If you do find that you are struggling with mental health issues or are feeling as though you can’t cope with life, what do you do? And where do you turn? This month, I’ve connected with some mental health practitioners to provide guidance as to what the different mental health practitioners do, to guide those of us seeking therapeutic help and guidance.
Interview with a Social Worker:
What does a social worker do?
People normally think of statutory social workers who are involved with the removal of children. This is only one area of social work, and you need to be designated to statutory social work.
Our goal within social work is about how to develop communities and to help communities thrive. We work with individuals, groups and families. We consider what are your resources – what are you lacking and what have you got. Social work is about developing and helping people thrive individually, group and community.
We look at using resources. For example, how do we help families, we try and work with what you have available to you. If you are struggling to move, we build in exercises to help you move within your environment. We play to your strengths and sensory capabilities. It’s about using the resources you have to manage mental wellness
What is the difference between a social worker and a psychologist?
Although social workers are not involved in any diagnostic work, they work with people, and can be your first source of therapeutic healing. We can refer for extra support or input around diagnosis if required. We help clients develop skills and help to manage symptoms, once they have a diagnosis. We look at the impact on your life, and what we can do with that. For example, what are your triggers for depression, and when you see that happening, what do you do, what are your options, and strategies in this space eg checking in with a friend.
Social work gives clients practical resources. What does your depression mean practically? Where is it stopping our life and what can we do
When would someone need to see a social worker?
There is no one size fits all when it comes to treatment. Depending on approach you’re needing, at the time, it will determine who you approach. At the end of the day, if you are struggling to function – you need to speak to someone. And you need someone who is going to listen and understand to help you pick up the different threads. If you feel like things are unravelling, you should seek help, before you feel like you’re too stretched. It’s hard for many people to admit that they’re not coping.
How do you find a social worker?
The best place is to look at the SAASWIPP Website, and search by interest topic. Social workers need to be registered to be on the website, and you will find information on whether they are cash only or you can claim medical aid. All this information will be available
Anything you would like to add?
Different people connect with different practitioners – this is about a process and a journey. While there has historically been a hierarchical perception and at times, real division between psychologists, there is most definitely space and a need for both. Even as mental health practitioners, we should always be working within the best interests of our clients, ethically and professionally. This should always guide practice.
If you do find that you are struggling with mental health issues or are feeling as though you can’t cope with life, what do you do? And where do you turn? This month, I’ve connected with some mental health practitioners to provide guidance as to what the different mental health practitioners do, to guide those of us seeking therapeutic help and guidance.
Interview with a Clinical Psychologist:
What does a psychologist do?
You get different kinds, but it depends on registration category. As a clinical psychologist, I am trained to treat and diagnose all clinical disorders, but also to help people through all hurt and pain.
What is the difference between a psychologist and a psychiatrist?
A Psychiatrist is a medical doctor and manages mental disorders with medication.
A Psychologist is a mental health professional, but not medical doctor. We can diagnose, but cannot prescribe medication, so a treatment plan involves psycho-therapeutic methods. Including behaviour techniques for clients. But more importantly helping clients heal through a supportive and caring relationship.
How do I know I need to see a psychologist?
As a necessity, things to look out for are suicidal thoughts and feelings, but also a struggle to live, where you are struggling to feel joy and the need to connect with others.
If ever you feel you need some kind of support, you can see psychologist. There are many of us who don’t have adequate support in their lives, and a psychologist can help provide that and help them build that into their lives.
Advice on finding a psychologist
My experience as a client and a therapist, is that race and culture matters. So I would recommend, that you seek out someone that you think would have sufficient lived experience that they could understand your context. Besides that, someone who is referred by a mental health professional is a good bet. And I would encourage you to look at people’s website, social media, to get a sense of the psychologist and their areas of interest.
Other types of psychologists
Counselling – They are not trained in diagnosing severe mental illness, but are able to offer psychological support and treatment for less severe emotional struggles.
Educational – They are involved in conducting psycho-educational assessments, diagnosing barriers to learning and helping to provide practical support and treatment plans for these learning barriers.
Neuropsychologist – They look at the impact of brain trauma on neuropsychological functioning.
Research psychologist – They conduct social science research in the area of social psychology in particular.
Other mental health professionals
Registered counsellors – They are not able to diagnose, but they are able to offer psychological and emotional support, to those suffering with less sever mental health concerns.
Clinical social workers – They are well trained in family and child work.
What is the therapeutic process like
Initially, the therapist needs to gain an understanding of why the client is struggling at this particular time, with these particular issues, given the unique path they’ve walked in life. The therapist is able to gain an understanding of the challenges they have, and what might be helpful in order to help them overcome these.
Prevention is better than cure, and while it might seem as though it is unnecessary, or even over pathologizing a situation to seek out therapy, if addressed early, things need a lot less therapy, and result in less emotional trouble. Even if one or two sessions can rule out what is causing trouble, it is better than leaving things ferment and causing other trouble.
The other day my son told me that they can’t cry because they are not babies any more, and I leapt at the opportunity to tell him that it’s always ok to cry. If you are feeling hurt, or sad, or angry, or even happy. It’s always ok to cry. I went on to say that even I cry, and his dad cries. Everybody cries.
I’ve alluded to it before, how we are socialized differently, and how little boys are taught that it’s not ok to cry, or get hurt. And as men grow older, they are taught that it’s not ok to feel big emotions. No one wants to be accused of being hysterical (a word which has its origins in the anatomy of a woman – the Greek word for uterus). Historically, for a man to do anything like a woman is bad, don’t run like a girl, or throw like a girl, or cry like a girl.
But when it comes to mental health, the rate of suicide amongst men is double the rate it is amongst women, however, the rate of depression diagnosis amongst men is half the rate it is amongst women. Surely, there is something wrong here?
