Wednesday, 30 November 2011

When we walk in darkness

“I’ve had plenty of opportunities to be depressed – I just haven’t taken them!”

The statement above was posted on a friend’s Face book page and it caused a lot of heated comment and condemnation, especially as it was reportedly said by a pastor. I have to admit that I agreed with the consensus, which was that such a comment was offensive and tasteless, not to mention possibly very damaging. It made me think both about how we can hurt people by making sweeping statements about very personal issues that we have little or no experience of, and it made me think about mental illness itself.
I also considered the statement in the light of Advent. The link between mental illness and Advent may seem remote, but Advent comes at the darkest period of the year and it involves a waiting, a belief that even if we walk in darkness, there may be light and there may be hope. Having suffered myself from mental illness, I know that it was not in any way an “opportunity” that I wanted to grasp. After the birth of my second son, a few days before Christmas, I developed severe post natal depression. Post natal depression has been described as crawling into a pit of blackness and being unable to find your way out; it’s not the sort of thing you sign up for!
Postnatal depression can progress rapidly from “the baby blues”, to acute depression, to borderline and then even full blown psychosis. I never reached the full blown stage, but I did reach a point where my thoughts began to seem like voices outside my control. When I became ill, and it is an illness, I realised something that I never had before. Before I had thought that the worst things to lose would be things like my job or my physical health. I had not considered the prospect of losing my sanity. I had worried about losing family or friends, but not of losing my identity or sense of who I was. It was as if I had walked out on myself. It was truly the most terrifying experience.
Advent is the promise of God with us. Christ came to the earth and experienced human life among the plain and impoverished, was born in unsavoury conditions, in exile, threatened by danger and persecution. To be human is to suffer; to be born is to die. It is not a pretty story any more than our lives are always pretty stories. So many human beings  walk in darkness.
Where was Christ during that black Advent and Christmas? Well, I think he was there in the love and support of my family and of my wonderful husband who did all the practical things and also managed to walk with me – and being alongside someone who is hopelessly and irrationally ill – suffering from an illness that you cannot see, is no easy task. Fortunately, perhaps because I received understanding , not  the sort of condemnation which would make my guilt worse, there was light at the end of my particular blackness.
Just as God came to suffer alongside us, to give us his light and to be with us, so we are called to be with others and to walk alongside them, to be Christ to them, especially when they are in dark places that we dread, or fear, or do not fully understand.

9 comments:

  1. Sue, this is such a powerful and moving post. Thank you for being so honest about your own experience of mental illness. I've once seen post-natal depression in a neighbour and it is a dreadful thing to go through. Closer to home two of my sisters have been diagnosed with bi-polar disorder, one mildly, one more severely. Both have their symptoms well-controlled by appropriate medication, but never would I think of what they have suffered as an opportunity to be grasped. Such crassness!

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  2. A lovely, heartfelt post, Sue. Thanks for being willing to tell your story.

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  3. Suem

    Thanks for this - which I found helpful.

    As you know I am at present coming to the end of my PhD funding & looking for temporary work while I write up my thesis. As a qualified social worker, agency social work is a natural port of call. I have 16 years qualified experience in addition to a consider unqualified experience. I have signed up with several agencies and each have been keen to sign me up. While going through my CV they have alighted on the fact I have had mental health experience and suggested a few jobs that they had on the books needing a mental health social worker. I pointed out I am not interested – give me palliative care, neuro-rahab or dementia care anytime over mental health.

    I am just not cut out for mental health social work. I have really enjoyed working with people who are seriously ill with some form of psychotic illness – be that depression or bipolar disorders or schizophrenia (and have considerable experience of both statutory and voluntary work in this field). But there is also what I’ll call the ‘culture’ of mental illness. i.e. the mental health professionals and agencies (which, ironically, can be pretty depressing in itself!); and the dependence and manipulative aspect of sizable MINORITY of people who have or had mental health problems. A good portion of the time and effort spent with people with psychotic illness is protecting them from themselves, protecting wider society (N.B. most people with mental illness are NOT violent or a threat to other people!) and protecting them from abuse (financial, sexual, physical etc.) from wider society (far more common than vice versa!). This is the kind of work I have really enjoyed. But I have also found it amazing that there are a goodly number of people with the label ‘mental illness’ who seem adept at manipulating situations for their own ends – and have a knowledge of the health and welfare system that puts me to shame!

    What I suppose I am saying is that there needs to be some discernment between what is helpful and what is reinforces dependence and keeping a person stuck in the same place. In John 5:6 Jesus asks of a sick man: ‘Do you want to get well?’ It is an odd question when you think about it, because we presume everyone wants to get well. But some people don’t – their illness becomes an identity and/or an excuse; I think there is a particular danger of this happening with mental illness. As you know I have suffered from depression and aside from its obvious and debilitating symptoms I am aware that there is also an aspect of self obsession, self-absorption and selfishness which further sunders the sufferer from their neighbour. The real challenge and problem for the sufferer and their friends and family is discerning where mental illness ends and just being a manipulative and selfish person begins. To put it succinctly, where do reasons morph into excuses?

    A comment such as: “I’ve had plenty of opportunities to be depressed – I just haven’t taken them!” demonstrates – in my humble opinion - a lack of sympathy and charity for others – and dare I say it, self knowledge. Sometimes there just isn’t any choice about becoming depressed. But I think care is also needed not to allow the person suffering from depression become dependent and debilitated beyond the period of illness.

