed is sad by saying “Oh, I don’t know them well enough, it’s not my problem.” I have a friend who I only get to see a couple of times a year due to distance, and despite not knowing each other particularly long or especially deeply, we talk a lot about their illness and their progress; sometimes, venting to a person you don’t have to see and engage with every single day can be an incredibly valuable tool in progressing through illness. Friends of mine going through their journey have found it very helpful to give the advice, “Before you do or say anything to me, think about whether you would do that to someone with another chronic disease like cancer or cystic fibrosis.” You probably wouldn’t tell a person with cystic fibrosis to go for a run because it’ll expand their lung capacity, you definitely wouldn’t tell a person with cancer with no determined cause that, deep down beneath all the mystery and what people have told them, their cancer was actually their own doing.
It is time to end our double standards and hypocrisy towards mental health. For too long, we have fostered the idea that we are all kind, loving and aware people who couldn’t possibly miss the fact someone is suffering in front of us. I believe we all have the best of intentions, but we suffer from a collective blindness when it comes to stepping up to responsibility. We wait passively for someone to come forward to us, and even in those moments when we do listen, we don’t act, because we are never told we have to. I am going to be accused of pathologising sadness and implying it can’t be an emotion we allow people to feel. To this, my response is that it is infinitely more harmful for your depressed friend to never feel that anyone truly cares about them, than the slight awkwardness you might feel from being perceived as over-worried about your friends.
So, what’s worrying you today?
Illustration: Hyperbole and a Half