I’m not “just sick.”

So I have a problem with one of the tactics I’ve seen used to fight stigma for mental illness, especially mental illnesses that are commonly associated with suicide. That tactic is the one I refer to as “things aren’t hopeless, you’re sick.” I had trouble putting my problem with this into words for the longest time, and I felt like I was a terrible person because I know that it’s important to see mental health problems in the same way we see physical health problems. That’s a fundamental part of destroying stigma. I’ve finally been able to break down my problems with this argument into two sections.

First, I think that this problem commonly manifests by comparing mental illness to the wrong types of physical illness. Raise your hand if you’ve ever heard “If you broke your leg, you’d go to a doctor. Why should treatment for mental illness be any different?” I’m not arguing the whole going to the doctor point, but breaking your leg is something that gets fixed and then you’re done with it. Your leg is usually fine afterwards, and that’s not the case with mental illness. It seems like a small nitpick, but people with mental illness regularly get shamed for both being on medication (and for not being on medication, but that’s a whole different post) and still needing to manage their mental health for longer than others deem is necessary. (“What, you’re still depressed? You really need to just get over it.”) I’m a lot more okay with the comparisons to diabetes in terms of access to medication, since diabetes is also a condition that different people manage in different ways.

Despite being okay with the diabetes comparison, I would prefer it if there was a stronger push towards portraying mental illness as being in the same crowd as physical disabilities.* I mean, they’re already covered under disability arrangements, but I know from reading comment threads online that I’m not the only person who has felt unable to get that day-to-day help because “having a mental illness isn’t disabled enough.” And really, while mental illness is similar to diabetes in that it can be managed in different ways and is ongoing, it is more similar to physical disabilities, which are also managed in different ways, are ongoing, are often ignored, and lead to accessibility issues (all of which are different depending on the person and their disability).

The second problem I have with this argument is that I most often see it used to talk to people with mental illness (I’ve gotten it myself more times than I can count), and that is all kinds of dismissive. I’m talking about things like “things aren’t hopeless, you’re just sick,” and “your brain chemistry is out of whack.” When you tell someone that their feelings are wrong, you’re, well, wrong.

Tangent: Some people find it useful to have other people give them reality checks (i.e. Captain Awkward has just recently had an open thread for people with anxiety where several people say they find it helps for people to remind them that the grocery store is not a scary place), but don’t just guess. Ask the person what is helpful for them. In the previous example, if you used the same tactic on me, you might think “Oh, Ariana is having trouble getting to the library, so I’ll just remind her that it’s not scary.” That doesn’t work for me. What works for me is to tell other people I can put it off until tomorrow, then surprise my brain by instantly doing the thing I was scared off. You wouldn’t know that unless you asked.

Back on-topic: I especially hear the “you’re just sick” lines when people talk about feeling hopeless or suicidal, and I can not think of a ruder thing to say to such an admission. While these feelings are common in people who have mental illness, they are not exclusive to mental illness, and, more importantly, why does having a mental illness make those feelings less legitimate? If someone who was grieving over a dead loved one said that sometimes they wished they wouldn’t wake up in the morning, would you respond with “oh, you’re just sick/grieving?” I suspect you’d be more likely to say that it was a really hard thing to go through, and, depending on how close you were to the person, maybe suggest a therapist or a support group. And really, it’s not a bad thing to suggest forms of help to a suicidal person, I’m all for that. The difference between these two scenarios is that in one the feelings are considered legitimate, and in the other, the feelings are dismissed. This is really dangerous, because dismissing the legitimacy of a person’s feelings makes it impossible to actually help them. If I can’t trust you to take what I say seriously, how can I trust you to listen when I tell you that I’m having serious side-effects from my medication, or to respect my decision to not be on medication at all? Why should I even bother telling you I’m suicidal in the first place?

———

* I know that there is a lot of stigma surrounding people with physical disabilities as well, but this isn’t the post for that. I do think that people with physical disability and people with mental illness are natural allies considering that there are similar issues at play, especially considering the difficulties shared by people with invisible physical disabilities and people with mental illness.

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