Lean On Me

Lean on me, when you’re not strong, I’ll be your friend, I’ll help you carry on.

I read a recent article in the Chicago Tribune about the increase of peer support groups as mental health treatment, rather than wholly centering on a physician or therapist to guide treatment. The article talks about how people with mental illness use these peer support groups to get

“a chance to discuss and maybe get help for problems that, all too often, their friends, families and even therapists didn’t seem to understand. How do you feel comfortable at social gatherings when everyone there knows you tried to kill yourself? Should you abandon your religious faith if you’re prone to thinking that you’re God? How do you handle your illness when your child has it, too?”

I obviously believe in the benefits of this kind of peer support and discussion, or I wouldn’t be writing about my mental health issues on a blog for people with disabilities. I have gotten invaluable support, information and insight from friends with mental health disorders. Not only the big issues, like reassurance that depression will eventually lift and the sky will not fall on my head. Some of the most useful stuff I’ve gotten is a discussion of which facial scrub best deals with the flaky dry skin caused by taking lithium. (I use Pond’s Fresh Start Exfoliating Scrub with microbeads! They do not send it to me – I buy it.) I also strongly support the centering of people with mental illness and their own experiences.

But I’ve also had a couple of times when being so close to friends with mental illness may have been a bad idea. My roommate and best friend in college also was struggling with newly diagnosed mental health issues of her own, and a crisis for one of us tended to precipitate a crisis in the other. I vividly remember sitting in the waiting room of the emergency room as she was being admitted, folded up in the plastic chairs in the waiting room, reading The Bell Jar while I waited for her to be processed. And going into an immediate spiral that ended with me checking myself into the hospital a few weeks later. Where, despite being strip searched and in a carefully controlled environment, I learned from my fellow patients how to find things to use to self-injure.

For me, the scariest thing about depression is how seductive it is. Just giving up, since nothing matters or will accomplish anything anyway, and letting myself turn out to be the failure and disappointment I know myself to be. (Says the depression voice.) And getting well, and staying well, and maintaining the wellness, can be so exhausting that it can be tempting to just chuck it all. So I can find myself fetishizing the experiences, the memories. The accessories – the things I used to self-injure, the dark rooms and shapeless clothes. The feeling of being insulated from the world, wrapped in cotton wool, removed.

That’s why these support groups scare me. I saw that article and I felt it in my stomach. I can close tabs and scroll past these things on the internet, but in a room, talking to someone, I can’t just put my hand over their mouth. Maybe this is something totally unreasonable, an unfounded superstition I have, but I feel like it might pull me back in.

By 26 April, 2010.    introspective, mental health   



13 Comments

  1. I can relate. As a person who lives with others with mental illness 24/7, I can’t avoid being there when someone else has a crisis, and I can certainly tell you, 90% of the time, when someone is in crisis, at least half the ward will be unquiet, too.

    On the other hand, I think some structured forms of peer support, like recovery workgroups, can be very useful. I may participate in one when they’re setting it up at my institution (signed up but haven’t heard back, so don’t know whether they think I’m unsuitable or they just haven’t gotten it worked out yet). As you say, there are those smaller and bigger things you can more easily learn from someone who has been there. Also, an advantage is that no-one will be in authority, so it isn’t like some people by definition “know better” than others, as is often the case in therapy.

  2. I agree with Astrid – I need someone stable around (Er, relatively stable. More stable than me?) for my own reasons, some I’m not quite sure I have the words to express.

    But a peer group session… that would be amazing. I’d love for the counseling people on campus to put up fliers announcing a meeting to discuss* “finals stress” and other issues… maybe there’d be too many people to have a real discussion because college is stressful and often when you first have access to cheap counseling or… well.. I don’t know.

    *DISCUSS the stress, not just offer massages and free food. We can’t really destress until we say why we’re stressed.

