Turning a lens on the challenges of mental health

“Everybody is an artist – self-expression is therapy in itself,” says Aoife Casey, an artist and mental health advocate from Ireland, currently residing in Spain. In the interview with Jennifer Oroilidis, MHE Junior Communications Officer, Aoife shares her personal mental health journey and how she uses art as a recovery tool.

MHE: Please tell me about yourself. Where are you from? What do you do for a living?   

Aoife Casey: My name is Aoife Casey, I was originally born in Dublin, and I am currently living in Seville, the south of Spain. When I was younger, I went to school in Thailand for five years. I have travelled and lived abroad for the past twelve years. I am a full-time TOEFL teacher. I teach English as a foreign language to all levels and all ages, from the age of five to adults. I am also a photographer, and up until the COVID-19 pandemic I was  registered with Airbnb Experience, meeting tourists in different destinations and taking pictures of them. It is a lovely way of meeting people from around the world and capturing their time here.

I can imagine. That sounds great. If you feel comfortable sharing: what are your personal experiences of mental ill-health? 

In secondary school, I really started to feel unhappy and was diagnosed with depression. And I have been on medication from about 15 or 16 years old. Then about 12 years ago, I was diagnosed with Non Idiopathic Neutropenia, a blood disorder that affects white blood cells. It basically meant I had no immune system. I had to inject if I was coming down with something. That was when the anxiety started happening as well. I had no way of knowing when I was going to get sick. And also, if I would get sick, it would usually be really sick. So, I always had a fear of “what is going to happen next?” and “the next one is going to be the big one.” My neutropenia has subsided in the past couple of years. But the anxiety that started with the neutropenia has already taken hold. That is one of the main things I am trying to manage at the moment.   

During your teenage years, how was the mental health support there? How did you reach out for support, and was it provided?

I do not know if you know much about Irish history, but support in Ireland for individuals with Mental Health Issues was very poor in the 80’s and 90’s. Many things in Irish history are very dark, and there are many things socially that just were not talked about: suicide, corporal punishment, rape, abortion, women’s rights to their bodies. It was all very stoic, a “just get on with it” kind of attitude. There was absolutely no support. I went to a religious school in Ireland, and the teachers knew that I was going through something terrible, but nothing was done, and nobody came and acknowledged it. I eventually went to my mother. She started the process of getting me to see a psychologist and a doctor and getting a diagnosis. Now it would be completely different. Ireland has come on in leaps and bounds in terms of mental health. There is just no way that would happen today. But at the time, mental health care just did not exist.

It is good to hear you had the support of your family to care for you even though the systems were not in place yet. Could you also talk about the stigma that you mentioned?

In Ireland, if you could walk, you would go to school. If you were sick, you still went to school. There was nobody to talk to. There was no support. It was not a nice time to be in school. Other places that I felt mental health was neglected entirely was, for example, when I was living in South Korea. It has one of the highest suicide rates in the world. In a weird way, it is accepted there, like plastic surgery and a few other things that I do not understand. But when I was there, it was just accepted. It was just part of life. Loss of life was collateral damage for the lifestyle and how up-and-coming they were in terms of technology and the world. They were so far ahead, but in other ways, they were so far behind. I found that very jarring and upsetting. Mental health was not acknowledged. I did a project about natural beauty while I was there. I feel a lot of it is all linked: plastic surgery and women’s expectations to be perfect. If they are not, then they get depressed. There is a direct link to the high suicide rate among women in South Korea. I feel it is all connected. If you do not love yourself and if society does not accept you for who you are, then you do not have hope. I got to the stage where it was affecting me. I am not going to change the whole culture. That is why I had to take a step back and move. Some things just are not going to change overnight.  

Being here in Seville is tough because, again, there is no comparison between here and Ireland. Ireland is just streets ahead. There are so many good organisations there. I have online counselling from Ireland. But in terms of support here, it is challenging. There are one or two English-speaking psychologists here. They were not a good fit for me. To have two in a place that is so populated just seems completely shocking to me. Even going to get a re-prescription of the drug I have been on since I was 17 years old – the doctor makes you feel so bad about yourself. When you ask for medication like that, it is kind of like you are wasting their time. “Come on, what are you doing here? You’re wasting my time. There are so many who could be here instead of you.” And that is so upsetting.   

