“I Have a Mental Illness” Project

Please come visit my new posting site (and podcasting site) ihaveamentalillness.com. I am a cofounder, though not the initial founder, that honor goes to another.

We are trying to educate the community. Please visit, and leave comments so that we can be a better bastion as time goes on.

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What Not To Say To Someone With Mental Illness

If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather. Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.

– Stephen Fry

Many people don’t know how to approach a friend or a family member who has depression. Many feel uncomfortable by this thought. Our society is partly in denial of suffering and does not accept that a person can suffer despite his best efforts. This discomfort and confusion may lead those around the person—despite their best intentions—to be “walking on eggshells”. This is very noticeable to the suffering persons and alienates them further.

I compiled a list of top 5 worst things and 1 best thing to say to a person with depression, with explanations.

What Not To Say:

1. “I know just how you feel.”

Possibly the most harmful characteristic of clinical depression is its inaccessibility to those who have not suffered from it. The feeling of isolation that the person with clinical depression feels is compounded by others’ inability to relate and sometimes even to merely accept that they have an illness. Unless you have tried to kill yourself or have actually been formally diagnosed with major depressive disorder, you don’t, and this will only minimize the person’s pain.

2. “Why are you depressed?”

Can be interpreted as a challenge (“are you really depressed?”). The person is depressed because he has clinical depression. And feeling depressed is only one out of dozens devastating symptoms of clinical depression. Just by asking this question you are demonstrating your ignorance of the very nature of clinical depression. The cause of depression is a mystery even in the medical field. Besides, why does it matter? Would you ask a cancer patient, why did you get cancer (bad mattress)? it’s a stupid question. Unless you care about the etiology of depression, this question will be perceived as a challenge. Only a clinically depressed person know what it’s like to be clinically depressed.

3. “You are more fortunate than some people.”

If you could just see the good in your life you wouldn’t be so miserable. The person with depression cannot control how he or she feels, just like a cancer patient cannot heal his cancer simply by thinking. Depression is the result of complex interaction of biopsychosocial factors continuously in flux. The person has no say in when or how it will lift. Saying this will make the person with depression feel guilty about his inability to feel pleasure despite having more food, money, and a better shelter than many others. Physical possessions do not determine happiness. Besides, the inability to feel pleasure is a hallmark symptom of depression. Not only does it invalidate their feelings, but also chides them for feeling this way, not to mention serving as a reminder of their inability to feel even a drop of pleasure. It’s like asking a quadriplegic person to pick up a rock. Saying, “others’ problems are worse than yours”, will only make the person feel even more guilty about feeling bad.

4. “snap out of it” / “it’s just a phase, you’ll get over it”

Try saying this to a person in a diabetic coma or with terminal cancer (the Burden of Disease for severe depression is the same as for terminal cancer). A person with depression, like with cancer, does not have control over his infliction. It’s like the person is in prison: it wouldn’t be helpful to say, “don’t worry, you’ll be free someday.” The fact is that it hurts and he needs your support and understanding.  It’s dismissive and can be interpreted as, “just accept that it sucks and don’t whine”, which leads me to number five.

5. “Stop whining about life.”

May be combined with “everybody has problems, but you don’t see them whining about them”, or “you’re being selfish”. Depression is not about whining.

Bonus: “How are you?”

Bad to ask especially when you don’t really want to know. Asking “how are you” may be done to appear caring, as if asking about your depression, but without the risk of breaching a boundary by asking about it directly. Actually responding by talking about your depression in detail would put the person off in such a casual setting, leaving you no other choice but to respond with the perfunctory “fine”. This may make the person with depression feel stigmatized and an outsider. So, only ask this question of somebody who knows you know about his or her depression or if you really want to know. Otherwise avoid it.

What To Say:

“It must be really bad for you to feel like this, please tell me more. Even though I can’t imagine what you are going through, I am here to support you.”

If you don’t know if something you say is appropriate, just say, “I don’t know what’s to say not to offend you, but I really want you to feel better. I’m sorry if anything I say hurts you. Let me know if it does so I can correct myself. Just know that I only mean the best.”

Misunderstanding Suicide

I recently heard about the verdict involving the student Dharun Ravi and the suicide of Tyler Clementi.

I will not here discuss the sentence of Dharun, this is outside the scope of my blog.

However suicide is not.

I don’t want people to cheapen suicide. And I feel that some people are by attempting to show a unitary cause-effect relationship between the invasion of privacy and his suicide.

I do not claim to know the mind of Tyler Clementi, and sadly his mind has left the communion of minds that is this world.

So I will speak from my own experience and make a suggestion.

I never attempted suicide in the strong sense, though it was constantly on my mind during the worst dredges of my severe depressed phase before being hospitalized.