If so many men are in such despair that the only way they see out is to end their lives, why are there not more male diagnosis of depression, of feeling empty? If we could treat more men for depression, then we could reduce the rate of suicide amongst men.
But to do this, we need to change our view of mental health amongst men. Seeking help in the form of therapy or other methods of mental health treatment should not be seen as something only women do. Men need to know about the benefits of talk therapy, and share it with their friends. Men need to learn the symptoms of mental illness, so that they can recognize it in themselves, but also in their friends.
There was a great campaign in the UK on bar coasters, where it asked questions like, “are you feeling a lot more angrier than usual?”; “do you not enjoy the things you used to enjoy?”; “are you feeling like you don’t fit in with your friends?”. These are the type of questions men should be asking themselves.
Depression isn’t only about sadness, and feeling weak, and something that only women experience. Depression is also increased anger and irritation. Feeling nothing. Decreased motivation. Just feeling off. Feeling like you don’t want to be with your friends, or that something is just different when you’re with them.
We need to teach men that it’s ok to not be ok. That it’s ok to cry. That it’s ok to ask for help. And to seek professional help.
The societal expectations of men are to be the heroes, the ones who stay strong for their families. But struggling with a mental illness leaves you feeling weak. And unable to take care of yourself, let alone your family. And because they’ve been raised to not talk about these feelings, and these fears of not living up to these societal expectations, all of these feelings are repressed and turned inwards. They may come out as anger or irritation, or the utter despair that leads to suicide.
Men learn early on, that it’s not ok to be introspective, to journal to dissect your thoughts, so why would talk therapy work? Women spend hours talking to their friends to solve problems and to discuss their lives “ad nauseum”. But for men, when there is a problem, they are taught that they need to man up, and punch things and fight. But the fact is, you cannot punch your mental illness.
We need to challenge the toxic masculinity that says we need to mock our friends for seeing a therapist, or for expressing emotions. Because that is what is causing the underrepresentation of male mental illness. Men are not doing well, and don’t want to express it to anyone for fear of being judged, or accused of “acting like a woman”.
We need to raise our boys to teach them that it’s ok to cry, no matter what age they are. It’s ok to feel sad, but it’s also ok to feel lonely, to feel empty. But most importantly, we need to teach them that when life is too much, we should seek help, from our family, our friends, or professional help if that’s what we need.
For a moment in time, we have stopped talking about COVID-19, and focused on humanity, and the current discourse is about how none of us should be silent about racism. There is a call for us all to be anti-racist. As people of colour, if you do not speak up, you are agreeing with racism. As white people, you are colluding with racists by not speaking up.
I am a believer in justice and standing up for the disenfranchised, because I know what it is like to not have your voice heard. Without systemic justice, though, nothing will be fixed. Within a system that is just, individuals all have access to all opportunities. And no one is discriminated against for individual characteristics such as race or gender or socioeconomic status. Or, mental health.
Historically, mental health has been developed by white males, and still today, the majority of the field is still white, so where does that leave the unique challenges of suffering with a mental illness as a person of colour. A lot of research has gone into the diagnosis of mental illness and the development of the diagnostic tools. And these are reviewed to ensure that our definitions are relevant to the context within which we live. However, we are still using diagnostic tools, which are predominantly developed with a Euro-centric, Western understanding of human behaviour.
As an example, there is still an underdiagnosis of girls with ADHD because the symptoms were initially based on boys, and hyperactivity may look different for a girl, which is why many women are only diagnosed with ADHD in mid to late adulthood. The same goes for Autism. And because women are socialized differently in society, women on the Autism spectrum, are able to hide their symptoms, because there is a societal expectation to fit in, and behave in a certain way to be regarded as a woman in this society.
There is also an underrepresentation of men with mental illness, because there is still the stigma of mental illness being an indication of weakness. Men are not readily willing to admit that they are suffering, and also willing to seek help, for fear of not “manning up”, or appearing weak. Boys are taught that they are not to ask for help, or cry.
What about the cultural meaning of “hearing voices”, such as when the ancestors are speaking? Or when you are called to be a sangoma? There are a number of beliefs within the African, South American or Asian cultures, which can be explained away as a symptom of a mental illness. So how do we differentiate between cultural understanding and mental illness symptoms?
Aside from the stigma of mental illness, there is the stigma of seeking help for mental illness, and seeing a psychologist for a “white” disease. As a person of colour your family might not understand or agree with you struggling with a mental illness, and you might be judged, or ostracized for seeking help for a mental illness. And being that many causes of mental illness relate to family dynamics and triggers as a result of lack of family support, this presents quite the predicament.
And finally, access to mental health practitioners. The majority of psychologists are white, and the majority of therapy is conducted in English, and Afrikaans. When searching for a psychologist, you may want to see someone who fits the same demographic as you do, or speaks the same language as you. How difficult must it be to undergo therapy to uncover deep-seated emotional and identity issues in a second, or third, language?
Also, the socioeconomic barrier for people of colour in having access to the mental healthcare professionals that they may need. A number of studies have been conducted on the inequality of healthcare systems, and mental health care is a privileged form of care, which further creates a barrier between the races and socioeconomic classes. Healthcare systems in South Africa have been shown to be unequally distributed within the country.
It’s also important to consider the fact that certain behaviours are prevalent amongst the impoverished, and when impacted by mental illness, they are not subtyped as being afflicted by mental illness, but are viewed as criminals or deviants. Because of unconscious bias in regards to race, there are certain characteristics attributed to certain races, like violence, which have the potential to result in misdiagnoses, or underdiagnosis. As an example, being lazy is attributed to being black, but one of the key symptoms in ADHD or depression is reduced productivity. This will be missed as a diagnosis, if it is assumed that the person is inherently lazy.
