Full Function

I have an eating disorder. I don’t have any problem with this label – I am bulimic. I have been bulimic (on and off) for 30 years. I have had disordered eating all my life.

I have depression. I don’t have any problem with this label. I don’t know if I’ve always been depressed? Perhaps I have, perhaps I haven’t. But most certainly, for the past two years I have been experiencing a major depressive episode.

I have anxiety. I sort of acknowledge this? I sort of don’t. I don’t always feel it’s a big deal. But then sometimes I think it’s a very big deal. I struggle with this label. I have been through periods of time where anxiety was a major issue, but most of the time I don’t notice it. I’m not sure if it’s because it’s not there, or if it’s because it’s milder and I have just used different labels for anxiety (stress, worry, nerves, shyness etc).

Despite all these labels, I function perfectly well. There was a time last year where everything collided and I fell in a pit and really, I wasn’t functioning at all well. In fact, in many ways I was near death. I was still getting to work (only ten hours a week) and could drag myself out of bed to get to gym and could slap an exhausted smile across my face for short periods of time. But I was fast losing the ability to even manage that when I was hospitalised.

I still have major depression and I still have majorly disordered eating, but if you ran into me in the street you wouldn’t know. I function well. I’m in a healthy weight range. I can get out of bed and work and exercise and cook meals. I can do anything I need to do – despite feeling outrageously fatigued all day every day. So to many people, it’s no big deal. I’m fine. I function, therefore my depression and my eating disorder are not problematic.

Is that true though? I don’t believe so.

A lot of people hold stereotypical images in their heads of mental illness:

•    Alcoholic: an old man lying on a park bench with a bottle in a brown paper bag
•    Anorexic: a skeletal woman, near death, with a drip and a nasogastric tube
•    Depressive: unshowered, crying, lying in bed all day with no capacity to get out
•    Addict: lives in a filthy squat, semiconscious with track marks up their arms
•    Schizophrenic: homeless in a railway station, humming about aliens

And all of these scenarios might be true. For some people. But in reality they are the end stage of severe illnesses, and the vast majority of people living with any kind of mental illness, are doing so invisibly. They are functioning well in society, living day to day, working, contributing, socialising, raising families – doing what everyone else is doing – with a great deal of difficulty and a great deal of hidden emotional pain. And more often than not, a great deal of exhaustion – physical and psychological – that makes it often nigh on impossible to enjoy life. But they scrape by.

Worse still, there are people who are anorexic, alcoholic, depressed, addicted to (pick a substance), or have a major mental health issue, and because they can “function” they refuse to believe they have a problem. They may in fact, wait until they’re at that end stage scenario before acknowledging there’s an issue – when it may very well be too late. The physical and psychological damage will be almost irreparable. The social and economic consequences might be devastating. And beautiful, sensitive, healthy, contributing members of our society, will be lost to us, because they believed getting to work each day, being in a healthy weight range, providing meals for their family, or just getting out of bed and having a shower, means they weren’t sick enough. The problem wasn’t big enough. Or perhaps they believed, the problem wasn’t there at all.

They’re wrong.

We’re all wrong.

We need to look out for the person who can get to work every day, but is too exhausted to read a book.

We need to nurture the person who is in a healthy weight range, but hates everything about their physical self and will go on any diet they think will cut another kilo or two – to make them “happy”.

We need to talk to that friend who uses illicit drugs and/or alcohol to “relax” at the end of each day.

As a society, we need to care for not just those who are on the verge of death because of their mental illness. We need to care much, much earlier. Not for a day. Not for a week. But for months and years. We don’t develop an eating disorder or severe depression or alcoholism in a week. It’s not going to go away in a week. It takes years. If ever… And it takes a village. Those with mental health issues need the same support that those with physical health issues need – doctors, therapists, pharmacists, friends, families, colleagues, neighbours. Society.

And if as a society, we nurtured those in the earlier stages of illness, perhaps those “high functioning” addicts and depressives, those people with hidden and invisible mental illness, would feel okay about acknowledging their issues much earlier on. Because the earlier the problem is tackled, the better the outcome.

In the inimitable words of that wonderful philosopher, Dr Phil, “You cannot change, what you do not acknowledge.”

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