    And I mean a real session… we had sessions in the psych ward (adolescent) and you said “I’m depressed because it’s raining” and then you got “feedback” like “you shouldn’t cry so much” (got that one) and “you should love your mom” (not for me, but I do remember that). But it wasn’t a real discussion because you couldn’t respond to the feedback or expand on your original thoughts, and the adult in charge was terrifying. (“I work in a prison! If you don’t get it together, I’ll see you there!” he said on my first morning)

  3. This is so dead-on. A lot of my friends also have depression and/or anxiety, and while it can be really nice to talk about things with them that I know other people won’t understand, I have to be really careful with one friend in particular because I can leave conversations with her feeling incredibly close to, as you say, “chucking it all”.

  4. I agree that support groups are a double-edged sword. But I am afraid they are going to be used more in coming years, at least here in the US, due to insurance costs. I feel that some people can get a lot out of groups- to them, a group is invigorating, allows them to see other perspectives and is enjoyable. For others, like me, a group is anxiety-producing and distracting. Like you point out, hospitals and treatment centers are often a place where people improve their ‘skills.’ Eating disorder treatment centers are particularly vulnerable to this in my experience. What bothers me is that every professional I know (psychology student) acknowledges how dangerous treatment centers can be, yet most of them embrace treatment centers as ‘the solution’ to certain disorders.

  5. @ KJ: Where I live at least, some people are actively being discouraged from going into hospital/treatment programs because of the risk that they will “pick up” ill behaviors from the fellow patients. Especially people with personality disorders here are n ot recommended to go into hospital, or only for brief crisis intervention, since it is reasoned they would just get mor eunstable if staying longer. Since none of my fellow patients have the same condition as me (autism), I cannot relate to the experience of picking up symptoms, but I can relate to reactive irritability when someone else is unstable.

  6. a crisis for one of us tended to precipitate a crisis in the other.

    It is incredibly reassuring to hear that this happens to other people. I feel like a terrible person because, whenever my best friend has a crisis of some sort, I do a couple days later, and I feel like I’m purposefully trying to take the attention off her and put it on me. I’m terrified of moving in with her, because I’m worried we’ll just feed each other’s illness, and her girlfriend will end up having to be the stable one for both of us.

    Thank you.

  7. I can’t go to such groups safely. I always knew it deep down but I finally learned it for good the day that I went to one where everyone tried to convince me that the things that happened to me in the psych system must have been for my own good, and how wonderful involuntary commitment is for “Those People” (of which I was one but they were not). And when I visibly reacted in complete terror, running so fast to hide behind the TV set that I bumped into the big easel thing holding the big piece of paper they write on and knocked it over…

    …the group (which had been sitting there knowingly and vocally supporting things that have nearly killed me several times) sat there and went around the room describing and “processing” how “unsafe” (ha!) I made them feel, and how “low functioning” and potentially dangerous I was compared to them, etc.

    Because talking about supporting things that kill people isn’t unsafe, but visibly having emotions instead of talking about them in incredibly abstracted ways, that is unsafe.

    I never went back. Not only was it clear people like me weren’t wanted there, but they made it clear that they had had people committed straight from that room for less than I had done. So being there was actually unsafe for me, rather than abstractified-support-group unsafe, where that word has come to mean “uncomfortable” rather than “dangerous”. (And that’s a trend in all support groups, not just mental health ones.) Plus, the group seemed to be more about wallowing than about doing anything.
    .-= Amanda┬┤s last blog ..Prism lenses =-.

  8. I’ve found support groups for communication and speech disorders to be quite tricky, also. I have unfortunately found more policing and skepticism than support. You know, the ol’ “You don’t sound like you stutter, thus you have no speech impairment!” or my personal favorite: “My stutter is SOO much worse than yours, you wouldn’t understand the REAL life of someone with a speech impairment!”. Ugh.

  9. There is also the chance that something that is actually a positive, helpfull thing for one person can be harmfull for another.

    For example, there was a thread a few days back at Shapely Prose where all the readers where asked to proudly state what they were good at. And it was a great thread, and I agree that women are far to often supposed to put themselves down, and that being proud of yourself is healthy- but after I read the post and some of the comments, i had to get away from the computer, because it was incredibly painfull for me to read.

