— Trigger warning —*

A couple of years ago when given a new diagnosis of my mental health condition I did what I suspect a number of people have done in those situations and googled about the condition.  I do not take Dr. Google in any way as gospel, fear not, but it is often a useful staring point for where I might be able to find out more or things I may need to go back and refer to my actual Dr. Like using Wikipedia to determine whether something you didn’t know is really obvious and you ought to have known or a bit more obscure and an interesting little interlude.

What was most stark was a study I found that suggested the average life expectancy for someone with my condition was 49.  I am now 49.

I nearly finished this entry right there with the last sentence, such is its power for me but it does require some further extrapolation and of course an average age is just a figure, the sum of all part as it were, but to say it shocked me genuinely would be an understatement because whether just to do with me or not this data was taken on the basis of other people’s lives.  Medical information that I find now a few years later suggests that actually life expectancy for those diagnosed with Bipolar is shortened by between 11 and 20 years, more factual specific data, not quite as punchy but certainly no less shocking.  To put this into perspective Obesity is thought to shorten life in men by up to 20 years and in women up to 5 years and there are national campaigns everywhere seeking to address the problem. The difficulty is that mental health doesn’t do things the way physical health does and therefore is far less easy to see, to diagnose or to treat but it is no less dangerous a phenomenon of our times and the impact no less debilitating as a disability to those suffering from it.

There are deaths that are directly attributable to a specific mental health condition, suicide being the most common and most tragic but what are less easy to factor in is all the co-morbidities that impact on the life of someone with a mental health condition, the greater likelihood of substance abuse or the damage caused by stress which are directly relevant but are practically impossible to quantify. I know my own capacity to deal with certain types of stress is drastically reduced, in particular at certain times, and that my own crutches include matters that tend towards greater likelihood of obesity and the like, which then bring the statistics associated with those conditions into play as well.

There is much talk of the beneficial effects of good diet and exercise and the effect this has on mental health, things which in lucid logical moments are of clear defined benefit but the watchword is in lucidity, much of the time when not in a good place one is not thinking about good diet, some people fail to eat, others eat too much and seldom is a good healthy balance the most obvious thing.  Likewise exercise is something that can not only bring health but joy to people, they enjoy going out for a walk, run, cycle etc. but when joy is the furthest thing from your mind what occurs with exercise can often be the same type of chore as cooking a healthy meal. You want to live by numbers, the lowest common denominator until things feel better, whenever that may be.  You make deals with yourself about how you will tackle things when you feel well again but very often that time never comes and this leads back into shame just as the financial crises we can end up in do the same.

We find crutches that make us feel a little better whatever that may be and like crutches there may be certain times when for short-term recovery these may not be a bad thing. But, like crutches there comes a point in time where you have to put weight on the leg and walk properly again or your ability to do so in the future will become compromised eventually perhaps irrevocably so and what was once a help becomes the very thing causing the maximum amount of damage.

Vicious circles abound in mental health, from the smaller consequences to much larger ones, for example lack of healthy diet means you may develop conditions which manifest physically on your skin or affect your build.  External appearance may not bother you in the good times but under the microscope of the bad times you see the flaws and you understand why they are there, the narrative becomes so easily self-critical – they are there because you are bad, broken, derelict, a failure.  You know the risks, you know the dangers and yet still you repeat the same patterns, what is wrong with you? You cannot even sort your own self out so what chance is there of sorting out anything else…? Where’s my crutch…?

Lack of healthy diet may lead to being overweight and the scrutiny is the same.  Yes it is my choice what I do and don’t eat by and large because I am an adult with an income and I can buy healthy or non-healthy foods.  I try to ensure I shop when I feel ok because the contents of that shop are geared around me looking after myself.  But then there are the downturns and the non-essential trips to buy the non-essential things because I might be feeling low and hungry for some comfort food.  Or maybe it’s the takeaways or the extra beers… etc.  Then I have spent money I didn’t need to spend, I have perfectly adequate food in the house, why have I gone and bought something I didn’t need and shouldn’t have again, why am I adding to my debts, why am I allowing food to go off because I’m eating crap?  I am bad, broken, derelict, a failure. I know the risks, I know the dangers and yet still I repeat the same patterns, what is wrong with me?  Where’s my crutch…?

I know these circles so well, often before during and after I am able to see the cycle for what it is, before I may try to put into place what I can to stop it and after the recriminations of the shame may make me also do similar and yet time and again the pattern goes on.

I am not seen as a risk to others nor to myself, what that means in medical terms is that I show no signs of physical violence nor activity that suggests I would commit suicide and those factors are correct.  But to assert from that that I am not causing myself harm completely misses the point.  I know the harm I cause both emotionally and physically, I imprison myself, frustrate myself, am ashamed of myself constantly. I know that I am rendered a less able, less successful, less happy person for those around me and therefore am I not causing them harm too?  The damage I have caused to others is unquantifiable and that ambiguity feeds so easily into a critical narrative.  Should it matter? Well perhaps, perhaps not but because I am who I am it does matter, how I have treated people matters to me in a sort of final reckoning way. I am not at all religious, any judgement comes from myself but I am aware of the tallies and I have a memory that retains the worst things all too easily whilst often forgetting the good ones which seems grossly unfair.

The fact that I am still here at 49 is not a testament to fortitude, it is not some form of success story, it is a set of circumstances by which one of my main vices, a sort of frustrated indolence, has led to there being no other option.  In actual fact I might muse that for me to be here at all represents in some way a tragedy like a strangled cry echoing or the light from a star existing in our sky long after its source has ceased to exist. Something that is noise after the usefulness has gone.  I don’t always feel like that but it is a train of thought I am familiar with.  To look at that which I might have done and the differences I could have made is the road to madness and one I have walked for many a year. The path is never easier nor the way back any clearer, the journey itself is so often tainted with fear, regret and shame that it is almost an emotional Sisyphusian struggle.  I wonder then how many others are in a situation where the reasons they expire might just be fatigue, the lacking of the ability to push the weight any more.  I hope they found rest.

*I put the trigger warning at the top not for effect and not because I feel it would specifically trigger anything but because I now know that if you’re just not in the mood sometimes it is helpful to know when to just walk away and come back to it later when you feel more ‘on it’. Prior to this year I knew of people talking about potential triggers but had no direct experience of it to draw on and I am very much an empirical beast.  Now I understand, in a relatively small confined way but no less significant for the window it affords me I had an incident that rendered me specifically in crisis at the time, disproportionately so, and mentions of it or reading through matters regarding it retained the power for some time to put me back in that place and experiencing the same level of distress.  I experienced a physical manifestation of what was going on in my head such that made me physically shake incapable of stopping.  This is not usual for me at all.  So now I understand the need sometimes for a trigger warning.

Song Of The Day ~ Honeyblood – Walking At Midnight