How I cured my 'mental illness'

The most wonderful thing that ever happened to me

Image created by ChatGPT, at the instigation of my friend Helen

For reasons that will become apparent, I don’t actually believe I was ever ‘mentally ill’ to begin with. There was never anything to ‘cure’ in the first place. Nonetheless, I owe my recovery from what was called ‘bipolar disorder’ to a series of encounters with mental health services that were so ridiculous, so illogical and bizarre that I finally lost faith in the diagnostic paradigm that had defined my existence for 20 years. It’s the most wonderful thing that has ever happened to me.

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After being diagnosed with bipolar at age 15, my life had fallen into a repeating pattern. I wasn’t idle, or inherently lazy. I was interested in the world and eager to find a bit of it where I could do something useful. I craved a sense of purpose and achievement. So I would start a course or get a job, set out on the path towards that goal. Only now, when I felt anxious or uncomfortable, I interpreted it as a ‘symptom’. Normal anxieties about failing exams or relationships with colleagues became pathological signs that my bipolar disorder was getting worse.

Mental health professionals agreed. If I really threw myself in to something I was getting ‘manic’. My doubts and anxieties were signs of ‘depression’. My medication would be adjusted accordingly and I would step back from whatever I was doing to ‘stabilise’. ‘Stability’ was presented to me by my doctors as the essential prerequisite to my achieving anything else in life. I worked hard trying to cultivate this mythical state of perfect neutrality, coming to regard myself as very fragile and brittle, liable to shatter under the slightest stress.

For 15 years, I lived in a completely maladaptive pattern of medically sanctioned avoidance. Every time I ran away from some quite normal life stressor (and I see now that that really was what I was doing, just running and running for years on end) the belief that I couldn’t cope was reinforced. I had an unhelpful strain of perfectionism anyway, and a deep rooted fear of failure. My subconscious belief was that it was better to quit than risk the humiliation of doing anything less than perfectly. The bipolar diagnosis was the ultimate excuse, presented to those parts of my mind in flight from adulthood as all the proof I needed that I shouldn’t try to face my fears.

Mental health professionals backed up these beliefs with prescriptions. “It’s all a matter of finding the right medication,” as one psychiatrist soothingly told me, as I wept tears of frustration over my ongoing failure to achieve the career and life I had always imagined for myself. At first, every new drug felt like affirmation, confirmation. None of my friends were taking psychiatric drugs. Here was tangible proof that my problems were exceptional, that my pedestrian fears and anxieties really were orders of magnitude worse than everyone else’s. Here too was hope. Every new prescription promised transformation in tablet form, the dissipation of the life challenges that I foolishly imagined were unique to me.

These dynamics reached their inevitable and unedifying conclusion just before I turned 30. Welfare dependent, heavily in debt and reeling from a bad breakup I found myself living back at home with my mum, staring numbly at the walls of my childhood bedroom and trying to come to terms with what felt like the catastrophic failure of my entire adult life. I was a mess. By that point, it was no longer the case that my fear of failure was irrational. For over a decade I had lived my life on the run from reality. Shame had become the defining emotion of my existence, so bad that I could barely stand the sight of myself in the mirror. I had reached a profound point of existential crisis. So I did what I had always done when I was in distress, what I had been taught to do, and contacted the mental health service for help.

This time though, I wanted to approach things differently. After 15 years of prescriptions it had not escaped my notice that, “It’s all a matter of finding the right medication” did not appear to be working out as promised. I was now taking an antidepressant, an antipsychotic, a mood stabiliser and a beta-blocker, augmented by standing prescriptions for diazepam, promethazine and risperidone for emergencies. Side effects had begun to stack up. More heavily medicated than I had ever been before, I also felt worse than I ever had in my life.

The logical contradiction this implied had become impossible to ignore and I decided I was done with prescriptions. Maybe it was even time to come off the drugs, to see who I was underneath. I was aware that my doctors would try to discourage me from this course. It had been drummed in to me over the years that not taking medication was irresponsible and irrational, like a diabetic refusing to take insulin. Even so, I thought I could overcome their reservations by demonstrating my sincerity and commitment, by proving that I was serious about learning therapeutic techniques to manage my condition without drugs. I fixated on my next psychiatric appointment, endlessly rehearsing in my mind what I would say.

It would be an understatement to say that that appointment did not go well. I was seen by a psychiatrist I hadn’t met before, an older gentleman who became extremely stern when I gave him my earnest pitch about ‘doing the work’ and reducing my meds. Glaring at me over his spectacles he gave me a lecture on personal responsibility and, yes, asked if I would refuse to take insulin if I were diabetic.

