Alex discusses some misconceptions about mental illness that exist in society. He notes that mental illnesses are complex and individual experiences of mental illness vary greatly. Environmental and genetic factors can play varying roles in the development of mental illnesses in different people. Alex also emphasizes that mental illnesses cause both emotional and physical pain, and depression is not just a loss of emotion, but rather the twisting of emotions. He also points out that anxiety is not just worry, but it can be a debilitating condition that takes away an individual’s control.

During the editing and proofing process of the Physics World article I wrote, a few misconceptions slipped in. Which is understandable. Before I became mentally ill, I believed many of the misconceptions I have listed below. As I slowly got sicker and sicker, I realised just how wrong most of the common perceptions of mental health conditions are.

A poor understanding of the brain in society leads to films, T.V. shows, articles and other forms of media misrepresenting what mental illness actually is like. Ironically, this misrepresentation can come from the mentally ill themselves. It can be immensely difficult to describe what it is like to have a mental illness because the very nature of the illness affects the organ that we use to describe what it’s like.

Our society is therefore filled with misconceptions galore. Which makes having a mental health condition or illness all that much harder to deal with. Something I hope to rectify very slightly here.

I want to emphasise that the article is based on my experience. The following will likely differ from person to person. Which brings me on to my first misconception.

Individual experiences of mental illness never apply to everyone, mental illnesses are inherently complex

There are so many articles and blog posts written like this one, hypocritical I know. Headlines like “Is Depression caused by societal influences.” No. “Is Depression caused by genetics?” No. Such global assumptions can be incredibly damaging and misunderstand what an interconnected complex system is – the key word being “interconnected.”

I think a good example is the global system of commercial airline routes. If you were able to magically make one airport in the world vanish instantly it will either have dramatic or minimal consequences depending on the one you choose. If you made Heathrow disappear, the whole system would be thrown into disarray. But if Juancho E. Yrausquin Airport on the island of Saba faded from existence, most people probably wouldn’t even notice. Crucially, however, its disappearance would still have a very small effect on the system as a whole. The airport carries 30,000 passengers every year, which isn’t insignificant.

From my understanding, every person has a similar but not identical neuronal interconnected system (i.e. a brain). Using our plane route analogy, some people’s brains might use Heathrow as the main international airport in the UK but others may use Gatwick instead. So an environmental influence (let us say a workers strike) that only affects Heathrow will have much less of an impact on people who use Gatwick as the UK’s main international airport.

Confusing plane analogies aside, in one person, environmental influence may be the dominant factor in their condition, with genetics contributing only a negligible influence (But it still exists!). In another person, the genetic influence might be the dominant factor. I’ve seen so many authors, me included, fall into the trap of assuming that their experience of mental illness can be applied to everyone who has been diagnosed with the same condition.

I believe that all anyone can do at this point in time is pick up on potential themes that the majority of sufferers might have in common. Which is the intention of this article.

Mental illnesses don’t just cause emotional pain – they cause real pain too

What is pain, if not the persistent over-excitation of neurons? When I first experienced the symptoms of depression, I was shocked to realise that it was painful. And by painful I do not mean the emotional pain associated with sadness or anger etc. It was more akin to pain from injury – but solely in my head. It hurt.

Of course, I did have a lot of emotional pain too. The combination of both the physical and emotional pain in my head made having mental illness absolute agony. So much so that I think I can understand why others would self-harm. To initiate a lesser pain somewhere else to occupy some of the brain’s limited energy capacity.

Depression is not “loss of emotion”

Often depression is described as like your soul being sucked out of your body or an emptiness or loss of feeling. That is, describing the decrease in intensity of emotions. I have found that this is half-true for positive emotions but isn’t true for negative ones. During my depressions, negative emotions (e.g. helplessness, loneliness and stress) actually increased in intensity. To the point that they drowned out the positive emotions. I still felt positive emotions, but they were fleeting and extremely reduced in intensity.

The major effect of depression is, in my opinion, the twisting of emotions – both good and bad. In the Physics World article, I described the early stage of depression as being like emotions losing their “colour”. Another word would be “flavour”. As an example, during my depressions things like sunsets used to evoke a mutant like, empty positive emotion. Negative emotions actually gained “colour”. They became this hellish monster that pervaded my mind almost entirely.

