Thursday, November 4, 2010

This Really Cannot Be Said Enough

(I won't link to the blog post that sparked this, but suffice it to say that yet another person finds mental illness shameful and doesn't want to seek treatment.)

When I first met my SIL, she had been diagnosed with bipolar disorder for several years and had been struggling with it for years before that. It took a long time to get the right medications in the right doses. She, in and of herself, was eye opening to me, in that she was the first person I'd ever met with a mental illness who discussed it as openly and unashamedly as one would discuss a physical illness*.

The same way I would say, without shame or reserve, that my hips are painful and stiff today, she would say that she found herself considering an affair during a manic state. The same way I would say that I couldn't keep up with housework, she would say that she demanded hospitalization because she couldn't appropriately mother her children.

That amazed me, and it shouldn't. It really cannot be said enough: illness is illness. You have no more control over your brain than you do over your pancreas or your bone marrow. So, unless you would be deeply ashamed of and not seek treatment for diabetes and leukemia, go to a doctor. If you are desperate and in constant agony, you need help. It doesn't matter whether that agony is . . . well, I was going to say in your body or in your brain, but pain is in your brain. Without my brain to react to it, my foot can't hurt.

Pain is pain, illness is illness and nobody needs to suffer. And nobody needs to be ashamed of falling ill. Diabetes is not evidence of weakness, kidney stones are not evidence of laziness, and obsessive compulsive disorder is not evidence of either. By the way, if you could wish yourself better, you'd have done that by now, so get to a doctor, okay?

*I'm using the distinction for conversational purposes, but really it drives me nuts. The brain is physical. Mental illnesses are the result of abnormalities in the functioning of the brain, and are therefore physical in nature. The distinction we make between mental and physical illness is meaningless and dangerous besides.


  1. Hmmm... hmmmmm... hmmmmm...

    This is the part where I agree with you.

    I work with men who have suffered TBI (Traumatic Brain Injuries). These were individuals who were "normal" folks until they got into their accident, and now they have a variety of physical, cognitive, and emotional impairments. I definitely agree that brain creates consciousness, and that people with mental illness shouldn't be stigmatized.


    In many cases people who suffer from less severe mental illness do have more control over the disease than let's say, controlling their pancreas. Often times talk therapy is about opening the possiblity to think/feel about a problem differently, as well as empowering the person so that they don't feel enslaved to the disease.

    I hope that made sense.

  2. My husband has a mood disorder that is either bipolar disorder or a mood disorder in that vicinity. He self-medicated with drugs and alcohol for years. It's not rapid-cycling bipolar, and he has never had more than one full-blown manic episode that required hospitalization. He has had several hypomanic episodes, and medication-caused, life-threatening syndromes that mimic mania. He would not, by many people, be considered to have a "severe" mental illness.

    I think the point PF is making (well, I might add) is that while my husband can go to therapy to evaluate his "magical thinking" and can learn techniques to point out to himself when he is engaging in disordered behavior, or what puts him at risk of going into a manic or depressed state, his mental illness IS a physical illness in that his brain chemistry just doesn't work correctly. If he stops taking his mood stabilizers or his atypical antipsychotic, his brain does not function correctly. He could be employing every cognitive behavioral therapy technique in the book, as conscientiously as possible, and he would be physically incapable of controlling the manic state that would ensue without the medication.

    Schizophreniform-bipolar spectrum patients, among other mental health patients, are no more "in control" of their diseases than is a diabetic who does not use insulin correctly. A diabetic can't talk their pancreas into functioning correctly.

  3. In the sense that one could control one's diabetes through diet and exercise, yes one could use therapeutic tools to control one's depression or bipolar, etc. However, you have no control over developing the illness in the first place. In other words, heres the point -> . <-

    here's Andy.

  4. YES. To, like, everything you just said. I started treatment for depression and anxiety back in May, and it's night and day. I'm only sorry that it took me so long.

    I mentioned it to my dad, whose first response, before I even finished my sentence, was: "Well, you might not have to be on it forever..." I could tell he was trying to understand, but it's clear to me that he still views it as something to be ashamed of. Maybe I won't be on it forever. But maybe I will. So the fuck what? What matters now is that I'm a functioning human being who isn't balled up in a corner crying for reasons she can't explain, who isn't constantly afraid that next time she'll snap and she actually WILL hurt her daughter...

    The world needs more people like your SIL. I'm trying to be one of them. I'm refusing to be ashamed of the fact that I'm medicated. The truth is, I knew going in how my dad would probably view my treatment, but my life got better the day I stopped waiting for someone else's permission to get well.