When considering mental wellness within the context of race (or gender, or sexuality), we need to acknowledge further layers of challenge, and stigma associated as a result. And ultimately the fact that anyone with mental illness, regardless of demographic wants to be heard and cared for, and understood.
Counselling Psychology in South Africa by Jason Bantjies, Ashraf Kagee, and Charles Young
HPSCA Report of the Working Group on Promulgation of Regulations
Synergi Collaborative Centre briefing paper on priorities to address ethnic inequalities in severe mental illness
The global pandemic has us all a little fearful, and paranoid, and stressed and anxious. And as someone for whom this is a daily experience, I thought I would share some ideas for maintaining mental health during these very uncertain times. Partly from my own experience, and partly from the advice from my psychologist:
Routine routine routine
It may sound boring, but one of the best things that has worked for me, has been maintaining a routine, albeit very different from my pre-global pandemic life. During these uncertain times, there is not much that we can control, but how we structure our days is something we can (relatively) control. Having that structure lessens my anxiety because I know what is coming. There is a lot to be said for having a plan. And look, it doesn’t always look the same, but if we have this plan, and try and stick to it, it gives us one less bit of uncertainty in our lives. And a small semblance of peace.
Our minds are overwhelmed with work, the Corona statistics, home schooling, staying fit and healthy, but also wanting to eat everything in sight (which is rarely a carrot stick), concerns about the health of our family, the general paranoia of not being able to touch anything before you’ve washed your hands and sterilized.
Spending some mindful time doing yoga or meditation will do wonders for your mental health. The key objectives of the yoga or meditation is to spend some time focusing on your body, and allowing thoughts in and then letting them go. These types of mindfulness activities, allow us to clear our heads, by making us focus on our breathing and body position. An easy meditation you can do for a few minutes a day, is body scanning: start at your head, feel its position in space, tense and release your face/jaw, and then continue to tense and release as you move down your body, from your shoulders, arms, chest, abs, legs, to your feet.
Spending time focused on something other than the thoughts running through your head will give you a space to think more clearly, and help with that feeling of overwhelm. Meditation has been scientifically proven to calm anxiety, so I definitely recommend spending some time out of your head.
3. Self Care
Ok, so right now, we’re able to go to meetings in our pajamas and slippers and no one would know. My advice here is to get dressed for work. And yes, for most of the week you will wear your apocalypse gear (stretchy pants /workout gear/ day pajamas), but try at least 2 days in the week to dress up for work, do your hair and make-up, wear shoes you can go outside in. Getting up and getting dressed is sometimes one of the easiest ways to alleviate anxious feelings. Look good, even if you aren’t feeling great. It helps, in a weird way, but it does.
Include some selfcare activities into your day. Selfcare isn’t always big activities like sitting in your bath, with a face mask, reading a magazine, with a glass of bubbly. It can be something as small as rolling your shoulders a few times at your desk to relax your body if you are feeling tense. Spend a few seconds deep breathing to calm down. Looking at a photo of your family. Micro selfcare is about anything, no matter how small, that is going to aid your feelings of anxiety or uncertainty.
So before the global pandemic, I had fitness goals, which have subsequently been put on pause. But nonetheless, exercise gives me energy. And in the moments when I’ve felt awful, lethargic, and demotivated, doing some form of exercise gives me those endorphins and energy to get me through the day. It doesn’t have to be a lot, I am currently doing about 15 minutes of basic functional fitness, using my body weight and things I have around the house, like chairs, and my children’s board books.
You don’t need to come out of this global pandemic fit enough to complete an Ironman, but doing a few minutes of exercise a day, will definitely help with the stress, anxiety, paranoia, loneliness, and general overwhelem.
5. Limit social media and news coverage
Social media is like a lifeline to the outside world, and if we stop, what are we going to do with our time? And if we stop scrolling, where are we going to see all those Corona memes? All true. But being on social media, and reading the worldwide corona stats daily will function to make you more paranoid, and feeling less than you are. Seeing all these super moms out there with perfect home school routines, and time to make their own playdough and paint, and making nutritious meals and snacks for their children, while your child ate cereal and a chicken nugget for supper while watching his 100th episode of Paw Patrol, is bound to make you feel like a failure. Not something you need right now. Also, try and limit your intake of news on Corona. We need to know what is happening in the world right now, but try to not go down a Corona media black hole, it’s just not healthy. Another tip, is to read/watch serious news in the mornings/early afternoon, going to sleep with those hard hitting news stories, can cause undue stress, and impact your sleep.
But stay on social media, we need those memes. Humour is so valuable in a time of crisis. So keep reading and sharing, but try and limit the time you spend there, to protect your mental health.
6. Video calls
Video calls is an awesome way to keep your distance, while staying connected. I’ve been able to stay in touch with my family and friends, and my kids are able to show them their toys and art that they’ve made. My kids have used Zoom for classes with their teachers, and parties with their friends.
Also, I happened to celebrate my birthday a few weeks ago, and we took to Zoom to party. We shared drinks, danced to music, it was one of the best birthdays I’ve had. I don’t know when last I’d laughed like that, since social distancing. It helped me to feel close to family and friends… healthily.
When you’re feeling lonely, video call a friend or family member or five. That’s one of the most difficult things we are going to experience during a pandemic that requires us to stay away from people. And we humans are social beings. Even us introverts. We all need our people time. So reach out when you need to.
For me, one of my favourite things to do is to sit with a good book, or spend some time writing creatively. These type of activities have come in handy while I’m staying home. A few suggestions are reading, colouring in, knitting, painting, playing with playdough, sewing, drawing etc. Activites that will allow you to sit quietly for an hour or two. These type of activities are also mindful activities that enable you do move outside of your mind, and focus on doing something practical.
