Depression and Imaginary Friends
Oct. 21st, 2017 07:21 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
keepingintouchIt has been long, long, LONG time since my crew have permitted me to call the imaginary friends, but this is the language that is used on the internet that gives me articles to read.
http://www.chatelaine.com/health/adults-hearing-voices-imaginary-friends/
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Imaginary friends can be helpful for kids. What about adults?
Meet Jenna, who has bipolar disorder, and Jensen, the supportive voice inside her head.
by Megan Haynes Updated Sep 19, 2016 1
Illustration, Noma Bar.
Every spring and fall, Jenna Walker* battled depression — a rhythmic, debilitating expression of her type 2 bipolar disorder. She was irritable and unwilling to be around other people, making her job as an administrative assistant untenable. She’d snap if her son touched her shoulder at the wrong moment. Medication didn’t always work. There were a lot of mornings she just stayed in bed, unable to overcome the emotional and physical exhaustion of her illness. She felt trapped by the competing needs for affection and solitude, a conflict that was hard for her family to navigate.
In 2014, after five years of suffering, she sought out a friend named Jensen. She shared everything with him. They became so close, they could communicate without words. He’s pragmatic, confident and focused — complements to Walker’s sometimes scattered personality. He tells her that she’s strong, that she can fight her depression, and when he says it, she believes it. He doesn’t treat her with kid gloves; he can be blunt, even harsh, but ultimately he’s one of her greatest supports. He also doesn’t exist.
Jensen is Walker’s imaginary friend, a construct she uses to help keep her negative emotions at bay. She doesn’t see him — he’s more like a presence — but she does hear and converse with him, and she pictures him as tall, with brown hair, a goatee and sharp features. When he’s around, he sits just at her periphery, to her left, she says. She likens him to a “giant steel beam” that props up a roof, providing shelter and protection to everything underneath. “He’s unmovable, indestructible. I built him to be that way.”
Related: I spent 20 years hiding my depression — now I’m ready to talk
Having burned through all the coping mechanisms suggested by her doctors, she decided she needed a mental barrier between herself and the pain — something to protect her from depressive thoughts. “I believed if I sell myself on this so hard… it will protect me.” She gave this barrier the shape of a man, modelled after a character in a video game she had been playing, and gave him a name.
As she dealt with day-to-day situations, she imagined Jensen’s responses and reactions to her actions, supplying both sides of the conversation. After about a month, she says, he developed sentience. She describes that moment as feeling a strange pressure in her head — like a dog, shaking off water — and then having the distinct sensation that someone was looking at her. It was after that, she says, that she first heard thoughts that weren’t her own.
Auditory hallucinations are a symptom of a number of mental illnesses: bipolar disorder, borderline personality disorder, obsessive-compulsive disorder and, most notably, schizophrenia. Between 5 and 15 percent of the general population will experience them at some point; and, according to a recent study from Harvard and the University of Queensland in Australia, auditory hallucinations are more common in women, though the reasons for this are unclear.
They are stereotypically associated with the decline of someone’s mental health, but some experts are beginning to view the experience as one that sits on a spectrum, similar to how we view autism; they argue that not all voices are unhealthy or destructive, and that some — like Jensen’s — can even help people cope with stress and illness. Discussions in online groups such as the Hearing Voices Movement have been shedding light on the issue, and this fall, the topic will truly hit the mainstream with the expected debut on ABC of Imaginary Mary, a dramatic comedy starring Jenna Elfman, in which Elfman’s childhood imaginary friend (a small, furry monster voiced by Saturday Night Live alum Rachel Dratch) re-enters her life, triggered by a stressful event.
Related: Serena Ryder opens up about her battle with depression
When Jensen first took on a life of his own, there was plenty about him that Walker didn’t like: He could be critical and would make snide comments about people around her, for instance. But he encouraged her to deal with difficult situations rather than avoid them and said he would always be there for her. The two developed a camaraderie. His primary job now is to push her through the pain — to help her through one more day, and then another.
Beyond telling her therapist (who has signed off on Jensen as a healthy coping mechanism) and her best friend, Walker, 35, has kept him a secret. She’s never mentioned him to her kids or her husband. “I feel like if my husband knew about Jensen, it would really stress him out that I had somebody riding shotgun in my head, and that I put him there.”
Walker’s concern isn’t misplaced: The illnesses that are accompanied by auditory hallucinations are among the most stigmatized disorders in society, says Dr. Sean Kidd, chief of psychology at the Centre for Addiction and Mental Health in Toronto, who specializes in schizophrenia. But there is a lot of research that suggests having an imaginary friend can be extremely helpful for children dealing with loneliness, abrupt life changes and bullying, and can lead to improved social skills and increased creativity. Can the same be true for adults?
