My body comes with a trigger warning – Self harm and stigma

Hello!  I wrote a blog for Mind on self harm,  stigma and conflicting messages. 

“Stigma” has two meanings. One is religious- they’re the literal marks on the hands of Christ at the crucifixion, and then bestowed upon those whom were holiest- and by extension, those who suffered the most. The other is social- a mark of disgrace. Self harm is both. It is highly stigmatised in society and within the health system, and it is a mark of suffering.

Suffering only has cache if it’s quiet, or, “dignified”. If you make people uncomfortable with your suffering, then there’s stigma. And therein lies the rub.

How do you combat stigma on something that makes other people uncomfortable?

How do you say people who self harm should be treated with kindness when their bodies are seen as attacks on others, to say that self harm shouldn’t be a problem hidden in the dark, when we do exactly that by not allowing representations of self harm?

I just have scars now. They’re very noticeable but also very faded.

Recently, I had a baby. In the postnatal ward, a midwife wrote that I was sitting on the bed holding my baby, “scars on arms”. That’s six year old self harm scars, as relevant to my medical history as a broken leg, and yet so very present, because they were, on a hot stuffy ward, visible. That’s what I was reduced to- “scars on arms”, the loving arms holding my newborn son, the arms of a new mother, a person, exhausted, elated, and ordinary.

If you’d like to rest the read,  it lives here.

Therapy Tales No. Etc- Death and Trauma. Fun.

Therapy is ending soon.

Losses, fears, love- that’s basically it. Losses of things I loved- including animals (I know pets die, but mine in sudden, cruel ways I can’t go into here but which haunt me) and people. They all died lonely, premature, unfair, painful deaths. As soon as I really understood what death really was (which happened when I had another loss- my friend who killed herself when I was 15), I have been completely heartbroken ever since. Of what life is. Of feeling. Of finality. Of memory. I can’t bear it, any of it. That’s when the fear really started. I’d always been afraid of my parents’ death, i obsessed over it. But that was my first big loss, of someone I’d seen so recently, so young, so similar to me. We were all steeped in bullshit pop music mythology, playing with self harm. But she died. Alone. And I was unforgiven for something. I never got to explain or say sorry. And she died. Died. Death. Forever. My first cremation, too.

Memory is important to me. Memory is evasive to me. I have convoluted memories of my own childhood.  Different from my siblings’ because we’re different people. Everything is kind of mixed up, muddy. Then my own brain conspired against me, and I don’t remember a lot of my periods of illness, or the life that existed, inevitably, as life does, within them. And I had my own fractious relationship with the truth when I was young.  When I look back I realise it was because I found it so hard to be living the life I had, so created another, not even one that was easier, but one I felt could justify the pain I was in without ever being honest about what was really causing it (it still feels churlish and trivial, and now I am at the other extreme of exposing honesty).  Other people have memories I don’t, largely negative and embarrassing. My own bad behaviour haunts me not just because it hurt those it was directed to (or caught within), but because I know it has become part of the memory arsenal, that chorus always waiting to be summoned, or to butt in, uninvited, and to hurt. And I hate that. I don’t want to be someone’s bad memories. Maybe if I can be better now, I can replace it or erase it? And all I want is to give my son happy memories. Robert says I’m morbid, which is true. He keeps us in the present- he thinks, “experiences”, I think, “memories”. Already living in the past tense.

Memory is all we have, really. In the end, if we’re lucky, that’s all we have. Since my dad died I have dug deep and cling to the good memories I have of him. Further and further away. It’s hard to remember happiness. It’s not the visceral gut punch of despair, more the balloon in your hand that drifts away, bright and then small and smaller. Physical pain is hard to remember (I couldn’t describe now what my contractions felt like, even though I know they hurt), but emotional pain recalls itself constantly. So I often only remember the bad things clearly (and how bad they were), and it feels like they just happened. How jealous I am of people whose parents weren’t like mine and who they went out to lunch with and they didn’t die like my dad did. Even those who did die but in ways that people had some sympathy for (alcoholics dying, lowest of the low, fuck their children, the way we were treated by the medical staff, my baby brother and sister, fuck them forever and forever for it, for every person afterwards who turned their face away from me),  I have to unfollow people on Facebook posting happy pictures with their parents. Out at lunch! Having drinks! Doing normal things.