Another suggestion here, is to dance. It may not be a calm activity, but who feels stressed after having a dance party in your lounge? (knowing that you can literally dance like no one is watching). So move that coffee table out of the way, put on your favourite tunes, and dance it out.
8. Writing – even if you don’t normally
Even if you don’t consider yourself a writer, it is really helpful to journal right now. We are all overwhelmed by what is happening around us, stress about the “new normal”, fear for ourselves and our families, having to fill multiple roles, and feeling lonely and distant from our friends and families. And it is so useful to get those thoughts down on paper. If you are lying awake at night, get out that journal and write down the thoughts that are keeping you awake. It may start out as a grocery list, but then evolve, like “buy tomatoes. Replace remote batteries. Why does my life suck right now? Is it because my dad never showed me enough affection?”
Hey, who knows, maybe you’ll find a hidden talent you didn’t know you had.
9. Sleep and wake times and meals
One thing that has become so easy is eating all day, but then also staying up all night because we’re binge watching Netflix, and then we wake up late. My advice here is to try and maintain the same bed time and wake up time. It won’t necessarily be the same as before, but it will relate to that routine you have set up for yourself. It sounds simple, but once again, something that you can control during a time when there is so much that is out of our control.
Closely linked to this is sticking to meal times. And yes, we are snacking an inordinate amount, but we need to ensure that we have our regular meals. If this is out of control , it can negatively impact your mental health. One thing I try and focus on, as a sufferer of anxiety, is to limit my coffee and sugar intake, and to ensure that I have regular meal times and snack times.
10. Time outside (Vitamin D)
Finally, spend some time outside, in the sun. We need to make sure that we get our vitamin D. Maybe have your lunch outside, or when you are journaling, do that outside in the sun. Also, something simple that you can do for your general physical health that will aid your mental health.
There is not much that we can control right now, so try focusing on what you can control.
When my good friend passed away last year, something struck me, related to my mental health journey. Whenever any of my colleagues, and family have approached me to express their condolences, and support, my response was, “I feel sad, because I miss her, but I’m glad she is no longer suffering.”
And that is what I realized the day after she passed. I’d been feeling sad. And I’ve been able to acknowledge that. And as I was walking into the office on that Monday, I was thinking about it. People will often say, “I feel so depressed…” but what you’re actually feeling is sadness. And while yes, I was going through a depressive episode at the same time, but, regarding my friend’s passing, I felt sad. And I was able to differentiate between the two emotions.
And while that may seem so minor, for someone who struggles to express emotion because for her entire life she was told that nice girls don’t get angry, and good girls don’t feel bad emotions, it’s a massive step to tease out sadness from depression. To be able to say that yes, I am depressed, but what depression feels like is a weight on my body, resulting in me not being able to get out of bed, or wash my hair, or eat. Whereas sadness, is a feeling of sorrow, of wanting to be around my friend, or wishing to hear her jokes, or spend time dancing with her, or looking at old photos, and realizing we will never have another photo together, nor share a birthday together again. It’s a feeling of longing.
Yes, this is a small win, but if this is you, give yourself a pat on the back. A lot of us have grown up being told things like, “Do not throw a temper tantrum” (when you did not have enough words to express your anger as a toddler), or “Oh come on, it’s just high school, it will be over soon” (when something made you sad as a teenager). And of course, “Nice girls don’t get angry” and “You would be much prettier if you smiled”. Let’s not forget, “Man up” and “Boys don’t cry”.
We’ve been taught, especially as women, that we always need to be happy, and that nice girls don’t get angry, so we never learn how to express anger in an appropriate way. And boys are taught that you need to man up, and that the best way to resolve a conflict is to fight it out, so they never learn the appropriate way to express anger either. And the same goes for other emotions. “Boys don’t cry”, but also, women shouldn’t be “too emotional”. How do I know what too emotional is? If I never learnt what the correct amount of emotion to express is?
And then as adults, we don’t even understand what is going on in our bodies when we feel emotion. And we have to re-learn how emotions feel, and how to express them, and the words for the different emotions, and also, how emotions feel in our bodies.
Last year, I learnt about expressing different emotions, and how to differentiate them from thoughts. So I may be mentally exhausted from working too hard, so it feels like tired, but instead of taking a nap, maybe I need to watch a silly show on TV to rest my brain. Or, know that I think that you your actions are unfair, but the emotion I am feeling is rejection.
The next step that I’m currently learning, is how my emotions feel in my body. We feel anger long before it erupts in shouting, for example. I have acknowledged that my anxiety is in my gut, and in the tension in my jaw and in my shoulders. But what I am learning is to pick up on the building of the anxiety before it’s a full-blown panic attack and then I have to take a lot more drastic measures to return to normal functioning, rather than picking it up while it’s still manageable. And maybe all I need to do is roll my shoulders or breathe deeply three times.
Another example, is knowing that when your partner starts making a statement that is a trigger for you and before he’s completed the sentence, your stomach is already in knots, and reading that feeling in your body, and being able to say to yourself that you are feeling anger, and frustration. So that instead of responding in anger, you respond by expressing the emotion that you are feeling, and stating that you cannot respond to the content of what he is saying, until you have a moment to calm down and think rationally again.
What’s also important to know, is that we don’t just experience emotions in our heads. Emotions are felt throughout our bodies, and we can pick up the signs in our bodies first sometimes. A small tingling in your fingertips, to suggest that you don’t feel comfortable somewhere. Before it becomes panic in your mind, and a sinking sensation in your gut, before you are in full-blown fight or flight mode. So start paying attention to your body, it’s more intone than you think. And it alerts you to your emotional state before you recognize the emotion.