I tried to point out that this comparison didn’t make sense: insulin effectively controls the symptoms of diabetes, whereas the psychiatric drugs I was taking didn’t seem to be working at all. I was taking four of them every day, had trialled a total of 12 different ones over the years, and now felt worse than I ever had before. He tried to persuade me to accept what would have been prescription number 13, becoming quite angry when I refused and instead asked for advice about tapering my mood stabiliser. Jabbing his thumb at his chest for emphasis he had said, “I am the doctor and I will make the medical decisions.” That had really put my back up. Bristling with indignation I had explained that I was the patient, and that since it was therefore me who had to take the drugs I did expect to have some say in the matter. The session had ended in an uncomfortable stalemate.

Even though I had expected some resistance, I was startled by the strength of opposition to the idea that I might try to manage my condition without drugs. No one could possibly say that I hadn’t given psychiatric drug treatment a fair trial, yet this psychiatrist refused even to contemplate the idea that perhaps it wasn’t working. There didn’t seem to be any professional threshold at which drug treatment would be recognised to have failed, and this began to bother me. Reflecting on the 15 years I had spent under the care of mental health professionals, I realised I had only ever been advised to stop taking a drug if it was due to be immediately replaced by another one. The first cracks were beginning to appear in the logic that had sustained my faith in mental health services.

I met that doctor for only 50 minutes and I never saw him again, but when I was assessed by a mental health nurse a few weeks later I learned that he had done something that continues to impact my life today. He had changed my diagnosis to ‘borderline personality disorder’. With ‘emotionally unstable personality traits’. Borderline is a highly stigmatising diagnosis, often handed out to (largely female) patients by (predominantly male) doctors who simply don’t like them very much. There is a stereotype of women with borderline as hysterical drama queens, and a corresponding tendency to paint them as unreliable witnesses, likely to be exaggerating or imagining things. Periodically, I still encounter this kind of attitude from medical professionals today. It doesn’t matter that I have long since stopped thinking of myself as ‘mentally ill’, or that I was given the borderline diagnosis after a single interaction with a psychiatrist who clearly disliked me. It sits on my medical record like a stone, a standing invitation to medical professionals to doubt my credibility.

At the time though, I still believed that mental health diagnoses were discrete, objective categories with targeted treatments, just like physical health conditions. As I irritably explained to the mental health nurse (who we will call Susan) I didn’t know what borderline was but I had been taking drugs to treat bipolar disorder for 15 years. Now it turned out that I didn’t have bipolar disorder. This seemed quite important. It suggested that mistakes had been made. Susan made reassuring noises about this and spent the rest of the assessment giving me a live demonstration of how very subjective and speculative psychiatric diagnoses really are.

She turned out to be a keen amateur diagnostician, eagerly offering up diagnostic categories like a series of hats she was inviting me to try on. First up was autism, prompted by my disclosure that I felt anxious in social situations. Had I considered that my ‘social communication problems’ might be a sign that I was on the spectrum?

I had raised an ironical eyebrow at this because, kindly as she was, Susan appeared to have some ‘social communication problems’ of her own. Early on in our meeting it had become apparent that she was struggling to understand a lot of the words I used. Periodically her brow would wrinkle in puzzlement and I would have to break off to explain what something meant. After I had had to define the ‘profoundly’ in ‘profoundly depressed’, the ‘existential’ in ‘existential crisis’ and the ‘diametrically’ in ‘diametrically opposed’ I had consciously modified my language to make it easier for her to follow. That was fine, and I didn’t actually disagree that I had ‘social communication problems’, but it was more than a little annoying to be told so by someone who needed a dictionary in order to decipher every second sentence.

I also had some experience of autism. My nephew Kyle is the same age as me but cannot speak, read or write and requires round the clock supervision to stay safe. While I was completely miserable, my problems obviously did not fall into the same category as Kyle’s. When I said as much to Susan, she asked rather wistfully whether I might be ‘masking’ my symptoms. She looked crestfallen when I explained that there was nothing I would like better than the ability to ‘mask’ my symptoms. I had never heard of the concept before but felt intuitively (and still feel) that if you are capable of ‘masking’ then there is a logical question as to whether what you are experiencing is really a ‘symptom’ at all.

Panic disorder was the next diagnosis that Susan invited me to try on. I had never had a classic ‘panic attack’, but I did sometimes hyperventilate in crowded public spaces. This had never happened very often. Did something really count as a disorder if it only happened once every three or four months? Susan conceded that it probably did not, but again looked visibly disappointed.

The last and most implausible diagnosis she suggested was gender dysphoria. It was my fault really. I had become interested in the debate over sex and transgender identity and had recently read an interesting paper theorising that gender related distress might be caused by problems with interoception. Very loosely, interoception refers to how we perceive our own bodies. As I explained to Susan, this had caught my attention because although I had never felt the slightest discomfort about being female I had always felt distinctly uncomfortable in my body. Maybe I had problems with interoception too. At this Susan had leaned forward with great eagerness.

