Look at the person, not the symptoms

MIND MOVES: Medication alone is not enough for those with mental health problems, writes TONY BATES.

MIND MOVES:Medication alone is not enough for those with mental health problems, writes TONY BATES.

A FRIEND of mine was admitted to a psychiatric hospital recently. Watching her progress, or rather the apparent lack of any, from the wings I have been struck by how our own best intentions to help a person in crisis often blind us to what they most need from us.

Sometime over the new year, she lost faith in herself. Everything frightened her, her confidence dropped to an all-time low, despair began to creep into her every waking moment, and she frequently found herself in tears for no particular reason.

Although we can be amazingly resilient as a species, we all have a breaking point. In my friend’s life, the build up of a number of stresses in her life over a period seemed to overwhelm her. A deep wound in her mind was re-opened and everything about life just simply became too much.

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Time out seemed like a good idea to both her and her doctor. A safe place where she could feel cared for and gradually come home to herself. She accepted that perhaps a short stay in hospital would give her the space to figure things out.

It’s now been two months since she stepped out of her life but there is no evidence that she has improved. She sits around most of the day in a room of her own and seldom has someone she can talk to.

Various medications have been tried, mainly with a view to lifting her mood. She feels that these have left her feeling disconnected from her body and her emotional life.

They gave her weekend leave and she felt worse when she returned. The staff took this to mean she wasn’t strong enough to be discharged and increased her medication. She said what got to her was the realisation that everything in her life that was unresolved was still out there waiting for her.

Time out can be healing for any of us. But when our refuge becomes an escape, an avoidance of challenges that won’t just go away, we may buy some time but we fail to prepare ourselves for the inevitable. I felt concerned that no one around her had allowed her to talk through how she planned to deal with the real practical problems she needed to solve. And also their apparent failure to recognise how this set her up for yet another experience of feeling overwhelmed when she took weekend leave.

Regardless of whatever diagnosis is given to people with mental health problems, an experience, which many have in common, is that they lose the courage we all need to live our lives. Behind every disorder is an intense experience of fear – the fear of problems that they feel are too much for them.

My friend was full of fear and had probably been carrying this fear inside her for years. She needed to connect with her fear, to get to know it and be empowered to deal with it. Ideally when she was in a safe place, with lots of supports around her. The curious thing was that no one enabled her to address her fears, preferring to wait for medications to take it away.

Another vital of a person’s recovery is that they rebuild a sense of who they are. We can do this only when people around us see us for who we are. My friend is a gifted young person with many professional and academic achievements to her credit. Yet in her conversation she said repeatedly and very quietly that she had no idea who she was anymore.

She felt this had something to do with the fact no one had really asked her, to date, about who she was. Because no one had taken the time to get to know her as a person, she had become increasingly alienated from her “self”. People had tracked her symptoms carefully but it felt to her that this was all they were interested in when they spoke to her.

It’s easy to watch from the sidelines and pass judgment. Yet I have no wish to do so. I’m certain that there are many good people caring for her who want her to be well.

And I’m not claiming that I understand all the elements in her life that have contributed to her being unwell. But I do know that this was someone who seemed to be in far better mental health when she was admitted to hospital than she is now, eight weeks later.

I can only hope that someone now takes the time to get to know her as a person, that they learn to see beyond her symptoms and appreciate that she is someone, like the rest of us, who is afraid and who feels terribly lost. That they don’t leave it to medication alone, but use her time in there to build up her confidence.

And that they give her some basis of hope that she can get beyond this intensely lonely experience of feeling helpless, and back into her life as the creative, gifted woman that she is.


Tony Bates is founding director of Headstrong, the National Centre for Youth Mental Health (headstrong.ie)