During the lockdown, I was running out of my medication, and I went, and they told me, “The nearest appointment we can give you is in two weeks on the phone” and I said, “But my medication is going to run out within two weeks.” and they said, “There’s nothing we can do.” And imagine if I had a heart condition or something else, would they be like that? No, they would not.

And as well, I really enjoy my work but again, mental health and having issues is just not seen as a valuable reason to be ill or to need extra support. But if you say I have a migraine, or “I can’t come to work today, I’ve done something to my shoulder”, then that is fine. But it is just not okay if it is something like this. It has to change. It just has to change. That is why I wanted to do this interview because it cannot go on like this – that people are ashamed and minoritised because of something they live with.  

You are right. Thank you so much for sharing your experiences. Although progress has been made in the past decades, there is still a long way to go. Stigma is still prevalent in different parts of Europe. That is why hearing personal testimonies by a mental health advocate like yourself is so powerful and empowering. I read an article that showed a statistic of people going through mental health challenges being more likely to seek help after reading a personal testimony of someone who was sharing their story. It breaks that stigma.

It does. And not just famous people or people you see in the media but people you know. People who share and talk to you about it. Just keeping the door open for other people to discuss. I, in my immediate family, have people with mental health problems. Some do not want to discuss them and others do. Whenever somebody is open about their issues and shares good things that help them, it makes you feel less alone. It makes you feel like somebody understands you. It is possible for me to have a good quality of life if I have the right support, which is so important.   

Exactly. That is also something we advocate for here at Mental Health Europe (MHE). We all have mental health, and it is just as important as our physical health. We also advocate for the psychosocial model of disability, which focuses on a person’s environment and life experiences and how that affects their mental health.

Exactly. Not everybody is the same. Even last week somebody in my job asked me after I opened up to her: “But why haven’t you fixed it? If you’ve had it for so long, why haven’t you fixed it? Haven’t you tried?” And I thought, “Okay, this conversation isn’t going to go anywhere because we have totally different mindsets. If people have not had experience with it, it is very hard sometimes for people.” There is this whole “fix it” mentality which just does not help anybody. Sometimes you cannot fix it. Sometimes it will not go away. We have to find another way of living with it and dealing with it. Talking and communicating is so important.  

Indeed, thank you for sharing this. Earlier, you talked about mental health support and the importance of mental health care. I am happy to hear that you could find online counselling. What we have seen in 2020 is that the pandemic disrupted many services in Europe.

It is a service from Ireland, Irish-counselling.ie. I found somebody I really connected with. That is so important. To find the right fit, to find the right person for you. I have been through many, many, many counsellors in my life. It depends on what you are going through. You might need something different, speak to another person. It all depends on what your needs are at a specific time. It is like speaking with anybody. Maybe you have friends you talk to about some issues with and other friends you talk to on other matters. But since March, I have been seeing this person, and she has made such a difference.  

Art or channelling your pain through art gives it meaning, if that makes sense. It is a way to process difficult experiences or feelings. You already mentioned the self-portraits you have been working on. Do you want to talk a bit more about that and why specifically self-portraiture helps you to manage your mental health?

It started out of necessity at the beginning because I just did not have a model. Then I realised that I was able to negotiate a story, a narrative. I enjoyed that I could set up a story about who I was, what I was. Most of the time, my face is not photographed because it is not about aesthetics for me. It is about the feeling of the picture. It could be anybody in the photos. That is what I like. That it evokes something. 

During the lockdown, it gave me a complete focus. I was utterly alone. It was my 40th birthday, and I was alone in my apartment. I had a routine. I got up at 7:30 am, I had my breakfast, I did yoga. Then I would set up my next project. I would sit on the terrace, making my costume from table cloth or recycled clothes or a hat. I would just invent a story and a narrative and a character. It would take me out of the box that I was in. It gave me some kind of power and creative expression. And also, really positively, it used up energy. I am a very energetic person. Only after you expand your physical strength can you delve into your spiritual, alternative, and creative side. I would find myself worn out at the end of the day because I had a tripod, I was shutter-speeding, I was running from place to place, jumping up and down. It worked in that way too, as physical relief.  

