Tip of the Iceberg

We often hear the statistic that mental health issues will affect 1 in 4 of us. This implies a quantifiable figure. Statistics is a science, so we could assume taking any population, from a country, down to the city, town or village we call home, then dividing by four, would provide a picture of the total number of people who will face psychiatric disabilities. As an example, I might consider the Hibernian versus Dundee Scottish Premiership football fixture I attended before Christmas. The official attendance on a bitterly cold mid-December evening was 13516 hardy souls. So, around 3400 from that crowd were living with the potential to succumb to depression, bipolar disorder, eating disorders, schizophrenia, post-traumatic stress disorder, or problems revolving around the vicious circle of alcohol abuse and mental health (known as dual or co-occurring diagnosis.) Sociological factors also fluctuate across the globe, and in countries with higher incidences of poverty, or where the populace live in warzones or under oppressive regimes, 1 in 4 is surely an underestimate.


But sticking closer to home, another reason 25% is undoubtedly the tip of a larger iceberg is that denial is so often a symptom. People might be aware of a rising sense of anxiety, or despair. Instead of admitting this, for fear of upsetting loved ones, or jeopardizing their employment, they might opt for silence. Especially amongst males, the proverbial ‘stiff upper lip’ has been casting a long shadow for generations.


When I was sinking towards a depressive meltdown in my 20s in the late 1980s, mental health was heavily stigmatized. I was still living at home, and my increasingly unnerved parents were simply advised by our GP to ensure I took anti-depressant tablets every night. My mum would add I might feel better after a shave and a shower in the morning, even as I was becoming overwhelmed with delusional thoughts. Alas, neither pills nor regular grooming halted my downwards spiral. Eventually, I performed a violent act of self-harm that prompted an ambulance journey to an intensive psychiatric care unit, where I was formally sectioned.


But even after days of heavy medication blurring my objectivity, there was an urge to deny I was ill. I felt like a wrongfully convicted prisoner, my every action scrutinized by nurses, my showering and shaving taking place under close supervision. I would plead my case to the psychiatrists doing their rounds, insisting I was the victim of some terrible mistake.


Let’s fast-forward. We’re approaching Spring 2022. From being in a position of good health (touches desk), I can view that aggrieved outlook all those years ago as being part of my illness. Much as I denied I was ill, my family and medical professionals recognised I was lying to everyone, especially myself. One of the biggest hurdles anyone undergoing a mental episode faces is this internal struggle between reality and fantasy. Thankfully, mental health is now far more openly discussed. I only wish my late parents could have accessed something called the Internet, where links would have allowed them to tap into a vast reservoir of guidance and support. Just like the community of kindred spirits who form Speakers Collective.





Mark Fleming is an author from Edinburgh. Diagnosed bipolar in his 20s, the ups in his life have included becoming a parent, and his post-punk band being played on Radio 1; the downs, spells in psychiatric hospital. He has talked about his experiences in prisons, schools and community groups, and just finished a memoir entitled 1976 (due for publication in 2022.)


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