Anyone who’s spent a lot of time being treated for mental illness likely shares my urge to puke when the word “support” comes up.
“So who do you have for support in your life right now?”
“Please rate the quality of your support system on a scale of 1-5.”
“Remember to call a support person and have them stay with you if you’re scared.”
… And a lot people who suffer from severe mental illness, which is, after all, destructive in part because of its isolation, are probably joining me in being all like, yeah, right. It’s like when you’re talking to a rich person and you complain about the weather and they suggest you cope by buying a vacation home in an exotic locale. I mean, it’s good advice, right?
What hardly anyone talks about, while they seem so keen on reminding you that you don’t have one, is how to actually build a “support system.” Or how to use one when you’ve got it.
It’s not as simple, after all, as making and keeping friends might be when you’re well. (I wouldn’t really know about the later part, but I have my educated guess.) Even if you were once more functional and were close to people then (and for many people, that’s not the case) things change when you are mentally ill. Friendship becomes a balancing act that seems almost impossible at times.
If you’re sufficiently insightful, you may feel that you always have to watch yourself to ensure you’re not a “bucket dipper,” someone who takes far more than they give, and whom people only consent to be around out of pity. If you have mood problems, you have to figure out how you will keep your friends when you get manic and out of control, or depressed and withdrawn and glum. If you have anxiety, you have to be worried about putting yourself in situations that will trigger you. It’s easy for those sorts of issues to take the fun out of things.
People have their own lives. If you’re in crisis or just want to talk to someone, what are the chances they’ll be available at that time, and do you have any right to expect or even ask that of them? Should you call them up a week in advance and ask them to schedule a couple of hours for you on, say, Tuesday morning because you think you might be feeling crappy then? What exactly are the logistics supposed to be here?
And perhaps people who speak so flippantly about “support” don’t comprehend what it’s like to openly talk about thoughts or exhibit behaviors that will inevitably seem strange and irrational. As an example, I’ll hand over a pair of my shoes from today to step into for a moment. (It’s not a gift I give easily, so y’all better send me some presents. No puppies and/or ponies please.)
Say you’re having a rough time, you haven’t slept more than a few hours total in six days. You decide you want a smoke but don’t want to get dressed, so you stand, in your tee shirt and underpants, in your balcony doorway and blow the smoke out the door. Just as you’re finishing your cigarette, two young women walk down the block, look up at you and start pointing at you and laughing uproariously. Not understanding why you’re funny but still mortified, you look down at them and accidentally meet the eyes of one. She screams with laughter, slaps her friend on the shoulder, and shrieks, “Stare as scary as motherfuckin’ steel!” and then they continue down the street.
You put out your cigarette and step back inside and draw the curtains. Your vision is blurry, your heart is racing unsteadily right behind your uvula, and you feel faint and sick to your stomach. You’re sure that they’re still talking and laughing about you as they walk on, and that later they will tell all their friends about how stupid and ridiculous you are. You keep hearing their words echo over and over in your head, and you can’t forgive yourself for what an idiot you’ve made of yourself, because it just goes to show what a worthless person you are. You resolve not to go outside for the rest of the day because they might still be out there and will be horrible again.
But now you can’t stop thinking about it. You feel completely shaken up. Your ears are ringing and your hands are trembling. If those two normal-looking strangers couldn’t help cracking up and taunting you, then what must people be saying who know you better, who know all the other foolish, subhuman things you do and say? You’re probably the laughing stock of the town. All those times you’ve thought you heard people laughing at you, you weren’t just being silly about it, they actually were. This is proof. Now you know.
Eventually the thoughts tearing apart your brain and the sensations in your body become too much, and you end up in a fetal position on the couch pressing your palms into your eyes, rocking and whimpering. You really wish you could have a drink or two, but you can’t. You try desperately to remember the techniques that are supposed to help, telling yourself it’s not you, it’s your brain chemistry, it’s not helpful, etc. But you are unable to refocus to another activity, because you are at a loss to think of anything you would actually enjoy doing and you don’t know what the point is, all you want is to stop feeling so bad. You turn on the TV and turn it up loud, but your mind just keeps tuning it out and letting the thoughts rampage through again, no matter how many times you shoo them away or try to ignore them. You stay curled up and panicking until your mind gets so exhausted that you just shut down and can’t think or do anything for quite a while.
Now. If that happened to you, how many people would you feel comfortable calling for “support,” and what would you say to them? Would you recount what happened and how you acted? Would you tell them about the thoughts? Or would you be too afraid that you’d sound childish, petty, pathetic and, well, crazy? What would you expect them to say? Would you ask them to tell you whether people make fun of you? Would you believe them if they did?
And still moreso– if you were in the midst of that kind of thoughts and feelings and you felt scared and wanted someone to be with you, how many people in your life would you want to see you that way? Incoherent, blubbering, wretched, like a two-year-old having a temper tantrum. And again, what would they do? Do you even know what you’d want them to do?
How would you feel afterward– needy, guilty, ashamed? What will they think of you? Will they ever be able to respect you and enjoy your company after knowing how you really are? Perhaps you might think of the song Lean on Me, and then realize that actually, your well friends are very unlikely to ever need to lean on you in the same way.
Those are all very real fears, concerns and confusions that have to be addressed if you seek support. And if dealing with it once sounds difficult– what if your life was full of similar incidents, all the time?
Of course, I don’t want to belittle the fact that some mentally ill people do have a group of close friends and family members to whom they feel comfortable turning in distress. That’s wonderful, and they are very fortunate. But if you talk to as many mentally ill people as I have, I think you will come away with an accurate impression that we tend to be chronically, painfully lonely.
And it’s really nobody’s fault. It’s not the fault of ill people for being ill, but while many mentally healthy people are indeed intolerant and unsympathetic, there are also many who are kind and understanding, and it’s not their fault either. It’s not their “fault” for having functional minds and lives, it’s simply their good fortune, and it can make their presence and insights invaluable to those of us struggling with our own brains. It makes no sense to be resentful or critical.* It’s possible to have friends you really care about, and who care about you, without this necessarily making a functional support system.
There will always be people with and without mental illnesses, and the divide between them will always be difficult to cross. However, mental health care could be drastically improved by placing more clinical emphasis on creating, maintaining and utilizing social supports, rather than simply asking about them. And that also doesn’t mean teaching people to give a firm handshake and [pretend to] look people in the eye and then tell them to run along and play with the other kiddies, perhaps by joining a club they’re interested in. Connecting with others is a learned skill that’s really, really hard work when you’re mentally ill; asking for and accepting support even moreso; it needs to be addressed as a serious, in-depth and crucial part of any psychiatric care.
Come on, mental health professionals, if professionals you are. What are all those letters after your names for if you can’t give us better help than a kindergarten teacher could offer? You can do better, and we need you to.
* From experience, I am wary of friendships or relationships between two people with severe mental illness. Perhaps sometimes it works, but all I’ve seen of it, with myself and others, is a parade of triggers and escalations. For example, a bipolar person (no, not headcheese) driving home from work at 85mph so that she can talk her psychotic friend out of killing himself. If we were negative numbers, when we got together we’d add, not multiply. So while it may seem logical that people with mental illness should stick together, in my opinion it’s not the basis of a healthy “support system.”