Too much of mental health education deals in extremes: we need nuance
I went to secondary school in the 90s. While my school was quite a liberal, progressive sort of place, my PSHE lessons on mental illness were distinctly lacking, owing more to the fact that they took place in less enlightened times than any deliberate negligence.
I talk to other children of my era and their experiences mirror my own. We each had a solitary PSHE lesson addressing mental illness at its most extreme – usually consisting mainly of a first-hand testimonial. In our school, we had a visit from a lady who had, she was at great pains to emphasise, once weighed only 5 stone because of anorexia. Others were visited by a man who had been repeatedly sectioned. A guy whose drug addiction had left him homeless and suicidal was also doing the rounds in schools, circa 1996.
The telling of these people’s stories was both interesting and necessary. In isolation, however, in the absence of any other information on mental health, they led me to develop inaccurate ideas about what mental illness was and prejudices about the sort of person they befell.
It was these preconceptions, involving the notion of mental illness only occurring within people who would blend easily into the cast of One Flew Over the Cuckoo’s Nest, that prevented me from getting the help I needed for my own struggles. For a long time I was in denial. After all I looked broadly normal (whatever that means) and most days I was functional. I got three As in my A levels for pity’s sake – mental illness didn’t, I believed, happen to people like me. Then, of cours,e there was the stigma and the fear, the idea that if I admitted what was happening in my mind I’d be immediately carted off in a straitjacket and incarcerated forevermore.
The media at the time was also notorious for sensationalising mental illness by focusing only on the most shocking stories, yet the ignorance spread far beyond the pages of magazines and the contents of documentaries. The first time I approached my GP, having by that point been battling daily-or-more bouts of bingeing and purging for over three years, I was told that my BMI was not sufficiently low enough to qualify for eating disorder treatment.
After I recovered and began campaigning, I noticed that there was a bizarre competitive edge to awareness-raising. Mental health advocates competed to have had the worst symptoms, to have suffered the most extensively, to evoke the most pity. On social media, people in recovery were told that they didn’t have real eating disorders because the real cases never got better.
A founding principle of the Self-Esteem Team is to "draw the three in four into the mental health conversation". We work on the principle that, while one in four people will statistically experience a mental illness at some point during their lifetime, four in four people have a brain and therefore a mental health. We sit in the ‘prevention’ or ‘promotion’ stand of mental health care – sharing tips on how to understand the way you think and behave, in the same way you might eat well and take regular exercise to provide a baseline of good physical health. We hope that, in doing so, we make mental health a universally relevant conversation because, well, it is.
Yet all three of us in the team are part of that quarter of the population who have had a mental illness and part of our aim as campaigners is to give mental illness a less terrifying face.
I still suffer from anxiety. I occasionally have panic attacks and they are horrible. I have had to learn, through various therapeutic interventions as well as self-education, how to separate rational thoughts from paranoid ones and when I am entering flight-or-fight mode. I am always able to function professionally (although my illness affects my ability to socialise). In fact, focusing on work provides respite from the spinning top that is my brain on the bad days. Just as writer Bryony Gordon wrote recently about how she spent years in the office during her career as a successful journalist with her iron in her handbag because OCD had left her so paranoid she had left it on (even though she doesn’t iron), from the outside I appear fine.
And a lot of the time I am – fine, I mean. Mental illness isn’t necessarily a death sentence, but it is something that needs to be acknowledged, understood and, in my case, lived with. I represent a demographic of people whose stories have traditionally flown under the radar, eclipsed by the more sensational cases. I believe it’s important people like me have a voice so that mental illness can be properly comprehended.
And so it was that I wrote an article for this month’s Cosmopolitan on what it’s like to be a successful woman in your thirties who gets panic attacks. The issue has been out for a week as I write and I’ve already received about 20 emails and numerous tweets from women saying, "Thank God! I thought it was just me." But the piece also attracted some controversy from those who thought I was trying to normalise an illness that is potentially crippling, or implying that it is an inevitable consequence of success – aspirational, even. One high-profile campaigner tweeted that "real" anxiety involves "not being able to leave the house", which bought me right back to those frustrating days of not having my eating disorder acknowledged.
This is the eternal conundrum in mental health campaigning: sensationalism vs trivialisation and trying to walk the line in between, where the truth resides. A large part of the problem is that the terms "mental health" and "mental illness" cover such a vast gamut of conditions, so nothing can ever represent everyone’s experiences.
It’s something I’m always keen to emphasise to young people who ask me if I regret my eating disorder. Of course I regret all those lost years and it would have been much better if I’d found a healthier coping mechanism for my anxiety. Eating disorders are nothing to aspire to. Equally, I don’t want to imply that it ruined my life irreparably and there is therefore no hope.
Anxiety makes my head a difficult place to live in, sometimes. But it has also made me more empathic. It’s given me an understanding which helps me do my job. Anxiety is what means I’m always 10 minutes early for meetings and push myself to perform my best. It’s also what gives me a chronic dose of perfectionism and a tendency to beat myself up when I get things wrong. That’s my experience of anxiety – but it’s by no means all-encompassing.
It is only by conveying the nuances and the complexity of the issues that we will ever smash stigma once and for all.
Natasha Devon is the former government mental health champion for schools and founder of the Body Gossip Education Programme and the Self-Esteem Team. She tweets as @NatashaDevonMBE