When Jensen broke out on his own, Walker panicked. She was sitting alone on a bus, staring out the window. The next moment, she had the unmistakable feeling that he was looking at her. He didn’t say anything — but she knew things had changed. “It was terrifying,” she says. “I didn’t know what to do. I thought I was losing my mind.”
Soon, the pair started to have what she describes as an unfiltered exchange of ideas. There was no barrier — he could hear all her thoughts, and she could hear his, an experience that left her feeling vulnerable and scared. After a week, she told her best friend. He was supportive and encouraged her to see if other people were talking about similar experiences online. She found a Reddit community populated with seemingly reasonable people discussing “beings” in their heads. All of a sudden, she wasn’t alone, and she had another name for what Jensen could be: a tulpa.
Tulpamancy — the act of meditating a mental being into existence — was first thought to be practised by Tibetan monks, says Samuel Veissière, an anthropology and psychiatry professor at McGill University and one of the few academics to have studied the subject, but its transition to a modern phenomenon happened largely online.
Related: Happy and bipolar — one woman’s journey to balance
Conversations around tulpas and imaginary friends first appeared on the message board 4chan in 2009, Veissière says, and then migrated to Reddit. After that, other online groups started popping up. Today, tulpas are thought of as a more defined version of the voices people might hear in their heads. They tend to have shapes and are considered to have consciousness independent of their hosts, who are called tulpamancers.
The subreddit, started in 2012, has more than 10,000 subscribers; however, only a small percentage are active in the discussions, says Veissière. He says people create tulpas for a wide variety of reasons: to help with coping day to day, like Walker, or for companionship. “There is a big concern among the community that they’ll be presented as ‘crazy,’ ” he says. “But nothing is ever cut and dried.”
Tulpamancers often (but not always) choose to create their tulpas, he says, training their brain to think with two independent streams of consciousness. Many will practise conversations in their head, focusing on creating a separate personality. (Walker unknowingly followed these steps in creating Jensen.) Eventually, it breaks off. Veissière likens the experience to learning to drive: Creating a tulpa takes practice, and eventually muscle memory takes over and does most of the work. “There’s a giant array of things the mind can do,” he says.
The notion that there is a spectrum of auditory hallucinations, from healthy to unhealthy, has become largely accepted in the medical community, but the concept has yet to make the leap into the mainstream. Some of the stigma people associate with hearing voices is cultural: North Americans, for example, are more likely to associate hearing voices with mental illness than those in other parts of the world, Kidd says, partly because of how it’s portrayed in media and film.
Stanford anthropology professor Tanya Luhrmann studied auditory hallucinations in North America and in India and Africa. She found that in the East, hearing voices is considered a largely positive, almost spiritual experience, while in the West, it is a source of distress. In the West, she notes, people value individual autonomy over collectivism, and so voices are seen as an intrusion.
Not surprisingly, people experiencing auditory hallucinations often hide it, afraid they’ll be labelled as “crazy,” says Ben Alderson-Day, a research fellow at Durham University in the U.K. and a member of the Hearing the Voice research group. As a result, the community remains understudied, and people in distress aren’t likely to seek help in time, he says.
One study in the Scandinavian Journal of Psychology found that only 16 percent of people who hear voices seek medical attention. When people stay silent, it can “lend itself to self-stigmatization,” says Kidd. “They take on these negative messages about what it might mean, as opposed to talking to a physician or friend and hashing out what it [actually] means, which can be quite therapeutic.”
Walker feels this pressure every day. “It’s a huge stressor,” she says. There’s not much she keeps from her husband, but she thinks telling him about Jensen would irreparably damage their relationship. So far, he has no idea — she sometimes zones out when she’s interacting with Jensen, but not to the point where her husband has ever noticed. And Jensen will usually stay quiet if she tells him to, so he rarely interrupts their conversations. She’s set some clear boundaries — and Jensen rarely breaks the rules.
Related: Self-care is vital to your health. Here’s how to practise it
Up until 10 years ago, says Kidd, the thinking was that any kind of auditory hallucination needed to be eradicated with medication and therapy. But that thinking has evolved: The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders places many mental illnesses associated with auditory hallucinations (including schizophrenia) on a spectrum. On one end, there is a percentage of people who are severely affected by their psychoses, in need of serious medical attention and unable to go about their daily routines. But on the other, there are people who hear voices and can still lead healthy and productive lives, he says.
Dr. Roger McIntyre, head of the mood disorders and psychopharmacology unit at the University Health Network in Toronto, says anyone who hears any kind of voice, even if it’s friendly and useful, should consider talking to a doctor, so the voices can be monitored and properly managed. But it’s when people lose control over the voices that they need to be seriously concerned.
