When a manic episode is brewing, before any thoughts get really strange, my body tells me what’s just around the corner.
Colours become hypersaturated and video-game like, often pulsating with intensity. Sounds are amplified, as if you’ve developed superhuman abilities. I’ll feel a growing pressure in my head and my vision becomes very sharp; I can see a lizard in a bush 15 metres away, no worries.
Electricity, like when you’ve accidentally touched a horse fence, shoots up and down my limbs. Quickly, my pulse rate rises (this has been measured at a hospital during a manic episode), my pupils dilate and saliva fills my mouth.
Then the ants come under my skin, marching up my legs and thighs, making me skip, then jog, then dance, then run. I don’t use “ants” as a metaphor here. I mean real, live ants. Real to me, anyway.
“Mental illness” suggests the sickness resides within your head and is neatly contained there. In my experience, that’s only partially true. While the origin of any mental disorder lies within the brain, misfiring as psychiatrists say, what is less widely known is how much mental illness manifests and is experienced as real by your body.
Yes, your brain is firing off without external stimuli (such as touch or sound), but that doesn’t mean the sensations, feelings and voices created aren’t real to you. The misfiring creates exactly the same experience of “reality” as when your brain is firing appropriately – only you can’t tell the difference between the two any more. Hence, psychosis.
This is one reason psychiatric wards can be such draining and chaotic places; they are incredibly active. Unlike the rest of the hospital, where most patients lie in beds, people with serious mental illness are often terribly busy.
The manic patients will group together around the nurses station, talking nonstop, demanding endless privileges, fighting and competing with one another, and generally causing mayhem (hello, friends).
The schizophrenics will be in their own world, but it’s often an active one, dragging suitcases down the hall, climbing (literally) the walls or performing complicated rhythms and rituals in line with their delusions. Even the depressives join in, often crying or rocking in the TV room or by the locked, steel front door.
Almost none of this is confined to bedrooms, but exists animatedly in hallways, kitchens and lounges (or your own home).
In my experience, even if everybody is deeply unwell, there can be some underlying need to connect, to be unwell together. This tells us something about the essential and enduring humanity at play even in the most severely “out of touch” people.
I think the physicality of mental illness is one of the reasons the general public can be so fearful. It’s not tidy, it’s not quiet. It’s deeply, physically, unpredictable. I understand that can be confronting, particularly if you’re walking down the street and you don’t know the sick person. Or even if that person is in your own home.
But there’s a flipside to this too. If mental illness lives so deeply in the body, and is acted out there, it can also be soothed in the body.
Psychiatrist Bessel van der Kolk writes in The Body Keeps the Score that treating the brain with medication and talking therapies isn’t enough – and alternative methods such as yoga and touch need greater recognition, especially in regards to patients presenting with PTSD and complex trauma, his speciality.
Generally now, if you’re sick enough, you’re offered medication or talking therapies. A good GP or psychiatrist will also encourage you to exercise or spend more time on your hobbies. This is important, but what’s often overlooked in this medication or talking dichotomy is the neglect of your body, and its own need to be cared for and soothed, as that’s where so many of the symptoms and tensions of mental illness reside.
A few years after my own diagnosis, I was finally living alone again and working a poorly paid job way below my abilities. My parents transferred money every week so I could see a psychologist, but we didn’t gel and the sessions weren’t useful to me.
So instead I used that money to have a facial or a massage every week – sometimes both. The therapist’s touch, the scented oils and the heated towels were so deeply therapeutic that for days afterwards my symptoms would retreat into the background. This woman, with no formal psychological or psychiatric training, could make the ants stop marching for a little while.
On one locked ward, there was a bathtub. It was known by the patients that if you were very, very good, you would be allowed the privilege of a bubble bath.
Like many patients, I became fixated on this tub – with spa jets! – and the craving of having hot water on my skin. We talked about it, we wondered what soaps and gels they’d have, and how the nurses would stop us killing ourselves if the water was deep enough.
I rang my brother on the public phone and demanded he buy me some rubber duckies to play with in the bath, which I was sure I’d eventually get into. I also very badly needed a cashmere towel and the most expensive, luxurious shampoo he could find.
I was never well enough to be allowed in the bath. Manic psychosis is fairly unpredictable.
But I am now.
A foot rub, dim lighting, a scented candle and a hot bath have all become weapons in my arsenal when an episode is knocking at the door (should I say smashing?).
Anything that takes you out of your mind and into the realm of soothing that poor battered body of yours, can help. Because your brain lies snug within your body – they’re not separate in any way.
It’s also something carers can offer loved ones, when so often they feel helpless in the face of mental distress, which, in so many ways, they can never touch.
Now, when the ants start crawling, I take my antipsychotics, yes, but I also get a foot rub from my husband, or my brother, or whichever kind person is around.
This isn’t an indulgence; it’s powerfully necessary.
I’ve never found touch able to stop an episode or reduce its severity once it’s peaking, but it can help you endure the awful bodily sensations that accompany your mind falling apart.
It’s a complement, not a cure.
When your brain starts misfiring, it takes a huge toll on your body. Muscles tighten, anxiety twists your insides, exhaustion sets in and you can vomit and have diarrhoea, among myriad other physical symptoms.
So much of being mentally ill is a lonely business. Even within diagnoses, presentations and symptoms vary so wildly. Every person is sick in their own way.
So, if your loved one is unwell, and it’s OK with them – touch them.
You don’t have to speak, you don’t have to have all the answers – just hold their hand through the storm.
• Eleanor de Jong is the former New Zealand correspondent for the Guardian. She now lives and works in the Kimberley town of Derby, Western Australia
• In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978. In the UK, the charity Mind is available on 0300 123 3393 and Childline on 0800 1111. In the US, Mental Health America is available on 800-273-8255
