Mental health is all about how we feel, think, and behave. According to WHO, 1 in 4 of us will experience mental health issues in our lifetime. Regardless of this fact, very few of us seek treatment, care, or even someone to lean on in our times of need, perhaps down to neglect or maybe even social stigma. But how can we change all that? Let’s talk.

Roger pauses mid-stir and looks up at me as he appears to second-guess himself. “It doesn’t make a difference to you though, does it? Just write the article and if I want you to take my name out later, I’ll just let you know and you can take it out, right?”

He returns to his coffee as I explain that, depending on his decision, I will take one of two approaches.  In including his name, I create a champion of normalization, an open advocate for conversations that need to happen in Gibraltar and across the world: a young man, unafraid to speak of his own experience with mental health issues. He nods approvingly – we’ve spoken in the past on the importance of making mental health as approachable a subject as that of physical health. “But on the other hand, if you don’t want your name in the article, I understand completely. In that case, I would write about the need to maintain some degree of secrecy in a world in which your peers and employers, present and future, might make judgements and snap decisions based on their limited understanding of mental health problems.”

Roger mulls it over briefly, then tells me to include his name. “I’ve spoken about this publicly before”, he reasons, “it shouldn’t be an issue”. Frankly, I am less certain. I tell him as much and repeat my assurance that he can change his mind at any stage. With that, he launches into a vivid account of what it is like to sometimes occupy the fringes of your own reality. “Everything seemed normal but I wasn’t part of it.  My mind wasn’t synced with what was going on around me…”.

***

In recent times there has been an unprecedented jump in the number of suicides we’ve seen in Gibraltar, and in their wake, broken hearts and unanswerable questions. Those closest to the departed have suffered a loss that most of us can’t hope to understand, but while these few will feel the pain of what has happened most deeply, a shadow has been cast on our entire community.  Mental health issues are often inextricably linked to suicide and while countless factors can affect an endless variety of specific situations, a common thread runs through these cases such that a conversation must take place about how we, as a society, can make progress in this area.

There is an understandable temptation to think back to how we might have otherwise influenced those who took their lives, but it seems to me a better service to their memory that we look forwards, and ask how best to prevent a recurrence of these tragedies in future.

It is with this in mind that I meet Roger, to speak of his first-hand experience with bipolar disorder.  Previously known as ‘manic depression’, bipolar disorder is characterised by swings between periods of depression, and of a highly elevated mood. Depending on the severity of the disorder, the periods of depression can be intense, and the elevated moods can reach levels defined as ‘mania’, during which the individual may experience psychosis. Roger had experienced serious bouts on both ends of the spectrum and was willing to paint a picture for me of how it had felt from the inside, looking out.

***

“Because everything you do has some flow”, he continues, “in extreme cases, you have professional athletes when they compete, or chess players, but even in normal life, everyone has a flow to what they do and when I’m depressed, that completely goes. Everything then breaks down, the gears grind to a halt and everything, the simplest things, require this extra mental effort that takes you completely out of the ‘now’, so you can’t experience life in, like, a normal beat.  Everything is unintuitive and slowed down and it makes you feel very, very aware of yourself, because you can feel that you’re having problems in processing and functioning in the normal way. And it makes you feel really isolated. You can’t look people in the eye when you’re talking, because you’re so aware of what you’re saying and so worried of what they think… Everything grinds to a halt.  Every process. So it doesn’t feel like you’re in life. It feels like you’re just attempting to be in life.”

It comes out in a flood, with barely a hesitation. I interrupt at this point without much grace, eager to note my own experience in this area; the sense of dissociation from everyone else is something which strikes a chord with me and it’s a feeling I imagine is shared at times by many others, to a greater or lesser extent. And therein lies what ought to be an illuminative truth about mental health – none of us have it perfect.

As Roger continues to build his narrative, I am struck by the disparity between the outward impression of the person I’ve known since the age of about 12, and that of the personal experience he is relating. However, certain traits that have always characterized him are what make this interview possible where others might have hesitated. There is an analytical tendency to Roger which he has turned on himself, and while this is certainly a help, it is his openness, his very direct nature, which I feel separates him from most. He doesn’t shrink away from conversations which continue to be shrouded in stigma and taboo, which people may speak about in abstract terms, but which we shy away from when they get a little closer to home. We have come some way in making mental health in general a subject we can freely broach in conversation, but there is still often a great reluctance to speak of our own.

And the shame of this is that perfect mental health is as unlikely as perfect physical health. Some obviously face bigger obstacles than others, but it is extremely unusual that someone go through life without so much as a sore throat or a case of the sniffles. So too does this apply to our mental well-being, and whether it’s brief anxiety or a debilitating breakdown, the knowledge that we all have our imperfect moments should spur us to reach out to each other more openly. Certainly in times of our own need, but also when we might offer our own shoulder for another to lean on.

Some problems are inescapable, some cures will continue to elude us, some tragedies undoubtedly await. But when we speak of social attitudes to mental health, the ultimate aim has to be an environment in which existing issues aren’t exacerbated by the added stress of secrecy. Creating a culture of openness and reciprocity is within our reach and we should be actively working on. making it a reality.

 

BY IAIN TRIAY-CLARENCE