One of the biggest advantages of being active online after the publication of This Life is Beautiful is getting to interact with its readers. I would have otherwise missed an opportunity to meet people from all walks of life and from numerous nations. It was inevitable, then that some of what they’d want to talk to me about were mental health – or the lack thereof – but I was caught off guard by the sheer number of people who wanted to confide their own concerns about their own conditions. Despite the improvements, I had seen in my own life and despite the way in which This Life is Beautiful had a polemical take on the bureaucratic nature of medical treatment, it appears not much has changed for an overwhelming number of others. This was not what I had expected to happen in the time of medical advancement that has elapsed since the experiences I wrote about some 30 years ago.
Arguably then, the real advancement is in raising awareness and bringing a fairly solid degree of discussion about mental health into the public domain, at least in the west. But I don’t think that many physicians or psychiatrists have caught up with the ‘coming out’ of this many individuals and the pluracy of conditions and ill health they experience. The bureaucracy is bad but arguably the attitude is worse; it would be unthinkable for someone with severe or entropic physical damage not to consult a doctor but people with mental health issues are being put off by the reception at the door.
Individuality, as I’ve stressed before, is absolutely critical. Because doctors are trained to look for the common symptoms between people to diagnose them, they are often constrained to sorting people into groups by the level of visible suffering they exude. If, for whatever reason, you’re not accepted into this cosy club of prioritised treatment, you’re forced to wonder what it is that you failed to perform. This necessitates a rather toxic degree of competitiveness between patients – one that’s measured in extroverted and luridly visible suffering.
The solution is to take the allotted time given between doctor and patient and craft an appropriate, accurate depiction of how your body and mind are working and why you may need medication or therapy to change it. This is rendered all but impossible by the attitude of many a psychiatrist – ones I’ve heard about and ones I’ve encountered myself, who constantly conduct themselves in a manner which indicates that they want nothing to do with you, not least your issues nor striking a rapport which might enable them to get to the nature of the problem more quickly – and apply their favourite combination of declarative clinical patronisation with a sprinkle of genuine empathy just that little bit faster. Still, there’s little convincing the medical profession that one-for-one individuality in cases is more efficient than standardised treatment, not less but the evidence reflects this.
How is a psychiatrist’s or physician’s impression of an illness supposed to develop if they don’t consider these differences between individuals? If they don’t put the legwork into understanding just how a condition can affect someone in daily life. All too often, patients met with this lack of understanding can quite literally suffer all the more for it. People who are finally put in touch with a doctor only to be treated obnoxiously and unfairly will feel a helplessness that quite readily turns to depression and rage – one that wasn’t even there in the first place.
All that being said, I don’t want to put anyone reading this off getting help, quite the contrary. I’d just ask those people who have approached me about their issues and those who I know are otherwise still out there to prioritise getting a doctor that can prioritise them. Someone who for the purpose of thirty to sixty minutes can be your confidant and friend.