‘Not sick enough’

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Content warning: suicide and self-harm

I have never been admitted to a psychiatric hospital. I have never attempted suicide. I’ve never abused substances, had delusions or self-harmed. I’ve never had to withdraw from school. I’ve never even taken a reduced course load.

So am I sick enough?

When I first thought about writing this column, I felt a little guilty. I have a chronic mental illness, but there are others with illnesses far more severe than mine; am I really the most qualified person to write about mental illness if the closest I’ve gotten to hospitalization is the visiting room? Can I really write about issues such as suicide if I don’t have the real-life experience? 

Mental illness isn’t easily defined. While my therapist has me rate how I’m feeling on a 1-10 scale each week, there isn’t actually a definitive way to “rank” my mental illness and its severity. Illnesses are relative; what is “severe” for one person is functional for another. Both deserve to receive as much treatment as they need. Although a person in a mental health inpatient unit is likely in need of more intensive treatment than I am, I know now that doesn’t mean I don’t deserve to go to therapy or that we both can’t talk about our experiences if we choose to. If anything, the breadth of our experiences showcases how different mental illness can look and feel.

This concern about being “sick enough” stopped me and many people I know from getting treatment for a long time. When I talk to my friends about seeking out therapy, many of them say, “Other people need it more.” This statement isn’t meant to dismiss therapy as an option only for the worst cases. Most people who say this are instead thinking that their suffering isn’t worthy of treatment, isn’t enough to warrant taking up resources or to seek help. At a university with limited mental health resources, we feel forced to think this way, to measure our experiences against our friends’ and make estimates of how “bad” it needs to get before we are deserving of help. But what does sick enough even look like?

The phrase, “Other people need it more” stopped me from going into urgent drop-in counseling when I was in crisis. I knew I wasn’t necessarily a danger to myself or others, but this phrase still echoed through my mind. When I was between counselors my freshman year, I didn’t go back to counseling until I couldn’t sleep for several days from heart palpitations and felt like I wasn’t in control of my thoughts. Because I waited until I experienced an extreme deterioration, it took me a lot longer and a significant amount of work to feel a little better, progress that would’ve been easier and faster if I hadn’t waited so long. 

When my psychiatrist first suggested I try transcranial magnetic stimulation, or TMS, treatment, my first reaction was that I can’t possibly be sick enough. Brain zapping seemed like an extreme measure reserved only for the most difficult to treat cases. The combination of my internalized stigma against such treatments and such illnesses, coupled with my understanding of mental health care as reserved only for the patients who suffered the most, led me to believe that TMS couldn’t possibly be an option for me. I wasn’t, couldn’t and didn’t want to be sick enough.

The truth is that I was sick enough and so are a lot of other people; TMS is just another treatment, not one reserved only for the most severe cases. The bottom line is that anyone who wants to try and has access to treatment is sick enough.

When we think of illnesses on a scale, as if there are levels of twisted achievements, we delay our own healing.

In a perfect world, there would be unlimited mental health resources, and we would all be treated for any issue that might arise with haste. In our less than perfect world, there is a three-week wait at the Tang Center. But that doesn’t mean you shouldn’t book a one-hour appointment. The Tang Center is a resource for all of us, and we should all feel free to use it, whether we need help coping with stress or we need assistance managing a more chronic illness. 

In the same way, I don’t rob someone else of their experience by writing about mine. I’m certainly no expert, but my perspective as someone who has a mental illness and has done extensive advocacy work surrounding mental illness could be useful to someone else. 

I am sick enough. I wish this wasn’t the case because not having a mental illness is the only scenario in which I would not be “sick enough.” But this is the illness that I have, and I deserve to treat it and to talk about it, just as anyone does, whether they have asthma, anxiety or mania.

Salwa Meghjee writes the Thursday column on destigmatizing mental illness. Contact her at [email protected].