What Is It Like to Be Mentally Unwell?

Our societies have become hugely more respectful of, and sensitive to, mental illness than any of their predecessors. We now know how to behave with patience when someone tells us that their mental health is suffering or when a colleague is granted time off work to address issues in their minds.

But this surface sympathy does not necessarily mean that it is natively easy for most us to understand what might really be going in states of mental ill health. We can be tempted – despite ourselves, deep down – to suspect that a sufferer may simply be exaggerating or malingering. Or we may feel that a sufferer has gone to a place lacking any connection whatsoever to anything we can know, imagine or relate to: they are (though we would never use the term) ‘mad’ or ‘insane’, conditions we are in no place to start to picture in any easy or intimate way.

So it can help to propose that most states of unwellness are not radically different from those occasionally and briefly experienced by all of us; they are simply much, much more extreme. Mental illness draws on all the challenges faced by an ordinary mind, and then exaggerates them exponentially. A mentally ill person is you without any brakes, you without any dampeners, you without any ability to change the subject, adopt a different angle or be refreshed by sleep. Being ill is less about what one is feeling and thinking as what one is no longer able to think or feel: within illness, there are no more counter arguments available, there is no reassurance, there is no more space between panics. There are simply undiluted doses of unworthiness, terror, suspicion, guilt and self-loathing.

An unwell person may – for example – become convinced that they have done a terrible thing, that everyone will hate them, that the end is coming soon. Kindly well-wishers will offer ordinary reassurance: it’s bound to be fine, nothing terrible is on the cards, it’s going to be OK… One might expect a crisis to be over in a few minutes. But the mind of the sufferer cannot achieve a benevolent perspective. Pure fear starts to course through their veins and brooks no opposition. They can no longer eat, or walk. Their shoulders stoop, they take to bed and weep. The next seemingly logical thought is that they must die – and that the world would be infinitely better off without them.

Or else a sufferer can become convinced that they are a bad person. It’s a common enough thought but again, the illness is identified by its extremity, not by its basic content. They aren’t in their eyes just a little flawed, they are fundamentally repulsive, they are entirely unworthy, they should never have been born. There is no room for forgiveness or allowance for humanity. When the illness is especially severe, a voice may tell the poor soul at every moment that everything they are and do and have ever achieved is a catastrophe. A state of mind that could in others be momentary invades their whole cognitive apparatus.

Mental illness afflicts people who are in many other moments of their lives competent, vigorous, kind and hugely joyous. It descends in an instant – set off by what could seem like a relatively innocuous setback (a challenge in love, a slightly threatening email, a small rumour etc). Like falling through the ice, one minute one is on the surface (and may have been there for months), the next one is in the freezing waters and in the gravest kind of trouble.

We should be educated not just to know that there is such a thing as mental illness but helped to feel what it might be like and to shudder at the connections between the states of mind we know already and those that are involved in a crisis.

Thereafter, we should be ready to give the mentally unwell what they most need: time to recover, immense love and sympathy while they do so and trust that they are not malingering. People have been mentally unwell since the beginning of our species. It is a major achievement of our era that we – the well and the not so well – are slowly starting to grasp what might be at play in one of the very worst and unfortunately most real diseases to which any of our organs is prone.