Everybody just needs something, a project. Another tool I use in dealing with depression and anxiety is always having a project set up. Always. Even if it is small. But always having something. Even if it is in a week’s time, a month’s time because now we cannot travel. We are very limited in what we can do. But if you always have something small planned, it helps.  

Having a routine and looking for projects that you can work on during lockdown is so important to give yourself some structure and get you through these uncertain times. What do you hope to invoke in people with your art? What kind of messages do you want to convey to other people, other artists who are experiencing mental health challenges?

I have researched a lot of other artists and people who are not artists. But I believe everybody is an artist. I do not think you need a costly camera or anything like that. It is essential, especially now, to slow down and look at your surroundings and look at your environment and see the beauty in everything. Even if it is something small. That is what gives me hope. And hope is everything. It does not take much. It does not have to be art or photography. It can be anything. But if you do something for yourself and express yourself, I feel like it is a therapy in itself. 

I have a few Instagram pages I follow and especially like because they go into the physical symptoms of mental ill-health. They give a description and explanation of why we have these physical symptoms. And I find that reassuring. I do not know if everybody else is the same. But it breaks down what happens when you have a panic attack into bubbles, and you can read them and be like, “Oh, that’s why my heart is pounding!” That, for me, is really reassuring. That it is not in your head. Your head and your body are linked. It is not your fault. You have these things happen to you, and this is why they happen. And for me, that is helpful. “Insight Timer” is an app I use, but I am sure there are millions of other ones. It is great because it has everything from Yoga Nidra to meditations, global meditations where you can go live together, and has 5-minute breathing exercises when you have a panic attack. I think these are crucial things to collect if you like. I know all of these things from friends. 

That brings us to our last question about how your community supports you. Be it your online counsellor or your family and friends. You mentioned the importance of having a community and having their support.

I have some very good friends who know when to step back and when to push a little bit. I think that is highly important. Not all the time you want to talk about it. Sometimes you just want them to say, “Look it’s okay, I understand. I’m here. I’m down the road. If you want me to pick up some milk and orange juice, just let me know.” My mother is a nurse, but she is also trained in alternative therapy. So, she has a nice balance between different options. For example, if I need to relax and sniff some lavender oil, but then if I need medication, I need medication. My father is the kind of person who is like, “I’m just there” and sometimes that is all you need. Sometimes you do not need somebody knocking on your door, pushing you, or texting you every five minutes. It is just like “I’m here, whatever you need” when I need it. I am the same for friends I know who struggle because I can see the signs when someone goes into themselves and becomes very introverted. There is taking space, but then there is letting them have that space but letting them know that you are there for them if they want to reach out.  

When I go home to Ireland, I cannot believe it. Mental health is on the radio. People are talking about it and doing walks for charity. We have a few excellent organisations: Pieta House, Samaritans, and Aware, particularly for depression and suicide. It is continuous and so open. It is like anything else. It is reassuring to go home and see that it is just part of society now. People are more aware of it. 

Hopefully, this interview will open up a conversation about this, especially among foreigners who live abroad. It just seems to be neglected pretty much – particularly in Spain, where I am now. I do feel isolated here in terms of mental health. There is just nothing. I have to reach out, and it has to be online. It has not come to Spain yet. As you said, it is reassuring whenever I see articles about people talking about mental health, especially people who are doing their best. Because at the end of the day, no one with depression or anxiety wants to be in their room crying all day. I think that is something that people sometimes think, “They want to be like that,” but we do not want to be like that. We, I want to have the most normal, productive life. I feel like that is my right as a person in society who gives back to society that I should have the support when I need it to try to do that.  

Yes, because if we do not teach the younger generations, how can we ever expect something to change?  

Exactly! I think there would have been a difference for me if I had had the support at that age. Thank you so much for giving me the opportunity  to share my story. I am looking for ways that I can do this and make it more transparent. I want to be transparent. I am 40 years old and my whole life I have had this. I have always felt that it was something that I was to cover up. And I do not want to do that anymore.