Ireland’s Health Service Executive puts forth great effort in preventative care for our physical health. Off the top of my head:
- Semi-socialized healthcare. The Medical Card insurance system ensures that affordable primary care is within reach of the financially vulnerable.
- Subsidized general physicians, prescriptions, and emergency hospital treatment.
- Preventative screening for certain cancers and physical conditions, along with free/good-as-free winter immunization clinics.
- Anti-smoking laws that are rather harsh by American standards.
- A burgeoning movement to introduce laws that will restrict junk food in a like fashion.
- In schools, our children are encouraged into physical activity.
And so on, but for our physical health. I am at a loss when it comes to a description for a mental health equivalent. There are no awareness campaigns at primary or secondary levels in schools that I am aware, nor much discussion between friends and family; indeed, there are big taboos still because mental illnesses are invisible-if I am physically fit to participate, why don’t I participate? So there remains deep-set misconceptions, ignorances, expected silences, and occasions of outright and disgusting bigotry around mental health issues in Ireland, especially among the older population.
My mum is case in point: No matter how I explained my problems her, despite whatever carefully-picked words I used, and in blithe ignorance of my painfully-written letter, she simply could not and cannot grasp my flirtations with self-harm, self-hatred, suicidal ideation, and depression.
She resolutely puts the horse before the cart: I’m not idle at home because I’m ill, but instead I am ill because I’m idle at home. A job will break me out of this. I may as well have spoken Klingon when I tried to explain for the fifth time that I there was no point in trying to find a job if I was unstable and at risk of another breakdown. My mother truly cares, but she is completely unable to understand it, because it was simply never discussed.
Even in the younger population, there can be pressure on you to sit down, shut up, fit it, and be healthy. Although I’ve had the immense luck to be surrounded by understanding friends and housemates in Galway who had their own demons to wrestle, I have seen firsthand people who were pressured by friends and coworkers to just get over it and be well again. Any whisper of mental problems at all in the workplace may as well be a death knell for your career-in my own job hunt, I’ve already run into concerns from potential employers that, at best, I’m a risky investment. Sure, Mark’s intelligent, but eh. You know? What if he goes all crazy again?
Despite all this, preventative care for mental health is nonexistent in Ireland, and post “incident” care is limited. A GP can issue a tentative diagnosis for stress and depression, but his or her ability to treat this is restricted beyond a referral to HSE services and a prescription for Lexapro. It is crass and unfairly reductionist of me to to word it so, but a GP can be looked at as a human version of WebMD or Google: They can diagnose and refer you, but they simply do not have the time, expertise or resources to treat you at the root.
I have had four encounters with therapy services between 2010 and 2014, and every single one was inadequate, although I didn’t cop onto this until later
I tried to commit suicide in 2010, realized just what was going on, and presented myself in the casualty department of UCHG. In conjunction with my family GP, I was trialled on several antidepressants, and referred to an emergency counselling service at Shantalla in Galway.
She helped with the immediate anxiety, but there was no cross-examination or any other questions asked. She sat there and listened while I talked myself down over the course of five or six sessions, then pet me on the back, and send me on my way. There were not attempts to uncover issues that I only became aware of in hindsight.
The second time was on campus at I.T. Sligo in late 2012. This counsellor was provided through the college, and just first, she did work talking me down from an anxious high, but like the first she wasn’t able to tackle them before I hit the limit on allocated sessions.
I tried to commit suicide after this, just before Christmas in 2012, and I turned to my GP in Sligo for help . He was useless.
He stuck his fingers in his ears, chanted “won’t prescribe anything, can’t help you, go to therapy, goodbye” and shoved me out the door with a blister pack of sleeping pills and a letter of referral to a community service in Sligo that at the time I mistakenly thought was provided through the HSE. This third counsellor told me to pray for respite and salvation, because the service was in fact provided through the Roman Catholic Church. I was in a room with a crucifix on the wall after I had attempted suicide, and I was being told to put my hands together and “…appeal to a higher power for respite and solace from your troubles.”
I’m not religious, I have never been religious, I am likely never will be religious, and although I could less who or what you may believe in, I still feel offended over the situation-would it have been possible for her to ask me?
In each case, I can’t blame the counsellor in question for how they interacted with me; I’m one patient among many, the services in each case were metaphorical boxes of sticky plasters, and there simply wasn’t enough time for them to build enough of a rapport with me-even Prayery McAwful in Sligo. If you’re feeling down or stressed, these are the services for you. If you have gone through major trauma, don’t even bother.
All of this is a roundabout way to come back to my fourth ncounter with counsellors, this time through the HSE’s Counselling In Primary Care (CIPC) service in Newcastle, Galway. I had a bad trigger event come at me unprepared, I snapped, I retreated to my attic basement, and I quietly sobbed and cut my arm up for a good week until friends prevailed upon me to see my doctor.
