My first contact with the term “mental health” occurred when I was nineteen. As a rookie cop, I was bombarded with a welter of legislation – after all, I had to know roughly what I was arresting someone for. Part of this legal lexicon was the Mental Health Act that allowed us sensible servants of the monarch to detain anyone who was barmy. Mental health was – I am ashamed to say – considered by me and many of my peers as an abstract occurrence that only happened to others. How wrong I was, as at this precise moment I developed a mental health issue of my own ─ anxiety; perhaps one of the mildest forms, but nonetheless a debilitating condition that had its roots within my initial police training.
Sitting at the front of the class, the lesson that afternoon connected with the Misuse of Drugs Act. The trainer popped a video into the player and the monitor sparked into life showing an outstretched arm. A sudden and unexpected swoop of the other arm ─ with a clenched fist ─ and blood erupted everywhere as the needle was rammed into the addict’s own upper limb. In those days police training wasn’t subtle. Why bother when a metaphorical cricket bat across the back of the head would suffice? How many sensitive souls who would have been incredible, caring, police officers left the service as a direct result of this type of emotional assault is open to conjecture. However, I managed to hang on – just; although I was damaged, and for decades later I had a disabling fear of having blood taken from my arm ─ to be specific, from the antecubital fossa ─ more commonly referred to as the opposite bit to your elbow, where the upper arm and forearm are levered together.
I shared this fear with very few people; some denounced me as some kind of drama queen ─ offering what they believed to be an easy solution. Rest assured, if simply getting a grip was all that was required, I would have done so long ago; but I endured fainting spells and almost biting a finger off as blood was taken from my clenched fist ─ while I lay down in dramatic fashion – my way of dealing with the trauma. I actively avoided any situation that engaged with the process; this became my reality. Blood tests became more frequent when I was diagnosed with type II diabetes, yet still the fear didn’t subside. Upon successfully reversing the self-inflicted lifestyle condition by taking responsibility for my own weight management, I thought that the monitoring would lessen. It didn’t. The checks continued, and that meant more blood tests.
Then I met Eadie; the only nurse in the whole universe who could, almost effortlessly, take a blood sample from me, via my unique and unusual method ─ whilst I looked in the opposite direction. Disaster struck when the pandemic separated me from my shielding Florence Nightingale. A different nurse laid the pillow out on the table in front of me and I nearly passed out. I had no choice but to rather sheepishly admit that needles scare the shit out of me; more accurately, needles that come anywhere near that particular region of my arm. Somewhat surprisingly, I was OK with other needles, such as my COVID-19 jabs. I told her that I needed to get a hold of myself. She patiently explained that phobias are as real as the imagination allows them to be, and that they are the most common type of anxiety disorder. More importantly, she offered help in the form of Cognitive Behavioural Therapy, more commonly referred to as CBT.
Following a series of online sessions, and acclimatizing to the once terrifying agents of fear, including the needle itself which I had framed in my head as a dagger, I did it! I had blood taken from my arm and didn’t even feel the scratch! But, having slayed this particular dragon, I acknowledge that anxiety is a feature of my persona, even if my outward appearance and usual cocksure and confident demeanor in most other parts of my life often seem to contradict this position. This is an ongoing journey for me, but one that has nonetheless convinced me of one important observation: we are all nuts, and the only thing that’s different in each and every one of us is where we sit on that continuum of craziness. I may presently occupy one of the lower rungs, but things can change. Mental health is fluid and I sincerely believe that we need to talk about it more openly. In my quest to do so, I had to be cautious since the issue is still shrouded in stigma and shares a perverse counterbalance with physical illness. If someone breaks an arm its easy to see and understand, and, perhaps, to make adjustments in how we interact with them; holding a door open, or pulling back the ring from a can of drink might be helpful. When someone breaks their mental health, it is far more difficult to detect, since we humans are great at faking it.
I was reassured to discover that the World Health Organisation appears to support my claim that we are all nuts, by proclaiming, “There is no health without mental health.” This claim makes total sense since everybody has mental health as well as health. They coexist, and often the pendulum oscillates between the two states. To further prove the point, it is comforting to note that many famous people have had their own mental health stories; Ludwig van Beethoven was bipolar, whilst Napoleon Bonaparte bore a narcissistic personality disorder. Sir Winston Churchill was hounded by his ‘black dog’ of depression, whereas Princess Diana suffered postnatal depression. In more contemporary times, Mariah Carey is bipolar, Justin Bieber has bouts of depression, and Leonardo DiCaprio has obsessive-compulsive disorder. Although these disclosures compounded my base belief, I sought a personal account to either compliment or confront my own hypothesis. Spending time with Madison metaphorically blew my mind.