  5. Andy,
    To continue the diabetes metaphor: I tried treating my depression through a combination of non-pharmaceutical means (mostly because I was desperate to fix this without medication). It helped a little, sometimes. But it wasn't enough, no matter how much I wanted it to be.

    It didn't matter how much I continued spinning my wheels; without the right traction, I was still stuck. The meds gave me that traction. I haven't abandoned any of the self-care I was doing before, any more than I'd be neglecting diet and exercise if I were on diabetes medication. But now, that self-care is actually getting me somewhere. I'm making progress, and I feel good about it.

    I'm sick, not lazy.

  6. Also, this:

  7. Hey, did I imply people were lazy who take meds? If I did I'm sorry. I've heard that people who have more severe symptoms find a greater relief from medications than folks who have milder symptoms (folks with milder symptoms don't find that much relief through meds).

    It's not just my work experience I'm drawing on either. My boy (8) has a minor disability that causes him to have a ADD-ish (Attention Deficit Disorder without the hyperactivity) behavior and the school was gently pushing for meds. With some fairly simple techniques (no meds) he is functional and thriving. In our society that has pharmaceutical ads everywhere there is a rush to medicate. Does this mean medication isn't immediately necessary for some people? No. Some folks who have major symptoms need medication fast. However, a healthy scepticism towards the pharmaceutical-industrial complex is healthy (in my opinion).

    @ PF "You have no more control over your brain than you do over your pancreas or your bone marrow." - When you talk about causes of disease that is true (maybe I didn't get your original point and that's my fault), but in terms of treatment I still respectfully disagree. I don't think talk therapy will help the functioning of one's bone marrow though it can help with a variety of psychological disorders.

    I find the best tract when discussing a topic is that when I disagree I am not disagreeable. I hope I've done that here.

    I took a look at the link, too. I'll leave a cooment later on (I'm off to bring my son to karate).

  8. Illness is illness

    The thing that makes "mental" illnesses different from "physical" ones is that the latter are often more objectively verifiable; we understand the symptoms better, and have more/better tests for the underlying problems.

    Maybe part of the reason for the squeamishness IRT the former is that we still have a hard time recognizing what the problem is. Obviously, societal and personal pressures can cause people to be treat mental illness differently, but it's actually difficult (for the average shmo) to tell the difference between laziness and a lack of motivation and depression. Heck, even the professionals disagree as to which is which.

    All this is to say that mental illness is treated differently in part because we have a tough time recognizing it for what it is. Just my 2 cp...

  9. and it's not like we UNDERSTAND how and why the brain works!!!

    i *HATE* having this convo. and i end up having it on a regular fucking basis, because my best friend *AND* my boyfriend NEED something.

    best friend? is a TEXTBOOK Borderline Personality Syndrom - and schitzo tendencies. she, quite literally, has no personality of her own, and MAKES ONE UP based on her favorite TV characters. it's... sort of scary.

    but she was raised Fundy Christian, and if i hear ONE MORE TIME "If God wants me to have this..." i'm gonna EXPLODE! i've used the diabetes comparision [and tons of others] and... she doesn't Get It. [i'm also afraid that she'd refuse insulin if she developed diabetes, because "God wants me to have it"!]

    boyfriend is less scary, not less heartbreaking.

    fuck - i have PTSD and chronic depression! except i can't take SSRIs and with PTSD it's not really meds that help. EMDR, on the other hand...

  10. Ariadne, it kind of really, really is! i started because i punched my boss [she came up behind me, while i was using a headset that covered both ears, and *grabbed my shoulder*, jerking me back. i swung. it was INSTINCT.
    give her credit - she apologized pretty much at the same time i did - we talked over each other - and she was pissed at herself for grabbing me, cuz she KNEW i had PTSD. she didn't even write me up and told HER boss that it wasn't me punching her - it was, however bad i felt about it - but that she accidentally threw me off balance and i accidentally hit her while flailing to catch myself. she was a good boss, other than her propensity for hugs and such :) ]

    3 months after i started, a *stranger* at a bar grabbed my ass [painfully] and i didn't instinctively punch him. i turned around, told him off, THEN punched him ON PURPOSE when he did it again.

    EMDR kept me out the phych hospital.

  11. It probably takes a great deal of 'stepping out of oneself' to objectively describe the depth of a one's mental illness, especially when one is in the throes of an acute exacerbation?

    Some people lack the necessary intuition to describe their condition as abnormal, or ill. Hasn't anyone heard the old 'touch of diabetes' or she was 'a little bit pregnant'? (Joke)

    Many mental illnesses are as treatable as high blood pressure, and maintenance medications may help provide a reasonable semblance of normalcy in maintaining a job and the usual commercial exchanges.

    Still, the cult of the mental stigmata isn't helped by the self-perpetuation of closet discussions.


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