On mental illness
Mar. 31st, 2003 12:17 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
thebratqueenMom and I got into a chat about mental illness tonight, a subject near and dear to our hearts. After years of being mentally ill, she's finally started to make a small hobby of reading more about it. This results in fun conversations for the both of us since lord knows this has been my hobby for years - possibly for the exact same reason.
Tonight we got to talking about how society - by which I mean American society since I don't know enough about how other societies view mental illness to comment - just so does not get it.
It seems to me that far too many people - from the actual mentally ill to their friends and family to, no surprise, insurance companies - do not get that mental illness is called mental ILLNESS for a reason. As in ill. Sick. Not healthy. As opposed to mental JUST NEEDS A KICK IN THE ASS AND/OR AN ATTITUDE ADJUSTMENT.
Now, I've been there. I've been depressed so I know how hard it is to realize that it's an illness talking and not just your own emotions. And for those who haven't been depressed it's hard for them to understand why depressed people don't want to do things that help make them feel better - such as therapy and meds. But, well, therein lies the whole illness part of the equation. Mentally healthy people have the ability to recognize when they're not well. Mentally ill people do not. Depressed people can't just haul themselves out of bed and do whatever they need to do. That's the point. It's as difficult for them to recognize that their behavior is out of whack as it is for a delusional person to recognize that no, there isn't a little green man sitting next to you and offering you some lemonade.
So, by definition, it can often be hard for a mentally ill person to get help because they may not even recognize that they need help. As out of whack as their lives seem to you, it feels normal to them. So making that first step to even recognize that something should be done is a monumental one wherein the greatest difficulty is the illness itself.
But once they recognize that they need help it still doesn't get easy, and herein I think lies those societal problems.
For starters, much as we talk about being a Prozac nation - and I don't dispute that there are people being medicated who probably don't need it - as a rule we don't actually support the idea that taking meds which improve our mental state is a good thing. Instead this is viewed as a weakness. You should be able to pull yourself up by your bootstraps and deal with the problem. Taking anti-depressants isn't a healthy thing, it's a fault. A failure. A use of drugs to create false emotions.
Except NO. Because this isn't about recreational drugs, which are an entirely separate issue. And this isn't about Mother's Little Helper either. It's about being ill, and needing medicine in order to get healthy.
If you are depressed - and I keep using this example because it applies to most of the people I know, not because I'm necessarily ignoring all the other forms of mental illness - it can be for two reasons. Either your body chemistry is out of whack, or you've just gone through a traumatic life event.
If your body chemistry is out of whack, then you're like a diabetic. Nobody looks at a diabetic and scoffs distainfully at them for taking insulin. Because they have to. This is the only way their body can function. We don't mock them and tell them to just try to regulate their glucose levels with the right attitude. We know that they're supposed to take the insulin because if they don't they'll die.
Well, people who are depressed need anti-depressants. Because if they don't they'll die. Out of whack body chemistry is out of whack body chemistry. The medication for it doesn't become less valid simply because the chemistry in question happens to be in your skull.
For a tramatic life event, the best comparison is someone who's just been in an accident. If I'm in a car crash and I'm seriously injured, then nobody would dispute if the hospital pumped me through with pain medication. It's understood that my legs have snapped into a thousand pieces the size of Smith Brothers' Cough Lozenges and there is no way that all the positive attitudes in the world are going to help make that pain go away. In comes the morphine.
But with the morphine comes other things. Because the end goal isn't simply to end my pain, it's to help get me to a healthy, functioning place again. So I take the morphine but I also do physical therapy - something which I can do because of the morphine. Then I gradually get rid of the morphine and learn how to walk (or wheelchair) without it.
Traumatic life events are the same thing. If someone's father has just died and they are now so depressed that they can't get out of bed, then meds are needed to help get them out of bed. Once they're out of bed then they go to therapy. Therapy teaches them how to function and deal with this great loss, and then the meds are no longer needed.
Therapy is also a part of the process for the long-term mentally ill as well. I can't count how many people I know who suffer from depression (or the like) who think that all they need to do is take their pills. It doesn't work like that. Again think of the diabetic. Yes, they take insulin. But they also need to learn how to function as a diabetic. They meet with nutritionists. They learn how to cook and eat differently. They teach themselves the skills they need in order to live with their disease.
It's the same thing for mental illness. Yes, take the Prozac, but to go therapy to learn how to get the skills to live with your disease. Pills just get your body chemistry into the right place. They don't teach you how to talk with your guilt-inducing parents, or give you the baby steps needed to get out of the house and out to the store without suffering a panic attack, or any of the other things that you haven't been able to do while you were ill.
It's a two part process no matter which way you're coming into it, and so many people don't get it. Most especially the ones who are actually ill. Get a prescription for meds? Meh, they don't want to take it. It's a crutch. They'll be fine. Or they do take the meds but as soon as they start to feel better they stop. Guys, it's not like cold medicine. You don't stop taking it once the symptoms go away. The symptoms are going away because you're taking it.