“Ahhh, so you have gender dysphoria,” she said. To my horror I saw her writing the words down in her notebook and enthusiastically underlining them.

“No, no,” I waved my hands hastily, “I’m perfectly happy being female. It’s an analogy.”

Susan’s brow wrinkled. ‘Analogy’ had thrown her.

“A comparison, something that is like something else without actually being it,” I tried, “Look, I definitely don’t have gender dysphoria.”

I watched her sadly crossing out her note with the distinct impression that I’d really spoiled her day by not having gender dysphoria.

Susan agreed to refer me to the psychotherapy service and suggested I attend something called a recovery college. By way of explaining what the college did she showed me a picture of the ‘road to recovery’. This was a sheet of A4 paper with a winding path snaking across it, divided into steps labelled things like ‘acceptance’, ‘self-care’, and ‘hopefulness’. Two smiling cartoon children holding hands were pictured at the start of the path, and the sheet was liberally decorated with rainbows, butterflies and bluebirds. There were bright primary colours. There were sparkles.

“The recovery college is for adults?” I asked hesitantly, taking in a particularly egregious graphic of a grinning Mr. Sunshine hugging a cloud.

“Oh yes,” Susan told me, “It’s just like a university course really.”

About two weeks after my meeting with Susan I received her assessment letter in the post. It appeared to have been written about somebody else. Susan wrote that I had been ‘excited’ (angry) to learn about my new borderline diagnosis, and ‘really positive’ (annoyed) about the prospect of learning more about it. Apparently I had also been ‘excited’ (nonplussed) to learn that I might have autism, and ‘enthusiastic’ (had outright declined) to be sent for a formal assessment, which Susan said she would action as soon as possible. Most upsettingly, Susan had listed, “Learn to be less manipulative” as one of my treatment goals. After an irritable phone call the autism assessment was cancelled and the letter was updated to remove references to my imagined ‘excitement’, ‘positivity’, ‘enthusiasm’, and ‘manipulativeness’, emotions that Susan appeared to have hallucinated.

I declined to meet with Susan again, but our assessment prompted me to wonder what it really meant to be diagnosed with something so subjective, so ethereal and intangible that it might, apparently, be one of any number of conditions. Bipolar, borderline, autism, panic disorder, gender dysphoria…did it even matter? I did some reading about psychiatric diagnosis, learning for the first time that mental health conditions are decidedly not like diabetes. I remember how shocked I was when I learned that the ‘chemical imbalance’ theory was a myth. I had heard some version of it from almost every mental health professional I had ever met. I don’t think I really took it in. I wasn’t quite ready to confront the idea that the diagnosis I had built my identity around was illusory, but my mind quietly filed the information away for later use. It would turn out to be very important.

Instead I invested my hopes in the psychotherapist and the recovery college instead, both of which would take another six months to access. By the time the psychotherapy assessment finally rolled around I was incredibly nervous. In my mind, everything hinged on this appointment. I felt like I was auditioning for a high stakes job and I took my interview prep seriously. Knowing how scarce resources were in the health service I was determined to show that I meant business, that I would work hard at my treatment, that I was committed to recovery and would be a worthwhile investment. A little sweaty and shaky I told the psychotherapist that if she could just help me to access the therapeutic care I thought I needed, I was sure I could get better and be less of a burden to mental health services. I told her about the self-defeating cycle that my adult life had fallen in to and about the excruciating shame I felt all the time. She listened for a while and then said, “Mmh hmm. And what’s your diagnosis?”

I blinked in confusion.

“You don’t know what my diagnosis is?”

“I can look it up in your medical records if you don’t know,” she offered, drawing a file towards her across the desk.

“But…haven’t you read my medical records?”

There was an awkward silence. She shifted uncomfortably in her chair, and then said, “I like to have patients describe their experiences to me in their own words.”

I took that in for a moment and then asked what seemed like a logical question, “Wouldn’t it be best to do both? Read the notes and have patients tell you about themselves?”

She squirmed again, but rallied and gave me a little speech about how important she felt it was not to make assumptions based on the observations of others. There was a note of self-doubt in her voice when she began, an awareness that what she was saying sounded rather silly, but she warmed to her theme as she went along. Conducting life altering health assessments with absolutely no knowledge of the patient was, apparently, a highly professional bias reduction technique. Best practice in fact.

Anger and desperation went to war in my gut. I had spent six months anxiously awaiting this appointment and the person who would determine my access to treatment had not even bothered to acquaint herself with my records before seeing me. I wanted to scream. Didn’t she realise how important this was? Awkwardly, conscious that she had the power to derail my ‘road to recovery’ (as I saw it at the time), I tried to find out.

