Does a breakdown require a doctor’s signature?

I was talking to someone recently who’d been sectioned and we were discussing mental health and well-being, and I brought up my breakdown. I briefly covered my experience and got told that I hadn’t had a breakdown, I would know it if I had, and that a real breakdown requires a doctor’s signature.

An uncle of mine echoes a similar thought because I’ve refused medication.

A close friend of mine disagrees I had a breakdown because I went to a counsellor once, right at the beginning, found it an awful experience, have refused every suggestion since, and have unwavering faith in my own ability to mend me.

From others, I’ve had humouring nods and smiles, the kind that usually come with a pat on the shoulder and the words, ‘You think that, babe’.

I’ve even been asked to supply evidence to support my claim that I had a breakdown and have been working hard to rebalance my brain.

There appears to be a consensus that without a prescribed cocktail and/or straitjacket the worst I had was a run of bad head days.

— — —

I disagree that a breakdown requires a doctor’s signature. 

To rebalance the mind, I don’t think medication and counselling is a fit all method.

If someone needs evidence, I think they should go and find it themselves. I don’t recognise the requirement, I’m sorry. I’m just holding conversation, not standing up in court.

I believe that if someone knows themselves, if they can recognise that something is off inside and explore it, and if they seek feedback and use it, they are better placed than a doctor to diagnose a breakdown. Really basically, the doctor is only recognising the signs, which are there to be seen no matter how anyone comes about it. Those endless dark days, my total unworth, the anger of my shadow in the mirror — those were some of my symptoms. All I did was cut out the middleman.

I believe in myself. I know I can get through tough times because I’ve done it. I know my method. I write. I focus and write. I explore and prod and write. I expand and counter my arguments and write. I would struggle to cope without writing. This blank screen I’ve filled with words is my counsellor. My breakdown gave me writer’s block and you’re reading the product of my medication.

(To the person who wanted evidence — this post count?)

— — —

I understand why some don’t consider my breakdown valid. It’s not that I didn’t feel glum, I just didn’t feel glum enough by their definition. 

If compared to the person who was sectioned, I really did have a run of bad head days.

Without a doctor’s diagnosis then of course my breakdown isn’t official-official, in writing, because nobody medically trained has confirmed it. There is a record of stress on my medical notes, but like I’ve been told, getting signed off work is child’s play. 

My reluctance to be medicated and/or seek counselling could be seen as a refusal to mend, especially if the observer is blinkered against the subtleties of progress. If they expect someone to be a certain way because they’ve seen it on a postcard, they’re likely to see that person that way because they’ve still got the postcard, it’s on their fridge, it’s there to make comparisons.

I just don’t understand why some don’t consider my breakdown valid (I know I’ve just said I do). It’s these conversations I’m having, I just don’t get them. I don’t see why the truth I know and feel to be true needs correcting. I’m not correcting theirs. I’m listening to someone’s experience.

Another thing I don’t understand is anyone’s need to be supplied with evidence. To be honest, I didn’t even consider it a possibility. Had I, I would’ve put together a folder as I went along.

— — —

Who I am and what I experience isn’t you in your life, and vice-versa. When it comes to what happens to us, we’re free to react and feel as we do. I don’t think it’s a competition. I’m not raising your anti-depressants with my sedatives. If you break a toe, I don’t have broken foot. 

I admit, when comparing breakdowns, mine doesn’t stay in the lead for long. 

There is that saying, someone always has it worse. 

But that doesn’t mean I didn’t struggle. 

It doesn’t take away how difficult it has been to get up some mornings and face another day knowing the repulsion I can find in a mirror. 

My drive to rebalance, to understand what went wrong and why and how — all these thousands of broken thoughts I’ve written — hasn’t been a series of nights in on the sofa. I don’t own a sofa. I have swivel reclining armchairs. Putting my pedantic attempts at humour aside, it’s been hours and hours of struggling to write.

It’s been anger and migraines. It’s been feeling so damn sick I could hardly move, and I’ve been so damn angry I’ve physically blown my inner ear out of whack and given myself vertigo.

The balance I’ve gained — my “improvements” as evidence-needer calls it — isn’t my two feet on a solid ground. It’s my acknowledgment that life is a tightrope that I need both my effort and faith to walk.

“Oh, but this sounds like depression, it’s not a breakdown.”

(I’ve only just thought, I should counter with the NHS website.)

But of all the things that tell me I had a breakdown, the months I’ve struggled to write scream.

(This is where people roll their eyes usually.)

I write like I breathe, it’s a need.

The difficulty I still find with writing shows me that what I faced was big, and it’s posts like this that show me that I’m regaining my balance. I didn’t need a counsellor or a doctor’s signature. My specific brand of breakdown has needed sentences I can write to heal.

— — —

So in answer to my own question, a breakdown doesn’t require a doctor’s signature. A person is able to have one without a GP.

Tomos James

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