Memory is the twoheaded monster. My memories of my dad are awful, Sometimes they engulf me and I feel like tearing my skin off in agony that I can’t go back, can’t change something, can’t intercept this awful image and make it different. That was it. And his memories. I think that’s perhaps worst. HIs life which he didn’t deserve. That he was so desperately unhappy. That he died like he did, and that I knew he was afraid of it. And there are tears pouring down my face as I write this. To be afraid without comfort. Without hope. I wanted to be there when he died to be a hand or a face or a word, and I wasn’t.

Me being there wouldn’t have changed the outcome, he would have died anyway. But I wanted to do something, anything.

My friend Brendan died not long after my dad. He was an alcoholic too, was trying to recover. He died of an accidental overdose and my last communication with him was a voicemail he left on the Monday before he died asking me to meet up, saying he was nearby, just passing, are you in? get in touch, and I was so up my own fucking selfish arse I never did and then he died.

In therapy we talked about safety behaviours and my big one is having my phone on me and being always contactable. I have a three hour commute to and from work and most of it is underground. I went for a rare night out on Tuesday and had a panic attack on the train as I visualised (fear not feelings etc, but it felt like a promotion, it felt like destiny), Robert screaming over our baby, screaming and screaming and I wasn’t there. That if he died I wouldn’t be there. What would his last memory be? Be held, be there, be loved. Not alone.


This is hard to write. I’ll come back to it.

It’s also about fear. I used to have nightmares about my dad dying from his drink. But he did anyway. It happened even worse than I screamed about. So why should I trust my fears aren’t real? That the worst won’t happen? It did. All the worst fears I have (dying myself is a worst fear that will inevitably be true, but I fear dying young, leaving my baby, Robert dying, my baby dying, my mum being unhappy and dying) came true so why not these? It’s hard not to take my anxieties as facts. They happened.  And with Robert and my baby in particular, who are my husband and my son, I love them so fiercely, I think, my love must insulate them from suffering, from death. But it doesn’t and it won’t. How can I ever accept that? I know it’s a childish and possibly a bit narcissistic but there it is. When Robert has the slightest bit of discomfort, my refrain is, “What can I do? How can I fix it?”

We talked about my intrusive thoughts which often take the form of, when I’m speaking to someone, imagining them dead. And realising they have the same expression, that I am just superimposing my dad over everyone’s faces, just reliving it constantly.

We didn’t even get on that well when he was alive. We had some beautiful moments, a lot of understanding, and he was a good person. But I often hated him for what he put us through. I used to fantasise about him falling downstairs and breaking his neck just so he’d shut up. Stop shouting. Stop drinking. Then we’d be free. (I hate this freedom. I hate myself).

So the therapist talked a bit about trauma and how events can be too big for the brain to process so they never become memories. They’re always happening instead. A sort of PTSD. And how if you break them down they can be processed and become memories and stop being so present. I’m skeptical. I have some extra sessions before we quit but feel like we’ve pulled a thread and I want the jumper back. And I don’t want to do the homework. I don’t want to write it all down. I want to keep pushing it all out. I don’t want to break it down. I don’t want to break down.

I cried a fair bit after that session and Robert gave me a lot of hugs when I came home. And then abruptly I just stopped talking about it, as I do, Silly, trivial, depressing.


(Stay with the feelings)

CBT Tales- session 1 and 2

Hello! I promised to update you on my therapy tales. I had my first session 2 weeks ago and it was so uneventfully boring I didn’t really have much to say about it. It was just going over what we’d be doing. He said a few times, “you fit the model so perfectly”, which I gather was meant to be reassuring but irritated me somewhat. I don’t want to fit any models but of course, we all do in varying ways. Especially us mental health bloggers who literally define ourselves by the set of symptoms we fit that all adds up to a few words on a doctor’s monitor and our entire lives.