“Your colleagues have been writing notes about my mental health for almost 20 years,” I indicated the fat file of papers on her desk, “Surely there might be something important in there?”

A spasm of anger crossed her face and then she carefully screwed her features up into an exaggerated expression of concern. It was saccharine, but didn’t quite cover up her obvious irritation. She sat back in her chair and said, with sententious seriousness, “Caroline, I need to let you know that you are making me feel very judged right now.”

“I am judging you,” the words had spilled furiously out of my mouth before I could stop them, “I’m judging you because I’m desperate for help, I’ve waited a long time for this appointment and you haven’t even bothered to prepare for it. Will you please read my notes before you decide whether I can access treatment?”

From that moment on it was clear that I would not be approved for psychotherapy. She just shut down. This was the way she did things and that was that. For the rest of the appointment we played a strange guessing game. In response to a question I would tell her about how anxious and ashamed I felt, and she would ask how I thought therapy would help. When I said something like, “Well, I hope it will help me feel less anxious and ashamed” she would look unimpressed and it would be clear to me that this was not the answer she had been looking for.

As the hour ticked by I began to wonder, desperately, if she was waiting for me to name a particular therapeutic modality or technique. “I’ve read that DBT can be helpful for borderline?” I ventured at one point, but this clearly wasn’t the right answer either. By the end of the session I felt completely hopeless and rather stupid. All my interview prep had been for nothing. I seemed to have revised for the wrong exam.

Unsurprisingly, when I received my assessment letter a fortnight later I had been deemed an ‘unsuitable candidate’ for psychotherapy. The psychologist noted that I was insufficiently clear about my ‘treatment goals’. It seemed that I would only qualify for help if I knew, in advance and in quite some detail, exactly what kind of help I needed and why. In my mind, I tried applying this rule to other medical conditions. Someone presents to the emergency room with chest pain but the doctors decline to treat them because they can’t specify that they need a heart bypass: “I’m sorry Mr. Smith but ‘please make my chest stop hurting’ isn’t a clear enough treatment goal. Come back when you’ve done some research.”

Unthinkable, of course, but I realised that the comparison didn’t make sense. There were no ‘chemical imbalances’. I did not have the mental health equivalent of heart failure and psychotherapy was not the same as a bypass. It didn’t actually make much difference whether I could access therapy or not, because the ‘mental illness’ I supposedly had was so subjective and intangible as to be constantly on the point of flickering into total unreality anyway. I could feel little Lego bricks slowly snapping into place in my mind.

I took these rumbling doubts with me to my first session at the recovery college. I am going to be extremely critical of what I experienced there, but I do want to note that it’s a model of care that some people find useful. Recovery colleges combine psychoeducation, skills based therapy and peer support for people with mental health problems. They often serve an important social function for people who are otherwise isolated or lonely, and they usually offer a path for attendees to become peer coordinators who help provide sessions to other patients. For some people, it works.

When I arrived in the room where sessions were held, I assumed it must have been recently used for a children’s activity. A pile of stuffed animals sat in the middle of a conference table surrounded by chairs. To one side an easel was set up displaying a large sketch pad. There were stacks of colouring books and poster paints, felt tip pens and crayons, safety scissors. A brightly coloured carpet surrounded by beanbags sat beside a little bookcase, reminding me of the ‘Reading Corner’ at my infant school.

On closer inspection though, I realised that this was not a shared room. A message on the sketch pad encouraged recovery college attendees to do some colouring in while they waited for the session to start. The colouring books turned out to have a mental health theme. I passed a lady dreamily colouring in the word ‘Anxiety’. I remembered Mr. Sunshine, and Susan telling me that this was “just like a university course”.

The next thing I noticed was that some of my fellow attendees were clearly struggling with their mental health far more than I was. I felt a huge wave of pity and compassion for a fair haired boy in his early twenties who was rocking rigidly back and forth in his seat, hands tightly clenched in front of him. He was red in the face and visibly sweating, so tense that he seemed to be holding his breath. A social worker sitting beside him was gently encouraging him to take deep breaths and periodically he would suck in a mouthful of air that audibly rattled in his throat.

As I took a seat, a tiny girl, heartbreakingly thin, was led to the chair next to me. She looked malnourished, sallow skinned and hollow eyed. It was hard to tell what age she was. I tried to smile a welcome but she folded herself up in the chair immediately, hugging her knees tightly up under her chin as though trying to make herself as small as possible. When I looked more closely I saw that every visible patch of her skin was covered in self-harm scars, livid white marks so deep that they had clearly needed stitches. I thought of my one, singular, self-harm scar, a long scratch above my knee made more than ten years ago. I hadn’t even gone to the doctor about it, couldn’t even remember now what had driven me to do it. Whatever it was it had clearly been nothing compared to the savage pain that had driven my seat mate to hack at herself so viciously.