My suicidal state was not a unitary cause-effect. It was the accumulation of world that I, like unto Atlas, carried upon my back. A singular world view of self-hatred and despair becoming massive and coming near the point of complete exhaustion.

And that point of complete exhaustion is suicide. The point at which I can no longer hold my world is suicide. Understand that at this point I believed that Hell was the end after death, that death was not really an escape. When the heat and stench of fire and brimstone engulf your being and yet this is preferred to the state of affairs, or when total annihilation of being is preferred we cannot be so naive as to proclaim a unitary cause-effect. Some people misunderstand it as “release”. It isn’t release. It’s extinction or worse. And yet living seems far beyond the “worse”…

To my compatriots in the depths of depression, press on, and receive the help of others if you can, you do not have to carry this alone. To my homosexual compatriots I say the same, and also say that you are not broken in your being, despite what some may say, that in fact your expression, understanding, and acceptance of your sexuality is indicative of the coherence of your being. You are you.

I wish the best for those who knew and weep for Mr. Clementi. In the great congress of minds we have lost a member, and this loss should be communally felt.

Be well,

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Starting an FAQ page

am developing a frequently asked questions page for this blog. The goal is to give answers to parents and associates of the mentally ill and give answers to the mentally ill themselves. I remember when I was diagnosed. I didn’t want to be. I thought it meant I was crazy. I literally screamed at the nurse that I wasn’t crazy before going to the fetal position and crying as I rocked back and forth. I repeated to myself “I’m not crazy. I’m not crazy.” So perhaps my leading question is:

Am I crazy? As asked by the newly diagnosed patient.

No, you are not crazy. Crazy is not really an appropriate term in this context, in that it is non-diagnostic and nebulous. What does crazy mean? Does crazy mean you may have a problem related to brain function that is causing visible issues that are directly and strongly affecting your life? Then I suppose I’m crazy. Hopefully that means “Oh, I’m in good company” rather than “Holy crap! How can I be in the same category as him??” But people often have this image of crazy that implies a person
A) doesn’t know they are crazy
B) acts without any rationale.
The first one is silly. When you are diagnosed and accept that diagnosis, you no longer fit that criterion even under the most lenient forms of “crazy”. The second is simply false. With very very few exceptions people act according to their present, sometimes evanescent, rationality. If you are manic for example, you may feel that you do not need to sleep. In this case it is perfectly rational at the time not to sleep. Is it deterimental? Often yes. But it is not irrational relative to the person making the decision. Perhaps we all need to realize this, even those of us who are mentally ill. We are still responsible for our actions in most cases, but we are not acting without reason. As an associate of a mentally ill individual one should not react as though their actions are random. They aren’t (except in some strange cases of schizophrenia and even that’s doubtful). We must understand that to that individual at that time what they are doing makes sense.

For example, there is a condition known as body dysmorphic disorder or BDD. This is a continuing and pathological state of believing oneself to be ugly and unattractive bodily. This is not the standard idea we associate here. This is much in the same vein as paranoia, at the time you don’t understand that this is wrong. You don’t even understand that there’s a possibility that this isn’t true. Rather than seeing attractiveness as being in the eyes of the beholder, you see it as, at least in your own case, factual and inescapable. Your friends, with good intentions, may try and convince you that you are good looking. In BDD this WILL NOT WORK.

So, I guess the take away is:

you’re not crazy. crazy can’t be mitigated. you are not crazy and therapy and if necessary medication are your best bet for stability.

If anyone has any questions they think should be on the page, leave your question in the  comments section and I will do my best to answer them.

It’s just in your head

Mental illness is a condition. We must remember that. A recent comment on a post led me to make this a post, since it was getting a bit long for a comment and contained issues that I wanted to express to the general public readers.

Some people have “pulled themselves out” of depression. But what does that mean?

If you pull yourself out of mental illness and get back to normal functioning… I don’t know, I’d be hard pressed to call that mental illness. Sure, you might be able to get to some form of function, but completely recovering by yourself to the same place you were before in my opinion is not mental illness.

Clinical Depression is mental illness.

Mental illness is by definition highly debilitating.

“In addition, for a diagnosis of major depression to be made, the symptoms must not be better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.”

—http://psychcentral.com/disorders/sx22.htm

One of the problems with depression is that people treat it differently than bipolar or schizophrenia, because for one reason or another only bipolars and schizophrenics are “crazy”.

For many people I would argue that they cannot get out of it themselves. I mean, think of a broken leg. Ya you can let it heal, but you’ll often be debilitated for life because of very badly healed bone.

