Time to Shout About Mental Health

I suspect that I, and others like me who are working for the Time to Change mental health awareness campaign, have many hundreds and thousands of speeches and talks and interviews still to go before we finally bring the walls of taboo and stigma crumbling down. The whisperers are people who come up to me and, unlike those who just want to say thanks for the talk, raise something else, lean in towards me and say very quietly "thanks for talking about mental health and depression, it really helps". It is good that they talk. But bad that they feel the need to whisper.
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I do a lot of talks, especially at a time like now, with a general election looming and also with a new book to promote. So I have a lot of experience of audiences and their behaviour.

At the end of most talks there is usually a gaggle of people who come up to you to prolong the discussion. Often they feel for some reason that I would not have answered their question had it been asked in front of everyone else. Others just want to prolong an argument, or have a moment of perceived intimacy. Some want to persuade you to go and do a talk for another event another time. One or two want to harangue.

But in the last year or two I have also noticed an increase in what I call the post event whisperers. Let me explain. In most of my speeches, whatever the audience and whatever the topic, I try to weave in messages about the importance of breaking down stigma and taboo surrounding mental health and mental illness. I talk often about my own breakdown and depression, always mindful of one of my golden rules of communication - namely that just when the communicator or campaigner can recite his own stories and arguments in his sleep, that is the point at which they might be beginning to reach the outer rim of the radar of public consciousness.

I suspect that I, and others like me who are working for the Time to Change mental health awareness campaign, have many hundreds and thousands of speeches and talks and interviews still to go before we finally bring the walls of taboo and stigma crumbling down.

The whisperers are people who come up to me and, unlike those who just want to say thanks for the talk, raise something else, lean in towards me and say very quietly 'thanks for talking about mental health and depression, it really helps.'

It is good that they talk. But bad that they feel the need to whisper. It is a sign that those walls are still standing, tall and dark and forbidding, and whereas it is easy for me to talk out, with a profile and plenty of opportunities and no desire ever to apply for a job again in my life, it is not so easy for people worried about the reactions of friends, family, colleagues and - crucially - employers.

At one such talk a few months ago, a whisperer asked if we could go somewhere private to talk. Depressive to depressive, I could see in her eyes why she wanted to. She told me she was a nurse working in the NHS. She said she had occasional very bad and sudden bouts of depression. She had one such on a Monday morning after a stressful weekend trying to fit her shifts around being with her two daughters. A single mother, she told me that as she realised the depressive cloud was about to fill her blood and bones, she called for her elder daughter to come to her bedroom.

'Can you phone the hospital and say your sister is not well and I need to stay home to look after her,' she said. Her daughter, aged nine and already used to this process, did so. The nurse then called her younger daughter through and said to her 'sorry love, but you'll have to stay off school because I have said you're not well and if you go some of the other mums who work at the hospital might see you when they're dropping off or picking up.'

Depression is bad enough. But think how much worse that a sufferer - one who works in the NHS for heaven's sake - has to lie and draw two daughters into the web of lies to avoid admitting the truth to employers she does not trust to understand.

Other whisperers - these tend to whisper a little more loudly - tell me of brothers, sisters, boyfriends, girlfriends, mums and dads, cousins and nieces and nephews, and they ask me what advice I have for helping someone who is depressed or otherwise mentally ill when you have no real experience or understanding of it yourself. And I say be there when the illness starts and be there when it ends and understand they are the same person. Don't ask what triggered it because usually they don't know. Above all never say 'pull yourself together' or 'what have you got to be depressed about when you have a home, a job, a family that loves you?' Just try to listen if they want to be listened to, and try to hear. Also try not to be there if you sense that is what they want too. And try to educate yourself so that you can start to advise with conviction and understanding about possible ways of treating the problem. Ultimately doctors, psychologists, psychiatrists and medication CAN help, but only if the whisperers' friends and relatives want them to.