At first she didn’t say anything, staring fixedly at her knees, but after a few minutes she introduced herself and asked what my diagnosis was. It turned out that we both had borderline. Mentally, I tried to make sense of that. What did borderline actually mean if it simultaneously described people who self-harmed so badly they needed stitches and people like me, people who were desperately anxious but really not at risk of hurting themselves? Could a category that contained such wildly different experiences really mean anything at all?

To my horror, the course leader began the session by producing a cuddly toy butterfly and announcing that we would go round the room and introduce ourselves, opening or closing the butterfly wings to indicate how we were feeling today. I cringed, glancing frantically round to gauge the response of my fellow attendees. I seemed to be the only one who was bothered by the nursery school paraphernalia, but it made me feel infantilised. I wondered bitterly if finger painting and hopscotch were on the agenda too, and felt myself beginning to seethe, just gently.

I gritted my teeth through round one with the butterfly, trying to smile encouragingly at the fair haired boy as he haltingly stuttered out his name between strangled breaths, but when the course leader announced that we would now do round two (using the butterfly wings to indicate how we would like to feel by the end of the session) I quietly left the room in search of coffee. To my surprise, like a greyhound after a rabbit, I was followed out of the room by one of the course coordinators. Catching up to me she peered into my face with wide worried eyes and said, “The butterfly exercise can be very traumatic. Are you OK?”

I blinked at her, struggling to construct a plausible scenario in which something called ‘the butterfly exercise’ could be causally related to ‘trauma’. I had a brief vision of the toy butterfly flapping over the trenches of the Somme, perching on the gates of Auschwitz, lying forlornly in the wreckage of the World Trade Centre. With as much dignity as it is possible to muster after someone has just implied that you might have been traumatised by a stuffed animal, I said, “I’m just getting coffee. You don’t have to follow me around the building. I’m 30.”

“Oh we have to,” she said, “In case you hurt yourself. It’s our duty of care.”

I really hate being monitored, observed, scrutinised. Most of the time I wish I was invisible and I always like to be able to quietly remove myself from a situation without causing a fuss. I bristled at the thought of being followed. Surely it was obvious that this was patronising?

“Well I’m going out for a cigarette,” I said coldly, “Does that count as hurting myself?” I moved past her towards the door.

Correctly judging that she was not welcome to accompany me she stood awkwardly in the café while I smoked my cigarette outside, moving every time I did to keep me in sight through the window. Indignantly I wondered what she thought I was going to do, impale myself on a picnic bench? I felt suddenly remorseful when I remembered the self-harm scars on my seat mate. I was no danger to myself, but some of the people here were, weren’t they? What were we all doing here together? The worried well and the seriously disabled, all grouped together, all diagnosed with the same things…

Back upstairs we were each given a copy of a book about recovery, the ‘text book’ we would be working from. It contained 365 ‘recovery exercises’, one for every day of the year, and naturally it had rainbows on the cover. For reasons that will become clear this book is no longer in my possession, but I wish I could remember what it was called. It was so fantastically stupid that I sometimes wonder if I hallucinated it.

The ‘recovery exercises’ included things like, “Pull a funny face at yourself in the mirror” and, “Do a little dance when no one is watching.” One particularly wise and life altering suggestion was to, “Sleep with your pillow at the opposite end of your bed.” As I flipped through the banal, juvenile ‘exercises’ I tried to imagine plugging the great, aching, shameful hole at the centre of my existence with the advice to, “Eat a tasty snack and rub your tummy.” This was condescending, insulting. My seethe kicked up a notch.

I excused myself to go to the bathroom and took a few deep breaths, urging myself (not very successfully) to try and keep an open mind. When I exited the stall I found that the course coordinator had followed me even here.

“Still not traumatised. Just peeing,” I said through gritted teeth as she watched me wash my hands.

When I resumed my seat the course leader was introducing the biopsychosocial model of mental health problems. ‘Psycho’ and ‘social’ were taking a backseat. It was ‘bio’ all the way. Then he made a pronouncement that I’ve heard from multiple mental health professionals over the years. It is always said in precisely the same way, in a tone of extreme gravity and seriousness, as though the information being conveyed is of truly biblical importance. It is always said in complete isolation from any other contextual information, decisively dropped into conversation like a stone into the sea. Leaning forward on the desk and staring intently at us one by one, he intoned the words, “Trauma literally changes the structure of the brain.” The ‘literally’ was emphasised. It always is.