For example, if Jensen were to break the “rules” that Walker has set out (such as not interrupting real-life conversations, or not coming into certain rooms of the house, like the bedroom), spew hateful or dangerous comments, or refuse to stay silent when told, it would be cause for concern, and a doctor should be informed, he says. “In other words, when [the voices] have a life of their own and intrude when they wish, that can be very distressing to people.”
If the voices start to interfere with a person’s ability to function, or if that person becomes lost in a fantasy world and loses touch with reality, it should be a big warning flag, he says. People should also seek help if the quantity of time spent with the voices is increasing, if the complexity of the phenomenon is increasing or if the patient starts to feel a weakening sense of control.
But Veissière says there are many circumstances in which hearing voices can be helpful. In his research, he found that the presence of a tulpa helped some patients with Asperger’s syndrome, attention deficit disorder and general anxiety. More than half of respondents on the Asperger’s or autistic spectrum, for example, said their ability to read other people improves with the help of the voice in their head.
People in the online tulpa community are also speaking out about how their voices have helped them. Joanna Bennett,* a Montreal-based engineering student who has a tulpa named Melissa, says the voice helps her cope with the anxiety she feels around decision making. She runs her ideas and plans by Melissa, and Melissa gives her two cents back. California-based Katie Chester,* who suffers from depression, says her tulpa, KT, helped talk her through a time when she was having suicidal thoughts.
When Walker told her therapist about Jensen, she was surprised by the reaction. “She didn’t think I was crazy,” she says. “She thought it was a creative and healthy way to be dealing with [my bipolar depression]. All this time, I’d been carrying this stress that if I told anyone, my doctor was going to send me straight to a hospital. I could have gotten up and hugged her.”
Walker sees Jensen as her safety net — someone she can talk to at any time, in any place. “Depression is lonely,” she says. “You feel isolated, so lost by yourself, and nobody seems to be able to bridge that gap. Having support that’s internal [makes it feel] like not only do I have someone who is there with me, but because he is a part of me, and aware of what my needs actually are, he gets it. It’s the happiest I’ve been in years.”
*Names have been changed
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FEATURES
I spent 20 years hiding my depression — now I’m ready to talk
For two decades, Stephanie Reidy was too ashamed to ask for help. It wasn’t until she came out of the mental health closet that she began to heal. Now, she is devoted to helping to break the stigma around mental illness.
by Stephanie Reidy Updated May 2, 2016 34
Illustration, Moonassi.
I once had a secret so shameful, I swore I would never talk about it. Now, I can’t stop.
I spoke about it for the first time a year ago, to a high school sociology class. Today, I’ll tell it to third-year students at Dalhousie Medical School in Halifax, where I live. Next week, it will be Saint Mary’s University, and then I’ll start another high school circuit. It’s a secret these schools agreed their students need to hear. And even though revealing it again and again, sometimes in front of hundreds of people, is daunting, I do it for the person I inevitably meet at the end of these talks — the one who, having heard my story, will tell me her own.
In my final year of university, I tried to kill myself. When I say it now, it seems like a casual, almost spontaneous event — but it wasn’t. My problems began in high school, although I didn’t see them as problems at the time. I just thought I was dull and lazy. I assumed my frequent headaches and upset stomach were normal and that everyone else was feigning interest in life too. Behind the smiling facade of a good student lurked the dim and murky face of mental illness. I was depressed.
The start of university was a relief. Life was more engaging; classes were stimulating, the people diverse. For a while, I laughed freely and the world seemed brighter, but then the darkness returned and I found myself hiding behind a mask once again. No one could see the effort that it took to maintain the charade. My bones ached from willing myself to be outgoing, expending all of my energy to participate and be socially active, only to collapse once I was home. I hated the phone: My stomach sank when I heard it ring, out of fear it might be for me.
Different types of depression have different symptoms
Seasonal affective disorder (SAD)
Usually brought on by the weather and the time of year.
Postpartum depression
Occurs following the birth of a child or a miscarriage. About 13 percent of women will experience this type of depression.
Dysthymia
Chronically low mood with moderate symptoms of depression.
Depression with psychosis
Severe condition that involves losing touch with reality and experiencing hallucinations or delusions.
By third year, the mask was starting to crack and the only coping mechanism I had was avoidance. I broke up with my boyfriend so that he would stop calling me. I distanced myself from friends and began skipping classes. The extrication was gradual but complete. Soon it had been weeks since I had been to a class, months since I’d spoken with a friend, forever since I had told my family the truth.
