Over the last six months or so, my attitude towards mental health and mental illness has shifted quite dramatically. It hasn't been an easy shift, or one that happened overnight. In fact, I resisted it quite strenuously because it flies in the face of everything I had come to believe. It's been slow and frustrating and has progressed by tiny, tiny increments, but all those little steps are starting to add up and I now find myself with a very different perspective.
One significant aspect of all of this has been recognising and accepting the role of personal responsibility in managing the difficulties I've been facing. For years after receiving a diagnosis of clinical depression, and even more so since the diagnosis of borderline personality disorder, I believed that those conditions were part of me, something I would always have to contend with, and most critically, out of my control. They were because of a chemical imbalance. That was a terrifying belief, because as I understood it, no matter what I did, or how hard I tried, things either wouldn't change, or they would change a little but quickly revert back. I believed I would always have to fight, to struggle, just about managing to keep my head above water. Part of this was based on an overzealous use of google, part of it on what I was told by the many psychiatrists I've met through the public health system.
I have at various points over the years heard that my depression was treatment resistant, that there was nothing more could be done for me, and that the likelihood of it recurring was not only almost guaranteed, but in fact increased exponentially with every episode. Hearing statements like that at a time when I was desperately vulnerable did little to make me feel any of it was within my control and reinforced my belief that it really wasn't worth putting in the effort of trying to make things better for myself.
There's a flip side to that as well though, and this one isn't so easy to admit. There was a strange sort of comfort in it being out of my control, because it gave me a reason to not try. I took solace in the fact that other people were managing it for me - my therapist, my gp, my psychiatrist, my husband.......but the reality is that they weren't managing it, not really. They were supporting me and keeping me afloat, but real and lasting change can only come from me and the work I choose to do myself.
We've all heard the comparison being made between diabetics needing to take insulin, and those with depression etc needing to take psychiatric medication. No one would be judged for taking insulin, they need it in order to stay well, so the argument goes that it's the same for psychiatric medication, whatever form it takes. What I've come to realise however, is that this really oversimplifies some very complex situations.
My sister recently discovered that she had developed type 1 diabetes and needs to take insulin daily to keep her blood sugar under control. All very straightforward, right? Well actually, no, it's not that simple. In addition to taking insulin she has had to drastically change her lifestyle, most specifically diet and exercise. If she had continued as she was prior to her diagnosis, even with the aid of insulin, she would by now be extremely unwell. It hasn't been easy, and there have been times when she's been extremely resentful of having to be so disciplined. But she had a choice - make the changes, and make her situation as manageable as possible, or ignore the need to change and put her health at greater risk.
It is exactly the same for mental health difficulties. I've said it before, I can only write from my own experience and I'm not a mental health professional, but here's what I know, what I've learned. Medication alone isn't enough. Therapy alone isn't enough. Medication and therapy aren't enough. I have had to look at every single aspect of my life, and no more than my sister, make fairly sweeping changes. I've had to face the parts of myself I'd rather not acknowledge. I've had to look at my behaviour, my attitudes, my beliefs, my lifestyle - everything. I've had to take responsibility for the fact that it is within my power, to an extent, to improve the quality of my life, and while there's great freedom in that realisation, it also carries quite a hefty price tag in terms of the work that needs to be put in, on an on-going basis. While others can support me in that, I am the only one who can actually do it.
As I write this, I'm incredibly wary of coming across as the type of person I found it impossible to listen to for the last eight years. Don't get me wrong, I don't have all the answers, not by a long shot, nor do I consider myself 'cured'. There are days when I don't want to get up, days when I don't want to eat right, or get myself to bed early. I'd rather hide with Netflix and a bottle of wine, stay in my jammies all day and ignore the consequences that will inevitably follow. What's different now is that when I make these decisions, I'm making them with full awareness of what I'm doing. Sometimes that awareness is enough to make me stop and reconsider. Sometimes it's not. Sometimes the effort required will feel beyond me, and that's ok. But what I know now is that one bad day doesn't equal the onset of a depressive episode. It's just one day, and if I can get myself through that one day, I can try again tomorrow.
I will always be emotionally sensitive, that's part of who I am. But I won't always have depression, and I won't always have borderline personality disorder. They are nothing more than a set of symptoms indicative of the need to make some changes to my life. It's what I do with that knowledge that counts.
This article first appeared on Newstalk.com