the difficulty of recurrent mental health problems

One aspect of mental illness I don’t see discussed much is when you suffer from recurrent mental illness, and have to go back time and time again to seek help.

It can be so disillusioning. So often the narrative is that yes, many people will suffer from some sort of mental health issue in their life, but a trip to the doctors, medication and talking therapy, and within months you’ll be back to ‘normal’. Job done, life resumes, soon that blip in the road is just a distant memory. And for some, I assume that this is the way it works for them. But for many others, bad mental health happens time and time again, and although each time you learn a little more about how to cope, it never gets easier.

I am in a bad patch.

I wrote about relapse last week on World Mental Health Day, and things have not improved all that much. My thigh is a mess, my brain is even worse, and just getting up and going to work is taking all of my time and energy and leaving room for nothing else. I even had to leave a show early last Saturday because my anxiety was so heightened, and I’ve never had to do that before. I’ve always been able to work through and stay out - but it was just too much.

I went to the doctor to explain that my mood had taken a nosedive and old habits were resurfacing, but it felt like he wasn’t taking me seriously because I couldn’t identify a trigger for this bad patch. Does there have to be a trigger for recurrent bad mental health when you have a long lasting mental health condition? I don’t know. He sure seemed to think there should be. Whether he thought I was exaggerating or making it up or something else, I don’t know. But the only advice I got was to continue taking my medication - 40mg of Fluoxetine - and to self-refer to IAPT.

And this is why it can be so hard accepting when your mental state has taken a downturn and you probably need to go and seek help again, because so often it’s just the same advice over and over again - and if it didn’t work the last time, or the time before that, or the time before that, why would it work this time? Don’t get me wrong, I LOVE the NHS, and I am forever indebted to it. But the mental health services are in dire need of some work. I’ve been in and out the system for years now, and never been provided with the right support.

Maybe if I had had the right support, back at the beginning, I wouldn’t be in this position now of having to go crawling back to the doctor every few months to admit that I’m not okay. Every time I start out thinking I can handle it by myself this time, to thinking ‘maybe there will be something new’, to feeling even worse because I should be better now. I’ve had medication, I’ve had therapy, I’ve been an inpatient - yet life is still a rollercoaster. Up days, down days, up weeks, down weeks, the cycle continues to keep turning and nothing interrupts it.

All this to say - I really don’t know what the point of this post is. Frustration is driving it, mostly. It’s turned out to be something different to what I originally set out to write, but sometimes you just have to get your thoughts down on paper.

And this is, for me, the realities of living with a long term mental health condition.

Mostly a lot of frustration, hoping every time a good patch rolls around that this is it. This time it will stay. We know what to do now - we can avoid spiralling down again. But inevitably, often for seemingly absolutely no reason, the bad days will come back. The anxiety will bubble up and become all encompassing, getting out of bed gets harder and harder, more of my time is spent sleeping, there’s an emptiness and a heaviness that won’t shift.

That’s where I am right now. I don’t know why. I don’t entirely know how to get myself out. I keep talking to friends, and practicing practical self care as much as possible (including buying new candles in a bid to force myself to tidy up my room), and I’ve done the self-referral to IAPT even though it’s 99% certain it’ll be CBT and that doesn’t work for me - I don’t know where else to go from here. All I can do right now is try and shelter the storm, and hope that is doesn’t wash me away.

Because truthfully, there’s a big part of me that believes one day I will tip too far over the edge and be washed somewhere I can’t get back from. I don’t want that to happen. In my rational moments, I don’t. In the darker moments, it does sound a lot easier than the alternative - fighting. This is a fight, in a way people probably don’t realise. Getting out of bed is a fight. Going about my daily life is a fight. Keeping my head above water as much as possible - a fight.

I am not okay.

Four small words that get harder and harder to say every time the darkness rolls around again. Four small words that get easier to admit every time the darkness rolls around again. I’m used to the charade of going to the doctor now, of listing every symptom I’ve been experiencing, being open, and hoping that this time it might be different.

But it never is different. And that might be the hardest part of all.