    Advent is the beginning of the Church year – but it is not just the precursor to Christmas. It is the sibling of Lent and is actually a season of self-denial and preparation. Sometimes we do need the help of others to lead us from darkness into light. But occasionally we need a bit of a tug otherwise we can end up as beggars by the roadside, content to be the victim of the other people’s charity and a desire to answer Jesus’ peculiar question in the negative.

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  4. Hi Peter, I know what you are saying, tugs can be a part of recovery. I actually went back to work (part time) at the end of my maternity leave. A few people said to me "Will you cope?" but my doctor's strong advice was to get back into the everyday world and usual routines. I found the first day back fairly overwhelming, but within weeks I was so much better as a direct result of being at work. It is important sometimes to be robust - as my doctor was- with those who are depressed. In my opinion, judging when that is appropriate is part of the skill of a good health professional.

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  5. Perhaps we really need another word to describe clinical depression. Almost everyone thinks they know what 'depression' is, and they use the word as a substitute for feeling temporarily unhappy or distressed about something. In my experience with regard to clinical depression no-one has a choice. In my case it hit me like a ton of bricks out of the blue and I became pretty much non-functional. I tried to get back to work too soon, against my doctor's advice, and I ended up far worse. It's so hard to work out when one is 'better'. Perhaps some of us really never get better. Many people say of me that I have fundamentally changed since my crisis, and I'm not yet sure if I will ever be able to go back to what I was.
    The comment you quote is just so cruel! A part of me wishes that person could share our experiences. I don't think he'd say that again!

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  6. Suem

    Thanks for this – as you note it is the skill to ‘tug’ or to hold back which is the hard thing.

    Perhaps the comment your Facebook chum made was because s/he had had experience or had been on the receiving end of some of the more manipulative aspects of mental health issues? Personally I think tea and sympathy can only take a person so far. Soon after I qualified as a social worker I got a temporary job working for a mental health support organisation in Manchester. I was almost immediately promoted to temporary senior support worker because I held a qualification and had managed a residential home before qualifying as a social worker - the permanent senior worker crashed her car with a client with her and was found to be stoned on cannabis by the police – resulting in instant dismissal (sometimes the workers in social care have more needs than the clients!!). I managed a small unit for young people who had been discharged from hospital following a spell as an in-patient. The unit was two council houses knocked into one on a large estate on the outskirts of Oldham.

    The focus of the work was encouraging independence and the goal was to move the residents on to independent living. Thursdays were one of the worst days to work, because all got their money and headed off to the local supermarket and bought crap (mainly consisting of gateaux, cider and cigarettes – they were all Section 117 clients; i.e. a duty of aftercare placed on the local authority and therefore they could not be charged for their care, despite being in receipt of DLA which is paid to help with the costs of care, and hence all had a disposable income of around £100 p/w – this was in 1995). Sundays through to Wednesdays were pretty grim times to work too, as many had no money, no cigarettes and occasionally no food. Hence after seeing this take place for a few weeks I got the key workers together and suggested we encouraged budgeting. I assigned workers to go shopping with the residents with the aim of teaching budgeting and I made the safe in the office available to put some money aside for later in the week. Did this work? Did it f*ck. Every Wednesday a group of five sombre residents would swear this week they would budget – if I was working the late on the Thursday I’d come into a living room thick with cigarette smoke, 3 litre bottles of cider about the place and party food piled up on the table. During the weekly period of dearth a worker complained to me that she was sick of giving clients cigarettes. I told her just to say ‘no’ when they asked. I smoked back then and every client would try and beg cigarettes off me when they had none and I’d say ‘No – you get enough money every week – in fact you have a greater disposable income than I have - learn to budget; going without now might just make you think what you do with your money.’ Yet when there were problems in the house the clients came to me and not their key workers. I think the reason why was because I wouldn’t collude with them and remained outside of ‘their’ world. Yes, they knew I respected them – but respected them enough not to keep them in dependence. Several went on to independent living. I will add that in part, the problem was the staff, who didn’t have the skills or ability to say ‘no’. Or to encourage helpful behaviour – and of course in ‘caring’ they met their own needs and gained considerable power over vulnerable adults. Yes, I did plenty of tea and sympathy, but I could also be quite brutally honest when behaviour, not the mental health problems per se, resulted in difficulties. The real problem is discerning when to chide and when to bless!

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  7. Hmmmm, well, I think in your line of work you see a lot of damaged people whose problems certainly aren't easily resolved! I am not sure all of that is attributable to mental health problems, although it is hard to distinguish the parameters between mental illness/ emotional problems/ poor self image/ self destructive behaviour. I know they can all mesh together into one messy knot! I know from dealing sometimes with very damaged students that their problems are very complex and they can be self destructive and manipulative. You are damned if you do and damned if you don't in your dealings with them and you do have to accept only they can ultimately solve their problems. I am not really talking about a saccharine "love" when I talk about walking with people. But I know if people hadn't kept trying with me - possibly when they really wanted to throttle me :)- I wouldn't have developed the strength to face the issues and difficulties.

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  8. I am sorry to hear about your experiences, Simian. I remember the "non-functional" feeling. It can knock your confidence, but I really do hope you will be able to get back to where you were, or at least to feel you are fully well again, even if you find yourself in a slightly different place.

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