Mental illness is often messy, shocking and dark. Our conversation must reflect that

There is a new and brilliant openness about mental-health problems – but we must make sure not to sanitise the issue with platitudes and obfuscations, says Bella Mackie

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By Bella Mackie on

When I was first diagnosed with an anxiety disorder, I had no real idea what the illness meant. A well-meaning doctor listened to some of my symptoms, but cut me off before I could really get into the main worries that I had. Pills were prescribed, therapy was advised. Ditto sleep, long walks, and breathing exercises.  

To me, this felt as about as helpful as sticking a plaster on an abcess. The appointment, which I’d made in growing panic and misery, was less than reassuring. Everytime I plucked up the courage to explain a particularly scary symptom, the GP would tell me that “worries” were normal for people with anxiety, and I went away feeling thoroughly unconvinced that I really fit in this category of people whose panic would be eased by a bath and an early night.

That night, I felt desperate enough to search the internet for anything that might explain the growing sense that something had gone very wrong in my brain. There seemed to be millions of results, but the website I initially landed on promised to list the symptoms of anxiety. I just wanted to know that I wasn’t alone, that my weird and terrifying thoughts were normal. I wanted a deep dive into all the “mad” things I was experiencing. But the website didn’t help. In fact, it did the opposite, explaining that the main symptoms of anxiety were: feeling restless or worried; having trouble concentrating or sleeping and dizziness or heart palpitations. The list felt sanitised, gentle, nothing like anything resembling the mess I was in.

Sure I felt all of those things, but they were really the least of it. I also wanted to vomit the moment I woke up; I’d have visual hallucinations of pornographic cartoon characters when I shut my eyes; I’d endure thoughts popping into my mind at all times of the day – the weirdest and most appalling ideas, which would get worse and worse each day – as if my brain was trying to one-up the terror at every turn. The world no longer felt real (a common symptom called derealisation that I didn’t find mention of for months after my diagnosis) and I had trouble seeing through the literal fog that clouded my vision every day.

OCD is not just about a tidy cupboard, or an urge to check the iron is still off – despite what you might read online. It’s terrifying, all-encompassing and utterly exhausting


So to read about feeling “restless” just made me feel more hopeless. I went looking for the nitty gritty grim reality of anxiety – and all I got was platitudes and vague descriptions. I felt even more isolated after reading the official NHS site sections on mental health, where symptoms are brief and advice is broad.

Most of us will recognise the stat that one in four of us will deal with mental-health problems at some point in our lives. That recognition is largely down to the great strides being made in breaking down the huge stigma surrounding mental illness: we are encouraged to talk to our loved ones about any issues we’re facing rather than suffering in silence as most people did in the past.

Charities like MIND have made a mammoth effort to challenge myths surrounding mental illness and to help show that being affected doesn’t have to mean living in fear. Even the royal family have gotten involved, championing the initiative Heads Together, which aims to help people feel more comfortable with their mental wellbeing and gain practical tools to help support friends and family. Increasingly the media is keen to cover mental-health issues, and the “mad and dangerous” headlines of yore are slowly becoming a distant memory. All of this is unquestionably brilliant progress. If I’d known about the work of these charities when I first experienced anxiety and depression, maybe I’d have felt somewhat less alone. But I think perhaps we have leaned too far towards safe and gentle language when we talk about our mental-health problems. In a bid to take away the fear and the suspicion that has always dogged these issues, we have made advice vague, simple and often too mild.

Because no matter the recent encouragement to talk and seek help, a lot of mental-health illnesses are, to be blunt, fucking horrendous. And we shouldn’t shy away from that: it only isolates the sufferer more if they hear a mild version of the truth - why do they feel so much worse? I don’t just want to hear that it’s OK to have “sad thoughts” – I want to know it’s normal to worry I’ve killed my mother (an intrusive thought), to have full blown panic attacks in supermarkets where my whole body shakes. I want to know that the night sweats that drench my body and wake my boyfriend up are something that absolutely fits into the spectrum of anxiety. I do know all this, but it’s taken 15 years to not feel that my symptoms were more gruesome, weirder, darker than those affected by “worries” or “stress”. It ultimately took an hour with a kind psychiatrist where I poured out every gruesome thought and he didn’t look shocked at any of it. In fact, he smiled.

I recently finished work on a book about mental health – and my mother was shocked when she read it. Of course, she had always known that I had struggled with my mind, but she said that I wrote about it with much more honesty than she had heard me use before. The sanitised version I previously gave her was partly because I didn’t want to look properly “mad” and worry her, but it was also because I didn’t think she’d understand my real thoughts. Her version of anxiety was exactly what we still learn about from mental-health campaigns – it meant worries, sleepless nights. It meant offering reassurance and positivity.

Positive messages about mental health are crucial. We must stop seeing those with problems as dangerous, different or irrational. But we should also be open about the fact that mental illness is messy, shocking and dark too. We need to be able to freely discuss the stranger elements of our disorders so that nobody feels they are alone with the scarier symptoms they face. I have a friend with OCD who tells me all her intrusive and obsessive thoughts. I share mine with her too and we both feel immense relief that we can nod and laugh at the (often nonsensical) things that torment our minds from time to time. Because OCD is not just about a tidy cupboard, or an urge to check the iron is still off – despite what you might read online. It’s terrifying, all-encompassing and utterly exhausting. I just wish I’d known that earlier.

We should all talk more about our mental health struggles, yes. But let’s do it with honesty. My worst fears about what my brain was doing were always soothed when I realised that someone else knew the weirdness I experienced. Writers like Bryony Gordon and Eleanor Morgan have been really open and brave in talking about the worst parts of their mental health problems – and we need much more of this. For mental health awareness week, let’s reach out to the many who still suffer in silence, and reassure them that their deepest worries will not alienate or disturb us. We’ve come so far and made such progress. We should build on tha, and be even more honest about our struggles. Let gentle words lead to stronger ones, let everyone emulate my kind psychiatrist and show that no symptom or fear is too strange to discuss. The nitty, the gritty and the weird. If you feel totally alone, remember that it’s all normal to someone else out there.


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Mental Health
State of mind

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