It’s so important to be able to express emotions, and that means being able to name them, and to know the difference between sadness, and anger. And to know that expressing emotion is not bad, if done correctly. What we’ve convoluted, as a society, is expressing emotion with how that emotion is expressed. And that is where the problem lies.
It’s acknowledging that your partner, for example, is allowed to be angry with you for something you said or did, but not allowing them to degrade you, or violate you because of their anger. And then for you to depersonalize the anger, by saying to yourself that they are angry with something you did as it upsets them, and it has nothing to do with who you are as a person. It’s feeling anger yourself, but not allowing the anger to forever colour your feelings towards another person.
All feelings are ok. It’s what we do with them that matters.
The emotions wheel (useful for identifying emotions):
Even though it’s 2020, mental illness is still very misunderstood. Everyone who has low self esteem or feels nervous, has anxiety. Everyone who feels sad sometimes has depression. Everyone who is obsessed with having a neat desk is OCD. And everyone who cannot focus has ADHD. And not all thin women are anorexic.
But to actually suffer with mental illness is not as romantic as movies would have you believe. Every day is hard. Because every day, you are trying to function like a “normal” human being. And people assume that everyone with a mental illness has to look the same way. And that incredibly confident CEO could never suffer with bipolar, right? Although this is not a post about the difficulties of being on the mental illness spectrum. This is about those symptoms that we don’t talk about.
Laziness. Well, actually, perceived laziness. Sometimes people who suffer with mental illness struggle to complete tasks. And while you are motivated to complete tasks, you actually physically cannot for a number of reasons. Fear of failure. Perfectionism. Lack of motivation. Inability to concentrate. Sure, not all laziness is as a result of mental illness, but we need to start digging a little deeper when someone seems to be lazy and unproductive. It isn’t always as a result of lack of effort or desire.
Unemployment. Even though many companies will have mental health and wellness policies these days, and mental illness is starting to have its time in the sun, like wearing green on mental health day in October, when someone is actually suffering, and it’s affecting their work, it’s chalked up to poor performance. Especially in big corporate companies, poor performance is very rarely connected to mental illness. And a lot of the time, if we can give people the support and time to heal from mental illness, as we do with physical illness, we’ll improve productivity in our organisations.
Divorce/Singleness. Mental illness affects relationships. For many years, I suffered with undiagnosed anxiety, and a lot of disagreements between my husband and I were fueled by my negative outlook. I’d always been an optimistic person, and here was one of the closest people to me, telling me that he couldn’t handle my negativity. Now that we know about my anxiety and how it manifests, we are able to manage symptoms, and he is better able to understand me. But for many people, who suffer with mental illness, they struggle to maintain relationships, with romantic partners, but also friendships. We spend a lot of time in a vicious cycle of wanting to be social, but not having the energy to be social as a result of spending all day fighting mental illness to be perceived as a normal/likeable/successful individual.
Unidentified physical illness. I have a number of friends and acquaintances who have experienced random physical conditions like carpel tunnel, bowel and bladder issues, and other conditions. And most of these are directly related to their mental illness. Now, don’t get me wrong. Not all physical illness are manifestations of mental illness, and even if they are as a result of physical illness, they are serious, and need to be treated as such. But what needs to be done is treat the mental illness and not just ignore it, because, if we do, the physical illness will continue. Also, some physical conditions are caused by the excess of cortisol in our systems as a result of anxiety for example. We need to start viewing the body holistically. The brain is an organ just like the heart or lungs or liver. And it can get sick just like those other organs.
Lack of confidence. I mention this separately, because a lot of people experience the symptoms of a mental illness, but with people who do not understand, they attribute these symptoms to be part of that person’s character. So we get labelled as aloof, or lazy, negative, aggressive. And if the person feels that this is not true to their character, there is the potential to feel unconfident and insecure in who you are. And if people don’t like you because of symptoms like your negativity, or perceived self-absorption, it can leave you wondering, what is so wrong with me? And then lack of confidence in abilities, because you can never do anything right because of unproductivity as a result of depression for example. Or not doing well at school or work, and wondering what it is about you that is making you so incapable of success, when it could possibly be ADHD that is affecting your work, as an example.
Failure. It goes without saying considering all the above, that people who suffer with mental illness suffer a lot from failure. Perceived failure sometimes as a result of impossible standards. Actual failure as a result of lack of productivity, or poor motivation, absenteeism, missed dealines etc. And that is the challenge, to separate the symptoms from character, and understanding yourself, to know where your symptoms are making you fall short, and what you can manage, and what you can change.
Ultimately, mental illness is an invisible illness, no one knows how much you’re suffering from the outside. They cannot read your thoughts, nor can they see the related emotional stress, or the physical tax mental illness takes on your body. But also, it is not clear how this invisible illness, which a lot of people don’t really understand, and cannot conceive of how it impacts your life, has these other impacts on your life, causing that vicious cycle of having mental illness, struggling, having it impact your life negatively, and thereby creating difficult life experiences which would impact anyone’s emotional stability, let alone someone who is already suffering.
Mental illness is complex. And while having a diagnosis can be liberating, operating in a world that doesn’t understand you and what that diagnosis means is difficult. And then the result of this lack of understanding is these “invisible symptoms” that do not appear on the DSM.
I am very open about my illnesses, and symptoms, and how they impact my life. And my husband has now gained more understanding so he has a better grasp of how my anxiety impacts both me, and our relationship. I have also joined a group at work to support sufferers and carers of mental illness, and my main objective of joining this group is to spread the awareness and understanding of mental illness, and how it impacts the working life of employees. The only way to counter these invisible symptoms that I’ve mentioned here is through knowledge, if you ask me. To have knowledge of ourselves, and our mental illness, but then also for non-sufferers, or carers to have the information to develop their understanding.
