High functioning

I know that for a number of people, a decline in functioning is a symptom of their mental health issue. Declining invitations to go out with friends, remaining in bed instead of turning up to work, or failing to hand in school or uni assignments on time. Yet, I find it quite difficult to muster up sympathy and take it into consideration when someone finds themselves unable to do certain things due to their mental health. I feel like I should be more understanding, but I tend to feel rather impatient, irate and at times even resentful of such people even if I’d never outwardly portray it.

I can try reason it out and rationalise it; everybody experiences different symptoms of their mental health issues, there are varying levels of severity, people deal with things in different ways, some people are just able to attain a greater level of functioning than others no matter how severe it gets…but it still doesn’t overrule how I truly feel. I guess a lot of it is probably due to my past experiences as a child and the role it plays in my life now.

As a child I had huge anxiety issues and I would cry in complete terror and dread at the impending situation or task. Despite this, I was never allowed a reprieve. There was no gentle guiding me and holding my hand so I could tackle it in little steps. I was forced by my parents to confront whatever it was, and thrown in head first no matter how terrified I was and how much I didn’t want to do it. I suppose the lessons learnt as a child has done me some good in a way. It’s taught me that I must fulfil my responsibilities and commitments no matter how awful I feel. And for the most part, I do, asides from when I’m in hospital. I’ve never backed out on a friend when we’ve planned to meet up just because I’m feeling anxious or down. When you don’t have that many friends to start off with, you can’t exactly afford to blow off the ones you do have…! I remember overdosing on paracetamol one day and going out with a friend the next, as if nothing happened. In my three years total that I’ve been a uni student, I’ve never ever missed a compulsory class at uni nor a day of work because I felt too miserable to show up. I may have backed out of my volunteer work before, but for the most part I keep my commitments. Last year I even went from the ED after being treated for paracetamol overdose straight to a volunteering event I said I’d attend, despite looking and feeling like shit. I never had the luxury of backing out as a kid, and I don’t afford myself the luxury of doing that now. That is the reason why the feelings I have towards people who do this are somewhat harsh. My thoughts go something along the lines of “Dammit, I suck it up and get on with it…”

Unless I’m practically dying, there aren’t many acceptable excuses. One drawback of this is that it means when I really can’t keep it up and handle it all any more, I go to extremes to avoid having to do my duties. Simply ‘not feeling up to it’ is not a good enough excuse, and so, I make it that I do have a good enough excuse. I make myself fit my definition of ‘practically dying’ by taking an overdose and ending up in hospital. It’s only then I give myself a reprieve and allow myself time to breathe.

Another reason why this issue particularly irked me is because it came up in the consultation I attended today regarding a new youth mental health service being set up for early intervention for BPD or risk of psychosis. One of the criteria that must be met for a young person to access the service is that they must have experienced a marked decline in functioning. I’m already feeling quite disillusioned with mental health services at the moment and that just reminded me of how frustrating it is for people to assume I’m fine and don’t need help because I appear to be doing all the things I’m meant to be doing. “You’re very high functioning,” the doctor said as I was discharged from my last hospital admission, as if that was meant to make me feel better. I can see why having high functioning would be an advantage and an asset, but it does not mean everything’s perfectly fine and dandy. Even up until the very day I end up in hospital, I will still most likely be attending all my commitments. It would be nice if people didn’t assume certain things.

8 thoughts on “High functioning

  1. wow! I know what you mean. I actually went through a year of overwhelming fear, anxiety, panic, and depression. I am a wife and a mother of a small child so i had to keep pressing forward every day. I couldn’t just stop my life. I would be in sheer terror at the grocery story or meeting up with a friend. It wasn’t enjoyable for one second but I feel that the fact that I kept ‘functioning’ is what helped me walk out of the craziness I was experiencing. I understand.

  2. As you say, everyone is different and symptoms manifest in a variety of ways. Just as it may be unhealthy to avoid everything equally it can be unhealthy to keep trying to push on when you’re very unwell.

    When I had very bad social anxiety I just couldn’t leave the house, however much I wanted to. I avoided everything. Now it’s slightly different, although I have times I feel physically paralysed in bed I try and force myself to go to my engagements because otherwise I feel like a failure and punish myself by self-harming.

