Thursday 24 July 2014

Innocent unawareness, prejudice, and fear

"Why is it so very hard for friends without illness to 'get it'?"

Fran asked that question yesterday in a social media group we're both members of. My response grew into some wider contemplations about awareness, prejudice and fear, which I thought would also be worth sharing here. I'd welcome any comments.

As one of the "well ones", I guess there are many different reasons why it can be hard to understand what someone with illness is going through.

Innocent unawareness

Through knowing Fran I've come to a far greater awareness of what it means to live with illness, including mental illness, but my knowledge and understanding is still partial. For example, I have no specific understanding of what someone with schizophrenia, say, might go through, because I have had no direct experience of that.

I would call this "innocent unawareness" in the sense that it comes from simple un-knowing. What is important is to be aware of those gaps in our understanding, and not allow those gaps to be filled in with unhelpful, incorrect, or even harmful, judgements and assumptions.


I doubt many of you reading this need lessons in how much stigma and prejudice still surrounds mental illness, especially from someone like me who has never experienced it myself. Those of us well ones who are "innocently unaware" can certainly cause hurt and distress, but there is a difference when it comes from personal or institutionally ingrained prejudice and ignorance.

Given how many people live with mental illness of some kind (we all know the one in four statistics) I find it hard to credit how such hurtful misinformation is still in circulation, but my incredulity won't help dissolve it. It shouldn't fall to the "ill ones" to have to try and educate the well population, but in many cases it does.

And let's not kid ourselves it's an easy ask, even at an individual level, even with family and friends who "should" be open to understanding, who "should" be prepared - eager even - to listen to what their loved ones are going through.


I think fear underlies a lot of prejudice and "wilful unawareness". In saying that I don't mean to excuse those who hold prejudiced and stigmatising views: we all have responsibility to acknowledge where by action or omission we hurt others, and to work to change those behaviours.

Through my friendship with Fran I have come to understand how important all this is, and to want to use my energy and skills, such as they are, to help defuse stigma and prejudice. But I am also very aware that I have not always been so open and aware.

My sister was diagnosed with manic depression in her twenties, and my mother has lived with anxiety, breakdowns and depression for many years, brought on or exacerbated by the strain of supporting my sister. I wasn't present for either of them, and I know that was largely through ignorance and fear. I am not proud of that, but I can acknowledge it happened, and hope to have learned something from it.

So, where does that leave us (and it is us, it has to be us. Not "us and them" but "us all")? I don't know. I guess just trying to make it through from day to day. Together. One step at a time.


Thursday 10 July 2014

"How do you treat bipolar? Will my friend recover?"

Someone diagnosed with bipolar disorder is unlikely to ever be permanently 'fixed' or 'cured', but that's not to say there is no hope, or that life will be unremittingly grim. Each person, like each diagnosis, is unique. Some people have periods of remission and stability lasting for years. Others may be less fortunate, but our experience is that it is possible to recover from the acute phases of mania and depression, and to take positive steps towards maintaining stability and wellness. These steps involve developing habits and strategies (including taking medication as prescribed) that foster self-care, and remaining vigilant for behaviours which might herald the approach of mania or depression.

During an acute episode of mania or depression the focus is on managing the symptoms and restoring the person to a place of balance. Once relatively stable, the emphasis shifts to maintaining balance and minimising the frequency and severity of future episodes. It is neither an exact science nor a fine art. Each change in treatment, especially a change in medication or dosage, requires time to stabilise and assess, in terms of useful effects and side-effects.

For someone with bipolar disorder, and for those who love and care for them, wellness can never be taken for granted. It's not something you can find and hold on to, or somewhere you can reach which is forever free from illness. It's more like a skill which has to be developed, practiced and refined: an ability to navigate a route through shifting sands, or sail a steady course through treacherous waters.

Gum on My Shoe: One Step at a Time with My Bipolar Best Friend Chapter 3 ("The Well of Wellness")