I’m sure you’ve heard of the Kubler-Ross model of Grief:
Denial and isolation
These stages are not linear and not everyone goes through
all the stages. It is, however, a useful model, especially if the emotions you
are experiencing during your period of grief are confusing. And grief is confusing
and difficult, and it helps to understand that where you are right now, is not
where you will be forever.
“You don’t get over it, you get through it. It doesn’t get better, it gets different”
Grieving the dead
I recently lost a friend. She was young, and while she was
sick for a while, when she did eventually leave this earth, it was still a
shock. I felt this incredible sadness and questioning, of why her, why now? I
had never lost a friend before, and I didn’t know what to do with my feelings of
When she passed away, what happened was that the feeling of
loss that I experienced for everyone I’ve ever lost, came rushing back. It was
like I was losing them all over again. My grandmothers, my father-in-law, my
uncle, my cousin. I was grieving for about 6 people all at once. I thought I’d
moved on and found a way to manage the grief of losing them.
But what I’ve realized is that that is not how grief works.
When it comes to grief, you will always feel a sadness and loneliness for the
person that you’ve lost. And the only thing that changes over time, is that you
build a different life from the one you imagined. Life doesn’t get better, it
gets different. You learn to manage the feelings of loss whenever you think of
Grief comes in waves, and even if you’ve reached a stage of acceptance,
you’ll hear a song on the radio that reminds you of that person, and find yourself
crying in your car 5 years after your loved on passed on. It doesn’t mean that
you’ve regressed, or that you haven’t really accepted the loss. It just means
you loved them, and you miss them. And that is ok.
Even though I’d lost my grandmother in 2009, when I got
married in 2013, I felt a sense of sadness on the day, when I thought about how
much fun I would be having with her on the dance floor. That is grief. It gets
you in those moments when you least expect it. And that feeling of loss hits
you almost like it did the moment you realized they would no longer be a part
of your life.
And that is ok. A quote I read recently said that it’s not the passage of time that is healing, but what you are doing in that time that heals. So grieve your loved ones, miss them, but also, live the life your dreams. It doesn’t mean that you’re “over them” or that you’ve forgotten them. So mourn, cry, do whatever you need to do. But also get up, and live your life.
Grieving the living
Sometimes, we go through certain experiences which necessitate that we need to separate ourselves from someone who is still alive, because it is too harmful to be in their company. This could be due to trauma, harmful relationships, dangerous relationships, many different things. But you need to be apart from them.
You need to go through the grieving process, and acknowledge
that that person is no longer in your life. And you need to feel sadness, and
loss, and eventually get to acceptance in the Kubler-Ross model, just like you
would if that person had passed on.
And it’s ok. Even if it’s a parent. Society may tell you
that you cannot cut yourself off from family, or that you cannot be estranged
from your mother because she gave birth to you. But what if the woman who gave
birth to you has done nothing but harm you since giving birth to you?
You need to assess which option is healthier for you
physically, emotionally, psychologically: to have them in your life, or to be
estranged from them. You need to accept that some people are too broken to
change, and then you will need to grieve the loss of them in your life.
Sometimes, someone close to you may suffer illness, or
disability and they change in ways that you cannot reconcile. You will need to
mourn the loss of who they were before, or what they were able to do or to be. And
then come to a place of acceptance for who they are now, and how your life
together may change.
But just like grieving the dead, grieve this person, or
people, and go through the motions of mourning and loss, and then live your
life, in a way that makes you happy. Do the things you need to do, to be able
to heal in the way that you need to.
Sometimes, we grieve things like loss of a career, loss of a family home, loss of a limb or loss of a marriage. And you have to go through the same process. In the same way as when you lose a person, and it changes you forever, losing intangible things can have the same effect.
And in the same way, go through the Kubler-Ross stages of
Grief, because your life has changed. And you need to acknowledge how it is
impacting your emotional state. And to get to a place of acceptance, of your
new life, and how it is different.
And just as you would focus on living your life without a
person in your life, and how different your life is without them, when you are
mourning something intangible, you need to focus on living your different life,
whether it is with a new career, or new place, or new way of being.
Sometimes, women who have children feel a sense of loss for
their pre-children life. And you may feel guilty, but it’s really ok. Mourn
your old life though, go through the Kubler-Ross stages so that you can get to
a place of acceptance. What is important is to remember is to accept your new
life, and then also focus on living your new life as a mom. Even though it is
hard, and different and everything changes: your body, your friendships, your
Just like when we are mourning people, we need to remember
that, you stop and mourn, and then you need to live your new life. In this new
way. It’s important for your healing and sense of self.
* * *
The thing about grief though. It’s never over. Because you
never stop loving. It comes over you in waves. A person could be gone for years
and then you smell their perfume, hear their favourite song, see an old photo,
and it all comes rushing back. The memories, the sadness.
What grief has taught me though, is to live my life. That life is short. And that tomorrow is never promised. And while these may sound like clichés, truly living a life of meaning is not that easy, but every day I endeavour to try.
“Grief, after the initial shock of loss, comes the waves… When you’re driving alone in your car, while you’re doing the dishes, while you’re getting ready for work… all of a sudden it hits you – how so very much you miss someone, and your breath catches, and your tears flow, and the sadness is so great that it’s physically painful” – a part of me is missing | The Mighty
Depression def.: a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. Depression causes feelings of severe despondency and dejection.
