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Wednesday, 13 August 2014

No Title: There are Just No Words.

This isn't really a post that has too much to do with Doctor Who. But it is still a post that needs to be written. Because something cannot be seen if it does not exist.

Mrs Doubtfire is quite posibly one
of my favorite movies ever.
By now, everyone who knew who Robin Williams is (note that I refer to him in the present tense--he will always be alive, in our minds and on film) probably knows that he has died. If you had not, I am so, so sorry to be the one to break the news to you. I can't say that a celebrity's death has ever caused an emotional response as deep as his passing has. The fact that it is likely a suicide makes it even more close to me. As soon as it was revealed that it was a suicide, everyone who had ever loved Mrs Doubtfire or Aladdin has immediately become The World's Best Suicide Prevention Advocate. While it is fantastic that the issue is getting the attention it is due, why did we need to lose one of the century's best performers for it to have that attention?

People assume that depression, and mental illness in general, is something that is obvious. But it's not. It's something that can hide for a long time, even in plain sight. 

Those of you who have seen this post already know about my struggles with my condition in a broad sense. But let's talk, let's really talk. 

The big thing that set my mental illness into motion happened in 2004/5. In short, and not to disclose any one else's personal information, my parents separated. I was about 10. I did not start self-injury until I was almost 17. The signs were there. Everything that would build up to that first cut fell into place quite nicely. So incredibly quietly that I was completely unable to identify how it all began until quite recently. I laid those pieces, some of them, in response to others being laid. Like how when you do a puzzle, to extend our metaphor, you put together the outside pieces first (if you didn't know that, enjoy your pro-tip for the day!) Yes, I made choices. But those choices were made in response to my biological programming having an error. If you're familiar with Star Trek: The Next Generation, (if you're not, go watch it; it's fantastic!) you know that Data's positronic brain establishes pathways in response to repeated stimuli. Ours do as well. It is a basic part of how we learn. We see a colour, someone tells us it is purple. Wash, rinse, repeat. Eventually, you learn that that is purple. This is how almost all learning takes place.

I'll get back to the point. The more those connections are reinforced, the stronger they become--and the harder it is to break that pathway. It becomes a habit. A few years after that habit was developed, I reached a roadblock. That behaviour was no longer producing the desired effect. It's like how an addict eventually needs more of the drug to get their high. (Do NOT read that as that I had done drugs. That is not the habit I am referring to at all.) So, my "drug-of-choice" changed. It became self-injury. No--not became, the self-injury was added to the mix. That first disorder did not leave.

Since this is primarily a DW blog,
lets add some DW to it.
A sad byproduct of self-injury that it is not only a sign (a very big, red sign) of depression, but it also causes depression if the person isn't already depressed. It's a bit wibbly-wobbly: the cause-to-effect isn't always what it is assumed to be. I don't know which came first for me. But I do know what happened next. I became suicidal. I lost count, but am proud to have survived no less than 4 suicide attempts. A lot of that number depends on what one considers an attempt. But the only person whose definition of attempt matters is mine and my doctor's. 

Ultimately, I had over five hospitalisations in a psychiatric unit, all occurring within two years of each other. This November will mark two years since the end of my last stay. Hopefully, that date will stay that way. 

When someone has cancer, it starts in one part of the body and can spread to others if not accurately diagnosed and treated effectively. This process is called metastasis. Mental illness does this as well. Of course, it all stays within your brain, but it moves to different parts, different manifestations, often without leaving that first place entirely, if at all. And just like other, more physically tangible diseases, it can leave it's mark on your body. Self-injury in all it's forms is not only seen in depressed patients. (Fun fact? We are not the only species to self-injure.) It can happen in patients with a multitude of disorders. 

"So, Ley, what are you getting at?"

Here is what I am getting at. The biggest thing we need in to do to prevent suicide is talk. I did not talk about that first disorder because I was scared of the consequences--disappointing people, losing friends, the whole deal. Because I was worried about people's reaction, it didn't get any light thrown on it until it was--almost--too late. If that stigma hadn't been there, if I wasn't worried about getting in trouble, there would be a totally different outcome. The fact of the matter is that even as I write this, I have a filter, because I know the same people who I didn't want to disappoint will probably see this, even now that I know that doing what I did wasn't quite as much of a choice as it was a requirement of my biology. We need to recognise that mental illness is not a choice the patient makes. I didn't wake up one morning and thing, "You know what would be fun? If I establish a set of learned behaviours that will ultimately lead to multiple suicide attempts! Yeah, let's do that." Once we rid ourselves of the assumption that people choose to have a mental illness, we can talk about it. And once we can talk about it, we can prevent it. Maybe Mr. Williams' death will really start a conversation about all this. We've been dancing around the issue of mental health for far too long. Let's not just have this death be a point in our society's road where we could have taken a shortcut but did not.

I think it's at least worth a try.

If you or someone you know is having thoughts of suicide, please, please contact the National Suicide Prevention Hotline at 1-800-273-8255. If you live outside the US, click here for a the listing of the equivalent service in your country. It will get better, it really will--I promise.

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