A Move To New York Made This Brit Realise We Don't Take Mental Health Seriously

Having spent months deliberating whether to go to the doctor, I finally booked an appointment. But after all the effort spent psyching myself up, by the time I was in the doctor’s chair of my south London surgery it was all a bit of an anticlimax. “I’ve been feeling low. I’d like to talk to somebody about it,” I told the doctor. My chest felt constricted and the words, spoken out loud for the first time, underpowered and a bit ridiculous. After she presumably assessed that I wasn’t in any imminent danger and offered me drugs, which I declined, within minutes I was back out the door. I remember walking home through Brixton feeling alone and exposed, having shared one of the most personal revelations of my life.

The doctor gave me a pamphlet with a phone number on that I could call to see if I would qualify to speak to a therapist. But the idea of having to make the same revelation again to a faceless stranger in a call centre and have to “prove” my need to talk was too daunting, and the doctor’s response made me feel like it wasn’t that important to seek help after all. Really, it was a convenient excuse to avoid facing up to my feelings. So, like a “true Brit”, I carried on ignoring them.

I’ve always been aware of the concept of the British “stiff upper lip” but I didn’t think it was anything more than an outdated stereotype until I moved to America. This strange concept of British reserve – to which Prince William has been bravely drawing attention lately, as part of the royals’ Heads Together mental health campaign – is apparently what prevents us and generations before us from talking about our feelings.

It’s the mentality that stops us from crying in public when we are sad, spending hours in the pub chatting without talking about our actual feelings and avoiding sharing our fears and failures. Instead, many of us seal it up and lock it away until it springs out on us without warning to cause potentially fatal destruction.

I was brought up in an English-Swedish household by parents who had conversations with me about my feelings. Old-fashioned uptight Britishness had absolutely nothing to do with me – or so I thought. But as I got older and things started to occasionally go wrong, as they invariably do in life, I began to struggle.

When I encountered difficulties I found that I just couldn’t talk about them. It wasn’t that there was nobody to listen, there was, but I did not want to admit what I perceived to be failure – to do so made me feel dirty and guilty. Or as I have since realised: vulnerable. British sarcasm doesn’t reward people for being honest about their feelings, it is more likely to embarrass them, so I put my childhood tendency to wear my heart on my sleeve away.

I saw therapy as something one would only turn to if absolutely necessary – by which I mean if lives were at stake. But I even struggled to share my inner thoughts and anxieties with close friends. If I did, the revelation would be preceded by a “please don’t tell anyone” or followed up with an apologetic text.

Then, just over a year ago, my fiancé and I moved to New York. I was initially sceptical of American sharing culture. The abundance of sentences beginning with “I feel like…”, confessional TV talk shows and the seemingly constant pursuit of self-improvement were unbearably alien to me. But without the network of friends I had in London, family far away and the shock of a new environment, my coping methods – or lack of – became untenable. My anxiety levels were higher than ever and again I started to feel depressed.

I finally sought the help of a therapist – which, if you have good insurance, is surprisingly cheap in the US, considering how otherwise flawed its health service is – and started to understand the importance and value of being open. I learned that, generally, only good comes out of saying how you feel and that deeper relationships develop from those conversations. It also made me happier. I started to see just how ingrained the stiff upper lip is, not just in British culture but inside of me. The natural inclination to say everything is fine, to not want to cause worry and – even more so in the post-social media world – to put up a joyful front at all times.

Americans’ openness with their feelings is not only apparent in their behaviour but also in their culture. Just look at the hit podcast S-Town, which, among other things, is essentially about one man’s battle with mental health issues. Or A Little Life, the incredible 2015 novel by American writer Hanya Yanagihara, which follows the life of a person with depression. More recently, New Yorker writer Ariel Levy’s memoir The Rules Do Not Apply amazed and astounded readers both sides of the Atlantic with her ability to write so openly about her innermost feelings and miscarriage.

The royal family’s campaign to open up the conversation around mental health issues and the comments of artists such as grime star Stormzy, who has spoken publicly about depression, are significant advances towards improving people’s attitudes towards the subject in Britain. The Conservatives’ pledge of 10,000 extra mental health staff for the NHS by 2020, and the provision of mental health first aid in schools and large organisations, is also a step in the right direction. However, for mental health issues to lose their stigma, Britain needs to stop seeing feelings as a weakness and therapy services need to be free, easily accessible, and without long waiting times.

At a recent talk in Manhattan I asked Levy whether she felt vulnerable after bearing her soul in the way she did in her latest book. Her response? “Privacy is overrated.” This is a mantra I am trying to learn from America. Instead of attempting to fool people that everything is rosy when it’s not, I now try to tell the truth about my feelings – and resist the urge to text people afterwards to apologise.