Q: How would you define Depression? (in layman’s terms)
A: My definition of depression would be a constant state of hopelessness, where you want to do things, but you just can’t. You want to get up and be productive, but can’t. You want to be surrounded by people but can’t. Because you don’t want to be a burden, but you can’t help being a burden.
Q: What are the symptoms? (as you know or experience them)
A: Some symptoms I think are answers to questions, like how
many days have you not been getting enough sleep? How much energy do you have?
Does your work inspire you? Do your friends find you talking really slowly, or
really fast? How often do you feel hopeless? Have there been any changes in
feelings, appetite, or sex drive.
Q: How does it feel to have Depression?
A: For me it’s, you really want to do stuff, but you feel
that you can’t. It’s not that you don’t have the will power. Some days you just
can’t get out of bed. You want to and you shout to yourself in your head to not
be lazy, but your body just won’t get out of bed.
There is a disconnect between what you want to do, and what your body tells you that you can do. What you want to do, what you should do, and what you end up doing. You may look at a list of things you want to do, and you try to do some of them, but you just can’t. You just don’t have the motivation, or the physicality to actually do the things. And then that perpetuates the feeling hopelessness and worthlessness because of not doing things, and that you are not good at anything, and it all just gets worse.
And I don’t know why, and it’s not something I want, but I
just create a situation where I have things that I want to do, but I just
For me, I don’t know about it being about being sad. People
may view depression as not outgoing or engaging with friends. It’s not sad,
it’s a purple haze, and it’s just not good. You could get a call from someone
who you really love taking to, but then not want to talk to them so you don’t
answer the phone, or you do speak to them, and you just don’t enjoy it, even
though you normally enjoy talking to them.
It’s like having an overwhelming sense of misery. It can be
sad, but we generally have reasons to be sad. But there isn’t always a reason
for feeling depressed. It’s a constant state of being hopeless, overwhelmed,
and a disconnect between what you want to do, and what you do do. It’s about
knowing that this isn’t normal for me.
I think that it’s important to be honest with yourself and
those around you, and put your hand up and say, “I’m not feeling great”.
Q: What are the treatment options for Depression?
A: I think there is obviously the quite clinical way, through
Cognitive Behavioural Therapy (CBT), to reflect with someone else. CBT enables
you to be guided through exactly what are the symptoms you are experiencing,
and then breaking them down into tasks to address them. To be actioning against
the symptoms, which could help alleviate the symptoms. This method is whereby
you have an impartial person work through the changes with you. Once you work through
it with someone it can be challenging, but I think when you really unpack every
step, it has a meaningful impact. It can really benefit you.
Every concern and problem are really overwhelming, but when
you pick out simple things to resolve the big and vague emotions you may be
feeling, you can focus on these, and then work through them methodically.
Less clinical, is surrounding yourself with friends and family.
Make sure you have other people you can confide in. Sometimes, all you need is
to share how you are feeling with someone, and you don’t have to be in a
formalized therapy situation.
If you have a chemical deficit, or if CBT doesn’t address
the core issues, you will need to use medication. For example, if your body is
not producing serotonin, SSRIs, might absolutely be something that your body
needs. Even with medication though, you need to make sure you’re eating well,
drinking well, and exercising, otherwise, you’re not giving yourself a fighting
It’s like with any illness, the medication alone will not
resolve the problem, if you do not adjust your lifestyle too. If you had heart
disease, you would be on medication, but you’d also need to adjust your eating
and drinking habits, to remain healthy. Healing mental illness is the same.
So don’t live in darkness, not eat, or move. Make sure you
have a nice place to live and a nice way to live. With good people who support
Q: Do you have to take medication if you have Depression?
A: You don’t have to. You might not have to. But you might have
to. And someone that’s a trained professional who understands the cause, might
say that you need meds. You need to be open to the idea. It’s not a sign of
weakness. If you had a vitamin deficiency your doctor would definitely
recommend vitamins. No one judges that. If you look at your brain, and if it’s
not producing properly, then you’ll need to go the medication route.
We need to accept that your brain is an organ just like the
rest of your body. If you had a thyroid problem, it’s a medical issue. Your brain
needs attention, just like the rest of your body.
If medication is needed, embrace it, if not then don’t worry
about it. Work with a professional. It might be meds that are required, but it
might be only therapy that you need.
If you do need meds, don’t just take it, and that’s it, you
need to adjust your lifestyle too and make sure you’re in a supportive environment.
You may need a combination of therapy and medication. You definitely need other
And know that you might go through multiple regimes of
medication. You might have to go through many brands and dosages. It might take
months before your body produces what it needs to work. It might not work at
all. It might be a year before you start feeling better. You might even be
diagnosed with treatment-resistant depression.
I still want to emphasise that, above all, it’s normal. And
it’s not fine, but normal, and you’ll need to explore which options work for
you. Not everyone needs medication, but if you do need medication, embrace it,
and keep trying.
It can be an agonizing, long journey, but make sure you’re
on the journey.
Q: Is it genetic?
A: For me, I think it’s a combination of your environment,
genetic factors, or it could just be an accident.
If I look at my family, it’s most likely genetic. A number
of my close family members suffer with some form of mental illness. So if I had
to look at it surgically, at my family tree pattern, I would say, yes it’s
genetic, but some families have no challenges at all, and a person in that
family could still have depression.
A lot of mental illnesses, are a product of environment, like
anxiety. Our society is changing, and it has been shown that 25% of girls
before the age of 14 have an anxiety disorder. And while young people today are
more open about mental illness, this is still not a stat we have seen before. It’s
because of the social pressures on social media. We’re in a hyperattentive
world. Where the number of followers you have, and the number of likes on a
post are important, and it’s resulting in a world focused on instant
gratification through visuals, and having the perfect social media life. The
success metric in our personal lives is around exposure. We are forced into a
mould, to be a certain type of person. And none of it is 100% true. So
definitely the environment we live in.