Anxiety is not “more worry”

The word “anxiety” has become disempowered. Most of us use it for emotional states that are better described by the word “worry”. Worry can be a powerful emotion, but the individual experiencing it always has some degree of control. Whether that is through distracting themselves from the worry or taking the relevant actions to alleviate it (e.g. if worried about a mole on your skin you can simply see a doctor about it). In anxiety, I believe that no such immediate control is possible.

In many anxiety conditions, the sufferer becomes incapacitated. Similar to the change of quality between sadness and depression described earlier, the same happens with worry and anxiety. Anxiety feels like you are transported to hell itself, with no means of escape. In a condition like generalised anxiety this is felt constantly, with no associated trigger at all. In my case, it feels like there is an invisible barrier stopping me from doing certain actions. The generalised anxiety causes me to lose complete control. The more I do the action that is associated with my anxiety, the deeper into hell I go. It has even corrupted my imagination. For years, ten minutes never went by before some image/thought of suffering or death entered my mind. At its worst, I felt like I was actually experiencing the suffering or death myself.

Trust me, you do not want to experience anxiety.

Mental illness is not only hard to spot from the outside, but from the inside too: it is literal brainwashing from within

For about 3 years I fully believed that others were experiencing the same types of feelings and thoughts as I was. Just to a much lesser extent. Only after taking pregabalin, the first drug that significantly improved my condition, did I realise that other people were not experiencing what I was at all. Others were not perpetually thinking about death or suffering, or persistently overcoming a sense of dread. While this might seem obvious to the five people (one of them my mum) who will end up reading this article, it most certainly was not obvious to me.

A significant chunk of this brainwashing comes from outside influences. The assumption/delusion that the experience of others is very similar to our own affects each and every one of us. Since my experience is so far removed from most other people, the result is the persistent softening of my experiences by them. I have lost count of the number of times others have assumed their experience of worry is in the same category as my anxiety. I understand why this happens – it is human nature to want to find others that have had similar problems or experiences. However, consider that instead of anxiety, I suffered from seizures. Would others who have suffered brain fog so readily place themselves in the same category as those who suffered seizures?

This has the effect of confirming the brainwashing from within. Confirming that the horrible experiences that a mentally ill person goes through is something everyone else goes through too – just to a much lesser extent. When the reality is that normal people don’t have experiences like the mentally ill at all.

I strongly feel that this brainwashing contributes to the high rate of suicide seen in mental illnesses. The challenge of being normal becomes too much.

Mental illnesses make people more resilient, not less

Mental illnesses are devastating. Not just the disease itself, but because of the lack of understanding of them, it feels like you are having to fight doctors and society as well as the illness. The world is not set up to deal with the mentally ill – in fact, I would say it is set up to do the opposite. To live in this world with a weakened brain and to fight for functioning requires a lot of resilience. Each minute a mentally ill person chooses to stay alive is an act of courage. Those who die by suicide will likely have endured many of these kinds of minutes. I don’t think this resilience is mentioned enough.

For those lucky enough to have support to not only stay alive but get back to remission, they will have endured one of the deadliest collection of diseases in human history. That counts for something, right?

Low self-esteem and depression are not necessarily connected

There is a question on the Patient Health Questionnaire that reads: “Over the last two weeks, how often have you… [been] feeling bad about yourself – or that you are a failure or have let yourself or your family down”. During the entirety of my mental illness, including crippling depressions, I have answered this question with “Not at all”. I would admit, it is weird having really high self-esteem and being depressed. But it is possible. It took a lot of work in the counselling room in order to get to this odd state of affairs, but I am quite confident that it saved my life.

I believe that for a person to commit suicide, pain is not enough, you must take away that person’s future too. If a person doesn’t feel they are valuable or worthwhile in society, then why continue living in it?

I think this is where society can play a beneficial role. I think it is far from certain that to suffer from depression means you must also have low self-esteem.

One thing I have learned from having high self-esteem is that there are not very many other people who have it too – irrespective of mental health problems. I believe that the counselling room is the best place to switch this around. Seeing a counsellor even once helps to reduce stigma.