Mind Out

I’m lucky, but…

If I am to use my “name” such as it is, to bang the drum for the cause of increasing society’s understanding and awareness of mental health and its issues, it is important for me to make sure that it is understood that I do know how lucky I am. Lucky to have friends, money and a light enough version of manic depression to make it less likely for me to suffer from the worst excesses of the condition.

I won’t lie, however, and when asked as I occasionally am, I cannot pretend. There truly are days when what is known as “suicidal ideation” has consumed me and it has taken all the effort I have to keep me from choosing the exit door from which there is no return. When I have mentioned this in print or interview it has, quite naturally, distressed those close to me or those, knowing me or not, who care about my well-being. I realise this and also understand why people think it would be better for me to shut up about all that rubbish rather than appear to welter in the fancy exotic luxury of having an “interesting” condition. It is important for me, as much as for anybody else, to understand that while my particular mood disorder might be what Americans sometimes call “Bipolar Lite”, it is still enough of a potential threat to my very existence for me to be wary about dismissing my version of this chronic condition out of respect for those who have it much worse.

Chronicling the chronic…

For some reason the word “chronic” often has to be explained. It does not mean severe, though many chronic conditions can be exceptionally serious and indeed life-threatening. No, “chronic” means persistent over time, enduring, constant. Diabetes is a chronic condition, but measles is not. With measles, you contract it and then it is gone. It can sometimes be fatal, but is never chronic. Manic depression, in other words, is something you have to learn to live with. There are therapies which may help some people to function and function for the most part happily and well. Sometimes a talking therapy, sometimes pharmaceutical intervention helps. Many in the psychiatric profession would suggest that neither talking nor drug therapies are as good on their own as they can be when used together. Some talk therapies might involve long term analysis, others utilise the quicker and more practical fix offered by methodologies like Cognitive Behavourial Therapy, which does not presume to understand root causes, but instead can offer tools and strategies for coping.

Other forms of mental ill-health…

I have gone on at some length about bipolar disorder because it is the condition I have most attempted to grapple with and comprehend. But there are many kinds of mental health problem which eat away at the happiness and prosperity of our country. Issues of self-image, like the kinds of body dysmorphia that can lead to life-threatening eating disorders for example; then there is the rising incidence amongst the young of self-mutilation and other forms of self-harm, there are unipolar depression, schizophrenia, learning disabilities, ADHD, Tourette’s, obsessive compulsive disorders of various kinds; there is autism and Asperger’s and there are all manner of phobias, syndromes and conditions that society often finds it hard to separate from the personality and even the moral worth of the sufferer. It is not for me here to say that all behaviours, moods, reactions and attitudes are attributes of brain and nothing to do with character, personality and what we are used to thinking of as “goodness” and “wickedness” – but I think any reasonable person can accept that the brain as an organ and the neural networks within it are quite as likely to suffer dysfunction as the back, the heart or the kidneys.

Of course the less merciful will say, “ how convenient that makes it for every criminal to be able to plead this syndrome or that condition as an excuse for crime and anti-social behaviour.” I am not pretending that this is not a real problem facing courts, but it is one that has been thought about hard for many many years and forensic criteria are constantly being established, declassified or refined. The best known collection of these definitions is the Diagnostic and Statistical Manual of Mental Disorders, the DSM, currently in its revised 4th edition, though soon to be reissued as the all new DSM 5. An unavoidably controversial publication, it seeks to distil current understanding of what is and what is not a “true” condition that passes empirical, rational testing in ways that everyone from a jury to an insurance company can agree upon or at least come close to understanding. In the forthcoming 5th edition, or so it is rumoured, the word “spectrum” will no longer be used to describe various sorts of autism, but rather each kind will be given its own individual ascription. In the its early editions, homosexuality was characterised as a disease, so it can be seen that the DSM is very much a work in progress and a reflection as much of public mores as eternal medical verities.

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3 comments on “Mind Out”

  1. AnneD says:

    There can be only one response to this blog: Thank you, Stephen.

  2. sallylowe10 says:

    It pleases me to know that you are to be the new Chairman of MIND, an amazing organisation which not only helps people suffering with mental health problems but also offers support to their nearest and dearest as I know from my own experience.

  3. Thank you very much for a well thought out blog. Mental health is, indeed, the last great taboo and I know several people who are suffering in extreme poverty because of it. The system simply doesn’t allow for people who can’t fill in forms or conduct themselves ‘correctly’ at interviews. If we all persevere in supporting people with mental health issues, rather than judging or mocking, we’ll get there.

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