Coming out of the dark: A journey to understanding and coping with mental health

Ashma John (Photograph by Nadja Ramsaroop)

It has taken me about two years to fully understand OCD and anxiety and to accommodate the idea of being comfortable with dealing with it. While there were days where I felt as if I had the world in the palm of my hands, the truth was I really didn’t know on which days I would feel as if I was thriving or barely surviving. Dependent on what triggers I was antagonized by or whether or not I broke my routine medication intake by accident, my anxiety could suffocate my ability to be rational, force me into isolation and even publicly shame me with meaningless tears.

Before I was diagnosed and prior to receiving treatment which comprised anti-depressants and cognitive behavioral therapy commonly referred to as CBT, I thought of my illness as a part of my personal identity. I was repulsed by the word psychiatrist and unaware of how cultural, social and economic influences can make the realities surrounding mental health invisible.

My need to constantly obsess, recheck, guilt trip myself, and panic uncontrollably over the slightest incident I thought defined who I was even though it was exhausting and uncalled for. I had such an obsession with checking myself for everything that a health care professional once said she felt incredibly guilty to take my money. Without it, my life felt strangely odd until I got the help I needed about two years ago. 

Cultural and social context

Being raised in a home and a society where abuse is normalized and where there is the ideology that mental illness can be beaten, prayed or emotionally abused out of someone, I had to suppress my anxious thoughts, or anything that bothered me for that matter, from a very young age. Abuse was so normalized that speaking about it seemed inconsequential and pointless for a very long time.

I remember looking at advertisements on the television for anti-depressants when I was younger and hearing them being called the pills for “white people’s sickness”. My mom had this strange habit of saying that our abusive household was like the university for it and that later on we would be able to make better decisions because of it.

I never imagined that the past reflections and realities of my life would one day resurface as a cause and solution for me as it pertains to my health. For the most part and for a very long time, I thought the refusal of help, which I was nurtured to believe showed strength, was a way proving that I was okay, and that it was shameful to show vulnerability. It created the most distorted meaning of strength that took years to unlearn.

I was so accustomed to silence and violence as a way of healing and dealing with any problem, that any alternative seemed a mad idea no matter who it was coming from. As the illness reached its peak, religious guilt and the concept of family honour also constantly crept in through social conditioning. I was made to feel as if I was being unfaithful to God and to my family for seeking external help. In the few instances where I confided in those close to me it was used against me by friends, family and society; I was seen as ungrateful for the life I had while growing up. My social and economic privileged background jarred with the disparity around me at the time and made it impossible for anyone to understand that matters of the mind were actually matters at all. Isolated is an understatement as it relates to how I felt but exploring the reality of my illness meant acknowledging that socio-economic and cultural factors had muzzled my voice and concealed my illness.

Getting help

I took a very long time to access help. Even when I ran out of my misguided idea of strength when I was at university and crashed emotionally and physically, it still wasn’t enough to convince myself that I needed it. It was, however, the first sign that something bigger was going to come that I would have to deal with eventually.

When I was first confronted with the question: ‘Have you ever been abused or faced trauma of any sort?’ by a university doctor, I said no without hesitation. As reasonably intellectually sound as I was, I still wasn’t ready to make the connection. A deeply-flawed culture of not expressing feelings does that to you. I felt immense shame, unworthy and ruined. All I could think of was how many people overshadowed my complaints. But this time, somehow hearing the question for the very first time from a medical professional transformed it into an actual issue worth being explored further.

My whole physical disposition changed as I contemplated my answer with my face buried in my lap. Shame would not leave me. Somehow, I sensed the doctor and I both knew that sooner or later I would be back ready to tell the story. I still believed at that time that suppression meant strength and it meant that I was okay. I just wanted to be okay.

It’s funny how when all we ever hoped for is offered to us we find just how difficult it is to enjoy it all. My entire life has been about coping. Finding myself in a situation where I didn’t have to always have a ‘Plan B’ was strange. Believe it or not, the desperate feeling of really wanting access to mental health help came when I found myself in the most safe and loving home I have ever been in; married to my husband. I couldn’t grasp that the life I always wanted had actually happened and neither could I understand nor appreciate why my husband wasn’t upset sporadically.

I had become so accustomed to unhappiness that without it life felt abnormal. It was as if I was waiting for a slap or an argument. I became paranoid, anxious and intrusive thoughts would haunt me as I aggressively tried to love my life wholesomely. I was reliving my childhood trauma and it was exhausting. I have always obsessed over the idea of marriage and it has always been the determining factor in every relationship I have been in. In the most beautiful way I have always imagined recreating my childhood family life as a gift to myself to allow the calmness and happiness I was deprived of growing up. But once I eventually had it I realized it wasn’t the complete solution to the problem I was burying. Filled with frustration, I cried so loudly one day when I lived in Belgium that neighbours were moments away from calling the police.

The little rational thought left in me and the memory of my first meeting made it feel okay to explore the reality of my history being the actual problem. Gaining courage to book my first appointment with a therapist was the most difficult thing I have ever had to do in my entire life but definitely the reason why I am still alive today.

What is it really?

Most naturally, one of my first questions to my clinical therapist and my psychiatrist after handing my thoughts over to them and receiving my diagnosis is why? It felt incredibly weird to know I was ill without feeling physical pain or seeing a bandage of some sort. I was still fighting cultural stereotypes of the perception of mental health in my first two appointments. I learnt that my illness could have been from an inheritance, a chemical imbalance or life events inclusive of abuse, bullying and bereavement or a partial mixture of all of the above.