There was a lot of diagram drawing on how thoughts and feelings and actions all interact. Talk of safety behaviours, and my biggest is keeping busy all the time, mostly by fucking about online, never letting that thought creep in, having my phone glued to my face until the very second I fall asleep. And it doesn’t work, because in the second afterwards, panic creeps in. And I have an awful tendency to use my phone to look up the things that scare me- cancer, death, cot death, death, death, more death.

Session 2 was yesterday. I wrote this for A Day In the Life, a website which gathers the stories of a day in the life of someone with mental health difficulties. You can submit yours too over at A Day In the Life. The stories are anonymous but I don’t mind outing myself for the purposes of this post.

26 August 2015

Today is Therapy Day. I had about three hours sleep, which isn’t good on Therapy Day. In the days before my baby was born, my medication (Quetiapine) would make me sleep for twelve hours straight. Now, with an internal Mum Radar activated, I wake up when he does (multiple times a night), although I’m pretty uselessly doped up from drugs and it’s up to my husband to feed him. The one time I tried I dropped the bottle and spilled milk all over the floor, mumbling dream talk, his crying from the end of a long, dark tunnel. So it’s pointless lack of sleep, but lack of sleep nonetheless. The baby, now five months old, has decided that 6am is a brilliant time to wake up, so I’m up too.

Despite being up from 6am, I’m still late for therapy. The hours in between are lost in a haze. I eat, too much, to try and muster some energy. A jam bun and some toast. In my sleepiness, I’ve forgotten my homework and worry all the way on the bus that the therapist will be pissed off at me for it. It’s just CBT- I say, “just” because it’s not the kind of therapy that plumbs your heart like a dentists’ drill. It’s functional, rigid, and thus requires concentration I can’t summon on so little sleep.

This is only the second session. The focus is on my anxiety about death. Or, as we find during the session of comparing, “Theory A to Theory B”, the focus is on my anxiety about my anxiety about death. The problem, the therapist says, isn’t that we’re all going to die. That’s true and has always been true. It’s that my anxiety about it is controlling my life. So we go through what happens when I feel anxious. About intrusive thoughts and how we shouldn’t try to control them. The more we try to control them, the more we think them. The aim, he says, is to accept them. To let them intrude.

Towards the end of the session he says we’re going to do something which may make me have a panic attack. It’s to feel where my anxiety is, to hold an image in my head and to focus on it. I try, but all I can focus on is the ticking of the clock coming to the end of our truncated session. I try to hold an image of myself panicking but nothing really happens. He then talks about how the more we look at an image, the more our mind will demonster-fy it. It might become interesting, comical even. I’m not finding this to be true, but I’m left with the instruction that the next time I get an intrusive thought or feel anxious to stay with it, examine it, and not try to suppress it. Good luck, me.

I leave and wander around the shops, thinking of lunch. I’m trying to treat these sessions as little holidays from my life, and take an hour afterwards to drink coffee or eat before I return to the baby, leaving whatever was in therapy scattered along the cafe tables. I get the bus home and exhaustion floors me. I can barely hold my head up and resolve to go to bed when the baby does. We’re all tired today, we forego any attempt at dinner and eat burnt creme brûlée that Robert impulsively bought from Tesco.  I take my medication just after I put the baby to bed, and let it drag me into the blackness of sleep by 8pm. He wakes at 10.30 and I do too, stumbling with my pillow into the spare room while my husband feeds him. And then back to sleep. It’s just like the old days- I slept for 12 hours.

First therapy appointment…

…is flipping tomorrow! That was quick. I was hoping for the traditional 18 month wait. Wish me luck.

Therapy Tales Part 1- So You’re Terrified of Death?

