What My Psychiatrist Doesn't Realize About My Smile

Dear Dr. X,

After a lot of internal debate and chain-smoking in the car park, I’m here. Walking into your office — and I’m not sure if this is a mistake — I already feel so uneasy. Yesterday, I had a list of things I wanted to tell you, but now? Nothing; my mind is blank, overcome by fear.

I sit down and you ask me how I am. I try my hardest to explain but it’s all coming out in chunks. You think you know and understand, but you don’t. What I say and what I feel are two completely different things. I’m trying to explain but you only hear the parts you want to. Then you ask the most dreaded question: “But you’re still working?” Yes. Yes, I am, but that doesn’t mean I’m not in inner turmoil; that doesn’t mean everything is just dandy because I put on a happy face at work. Yes, I work, but on my days off I spend all day in bed, unable to face the world and every single day, working or not, I ask myself the same question: “is life really worth living?” More often than not, the answer is no. Then, I have a decision to make. Countless times I have ended up in hospital through self-harm or suicide attempts.

You look at my notes and ask, “what do you think will help?”

I don’t know, isn’t that your job to decide? I’ve tried everything I can think of and I’m still stuck in this vicious cycle. I tell you I haven’t eaten in days, that I purge almost every meal. I tell you how much weight I’ve lost in such a short amount of time. You can see it, but what was your reply? “We can’t help you unless your weight is critically low.” What message is that meant to send? Lose more weight, starve for longer, purging isn’t that big of an issue, eat fewer calories.

Falling in love is your solution. Most days, I can’t bear to look at myself in the mirror; how am I meant to let someone else love me when I can’t love myself? How can I find a boyfriend after the trauma I’ve been through? You make it sound so easy but the way I see it, I’m not even worthy of love.

I tell you I want support, but you go and cut my support because even with it, I’m still ending up in hospital. I have mental illnesses. You wouldn’t tell someone with a physical illness that their treatment was being stopped because they ended up in hospital, so why are you, a professional in mental health, saying that to me?

I tell you the voices are controlling my life and I get no peace from them; they tell me to hurt myself, demand it even, and it doesn’t seem to ease until I do. You tell me to challenge them. Like it’s that easy. They are literally screaming at me, threatening my family and friends if I don’t do something destructive. They feel so real; obviously, I’m going to be scared of them. You can’t understand because you’ve never experienced it and I’m glad, I wouldn’t wish this on my worst enemy.

After 20 minutes and a quick scan of my notes, you think you know all about me, but that’s just the tip of the iceberg. See, I’ve learned not to tell professionals about my problems because where has that got me before? Sectioned.

I walk out of your office, smiling, get to the car park and break down. I self-harm. I feel so much worse than when I went in. We got nowhere and stupidly, I agree to see you again. You think everything is fine because I smiled when I walked out; I’ve learned to put on a brave face. You agreed my case is complex but you’re so quick to assume I’m alright because I can smile. If only I had learned sooner that smiling can solve everything.

Follow this journey on the author’s blog.

What would you tell Angela about her experience? Give her some encouragement in the comments below.