• Mark Palmer

Out of Sight Should Not Mean Out of Mind

Have you ever thought about how much of modern life is based on the invisible?

You are almost certainly reading this via the internet, one of the most important tools in everyday life. While I appreciate that there is a physical aspect to the internet, for most of us it is something that is just there and we use all the time, only seeing the device in front of us at the time. We now accept this without question (until it goes down!)

Similarly, for many of us, money is becoming increasingly invisible. It is just a number on a screen. When lockdown first hit, cash withdrawals in some parts of the UK fell by 80%. We do more and more of our shopping online, spending invisible money on the invisible internet. We accept the invisible without question in some of the most important aspects of our day to day lives.

Yet when it comes to our health and wellbeing, we still struggle with the invisible. When we see someone with a leg in plaster, we accept completely that they are injured and will therefore likely have some temporary limitations on what they can do (though we should never make assumptions about this!). Similarly, someone with Covid needing a ventilator or additional oxygen to breathe is clearly seriously unwell. To suggest that either of these people were simply imagining their condition would be unthinkable to most of us.

But when it comes to mental health, invisibility becomes a big problem. I have had anxiety and depression for many years, and I can say without a doubt that they have impacted my life far more than any physical ailment or injury I have ever had. But because they are invisible conditions, it has been much harder to recognise and address them, and on occasion for others to take them seriously. I have been told on many occasions that I was making up my condition and using it as an excuse. If only – if I was making it up, I could have chosen to stop doing so, rather than continuing to have days when even a huge lottery win would have failed to stop me feeling beyond despairing!

This disregard for invisible conditions needs to change. We have spent over 2 years with our lives being governed by a virus, the effects of which could be widely seen, but which itself could not. Indeed, in retrospect, the lack of early understanding of asymptomatic transmission may well turn out to be one of the most significant episodes of the pandemic.

Mental illness is real. It can happen to anyone at any time, and there does not need to be an identifiable cause, just as you can pick up a bug or a virus however careful you are. We would not blame someone else or ourselves for contracting a physical ailment (unless they were completely reckless in a situation known to be highly risky), and the same should be true for mental illness.

This principle also applies to care and treatment. You can no more “pull yourself together” and “snap out” of depression or anxiety than you can from Covid or a broken leg. Yet after more than 30 years of depression and anxiety, I still tell myself to get my act together every day. It is just not that simple.

You would not dream of trying to carry on with your life as normal with a serious physical condition. Yes, you do what you can, but you recognise that your priority has to be healing and recovery. Nobody thinks any less of someone going to bed for a couple of days to try and sleep off a bad bout of flu. But do the same to get over a bad bout of depression and you may well be labelled as idle and self-indulgent. Such is our culture and the nature of mental illness that even if those around you do not think this of you, you may end up thinking this of yourself.

It is high time that we ended the stigma and took mental health as seriously as physical health. This means behaviour change as well as nice words. It is no good for authorities and employers to talk about the importance of mental health while continuing to treat people in ways which clearly contradict this, as so often happens. That is like telling people to take care of their physical health and then ordering them to attempt an Olympic downhill skiing run with no experience, training or safety equipment.

Taking mental health seriously means accepting what people say about what makes them struggle, even if it is inconvenient to your objectives. It means not telling anyone that they are just making it up and need to pull themselves together – just because you cannot understand what a condition feels like does not make it any less real. It means asking people what they need and what would help them, and acting on this.

Taking the invisible seriously is something we all do every day in some areas of our lives. It is high time that we treated mental health the same way.