Dissociative Disorder: Studying and mental health

The following is a guest post from one of our MAP Mentors, Andy Divers. Here he talks about his experiences with mental health in academia, with the hopes of reminding other philosophers that they're not alone in what they go through.

The real problems started when I was in the 2nd year of studying my PhD. Much of what happened is, admittedly, something of a blur but hopefully from what I can recount, I can show that it is possible to manage study or research and a long-term mental illness, even when things seem at their worst. Even when there isn’t the support that you need (or would expect) from your institution, there are still places that you can find help.

Perhaps also, this is an exercise in banishing demons. One of the worst things I found during the time in which I struggled was that I felt very much alone. It probably (and does) sound like a cliché, but it’s true. Perhaps it was because of my poor mental health at the time, but I also felt that I was made to feel alone during that time: something I wasn’t expecting from the well-educated, intelligent individuals that surrounded me. I assumed that such people would have an enlightened outlook about mental health issues, but I very quickly learned that I was wrong. My aim here is not to point fingers, or to suggest that my own situation was somehow worse than others, simply that I would hate to think that anyone else has gone through a similar situation and felt the same as I did. I honestly believe that mental health is more of a taboo within academia than it is in other professions, and I have found that there seems to be a pernicious assumption that because one has the ability to harness their minds when directed towards the challenges of complex thought, that this somehow means that mental health problems should also be something that one also has control over. Similarly, the very cut-throat way in which modern research functions means that any sign that you are not ‘up to the job’ is taken with a dim view. And I contend that within many universities (and certainly within my own experience) succumbing to mental illness in whatever form it takes, is very much viewed as a weakness.

A bit of background is probably necessary in order to make sense of the situation I found myself in. I have struggled with mental health problems of one kind or another for as long as I can remember, though I suppose they raised their head so others could notice around the time I was 13 or 14. This is when a number of ’peculiarities’ about the way my mind worked began to emerge. Initially, I wasn’t aware that my own experiences of what I can only really term as ‘mental phenomena’ were any different to anyone else’s, and by the time I did notice it was all too clear to me that this wasn’t something it would be wise to readily divulge information about. In short, for a number of years I simply tried to keep things to myself in the hope that if everyone else was unaware of my situation, then maybe I could also forget about it: something that was never going to work and invariably didn’t.

To some extent I managed to keep most of this at bay until early in the 3rd year of my undergraduate studies. I spent around 3 months (or thereabout) on a sofa, only really raising myself for the very rare occasions on which a helpful housemate forced me to eat something. Luckily, I was able to churn out at least something come the end of term and essay time, and thus was able to pass under the radar so to speak, although I was sent numerous letters asking where on earth I had been all this time. Certainly not my finest hour, but not one that was catastrophic for my future aspirations in academia either.

To cut a very long story a little shorter, alongside the sometimes aggressive unipolar depression that I suffer with, I also used to regularly have rather profound panic attacks. The sort of ones where on occasion I have been known to pass out - often at the most inopportune times possible. For years, this was my diagnosis, and an endless parade of mental health professionals, doctors and the like tried to help me manage these conditions. There was always the feeling, though, that something else was amiss. In addition to the fact that both my mind and body seemed to regularly conspire against me, I also have these ‘peculiarities’ that I mentioned before. As it transpires (and after nearly 10 years of myriad attempts to explain what was going on) I was diagnosed with Dissociative Disorder. For anyone that also lives with this, be it directly or through contact with an individual who suffers with Dissociative Disorder, you have my deepest sympathy. There will be those who know the condition and what it involves, but for those of you that don’t, the condition manifests itself in me in the form of auditory hallucinations, mental ‘other-ness’ and dissociative amnesia, as well as other problems which I will mention later. The hallucinations may at first sound the more terrifying prospect of the group, but I can attest to this not being the case for me. Granted, no one really wants to hear voices, but once I had spoken about them in the right setting and because I have always known that these are not ‘real’ in the same sense that the voices of other people are (setting aside the obvious objections no doubt from avid students of metaphysics and epistemology) I have been lucky in the sense that although the voices are always there, I am with some degree of self-training and effort, able to ignore them to a greater or lesser degree. I am also lucky (I think) that these voices are always just out of ear-shot (or mind-shot I suppose, given the inescapable fact that these voices are not the product of sound, but of pseudo-sound concocted entirely by my brain) and so I have never really found these to be overly troubling.

As far as mental other-ness goes, I have always had the experience from time to time that thoughts I’ve had are not necessarily my own. That is to say that although these thoughts must necessarily be my own, that I have the sensation that I am nonetheless not the author of these thoughts. Initially of course, this sensation was unsettling - especially when I began to learn that others didn’t share this experience. Again though, since logic dictates that these thoughts must be mine (I do not think that another entity of some kind is responsible for planting such thoughts in my mind) and also because these thoughts of which I do not feel in strict possession usually contain some of my better ideas, this is not something I have sought to remedy, nor to examine too deeply.