If your mind works like mine then you will have a lot of questions about this statement. In one sense, it is trivially true: trauma does change the structure of the brain. The trouble is that everything changes the structure of the brain. Having breakfast this morning changed the structure of my brain. So did reading the newspaper and going for a walk. The structure of my brain is changing as I type this sentence, and the structure of your brain is changing as you read it. I think what is actually meant is something like: “Trauma literally changes the structure of the brain, in a way that is bad or different from the ways in which the structure of the brain is changing all the time anyway.” In my experience, this context is never provided. I’m not even sure it’s true.

Even if it was, I would still have a lot of questions. How is ‘trauma’ defined and how do you measure it under controlled conditions? Some people feel traumatised by going on rollercoasters. I certainly do. Other people love it. How do you separate the effects on the brain of ‘trauma’ and the other adverse circumstances that often accompany it? Is poverty a kind of ‘trauma’? Being a single parent? Or does ‘trauma’ only describe really extreme experiences, of being tortured or kidnapped or sexually abused? Who decides?

Most importantly, what is the impact of telling people who have had traumatic experiences that they have effectively sustained an untreatable brain injury? That if, unavoidably, they are exposed to trauma again then they will sustain another one? If the statement was, “Trauma literally changes the structure of the brain, but that’s okay because the brain is an incredibly flexible organ capable of recovery” it might be alright. But I have never heard the information conveyed in this way. It is always stated as a dogma, a dead end. Very sad, but a done deal. This doesn’t seem helpful.

I put my hand up and tried to raise some of these questions. Which part of the brain was changed by trauma? What kind of trauma? Where could I find the research he was citing? The course leader didn’t know, and looked unhappy to be asked. I was about to say something else when the girl sitting beside me began scrabbling at my arm, clutching at me urgently with her skeletal fingers. The course leader gratefully moved on as I turned my head to hear what she was saying.

“It’s your BPD, it’s your BPD!” she was hissing frantically, bobbing up and down in her seat. I had never heard the abbreviation ‘BPD’ for borderline before and initially had no idea what she was saying, “Your borderline!” she said, “It’s your borderline making you do it!”

I shook my head at her, silently contemplating the range of horrifying dystopias made possible by the idea that asking factual questions about medical research is a ‘symptom’ of mental illness.

Turning back to the course leader, I listened in amazement as he explained that depression was caused by a lack of serotonin in the brain. The chemical imbalance myth! Out in the wild, coming out of the mouth of a qualified mental health professional, despite all the research I had read debunking it. My seethe abruptly crystallised in to good old fashioned anger and I heard myself shouting out, “But that’s not true!”

There wasn’t much time for anyone to respond to this because the girl sitting next to me now took it upon herself to explain to the room at large her theory that it was my “BPD that was doing it”. Abruptly, I decided that I was done. There was nothing here for me. Nothing that was true or meaningful, at any rate. I grabbed my bag and left.

There is my life before that incredibly surreal day, and there is my life after it. The recovery college is the thing that finally shattered my belief that mental health professionals possessed some kind of profound wisdom that was essential to my recovery. The contradictions and inconsistencies finally overwhelmed me as the last Lego brick snapped into place. I had no idea what I was going to do as I drove away from the recovery college, no idea how I would cope with the feelings of shame and anxiety, no idea how I would pull myself out of the hole I’d dug, no idea how to build the life I wanted.

What I did know, with an absolute cast iron certainty that has never left me, was that mental health professionals didn’t know either. Faced with what felt like the most significant crisis of my life, they had offered me drugs, cuddly butterflies, children’s books and lies about ‘chemical imbalances’. I was terrified, but I swore to myself that I would never ask a mental health professional for advice again.

That night I took some savage pleasure in setting fire to the wretched recovery book in an impromptu bonfire in the back garden. My mum, a pagan hippie type in her mid-70s, told me it was a ‘ritual cleansing’. It certainly felt like one as I watched the happy rainbows on the cover melting in the heat, the pages disintegrating into smoke and drifting away, taking ‘bipolar’ and ‘borderline’ with them.

Having burned the recovery book, I bought myself a new one: Twelve Rules for Life by Jordan Peterson. I didn’t know much about him and had no idea the book would be so useful to me, but I found myself taking notes as I went along. I still refer back to them sometimes if I’m trying to make a difficult decision.

Peterson’s premise was unlike anything I had encountered in mental health services, where the position had always been that happiness and contentment were the norm, always just one prescription away for those of us who didn’t experience the world that way. Rather than positioning suffering as an aberration, a defect to be corrected through drugs or therapy, Peterson argued that life is, fundamentally, a very difficult and painful business. If you move around the world with your eyes even half way open you will inevitably encounter a certain amount of cruelty and injustice. Even the luckiest among us will experience the pain of losing a loved one. It is entirely correct and normal to feel distressed about this. As Samuel Beckett wrote, “You’re on earth. There’s no cure for that.”

