By James Downs
CN: anorexia, bulimia,
mental health services, suicide
We experience the world through our bodies. Every day, we rely on however much physical health we have to meet our goals, from going to different places to taking part in the activities we enjoy, and generally trying to feel as well as we can.
Whilst being physically fit and well can feel great in itself, there are so many other things in life that we value which are more important, so many reasons why it is worth having a body in the first place. The same can be said for mental health. We rely on mental health to live the lives that we want, and even in the times when we struggle with our own thoughts and feelings and long to feel even a moment of well-being, we know that not having mental health problems isn’t our highest ambition. Trying to overcome mental health problems isn’t simply about wanting to not suffer any more: it’s about trying to achieve a life worth living, and doing all those things that we value, that give us meaning.
“I was more concerned with what I could do with my life instead: why should I give up anorexia or bulimia when I didn’t know whether I’d be able to find support in other ways?”
For me, a decade of struggling with an eating disorder, which nearly cost me my life on several occasions, involved deeply questioning the reasons why I wanted to get better. Thinking about ending my life also made me think about the things I’d want to stay alive for, and what I could do with my health if I recovered it. My eating disorder was a powerful way of coping with distressing feelings and severe emotional dysregulation, and without it – even though I’d be healthy – I wouldn’t be able to see what I had left to rely on. When I went through mental health services, I was often frustrated with the negative focus on giving up my problematic behaviours, how removing dangerous symptoms seemed to be the only goal. I was more concerned with what I could do with my life instead: why should I give up anorexia or bulimia when I didn’t know whether I’d be able to find support in other, less damaging ways?
In the end, one of the main things that drove me to access treatment and to get the support I needed was the hope of being able to do things that were nothing to do with mental health. Yes, I needed to replace my eating problems with healthier skills that I learnt as part of my therapy (DBT), but this was so that I could go on and do the things I wanted to, such as start voluntary work and eventually go back to university. Just like I need my physical health to go out to my lectures in the morning, I need my mental health to be able to sit and read, to concentrate or to not become too much of a perfectionist with my work. I need my physical health to go travelling in the summer, and I need my mental health to enjoy it mindfully, to be open to new experiences and to share it with my friends. Of course I enjoy having mental health in itself too: things I previously took for granted, such as being able to socialise without anxiety or to eat a meal with friends, now have an extra level of meaning to me. But appreciating feeling mentally healthy is only part of what I want from life.
“Just like I need my physical health to go out to my lectures in the morning, I need my mental health to be able to sit and read, to concentrate or to not become too much of a perfectionist with my work.”
The sad fact, however, is that in the society we live in, having problems with your mental health can mean that there are barriers to taking part in those meaningful activities that you value. Change is happening: for example, we are seeing more parity of esteem with physical health. But in context, participating in society can be a huge challenge, due to cuts to disability benefits and public services like libraries and leisure centres, a limited understanding of mental health in many workplaces and educational institutions, and barriers to accessing the support you need from the NHS. Supporting people is more than supporting them to not be ill: it is about facilitating them to achieve the things that they value and reducing the obstacles that prevent them from participating in society on an equal basis.
Being isolated from others and losing freedom is one of the most distressing things about mental health problems, which in turn thrive on loneliness, isolation, secrecy and silence. For this reason, it is important to recognise the role of a whole range of factors in maintaining well-being, from social and economic factors to the public services that we use. Saying that there is more to life than mental health, and more to providing support than traditional mental health services, should never be used as an excuse to withdraw services that are critically needed by so many people.
“Mental health problems thrive on loneliness, isolation, secrecy and silence.”
Of course, nobody wants services that promote dependence and become ultimately disabling by encouraging reliance, deskilling people from doing things that they would want to do for themselves. But this isn’t what real life support is. Life support is about enabling people to fulfil their potential rather than just getting by, to overcome the disempowering effects of mental health problems and build lives worth living. This process will be different for every individual, and we must remember that the road to becoming independent and engaged with positive activities is not always a straightforward one. People will always need professional support as they would with a physical disability: this should be seen as normal and nothing to be ashamed of, and individuals should be allowed to make progress at their own pace.
Looking back at my experience with mental health problems, it has certainly been a long and complicated journey, one that extends into the future as I continue to manage my mental health (which after all, is something we all have, whatever shape it’s in!). When I was in the grips of severe eating problems, my life was overwhelmed with mental health struggles, and I could rarely see a way out. Now, while mental health is a big component of my life, it isn’t all of my life. I’ve needed support, but with the right approach, I believe we can help all sorts of people to lead the lives they want whether they have mental health problems or not.