What is troubling however, is the dissociative amnesia that comes along with everything else. This is certainly not ordinary forgetfulness, nor is it akin to any other kind of memory lapse, even the most persistent or frustrating kind. This is memory loss that over time begins to gnaw at the most fundamental notions of those things you take to be identity-constituting, especially when it happens in the company of others. The earliest alarm bells relating to this ‘amnesia’ in my case surrounded regular loss of time. We all know the adage that ‘time flies when you are having fun’, but this is something on an entirely different level. What I experience is as if someone has gone around spinning all the clocks around me on by anything from about 20 minutes, to at its worst, several hours or even whole days. The thought that I had quite literally ‘lost’ whole swathes of time is something that terrifies me, and avoiding the recurrence of such events is something which I am constantly mindful to strive for. Coupled with the sensation of lost time, I have on occasions too numerous to remember (with its full force of irony) found myself in a different room, mid-conversation with someone, or at times even in a completely different place with absolutely no, even faint, idea about how I got there. It turns out that the triggers for the onset of my dissociative episodes are feeling afraid, threatened, trapped or ashamed - not exactly ideal when due to my other mental health conditions this was how I felt (and to some extent still do feel) on a more regular basis than that average individual.

This would, I’m sure many would agree, be worrying enough in itself. However, it was the revelations from others during these mental ‘holiday’ periods that uncovered the real horror of what was going on. It wasn’t that I was on auto-pilot so to speak as I had first thought when I was losing time: I wasn’t wandering through life like some kind of automaton with no direction - someone was very much at the wheel, but it wasn’t me. Others began to tell me during the periods where I had no recollection, that a very unwanted and very noticeable change came over me. Again, cutting through a lot of detail to explain things more succinctly, what I was told was happening was that to all intents and purposes another personality entirely was taking the reins in those periods where I was experiencing a total lack of memory. The reason I had no recollection it seemed was because although I was present in a physical sense, mentally it was a different matter entirely.

With the benefit of enough treatment and medication to have stabilised my condition, and also with the armour of a recognised diagnosis to shield me from the reactions of those to my behaviour (that range from the merely disapproving right the way through to the downright disgusted, afraid and violent - all of which I have encountered at one time or another) I can now talk with less terror and dread about the character and extent of my brain ‘holidays’ without the fear that once imposed complete silence on me. As I have said at the beginning of this, the reason for me doing so is to help others see that whatever mental health problems they are suffering with, they are not alone. I also know only too well that talking about mental health is often easier when one is not afflicted by it. More often than not, I have found that those who are the greatest supporters of opening up dialogues about mental health difficulties tend to be well-meaning advocates, rather than those who are themselves suffering. After all, if one doesn’t suffer from a mental illness, be it a one-off period or a long-standing and permanent condition, then they have nothing to lose by urging candour and honesty and outing themselves.

Now that I have (with apologies for its length) given some background about my situation, I can press on to explain how this led to the series of events with which I began. During my 2nd year of PhD study, I began to notice a lack of concentration beginning to plague any attempt I made to sit down and do some serious work. Of course, this is not something that is especially rare, and I have certainly gone through periods where I have lacked focus and have had to step away from writing, or have had to dig deep and really grind out the words, but this was different. Every time I sat in front of my laptop to start the process of writing, I simply couldn’t access any of the knowledge that had previously been in my brain. I knew it was there of course, because through the process of research, reading, note-taking etc., I had put it there, but when faced with recalling this information to commit it to the page, I was at a total loss. Things which had previously made sense to me suddenly became indecipherable.

More worryingly, even things I had previously written were now beyond my ability to grasp. No matter how hard I tried, I simply couldn’t understand either the literature that I should have been (and previously was) familiar with relating to my work, nor (even less forgivably in my eyes at the time) could I even grasp the thoughts that I had myself formed. If anyone has experienced something similar, then once again, I can offer you nothing but my deepest sympathy because not being able to understand something that is the product of your own mind, and have the evidence in black and white in front of you, is perhaps one of the most horrifying experiences that I can think of.

Potentially my biggest mistake at this time was trying to hide the fact that I was unravelling in a very real and profound sense. Due to a whole host of reasons, I had felt inferior to those around me - I already felt like a fraud, and was desperately trying to make sure that nobody found out. As deadlines approached, and I had no evidence of anything vaguely productive, instead of admitting the problems that I was having I entered into a cycle of bargaining with my supervisors. “I could send the 5,000 words I promised next week, but why don’t I send 8,000 the week after?”: this misguided tactic on my part continued to the point where I was sat in front on my laptop some 2 months later with somewhere in the region of 15-20,000 words to submit in the next 24 hours, and still no idea of where to start or even what anything that I had already done actually meant. I had to admit defeat. This, I thought, would be my lowest ebb and would be as bad as things would get - I would be honest about the situation and my failings, and with the support of those around me, I could get back on track and with some hard work I would catch up to where I should be. Not for the first time, I was very wrong.