I still had no idea, however, that I was depressed. I just felt broken inside, numb to every feeling except fear, as one question — “What is wrong with me?” —constantly raced through my mind. Soon I was failing classes and in a panic, desperate for a way out. There was lots of help available to me: family, friends and counsellors. I didn’t go to anyone. I was ashamed.
In the twisted logic of mental illness, suicide truly seemed like the best solution to my problem. So I told my doctor a story about suffering from insomnia. At the pharmacy, I filled the prescription for sleeping pills and then, scared they wouldn’t be enough, went to a different cashier to buy an over-the-counter sleep aid. I couldn’t see that I was sick. All I knew was that I didn’t want to burden my family with my failure, and deciding to kill myself brought a huge sense of relief.
By luck or fate, my sister came home early that day and found me on my bed next to the empty bottles of pills. I regained consciousness in the emergency room, as my stomach was being pumped full of charcoal. My note had been read and my secret revealed. Dreadfully embarrassed, I once again began insisting that I was okay. I claimed it was a rash act — something that everyone was quick to believe, because they desperately wanted to. I was discharged from the hospital that night with a suggestion to see a psychologist. I lied my way through a few appointments and then returned to school. My life once again appeared normal, but below the surface, my depression simmered.
Since my suicide attempt, I have travelled, fallen in love, married and had two wonderful children — all while still suffering silently from depression. My husband was the one person outside of my family who knew about the sleeping pills, but he thought it was all in the past.
I hit rock bottom again in the years after my kids were born. And again, I got to the brink of taking my own life — but this time, terrified of leaving my children motherless, I sought help. I went to the doctor and exposed my wounded soul. She diagnosed me with major depressive disorder and prescribed the medications that have saved my life. Only then did I tell my husband. But I still wasn’t ready to tell the world.
Illustration, Moonassi.
It has taken me 20 years to get to this point. After six years of furtive treatment, I came out of the mental health closet last year for good. It was a dark winter and I could feel my mood slipping again. Suddenly, I didn’t have the energy to keep pretending. With a blog post read by thousands of people, I took off the mask. I was contacted by friends, past acquaintances and scores of complete strangers who told me that my story was also theirs and that they no longer felt alone in their illness.
I’ve seen a few therapists over the years. One asked me to write a letter of forgiveness to myself for my suicide attempt. I refused. How could I forgive myself for such a wretched act? I was still too embarrassed, ashamed and unwilling to absolve myself of blame. Once I revealed my illness to the world, however, this crushing weight of regret began to ease.
I now take three different pills for my depression, and writing has become my therapy. I feel healthy, and I am consumed with a passion to reach out to people who may have their own struggles with mental illness, especially those in high school and university, at the age when I needed help the most. I want to break down the stigma that surrounds the subject of mental health. I don’t want anyone else to be too ashamed to ask for help, to die of embarrassment as I nearly did.
8%
Percentage of Canadians who will experience major depression at sometime in their lives.
3.2 million
Total number of 12-to 19-year-olds at risk for developing depression.
2x
Greater likelihood for women than for men of being diagnosed with major depression. – Sources: Canadian Mental Health Association; Centre for Addiction and Mental Health
Through my presentations and my writing, I’m now able to reflect on my past with a much less judgmental eye. I often think back to that therapist who wanted me to write the letter of forgiveness. Why am I now able to offer myself a pardon? What has changed? Perhaps living openly with my depression has allowed me to become truly healthy. I can recognize that I’m a strong and vital person, not in spite of my depression but because of it. And now that I can see the truth, I’m eager for everyone else to see it too.
If there is one message I want to get across to people, it’s that it’s okay to need help. That’s what I was desperate to hear, but didn’t, when I was at my lowest point. The same way you would see a doctor for a persistent cough, you should see a doctor for a persistently low mood. Depression is a medical condition. It may not always require medication, but it does require professional attention.
Stigma can be the largest barrier to getting help for a possible mental illness. In fact, two-thirds of people with a mental health problem won’t seek help, mainly for fear of being labelled by their peers. Research has shown that the best way to break down this stigma in young people is through positive interaction with someone who lives with mental illness. When they hear personal stories of hope and recovery, it changes their attitudes and behaviours. I’ve seen it in action.
Without fail, at the end of each of my talks, a group of people come up to thank me for sharing my story, and one person lingers behind. There is always that one who is waiting for everyone else to leave, waiting to get me alone, waiting to talk privately. At my first high school talk, that person was a young woman in grade 12. She was depressed, lonely and scared. She had been thinking about suicide and I was the first person she felt she could tell. With her permission, I brought her teacher into our conversation. By the end of the day, she had arrangements to be seen by a mental health nurse.
