Alex describes their experience of living with mental illness and the difficulty they face in explaining their feelings to healthcare professionals. They highlight the constant feeling of “okayness” that healthy individuals have, which is absent in those with severe mental illness. Alex compares their struggle to describe their experience to the feeling of needing to pee but not being able to find a toilet. They describe the similarity between the urge to hold on and the temptation to give in to the suffering in both situations. The article ends by emphasizing the difference between the inevitability of relief when one needs to pee and the absence of relief for those living with severe mental illness.

I had just left an rTMS session a little frustrated. The nurses ask how I have been to report back to the doctor, and I always find it difficult to describe. Not because there is some doubt as to what I am feeling (even if I do not understand why I am feeling it) nor because I do not have the language to describe it. I have realised after years of living with mental illness that my words become misinterpreted. I have felt consistently that every doctor and psychiatrist I have had so far has thought I am at least 3x better than I actually am. I think those who have never lived with a severe mental illness don’t realise that for the entirety of their lives they have this background feeling of ‘you are safe enough right now’ running through their heads – sometimes even through deep feelings of grief, sadness, anger and worry. This background ‘okayness’ may only go away for a moment, a day, a month at most (but usually remains in some form even if it doesn’t feel like it). But to the healthy-minded it always comes back. There is eventual relief. This does not happen with the mentally ill.

I was trying to describe to the nurse how a little bit of this ‘okayness’ had started to come back after I started lithium treatment. I said “the days are easier, time goes by faster than it did before”. After some more discussion, the nurse says “so time used to drag and now it is not?”. Time being a drag is like boredom. What I was experiencing was most definitely not boredom. But no matter how hard I thought (thinking is very hard nowadays) I couldn’t think of a way to explain what I was feeling in a way that the nurses could understand. How do you tell someone that under specific circumstances, the feeling they have in the back of their minds they don’t even realise is there, can go away?

I got in the car needing to go to the toilet, but in Covid times made the crucial error of deciding to try to hold on for the 1 and a half-hour car ride home, rather than risk a public bathroom. Around half an hour in the call of nature was getting louder. I really needed to go. Alas, it was 20 minutes until the next service station. A situation most of us have probably been in, even if the scenery is different (meetings, assemblies, public events).

A familiar feeling reared its head in the back of my mind. Time started to ‘drag’, but not out of boredom, it was out of suffering. Every minute felt like an eternity. This experience was eerily similar to parts of my depression and anxiety when it was at its worst.

Desperately trying to think of a way out, searching for some form of relief, but having none available. This conscious urge to try and hold on, not to let go. The strong temptation to let go now, knowing that the suffering will end.

If a person were to give in to the temptation early, one ends in temporary embarrassment, the other simply ends.

When you need to pee, relief is inevitable. Severe mental illness is not the same. It is like needing to pee all the time and never being able to – you simply have to wake up the next day with this in your head. You count the minutes and the hours. You try to get to the next day. You try to hold on. Time becomes a drag.