The course of action that was suggested, in such a way that very much suggested that this was my only option, was to intercalate. Intercalation I was told, was essentially a break from my studies (6 months in my case – the longest time it was possible for me to do so) in order to give me time to get better. This meant that I would be able to get myself sorted, without the pressure of having to continue my research for a while. The idea of intercalation was not something that I had wanted to do, but I appreciated that since the transgression that put me in the situation I now found myself was mine, I wasn’t in a position to argue. Given the incredibly precarious state of my mental health at the time, I also didn’t feel I could argue, even if I thought I had reasonable grounds to do so. Bearing in mind that at the time, the periods at which I was in control were becoming severely eroded, and given that the triggers for these episodes lies in part when feeling trapped, that I was already struggling to keep things together, and that the fear that the oppressive atmosphere that I found myself in would trigger an episode, only made the situation worse. As such, the wheels were set in motion for me to intercalate to take some time to ‘get well’ and get back on track. Ultimately, this isn’t quite how it worked out, and there was still plenty to make my health considerably worse by the time I did intercalate.

The first thing that I should have expected was that intercalation would hit me very hard financially. The day my intercalation became official, all of my funding stopped. Of course, I’m not about to suggest that I ought to have been paid when I wasn’t working, and it really should have been something that I had seen coming, but for a whole host of reasons, I didn’t. I found myself then in a situation where I was contractually unable to work (again a reasonable assertion, as if I was well enough to work, then I should be working on my thesis). However, what this led to was a situation in which on top of all of the other stressors that I was currently trying to navigate, I now had the worry of what to do in a situation where I had literally no source of income for 6 months - and no way to work during that time. As a result, I had to move out of my flat, and ended up amassing a phenomenal amount of debt, borrowing just enough money to keep me afloat during that time. Not something that was conducive to my supposed ‘getting better’ during my intercalation period.

All this of course occurred once I had actually commenced my intercalation. One of the largest (and most damaging) hurdles that I was to face was during the very short period of time between deciding that I was to intercalate, and getting everything I needed to do so ready. For the most part, this was quite straightforward and the process was made a lot easier by the support I got from my main supervisor. The part of this process that was neither straightforward or made easier was proving that I was unwell enough to justify my previous lack of output or indeed the need to intercalate, as opposed to being unceremoniously ousted from my post on the basis that I simply hadn’t done the work rather than being unable to work through ill mental health. Again, I didn’t have a problem with this requirement - after all, if I was going to be signed off as too unwell to continue (at least for the time being) with my studies, then I should have to prove that I’m not ‘swinging the lead’ shouldn’t I? Putting aside the fact that it should have been (and was) very clear to most around me that things were very far from O.K., I suspended my indignation at the suggestion and looked at it from as objective a point of view as I could.

The proof that was needed of me was a doctor’s letter detailing my diagnosis, stating my condition and that I wasn’t ‘putting it on’. This wasn’t a problem, since my troubles were very much genuine, and I had a good relationship with my G.P., as I had been a regular visitor to the Health Centre, and on more than one occasion had full-blown breakdowns in their presence - so it’s safe to say that they knew me well, and had genuine concern for my well-being. Moreover, I had close ties to a number of a mental health professionals, given that at the time I had not yet been conferred my diagnosis of Dissociative Disorder, and was thus an interesting mystery to try and unravel. Even though I did not have a specific diagnosis for the issues that were caused by my Dissociative Disorder, I was nevertheless already diagnosed with severe depression, and this meant that I could indeed prove that the difficulties I was experiencing were genuine. As well as this, even though they weren’t quite sure what to call it or what exactly was wrong, there was definitely the consensus that something was wrong, and so my Doctor’s note attested to this fact.

Again though, a fairly simple task (relatively speaking) was made much more difficult. The upshot of which is that (for reasons that I have never been able to fathom and was never given an explanation for) it was imperative I got the above Doctor’s note within the next 24 hours. Not only this, but if I failed to produce the note in this time my registration at the university would be terminated, as would my studies and my job. Luckily (again) I was able to get both an appointment and a doctor’s note within the ridiculously slim allotted time, mainly due to the fact that I was a regular with my G.P., and I think I must have sounded as desperate as I felt when I rang to ask for an appointment. I am eternally grateful to my G.P. not only for rescuing my PhD at this point, but for rescuing me on countless occasions during that period. Of course, family and friends were there to support me but I always felt that I was burdening those around me and tried as much as possible to shield them from the worst that I was going through. It wasn’t something that they made me feel, but something I myself was responsible for. The result was nevertheless the same and my advice, if I am placed to offer any at all is not to repeat my mistake: those around you will be there to support you if they are worth anything at all, and the effort of trying to ‘put a brave face on things’ was at times more than I could handle and definitely did nothing to help me recover.

In the end, I returned from intercalation and managed to successfully complete my thesis. Perhaps more importantly, through a fair amount of work from some truly committed professionals, supportive family members and to some extent myself, not only did a real diagnosis emerge, but I began to improve over time. I am under no illusions that I am somehow all better; Dissociative Disorder is not something one ‘gets over’, and some days are definitely much better than others, but hopefully anyone else in the same or similar situation who reads this will know that things do get manageable, if not fixed, once you open up and try to find support. I may be biased, but I also think that had something like Minorities and Philosophy have been something I was aware of at the time, that things may have perhaps been a lot different, and a good deal better.

Andy is an independent researcher, specialising in bioethics, agency and the philosophy of childhood.


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