As the post talk whispering goes on I am confident that one day we will look back and ask ourselves why - just as cancer was once whispered about as 'the big C' - we felt so ashamed to talk about something that affects so many people. We will look back with real shame and ask why people with schizophrenia live on average 20 years less than others because we don't research the disease and the drugs as rigorously as we do those for other illnesses. We will look back and realise that in writing off people with mental ill health we are stopping ourselves from fulfilling not just their potential but our own as countries and societies.

In the Time to Change campaign we say one in four will have a mental health problem at some point in our lives. But you know what? It is nearer one in one. We all have physical health and we all have mental health. Some days it is good and some days less so. Just as some people get very ill physically - cancer, pneumonia, liver disease and the like - so some get very ill mentally. And here is the thing. It could be any of us.

Mental illness is no respecter of wealth, class, creed, nationality, sex or job. It just is, and the sooner we are as open about our mental health as we are about our physical health, the happier and better off as nations we will all be.

In Winners and How They Succeed, I devote two sections to mental health. One is about the extreme mindset, the Lance Armstrongs of this world who are maladaptively competitive, who will do anything to win. When I interviewed the American cyclist several years ago, and asked whether the fear of dying when he had cancer was lesser or greater than his fear of losing the Tour de France to Jan Ullrich, he gave me the full on maladaptively competitive stare and said: 'losing and dying - it's the same thing.' Mmmm. Maybe. Maybe not.

There is however a positive side to mental illness too and this is also part of our Time to Change campaign. As I say in the book, Winston Churchill is seen as the greatest ever UK prime minister, Abraham Lincoln as the greatest president of the US. Both were depressives, Churchill of the manic variety. Charles Darwin - incidentally born on the exact same day as Lincoln - was agoraphobic. Florence Nightingale and Marie Curie, two of the most important women in history, both struggled with what today would be defined as serious mental illness. Imagine a world in which those great people had not been able to achieve their greatness. And perhaps try to understand too that the so called 'madness' was part of the greatness.

Last year I was asked to talk on a panel at the National Theatre, before a performance of King Lear, about power and madness. Also on the panel was a fascinating American Iranian psychiatrist, mood disorder specialist Nassir Ghaemi of Tufts Hospital in Boston, who has written a first rate book called First Rate Madness. I ended up interviewing him for my book because of his insights into a more positive assessment of mental instability.

He is now writing a book about Martin Luther King, who like Churchill was bipolar (though Ghaemi and I both prefer the more old fashioned 'manic depressive' descriptor. )

He says KIng's mania helped give him the confidence and charisma, the energy, the ability to inspire and hold together big egos and disparate groups as he led a movement for change. And the suffering of depression gave him profound empathy with those who suffered through the denial of basic rights, empathy which fuelled his passion for the cause.

In saying all this I intend neither to glamourise nor to trivialise the suffering of mental illness. But as I often tell the whisperers, good can come of bad. I tell them that my 1986 breakdown, though at the time the worst thing that ever happened to me, turned out to be the best. I sorted myself out. Refocused priorities. Stopped drinking. Admitted problems. Above all learned resilience and had forever a yardstick against which to judge pressure and depression. These days, when a bad bout comes, I take strength in several ways. I tell my partner Fiona, whereas for years I hid it. I write about it. I see a psychiatrist and if he advises so I get medication. I tell myself I have got through this before. And I say to myself if a full blown psychotic breakdown that caused you to be locked up for your own safety was nine out of 10 bad, this is not much higher than five.

Many are not so lucky. Suicide is the biggest killer of young men in Britain today. We could reverse that shameful statistic. What is more we would reverse it if instead of society making them feel shame about their low moods, instead of them thinking nobody else really understands, instead of thinking that mental illness is a weakness, we just accepted it for what it is. Illness. Pure and simple. To be treated with proper resources not the cuts to mental health services happening piecemeal all over the UK now. Above all though with compassion and understanding, not just from the medical profession but from all of us. Because all of us have a vested interest in everyone having better mental health. And it will only come if this campaign is won. It will take time. But we will get there and we will wonder why the hell it took so long.

Alastair Campbell is an ambassador for Time to Change and for Alcohol Concern. His latest book, Winners and How They Succeed, is a Number one bestseller, £20, Hutchinson.

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