This being the case, ‘happiness’ is not necessarily a terribly worthy or achievable goal. If you’re very fortunate indeed, happiness may be a by product of trying to live your life as well as possible despite the inevitably of suffering. This was a revelation to me. I realised I could feel awful, appalling in fact, and still try to live my life in a way I felt proud of. After reading Peterson it seemed absurd that I had spent so many years trying to achieve ‘stability’. It was no good waiting for the anxiety and fear of failure to go away before trying to do anything. I would be waiting forever.

If you are reading this essay in the hope of curing your own ‘mental illness’ then I highly recommend Peterson’s book, but I’m afraid there’s no way to replicate the next step of my recovery. If I could bottle the friendship of Helen Pluckrose I’d offer everyone a sip, but I’m afraid I just got wildly, unimaginably lucky when I met Helen.

I first heard about Helen because she and her colleagues James Lindsay and Peter Boghossian had written a series of fake academic papers about race, gender and identity. Aping the style of modern social justice activists, they had made them as egregiously, outrageously unethical and ridiculous as possible. Take, for example, the fantastically titled “Human reactions to rape culture and queer performativity at urban dog parks in Portland, Oregon”, in which they claimed that dog owners were more likely to break up male on male “dog rape/humping incidents” due to pervasive homophobia. They invented an entire data set, claiming to have spent 12 months inspecting the genitals of passing canines. Another paper argued that ‘Queer Astrology’ should be considered a scientific discipline just as valid and factual as astronomy, and a third proposed that male students should be made to atone for their ‘privilege’ by sitting on the floor in chains during class. A distressingly large number of these papers were accepted and uncritically published by mainstream academic journals. Some of them, including the dog park paper, were nominated for prestigious awards. Colloquially known as ‘the grievance studies affair’, the hoax exposed a crisis of credibility in academic institutions, with fashionable political orthodoxies being given a free pass by peer reviewers even when they were epistemologically unsound or straight up absurd.

I loved Helen’s work, which you can read here. She’s an incredibly rational, compassionate thinker, someone who really believes in human worth and value. “Not bad, for large brained apes,” as she sometimes says to me. (It should be pointed out here that Helen’s humanism does not prevent her from routinely wishing to decapitate the particular human doing something infuriating in front of her. When she first read this essay she advised me that it should really read, “Stupid, irrational large brained apes.”) She is also, as may be guessed from the dog humping paper, very, very funny.

Through her writing I found my way to the philosophy of classical liberalism, falling in love with the idealism and humanism of John Stuart Mill. Quite by accident, I went on an incredible intellectual journey in the six months I spent waiting around for various mental health interventions. Those interventions turned out to be perfectly useless, but I am still sustained by the passion for liberal thought that Helen’s writing first inspired in me. One of the most fascinating things about contemporary debates over identity is the enormous range of domains the subject ends up touching on: medicine, philosophy, ethics, law, history, education, politics…I devoured it all.

Kooky as it sounds, I believe some fateful cosmic force determined that Helen and I should meet each other. When I first saw her being interviewed I had the strangest feeling that she was someone I already knew. I had never met her in my life, but every gesture, every expression seemed warmly familiar. When she posted on social media saying that she was overwhelmed with emails, I thought of Twelve Rules for Life, wrestled down my crushing fear of failure and humiliation, and reached out asking whether I could help.

To my amazement she accepted, and it turned out that in a funny way I did already know Helen. We are remarkably similar in some ways, even though we are strikingly different in others. Helen can unpick my thoughts and represent them back to me in a way that illuminates parts of my psychology that I’ve never really understood before. I like to think I am sometimes able to return the favour, but Helen is really like my fairy godmother: the blessings go all in one direction. Admittedly she is a vengeful fairy godmother, always ready to smack me about the face with her magic wand if I am talking myself down. She is simply one of the finest people I know.

This was 2020 and lots of people were reaching out to Helen because they had been impacted by the polarising brand of identity politics that was turbo charged by the murder of George Floyd and the Black Lives Matter protests. Many people were having real life experiences not unlike the absurdities imagined in the grievance studies papers. We heard from people being threatened with unemployment for criticising concepts like ‘white privilege’ or ‘systemic racism’ in workplace diversity, equity and inclusion trainings. Not because they’d actually done anything racially prejudiced you understand. Simply because they had objected to the philosophy of division and disempowerment propounded by self-proclaimed ‘antiracists’ like Robin Di’Angelo and Ibram X. Kendi. No one has a more detailed knowledge of critical race theory than Helen, and together we tried to help people raise their objections in a principled, knowledgeable way.

