Battling anxiety: ‘Our mental health system needs to change’
Lauren-Shannon Jones writes about the difficulties in getting help for mental illness
Lauren-Shannon Jones: ‘Opening up to people about mental illness feels good.’ Photograph: Alan Betson
I was wearing tracksuit bottoms and a T-shirt because I hadn’t been able to dress myself very well for the previous few weeks. Everything I wore made me feel ridiculous in the face of what I was going through.
With mental illness there is often an impulse to bring the inside out, to show some physical evidence of the screaming turmoil within.
In the past I would burn myself with cigarettes and bang my wrists on the corners of furniture. Now even that felt stupid and exhausting so instead, I didn’t wash my hair. I didn’t eat much either.
And on the day that I finally decided that I had to see a doctor, I wore what I had worn for the past three days before that – grey tracksuit bottoms and a black T-shirt.
In the waiting room of the GP’s surgery in Dublin, I took my coat off and I noticed that the T-shirt was covered in dog hair. I put my coat back on.
I thought afterwards that maybe that had been a mistake, that I should have dressed up a little. That maybe looking too much like a self-neglected crazy person had sold it too hard.
It was too hot in the waiting room and I couldn’t take my coat off, and I could feel the panic starting the moment that I sat down. My heart was punching out of my chest and I felt a sense of desperation. That’s always how it begins, with a desperate impulse to escape that comes from nowhere. It’s a fight or flight response that doesn’t make any sense.
Who needs to escape from things like brunch? Me. I do.
Anxiety was stealing away fun little moments and returning them misshapen, as threats.
I went to the receptionist and asked if I could wait outside for a while. I told her it was because it was hot in the waiting room and I felt faint, but really I badly needed to get my heart back in order, because I felt if I didn’t, I was going to die. But I was too late, because that’s when the doctor called me in.
Rush of tears
I sat down and took my coat off, taking a moment through the panic to be ashamed of the dog hair.
I felt it was horribly inevitable I was going to cry. I had come all this way, walked here with as much dignity as a girl wearing a gigantic coat over three-day-old tracksuit bottoms could muster, and now I was going to cry in front of the doctor.
It all came out in a big rush. I needed to get as many words out as possible before having to swallow the cry down.
“I’ve been having a lot of trouble with anxiety and now it’s at the point where I can’t do much anymore.”
“And I was wondering if there was something I could take for that.”
She took a long moment to stare at me before asking if I’d tried therapy. I told her I had been in therapy fairly regularly since I was 11.
Personally I don’t know anyone who’d be willing to take medication as a first resort .
“We don’t give out Valium and Xanax here because they’re habit-forming,” the doctor told me. I hadn’t asked for Valium and Xanax.
“We don’t have any record of you at this office. Who is your GP?”
I told her my GP was in Ballsbridge.
“Then why did you come here?” she asked. She looked put out.
I tried to explain to her it was because I couldn’t take the bus anymore. I couldn’t get on any public transport, and taxis weren’t an option either today because the panic was so bad.
All of the things I couldn’t do anymore started piling up in my head, and I realised that this really was it.
This was my last chance to solve this, because I was too sick to go to brunch, go for a drink, get in a car, or go to a friend’s birthday party, and nobody can live like that for very long.
My options at that point were sitting in my house, shaking, or walking my dog, while shaking.
I started crying. It just melted out of me in horrible, desperate sobs. I was alone in this room with this incredibly unsympathetic woman, and this was my last chance to get my old life back. My old self back.
The doctor pushed a box of tissues across her desk and sat back in her chair with her arms crossed. She looked like somebody not enjoying a terrible play.
I was trying to get myself together in all the best ways, by reassuring her over and over that I was okay (when I definitely wasn’t), pressing the heels of my hands onto my cheekbones and looking up at the ceiling while making insane gasping noises. This went on for ages. The doctor didn’t say anything.
When I had finally exhausted myself, she asked me why I was crying. She sounded very bored. I realised then that if I left now, I would walk straight out into traffic, so I went very calm and asked her to please refer me to a hospital because I didn’t feel safe.
“You can go to the emergency room but they won’t be able to do anything for you there,” she said. She was acting as though I was a normal person and not a trembling, covered-in-snot person.
She was speaking to me breezily, as if me breaking down had been very awkward for both of us and she was now doing me a favour by pretending it hadn’t happened.
“I’ll refer you to the unit in your area, but it will take a while to process,” she warned me.
A while? But I was ready to walk out into traffic right this minute. A while was too long. I needed her to understand that the only way I could safely leave this building was in an ambulance, so I leaned forward and told her again.
“I don’t feel safe.”
I had to whisper it because using my outdoor voice would start the crying again, and that had obviously been awkward.
“I can’t give you anything today,” she said very clearly, like someone talking to a child.
I started nodding, because I understood. I kept nodding all the way out of the room and was still nodding in agreement while I paid, then dropped my change and the receipt because my hands were shaking so hard.
In retrospect, I suppose the behaviour of someone deep in a mental health crisis does somewhat resemble the drug-seeking behaviour this doctor clearly suspected me of.
The thing is, when somebody goes to seek help, that can often be a last resort rather than a first step. It needs to be treated with delicacy to stop it turning into a final straw.
I was treated like a criminal for trying to climb out of the pit of depression and anxiety that was slowly destroying my life.
In the moment I most needed to be understood, a doctor misread me so absolutely that they sent me back out onto the street in a far worse condition that I had been in when I arrived. It felt like a suckerpunch to the gut. It felt like complete hopelessness.
I stood on the street outside the surgery and managed to call the helpline at St Pat’s. I don’t know who the woman was who answered, but she saved my life. I made it home that day, and I’m slowly getting better. And I can talk about it now, which is the most amazing thing.
Opening up to people about mental illness feels good. It’s like being stranded for years on a desert island, and then one morning the mist clears and there’s a hundred other people on a hundred desert islands all around you, connected by sand bars under the water.
The more people I talk to about it, the more experiences I hear about that are similar to mine. I’m not certain what the answer is.
I understand that doctors need to mindful of drug-seeking, and that it must be difficult to balance that with their duties of care. Perhaps more specialised training is the answer.
For sufferers, openness can help. I have a friend who suffered a bad patch of debilitating anxiety and depression last year, and the most comforting thing in the world was to call him up and ask him to “tell me again about how you got better”.
The Irish mental health system is incredibly difficult to navigate. It needs to change. And it really does start with talking about it.