“People say you have an inner voice in your head that is ─ I guess ─ your conscious guiding you through life. I, on the other hand, was cursed with three horrendous voices projecting hate towards me. I’ve had them from an early age and my mum also has an history of mental illness.” My solitary internal murmur instructed me to continue my hush and Madison deftly filled the void. “I couldn’t openly talk about what I heard. Where would I start? I was afraid at that age ─ was it normal, or was I an oddity? All I knew was that the voices made me feel really bad and projected hate. They would tell me that my family members would die, especially my grandad. He was like a dad, adopting me when my mum and stepdad relocated to Germany with the army. The intrusive thoughts were a torturous hell.”
With an almost apologetic intervention, I wanted to know what coping mechanisms – if any ─ Madison had managed to harness. “At night I often saw things moving in the darkness. It was scary. I was young and had a lot to focus on at this time in my life. But who could I turn to, and who would believe me? I tried to tell my family, but my mum was in denial about her own mental illness. I was just told I’d grow out of it.” But Madison didn’t grow out of this torment, and aged fourteen, whilst on a family trip to Aberystwyth, Wales, contemplated suicide. “We went for a walk up Constitution Hill. As you get to the top there is a sheer drop. My voices had already got to me on this day, telling me my family were going to die in a car crash. I stood on the edge of the drop, closed my eyes, and thought about falling, hoping this would be the end of it all.” A hand on their shoulder broke the trance. The just-about coping strategy continued throughout adolescence and into early adulthood. In 2015 things took the most hideous of turns.
“Over a period of weeks, I slowly started to lose an awareness of myself. My reality crumbled and I tried to take my own life with an overdose of drugs whilst cutting my arms to the point where I needed stitches. The blood just poured from the self-inflicted wounds. I became delusional and had totally lost control.” Thankfully, a friend intervened and Madison was latterly admitted to a mental health unit. Nevertheless, the suicide attempts continued. “I was finally put on medication for the first time and monitored for a period, subsequently being diagnosed with Bipolar disorder. Slowly, I became more aware of myself and the self-destruction.”
For a while, life was on an upward trajectory with medication and the active support of a community psychiatrist providing a degree of optimism. “The voices seemed to be more manageable, and the hallucinations were less. I was diagnosed with suicidal ideation and believed that these thoughts were simply a part of my life, but at least I felt I could move forward.” However, in 2020 things took another unwelcome turn. “I stopped taking my medication; the voices had told me that I was being poisoned. I gradually became unwell and started seeing things again.”
“I went to several shops and bought boxes of paracetamol, together with a bottle of wine. I called my manager ─ tears streaming down my face ─ and I told her that I couldn’t go on. I just couldn’t cope with the torment and my mind tearing me apart. At this moment, I wasn’t aware that my family had called the police and reported me as a high-risk missing person.” Fortunately, police intervention occurred resulting in an emergency psychiatrist sectioning Madison. “I was taken to hospital and put under observation. Because I tried to hang myself the first night, my room was stripped, and I was put on a five-minute suicide watch for the first week.” A further diagnosis of schizophrenia followed, albeit a discharge on Christmas Eve allowed Madison to experience a less disruptive mental health pattern and a more positive pathway.
“Moving forward, I have regular injections of medication so that I can’t be tempted to stop taking it, and I see my psychiatrist regularly. I still struggle with the concept of accepting life and I now have an advanced decision in place in case anything happens in future. I can at least have some control.” With an incredible smile, Madison concluded our conversation in pragmatic defiance: “I’m not saying my life is all sunshine and rainbows, but I’m here!”
Madison’s journey is still a work in progress – as is my life. I’m on that continuum of madness and I am reassured to note that I share this environment with the rest of humanity – even if some people may choose denial – sometimes because of ignorance, or more often than not, because of shame. If this account helps at least one other soul, then we have made a significant breakthrough; yet, confronting the demons of the mind isn’t always enough, and the complexity of the psyche should never be underestimated. Help is always there.
I will leave the best – yet most poignant ─ statement to the profoundly missed Robin Williams, who once quipped, “If you’re that depressed, reach out to someone. And remember, suicide is a permanent solution to a temporary problem.”
© Ian Kirke 2023 / @ianjkirke