Unconscious bias training kept coming up. I had loathed the idea as soon as I heard about it. There’s something degrading about the notion that we’re puppets controlled by invisible forces, rather than free, choice making individuals. Instinctively I felt that the concept was either an excuse for actual bigotry (“It weren’t me guv, my unconscious bias made me do it!”) or a violation of the privacy of mind. Does the person who pays your wages have the right to ‘train’ your innermost thoughts? I think not.

Since Helen and I were routinely helping people write letters to their employers explaining the problems with unconscious bias training, I tentatively suggested I write them up in to a report. I toiled over it for a week, thinking of almost nothing else. I triple checked every figure, agonised over every sentence, and when I sat down to send it to Helen I was so petrified that it would turn out to be shamefully and humiliatingly bad that I nearly couldn’t do it. I almost, but not quite, ran away again. After I had finally worked up the courage to press send I wrote anxious notes to myself. I still have them: “You are doing your best, that is all you can do. Failure is a learning experience. Helen is a kind person. When she says the report is unusable I am sure she will let you down gently.” I was quite convinced what I had written was rubbish.

Two days later Helen replied to say it was very good. She hoped I didn’t mind but she had shown it to a journalist and he wanted to publish it. She didn’t realise at the time how terrified I had been to send it at all, nor what an incredible achievement this felt like for someone whose last significant milestone had been passing a small handful of GCSEs 20 years ago. I was ecstatic. I was asked to write a short accompanying article and that was published too. I couldn’t stop looking at them. My words, my ideas, my arguments, all there in print in front of me! I’ve been fortunate to publish lots of pieces since then, but my heart still soars every time something I’ve written is accepted for publication.

I’m still petrified that everything I write will be embarrassing rubbish too. My fear of failure is as bad as ever. Nowadays I try to crush it down into the soles of my shoes and walk around on it for a bit, rather than running immediately in the opposite direction looking for a psychiatrist to ‘stabilise’ me. Sometimes my articles are accepted and sometimes they’re not. I’ve survived the rejections and I cherish the successes.

Helen and I ran an organisation together for a while, Counterweight, and she wrote a book about what we learned from helping people defend liberal principles in a sometimes illiberal political climate. She introduced me to the most fascinating people and to my absolute astonishment some of them offered me paying work. I was so proud to pay taxes after 20 years of welfare dependency, so thrilled that I was contributing. Wherever I went I encountered new ideas and I learned, voraciously, from people I am incredibly proud to have called colleagues. Many of them do not fully appreciate, I think, what a completely transformative period of my life this was and what a crucial part they played in that transformation.

After six months I found myself in a hotel room in London, exhausted and exhilarated and happier than I had ever been in my life. I had just helped organise a film screening and it had been a very successful evening. Sitting on the balcony in the warm summer air, I caught sight of the self-harm scar on my knee and just marvelled at the transformation that had come over my life. What had I been doing for the past 20 years? Ceaselessly striving for a state of suffering free ‘stability’ that didn’t actually exist? Trying to control a ‘mental illness’ that had evaporated the moment I lost faith in the mental health professionals who had diagnosed me with it in the first place? And all that time this richly wonderful life had been out there waiting for me.

There was one final stage in my recovery. Even though I had stopped thinking of myself as ‘mentally ill’, I still believed that I was fundamentally a very defective and unreliable person. When I was going to be working with someone, I would try to give them an apologetic heads up about this by announcing my diagnosis: “Yes, I’d love to write a report for you. Just so you know, I have borderline personality disorder.” (I will always remember fondly the colleague who replied, “That’s nice dear. Shall we just see how it goes?” We campaigned together side by side for two years.)

In retrospect, it was quite ridiculous. I had a vestigial urge to pre-empt failure, reaching for the familiar language of mental health as a kind of get out of jail free card. Finally, at the end of a Zoom call, Helen said to me, “Carrie I think you should stop telling people that you have borderline personality disorder.”

My stomach lurched. I was humiliating my friend, making her look bad in front of her colleagues. I stuttered out a desperate apology. Regarding me over the top of her glasses with pursed lips, Helen puffed. This is a sound of politely contained displeasure, made by Helen only when the person being puffed at is in real trouble.

“No Caroline, it is not because you are embarrassing me,” she said. I am only ‘Caroline’ to Helen when I am being scolded, “Quite the opposite. You are competent and capable and, quite frankly, terrifyingly organised. People are therefore confused when you announce that you have a mental illness.”

So I stopped telling people that I had borderline personality disorder. I waited breathlessly to be ‘found out’, exposed as a fraud. I waited for it to matter that I had once had something called ‘bipolar’ or ‘borderline’.

I am waiting still.

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