29 Oct 2014

What can I say to you? - for #GeekMentalHelp Week

Last night I listened to several people talk bravely and movingly about their struggles with mental health problems in the tech industry, as part of a series of conversations for #GeekMentalHelp week. Although I don't quite qualify as a geek, I felt I have enough of a connection with both the industry (translation: I have a lot of friends and relatives who can answer the question "So what exactly DOES it mean to get forked in the Github?") and definitely enough of an investment in mental health issues to go along and listen. I also think that more broadly, the term geek can generally apply to anyone creative, intelligent and curious who needs meaningful work in their life, and that I certainly fulfil those, plus a lot of less flattering categories (tendencies towards social anxiety and introversion, love of rituals, order and spreadsheets, a disdain for the superficial, lover of puns etck).
The organisers encouraged us to join the conversation, to write, to add our thoughts to the mix. I wanted to but wasn't sure what I could say that would be encouraging. My experiences trying to get my mental health problems sorted via the NHS have been mixed, to say the least. Like some of the speakers said last night, I don't always blame the system, usually rather the lack of resources it has, but that said, I did encounter deeply obstructive individuals (and practices) during in my fight to get help and a proper diagnosis, and I do firmly blame them for doing nothing less than endangering my life. I had to go private to actually get proper help, and to receive an accurate diagnosis. After believing for all of my adult life that I suffered from clinical depression, it took one visit to a private psychiatrist to be diagnosed with borderline personality disorder. That was 10 months ago, and I am still pretty angry that it took until the age of 30 for someone to just say those words and provide the answer to why my behaviour and moods don't respond to traditional treatments for depression. I first sought help for my mood swings when I was 21. That's 9 years of living under a misapprehension about what's wrong with you. That's 9 years too fucking long.
Private medicine is not an option for many people, so that's one of the reasons I felt it wouldn't be particularly helpful to share my story - although it was family members who actually swooped in and paid for it after I had hid my struggles from them for so long, and after things had got to such a point where there was no hiding any more. Perhaps the takeaway here, then, is that people can be more helpful than you think if they actually know what's going on. I let all the usual things stop me from saying anything - stigma, pride, sheer stubbornness, fear of being misunderstood - as well as the fact that, when my BPD is at its worst, it renders me actually mute.
I think introversion is a common personality trait amongst geeky people, and it manifests itself in the rather British attitude of not wanting to make a fuss, not wanting people looking at you, not wanting to be the person who "causes drama". I will physically go and hide rather than be that person, so embarrassing do I find my sudden and inexplicable outbursts of emotion. When I told one person about my BPD diagnosis, she said "You don't seem like it...you're not manipulative.." (manipulative behaviour being one of the markers of the condition). My only response was, I guess I hide it well. Because I don't want to be that person - who is seen as hysterical, unreasonable, demanding or needy. Who would? 
Silence is easy.
Confessing is hard.
But letting things get so bad that you end up in A&E is not going to protect your pride one bit, I can tell you that much. These days I try to say something before the sudden and violent mood changes that dictate my life close me down. I don't always succeed, but thanks to a decent psychiatrist and getting on the right medication, I also have some things in place to stop the runaway train before it jumps the tracks. For years I told people that my moods could change so suddenly, violently and inexplicably that I sometimes wished someone would just shoot me with a tranquiliser dart. People would nod, smile and empathise, but I don't think anyone realised just how valuable the option of a sudden chemical cosh would be. All the visualisation techniques and deep breathing in the world can't do a thing for me when I'm in the middle of a 2 hour crying jag. I am glad that I now have anti-psychotic tablets that I can take and know that said tranquiliser dart is going to come in and reset my brain. I carry the tablets everywhere I go -  in every one of my handbags, in my purse, my car, my roller derby kit bag. Knowing I had some backup was all I wanted, for so many years. And someone finally gave it to me.
This is not a tirade against techniques such as CBT or mindfulness, which many people use and do find helpful, but it's simply to say that these things don't work for all of us, and they have a much more limited chance of working when you haven't even been correctly diagnosed in the first place. I was offered both these things through the NHS, and they helped a little with anxiety, which experience tells me is very likely to affect intelligent, creative people, because they tend to be highly self-critical. However, nothing does the trick quite like just being able to take an anti-psychotic and slow the fuck down.
A lot of the talks last night centred around work, and how the pace in the tech industry can lead people to burn out, or immerse themselves in work to such a degree that they cease to face their emotional problems. Personally, I walk a tightrope between needing stimulating and challenging work which regularly involves novelty so I don't get bored, and feeling terrified and trapped and depressed and wanting to run away from anything that constitutes a full-time job. For this reason, I'm freelance and I work from home. That way, I don't run the risk of bursting into tears at my desk and a colleague having to hurriedly hide me in the boardroom (this actually happened). Currently I pride myself on doing great work, and never missing a deadline, and I'd like to think all my freelance clients would back that up. I've just written a book, and I'm immensely proud of myself for that achievement. I have no problem with disciplining myself to get work done. But put me an office, and I'll start to feel like a caged animal. I need that option for escape. I need that wiggle room so that if I can't get out of bed, it affects no one but me. I need that margin for error to be able to walk away from a freelance gig without worrying that I've pissed off an employer and am going to earn a black mark on my CV.
Mental health issues may be technically protected as a disability under the Equality Act, but who really feels brave enough telling an employer they need to work from home because they suffer from borderline personality disorder and otherwise run the risk of freaking out and crying in the middle of the office because they've suddenly been hit by a crushing boulder of depression while editing Tuesday's press release? Is any company going to provide 2 hour breaks so an employee can wait for their calming medication to kick in because a colleague made a throwaway comment which left them so angry they can't stop shaking? So, I do that stuff on my own time. The unpredictability of the freelance market is, to me, worth the trade-off of having my schedule and physical working location dictated by an employer. I've tried it, and I can make it work for a while, but when it stops working - it really stops working.
So what would I say to someone who feels themselves coming unstuck, given that my experience is so personal and unique? I suppose that despite that, the takeaways are broadly the same. I would say - demand the help you need, however you have to do it, even if you're so embarrassed that you need someone else to speak for you, then do it. Get an advocate. Put it in a letter. But get the truth out there. And then keep pushing. The squeakiest wheel gets the grease. Demand people listen - your employer, your family, your friends, and most of all, the medical profession. Ask for a second opinion. Ask to be seen sooner than in a fortnight. You may tell yourself that the system is already struggling with demand, but that demand is comprised of individuals, of which you are one. Each has an equal right to help.
I would also say: do the kind of work you know you can stand. I got a lot happier when I quit office work for freelance life, and quit doing unrelated jobs in order to start writing full time. It involved sloughing off a lot of socially ingrained expectations, and dealing with a lot of uncertainty, but ultimately it gave me my sanity back. If you are a geek - i.e. smart, creative, analytical, thirsty for challenge - chances are that the standard construction of work bores the shite out of you. If you're a square peg, don't try to push yourself into the round hole of a job that looks good to others. Only you have to ultimately live with your choices. If you're not happy in your work, change something.  
Reach out to the people you love, just like you would want them to reach out to you if they were in pain. 
Soothe yourself any way you can. Some people find animals therapeutic. My brother goes for runs to clear his mind. My dad is never happier than when he's power washing paving slabs.
Remember the words "Fuck the poets of the past, my friend - there are no beautiful suicides."
And remember to keep breathing.

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