And even if you get someone who manages to even semi-regularly take their meds, then there's the second hurdle of therapy. They don't like it, it's no fun, there's no point, they've got friends so what do they need to pay a therapist for, they're taking meds so what do they need a therapist for.
But again no. Because only a therapist can monitor your progress. You don't ask your friends to set your broken bones for you, why would you ask them to fix your head? They don't have the skills. And, as I've said, pills alone just don't cut it. Because even if the cause of your mental illness is an out of balance body chemistry, you still need a few rounds with the right therapist in order to learn how to adapt to this.
And if therapy isn't fun - well it's not meant to be. Physical therapy for someone trying to walk again hurts like hell. Mental therapy for someone trying to function hurts too. It's just how it goes.
It drives me - well, nuts that we as a society just don't get this. Again, sure, there are those that do. But I find these are the people who have learned to be this way. Heck, if I didn't grow up with a crazy mom who was actually doing the meds and therapy all throughout my childhood I don't know that I would be this clueful about it either.
The default mode seems to be that meds and therapy are unnecessary, addictive and/or shameful. Which makes no sense. Don't we like healthy people? Why do we create this environment which basically encourages the mentally ill to stay ill? Because that's what this shame spiral around meds and therapy essentially amounts to.
Plus it creates and encourages the persistant thought amongst some members of the mentally ill that they aren't ill. Either in the sense of "I'm not depressed, I'm just lazy" or in the sense of "Society only wants me to take my meds because they fear the brillance of my thinking! I therefore choose to remain bipolar in defiance of that!" Doesn't matter which one you get, the end result is the same - someone who is sick, in need of help, living a life that's only going to end in disaster and now has no ways to fix it. (Or living a life with a lot of enabling friends and family who keep them from seeing how ill they are, albeit with the best of intentions)
We as a society have got to get the hell over this. We've been aware of mental illness for centuries now and the best we can collectively offer is "buck up little camper"? What is this, the dark ages? How do we not get this? How do we not get that someone who's remained in bed for months/lives amongst piles of trash/is too scared to leave their own home/has no control over their own emotions/whatever is a person with a serious problem? It's not self-evident? What do we need, the Jeff Foxworthy of psychiatry? ("If all you've done for the past three weeks is stare at the wall - you might have a mental illness! If you sat down one day and tried to rip your own skin off just to see if you had bones - you might have a mental illness! If you can't go to work today because you saw someone who was wearing a red shirt - you might have a mental illness!")
Repeat after me: mental illness is an ILLNESS. Which means we do not think less of people when we find out that they suffer from it. We do not think that someone is lazy when all rational evidence points to a serious problem. And we do not avoid taking medicine and going to therapy or encourage others to stop taking medicine and going to therapy WHEN THIS IS HOW PEOPLE GET WELL.
Guys, it's not rocket science. Work with me.
Tonight we got to talking about how society - by which I mean American society since I don't know enough about how other societies view mental illness to comment - just so does not get it.
It seems to me that far too many people - from the actual mentally ill to their friends and family to, no surprise, insurance companies - do not get that mental illness is called mental ILLNESS for a reason. As in ill. Sick. Not healthy. As opposed to mental JUST NEEDS A KICK IN THE ASS AND/OR AN ATTITUDE ADJUSTMENT.
Now, I've been there. I've been depressed so I know how hard it is to realize that it's an illness talking and not just your own emotions. And for those who haven't been depressed it's hard for them to understand why depressed people don't want to do things that help make them feel better - such as therapy and meds. But, well, therein lies the whole illness part of the equation. Mentally healthy people have the ability to recognize when they're not well. Mentally ill people do not. Depressed people can't just haul themselves out of bed and do whatever they need to do. That's the point. It's as difficult for them to recognize that their behavior is out of whack as it is for a delusional person to recognize that no, there isn't a little green man sitting next to you and offering you some lemonade.
So, by definition, it can often be hard for a mentally ill person to get help because they may not even recognize that they need help. As out of whack as their lives seem to you, it feels normal to them. So making that first step to even recognize that something should be done is a monumental one wherein the greatest difficulty is the illness itself.
But once they recognize that they need help it still doesn't get easy, and herein I think lies those societal problems.
For starters, much as we talk about being a Prozac nation - and I don't dispute that there are people being medicated who probably don't need it - as a rule we don't actually support the idea that taking meds which improve our mental state is a good thing. Instead this is viewed as a weakness. You should be able to pull yourself up by your bootstraps and deal with the problem. Taking anti-depressants isn't a healthy thing, it's a fault. A failure. A use of drugs to create false emotions.
Except NO. Because this isn't about recreational drugs, which are an entirely separate issue. And this isn't about Mother's Little Helper either. It's about being ill, and needing medicine in order to get healthy.
If you are depressed - and I keep using this example because it applies to most of the people I know, not because I'm necessarily ignoring all the other forms of mental illness - it can be for two reasons. Either your body chemistry is out of whack, or you've just gone through a traumatic life event.
If your body chemistry is out of whack, then you're like a diabetic. Nobody looks at a diabetic and scoffs distainfully at them for taking insulin. Because they have to. This is the only way their body can function. We don't mock them and tell them to just try to regulate their glucose levels with the right attitude. We know that they're supposed to take the insulin because if they don't they'll die.
