Whoops! I seem to be disclosing all over the place.
Which is odd, even the word, “disclosure”, as though you’ve committed a crime. A lot of other illnesses are just, well, discussed. In a camaraderie sense, or even (if you’re Northern Irish like me, as it is our national pasttime) in conversation over the fence with a fag. Fibroids, thrush, pus-squishing ingrown toenails. Nothing is too personal for the Northern Irish.
Except, maybe, mental illness.
In placement I have only admitted that I have my own mental health problems to people I feel I can trust. I wonder why I tell them, and the reason is (partly) that it’s very difficult not to. I don’t habitually wear my, “I AM A MENTAL” t-shirt (that’s for special occasions). But I do have more knowledge than the average first year student mental health nurse, I know THE SHIT out of the benefits system, and it’s because of my experiences as a patient and activist, and of my interest in mental health.
So this is why it has only been broached with the people who I feel comfortable with. They are generally the ones who ask, “So, how do you know/why are you/what got you interested in mental health?” I don’t want to lie, and I’m not sure what the lie would be. I know because I was a patient and because I am interested, my knowledge has been extended by being a writer and an activist on mental health issues. From the latter, it is guesswork that I became so passionately interested and involved because of my own experiences. It is the nature of activism.
It’s also because it’s everywhere, and making me more aware that this issue of the mentals will probably rear its head again. For example, I spent the day with a perinatal psychiatry team. I want to have children one day, very much. I have generally been advised against it for health reasons, and there is the reality of it. People are automatically referred to the service (good) if a) their mother had post natal psychosis (in that case my mum gets me an automatic referral as she suffered from it twice) and b) if they have a history of severe depression, bipolar disorder or schizophrenia. It makes me afraid for myself. I feel I will cope with it, but it taints the whole rosey image of pregnancy somewhat. You’re meant to be in a rocking chair, smiling serenely, with glowing cheeks and long hair, not having people monitor you in case you go mad. I’m glad they do, of course. But it was never how I imagined these life events. Nor to being advised to, “take care” planning my own wedding in case the stress and excitement makes me go a bit doolally.
I wouldn’t disclose (tell?) anyone I got even the faintest bad vibe from and it has all been in relevant, fairly passionate conversation.
I don’t feel particularly ashamed. Not as much as I used to, anyway. Indeed, I guess a bit of me still whispers, “Stigma is bullshit! Disobey! It’s their problem if they treat you differently!”, even though I have long since said that nobody should feel the need to OMG FIGHT STIGMA!!!!1 on their own, putting themselves in situations that might make them feel uncomfortable. It is not, one by one, our fight, not alone.
There’s also the fact that I’ve been largely fine for quite a long time. I have my little lapses due to stress but so far I have managed them. More than my illness these days, it’s my medication that affects me. It’s the medication that means I sometimes utterly just blank out and have no idea what someone said to me and renders me a DUUUUH in the mornings. Often I mix up my words (I have done so a few times in this post, the edit button is lovely). But I’m quite high functioning. I don’t think people can guess without any foreknowledge.
It all begs the question though- what should I do with this blog? When I was applying for jobs and university, I hid most of the archives (and most remain still hidden), leaving up the Stable Years. But I’m going to be Googled by patients, I’m fairly sure (I’d do it). It is something I need to give some serious thought to.
It’s not just Dr. Google and people I might care for. It’s the professionals, too. There is still undoubtedly stigma in the mental health system against professionals and wannabe-professionals with mental health problems. To see the devastating impact of that, read the Daksha Emson Enquiry. Dashka Emson was a psychiatrist with bipolar disorder who hid her illness for the most part, but more than that, her care team downplayed her illness due to the stigma of it. She killed herself and her baby daughter.
I do not want to be labelled as someone with mental health problems as it is only a tiny bit of me. I don’t want it used against me. But at the same time, I do need certain concessions and I don’t want to feel ashamed of it- in fact, I’m downright proud of a lot of the things that having mental health problems has led me to, gotten me involved in, opened my eyes to. I also don’t so far don’t think it has affected me on placement or my practice. I hope it doesn’t and I will make sure of that. So far I also haven’t had any, “Oh my god, that’s ME!” moments, nor do I want them, because it <i>isn’t</i> me. I <i>don’t</i> know how someone <i>feels</I> just because we might have similar experiences and I haven’t fallen into that trap yet.
I need to be careful though, and I am realising this. I think because it’s my first placement I’m still in trial and error stage, and I have met people on it that I get on well enough with to relax around. It will not be like this in all places, and I think for my own piece of mind I will hold that information back. Also in subsequent placements, I will have the previous placements to explain my knowledge/experiences. I don’t really want everyone knowing.
I would never disclose to a patient (client? Service user? I’m not sure what the word is) . It is not appropriate, it’s not professional. On a more human level, I also don’t think it’s right. It might make them feel, “Oh great, so I have to deal with your stuff now!” That’s not their job! It’s a professional relationship, I worry about them, not the other way around! And as much as you may care for, relate to and get on with somebody, you’re still in a position of authority. It’s something I find it hard to get my head round, but it’s true. I’ve been on equal footing for so long I’m still not sure how to navigate that. If I was giving a talk or something, or they Dr. Googled me, that’s different. I don’t want to hide in the shadows for that reason. Google and suchlike isn’t the same as having someone in a room and saying it. Either way, I think I’d be quite uncomfortable and it’s something I have to begin thinking about.
It’s a double edged sword. Personally, I have found it quite inspiring when someone with mental health problems functions well after not-functioning. I know how impossible, ridiculous and surreal it is to believe that could ever happen when you are in the depths.
I also like the, “Aaah, you understand!” feeling of speaking to someone with mental health problems. Even if they are totally different ones. They understand the stuff not in papers or seminars; the loss of your identity, the loneliness, the slog, the feeling ashamed and apart on the bad days.
But as a nurse? Or as a therapist? (When I am finished my nurse training and get more experience, I want to train in psychotherapy. Which type, I’m not sure. I might try and get some therapy myself to see. I know I will be getting my own therapy if I go onto train- I think that’s such a good idea that all health professionals should be offered this). I’ve had a few different perspectives on this, ranging from, “It’s brilliant! You know the system from the inside and outside, you can be a wonderful advocate” to more cautionary ones. But that’s having mental health problems- it’s not the same as people in your care knowing that you do.
Are they a good example or bad example? Do they have a right to tell you what to do if they didn’t do it themselves? Would you worry about having to look after them too or feeling they are assuming your own experiences, based on theirs? Would you worry they can’t keep a proper distance, one you might need, and one they do, too?
If you are being really honest with yourself (and me), how would you feel knowing your nurse, doctor, therapist and etc had mental health problems?
(My own answer- I don’t know).