Are you better now?

Anyone who has done a bit of background reading on mental illness (and I became obsessed with finding out all I could, especially when I first began to suspect that this was why life was suddenly so wrong), will have come across the Rosenhal experiment. Rosenhan arranged for 9 healthy people, including himself, to be admitted to mental wards by (falsely) claiming they had been suffering auditory hallucinations. All were admitted and from then on all told the truth about how they were feeling. The hallucinations were gone and all felt fine. None were released immediately and the average stay was 19 days (the longest was 52 and Rosenhal himself was a patient for 2 months). None of the mental health professionals suspected any deception although a significant minority of fellow patients expressed a belief that the “pseudopatients” were faking. In a follow-up experiment, Rosenhal told a hospital that he was repeating his experiment over a three-month period and sending some “pseudopatients” for them to identify. The hospital identified 41 imposters and flagged up a further 42 as suspects. In fact, Rosenhal had sent none.

In some ways, I want depression to be considered a disease. I think that would go a long way towards feeling less ashamed and less of a disappointment. Sometimes I wish there were physical symptoms to accompany my mental ones although at other times I’m glad of the privacy depression affords me (now that my public meltdowns and panic attacks have mostly disappeared). Out of hope and a sense of obligation to other sufferers, I call what I have an illness but no matter how much I advocate the opinion that depression is not down to any personal failure, I only believe that for other people; it’s difficult to apply it to myself. If society could accept depression as just another illness, perhaps the stigma would lessen, even disappear. Perhaps I, and others in the same position, would feel more willing to be open and honest. Perhaps I wouldn’t be reluctant to book a doctor’s appointment because the receptionist makes you say what’s wrong and I’m embarrassed.

On the other hand, mental illness does differ from physical illness. There’s nothing concrete to diagnose and nothing concrete to see. Diagnoses are difficult, and, as the Rosenhal experiment shows, often rely on the patient’s own testimony – and this makes people suspicious. Even at the height of my depression, I would have the occasional good day. Now, when my depression is still acute but less so, I can go for several days feeling back to “normal” before, out of nowhere, I’m back down again. If I had cancer, no one would think I were cured just because I had a day when I felt full of energy or optimism but there is a misunderstanding that depressives are always sad. If I’m not in tears, a razor hovering over a wrist, I must be well.

I laugh, I giggle, I smile, I even have fun sometimes. I make plans even while fearing the future and hoping it doesn’t come. I have ambitions even though the last time someone asked me where I saw myself in 5 years, my only thought was “I have to do 5 more years of this??”. I go to a comedy film and laugh at the jokes. I go out for dinner with friends and join in the conversation. It was only during my final weeks of work that anything was noticeably awry. When I laugh and smile and join in why would anyone belief that anything was wrong and so why would they pander to that or take into account that I am ill?

People with depression smile, they say they’re OK (sometimes they are), they laugh, they go to parties. It doesn’t mean they are not suffering. It doesn’t mean that tomorrow they won’t suffer again. It doesn’t mean that they aren’t desperately trying to ask for help without having to say the words. Depression is quiet and it is insidious and it is all too easy to hide. 

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