The Stigma of Remission

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Today, I am in remission.

I know that ‘remission’ is not a word often associated with mental health. But I think it should be.

Remission is defined as, “a temporary diminution of the severity of disease or pain.”

I am still on medication. I see a therapist and GP every week. I see a case manager every fortnight. I see a psychiatrist every month… But the pain? The severity of the overwhelming sense of hopelessness and worthlessness that accompanies depression? It is temporarily diminished. And for today, I feel the most fabulous I have felt in 12 months.

Even if you argued for some absurd reason that the medical definition of remission could not be applied to mental illness, then perhaps we can simply utilise the British definition, that is, “the reduction of a prison sentence.”

Equally as applicable.

But whilst I may be, and feel, on the road to recovery once more… I am acutely aware that the battle is far from won. I don’t want to take medication forever. I want to upskill my mind to be able to better cope with my illness. I want to regain control over my body. I want to develop my own brand of military operation, to fight this war within me.

My world has not changed. Not really.

What has changed, is that those spikes around me that penetrated so deep before, have been numbed. They are still there. I just don’t feel them so much, thanks to a colourful cocktail of drugs.

But what happens the day I stop taking the medication? What happens the day the anaesthetic wears off and I am to face the pain in full force once more?
I am terrified of that day.

And I am not only terrified for myself. I am terrified for my little family, for my husband, for my sister… I am terrified that I will once again become a burden, a lead weight, in their world. I am terrified that I will once again, be flooded with guilt, because this illness bears a burden of responsibility… a burden of healthy, until proven ill. And even then… it seems that the words ‘medical condition’ become synonymous with ‘measured choice’.

I saw a new doctor the other day. I have been referred from the intake team at the outpatient clinic, to a longer care team, and have subsequently changed case manager and psychiatrist. The appointment, I assumed, would be between this new psych and myself, however, I walked in to a room with four spectators. Two students, the new case manager, the new psych, and me.

The word ‘ashamed’ would be an incredible understatement when considering how I view my own mental health and current situation. In the space of two years, I have lost a decade long career. One of which I was proud of, and that made up such a huge portion of my sense of identity. I have been hospitalised for my illness. Whilst I am glad to have shared my story, and firmly believe that mental illness is in desperate need of awareness, I am not immune to the stigma associated with depression and suicide. I am not unaffected by the hushed comments, sideways glances, and subsequent shame. I have pushed away the people closest to me, to protect them from the toxic state of this ailment.

I am sure you can appreciate my reluctance to disclose intimate details regarding my condition to this audience of four. I found myself stifled by stigma.

Stigma that I wasn’t even sure existed.

Stigma that had been so prevalent, for so long, in the arena of mental health, that it had almost now become a symptom in itself. A perception of how I was viewed in the world. How I was defined.

My ‘remission’, the remission of other patients who are recovering and winning their fight, would always be at risk of being out shadowed by the lingering aroma of shame.

This battle is not an easy one. Not for anyone involved in the fight. It is long, and drawn out. It is isolating, and cold. It is frightening, and there is a very real risk of this illness killing it’s victim.

We have to start celebrating the survivors. We have to start celebrating those in remission. We have to make sure that every person donning the armour and marching into battle knows that they have the full support of the medical community, and we need to remove the self-administered symptom of stigma, and subsequent guilt, shame, and handicap.

Because the third, and final definition of ‘remission’?

“The cancellation of a debt, penalty, or disadvantage.”

I am declaring my debt cleared. I am declaring my sentence over. I am declaring my pain diminished.

I am, as of right now, in remission.

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Voting No? Read this First.

I am taking time out from my usual mental health awareness posts, to discuss the proposed legislation changes in Australia in regards to marriage. This is a topic about which I am extremely passionate, and I believe that we need to consider some of the facts regarding this issue. For the purposes of this discussion, I have predominantly referred to Western Australian state law, however these same scenarios and concepts could easily be applied to any state in the Commonwealth.

There are four purposes and intents of legislation.

These are – establishing standards, maintaining order, resolving disputes, and protection of rights.

I would argue that the legislation change in relation to marriage pertains to the last two; resolving complaints and protecting rights.