Well, people who are depressed need anti-depressants. Because if they don't they'll die. Out of whack body chemistry is out of whack body chemistry. The medication for it doesn't become less valid simply because the chemistry in question happens to be in your skull.
For a tramatic life event, the best comparison is someone who's just been in an accident. If I'm in a car crash and I'm seriously injured, then nobody would dispute if the hospital pumped me through with pain medication. It's understood that my legs have snapped into a thousand pieces the size of Smith Brothers' Cough Lozenges and there is no way that all the positive attitudes in the world are going to help make that pain go away. In comes the morphine.
But with the morphine comes other things. Because the end goal isn't simply to end my pain, it's to help get me to a healthy, functioning place again. So I take the morphine but I also do physical therapy - something which I can do because of the morphine. Then I gradually get rid of the morphine and learn how to walk (or wheelchair) without it.
Traumatic life events are the same thing. If someone's father has just died and they are now so depressed that they can't get out of bed, then meds are needed to help get them out of bed. Once they're out of bed then they go to therapy. Therapy teaches them how to function and deal with this great loss, and then the meds are no longer needed.
Therapy is also a part of the process for the long-term mentally ill as well. I can't count how many people I know who suffer from depression (or the like) who think that all they need to do is take their pills. It doesn't work like that. Again think of the diabetic. Yes, they take insulin. But they also need to learn how to function as a diabetic. They meet with nutritionists. They learn how to cook and eat differently. They teach themselves the skills they need in order to live with their disease.
It's the same thing for mental illness. Yes, take the Prozac, but to go therapy to learn how to get the skills to live with your disease. Pills just get your body chemistry into the right place. They don't teach you how to talk with your guilt-inducing parents, or give you the baby steps needed to get out of the house and out to the store without suffering a panic attack, or any of the other things that you haven't been able to do while you were ill.
It's a two part process no matter which way you're coming into it, and so many people don't get it. Most especially the ones who are actually ill. Get a prescription for meds? Meh, they don't want to take it. It's a crutch. They'll be fine. Or they do take the meds but as soon as they start to feel better they stop. Guys, it's not like cold medicine. You don't stop taking it once the symptoms go away. The symptoms are going away because you're taking it.
And even if you get someone who manages to even semi-regularly take their meds, then there's the second hurdle of therapy. They don't like it, it's no fun, there's no point, they've got friends so what do they need to pay a therapist for, they're taking meds so what do they need a therapist for.
But again no. Because only a therapist can monitor your progress. You don't ask your friends to set your broken bones for you, why would you ask them to fix your head? They don't have the skills. And, as I've said, pills alone just don't cut it. Because even if the cause of your mental illness is an out of balance body chemistry, you still need a few rounds with the right therapist in order to learn how to adapt to this.
And if therapy isn't fun - well it's not meant to be. Physical therapy for someone trying to walk again hurts like hell. Mental therapy for someone trying to function hurts too. It's just how it goes.
It drives me - well, nuts that we as a society just don't get this. Again, sure, there are those that do. But I find these are the people who have learned to be this way. Heck, if I didn't grow up with a crazy mom who was actually doing the meds and therapy all throughout my childhood I don't know that I would be this clueful about it either.
The default mode seems to be that meds and therapy are unnecessary, addictive and/or shameful. Which makes no sense. Don't we like healthy people? Why do we create this environment which basically encourages the mentally ill to stay ill? Because that's what this shame spiral around meds and therapy essentially amounts to.
Plus it creates and encourages the persistant thought amongst some members of the mentally ill that they aren't ill. Either in the sense of "I'm not depressed, I'm just lazy" or in the sense of "Society only wants me to take my meds because they fear the brillance of my thinking! I therefore choose to remain bipolar in defiance of that!" Doesn't matter which one you get, the end result is the same - someone who is sick, in need of help, living a life that's only going to end in disaster and now has no ways to fix it. (Or living a life with a lot of enabling friends and family who keep them from seeing how ill they are, albeit with the best of intentions)
We as a society have got to get the hell over this. We've been aware of mental illness for centuries now and the best we can collectively offer is "buck up little camper"? What is this, the dark ages? How do we not get this? How do we not get that someone who's remained in bed for months/lives amongst piles of trash/is too scared to leave their own home/has no control over their own emotions/whatever is a person with a serious problem? It's not self-evident? What do we need, the Jeff Foxworthy of psychiatry? ("If all you've done for the past three weeks is stare at the wall - you might have a mental illness! If you sat down one day and tried to rip your own skin off just to see if you had bones - you might have a mental illness! If you can't go to work today because you saw someone who was wearing a red shirt - you might have a mental illness!")
Repeat after me: mental illness is an ILLNESS. Which means we do not think less of people when we find out that they suffer from it. We do not think that someone is lazy when all rational evidence points to a serious problem. And we do not avoid taking medicine and going to therapy or encourage others to stop taking medicine and going to therapy WHEN THIS IS HOW PEOPLE GET WELL.
Guys, it's not rocket science. Work with me.
