Roses are Red, Winter is Blue

It’s that season again. Some love it; some (I’d like to think most) hate it. If you are like me, then you fall in the latter group. Some hate it so much that it makes them blue…literally. Ironically, mental health awareness is observed during the month of May, which happens to be the first month of winter.

I thought I would write about something a lot of people don’t really want to or are uncomfortable talking about: Psychotherapy, commonly known as counselling. How comfortable are you talking about how you’re feeling especially if those feelings are not “share worthy”? Human beings are generally happy to share the niceties of life; the happy, joyous, “fluffy” and frivolous experiences, while sad, heartbreaking, or that which they perceive as embarrassing is swept under the proverbial carpet.

One has to wonder why, in the age of all things awareness; there is still stigma around mental illness and counselling. Goodness knows we live in what seems to be more stressful times compared to our parents and their parents. Or perhaps it is just a different kind of stress? I mean Apartheid, World Wars and the Holocaust were quite stressful, I’d say. Every generation has its challenges. It would seem that with every generation we are always changing for the better (we hope), upgrading ourselves so to speak. Look for instance at what we have achieved in terms of technology, and yet it would seem we are not evolving nor improving much when it comes to certain things. Stigmatising illness, especially mental illness, is one of those things.

People who suffer from some kind of mental illness or disability are most likely to be judged and looked down upon by others, regardless of type and extent of illness or even reason for the said illness. (*Disclaimer: NO illness should be judge ANYWAY). Stigma can be defined as a mark of disgrace that sets a person apart from others (who are seen as “normal”).  Those who stigmatise others for whatever reason often judge and ridicule them. This often has negative implications for people living with mental illness: constantly feeling that you are “abnormal” can lead to distress and anxiety, further feeling shameful and hopeless, further exacerbating the illness and also causing delay in seeking or accepting help (counselling) or even worse, not seeking counselling at all.

When it comes to the blues, I am pretty sure all of us have experienced them at some point in our lives for whatever reason. For some people it is easy to “build a bridge and get over it” and for some it can be quite a daunting task and journey to recovery and “normalcy”. Depression is the leading cause of mental disability worldwide. I don’t think that this is a new age thing but it is perhaps more talked about now than in the olden days. Be that as it may, talking about being depressed or struggling with emotional issues is still seen as a sign of weakness. And seeing a shrink / seeking counselling are still perceived as taboo / weird. Still, there is much stigma around even a common mental disorder such as depression. I will never understand why it is “acceptable” to have diabetes, yet seemingly unacceptable to have depression. Both involve an imbalance hormones and chemicals in the human body. Perhaps as a health care professional I am biased towards awareness and treatment of ALL illnesses, including depression.

For the purpose of this article, I want to concentrate more on the necessity for psychotherapy than depression specifically. Many people shy away from psychotherapy / counselling, because to seek help to sort out your head / psychological issues is THEE ultimate sign of failure? The consequences of not treating depression and other mental illnesses are just as real and may be as tragic as not treating diabetes. When diabetes is not controlled, the patient may suffer a heart attack /stroke /go into a diabetic coma. Same goes for depression. It may be so severe that the person may suffer from acute psychosis, nervous breakdown and even suicide.

Psychotherapy can be defined as the treatment of mental disorders by psychological rather than medical means. Loosely translated, psychotherapy is basically “talk therapy”, whereas “medical therapy” refers to medications and procedures which are aimed at balancing the chemicals and hormones which become unbalanced and lead to depression and other mental disorders. Some people need both medical intervention and counselling to fix the problem. Unlike other parts of the body, we cannot look at or touch the “psyche” when it is unwell. We cannot do an X-Ray to show the patient what went wrong. So, treatment here involves talking through things to understand the disorder and related emotions, moods, thoughts and behaviours. There are various approaches of psychotherapy depending on the situation/s which led to the disorder in the first place. Recommendations may range from one or a few sessions to hospital admission followed by weeks /months of follow up sessions to assist a person to get through what they are going through and get them back to a fully functional state. The ultimate aim of therapy is to teach coping mechanisms and strategies to deal with the problem, take control of one’s life and to respond in a healthy and appropriate manner to different everyday challenges.

Back to stigma, this is probably at the top of the list of reasons why people think twice or hundred times before seeking counselling. What will people say (when they find out I’m seeing someone about my problems)? Well, people will say many things, always, for this is human nature. Stigma also perpetuates the misconception that people who need counselling “are mad” or are failing at life. People would rather suffer through immense pressure and stress to a point of major depression and nervous (mental) breakdown than deal with a problem while still able to make sense of it and manage it well. People would rather get divorced citing “irreconcilable differences” which they never worked through and tried to reconcile because the world will judge them for going to marital counselling. It’s much like having right lower abdominal pain, suspecting it may be an appendicitis, then ignoring the nausea, vomiting and fever until it ruptures and you are writhing in pain, all the while telling yourself “it will get better” and you stay home and hope for the best, until  you die of shock and sepsis. Emotional pain is no less than physical pain. Perhaps it is even more important to attend to and treat psychological problems as this is at the core of how we see and define ourselves. If you have an abscess, you get it drained. Psychotherapy is like draining the abscess of the mind by cutting through the emotions and letting the pus spill through words, tears and sometimes even laughter.

Perhaps it is time we start evolving our way of thinking as much as we have evolved technologically. And seeing that most of us love the glossy side of life, perhaps we can learn a little from the world of glitz and glamour. Because as John Carson once said: “In Hollywood if you don’t have a shrink, people think you’re crazy”!!

The SA Depression and Anxiety Group can shed more light on various mental health disorders and also guide you in the right direction regarding where to get treatment: www.sadag.org. Also try Lifeline SA on www.lifelinesa.co.za

Until next time, “Don’t worry… Be happy” J

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