The first time somebody said the words medical leave to me, it felt like both a deep personal insult and a prison sentence. I heard “you aren’t good enough to be here” and “you’re letting down everybody who believed in you” and “you’re never going to achieve anything” all at once. I knew the suggestion was a logical one — it came towards the end of my first term at Oxford, the majority of which had been spent too terrified of human interaction to leave my room and too cripplingly depressed to do any work — but I saw the time out as an indulgence I wasn’t willing to allow myself; I was, I insisted, not somebody who let their mental health get in the way of achieving things.
The fundamental flaw in this sentiment is one of many things I came to discover over the following months. Contrary to what countless motivational quotes would have you believe, you don’t get a choice over what you ‘let’ your health stop you doing. The ‘no such thing as can’t’ rhetoric is nice, but it erases the fact that for a person with a mental illness there arecan’ts: unfinished essays and missed social commitments and ambitions put on hold because they just aren’t possible right now. People with mental health problems can and regularly do achieve incredible things, but sometimes there comes a point where your health renders certain tasks impossible and no amount of positive thinking will change that. I got better at not feeling ashamed about the things I couldn’t do once I accepted that they were not down to a lack of willpower on my part.
Still, I stubbornly rejected the possibility of taking medical leave for a month or so after it was initially suggested. In the end it was not until the eve of my first collections at the start of Hilary, on a self-inflicted visit to A&E, that I considered I might be ‘ill enough’ to justify it. I had always skirted around explicitly calling myself mentally ill, partly to escape the stigma which surrounds the label but equally because I didn’t feel entitled to it. Mental illness is dangerously good at convincing you that it doesn’t exist; you convince yourself that it’s an excuse, an overreaction, a fundamental personality flaw. In retrospect I’d say I have had mental health problems since my early teens, and during sixth form in particular — but I was bright and hard-working and I was heading of to flourish among the dreaming spires; I couldn’t really be ill, right? I spent the last few months of year 13 literally unable to enter a classroom without experiencing intense heart palpitations and nausea and self-harmed in the school toilets several times a day, but it’s amazing what an Oxford acceptance letter and a clutch of A*s can hide — even from yourself — if you want them to.
When I agreed to take medical leave, I lost the convenient facade of neurotic high achiever behind which I had been able to hide. I could no longer pretend that everything was fine; I could only do my best to ensure that what people knew was on my own terms. So I started talking.
Not by coincidence, today is Time To Talk Day, a national event organised by the UK mental health campaign Time To Change to challenge stigma through open discussion about mental illness. I wanted to post this blog today because the day is important to me, both for what it works for and for the personal significance it holds. A year ago today, I was at home having very recently rusticated, and I posted on facebook about the event:
As somebody who recently made the decision to take time out from university because of my mental health, this campaign is very important to me on a personal level. But I also know that it’s something which affects an enormous number of people. In any given year, one in four people will experience a mental health problem. If that statistic surprises you, it’s probably because too many of those people don’t feel able to talk openly about their experiences. That is something that needs to change.
At the time, that small acknowledgement of what was going on in my life was the most public I’d ever been about my mental health. It wasn’t much, but it was scary and significant and the supportive response both from friends and from people I didn’t think were aware of my existence was overwhelming and humbling. I believed, and I still believe, that our own stories are the best weapons we have against the stigma surrounding mental illness, and by telling them we can move closer towards a society in which these things are okay to talk about. I am motivated to keep talking by the hope that eventually every single person who’s ever told me “thank you for talking about that — I can relate but I don’t feel able to talk about it” will know that they have no reason to be ashamed and will feel able to speak up if and when they want to.
In learning to be open about my mental health I found the necessity of sharing not only the negative but the positive. Mental health victories don’t tend to come with bragging rights; you’re never going to find ‘Congratulations on not self-harming this week!’ or ‘Well done for making it through another year of your potentially life-threatening mental illness!’ cards in Paperchase. Achievements are meant to be the things your parents can boast about in emails to old friends: competitions and certificates and another trophy to gather dust on a shelf. But today I woke up without wishing that I hadn’t and ate breakfast without feeling guilty about it. I got up before noon and showered and dressed and I haven’t cut myself in almost a fortnight. I am proud of these things and I will say so over and over until the word “proud” stops leaving a bitter aftertaste of unbelonging.
When I took medical leave I genuinely believed, melodramatic as it might sound, that I was throwing my life and all meaningful opportunities away. I’d be lying if I claimed that the time away wasn’t difficult: medical leave was in many ways a hugely isolating and discouraging experience, and every day waking up not in Oxford served to remind me of what I constantly struggled, with varying degrees of success, not to see as a personal failure. But scattered among the difficult experiences I found moments of clarity: I learnt to be more comfortable in myself as a mentally ill person, to see my mental health problems not as defining characteristics but as parts of me which I didn’t want to be ashamed of anymore. Perhaps most valuably of all, I found a voice and a will to speak that I didn’t realise I had in me.
I recently received the news that I am still not considered medically fit to study and would have to take medical leave for a second time. This, to put it lightly, was bloody hard. I’ve had to accept that my mental health problems probably won’t be going away any time soon, if at all; that recovery for me means an ongoing search for better ways of coping as a chronically mentally ill person. Significantly, I have come to feel comfortable using the label disabled to describe myself, which in turn has given me the framework of ableism with which to understand and put words to the ways I have been socialised to resent myself when my mental health prevents me from being productive and functioning as I am supposed to. Unlearning 20 years of internalised ableism takes time; it is a constant process of challenging the instinct to apologise for the space I occupy and some days I don’t manage it, but that’s something I’m working on.
The focus of this year’s Time To Talk Day is ‘Take 5’: take 5 minutes out of your day to have a conversation about mental health. If there’s a conversation you’ve been waiting to have, please let today be the motivation you’ve been waiting for — make that doctor’s appointment, reach out to a loved one who might be struggling, answer honestly when a friend asks how you are. Above all, please know that your experiences are valid and worth talking about and you have nothing to be ashamed of. Conversations about mental health can feel difficult and scary, but the more we have them the easier they will get, and that’s definitely worth a few minutes of your time.