Mental illness

For the church newsletter, a sequel to “Should I go to the doctor?” https://ramblingrector.me/2020/05/16/should-i-go-to-the-doctor?/

If you have a broken arm, you go to hospital where it’s dealt with. If it happened playing sport or doing something heroic, your injury will be a badge of honour. If you’re a schoolboy whose arm was broken in a rugby match, you’ll be unbearable as you flaunt the evidence of your manliness. I don’t know how schoolgirls regard bones broken in, say, a hockey match because I’m not a girl.

If you have a faulty electrical circuit in your brain and become depressed, or self-harming, or in any way unable to cope, chances are you will not consult a doctor, but will soldier on, telling nobody, sinking deeper into the doldrums. If you tell someone else you run the risk of being patronised or ridiculed as odd, inferior, inadequate, even possessed by evil spirits—yes, that view is still held by some and is common in some cultures.

We can see, touch and understand a broken bone or a leaking blood vessel or a blocked tube. But we’ve little or no idea about what goes on in the brain. We talk about and are even proud of our broken bones, but we are embarrassed about and even ashamed of our broken minds. It should not be so.

Why do people become mentally ill? 

Maybe because some people don’t produce quite enough of a certain brain chemical which is used for one nerve cell to communicate with another. Maybe because some people produce too much of a different chemical. The one might result in depression, the other in mania or overactivity. Maybe some mental illness arises because repeated traumatic childhood experiences result in the development of electrical networks in the brain that enabled us to cope then but are unhelpful now. Maybe some people develop such networks in the brain as a result of genetic inherited patterns. It’s all a bit of a mystery.

If you use your imagination you might be able to see that some of these conditions can be helped by learning to think differently: counselling and cognitive behavioural therapy (CBT). Believe me, these are hard work and take time. Other conditions can be helped by chemicals. Sometimes a bit of both is good, with drugs kick-starting a longer period of counselling or CBT.

Recognising mental illness is difficult. We all have different personality types. Some people are prone to depression, others to overactivity. When does an exaggerated characteristic become illness? 

Sometimes such instability is productive. You may have heard of Tourette’s syndrome in which people have a mind that fizzes with ideas and a mouth given to uttering a constant stream of shocking profanities. If you are, for example, a jazz musician who is most productive when Tourette’s is at its height, the last thing you need is for the symptoms to be taken away with drugs, especially if it’s the jazz that puts bread on the table. Being “abnormal” in this way is no bad thing. There have been studies showing that the most original and creative scientists and artists can in some way be regarded as not quite mentally “normal”.

Please remember that there is in truth no such thing as “normal”: it is merely a statistical definition. To give one example, “schizophrenia” is used in different ways in different societies. In totalitarian states the chances are that if you are critical of the way society is organised, constantly sniping at government policy, you’ll be declared schizophrenic and confined to an asylum (for “protection”) or prison camp. Our society is highly critical of this, but hypocritical in that we do the exact same thing using different criteria. I leave you to think about that. Perhaps “normal” means “able to cope with society”. But what if society itself is abusive and oppressive? We need to fight for justice.

It’s also true that the brain receives information from all parts of the body and we know little about how this affects mental health. There is growing evidence that what goes on in the intestine affects our mental wellbeing – the “gut brain” sending information to the “head brain”. You know about gut feelings – this is what I’m on about. So, eat well, treat your intestines with respect, and if your diet upsets you in any way, change it. Don’t be a fool.

Similarly, exercise. It releases brain chemicals that improve the mood. It gives a sense of achievement. The best medicine is your own sweat produced by exercise. Just do it. 

Let me give you my theory about how some mental illnesses arise. We need to start with some evolutionary history. 

As you pass forwards (upwards in apes like us) from the spinal cord you come to the brainstem. In simple terms this deals with automatic things, control of breathing and heart rate, balance, coordination, awareness of position in space – stuff that we need but have no real control over. Next come the paired structures, right and left cerebral hemispheres. These are where awareness and thinking occur: we process information in order to make decisions. Part of the hemispheres deals with urges (sex, hunger, fear), memory, mood and emotion (these are linked) and another part with logical thinking, analysis, reasoning. 

I’m pretty sure that some mental problems result from tension between these two parts. For example, I might in a fit of anger feel the urge to punch your teeth down your throat, but the thinking part of my brain tells me that if I do, there will be undesirable consequences for me, and therefore I override the urges and refrain. Too much of this kind of repression results in a building up of frustration that, if not dealt with by exercise or kicking the cat or some such, is not good for mental health. Learning to recognise and cope with anger is a good thing. Anger, by the way, is good. It spurs us to improve what needs to be improved.

This is only a theory and it can’t be proved, but neither can it be disproved.

I said above that counselling was useful therapy, and to my mind it would be better named “listening”. Every single one of us is capable of being a listener. It’s one of the things that people with mental illness need. They do not need to be judged. They do not need to be told what to do. They do not need to hear your opinion or why you think they’re in the position they’re in. What they need from you is simply companionship. Look at that word “companionship”. In the middle of it is panis, Latin for bread (pain in French). Bread together. What they need is for you to take them for tea and something to eat. Sit with them. Listen to them. Keep your ears open and your mouth shut except when eating and drinking.

If you do that you’ll be increasing the amount of delight in the world. There is no better thing to do.

Men suffer disproportionately from depression. It is said that Staffordshire has the highest rate of young male suicides in the country: you will know how often the A38 is closed and the rail service disrupted for undisclosed reasons. Men are less likely to talk about their feelings than women who often need no encouragement. 

In Burton there’s a charity supporting men’s mental health. It deserves your support. 

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