Illustration by Kate Towsey for Varsity

Content note: This article contains discussion of bipolar and borderline personality disorder, depression and antidepressant medication, self-harm, panic attacks, and terminal cancer

Last month, I was told by a mental health service in Cambridge that I wasn’t “ill enough” to get a diagnosis. After a disastrous nine months on anti-depressants that had left me calling home regularly begging to be picked up from university, getting drunk to the point of passing out in my kitchen because everything just felt so unbearable, and spending countless nights on the phone to 111 or in A&E, I’d finally had a reassuring conversation with my GP.

We began to talk about my family’s mental health history. My mum, I told them, was sectioned when I was twelve — in hindsight, she had showed bipolar tendencies, though as far as I was aware she had never received any sort of diagnosis. For years, I thought that I had depression. My GP told me that it was more likely that I have Borderline Personality Disorder or that I’m bipolar myself — BPD was a condition I’d never even heard of before — because they have genetic predispositions. Everything fell into place.

There’s a pervasive narrative that mental  ill health is somehow less serious than a physical ailment

But because of the nuances of bipolar disorder and BPD, a GP couldn’t diagnose me: I had to speak to a specialist. Until then, they didn’t want me to be taken off medication because they were worried about what I’d be like without it, so I started the switch from fluoxetine to sertraline. And I was referred to Prism (now called the Primary Care Mental Health Service), a mental health service which would see me the following month to start the diagnosis process. For the first time in years, steps were being taken in the right direction.

But my hopefulness wasn’t to last. The person who spoke to me at my initial consultation was understanding and caring. So far so good. But then, things started to go downhill. I was given a card with a list of helplines on it (most of which I have already used), a promise that I would receive a phone call after a supervisor had been consulted, and a nagging feeling of my experiences being invalidated. A few hours later that phone call came. Because of the nature of bipolar disorder and BPD, I was told, I’d need to receive further consultation from a specialist,  which I currently wasn’t “ill enough” to receive: the only way that they could offer me a diagnosis was for me to be sectioned. (A spokesperson for the Primary Care Mental Health Service said “if anyone who has used the service is unclear about the advice given or wishes to seek further clarity [...] they can speak to our Patient Advice and Liaison Service which will answer their questions or concerns as quickly as possible.”)

I don’t blame the health services for not being able to offer me help — the underfunding of NHS mental health services is well known. I wasn’t even upset about the mentioning of sectioning, though it’s a very sensitive topic for me. It was the phrase “not ill enough” that really got to me. Reaching out to a medical professional for mental ill-health is an incredibly difficult thing to do: it takes admitting to yourself that there is a problem and then, the hardest step, believing that you deserve to be helped and to get better. My mental ill-health leaves me with a lot of self-loathing so thinking I deserve help at all is difficult, and being told that I’m “not ill enough” just reinforced that horrible notion that it’s ‘all in my head.’

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I remember when I first came to terms with how serious my mental health problems were — I was having multiple panic attacks a day, was self-harming, and my mum had just been diagnosed with terminal cancer. After a particularly bad panic attack which resulted in me having to spend time in A&E, I had finally built up the courage to speak to a GP. She asked me if I’d tried breathing into a paper bag. My mental health struggles were invalidated with that one phrase, all the courage I’d built up to go and seek medical help torn down in a moment. It took over a year and multiple trips to the GP to finally be prescribed beta blockers— without which I wouldn’t have made it through my A-levels.

There’s a pervasive narrative that mental ill health is somehow less serious than a physical ailment. If someone has early stage cancer, they get offered treatment. You don’t wait until it reaches a terminal stage before turning around and offering chemotherapy. Why, then, do I have to get to such a fragile state that I need sectioning before I am offered support for my illness? Bipolar disorder and BPD are often treated with different medications than those for depression, but here I am still taking antidepressants which, for all I know, are doing more harm than good.

Deciding a course of treatment based on whether someone is “ill-enough” isn’t just wrong – it plays into a culture of not seeking out support for yourself because someone else, somewhere, has it worse. Over the years I’ve had frustrating conversations with struggling friends who’ve felt like they shouldn’t reach out because there’s always someone sadder or more stressed or in more need for help than they are. But everyone deserves to feel that they are supported, no matter how serious they may see their problem to be. Someone experiencing mild symptoms of depression deserves help and support as much as someone who has severe ones. Someone who has one panic attack a month deserves to feel listened to as much as someone who has them more regularly.

But so many people don’t reach out, don’t talk about it because there’s a culture around mental health where people feel the need to quantify how much they’re struggling. Keep a stiff upper lip, there’s someone who has it worse than you. If she’s coping, then I should be able to, too. This culture is slowly beginning to change, but there’s still a reluctance among many to accept that medications for mental illness are not a sign of failure, but are just as important as medications for physical ill health.


Mountain View

Our relationships are vital to our mental health

No matter whether you think someone has it worse, you should reach out for support. Your voice is worth hearing and you deserve to be given help if you’re struggling. Talking is so important. Once you start dialogues with the people around you, you’ll realise that there are more people who have struggled than you think. Treat yourself with the same love and kindness that you’d treat a friend with. And don’t let anyone tell you that you’re “not ill enough” to be supported.

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