I have been wanting to write about mental health for a long time, but it always seemed like the type of issue which could easily result in workplace discrimination and unnecessary stigma, so I remained silent. As much as I know that someone with a mental illness is just as able and often more able than someone who does not have a mental illness, I chose to keep quiet about mine for fear of being judged and thought of as less than capable, a liability to an employer, or weak.
I remember how difficult it was for me to tell my closest friend about my diagnosis and when I finally did tell him, I felt small and weak and so incredibly alone. This was not because he was not supportive or because he was ignorant; it was because I just felt that way. It is difficult to change how one feels about a mental health diagnosis, regardless of how incredibly supportive one’s support structure is. Whenever I have to tell someone (other than a medical doctor or therapist) about my mental health, I shrink a little bit with fear because what if that person thinks that I am weak, different or just stops talking to me? What if he or she judges me and discounts all of my ideas because of this one aspect of my life? What if I make a mistake and now this person thinks that because of that, every other person with anxiety and clinical depression is inadequate and prone to making mistakes by extension? If this is how I, a liberal twenty-three-year old university graduate feels about my mental health, I can only imagine how difficult it must be for an eighteen-year-old who just started to study at a university, or a sixty-year-old man who grew up thinking that depression was a made up ‘white’ illness for bored housewives.
The worst part after my diagnosis was that I knew when I had a ‘down’ day, but it was difficult to explain to others why I was cancelling plans or feeling down, because mental health issues are not visible and generally aren’t taken seriously until one has an episode and ends up in hospital. It is also an ongoing illness which isn’t automatically cured by medication after a week or two like the flu – it is often incurable.
My initial medication lost its effectiveness during a particularly stressful academic period, our June test period. When I finally realised that my medication wasn’t working anymore and that it wasn’t just me being stressed (because the medication doesn’t take away healthy human emotions and feelings) the tests were upon me and I had to survive. It was an extremely difficult moment in my life because I knew how important those tests were, but there were days when I would get out of bed only to use the bathroom because I was that depressed. There was one particular week that went by and I still do not know where it went because I spent most of it in bed. I don’t even remember eating during that week.
The worst part about depression (for me) is the extreme loneliness. I was surrounded by people, but I was still so incredibly alone. I hit rock bottom when I walked to a train station and stood on the platform, more than ready to jump. I’m not entirely sure why I didn’t jump that day, there were many different reasons: I have two younger brothers who need my financial help as they pursue their tertiary studies, I have a mother who would be devastated if I were to jump, but none of that mattered to me in that moment. The thing about depression is that it causes you to hate yourself and therefore by extension you believe that no one else could possibly love you, that no one could possibly miss you if you were gone, that no one would really even notice if you ceased to exist. In that moment on that platform, though, the one thing that kept on going around and around in my head was that I had forgotten to write a note. I don’t know why it bothered me so much, but it did, so went back home and decided to write one.
I had a therapy session later in the morning and I thought “hey, what the hell, let me go to this session one last time”. If anyone ever tells you that therapy is a waste of time or that you are weak for going to therapy, do me a favour and show that person your middle finger and go to your therapy session anyway. After being in therapy for years and feeling no different, on that day, at my lowest, going to that session was the best thing I could have done. The concern on my therapist’s face the moment she saw me (I didn’t even have to say something) said much more to me than anyone ever had.
That day, I made a pact with her and with a friend that if I ever felt particularly suicidal again, I would go straight to an emergency room. That level of accountability seems to help, because although I haven’t felt suicidal in a long time, just knowing that I am accountable to someone, that I made a pact, makes me rethink my situation before I act.
If you are feeling suicidal, please do that. Find a buddy and tell your buddy that you need help; ask that person to be there for you to talk to if you need someone while you try to get your medication sorted or while the medication is not yet effective (anti-depressants often take two weeks to start working properly). There are also suicide prevention helplines – please call one of those if you need help.
The South African Depression and Anxiety Group (SADAG) has some very useful resources which really helped me when I was beginning to suspect that my low mood wasn’t “just one of those days”. One of the best resources on SADAG’s website is a variety of quizzes, the results of which indicate a possibility of depression, Postnatal Depression, anxiety, bipolar disorder, PTSD (Post Traumatic Stress Disorder) and/or ADHD (Attention-deficit/hyperactivity disorder). If you are suspecting that you might be suffering from one of the above, take the appropriate quiz and follow your results up with your general practitioner or a psychiatrist, whichever is more accessible to you. SADAG also has a toll-free helpline which you can call if you have any queries or need help locating your closest emergency room, psychologist or psychiatrist. There are also suicide prevention helplines and support groups available.
On the issue of psychologist versus psychiatrist: a psychologist does not have a medical degree and therefore cannot prescribe medication, but is trained to provide therapy. A psychiatrist, on the other hand, is a medical doctor who is able to diagnose mental illnesses and is able to prescribe medication. A general practitioner is also able to prescribe medication, but it is always a good idea to go and see a psychiatrist to evaluate the prescription so as to see whether the dosage should be adjusted or not.
Medication for mental illnesses can be tricky in the sense that there is not one blanket medication that works for every human being. Sometimes it takes a few different trials and/or dosages to get the correct balance, sometimes the side-effects are not ideal and sometimes the medication loses its effectiveness over time, which means that new medications and dosages have to be experimented with. It is an extremely frustrating process, but please do not give up, because once the medication actually starts working it really does make a massive difference to the wellbeing and general level of functionality of someone who suffers from a mental illness.
The Student Wellness Service (SWS) at the University of Cape Town (UCT) is usually fully booked, but there is a waiting list for therapists. The therapists are brilliant and often refer students to the psychiatrist there, so it is a cheaper consultation (although the waiting list for the psychiatrist is usually also very long because there is only one) than with a private psychiatrist.
Please do not let financial constraints deter you from seeking help from SWS. The general cost of one therapy session is R150, but anything at SWS is free of charge for students who are on financial aid and prices are negotiable for any other student. The charges are added to your fee account, though, so be sure to clear those charges before results are released, otherwise you will not be able to access your results.
I urge you to seek help if needed and even if you do not believe that you need help yourself, go and check out the SADAG website and read up on mental health issues. This is an area of life which is often overlooked and minimized because of ignorance and this can be frustrating and hurtful to loved ones who might need your support. Try to educate yourself and do some research because a good support structure is vital to someone with a mental illness in those first few months after the diagnosis.
Also refrain from using harmful, ableist language such as:
- I understand how you feel;
- Just think positive thoughts;
- Everyone gets sad – you’ll be fine;
- Suicide is a sign of weakness;
- Pray about it;
- Get over it.
There are many more and as you read and learn more about mental health you will learn about these do’s and don’t’s, but please follow the links below for any additional information:
- Reasons I kept living
- 21 Things people with anxiety want their friends to know
- I don’t need to pray about it, I need to go to therapy
- Things you shouldn’t say to people with depression
There are obviously more resources out there, so don’t stop here. UCT students can follow the UCT Mad Hatters Society Facebook page (it actually gives me life).
If you are struggling right now: please do not think that this will blow over or that you have to ‘tough it out’. If someone can go to a doctor because they have a common cold, you can seek medical help for a mental illness. Do not let anyone discourage you from taking your medication. No one would tell a diabetic not to take his/her insulin, so no one has the right to tell you not to take your medicine. Seek help, take your medication, get therapy and/or join a support group, it will make such a big difference to your life. You will actually feel like a human being again.
Most importantly: no one can change or minimize your lived experience. This is tough and you are a warrior for seeking help, you are a warrior for surviving.