My GP in Galway proverbially hugged me, apologized for the lack of care in Sligo, put me back on Lexapro for anxiety, gave me a letter of referral to CIPC, and sent me back out the door. I was stuck in waiting list limbo until the middle of February because of a mix-up in the correct contact number for me, but I was finally reached and given an early March appointment.
I had a single thirty minute interview with a CIPC counsellor wherein I was interviewed for suitability, and basically found to be too damaged for the service. CIPC is supposed to be for people who have clear-cut problems. Bereavement and stress are the lynchpins of the service, where I have clinical diagnosis of PTSD, Major Depressive Disorder, and enough time on my hands for introspection that I’ve been able to put my finger on some of the deeper causes. Yeah, no, sorry Mark, there’s the door.
All of my experiences have led me to believe that Ireland has awful mental health care on the whole, although there is pretty solid crisis care both from the HSE and from the community if a person threatens to self-harm-there is widespread awareness of suicide and its hidden danger-but meaningful long-term therapy either nonexistent or simply out of reach if you live outside of a major city.
I’m loathe to bitch and whine about faireness, because we both live in a world where I’ve seen precious little and because karma, but after I turned to the HSE for help I was put into a weird bind that required me to get better, find a job, and make money so that I could pay for the kind of serious treatment that I needed to get better, find a job, make money, and pay for treatment.
In the end I got well in own time with the almighty assistance of close friends, and now I’m trying to find a job so I can make the money in order to pay for treatment. Yay.
Mum fell out of bed last Thursday morning at 7am. I had to roll out of bed, run across town, fetch her back into bed, and make her a quick cup of tea before the crack of dawn.
Mental Mona just glared at me for the wishy-washy tone I would have taken, so:
I’m deeply concerned about mum’s reduced mobility. She has a severe form of arthritis in her right shoulder which has reduced that arm’s function to almost zero. She can stir a cup of tea on a good day. Mum is old and invalid, and this is only going to continue. At best mum won’t get any worse in the near future. At worst there’ll be sharp and sudden decline to complete dependence. But this the real world, and so mum will struggle on in her lonely independence, and downplay her condition, and quietly increase her reliance on Jenn and I.
I’m concerned because I don’t want to be caught as her caregiver. Jenn has Ella and Oisin to take care of, and Frank has done his best to keep himself scarce around Prospect Hill this last year. I’m on the dole, I haven’t hobbies, and my own family is conveniently located halfway around the world. I’ve seen the awful toll that caregiving takes; Holly was reduced to tears more than once, and finally just said “no more” because she just couldn’t cope any more; and I saw what mum handled with nan-and that with dad gloomily smoking himself to death at the exact same time.
It’s awful to sit there and watch someone rot away, and I want to skip out on that. Mum asks me to move back in at least once a week, like patient clockwork. I’m happy to help for now, and get off my arse to go up every day. I love mum to death, but I’d almost move back in with Mariah before I would move back in with mum.
One of the earliest posts on my blog was a February 2006 reflection of my relationships and friendships. I felt an update was needed.
One half of my backfill has come from take old photographs from the all the different image hosts that I’ve used down through the past years. I create new and backdated posts for these images.
The second half of posts are those that in need of minor attention in order to bring them up to the standard I’ve used since 2010. Fix the link, check the spelling, add the tag, pick the category, save the post, go to the next, repeat.
The tiny third half of posts are that aren’t complete, where I either told a half ofthe story, self-censored because I feared a backlash, I wrote in the assumption that the reader would be familiar with the subject, or I simply forgot. That hasn’t worked out too well. Acquaintances and readers come and go, friends shuffle off this mortal coil, I’ve forgotten just what I wanted to allude to, or I simply feel it is time for me tell the full story.
The third of the two halves of posts are the ones that take up the most time. I mean, I can draft, write and publish a new posts in under sixty seconds. It takes less than ten to fix an image’s broken link. But when it comes to the parts of my life where I find that I still have a story to tell, I mark myself as offline, roll up my sleeves, pull up the reference material, and write.
There isn’t a whole lot of preparation or order to how I tackle posts; I just pick a month at random and dive right in, because otherwise it becomes a chore, chores lead to boredom, and boredom leads to video games. My current block of posts is from the first six month of archives. I culled about thirty posts where the images no longer existed (on Photobucket of all places), fixed a lot of broken HTML, added a handful of images to Dropbox from Flickr, and rewrote two posts to everyday standards of grammar.