People often do not treat mental illness and “physical” illness the same way. For some reason antidepressants are a “crutch” that isn’t necessary, while a physical crutch is at least temporarily necessary if you want to be able to deal with anything more than laying down. Antidepressants are more like a wheel chair in many cases. A paralyzed person can work without a wheelchair, but it’s damn near impossible. I don’t see why people assume depression or bipolar or schizophrenia is necessarily different.

There are cases of temporary mental illness, that is, mental illness that seems to be healed after a certain amount of time. And I do believe that can be real depression. Just like pneumonia is a temporary illness if you get it dealt with, in some cases depression can be temporary.

We must be careful though. Depression is not just the feeling or the apathy. If it is truly a brain chemistry issue, fixing your own physical brain is extremely difficult or possibly impossible. Depression can entail a lot of things that are very hard to deal with. In my case (with bipolar) I had psychosomatic aphasia and paralysis. I also have Tourette’s and OCD. Those two are often comorbid.

Attempting to deal with it completely by yourself is what people usually do before they get help. No one wants to think of themselves as mentally ill. You have to get to the point where you can’t get out of it yourself and are willing to admit that you’re ill. Or to the point where you’re a danger to yourself or others.

I really am not trying to single the commenting person. First, the position given was vague and I don’t want to impute intent or meaning when I’m not completely sure. Also it’s a common position and should be addressed to everyone. I’m not mad about what the person wrote. Honestly it gave me the inspiration to write this post. And I certainly do not impute all these beliefs to that person, I’m relatively sure that person didn’t mean everything that I wrote down. It just reminded me and I wanted to write out the possibilities thoroughly.

Emotionally Unstable: The Myth Gone Bad

Is it just me or do people cringe most or get most annoyed not by longwinded argued points, but by assumptions and off-hand remarks?

I was just watching this:

Slut Shaming

The part that got me didn’t have anything to do with the girl. The part that ticked me off was the off-hand remark about kids being emotionally unstable.

Let’s think carefully about that word for a minute.

What does it mean to be “emotionally unstable”? Does it mean the person is just a little away from the average in emotional scale?

No. He doesn’t give us that option.

He links it directly to “medication” going around. And somehow that is an explanation for more kids being emotionally unstable. This argument can be used to belittle clinical conditions. Granted, so can overprescribing medication. But we can’t merely say that all the growth is from the psychology of children changing or overprescription.

What about those children who wouldn’t have been found in the past? How many autistics went unhelped because it just wasn’t diagnosed or hadn’t been studied fully and so it was determined only by very obvious signs. What was a schizophrenic before the term came around?

He was just crazy. Mad.

Bipolars? Mad. Depressed? Lazy. Fibro? Liar. ME? Weakness. Autistic? Mad. Aspergers’? Weird or Neurotic

With better diagnostics and more studies shouldn’t we expect more children to be helped by medication and therapy? I know a young child who was diagnosed early with Asperger’s Syndrome. Did you know that there is a higher rate of suicides in Asperger’s children than those who do not have the condition? His mother was able to get him into special help so that he could learn to socialize with other children despite his socialization problems related to Asperger’s.

This very well may have saved his life.

People want to believe that mental illness really isn’t there. Especially in those illnesses where it isn’t extremely obvious due to hallucinations or the like. They want to think that this isn’t real. I’m not sure if this is so much because they can’t see it or because they just can’t conceive it and don’t want to believe that it could actually affect someone such that their actions are severely affected.

Think about the death penalty.

Why is it that we want/have wanted a “humane” death penalty at one time or another? I propose that it has nothing to do with the executed. It has to do with the executors. By that I mean not only the operators of the machine but also  all the people of the area that were for the penalty being used. And I would argue it has nothing to do with their sense of conscience.

It’s because we don’t want to see death.

We want death to be quick and painless (or as painless as possible) because we can’t think about death for more than a few seconds in real life.

I thought of this when watching Green Mile during the botched execution seen. One of the executors didn’t wet the sponge on the victim’s head to allow for a quick death. A lot of people are watching him be killed/executed. But when it goes to long, and death stares them right in the face, they run like hell.

And perhaps this is part of the mental illness myths. We don’t want to believe they’re that serious. We don’t want to believe that that could happen to us or our children and that we or our children have no control of that? What do we do about a disease that we can’t see and has no complete physical understanding?

The unknown stares back at us and it is a darkness which we want no part in.

Well, I don’t get that luxury.

So I’m bringing my own dry sponge.

Mental Illnesses: Perspectives From The Mentally Ill

I’m working on putting together a new page on the site. This is for people with mental illnesses to describe their understanding and their experience of mental illness. I want to cover at least:

Depression, Bipolar (I and II), Borderline Personality Disorder, Adult ADHD, and Fibromyalgia.

A person on ProBlogger thought of this. A page to describe mental illness in a personal way, rather than a behavioral diagnostic of webMD. Not to disparage webMD by the way. They provide a good service. But they don’t have a personal description. They don’t have implications the illness has on everyday life.

