Lucy Foulkes - What Mental Illness Really Is... (and What It Isnt)

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First published in Vintage in 2022
First published in hardback with the title Losing Our Minds by The Bodley Head in 2021

Copyright Lucy Foulkes 2021

The moral right of the author has been asserted

ISBN: 978-1-529-19506-4

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There is no uncontroversial language when talking about mental illness and that includes the phrase mental illness.

Nathan Filer

When it comes to matters of human distress, some people argue that the labels of illness or disorder are unhelpful, and I am entirely sympathetic to this view. The concern is that these terms are stigmatising and medicalising, implying entirely internal causes or personal fault when as we will see so many of these symptoms are an understandable response to suffering and hardship brought on by stressful lives. But alongside this, I also believe that some psychological experiences are so distressing and disabling that the labels of illness and disorder can be useful and necessary. I therefore use these terms, cautiously, throughout this book. But I recognise that this language, like all language on this topic, is imperfect and I talk about that quite a bit too.

Let me paint a picture of an idyllic life. Its my life, in fact, when I was twenty, in the summer after my second year at university. I was studying psychology, which I found fascinating. I had just started going out with my boyfriend, another student, and I was falling in love. I had a great summer job as a swimming teacher; I was close to my parents and my brother; I had a lovely bunch of friends both at university and at home. From the outside, my life that summer was incredibly easy, hopeful. But on the inside I was unravelling.

I was in Turkey when everything came undone, on the first night of a week-long holiday with my three best friends. The problem had been brewing for a while I had been feeling low for months but on that holiday a switch flicked in my head, and I suddenly became much, much worse. Walking back to our apartment after a day at the beach, seemingly out of nowhere, I began to feel like I couldnt breathe. My thoughts became dark and opaque. We found a doctor, and he said to me in broken English, perplexed Why you crying? Youre on holiday. He injected me with Valium, my friend beside me holding my hand. I flew home the following day, hoping vaguely that when I got home somehow everything would be okay. I was wrong. That summer was the start of months, of years, of my experience of mental illness.

When I walked into my kitchen after the flight, I had a strong sense that the room was unfamiliar. I knew objectively I was in my own house, but at the same time, it felt like Id never been there before. (I later learnt this is called derealisation, or jamais vu never seen a sinister sister to the more common dj vu.) It cloaked me like a cloud, a creeping, awful feeling, and I realised something serious was happening to me.

My dad took me to an out-of-hours clinic in a local hospital where I was prescribed more Valium, and then to a GP the following day, who gave me antidepressants. After the longest, darkest month of my life, I went back to university for my final year. I wasnt ready to go back, but I was too scared of the alternative: a year at home without distraction. At university I was a ghost in my own life: scared to be on my own; not sleeping; crying on campus and on trains.

It took about four months before I felt a glimmer of something that wasnt depression or anxiety, and about three years until I believed that those feelings wouldnt dominate my life. Over the years, Ive seen many therapists and I also took medication on and off for about five years. I am much, much better now, and have periods where this all feels like a distant memory. But as anyone with similar experience will know: it lives with you.

But this book is not about me. There are plenty of excellent memoirs out there depicting what mental illness feels like, many of them by people who have suffered far more than I have. Instead, this book is about whats been happening around me: in the research world and in society at large. After I finished my degree I did get there in the end I decided to stay in academia, and I now have a PhD in psychology. I now work as an academic psychologist, researching mental illness, working with some of the most innovative mental health researchers in the world. This book is partly about this academic knowledge: mental illness is a fascinating, intricate, messy area of science, and there are so many stories about this research that need to be told. But something else has happened since I was first unwell, something in society, and the book is about that, too.

When it happened to me in 2008, no one talked about mental illness. The doctors and psychologists I saw told me it was very common, that they saw lots of patients with depression and anxiety, especially young people like me. When I looked around me, though, at society, at my peers, I saw nothing. There were some books, a few websites, but no presence, no public conversation. Professionals telling me that I wasnt alone was irrelevant, because everywhere I turned, in every practical respect, it felt like I was. However, this public silence was about to change. I didnt know it then, but my experience happened around the time of a significant cultural shift.

It started in 2007, with a charity called Time to Change, whose goal was to end mental health discrimination and stigma. Their mission began quietly, but in 2011, they launched a national campaign, with four weeks of television adverts and the following tagline: Its time to talk. Its Time to Change. Celebrities like Stephen Fry and Ruby Wax were involved, discussing their own mental illnesses. The campaigns flagship statistic that one in four adults will experience a mental illness in any given year started appearing widely. I clearly remember reading a Time to Change leaflet around then. I was working as a research assistant after my degree, and I used to go to secondary schools and ask teenage participants to complete a series of cognitive tasks on laptops. While waiting for one of them to finish, in an upstairs room of a maze-like old school, I started reading some of the health information on a noticeboard. One of the leaflets, bubblegum pink, was about the Time to Change campaign. I remember being struck by the one-in-four statistic, and the celebrity stories: realising there really were other people out there like me.