Almost the first post I ever wrote on my site, when the blog was only two months old was a spiel made on and about Saint Valentine’s Day, and how I connect with other people. I was young, naive, and sheltered (and pretty dumb if you go by my original spellings-did I even know what the fuck a spell check was? :/ ). I embraced the whole “forever alone” thing with a wink and a smile. I mean, fuck, Me? Friends? Lol, so silly! I’m happy alone. It was a cringeworthy post, and I dutifully cringed. Christ, I even made a shitty joke about oral sex, which is only funny now because I was basically a virgin who still lived with mummy when I wrote that post.
The date and subject of the post are noteworthy since Saint Valentine’s Day has come and gone again this week past. I’ve changed since the first post, and Jenny and Holly have both encouraged me to revisit the past without taking Mjolnir, hammer of Thor, to the stupider parts.
For all of our sakes, I’ll ignore the awful prologue I wrote for that post. Or that I wasn’t even honest, because I was in the middle of a heated entanglement-I had already found for myself a goodly measure of satisfaction and happiness.
I hadn’t experienced true loneliness when I wrote this post. I dabbled in it, enjoyed a touch of the rare old Irish isolation here and there, but I hadn’t yet been physically cut off from my friends and family by oceans, deserts, continents, and entire timezones, or retreated to my room, grew a majestic beard, and spent like a year as a nocturnal hermit, because I was hurt and fuck off other people. The latter almost killed me, because there was no there to catch me when I crashed. Nicole was my angel, but even she could only do so much when I turned off the computer, pulled out a knife, and decided to cut my arm up for reason of both business and pleasure.
There’s nothing morally wrong with introversion at all, and you should always be free to follow your own path to happiness. If you like people you like people, and if you don’t then you don’t. Many of us cannot either abide or manage the contact of others, and minimize it. I’m one. I’ve become less of a hermit as I come through the depression, but I’m still sensitive to groups of humans, and the pressures they can put on me.
Whether or not being an introvert is healthy for you is a superior question. There are some great perks with being asocial: You have the freedom to do whatever you like, whenever you like, without the need to plan ahead with others.
Unfortunately, when you go to the places and do the things, you start to notice that you’re alone, and loneliness creeps in. Your cat can’t sanity check your behaviour if you start to act abnormally, nor can your dog pull you up when you hit rock bottom and all you see is The Problem.
The unflagging love, support, and care of all of my friends and housemates is what has kept me alive. Nicole held my hand through my worst manic spells, Jenny is the sweetheart I can’t caustically bitch to about anything (anything), and Holly’s lovingly lanced more than one abscess with her eternal cheer. Alanna and Casey took me into their home and put a roof over my head. It was the physical security and peace I didn’t realize I needed until I had it. Sometimes Alanna and Casey even eat the food I cook without blanching.
I still hate most people, insofar as I hate that I have to interact with you. I know you’re blameless. I know you have an internal life as rich and full as my own, but I don’t want any part of it. I want to talk to you and complete our transaction without crossing your conscious threshold and Becoming Noticed.
I am, I guess, still an introvert, although now I’m an introvert who cherishes his friends and recognizes that some amount of physical interaction is extremely healthy, and helps to sanity check my behaviour-if I act crazy, some helpful soul will tell me.
Out of that entire post the very least I’ll grant you that I remain a massive geek, although I’m kinda over whatever the latest and greatest book or television series might be; I see them all as just vomited-up collections of the same tropes. I’ve moved on to programming, hard science fiction, and, occasionally, a stolid bottle of whiskey to wash down some godawful shooty-explody space opera.
Cory Doctorow’s Eastern Standard Tribe was spot-on. Mr. Doctorow always looks ahead, and in EST he foresaw our online social networks, distributed work groups, and ubiquitous smartphones, all years before they arrived in the real London and New York.
Did I really wonder what couples were like? I’ve been there. Got engaged, got married, had a kid, had another kid, separated from Mariah, reconciled with her, was almost murdered by her, and separated again. I suppose I’ll eventually divorce her.
I’ve formed and broke several other relationships since, even had flings with a few women who were the same age as I was when I wrote this post. They were vapid bimbos with no life experience. They haven’t been through the grinder, and I struggled to find interests in common. Sure, you’re sweet, you’re sexy, you’re actually pretty smart, and you have boobs that could smother me, but I honestly could care less about your favourite soap opera or celebrity.
I know what it is like to be one of those couples now. The fights, the friction, and the small lies to smooth the path. The love and elation, and the raw pleasure of physical contact. I wish everyone well with that.
And, oh god, kids. The original post was made maybe a few weeks before I sparked up any serious conversation with Mariah. To Forever Alone Mark, kids are bizarre creatures that make noise and trash the house. Now I have two, most of my friends have least one… and actually, kids are bizarre creatures that make noise and trash the house.
Children are apparently as universal constant as c in a vacuum.
These were originally comments made on a Facebook photograph, which I’ve edited slightly for this format.
