It’s very hard to know whether you’re wrong or right about things, even when you have all the information that you think you need. In fact, while I would always advocate acquiring facts and proof, I think that it’s virtually impossible to do this in a non-biased way – we can’t help but be pulled towards those facts that support our own inclination. This doesn’t make it wrong, as there may be good underlying support for how we feel, but it may make it a little less convincingly evidence based.

I think I believe that I have a mental illness, but sometimes I don’t. I suspect that rather confused sentence sums up the situation for many of us – we are told by doctors that we are ill, but family or friends may query this. Other doctors and health professionals may also query it. We may suspect that even more people query it, because we’ve heard them do so about other people we thought were ill. How on earth are we supposed to believe anything, let alone make sensible decisions when it comes to treatment? This is particularly important in mental illness, where a different opinion than your doctor might lead to coercion, a very difficult situation.

I don’t think many doctors like treating patients against their will or beliefs. I accept that some will disagree with this, and that this is only my belief. But I think they do it because they believe that the patient is very ill, and this is usually backed up by what the patient says and the way they act. The problem is that the patient’s beliefs are different, and, even when allegedly well, they may not always agree with what happened. Psychiatric treatments do, in my view, definitely relieve acute distress and illness; in the longer term, the ratio of benefit to harm can be less clear.

The point is more that neither patient nor doctor can ever be entirely sure that they are right, something which is even harder when you are both. For me, this has been exacerbated in the last few years by joining the ranks of social media, where debates about mental illness and its treatments wax and wane. Oddly, it has also been liberating, and has enabled me to share many of my internal conflicts and thoughts, sometimes with those who have similar beliefs, and sometimes not. Both matter. Validation can be important – for me, the realisation that there are others out there asking the same questions as me has been a great boon. But having my beliefs questioned, or even decried, is also very necessary. Indeed, it is what we should expect if we share opinions. Why should people agree with us?

Do we need to believe? Why can’t we just live with possibilities and changing thoughts? I think uncertainty is very hard for many of us, and, when something new happens, like mental illness, we want an explanation. It’s a human need. My doctors said to me from the beginning – this is an illness – but I have never fully been able to believe them, and I think it’s important that they understand this rather than merely dismiss it as wrong. My parents, who are highly educated (but not health professionals) did not believe in my mental illness. They thought something was wrong, but have never really accepted it, and, for me, this undoubtedly influences my thinking. I didn’t – and don’t – feel allowed to be ill. And when I try to believe it, it feels like rebellion, that I am following an alternative belief set, almost a religion. My desire to become a psychiatrist myself may have been strengthened by the hope that it would offer me further structure and understanding, which it has done, at least when I treat others.

The problem with belief is that it doesn’t require proof. As soon as I say I believe something, I have lost that necessity for evidence – yet we have to believe things. Humanity has depended on its beliefs over millennia, even the belief in our own existence. So I think it boils down to believing what makes sense to us, and what helps – which may well include evidence – but perhaps also accepting that we may be completely wrong. I’ve waited many years for proof of my illness, and I think I have to acknowledge that there isn’t going to be much more. I can keep asking professionals, and others, but what can they really tell me that I don’t know myself? I could become even more ill than I’ve been, but I’d really rather not. Or I could never be ill again. And, even then, what would that really prove?

I’ve asked these questions in my writing, and on social media, but they are inevitably presented in the way that I want the reader to understand them – that’s normal, and I don’t see how I could do otherwise. This has helped me to establish a framework for belief that involves acceptance that I have bipolar disorder, and that I should take medication, which I do. But it wouldn’t take much to make that edifice crumble – it does not have the solid foundations that I always hoped for. And perhaps realising this has been more important than sharing my views, or trying to impose them on others (which I hope I don’t do too much). 

Historically, we often look back with incredulity at what our ancestors believed, so it’s not a big jump to assume that our descendants may also raise their eyebrows at what we do. It’s like surfing the peak of a wave (something I’ve never done) – there’s always that hope, or even belief, that we are about to arrive, and will understand everything. But perhaps it’s important to remember that every surfer falls off eventually, and won’t be remembered for long. There will always be something new or different for us to want to believe.

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