I have experienced mixed anxiety and depression on and off for years. For a long time, I did nothing – it was merely a mental black hole hidden deep under a ‘shy’ personality and good grades at school. I told no-one; I didn’t even admit to myself how I was feeling for a long time. In this sense, finally opening up, going to counselling and ‘talking about it’ has helped a lot. It has also helped to see the discourse around mental illness becoming more and more mainstream, with a greater awareness that we all have mental health and must take steps to protect it, just as we might with a physical injury. Among many others, Matt Haig’s book “Reasons to stay alive” and his Twitter feed give me hope for the normalisation of self-care habits and the ability to talk about the difficulties we face in this crazy world.
We are moving, I hope, towards a society where we take up the responsibility of checking up on the people we care about. A society where we feel able to speak about mental health without speaking in hushed tones and whispers. Where saying we are mentally ill is met with the same level of understanding and sympathy as if we were physically unwell. “Talking about it” is certainly a step in the right direction. But it is not enough.
There are parts of mental illness which cannot be solved by simply “talking about it” – illnesses whose effects are not so well known or not so commonly discussed. Illnesses which are incurable, lifelong, or poorly understood even by medical professionals. Illnesses whose symptoms make their sufferers appear as socially outcast, ‘different’, or which prevent people from maintaining stable jobs over a long period of time. As recently discussed in the Guardian by Hannah Jane Parkinson, mainstream conversations around mental illnesses still fall short of acknowledging how mental illnesses have an impact on the person that physical illnesses do not – we might start acting differently, lashing out at friends and family, or taking damaging risks that we would never take without being unwell. “Talking about it” might help defeat the stigma surrounding such illnesses and raise awareness of their existence. It might help people feel less alone and improve symptoms for some people. It might even be a way of collecting more information, to understand mental illness better.
But it won’t make it go away.
Many mental illnesses can never be treated by talking therapies alone, and may require a complex journey of trial and error until the most appropriate combination of medication and other treatments is found. In the meantime, the symptoms may be extremely disruptive and difficult to face for not only the patient, but their family and friends. Talking about it will help cope with this, but it is not the only solution – and what is more, it is not the sole job of those friends and family to solve the patient’s problems.
It is, ultimately, the job of the healthcare system.
When that system is underfunded and in crisis, ‘talking about it’ can only go so far. People who are struggling are told that they are not struggling “enough” to get help; they are left on waiting lists for months when even getting through a single day is difficult. They see doctors who do not know what is wrong with them and are overstretched to the point that they do not have the time, resources or patience to find out. They are pointed to therapies that do not work for them simply because the ones that do work are oversubscribed. They are sent home in tears because there is just not enough money to help them. This is why talking about it is not enough.
If we truly want to help, then we must go further than talking about it. We must acknowledge the links between mental illness and other social factors – gender, sexuality, ethnicity, class, education. Families from the lowest income brackets are more likely to experience common mental illnesses, as are minority ethnicities and sexualities where the greater risk of hate crime might lead to greater mental distress. These links cannot be solved just by talking about them.
We must talk about difficult truths. And then we must act.
The government must invest in healthcare and mental health services, with careful attention paid to the socioeconomic and geographic sectors which have the greatest need. We must vote for politicians who will not continue to leave the NHS overstretched and underprepared to cope with the burden of mental illness. We must, when it is possible, donate to mental health charities, research groups, or volunteer for support roles.
Above all, we must be there for those people in our lives who are struggling, all the while understanding that they might act in ways that are difficult or unfathomable to us. The mentally unwell do not act how they would if they had a broken leg, even though both ailments are equally valid. We must remember this, and remain supportive while they get professional medical help – preferably without a three-month waiting list.
Talking about mental illness is perhaps more important than ever. But when we talk about it, we must afterwards remain true to our word.