    Not because of anything negative or “triggering” in the traditional sense, but because being proud of myself, feeling good about myself- those are things that my depression makes incredibly difficult. Not hating myself is an accomplishment. I am just not at the point where I can believe that I am actually good (knowing that this is heavily influenced by my illness does nothing to change the fact).

    So even when people are not being intentionally disparaging, as others have experienced, or having a crisis themselves- sometimes, just seeing other people being happy or feeling accomplished can be detrimental for my own health. Through no fault of the other people at all. Just because that’s sometimes what depression is like.

  10. I don’t want to deal with peer support groups because *they aren’t trained*. Period, end. I went to a group therapy for cognitive-behavioral-therapy for depression/anxiety. The very first meeting I had to explain, TWICE, why no, I couldn’t exercise because of the severe side effects of my migraine medication, not even a little bit. The facilitator didn’t step in.

    I called and explained why I wouldn’t be back. The facilitator offered to have me come back to help the group discuss what had happened; I declined. But that’s why I don’t like peer groups. You get exposed to all the maggoty ideas floating around in the popular consensus. Just because somebody else is depressed doesn’t mean she’s sensible or a worthwhile source of information in general.

    As Dave Barry once said about Lamaze classes, “I realized that all I really had in common with these people was that I’d been doing approximately the same thing nine months ago.”

  11. For me, the scariest thing about depression is how seductive it is. Just giving up, since nothing matters or will accomplish anything anyway, and letting myself turn out to be the failure and disappointment I know myself to be. (Says the depression voice.) And getting well, and staying well, and maintaining the wellness, can be so exhausting that it can be tempting to just chuck it all. So I can find myself fetishizing the experiences, the memories.

    I have never heard it put so well. And combined with the fact that I’ve been plagued with depression on and off – a lot of on – for so many years… People who haven’t a clue tell me that I need to *want* to get better, and understanding despair/the need to give up as *part* of the illness just doesn’t seem to happen, no matter how well-meaning the person I talk to.

    @lauren – I had a really hard time reading that thread at first, too. I’m not “too bad” at the moment, so I forced myself to think and participate lest I end up spending all day berating myself for ‘running away’ from it. It’s tough when you can’t think of a *single thing* you’re remotely good at. *internet cookies for you*

  12. @tesria I’ve had actual therapists feed me the “You have to want to get better” line when I’m not getting better quickly enough for them. It’s not a matter of wanting to get better; I highly doubt anyone who’s depressed *wants* to stay depressed. You would think that trained professionals would understand that *wanting* to get better doesn’t magically negate that “need to give up” that’s part of depression.

  13. Tesria
    Thanks! *munches on delicious cookie*

    It’s really frustrating that this seems to work both ways- I spend time with someone who is in a crisis and it can remind me of my own troubles and push me towards a decline, or I spend time with someone who is at an awesome place and it shows me where I am not, and then that causes a crisis. It’s one of the things I hate so much about my depression, the fact that it can be triggered by anything, if I am having a vulnerable day. And of course, hiding at home trying to avoid everyone doesn’t help, either.

    I think, on top of the “triggering each other”-problem, peer support is also always on a dangerous line between “you are not alone” (so important) and “we are all the same” (so damaging when it leads to “what works for one works for all”).

    I mean, sometimes my mom is the best person in world for me to talk to- because she knows what depression can feel like, because she has been dealing with for a lot longer. And then sometimes, I have to keep away, or ask her to stop giving me advice, because her depression is not my depression. Aside from a possibly shared genetic contributor, our depressions don’t have the same causes, don’t have all the same symptoms, are not part of the same lives and can not be treated the same way.

    And even when all she is doing is to try her best to be supportive- sometimes she makes it worse. Because her meds didn’t work for me, because there are aspects of depression that I struggle with that she didn’t- just like there are the other way around. And that realisation, the fact that even people with the same illness can not always understand you, might judge you, might think you are exaggerating, or just a little bit lazy- that can hurt so much more than not being understood by “outsiders” who you don’t expect to get it.

    (My mom has gotten much better at not pushing. It’s a process for both of us, but despite the issues and occasional misssteps, my family is still the most amazing supportsystem I have)