The argument has been made that gay couples already have all the ‘rights’ associated with marriage, under the de facto status. Marriage and de facto are not the same. It might not impact much for a same sex couple in day to day life, but in any event where the relationship status impacts the outcome (such as a separation, or death of one spouse), a de facto couple needs to prove their relationship status. Under Western Australian law, the following factors are taken into account when ‘deciding’ the validity of a de facto relationship:

– the length of the relationship
– whether you live together and for how long
– whether there is a sexual relationship
– the financial dependency between the couple
– the ownership of property
– how committed you are to shared life
– whether you care for or support children
– the public aspects of your relationship

A married couple, on the other hand, does not need to do this. They can simply produce a certificate which verifies their relationship status.

The consequence of this, is that a Court could decide that the de facto couple do not meet the requirements and state that they are not de facto, stripping them of any rights associated with this status. There is no such risk for a married couple.

One of the concerns raised in regards to marriage equality has been around surrogacy and the possible increase of children being removed from biological parents.

In WA the Surrogacy Act 2008, states that an eligible couple have to be of the opposite sex, AND there has to be a medical reason that is preventing the woman going through with a pregnancy. This piece of legislation is entirely separate to legislation related to marriage, and any legislation change to the institute of marriage, does not in any way impact the legislation regarding surrogacy. That is separate debate for a separate time.

I agree that any changes to the Surrogacy Act in any state need to be carefully considered and discussed prior to the legislation being changed. But that is a completely separate issue and is not at all associated with any changes made to legislation pertaining to marriage.

Another issue regarding children that has been made, is that marriage is an institute, created for the purpose of creating a family – for procreation. Therefore, gay marriage does not fit this, given that gay couples cannot reproduce without aid. However, by this logic, any couple that enters into marriage without the intention or ability of reproducing, also does not fit – my marriage included. Is my heterosexual marriage now invalid? Of course not. Marriage, according to law in Australia, is the union of a man and a woman to the exclusion of all others, voluntarily entered into for life. It is not dependant on any requirement that children become part of that union, in fact, even children are excluded from the union by definition. Marriage is a relationship status under the law, between two people only, and the exclusion of individuals to this status based on sexual orientation, is discriminatory.

Some religious groups have raised the concern that legalising gay marriage will take marriage as a religious concept, away from the church.

However marriage has already been separated from the church. Non-religious couples are able to opt to use a celebrant, and have no religious aspects included in their marriage ceremony. Couples are able to attend the registry office and legally become married without any involvement or association with the church. Introducing marriage equality does not impact this pre-existing situation at all. Further to this, Section 116 of the Australian Constitution specifies that the Commonwealth shall not make any law for establishing any religion, or for imposing any religious observance, or for prohibiting the free exercise of any religion, and no religious test shall be required as a qualification for any office or public trust under the Commonwealth. Therefore, not only is marriage, as a legal union, already separated from the church, it is unconstitutional for religious reasons to be used to impose specific requirements in legislation.

Further to this, I would like to draw attention to the lack of reference to the issue of homosexuality in the New Testament. There are verses that may relate to the issue; however, have also been interpreted as referring to prostitution and pederasty, rather than a loving relationship between two people. However, if you are looking for ‘love’? You’ll find it referenced over 250 times. Given this, even if religious observance was able to be imposed through legislation, it would be difficult to suggest that Christianity (which is grounded in Jesus’ teachings) does, without any chance of doubt, have an opposition.

Some wedding vendors are voicing a concern that their ‘freedom’ and ‘rights’ will be impacted, if marriage equality is introduced, because they will be ‘forced’, against their conscience, to provide services and products to gay couples. In regards to the ‘rights’ and ‘freedoms’ of businesses to discriminate against an individual based on sexual orientation, this is already outlawed. The Equal Opportunity Act 1984 WA states that businesses are not allowed to discriminate, refuse service or provision of products, on the grounds of race, religion, sexual orientation etc. You can already be taken to Court if you are found to be refusing service or provide products to customers based on sexual orientation.

The core function of a business is to produce a profit in exchange for a product or service. That is your right as a business owner. Being able to discriminate against the customers or clients that approach your business is not your right. And is already illegal. Your rights are not being impinged in any way, and they certainly aren’t changing or decreasing if we legislate in favour of marriage equality.