(If you’re wondering where my previous post went, I have made it private as I’ve found this to be true. Thank you for all your comments and encouragement!)

So, I’m starting therapy for death anxiety (my medical diagnosis that led me to it are generalised anxiety disorder and panic disorder but I prefer to think of them as ARGH).  Expect this series of posts to be even more introspective and self obsessed than usual, and for this blog, that’s saying something.

Two years ago (christ), I wrote a post called, “When Fear Becomes Phobia”. It described my ARGH FUCK panic around death and deadness, and how my world was getting smaller and smaller because of it.  Last year, I went to the doctor and asked for help. She was so sympathetic that she made me cry. Saying what an awful thing to carry around with me for 12 years (14, now) and she referred me to therapy. I found out I was pregnant, had an assessment and things didn’t go any further because I was suffering such crippling morning sickness that the 40 minute bus journey to the appointment was 1 hour 30 minutes because I’d have to jump off twice to vomit. Later on in pregnancy, I dispensed with such courtesies and just huffed up all over my lap, or into a friendly plastic bag.  Pregnancy was also pretty distracting- all my anxieties were focused on that, and I didn’t have the mental reserves to panic about death anymore.

My panic has returned, as it does. It’s not constant and strikes at night when I’m trying to sleep (and flip, I need my sleep!) It doesn’t disturb anyone because I sleep in the spare room (Robert does night feeds due to my medication). It means it’s quiet, private, lonely. It comes and goes, ebbs and flows.  It’s probably unsurprising. I had a baby, then I lost my grandmother, and it was my dad’s anniversary.  Catholicism ritualises death in a way that’s both comforting and horrifying. It makes you look at it, it makes an object of it.  She was in a coffin in the sitting room that my dad’s coffin was in, for days, with the same yellow, unnaturally smooth, chillingly cold skin that you have to touch to say goodbye. Their coffins, and every childhood Christmas. These things bring death bubbling back to the surface of your mind. It’s hard to close it out when you’re trudging up a hill behind it. Robert’s grandmother died the month after, and her funeral was like a trip to Argos. Closed, quiet, scripted, burned. I prefer the visceralness of Catholicism, even if it haunts me. It does at least give death, and life, some gravitas.

So, I’ve been referred back to therapy for it. My psychiatrist initially wanted to increase my medication but I refused. This feels existential, albeit obsessive. I’ve often been able to distract myself and try to be less up my own arse, but distraction is tricky and I’m introspective generally. It doesn’t need to be medicated away- that just makes me feel worse.

The assessment happened pretty quickly. A chat over the phone, which gave me a sense of pride that I didn’t have to list a litany of other issues. I haven’t self harmed in six years, my bipolar disorder (if I ever had it) is pretty well controlled. I wasn’t depressed, wasn’t struggling otherwise. I’ve come quite a long way. I knew what they’d recommend- CBT (*spits*) but I’m willing to give it a chance.

The therapist is called Sean, which means the assessment didn’t entail the usual 45 minutes of tuition in how to pronounce my name. It’s high intensity IAPT (Improving Access to Psychological Therapies), so the sessions aren’t at the mental health team (thank bollocks, I used to work at my local one), but in an unassuming house with comfy sofas, pot plants and James Frey books that I had to stop myself openly guffawing at perched proudly on the Ikea shelves.

He asked me what I wanted help with so I explained. I forgot to bring the questionaire they sent me so went through some of it there. My depression score was low, as I knew it would be. People tend to assume I must be suffering from depression if I’m having panic attacks and anxiety.

Au contraire.

Depression is both a mortal enemy and an enemy of mortality. For me, it is ageless, timeless emptiness. It tries to kill me, and it kills the thing inside me that makes me afraid of it doing so. I want to die when I’m depressed.

So when I’m not depressed, I’m scared of that. It’s like being held under water and a peaceful acceptance of what it happening envelopes you, until the final second, and you kick, you convulse in order to be free, to be alive, to throw off the aggressor and then relive over and over at how close you came to drowning.

