Mental health

Most people consider going for a walk or a run as a sort of optional leisure activity, something you get round to once you’ve been to the shops. But when the government announced its coronavirus restrictions, there it was in its own category of ‘essential activities’: daily exercise. Yes, there have been rows about whether sunbathing or sitting on a bench to eat a snack are acceptable, but by and large the message has been clear: we need to get outside to stay well. But it’s not just exercise that’s essential to our lives, it’s nature too. We have become used to thinking of nature as something we need to travel to see, a middle-class luxury along the lines of buying expensive cheese or owning a labradoodle: nice, but not the stuff of staying alive.

Silicon Valley parents are famously strict about their children’s screen time, even as they dish out their ‘crack cocaine’ technology to the rest of the world’s youth. Last week, however, Tucker Carlson upped the ante: he called on Congress to step and ban children from smartphones, as they do with alcohol. Researchers have demonstrated a link between hours spent in front of a screen and depression and anxiety levels in children. But screen usage damage isn’t just in our heads; increasingly, it’s also in our hands.  ‘Children are increasingly finding it hard to hold pens and pencils because of an excessive use of technology, senior pediatric doctors have warned,’ reports the Guardian.

Antidepressants saved my life, I am sure of that. But I am also certain they made my mental illness much worse too. It has taken just under two years from my first very dark thoughts to me feeling sane and — largely — back in control of my mind. That’s not merely because it takes time to heal, but because it took at least six months for the doctors to work out what pills to give me. My symptoms of anxiety and depression started in the spring of 2016, and the first few drugs I was prescribed didn’t work. In fact, they really did just make things worse. The GP listened to me describing my symptoms, and handed me a course of Citalopram, a very common antidepressant.

It was World Mental Health Day this week — and it drove me mad. I don’t have ‘mental illness’. I have bipolar disorder, and I feel as possessive about my diagnosis as Gollum did his precious ring. One term. One label. To lump the manifold terrors of the mind together under the monolithic ‘mental illness’ is an offence against the person. Failing to differentiate shifts the stigma like a bubble under a carpet. So I was horrified to discover, in my latest stint in a psychiatric hospital, that others experience exactly the same as me. Others use the same ‘maladapted coping mechanisms’. They are also their own worst critic; they replay their mistakes; they are wracked by ‘meta-worries’: being worried about being worried.

Are British teenagers suffering from an epidemic of mental illness? Yes, according to a ‘government-funded study’ which found that 24 per cent of 14-year-old girls are suffering from depression. This has been seized upon by critics of Conservative education policies; they see it as ‘proof’ that the increased focus on teaching children knowledge, as well as more frequent testing and the GCSE reforms, have literally driven children mad. ‘One in four girls is clinically depressed by the time they turn 14,’ reported the Guardian. I’m sceptical about this and I took a look at the research carried out by the Centre for Longitudinal Studies, which is based at UCL Institute for Education.

In the NHS clinic where I work, adults who suspect they may have Asperger syndrome wait almost a year for a diagnosis. The clinic takes referrals from all over Cambridgeshire and Peterborough (a population of 860,000), but we have to see all of them in the hours of a single full-time doctor. And the clinic is not given funds to run a follow-up support service once someone has been diagnosed. These individuals struggle to socialise, are neurologically different, and are overlooked because their disability is invisible. Many have experienced bullying in childhood, underemployment in adulthood and exploitation because of their social naivety. Many are made to feel inferior despite their often considerable talents. No surprise that many develop depression.

Arguably the cruellest thing you can do to human beings is to rob them of faith in their own sanity. People can endure physical torment, even torture, so long as their minds are clear. If they feel sane, they can still make sense of what is happening to them and work out how to survive. But if you undermine somebody’s mental stability, they soon unravel. In the words of John Milton’s Satan in Paradise Lost, ‘Which way I fly is hell; myself am hell;/And in the lowest deep a lower deep,/Still threatening to devour me, opens wide.’ Chipping away at a person’s mental health is known as ‘gaslighting’, after Gas Light, the Patrick Hamilton play that in 1944 became a classic Hollywood melodrama.

A white van pulls up outside St Giles in the Fields, an imposing 18th century church in central London, around the corner from Tottenham Court Road station, for a couple of hours every Saturday afternoon. St Giles is known as ‘The Poets’ Church’ because it has memorials to Andrew Marvell and George Chapman, but this humble van makes the nickname more fitting. It’s a library. To be homeless is to have no fixed address, which means you can’t borrow books from a public library — but it doesn’t mean you’ve no desire to read. Quaker Homeless Action set up this mobile library in 1999, making runs into London twice a week and lending books to more than a thousand homeless people a year.

There are no roads from the Peruvian river port of Iquitos, but the rich take aeroplanes. Those who cannot pay to fly may pay the premium for the 40ft motorised express canoes that take only a day to roar to and from the upriver port of Yurimaguas with its bus station. But losers in the global race cannot afford speed. For them there are only the big, slow, hot, lumbering cargo boats: nearly four days’ journey from Iquitos to Yurimaguas. So the moment a passenger walks up the gangplank and strings their hammock between the iron rafters of the open--sided deck, we can guess he or she is not one of life’s winners. Anyone who was wouldn’t travel this way. No less than among the rich there is social stratification among the poor, and the river fast shakes people down.