Michael, if you say that then you really don’t grasp how suicidal ideation or severe depression work. I can’t blame you, because it is so very hard to put yourself into a broken mind, but it’s still a glib sentiment that I can be annoyed by.
I made my own snarky comment since I’m a two-time suicide survivor, and someone who had a fixation on death for something like two years. It sucks, it’s hard to live with, and you eventually get to the stage that the simple fact you are in this state compounds your illness. Holly knows all of this, so I said “fuck it,” and typed.
When you are in this state, several things go on at the same time:
- The Problem. The Problem is the alpha and omega of your life. While a great many lesser and greater things all contribute to your condition, The Problem is a three hundred pound tusked orc monster that never stops chasing you, not for one moment.
- The Problem is insurmountable and unexplainable. You cannot see any way around, over, or through it. Nobody else can really understand The Problem like you do.
- By this point, your self-esteem has tanked to next to nothing. You are a worthless failure because you cannot resolve The Problem. You feel like a burden on your friends and family because of The Problem, which might seem so minor to them.
- Because of your self-esteem, you are loathe to even reach out to others who have also had the same Problem. You feel bad for dumping The Problem on other people, for any reason, so you bottle it up. The Problem cast a spell of shame on you. You wake up some random day and discover that you’ve forgotten how to tie your shoes. How the hell do you ask for help at the age of 30?
- You want to get away from The Problem, however you can. Some people turn to substance abuse, other people (me) self-harm, because it makes the loathing and sadness bearable, at least for a while.
- It can be hard to communicate The Problem and your associated issues to other people, without triggering a huge overreaction because they are afraid that you’ll slice open your wrists then and there. Maybe you just want to talk, eh?
All of this is an abnormal mindset, but just like any other mental illness, it seems completely normal, logical, and grounded in reality to the person who is ill. After a while it becomes who you are all the way down to a cellular level. You become afraid of a cure, because you are so used to The Problem.
Mostly, you’ll live day to day with The Problem without much external sign of it, until holy shit trigger event. Some teeny-tiny thing occurs. It can be anything.
For me, the first time was when I accidentally put an iPod in the wash, and the second time was when I was killed by another player in a video game. It was the last straw. I’ve had all this undeserved shit in my life, and now I’ve fucked this simple small thing up too?
This is proof-positive that you’re a burden on the human race, so fuck it, let’s just do this motherfucker. This happens in the span of a breath, and you won’t show any outward sign of what has changed inside. You smile, you nod, you chat and respond normally while you root through the kitchen counter for your knife sharpener. If you have any emotion, then it’s probably a kind of bittersweet elation, because you’ve finally accepted your failures and come to see that death on your terms is better than life on The Problem’s terms. The weight of The Problem slips off your back just like water off of a duck’s. You’re free at last.
So I died in a video game and twenty minutes later I had cut my arms to bits with a kitchen knife, and I was sobbing like a child with a grazed knee while I worked an improvised noose around my neck on the stairs of my apartment.
Saying “there are people there, reach out to them!” is a shallow sentiment. It can be impossible for us to engage about it. If I cut myself off from my closest family, then I’m probably not going to instead reach out to some bumblefuck stranger.
No worries, Amy. I’m part of an informal group that makes this a point: We feel that to get our stories across firsthand is worth more than any number of advertisements where people sit and stare at the wall.
Actually, I’ve found a lot in common between Missouri and Ireland, where there’s this pressure to fit in and not make waves, no matter what goes on inside of you, or to you. The parts of society you are taught to look up to are conservative and religious, and if you come out to them as different, then you turn into a nail to be hammered back into place. If you let people do it. It sucks, it kills, and all it takes is one person to stand up and talk to start a change.
I’m on the mend myself. I’ve already been through the wringer, but there are still men and women out there who are locked up in their own personal nightmare with no way out. It can be hard to approach them, or for them to approach you; I mean, everyone around you tells you to buck up and get the fuck over it. So we just place ourselves here and there there around the Internet like helpful little spiders, and listen if you talk.
Everyone finds a way their way to manage it. Again, some people drink or take drugs, I cut myself and turned into a hermit, and others just kill themselves. A lot adopt a lifestyle that simply doesn’t leave them enough time to think, let alone speak. Some get cured, most won’t. Even if we’re cured, the threat of a relapse is always going to be there. For me, it was the love and persistence of a few close friends that helped me back on my feet, along with independent, neutral validation that I wasn’t in fact evil. I had fucked up and hurt people, sure, but I reaped a hundredfold of what I had sowed. I had paid for my sins, and everyone I loved helped me see this.
Great, sure, I survived. Someone else won’t, sadly. They’ll smile, and nod, and reply to you affably while they root in the kitchen counter for the knife sharpener.