This morning I went to the doctor to get my mental healthcare plan reviewed. Ironically, while I'm grateful to get the steps and medication and referrals and further appointments that I need, this is an activity that never fails to make me feel depressed and hopeless. If you've had one done before, you'll know that the highlight among the various forms that need to be filled in is a questionnaire on which you rank your current level of shitfeeling on scales from 0 to 3, and then you get given an overall score. The higher your score, the more likely you are to be feeling shit.
When I first got a mental healthcare plan, a long time ago, I quite liked doing the scale questions (which do have a name that I can't remember right now). It's a way of objectively establishing that something is wrong, which was initially relieving. You don't have to come up with the words yourself, just the rough level to which a sentence matches your state of mind over the past month. And you can measure your own progress, too. When things started to get better for me, I could do this test, whatever it's called, and be sure that I was recovering. And I could also tell my family and friends, 'hey look, I really am a lot better'. It was a tool to prove I was becoming worthy of being in society again. And amid the whole bureaucratic exercise, this was something, to some extent, within my control.
But today, I got no sense of relief or accomplishment out of the scale. It felt a little bit like failing a test, but it's more complex than that. Throughout the process, my doctor assured me that it was 'just procedure' to ask questions about whether I was feeling suicidal, whether I was in a space where I might hurt other people. I didn't mind. I understand why they need to be asked. But amidst the constant reminders that these things are procedural and aren't intended to 'mean anything', I wondered what exactly was the point of asking them, of being there at all. Why did it take two hours to provide such minimal information, that my doctor conceded was inherently meaningless? I think I've entered a stage where I'm not talking about 'recovery' anymore, but 'management'. And that means maybe I'm going to have to acknowledge that basing my worth on a set of completely arbitrary questions is not the best way to proceed.
Anna Spargo-Ryan wrote an excellent essay a couple of years ago on why things like World Suicide Prevention Day are a bit counter-productive. Because when people have a tendency to feel shit, pointing out this tendency is the last thing they need. When you feel shit for years, decades, whatever medically-diagnosed (or not) form this takes, you don't need people telling you offhand that it's bad to be that way, and that they hope you're not like that.
The stigma around mental illness goes deep, and it's not just about being 'treated differently' than so-called normal people, it's about having an incredibly poorly-developed vocabulary yourself about how and when and why mental illness can affect your life and the ways you are able to live it. For me it all crystallises in this stupid anxiety-depression scale. When I ace the test, I feel good, my doctor feels good, everyone is proud of me and life can go back to normal. I am acceptable. I even wrote an article last year about how good being acceptable feels, how right it is to fit neatly in a medically-sanctioned box. But when I fail the test, everything is put on hold until I meet the right criteria again. I'm getting to the point where I rarely meet the right criteria, or at least I don't feel like I do. So what do I do now?
This emotional investment in what is essentially a box-ticking exercise seems like an additional headache that I just don't need. The world is three minutes from nuclear war. My taxes are funding a hate campaign against LGBTIQ+ people and their children. I wonder if the people who make these sorts of decisions ever feel like a scale in a doctor's office precludes their ability to live and speak in the world. My guess is no, they don't.
The experience of diagnosis, treatment, the healthcare system in general, can divide and effervesce subject-hood at its very core: the body. If this has happened to you, for whatever reason, I just wanted to say this to you as well as to myself: You're allowed to be the way you are. You're allowed to pursue the treatment you want and feel you need. You're allowed to define your own horizons and know that they may not fit on the Medicare form or be part of the drop-down menu, or have a name or a shape yet, or fit on a scale from 0 - 3. They might be a 6 or a 9,000. As my doctor says, waving his hand with incongruent nonchalance in my face, it really doesn't matter. But you, and I, do.