But also, it is as a result of the challenges we experience in our lives. Instances of mental illness, like depression, also occur in relation to the number of wars, colonization etc a society experiences, all problems forced on people by others. PTSD has been known about for thousands of years, in that, during the Crusades, soldiers would still hear clashing of metal long after leaving the environment they were fighting in. This shows that mental health has been documented for thousands of years, in written records. It’s always been a problem, but we’ve never looked at in the right way. Younger people are talking about mental health more these days, we are starting to see more mental health memes. The world is starting to have a more casual relationship with mental health. Children as young as 14 years are talking about it. Sometimes younger.
Overall, mental illness is both genetic, and environmental.
For example, you might get cancer even if you don’t smoke or
drink. It could be that it is genetic, but we cannot be sure what the exact
The brain is complex. Don’t try and put it in a box.
Q: Anything else you would like to add
A: I heard my cousin’s kid of 7 years, tell her mom, “it’s
not good for my mental health” and I just think that she has had exposure at
such a young age to have the language to express that her mental health is
important. Overexposure of stress is not good, and young children are
We are on the cusp in history where the generation before us
denied mental health, and our generation is starting to talk about mental
health, and being open about it, and I’m sure the next generation will have
Young kids are talking about stress and mental health. We
are starting to talk about it in legislative, medical, social society. We are
changing the landscape in the ways in which we talk about mental health.
What is important is empowering the frontline, those who are
the first people who are going to be managing the symptoms of a mental illness.
For them to be able to recognize it as mental illness, and then treat it as
such. We need to empower them in the knowledge of the right action to take.
We’re starting to see a lot more openness around mental
health, even in societies where it was previously a taboo.
It doesn’t matter who you are, your age, or upbringing – anyone can suffer unique mental health
challenges. From all walks of life. It’s not a failure. There are treatments,
and there are things you can do to improve your life.
If you want to, you can change the world. We are ready.
We’ve never been more ready. It’s a really beautiful time to talk about mental
Just talk. If you’re not having a good day, say so. Just
If you’ve had a bad weekend, don’t lie. Don’t think of a
different things to say, to make up a story of a good weekend. Just say how it really
is. You’ll negatively impact yourself if you are not honest about your mental
Talk about it. Write a blog. Whatever it might be. You’re
going to change someone’s’ life. And they’ll change your life. There’s a ripple
effect of mental healing.
Be the young girl saying that she doesn’t want to do
homework because she’s stressed
Or the 80 year old who is admitting that she is not doing
Or members of the LGBQTIA community, and all the mental
health issues they struggle with.
Women are more likely
than men to get depressed – One of the reasons is due to the different
challenges women experience. But also because men don’t seek mental help.
People in the developing world, where there is no access to
treatment. People are exposed to mental health issues but what they see is violence
or they are violent. But because they are not treating the illness, there is a
vicious cycle of violence and illness and homelessness. In the developed world
they have access, and no one knows they have mental health issues.
Look at it as what it is. It’s who we are and what we are
and how we talk will create the perception of what mental illness and mental
We’ll see the mindset change that we want to see. In 30
years we’ll live in a beautiful world. But until then we have to talk.
Resources available to you, if you are struggling with Depression:
Schizophrenia def.: A long-term mental illness of a type involving a breakdown in the relation between thought, emotion, and behaviour, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
Q: How would you define Schizophrenia? (in layman’s terms)
A: Schizophrenia is a complex mental illness. The person suffering from it has a distortion of reality and hallucinations to the point that they can talk to themselves.
Q: What are the symptoms? (as you know or experience them) Is it like having multiple personalities?
A: People suffering from Schizophrenia don’t have multiple personalities, they just have a different reality. They build their own world and they cannot differentiate between what’s real and what isn’t.
In many cases they suffer from hallucinations and hear voices. They might even have full conversations with the “people” talking to them or swap from “someone” taking to them and then answering. This is the reason why it might appear as though they have multiple personalities, which isn’t the case. Having said that, due to all that’s going on in their head, they might become very absent and while you think you are having a conversation with them, their mind is somewhere else.
Q: How does it feel to have Schizophrenia? Or to be the carer (family) of someone who has Schizophrenia?
A: I remember it being very challenging and confusing. When I was younger, I couldn’t fully understand what was happening and would sometimes wrongly push the person to “just get better” or “do something to change it”. With the years, I have learnt that it cannot be cured and that the people suffering from it are actually in a lot of despair, which is the reason why in many cases they end up committing suicide to end the suffering.
Q: Are there treatment options for Schizophrenia?
A: There is unfortunately no cure, but medication and therapy are two ways in which to minimize the symptoms.
Q: Do you have to take medication if you have Schizophrenia?
A: Schizophrenia tends to be for life and yes, medication is needed. Unfortunately, the process to find the right mediation isn’t an easy one and patients have to go through trial and error until the right one and dosage are found. This process is challenging as the person might see their symptoms worsening for a bit of time.
Q: Are you able to keep a job if you have Schizophrenia?
A: I guess it depends on the level of the illness. In many instances the distortion of the reality or hallucinations are such that keeping a normal job isn’t possible. It will also depend on whether the person suffering from it is going though a bad period.
Q: Is it genetic?
A: To date there is no clarity as to why Schizophrenia happens. It’s known that there is a genetic component to it but that isn’t the only one. Environmental and altered brain chemistry play a big role too.
Q: Anything else you would like to add
A: As humans, we tend to be scared of the unfamiliar, therefore, it’s incredibly important that people talk about mental illness openly. There is nothing to be embarrassed about and only when people talk about it, will the topic be normalised.