It is because of this girl, and others who have since revealed their secrets to me, that I am continually re-inspired to tell my story. In a few minutes, when I stand at the front of this auditorium, I will concentrate on speaking to today’s one person. That’s why I’m here.
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http://www.chatelaine.com/health/adults-hearing-voices-imaginary-friends/
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Imaginary friends can be helpful for kids. What about adults?
Meet Jenna, who has bipolar disorder, and Jensen, the supportive voice inside her head.
by Megan Haynes Updated Sep 19, 2016 1
Illustration, Noma Bar.
Every spring and fall, Jenna Walker* battled depression — a rhythmic, debilitating expression of her type 2 bipolar disorder. She was irritable and unwilling to be around other people, making her job as an administrative assistant untenable. She’d snap if her son touched her shoulder at the wrong moment. Medication didn’t always work. There were a lot of mornings she just stayed in bed, unable to overcome the emotional and physical exhaustion of her illness. She felt trapped by the competing needs for affection and solitude, a conflict that was hard for her family to navigate.
In 2014, after five years of suffering, she sought out a friend named Jensen. She shared everything with him. They became so close, they could communicate without words. He’s pragmatic, confident and focused — complements to Walker’s sometimes scattered personality. He tells her that she’s strong, that she can fight her depression, and when he says it, she believes it. He doesn’t treat her with kid gloves; he can be blunt, even harsh, but ultimately he’s one of her greatest supports. He also doesn’t exist.
Jensen is Walker’s imaginary friend, a construct she uses to help keep her negative emotions at bay. She doesn’t see him — he’s more like a presence — but she does hear and converse with him, and she pictures him as tall, with brown hair, a goatee and sharp features. When he’s around, he sits just at her periphery, to her left, she says. She likens him to a “giant steel beam” that props up a roof, providing shelter and protection to everything underneath. “He’s unmovable, indestructible. I built him to be that way.”
Related: I spent 20 years hiding my depression — now I’m ready to talk
Having burned through all the coping mechanisms suggested by her doctors, she decided she needed a mental barrier between herself and the pain — something to protect her from depressive thoughts. “I believed if I sell myself on this so hard… it will protect me.” She gave this barrier the shape of a man, modelled after a character in a video game she had been playing, and gave him a name.
As she dealt with day-to-day situations, she imagined Jensen’s responses and reactions to her actions, supplying both sides of the conversation. After about a month, she says, he developed sentience. She describes that moment as feeling a strange pressure in her head — like a dog, shaking off water — and then having the distinct sensation that someone was looking at her. It was after that, she says, that she first heard thoughts that weren’t her own.
Auditory hallucinations are a symptom of a number of mental illnesses: bipolar disorder, borderline personality disorder, obsessive-compulsive disorder and, most notably, schizophrenia. Between 5 and 15 percent of the general population will experience them at some point; and, according to a recent study from Harvard and the University of Queensland in Australia, auditory hallucinations are more common in women, though the reasons for this are unclear.
They are stereotypically associated with the decline of someone’s mental health, but some experts are beginning to view the experience as one that sits on a spectrum, similar to how we view autism; they argue that not all voices are unhealthy or destructive, and that some — like Jensen’s — can even help people cope with stress and illness. Discussions in online groups such as the Hearing Voices Movement have been shedding light on the issue, and this fall, the topic will truly hit the mainstream with the expected debut on ABC of Imaginary Mary, a dramatic comedy starring Jenna Elfman, in which Elfman’s childhood imaginary friend (a small, furry monster voiced by Saturday Night Live alum Rachel Dratch) re-enters her life, triggered by a stressful event.
Related: Serena Ryder opens up about her battle with depression
When Jensen first took on a life of his own, there was plenty about him that Walker didn’t like: He could be critical and would make snide comments about people around her, for instance. But he encouraged her to deal with difficult situations rather than avoid them and said he would always be there for her. The two developed a camaraderie. His primary job now is to push her through the pain — to help her through one more day, and then another.
Beyond telling her therapist (who has signed off on Jensen as a healthy coping mechanism) and her best friend, Walker, 35, has kept him a secret. She’s never mentioned him to her kids or her husband. “I feel like if my husband knew about Jensen, it would really stress him out that I had somebody riding shotgun in my head, and that I put him there.”
Walker’s concern isn’t misplaced: The illnesses that are accompanied by auditory hallucinations are among the most stigmatized disorders in society, says Dr. Sean Kidd, chief of psychology at the Centre for Addiction and Mental Health in Toronto, who specializes in schizophrenia. But there is a lot of research that suggests having an imaginary friend can be extremely helpful for children dealing with loneliness, abrupt life changes and bullying, and can lead to improved social skills and increased creativity. Can the same be true for adults?