There is no set reason as to why. I learnt that despite the fact that bruises and scars may heal relatively easy in most cases, mental trauma was one of the most difficult and complex things to settle without help of any kind. With the help of therapy, I started to look at abuse and trauma from a medical perspective as opposed to something cultural. I learnt that exposure to high levels of trauma in children affects brain development, hormonal systems, the immune system and the way DNA is transcribed.

I later learnt that a developing brain that is chronically stressed releases a hormone that shrinks the size of the hippocampus, an area of our brain responsible for processing emotion and memory and managing stress. A brain dealing with unpredictable chronic stress due to antagonistic childhood experiences, can potentially face neuro inflammation. This means that children who come into adolescence with a history of adversity and lacking the presence of a consistent, loving adult to help them through it may be more likely to develop mood disorders or have poor executive functioning and decision-making skills. While these are just a few changes that happen to the brain it is not difficult to see why those who have experienced trauma of some kind engage in high-risk behaviour, have a triple lifetime risk for heart disease, lung cancer or even contemplate suicide.

My reality

Unfortunately, as a child, I experienced and witnessed some horrific, inhumane acts of abuse at the hands of both of my parents. I have lived through public beatings of my mother with computer cables as members of her staff watched on, the bursting of the lips and branding of the skin of a sister with a leather belt because she shaved her legs, the chiseling of another sibling’s finger with a kitchen knife, the whipping of another sister while she lay looking lifeless and barely covered in our yard, the promotion of sibling rivalry by show of favouritism and discussing the downfall of one child with another. There were countless other instances, but these are the ones I remember every day.

I have vivid memories of praying through the screams, my heart beating like a racehorse and being highly anxious over not knowing when the next outburst would occur. I would have traded an arm and a leg for it all to stop. Amongst the chaos and despite being financially stable, my siblings and I were left to raise and learn about ourselves with hardly any parental guidance. Despite being physically present, my parents were never in our lives. Our relationships lacked the most pivotal necessities for a child’s holistic brain development such as care, love and attention. The marriage of my parents was burdened by intimate partner violence and equally marred with deep racial and gender-role frustrations which then extended onto their children and work/life balance. Both of my parents grew up in extreme poverty and in homes where abuse was condoned.

According to an article published by UNICEF titled ‘Behind Closed Doors: The Impact of Domestic Violence on Children’, the single best predictor of children becoming either perpetrators or victims of domestic violence later in life is whether or not they grow up in a home, where there is domestic violence. Studies from various countries support the findings that rates of abuse are higher among women whose husbands were abused as children or who saw their mothers being abused. Children who grow up with violence in the home learn early and powerful lessons about the use of violence in interpersonal relationships to dominate others, and might even be encouraged in to doing so. But the article stated that not all children fall into the trap of becoming victims or abusers. Many adults who grew up with violence in the home are actively opposed to violence of all kinds. Many children who are present during acts of domestic violence try to help. One study showed that in 15 percent of the cases when children were present, they tried to prevent the violence, and six percent tried to get outside help.

There is no denying that much of this passed through generations in my family while being cushioned by society’s general acceptance of male dominance and superiority and the general ideology of parenting through violence and forceful authority.

Temporary band-aid

There were brief moments of clarity though. I was extremely fortunate to learn to ask questions and I was made to feel it was okay by my late godmother, who was a nurse and counsellor. She took us to church every Sunday. Making her part of my life was the best decision my mom ever made for me. Talking with my godmother served as my debriefing sessions. My curiosity was motivated by the freedom and light heartedness they allowed me to have. Our little conversations gave me enough to carry on day to day.

Questions and opinions about feelings and frustrations were listened to instead of attracting abuse. However, these did land me in constant isolation and managed to get me kicked out of my family home for a period in 2015. It was a roller-coaster. I sometimes struggled to see the benefit of it because of the isolation and uncertainty it brought. I felt cornered and the subjection to abuse felt necessary to survive despite temporary moments of clarity and peace. I also developed an eccentric, visual personality through fashion. It helped me constantly reinvent myself and distance myself from my reality. It was, however, never enough.

Actual help

CBT and antidepressants have managed to bring me to a consistent balance for the first time in my entire life. They have afforded me the opportunity to look at trauma from a logical medical point of view as opposed to a cultural one. While it doesn’t mean that the abuse sustained was okay or my emotions were invalid, it enlightened me on the hardships my parents must have faced for such a reality to even occur and the importance of ending the cycle.

I feel less anxious and I spend more time living in the present. Treatment varies for different types of mental health illnesses and the extent of the illness. While the idea of taking a pill to feel happier and settled was a shameful feeling to have, mental illness, regardless of how we look at it, is still an illness. Treatment for mental health is multidisciplinary. It can incorporate home visits, care coordination, medication and therapy. There is no set cure for everyone. In many cases treatment isn’t even lifelong because of how effective the therapy is when coupled with the early intervention.

I acknowledge that I was extremely privileged to receive access to some of the best help and fortunate enough to eventually be able to walk away from my abusive environment. In many cases this isn’t the reality for those living in or surviving abuse. The greatest privilege, however, is knowing and understanding that mental illness is not some faux illness and acceptance of help is normal and standard.

For those who have experienced abuse of any form from a family member, partner or anyone for that matter, know that you are never alone. I know of the immense shame and unworthy feeling that you carry but understand that there is always help. Regardless of your age, sexual orientation, class, colour or creed, discussing your feelings and formulating your own opinions is never a bad thing and is always valid. I hope we all find lasting peace as a community and all actively try to play a part in recognizing that abuse and mental health are not just family matters meant to be kept under lock and key. Mental health can affect anyone, regardless of socio-economic status, spiritual beliefs or physical well-being. The more we speak about it the better off we will all be.

 

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