I do sometimes feel depressed because of the panic. I feel frustrated and angry with myself that I have panic attacks. I feel frightened and distressed by some of the intrusive thoughts I have (like when I’m speaking to someone and suddenly an image of them dead flashes into my brain, with hallucinatory vividness) and sometimes they make me feel like I’m going mad. But depression and this panic don’t come together, and that’s a big massive pain in the hole. The panic tends to be the worst during the happier periods of my life. I’m happy, hurrah, and then my mind goes, “This will end it, all of it, everything, and because it will end, this is meaningless, you won’t be here one day, any day, none of them will” and that’s just BLOODY FUCKING GREAT isn’t it. I don’t want to die, ever, because I enjoy my life. I’m essentially a happy person who wants to see what’s going to happen.  I want to be standing at the end of the universe with Robert and Oisín watching supernovas and planets and the sun.

(Rest your head)

(Close to my heart)



(Never to part).

Maybe it is partly a coping mechanism, the fear. Like pinching yourself.

He asked me if I had other anxiety- I do, social anxiety, but I’m dealing with that in my own way so I didn’t want any help which he accepted (and I think it’s tied up in this anyway).

Two things were said during the assessment that made me willing to continue. One was something stunningly obvious but that I had genuinely never considered. The therapist said that my kind of anxiety is, “idiosyncratic”. It’s not a common reason people come to therapy. That floored me. “Doesn’t EVERYONE feel this way?” I said. No, apparently not. At least, not to the degree they end up in therapy. So, is it that this is such an ordinary fear we live with it and are in denial, or am I the odd one for being periodically consumed by it?

Another was asking me where I think it came from. Nobody has ever asked me that before, and it’s not something I’ve thought about. The worst of my panic began when I was 15. That’s when it started flinging me screaming across the room. “Is that when your friend committed suicide?” Yes, it was- but the panic attacks started before then. Robert (who I first went out with when I was 14), remembers my panic on the phone, but it was more contained, and I was easier to comfort and distract.

It started well before then, when I was about 7 (?). Both my parents had mental maladies. I felt like they were going to die and I was terrified of it. I became aware they wouldn’t be there one day and I feared all the time it was the day. I used to pad into their room at night to check they were still breathing, then pad back and lie awake in the moon (just like I do now with the baby!). I realised I was going to die too, and sometimes would wake up screaming.  Death felt close, ever present, non abstract. I could only perceive it in my childish way, but I never felt safe, and I never have since.

Of course, that’s just a bit of it- I might be wrong, but I had never connected the two things before. I had a massive resurgence after my dad died, too, which is natural. But it wasn’t so much his death as knowing that he feared it. That kills me, still. I hate that he was afraid. If I could do one thing in my life, one magical thing, it would be to take that fear from him before he died.

He asked me what I wanted to get out of therapy. I don’t know really. Not to have panic attacks anymore. To be able to watch/read/listen to anything again. Not to have to ring in late to work because I’ve disintegrated at a funeral procession. To fall asleep. To be able to think about Oisín’s future. At the moment, I’m too scared to talk about it, think beyond tomorrow, in case he’s not here for it, or that I’m not. I’m petrified of something happening to him, and feel superstitious about it. It’s a loss I know I would never, ever recover from, be able to go on living beyond.  Pregnancy should have taught me the futility of this- when it seemed like there was bad news at the 20 week scan, my anxiety didn’t protect me. It didn’t cushion it, it didn’t make anything easier.  I want to be able to talk to Robert about him riding a bike, or going to school, or falling in love. I want to be here and present in the moment without thinking how it’s going to end. That it is. I want to be able to sleep without hours of panic beforehand. I want to be able to not feel regret about not living if I do die tomorrow. When I’m going through anxious periods I always feel mildly dissociated, not here. I don’t want to feel that way anymore. I don’t want horrible flashes in my brain anymore. I don’t want my coping mechanism for the feelings of helplessness and inevitability to be nihilism, as it means I make unhealthy choices (like smoking, which will actively shorten my life, and thus leads to more panic attacks). I want to be present for myself, for my child. Life is so brief. And it is all.

