Posts Tagged ‘mental illness’

Insert Picard facepalm meme here

This is getting way too predictable. Guy shoots people, concerns about mental illness start cropping up. Repeat after me: The mentally ill are no more likely to be violent than the general population.

What really gets me about this one, though, is the utter lack of evidence that the guy is mentally ill. His family mentions him as being ‘troubled’…but what does that even mean? It’s way too vague a term to tell us anything. There’s no indication that he was being treated for anything (in all fairness, as an adult that ball was entirely in his court, so if he didn’t want help he didn’t have to get any). There’s no comment about him having been violent in any way before this. The most of substance that is said in the article is that he stopped going to church a few years ago. Which, like the ‘troubled’ comment above, tells us absolutely nothing. Lots of people stop attending services all the time, and it doesn’t really mean anything more than they decided they didn’t want to go anymore. Heck, I didn’t go in college only because I couldn’t be bothered to go off campus for it. He had the choice whether or not to attend, he chose not to, for reasons that we can only guess at. I remember learning that to be news, something had to be ‘significant, interesting, and new’. I’d say this article only passes the last of those, because it doesn’t have enough substance to it to be significant or interesting.

The other thing that drives me nuts about this is that it highlights genuine issues with the worst possible light. Yes, there’s an issue with stigma about being mentally ill. Yes, this makes it harder to convince people who need help to get it. Yes, we need to deal with that. But bringing those issues up in the context to trying to prevent an event like this one really doesn’t help. It just reinforces the idea that being mentally ill makes people dangerous, which will make people less likely to admit to themselves, much less others, that they are sick, which will make it harder to get people the help they need for their own sakes. Can we stop framing this as something that’s needed to stop violence and just deal with it as an issue that needs to be addressed for the sake of helping sick people?

Depression isn’t really about being depressed

I ran across a post on Hyperbole and a Half talking about her history dealing with depression. My own story diverges from hers a lot in some ways–I never hit quite such a low point (though how I managed that I can only attribute to sheer stubbornness) and things were such a slow, mild descent that people didn’t really seem to notice that anything was wrong (my mother’s initial response was that I didn’t seem depressed) so I didn’t deal with efforts to ‘cheer me up’. It took flunking school and a teacher telling me “you need help” for me to finally admit that the signs I’d been noticing for years were indicative of a larger problem that needed to be addressed, not just ignored and pushed through.

Her description of depression though, no longer being able to enjoy anything, was spot on with my own experience. To put in in my own words, think of the one thing that makes you happy, that more than anything else brings joy to your life, that you can count on to pick you up when you’re feeling down. Now imagine that thing no longer having any effect on you. That was me at my worst.

People generally aren’t great at understanding mental illness. That’s not surprising, as in some ways the difference between normal variation and actual issues in need of professional attention come down to how much of a problem they’re causing. So it doesn’t surprise me that some people seem to think of depression as simply being sad, but IME that doesn’t really encompass what it is. I’ve struggled with social issues my whole life, so in some ways I’ve always been depressed, but the difference between that and having a clinical diagnosis of depression is kind of like being wet versus being underwater. I wasn’t just unhappy, I was unable to be happy. The enjoyment had been sucked out of everything in my life, to the point where I wasn’t doing much more than simply existing because I couldn’t be bothered to do anything more. And it’s something of a self-reinforcing cycle–a common piece of advice is to keep busy (which DOES help), but if nothing is enjoyable then it’s hard to motivate yourself into any sort of activity.

One other thing that stuck out to me was a comment about always wanting to not care anymore, and finally getting there. I think that’s a state we’d all like to be in, to feel secure enough in ourselves and care little enough about other people to be able to brush stuff off, a Hyde-like ‘zen’. What I got wasn’t that. It was a lack of caring brought upon by despair, from feeling like nothing I did made any real difference so what did it matter anyways? That’s a pit of its own, and in no way a good place to be.

Although things are a lot better for me now, I’m still dealing with these things in lesser amounts, and I always will. Even with treatment I need to actively work at times to keep from falling back into depressed moods where I no longer care. While happiness is again a possibility for me, the darkness still lurks and is still capable of dragging me into places I don’t want to be in the right circumstances. I want people to understand that depression–clinical depression–isn’t just about feeling sad. It’s about feeling hopeless, and that’s far harder to shake than simply being down. If you know someone like this, don’t try and get them to ‘snap out of it’–if anything that’ll just make them feel worse when they inevitably are unable to do so. Encourage them to seek the professional help they need. I know a lot of people see this as a sign of weakness, especially in our individualistic society that puts self-reliance on a pedestal, but this is too big a problem for anyone to deal with on their own, and too important to try and deal with without trained support. This goes for any mental illness, really. Be supportive of people getting the help they need to feel better, because no matter what they deserve that.

Context, Context, Context

In the wake of the Newton tragedy, a particular blog post has gone viral. You’ve likely heard of it–“I am Adam Lanza’s Mother”. This article is powerful, and should prompt us to look at the mental health system in the USA–which somehow manages to be even more broken than the rest of the healthcare system–to make sure that people get the help they need.

But.