So I ask you, if you are planning to vote ‘No’… what are you actually against?

The platform for debate and campaigning that this plebiscite is facilitating is enormous. Let’s think carefully about what we share, post, and preach. It is going to become, if it hasn’t already, an extremely difficult time for some, already vulnerable, members of the LGBTIQ community and their families. For them, this is not just a ‘debate’, it is a fight to justify their validity and value in the world. And the outcome is a statement about their lives, and their future.

Have an opinion if you feel it necessary – but make it an educated one.

Cocktails Over Compassion

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Today, I am sad to be part of this world.

I am sad to be part of a world where the suffering of others has become a second, or third, or fourth priority – if a priority at all.

Where has our humanity gone? Where is our empathy and concern for our fellow man?

Recently, I took a trip to Indonesia. On the way from the airport to my hotel, I stared out my window… I soaked up the beauty of the greenery, the incredibly decorated architecture, the hustle and bustle of the highway. I looked at this country… but I didn’t really see it.

As Western travellers to Indonesia,  we get in taxis and pay a few dollars for a trip that would have cost us double, triple, even quadruple, that price at home. We drive past the poverty, the poor living conditions, the stray animals that are covered in fleas and malnourished. We drive past the pollution and hunger, and we are dropped off at an establishment that is a paradise, built for us, amongst this corrupt and poverty stricken country.

We use it as a playground. We bring millions of dollars here, and then, instead of showing any shred of humanity and helping these communities that need what we have so much more than we do, we spend it on ourselves. We buy cocktails, and food, and stay in hotels that boast facilities far beyond our needs. We haggle to the death for cheaper prices, and don’t even seem to realise that we are bartering over a dollar or two. To us, an insignificant amount… to them, that is a meal. That is clothing. That is medical aid. That is rent.

Don’t get me wrong… I have loved sitting by the hotel pool. I have loved relaxing and sipping a cocktail. I have loved getting massages and eating delicious food. I am not void of guilt when it comes to this issue. But the more I opened my eyes and really looked… The more I researched and learned about the Indonesian culture and standard of living, the more I felt sad.

Sad that we think this is OK.

What are we thinking?

Why aren’t we helping?

When I raised my thoughts with another traveler… their response was that the locals were ‘manipulative’ and bartering is part of their culture, insinuating that it would be rude not to try and knock the price down. They also made the comment that we can’t help ‘all of them’, so there was no point helping just one. And finally, the concern raised, was that if we start paying ‘them’ more, then prices will inflate, and ‘they’ will always expect that kind of money. Are we really justifying our appalling behaviour, by using the protection of costs to us as the reason?

Maybe I am being manipulated by the mother on the street asking for money for her child. Maybe I am crazy for telling my taxi driver to keep the change from 100,000RP for a 30,000RP trip. Maybe it was silly of me to buy the staff at the hotel some donuts to share, and some cool drinks to have in the heat. Maybe I am ‘adding to the problem’ by keeping some chicken in a napkin and feeding a stray kitten on the side of the road.

Maybe.

But I no longer want to come here and behave how I, and so many others have.

And this is not an issue isolated to Indonesia… or to foreign travel in general. This is an issue that seems to have infected every aspect of our lives. We operate in the world in silos. We are desensitised to our own lack of empathy. We feel the need to defend our ‘right’ to live ‘how we want’, and disregard the impact on others.

I don’t think humans are meant to be islands. It takes a village, not just to raise a child, but to survive, and to thrive. We need each other. I think our isolation, and intentional ignorance impacts us in a bigger way that we realise. We have lost touch with how to be people. Depression, anxiety, bi-polar – some of the most prevalent mental illnesses, are often caused by our inability to be ourselves. By having to bury parts of who we are. By not being true to our nature. And we are all now susceptible… because we are living in ways that go against our instinctual drive… because we are living in ways that fail to tap into, or acknowledge, our inbuilt empathy, and benevolence.

We have misplaced our compassion.

We drive through those Indonesian streets, and we don’t even look. We don’t want to look.

And that is sad.

I, for one, think it is time we built back some humanity into the picture, and I find the scariest thing, is that too many of us didn’t even realise we lost it in the first place.