When Jensen broke out on his own, Walker panicked. She was sitting alone on a bus, staring out the window. The next moment, she had the unmistakable feeling that he was looking at her. He didn’t say anything — but she knew things had changed. “It was terrifying,” she says. “I didn’t know what to do. I thought I was losing my mind.”
Soon, the pair started to have what she describes as an unfiltered exchange of ideas. There was no barrier — he could hear all her thoughts, and she could hear his, an experience that left her feeling vulnerable and scared. After a week, she told her best friend. He was supportive and encouraged her to see if other people were talking about similar experiences online. She found a Reddit community populated with seemingly reasonable people discussing “beings” in their heads. All of a sudden, she wasn’t alone, and she had another name for what Jensen could be: a tulpa.
Tulpamancy — the act of meditating a mental being into existence — was first thought to be practised by Tibetan monks, says Samuel Veissière, an anthropology and psychiatry professor at McGill University and one of the few academics to have studied the subject, but its transition to a modern phenomenon happened largely online.
Related: Happy and bipolar — one woman’s journey to balance
Conversations around tulpas and imaginary friends first appeared on the message board 4chan in 2009, Veissière says, and then migrated to Reddit. After that, other online groups started popping up. Today, tulpas are thought of as a more defined version of the voices people might hear in their heads. They tend to have shapes and are considered to have consciousness independent of their hosts, who are called tulpamancers.
The subreddit, started in 2012, has more than 10,000 subscribers; however, only a small percentage are active in the discussions, says Veissière. He says people create tulpas for a wide variety of reasons: to help with coping day to day, like Walker, or for companionship. “There is a big concern among the community that they’ll be presented as ‘crazy,’ ” he says. “But nothing is ever cut and dried.”
Tulpamancers often (but not always) choose to create their tulpas, he says, training their brain to think with two independent streams of consciousness. Many will practise conversations in their head, focusing on creating a separate personality. (Walker unknowingly followed these steps in creating Jensen.) Eventually, it breaks off. Veissière likens the experience to learning to drive: Creating a tulpa takes practice, and eventually muscle memory takes over and does most of the work. “There’s a giant array of things the mind can do,” he says.
The notion that there is a spectrum of auditory hallucinations, from healthy to unhealthy, has become largely accepted in the medical community, but the concept has yet to make the leap into the mainstream. Some of the stigma people associate with hearing voices is cultural: North Americans, for example, are more likely to associate hearing voices with mental illness than those in other parts of the world, Kidd says, partly because of how it’s portrayed in media and film.
Stanford anthropology professor Tanya Luhrmann studied auditory hallucinations in North America and in India and Africa. She found that in the East, hearing voices is considered a largely positive, almost spiritual experience, while in the West, it is a source of distress. In the West, she notes, people value individual autonomy over collectivism, and so voices are seen as an intrusion.
Not surprisingly, people experiencing auditory hallucinations often hide it, afraid they’ll be labelled as “crazy,” says Ben Alderson-Day, a research fellow at Durham University in the U.K. and a member of the Hearing the Voice research group. As a result, the community remains understudied, and people in distress aren’t likely to seek help in time, he says.
One study in the Scandinavian Journal of Psychology found that only 16 percent of people who hear voices seek medical attention. When people stay silent, it can “lend itself to self-stigmatization,” says Kidd. “They take on these negative messages about what it might mean, as opposed to talking to a physician or friend and hashing out what it [actually] means, which can be quite therapeutic.”
Walker feels this pressure every day. “It’s a huge stressor,” she says. There’s not much she keeps from her husband, but she thinks telling him about Jensen would irreparably damage their relationship. So far, he has no idea — she sometimes zones out when she’s interacting with Jensen, but not to the point where her husband has ever noticed. And Jensen will usually stay quiet if she tells him to, so he rarely interrupts their conversations. She’s set some clear boundaries — and Jensen rarely breaks the rules.
Related: Self-care is vital to your health. Here’s how to practise it
Up until 10 years ago, says Kidd, the thinking was that any kind of auditory hallucination needed to be eradicated with medication and therapy. But that thinking has evolved: The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders places many mental illnesses associated with auditory hallucinations (including schizophrenia) on a spectrum. On one end, there is a percentage of people who are severely affected by their psychoses, in need of serious medical attention and unable to go about their daily routines. But on the other, there are people who hear voices and can still lead healthy and productive lives, he says.
Dr. Roger McIntyre, head of the mood disorders and psychopharmacology unit at the University Health Network in Toronto, says anyone who hears any kind of voice, even if it’s friendly and useful, should consider talking to a doctor, so the voices can be monitored and properly managed. But it’s when people lose control over the voices that they need to be seriously concerned.