Timing is a major factor in why I have a problem with this post, with the other main one being that the writer makes a direct comparison between her son and the Newton shooter. After any story like this breaks, certain narratives automatically unfurl in such a routine manner that they’re hardly worth following anymore. One of them is always about mental illness and finding ways to prevent people with mental health conditions from violent behaviour. This narrative is so, so often oversimplified, and while certain conditions do have a propensity towards violent acts, most don’t–especially not of the calculated type seen in mass shootings–and the broad-brush way that we talk about mental health winds up giving the impression that anyone who is mentally ill has a higher chance of being violent, which is far from the case. When specific diagnoses get thrown out, they’re usually the ones that happen to be talked about most often, throwing undeserved stigma onto them, and so often the people doing the talking clearly have no idea what those conditions entail. Autism is one that gets a lot of flak these days, because autistics tend to be outsiders to society and are often thought to lack empathy for other people, but it is not a condition that includes violent tendencies (outside of meltdowns, which are a much different animal than what people are actually talking about) and I suspect the legalistic mindset would hinder autistics from behaving in these ways.

The Long article far from helps our cause right now (especially since she can’t tie her son’s behaviour to a specific diagnosis, so he can only be described as ‘mentally ill’). It is part of the narrative that passes as a ‘conversation about mental health’ in this country, a looming monolith that casts a dark shadow over the significant portion of the population that has a mental health condition. It does not foster the understanding we need, just the stigma that we don’t. It furthers the idea that all mass killers must be mentally ill, a simplified hand-waving of the things that actually lead to these events that stops most of us from ever really understanding the question that’s being asked. The question is–how do we stop these things from happening? And while better mental healthcare is something that needs to be addressed, for it’s own sake, we’re too busy talking about what is/was obviously ‘wrong’ with the killer to ever actually get around to doing anything.

The sympathetic psychopath

So, there was a bit of a dust-up yesterday after Amanda Marcotte posted about an article on children and psychopathy on Twitter. I’m not going to get into that argument here (Short version: the condition was compared to autism, a comparison which is unfortunately both common and damaging for autistics), but I do want to address her underlying point: why don’t psychopaths get sympathy if they really ‘can’t help it’? While I can’t speak for others, the point for me is very simple:

Sympathy for psychopaths is dangerous.

Psychopaths don’t have the moral conscience that most of us possess. While most people feel sympathy for at least some other people, psychopaths don’t–they are in effect a nexus of self-centered-ness. They are adept at reading and manipulating people, and because of that trait, being sympathetic to them opens one up to being used by the psychopath. One of the issues with trying to treat psychopaths is that, because of their nature, trying to ‘help’ them usually winds up doing so in the opposite way than intended–it gives them better skills to use others. Showing sympathy is, to them, a weakness to be exploited.

(Which isn’t at all to say that I think they don’t need to be understood and treated if possible, but the nature of the condition makes treatment very tricky.)

Another factor, however, is that while many people with different neurologies do suffer as a result (either as an intrinsic part of it or because of a mis-match with society’s expectations), I’m not aware of any reason to believe that’s true of psychopaths. It’s a pretty old trope in fiction that good is hampered by its desire to protect others, while evil is free to create havoc because it simply doesn’t care. Lacking an ability to care about what happens to others, morality goes out the window–the only question is how to attain ones goals. Trying to do what’s ‘right’ is just an arbitrary limitation, or at best a useful smokescreen. As Machiavelli said, the best thing is to appear just but be unjust.

Pretty hard to feel sympathy for someone who isn’t suffering. Especially when that person has absolutely none for you.

Necessity

There’s a couple of lines of thought that we usually hear when it comes to mental illness in our country. One is the old “it’s all in your head” line. Which is kind of dumb, because that’s what ‘mental’ means. I know the implication is that you’re making it up, which frustrates me because it handwaves away all the struggles and suffering that people with mental illnesses–such as myself–have to deal with. People tend to think of depression as being ‘kind of down’, which really misses just how bad a disease it is. Depression is losing interest in everything in life because you just don’t see the point anymore. Happiness is a myth and striving for it just makes you feel worse when you inevitably fail.

The other line has to do with treatment for mental illness, particularly medication. This would be the “just snap out of it” mentality. Mention you’re on psychiatric medication in the wrong place and you’re likely to get flooded with ‘lifestyle’ advice on how to make do without medication. I don’t want to disregard such advice as being useless, but the people who insist that you make do without medication are basically saying, “you don’t really need to be on those pills if you just try hard enough.” Which to a certain extent is probably true.

What the people who give such advice are missing is that mediation helps a lot of people. Maybe those of us who rely on it can make do without it, but it would be harder. And that’s effort that could be better put to use elsewhere doing things like, I dunno, living. By which I don’t mean the physical act of living, but the things we do that make life worth living. Even on medication, there are things you can do to help yourself feeling even better. Having depression, a common piece of advice is to keep active (not necessarily physically–a therapist actually told me to keep playing video games once). And I’d be lying if I said it didn’t help. But it would be a lot harder to follow that advice without medication. At one point I was spending most of my day in bed because I had so little interest in anything. The mental effort it took to do anything was immense. It is still difficult at times, but a whole lot easier than it was before I was started taking medication.

The ideas I outlined above are very harmful to people who are already suffering. It pushes us away from seeking treatment. They push us away from the tools we need to be able to function as people. They push us towards throwing boatloads of energy into climbing out of a hole with our bare hands when instead we could have a ladder.

Could I ‘make do’ if I decided to stop taking anti-depressants? Probably. Strictly speaking, medication isn’t a necessity for me. But it has been an enormous benefit to me, and asking me to do without when it is available to me is asking me to make life needlessly difficult for myself.