    Maybe if you could give yourself a reprieve when you’re not feeling good it could avoid stays in hospital and becoming more unwell? A type of early intervention, are your stays in hospital not worse and more distressing than perhaps staying home and resting rather than going to a lecture? Obviously I don’t know what the psych hospitals are like in Austrailia but I can’t imagine they’re that lovely! :-)

  3. Oh, Lord, I hate that whole ‘you must be low functioning in order to access this service’ thing. I’ve seen people with psychotic depression convince mental health clinicians that they’re perfectly well. People with mental illness, even severe mental illness, still have the capacity to be ‘high functioning’.

    But I agree with EscapingEntropy. When things are crappy, you’re allowed to give yourself a break, and it doesn’t mean you’re using mental health as an excuse. It means that you need a break. I don’t have to tell you that burning yourself out isn’t the greatest thing in the world for mental health. Or, I suppose, the other way of looking at it is to not overcommit yourself, especially if things are sucky. You’re allowed to breathe, I promise.

    Take care of yourself, love. xx

  4. Completely agree. We don’t all turn into non-washing, closet-hiding individuals. No offense to people who are, but it seems like another nail in the casket when people assume that just because you can hold it together on the outside means that you’re holding it together on the inside.

  5. Interesting. I am also a hold it together type, but to be honest, I find that irritating. I read a lot of blogs of people like this and I do get kind of tired of the whining – holding myself together, I’m so strong, etc. Many of these people are recieving some kind of public assistance, or government healthcare. That frustrates me a lot because frankly, if a person is holding it together well enough to perform at a job or university, then I don’t want my tax money going torwards him/her – let it go towards the people who are literally incapable of caring for themselves. If those other people are so well able to function, then great, let them use the money they earn from behaving like normal people to go towards their own healthcare. It’s a goverments responsibility to care for the people who can’t care for themselves — not those who can.

    • That’s what frustrates me, when it is assumed that because people are functioning, then they’re not suffering as much and therefore don’t need help. I disagree with your point about government healthcare- if someone has mental health issues, regardless of whether they’re functioning or not, they should be eligible to receive help. Someone could for example be still going to work daily but feeling really miserable, feel worthless and hopeless, and having strong thoughts of suicide. Or someone could have a severe eating disorder but still attend all their uni classes. Those people are likely suffering as much as someone who say, stays in bed all day because of their depression. The symptoms and manifestation of the illness is different, but both have issues that warrant help.

      As for your point about government assistance, well, if a person who’s unwell is working, it probably means they’re paying tax too. If two people have the same severity of illness but one is working, one is not, then couldn’t it be said it’s unfair a proportion of the taxes paid goes to the one who’s not working, even though they’re both unwell?

      There are of course many people on disability payments that do need and deserve it, but there are also some people who claim disability yet could be working…

  6. Hi, just found your blog. Wanted to share my experience of being a uni student some years ago. I was in, and then recovering from an abusive relationship, and subsequent mental health issues. I only asked for special consideration once, early on, but when I really needed too, because my mental health was at its worst, I didn’t feel WORTHY to ask for it! I was/am a “coper”, I attended class and did my work. I also didn’t do as well as I could have. This has now haunted me for years as I try to get into further study. Because I didn’t pursue a particular direction in undergrad, I am looked upon less favourably by those assessing applications. I didn’t pursue that course because again, I didn’t feel worthy! I’ve since undertaken another post grad uni course and am getting much higher marks. I can only hope that I will eventually get into the course I really want to. Perhaps if I hadn’t been such a ‘coper’, I would have gotten the help I needed to excel, when from what I see now, I had the potential to, rather than being mediocre.

  7. I identify so much with this post, including the bit about struggling find sympathy for those who lose functioning entirely. Sometimes anyway. I have high levels of empathy and feel for people but sometimes my own frustration gets in the way of that. I think these are my issues. Like you, I can’t give myself a break. I have never been able to, because I don’t like showing vulnerability. I have to make sure I don’t judge others by my own possibly unfair standards.

    I also agree and am angry about being treated like I didn’t deserve help because I was high functioning. Most psychiatrists didn’t care about the level of suffering, the misery, the impact on my work/study/relationships – they just saw someone who got out of bed every day and continued functioning. Only one ever saw through that and forced me into taking a break.

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