For example, if Jensen were to break the “rules” that Walker has set out (such as not interrupting real-life conversations, or not coming into certain rooms of the house, like the bedroom), spew hateful or dangerous comments, or refuse to stay silent when told, it would be cause for concern, and a doctor should be informed, he says. “In other words, when [the voices] have a life of their own and intrude when they wish, that can be very distressing to people.”
If the voices start to interfere with a person’s ability to function, or if that person becomes lost in a fantasy world and loses touch with reality, it should be a big warning flag, he says. People should also seek help if the quantity of time spent with the voices is increasing, if the complexity of the phenomenon is increasing or if the patient starts to feel a weakening sense of control.
But Veissière says there are many circumstances in which hearing voices can be helpful. In his research, he found that the presence of a tulpa helped some patients with Asperger’s syndrome, attention deficit disorder and general anxiety. More than half of respondents on the Asperger’s or autistic spectrum, for example, said their ability to read other people improves with the help of the voice in their head.
People in the online tulpa community are also speaking out about how their voices have helped them. Joanna Bennett,* a Montreal-based engineering student who has a tulpa named Melissa, says the voice helps her cope with the anxiety she feels around decision making. She runs her ideas and plans by Melissa, and Melissa gives her two cents back. California-based Katie Chester,* who suffers from depression, says her tulpa, KT, helped talk her through a time when she was having suicidal thoughts.
When Walker told her therapist about Jensen, she was surprised by the reaction. “She didn’t think I was crazy,” she says. “She thought it was a creative and healthy way to be dealing with [my bipolar depression]. All this time, I’d been carrying this stress that if I told anyone, my doctor was going to send me straight to a hospital. I could have gotten up and hugged her.”
Walker sees Jensen as her safety net — someone she can talk to at any time, in any place. “Depression is lonely,” she says. “You feel isolated, so lost by yourself, and nobody seems to be able to bridge that gap. Having support that’s internal [makes it feel] like not only do I have someone who is there with me, but because he is a part of me, and aware of what my needs actually are, he gets it. It’s the happiest I’ve been in years.”
*Names have been changed
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FEATURES
I spent 20 years hiding my depression — now I’m ready to talk
For two decades, Stephanie Reidy was too ashamed to ask for help. It wasn’t until she came out of the mental health closet that she began to heal. Now, she is devoted to helping to break the stigma around mental illness.
by Stephanie Reidy Updated May 2, 2016 34
Illustration, Moonassi.
I once had a secret so shameful, I swore I would never talk about it. Now, I can’t stop.
I spoke about it for the first time a year ago, to a high school sociology class. Today, I’ll tell it to third-year students at Dalhousie Medical School in Halifax, where I live. Next week, it will be Saint Mary’s University, and then I’ll start another high school circuit. It’s a secret these schools agreed their students need to hear. And even though revealing it again and again, sometimes in front of hundreds of people, is daunting, I do it for the person I inevitably meet at the end of these talks — the one who, having heard my story, will tell me her own.
In my final year of university, I tried to kill myself. When I say it now, it seems like a casual, almost spontaneous event — but it wasn’t. My problems began in high school, although I didn’t see them as problems at the time. I just thought I was dull and lazy. I assumed my frequent headaches and upset stomach were normal and that everyone else was feigning interest in life too. Behind the smiling facade of a good student lurked the dim and murky face of mental illness. I was depressed.
The start of university was a relief. Life was more engaging; classes were stimulating, the people diverse. For a while, I laughed freely and the world seemed brighter, but then the darkness returned and I found myself hiding behind a mask once again. No one could see the effort that it took to maintain the charade. My bones ached from willing myself to be outgoing, expending all of my energy to participate and be socially active, only to collapse once I was home. I hated the phone: My stomach sank when I heard it ring, out of fear it might be for me.
Different types of depression have different symptoms
Seasonal affective disorder (SAD)
Usually brought on by the weather and the time of year.
Postpartum depression
Occurs following the birth of a child or a miscarriage. About 13 percent of women will experience this type of depression.
Dysthymia
Chronically low mood with moderate symptoms of depression.
Depression with psychosis
Severe condition that involves losing touch with reality and experiencing hallucinations or delusions.
By third year, the mask was starting to crack and the only coping mechanism I had was avoidance. I broke up with my boyfriend so that he would stop calling me. I distanced myself from friends and began skipping classes. The extrication was gradual but complete. Soon it had been weeks since I had been to a class, months since I’d spoken with a friend, forever since I had told my family the truth.
I still had no idea, however, that I was depressed. I just felt broken inside, numb to every feeling except fear, as one question — “What is wrong with me?” —constantly raced through my mind. Soon I was failing classes and in a panic, desperate for a way out. There was lots of help available to me: family, friends and counsellors. I didn’t go to anyone. I was ashamed.
