R U OK? Not Even A Little Bit

There are dozens of guides floating around social media today, giving advice on how best to ask R U OK? What to do if someone says “no”. How to follow up on the question in the future.
The problem is, that achieves very little for someone with depression. Someone actively contemplating suicide isn’t about to turn everything around because you reminded them that they can call Lifeline or visit a GP.
Workplaces still have no idea how to deal with employees living with depression. Universities offer little more than empty platitudes to those feeling crushed by their study load. Even the unemployed have little recourse when it comes to seeking assistance, because of the overwhelming cost of treatment.
Sure, we can all pop another pill to help deal with our shit, but what does that really achieve? The work is still there. The assessments are past-overdue. The stigma of living with mental health issues still exists as others continue to joke about depression or whip out the kid gloves whenever you walk into the room.
There are problems that don’t go away, and any time you ask for help, you’re faced with a system that expects you to pick yourself back up.

#RUOKDay is a hollow excuse to congratulate ourselves for doing nothing to combat depression and suicide.
The purported aim is to “start a conversation”, because apparently that all someone suffering under the relentless burden of mental illness needs. A good chat.
The only positive result of this gimmick is that broader Australian society will feel better for claiming to have achieved something by making it trend on social media all day. The victims, meanwhile, are left to languish for the other 364 days of the year, because of the system that pretends we don’t exist.

The official advice for R U OK? Day is to talk to someone with depression about their issues and tell them where to get help. But this changes nothing. It doesn’t address what they might need.
When you ask someone “R U OK?” in a text message, are you prepared to offer them a couch to crash on for the next six months as they try to put their life back together?
Will you pay for their visits to a psychologist? Medicare barely covers it and bulk-billing for mental health is ineffective.
Do you have the capacity to change a system that puts the onus on the victim? Where anyone asking for help is first expected to help themselves?

For all the corporate enthusiasm for R U OK Day, for all the politicians attending events, very little changes. Mental health services continue to be defunded. Accessing proper treatment is always a challenge. For anyone who really needs help, finding it is almost impossible.
The first recourse for mental health treatment is for a GP to prescribe antidepressants and occasionally write a referral. After that, you’re on your own.
That was my experience when I first asked for help a few years ago. I was admonished for being depressed by my GP, given a prescription and shown the door. No follow ups, no real questions, just a “We all have issues, this will help”. Except it didn’t. The antidepressants worsened my mood, I became irrational and irritable. While a pharmacological approach can work for some people, it won’t work for others, because *big shock* we are all different. Our chemical makeup varies from person to person. There is no one, big catch-all approach to mental health treatment. It is still a case of throwing ideas at a patient and hoping one will stick.
I wound up in a psych ward after a suicide attempt, I was there for a week and a half before I saw a doctor, and within hours of talking to the doctor, I had been discharged, because I managed to convince them I was fine. Which I wasn’t. I just didn’t want to spend another minute in there, being ignored as my problems in the real world piled up.
My time in the psych ward taught me a few things

  • The public health system doesn’t know how to treat depression. I spent a week locked in a room taking antidepressants, I could have done this at home.
  • Workplaces are incapable of dealing with someone with mental health issues, because they’re stuck demanding medical certificates for any time spent absent.
  • People in the broader community don’t know how to approach depression and suicide. I had people I considered friends making bets about when I would kill myself. I found out that one of the people who triggered the attempt that put me in the psych ward was being told my every move by one of the nurses in the ward, as they knew each other.
  • The NSW Police only care about suicide and depression when they have to clean it up. When it came to the related court date, which I won’t discuss here, I overheard two officers gleefully discussing my attempt and treatment, as it strengthened their case against me.

After I got past this, I tried finding a psychiatrist who could help and wound up shelling out $400 per session to learn very little about myself that I didn’t already know. I know why I’m depressed. I know my triggers. I don’t have a way of effectively dealing with them because there is no system in place that allows any of us to take a couple of weeks out of life to heal. Our neo-liberal capitalist society doesn’t have time or space for prolonged weakness. You have a matter of days to sort yourself out, or you are left behind.
This is the boat I am in right now. For the last month I have been trying to pull myself out this psychological quicksand, only to find myself sinking further in. I’ve stopped going out. I’ve stopped going to uni, which, of course, means I’ve failed this semester, further compounding the issue. I need a medical certificate and to apply for academic consideration before I can even consider continuing with my study and that in itself is a whole world of stress I can’t deal with right now.
I’ve found myself hiding from the world, hoping that someone will notice I’ve vanished and offer to pick me back up, to help me fix the problems I’m facing.

So when someone asks me today, R U OK? My response will be “Yeah, I’m fine” because I don’t want the platitudes, I don’t want the standard response or the standard treatment because I have tried that and it failed me. I want to be better, but I know that I will struggle until the system we have built for treatment becomes adaptive, and I know that I am not alone.
Am I okay? No.
Are you okay? No.
Does it make any difference to ask? Who knows.
All I know is, for those of us living with depression, society needs to change for the better before we can.

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