He said that this will involve some unpleasant feelings, but that it usually helps. He says when it doesn’t, “work”, it’s often because people haven’t done the things long enough (bit of, “blame the patient” here, but I understand what he means as my last assessment person gave me a workbook I barely glanced at). I’m pretty frightened of what this is going to entail, and how hard it’s going to be. I’m aware it might mean it gets worse before it gets better, and I’m feeling pretty apprehensive about that. Shit scared, to be honest.

But I’m doing it. So let’s see where this goes. I’ll keep you updated!

Labour are miserable, spineless, traitorous cowards.

And they are rapidly becoming indefensible. For anyone who looks to them for hope or humanity, we are further abandoned. People are suffering and the suffering is going to become even worse and Labour stand by to watch it happen.

Shame on Labour. I am disgusted I ever voted for or believed in you. I give up.

Well done to the 48 who voted with a conscience (including David Lammy, oddly) but you still belong to a party of bastards.

I know this post is insight free, just wanted to register my anger somewhere.

Ruby Wax Is Right- You Don’t Have To Tell Your Employers You’re Mental

Ruby Wax has caused a minor kerfuffle by suggesting that those us whom struggle with our mental health should keep it quiet from employers, and in fact, lie to them in order to protect ourselves.

How many of us have had, “a cold” when general misery has flattened us to our beds? Had dodgy trains when it’s really been a panic attack?

In a perfect world, we’d be able to tell the truth. And our employers would be able to respond compassionately and sensibly. But it’s not a perfect world. Nor is it some post-stigma world as Eleanor Morgan suggests in her response to Ruby Wax:

For Wax, a prominent advocate of mental health awareness and visibility, to tell those of us who experience a mental health problem – one in four in the UK each year – that we’re still stigmatised seems a significant regression. Because as a nation we’ve got much better at not looking on those with mental health problems as weird.

If this has been your experience, then frankly, you are privileged. You are lucky. Mental health problems and the people who experience them are still stigmatised. Just because we’re a bit better now doesn’t mean there aren’t people collapsing under the weight of the word, “psycho”, thinking of which imaginary family member they went to care for in that gap in their CV, having obvious self harm scars people frown at and comment on, being laughed at in the street by your neighbours, having friends and strangers speculate on their mental health when they leave the house or spend their benefits money on something other than bread and water as meaning that they, “can’t be that depressed”, writing their DLA form knowing they’re fucked anyway because in this shiny, happy, post stigma world, mental health problems are being written out of the script altogether and it’s just mind over matter, just Not Trying Hard Enough. It’s hard to know which is worse- being written off as a psycho forever, or your experiences being flatly denied in crazy-making gymnastics which make you wonder if you imagined them all, too.

I’m privileged. I’m sure most of you know this, but I work for Mind, the mental health charity (and it goes without saying that this blog is my opinion, not theirs). My manager is, as you’d expect, very good about mental health and they know all about mine, and what to look out for if I’m getting unwell (thanks to a WRAP). I have reasonable adjustments and understanding for my issues (I’m not too sharp early in the morning due to medication, for example).  In my case, I feel valued partly due to my experiences, and not in spite of them. And that makes me very lucky.  Although we want to work towards a world where this is the rule, not the exception, there’s no way of knowing what your workplace is until you get there.

And it’s fine not to want to tell.  There’s so much talk of, “fighting stigma”, as if that makes us all these foot soldiers. You don’t have to be. You don’t have a responsibility to disclose to, “fight stigma”. You don’t have a responsibility to anybody else but yourself and you should never feel bad that you want to protect yourself. You aren’t failing anybody, letting any side down, by not wanting to be open about your experiences or diagnosis. The reason celebrities can come out and speak is often because they have a lot less to lose (but even then, look at the reception different celebrities get, how struggling with addiction and depression is treated differently from just depression, how Paul Gascoigne is an object of ridicule whereas Stephen Fry isn’t, and in particular, look at the attitudes towards women who speak out as being trivial, hysterical or overemotional).