In the twisted logic of mental illness, suicide truly seemed like the best solution to my problem. So I told my doctor a story about suffering from insomnia. At the pharmacy, I filled the prescription for sleeping pills and then, scared they wouldn’t be enough, went to a different cashier to buy an over-the-counter sleep aid. I couldn’t see that I was sick. All I knew was that I didn’t want to burden my family with my failure, and deciding to kill myself brought a huge sense of relief.
By luck or fate, my sister came home early that day and found me on my bed next to the empty bottles of pills. I regained consciousness in the emergency room, as my stomach was being pumped full of charcoal. My note had been read and my secret revealed. Dreadfully embarrassed, I once again began insisting that I was okay. I claimed it was a rash act — something that everyone was quick to believe, because they desperately wanted to. I was discharged from the hospital that night with a suggestion to see a psychologist. I lied my way through a few appointments and then returned to school. My life once again appeared normal, but below the surface, my depression simmered.
Since my suicide attempt, I have travelled, fallen in love, married and had two wonderful children — all while still suffering silently from depression. My husband was the one person outside of my family who knew about the sleeping pills, but he thought it was all in the past.
I hit rock bottom again in the years after my kids were born. And again, I got to the brink of taking my own life — but this time, terrified of leaving my children motherless, I sought help. I went to the doctor and exposed my wounded soul. She diagnosed me with major depressive disorder and prescribed the medications that have saved my life. Only then did I tell my husband. But I still wasn’t ready to tell the world.
Illustration, Moonassi.
It has taken me 20 years to get to this point. After six years of furtive treatment, I came out of the mental health closet last year for good. It was a dark winter and I could feel my mood slipping again. Suddenly, I didn’t have the energy to keep pretending. With a blog post read by thousands of people, I took off the mask. I was contacted by friends, past acquaintances and scores of complete strangers who told me that my story was also theirs and that they no longer felt alone in their illness.
I’ve seen a few therapists over the years. One asked me to write a letter of forgiveness to myself for my suicide attempt. I refused. How could I forgive myself for such a wretched act? I was still too embarrassed, ashamed and unwilling to absolve myself of blame. Once I revealed my illness to the world, however, this crushing weight of regret began to ease.
I now take three different pills for my depression, and writing has become my therapy. I feel healthy, and I am consumed with a passion to reach out to people who may have their own struggles with mental illness, especially those in high school and university, at the age when I needed help the most. I want to break down the stigma that surrounds the subject of mental health. I don’t want anyone else to be too ashamed to ask for help, to die of embarrassment as I nearly did.
8%
Percentage of Canadians who will experience major depression at sometime in their lives.
3.2 million
Total number of 12-to 19-year-olds at risk for developing depression.
2x
Greater likelihood for women than for men of being diagnosed with major depression. – Sources: Canadian Mental Health Association; Centre for Addiction and Mental Health
Through my presentations and my writing, I’m now able to reflect on my past with a much less judgmental eye. I often think back to that therapist who wanted me to write the letter of forgiveness. Why am I now able to offer myself a pardon? What has changed? Perhaps living openly with my depression has allowed me to become truly healthy. I can recognize that I’m a strong and vital person, not in spite of my depression but because of it. And now that I can see the truth, I’m eager for everyone else to see it too.
If there is one message I want to get across to people, it’s that it’s okay to need help. That’s what I was desperate to hear, but didn’t, when I was at my lowest point. The same way you would see a doctor for a persistent cough, you should see a doctor for a persistently low mood. Depression is a medical condition. It may not always require medication, but it does require professional attention.
Stigma can be the largest barrier to getting help for a possible mental illness. In fact, two-thirds of people with a mental health problem won’t seek help, mainly for fear of being labelled by their peers. Research has shown that the best way to break down this stigma in young people is through positive interaction with someone who lives with mental illness. When they hear personal stories of hope and recovery, it changes their attitudes and behaviours. I’ve seen it in action.
Without fail, at the end of each of my talks, a group of people come up to thank me for sharing my story, and one person lingers behind. There is always that one who is waiting for everyone else to leave, waiting to get me alone, waiting to talk privately. At my first high school talk, that person was a young woman in grade 12. She was depressed, lonely and scared. She had been thinking about suicide and I was the first person she felt she could tell. With her permission, I brought her teacher into our conversation. By the end of the day, she had arrangements to be seen by a mental health nurse.
It is because of this girl, and others who have since revealed their secrets to me, that I am continually re-inspired to tell my story. In a few minutes, when I stand at the front of this auditorium, I will concentrate on speaking to today’s one person. That’s why I’m here.
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