Lovely friends,

Today, 18th January 2019, marks twenty years since I was first diagnosed with a mental illness.

My oldest friends have laughed with me and commented that in hindsight it was obvious - these days my mental illness would be identified much earlier, probably primary school. But my oldest friends might also pause to think, hang on - twenty years? Has it been that long?

The biggest changes over the past twenty years haven't been in me, or my treatment, or my mental health. The biggest changes have been in our society's attitudes towards mental illness.

You see, it isn't just about the diagnosis. It's about the shame, the stigma, the fear. The bloody stupid, damaging, dangerous secrecy.

The first time I was seriously depressed was in 1996. I was self-harming, as teenagers often do when their feelings overwhelm them. I told my friends, who told the counsellor. The counsellor told me that I was overreacting, and suggested my parents should ground me. And that was as far as it went. It could so easily have turned out badly. It was months before I could see any point in living at all, but I had some wonderful friends who stuck by me despite every attempt on my part to alienate them.

In 1999, I saw another counsellor, who sent me to a doctor, who told me that I was suffering from an episode of depression, probably compounded by anxiety. She prescribed me my first SSRIs (antidepressants) and I had the first good night's sleep I ever remembered. 

That GP wanted me to see a proper psychologist, and get proper help, though, and here's where I see the biggest changes in our society: I didn't. I didn't tell anybody, not my friends or my family. I didn't book in to see a psychologist. I didn't even go back to that same GP again. I did not tell one single solitary person about that diagnosis. I suffered in silence for two more years.

When I finally decided it was time to get proper help, I was at uni. This was early 2001. By this stage I had a series of increasingly severe phobias, including the one everyone noticed - that phobia about planes crashing into me - as well as the secret phobia, where I panicked about going up and down stairs. I rang up the uni medical centre and they arranged an appointment.

On the first floor.

There was no lift.

It was just like at the university library: there probably was a lift, but it wasn't accessible to the general public. I was too embarrassed to tell the staff that I couldn't use the stairs. Clearly I could: I wasn't in a wheelchair! In those days I didn't even have the words to be able to say, "I have a mental illness and I struggle to use the stairs. Do you think I could use the lift?"

I left without seeing the psychologist, and instead spent a whole fortnight's pay (I was a part-time working uni student remember!) to see a private psychiatrist in the city, in a proper tall building where everyone used the lift.

It was then that I finally told my parents and my closest friends about my diagnosis. Nobody really knew much about Obsessive Compulsive Disorder, except that it was supposed to be all about washing one's hands, which I didn't do any more than a regular person, but it was okay. I wasn't shunned. The few people who knew tried really hard to show that they were supportive, and did their best to help.

The first time I told my work colleagues I was a dental assistant. I was surrounded by people whose job involved washing their hands dozens, if not hundreds, of times per day, and regularly administered drugs to patients that altered their moods and consciousness. Most of my colleagues didn't mind at all, and a few went out of their way to read up about OCD.

Over the years I became gradually more and more open about it. My extended family found out; as far as they were concerned my OCD was no weirder than my habit of hiding under the dining table with a book while everyone else was outside playing cricket. I started new jobs and made a point of being open with my colleagues: when it came up I would mention that I had a mental illness. By now mental illness was being talked about. 1 in 4 people might have a mental illness. People were taking all kinds of SSRIs, not just the old Prozac. Jack Nicholson was on our screens counting the cracks and checking the light switches and being the hero of the romcom. Occasionally somebody would say something rude about my 'craziness' but I was always much ruder back.

The first time I announced it - "I have a mental illness" - to a general audience was at a Mental Health First Aid course at work. There were a few surprised faces among my colleagues on the course, but none were as surprised as I was when the trainer showed us that OCD can be as debilitating, as disabling, as paraplegia.

That course marked the start of a huge cultural shift in my workplace. Not long after the course I had a phone call from a middle-aged tradie in a remote country town asking me what he should do - his staff member was feeling suicidal. He'd asked the questions just like we learned, and now he needed some help. But - stressed the gruff voice on the phone - he wanted to deal with it in a sensitive way. He didn't want the suicidal colleague feeling judged.

After that phone call, I sat down at my desk and cried. It was one thing for my close colleagues - the HR team and the health professionals - to be understanding (my boss saw me crying and apart from checking I was okay, he didn't even bat an eyelid). It was another thing entirely for a very blokey bloke in a blokey workplace culture to be talking about the best ways to support a colleague through a mental illness, asking for assistance in ensuring that his colleague didn't feel less valued or respected while also getting the help he needed.

For me, that was the day I realised we'd made it. Sure, there are still a small number of people out there thinking that mental illness is a sign of weakness, or craziness, or that it's all made up. But that isn't the general consensus in our society any more.

We still have a long way to go: mental health services are grossly underfunded, crisis support is limited or nonexistent in some parts of the country, and there are still twice as many suicides as there are road accident deaths in Australia.

I personally still have a long way to go. I spent the whole of 2018 unmedicated, and there are lots of people who will want to congratulate me for that. Please don't. It isn't permanent: my mental illness changes over time, getting better and worse in waves. I have no doubt that one day in the future I'll be back on medication, and there's no shame in that. Hopefully I'll catch it quickly enough that I will not develop any really difficult obsessions or compulsions ("OCD is like a box of chocolates you stole from an evil wizard. You never know what you're gonna get.")

I could try and tell you what I've learned from having a mental illness, or where it has taken me, but we don't have another twenty years to cover it all.

After my time as a crisis counsellor I try to avoid giving advice. It's self-indulgent and it doesn't work. What I will do, though, is ask you take a moment to look at your own life. When did you last read or hear a news story about mental health or suicide prevention? When did you last see a friend posting about mental illness, or RUOK? When did you last have a conversation with someone about how they were feeling, and how their mental health is? When did you last say you needed to stay home and have a mental health day (and secretly, you really meant it!)?

The biggest change in the past twenty years is not in me, or my treatment, or my mental health. The biggest change in the past twenty years is - you.