We need that. The world needs that. The mentally ill and those who are not need that.

Message me at

archangel.associate@gmail.com

with a story. I won’t necessarily post them, but if I do I will not edit them. By that I mean the person will tell their own story as they see it. Editing the work would make it partially mine, and not fully theirs.

I’m Bipolar, Pleased To Meet You

I was in the DMV not too long ago and I was talking to a cop. He had just changed beats (is that the right word?) from Oakland to a moderately rich suburb. I said that it must be a break going from Oakland to that place. He said he preferred Oakland. I asked him why. I can’t remember exactly how he worded his response but the answer was essentially, if you treated people in Oakland like decent human beings, with dignity and respect, most of them acted like decent human beings in return. If you treat them otherwise they act however you treat them. You treat them like animals they’ll bark like animals. But in the suburb the rich felt entitled over him, because he was a cop and happened to be of a minority race.

 

I would ask that people treated the mentally ill like decent human beings. We are. Or most of us are anyway, I mean there are crude nasty human beings, but most people are decent, good folk if you treat them that way. We’re not criminals because we’re ill. We’re not to be pitied because of our illness. We are not so different from you all. Don’t treat mentally ill adults like children. We aren’t children. Don’t treat us like a plague upon society. We’re not.

This applies to many different groups, not just the mentally ill. If you see a physically disabled human being treat them like the second half of that title, not the first. Granted, at some points we are treated differently. For example at my university since I am considered disabled I can take fewer units than the minimum. Similarly a person in a wheelchair can park in handicapped spots. You know the similarity in those cases? It doesn’t affect you. Sure you might have to park a little further back. Sure you might have to take the minimum number of units or over. But remember an earlier post where I made the point:

The true unfairness isn’t that the person in the wheelchair gets to park closer to the store.

The real unfairness is that he’s in a wheelchair.

We are human beings, I promise. We are mostly decent human beings like the rest of you. I promise. So why not do this today: If you see someone in a powerchair, or someone disabled in some other fashion, say hello. Maybe even ask how they’re doing. Maybe it’s just me, but if I were in a powerchair I would feel lonely a lot because people, with the best intentions of not embarrassing the disabled person by staring at their wheelchair/powerchair, ignore them. So I shall name today: Say Hi To The Guy In The Wheelchair Day. Or maybe good morning, I don’t know. Something nice. (Though perhaps not “That’s a nice wheelchair you have there!” they may not appreciate that one, but who knows maybe a lot of thought went into it I don’t know.) But We shouldn’t need to have a specific day to do this. People are people are people.

We have feelings.

We don’t like feeling alone.

Be well, both to those in the wheelchair and those who can walk.

Unfairness and Disability

Reality can hit the disabled quite hard. While many countries have developed methods to make sure to include the disabled as much as possible in everyday life, it doesn’t change the fact that the individual is disabled.

For example if you are paralyzed from the waist down, there is a lot of assistance you can make use of. However this doesn’t change the fact that you cannot move your legs in the normative fashion. Being disabled means precisely what it says regardless of what assistance measures can be given.

There are things an able bodied person can do that you cannot.

I think anybody who complains about measures to help the handicapped or disabled, or those who promote the idea of idiotic statements like “handicapable” should remember this.

You may be angry that the handicapped get nice parking spaces, or that the blind or deaf have assistances. Or in my own case you may be angry that I am allowed to take less than the minimum number of classes and still be a full-time student. But remember…

The blind still cannot see.

The deaf still cannot hear.

The parapalegic still cannot walk.

And I still cannot manage the number of classes that the average student can, and I still pay the same fees the average student pays.

It’s very hard to see the disability related problems unless you are often in contact with someone of a disability. For example, how long does it take you to shower? Imagine how much longer that would be if you didn’t have the use of your legs. How hard is it to justify why you need a crutch if you break you leg? Imagine how much harder it is to justify why you need antidepressants when there’s no physiological test that instantly shows that you have clinical depression.

I ask that people would think about any “unfairness” by accessibility options given to the handicapped and compare it to the true unfairness of being handicapped.

Mental Health Advocacy and its Personal Consequences

There’s a bit of a problem with being an advocate for the mentally ill I’ve found in my case…

People know when they meet you that you are mentally ill.

This makes things… interesting to say the least.

I’m still totally unsure of how to deal with this. To be a little less heady than usual, it’s hard to get a date when they know up front that you’re bipolar. It’s something that you usually can just work up to… strange to have it up front.

But perhaps that’s better. Perhaps it’s better for someone to know upfront, then they can decide right then and there whether they want to pursue you or not.

I would like to date someday, but I will always be an advocate. I suppose we’ll see how this goes.