And things may be evolving, as Eleanor Morgan says. The discourse may be changing around depression and anxiety- but it’s not so much around personality disorders and psychotic illnesses like schizophrenia. Could we change it by opening up? Maybe- but often the shittiest response is in the mental health system itself both to its patients and its employees, and if it’s been demonstrated to you time and time again that yes, you actually do have something to fear, and you will be treated badly, how is someone going to get the confidence to open up generally?

Of course, if you need support and understanding, it is better to tell. If it becomes unavoidably obvious, it’s better to be honest. But although Eleanor says,

Here are the facts: it’s illegal to be dismissed from your job because of a mental health problem. The Equality Act, bringing together the laws that were found in the Disability Discrimination Act, Race Relations Act and Sex Discrimination Act, protects people from discrimination on the grounds of disability. If you have a mental health problem you may not think of yourself as disabled, but if it has a significant impact on your day-to-day life for a period of time, it will probably be considered a disability under this law. It’s a very detailed law, but Mind provides a legal briefing about how it works.

Most important, an employer should not treat you unfavourably because of a disability, and must make “reasonable adjustments to work practices, and provide other aids and adaptations” – for example, being flexible about hours, and temporarily allowing you to work part-time, or have a period of sick leave with the clear reassurance that you are still valued as an employee. If you feel as if you’ve been fired under the cloak of “something else”, chances are you will be protected.

It is extremely hard to prove you’ve been sacked for mental illness, as well as extremely time consuming and legalese. If you’re a temp, you might feel like you have little recourse, likewise if you’re on a zero hour contract and they stop giving you hours. I’m neither wealthy nor successful but i have been fired for my mental health. I was a temp, and there was an extremely specific search to this blog that only my employer could have made, and the next day, I was fired. They just “didn’t need me” anymore. I knew they’d found my blog and read it and that was that, but I couldn’t prove it. And many people with mental health issues will be in unstable employment where it’s tougher to know your rights, or harder to fight for them. And as for, “getting back on your feet”, as Eleanor puts it, no matter how much we want to say mental health and physical health are the same, they aren’t. They should have parity of esteem, but mental illness affects people differently than physical health. You may get, “back on your feet” but have lost your family and friends in the process, and you might have to be on medication for the rest of your life that will affect you physically and cognitively. In a lot of cases, you can be well, “recovered” but need adjustments for the treatment.

Those adjustments may not be made for you, either, due to the nature of your job. I left my nursing degree due to being told to suck it up- I had to work nights and late earlies which meant I wasn’t able to take my medication and invariably I became ill. There was little practical support and no adjustments (and that isn’t even accounting for the shit attitudes I encountered as a mental health nursing student with mental health issues, including a staff member grabbing my scarred arms in front of a patient and shouting at me). My experiences might not be reflective as a whole, but it also shows that there isn’t a cohesive approach to helping employees (or students) with a mental health issue.

The onus on fighting stigma shouldn’t just be on us, but on the people who treat us, the people whom we work for, the people who love us. Whereas Ruby Wax compares mental health to gay rights, and it was gay people who fought for those rights often to a huge personal cost (and their lives), we should be able to count on the backup of those institutions for whom our diagnosis, in one way or another, matters. If you want to tell, if you want to be the one to challenge it, if your workplace is trying, then tell. It can definitely be a powerful thing to take that control instead of worrying about being, “found out”. But please, don’t feel bad if you don’t. Don’t feel like you’re buying into a, “regressive” idea, because you aren’t. It’s okay not to tell.

And employers who are crap with this stuff- you’re missing out on some amazing people. It’s your loss.

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