Look, I know I keep banging on about attitudes to mental health, but honestly it makes me mad. Last night we were watching Mad Men and scorning the casual sexism/racism that informed the early 60s. How could anyone have thought in such blind and bigoted way? It’s like watching monkeys in suits. With scotch, lots of scotch. And cigarettes. (Actually on the whole smoking issue, I was laughing at the fact that consumers then didn’t realise that it damaged your health. Deluded, eh? But here’s something funnier – even with the facts at my disposal, I merrily smoked my way through young adulthood).
Anyway. My point is this. Despite years of research in psychology and pharmacology and emotional intelligence, we still treat mental health like an embarrassing uncle at a wedding. ‘Don’t look now but Joe’s breaking out the frog dance routine. Eyes down, eyes down. Ignore him and he’ll go away’. That sort of thing.
Sure, we talk a good game. No shame in depression. Eating Disorders. Chronic Fatigue. Just don’t bring them to my surgery. Or my home. And if you do, be prepared to be labelled, laughed at, patronised, marginalised, scolded or dismissed.
I know exactly how you feel. But when I have bad days, I just get on with it.
We have patients here who are really sick.
It’s all in your head.
Weren’t you here with the same problem last week?
Why don’t you just eat?
It must be such a strain on your poor mother/sister/husband/partner/kids.
Yeah, everyone gets tired, but we can’t all just go back to bed.
I don’t believe in feeling depressed.
Just take these tablets.
For more see Ten Things Not To Say To A Depressed Person.
And here’s the thing. It takes a lot to open up. Every time you tell your story it gets cheaper.
If you’re depressed, you already hate yourself. If you’re binge-eating, telling someone else is bloody scary. If you’ve got chronic fatigue, getting out of bed is an amazing achievement, let alone booking and then turning up for a doctor’s appointment.
There’s a searing Chris Morris sketch where he talks about ‘Good AIDS’ and ‘Bad AIDS’. Good AIDS happens to people who have dodgy blood tranfusions. They need our sympathy and our help. Bad AIDS happens to homosexuals and drug users. They deserve all that’s coming to them. This is brutal satire but it only works because many people actually think this way.
And sure, when you’ve been working round the clock with cancer patients and hit and run victims and premature babies, it’s harder to pump the stomach of someone who came in just a few months ago. To run an ECG on another stupid little girl who won’t eat. But you know what – their life matters too. And where do we draw the line of judgement? The cancer patient who smoked? The amputee who was texting while driving? The office worker with exhaustion who wouldn’t cut down their hours?
It’s not the medicine that’s hard to swallow, it’s the judgement that comes with it.