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12 August 2014 @ 11:23 pm
We're talking about mental illness all wrong  
This post discusses mental illness and the death of Robin Williams.

Like many people, I've spent the last 12 and a bit hours feeling a loss. Brilliantly talented people are rare, and their work lifts us as a culture. Sometimes it lifts us as human beings. Sometimes, as with all the laughter Robin Williams provoked, it just lifts our days.

So when the news of his death came across this morning, we stopped getting ready for work here and felt what we would both now miss, and then felt even sadder as we remembered his children and his wife.

And then the newsreader said 'It's believed Williams committed suicide. He had struggled with depression and alcoholism.'

And he didn't have a voice of judgement, and he sounded sad, too, and he was about a million times better than those dickheads over at Fox News, but at the same time, I thought, 'But that's not how you would have said it if he had cancer.'

Because the thing I've realised is that we have a different public language for mental illness and for 'real illness'.

In the main evening news, the presenter had different language. She said, 'Robin Williams has passed away after a long battle with depression.' And I thought, yes, that's it, because mental illness is like cancer.

It's exactly like it. Some cancers and some mental illnesses are discrete – they take up a certain space, are treated and then are gone. They are something you had, but that are now over and done with. After them, you treat yourself a little more kindly: eat more organic food, go for a run or a walk every day, work a little less, live a little more.

Others are ones people live with. You need treatment, and you need to keep watch, to make sure it's behaving, that it's keeping to the limits you can live with and letting you lead your life around it. You still have so much life around it, you just need to be vigilant, and to jump on top of things quickly if it ever looks as though it might be getting the upper hand. You can live a life like that, you can live a great and long life like that.

Then there are the ones that go to war with you. The treatment will be liike a battle, but you can face it down, you can win. And maybe you do win. Or maybe you win once, twice, a dozen times, but lose in the end, because it came back stronger, or because you were worn out. But you fight for as long as you need to, because that's what we do, and if you run out of strength before you run out of disease, the people who loved you will understand.

And then there are the diseases that devastate, that destroy swiftly and wholly and leave you astonished as to how your body could have turned on you like this and that leave your friends and family floundering, lost, because you were just here, and now you're gone.

And when any of these ARE cancer, we have this whole public language that we trot out. He fought bravely. She struggled for many years. He succumbed at last. She was suddenly struck down.

But when it's mental illness of any sort, he is said to have taken his own life. Police on the scene say there were no suspicious circumstances to her death. He committed suicide. She was found alone with empty pill bottles, viewers who are distressed by this information should call …

As a professional journalist, you receive training. For a long time they told us, 'Never say suicide. It encourages others to copycat.' But at the same time, we were told, 'And when a famous person has or dies from cancer, the one good thing is that you can encourage a massive spike in screening and treatment by providing health information with the story.' In a moment of deep common sense, a few years back some of the major mental health groups went out and spread the message – 'We have screening, too!  We have symptoms people should look out for, we have helplines they can call, we have systems that can save.'

And those messages do save: we know for a fact that people call the helplines listed at the end of news stories, and they get help, and many nip their illness early, before it can grow strong.

But I am left wondering: why do we have the different languages? Why do we have one way of talking about all the things that go wrong with the body outside the brain, and another for most of the things that happen inside it?

I had a friend who thought she was going mad. She found out she had a brain tumour. She was relieved. What kind of world is this that brain cancer was preferable? It's a question she asked later, cognizant of the fact that her diagnosis had come with words like 'operable', 'curable' and 'early', but in honesty, she said that she understood cancer, she knew what the support networks were, she knew her friends would stand by her with cancer.

I think we need to start thinking of mental illness as just illness. It's like cancer, it's like heart disease, it's like the flu. It's like so many other things that we are less scared of, and that make us less frightening to other people. I think we need to do this so that we remember that it IS an illness, and that people suffering from whatever form of it need funded and accessible help, and ongoing care, and support, and that if they die of it, they die of the disease – not by choice, or despair, or 'cowardice' (you're so predictably awful, Fox News), but simply because they were sick.

Because if we remember that it is illness, people are faster to seek help. And doctors are more straightforward in what they look for and what they can offer as treatment. And all of the employment entitlements that come with being sick will be there, and there will be less fear.

And there will be less to be frightened of.
 
 
Nennenenne on August 12th, 2014 01:43 pm (UTC)
Difficult topic. Really, really difficult. I grew up with a mother who had severe mental problems, depression, narcissism, and disinhibition and meanness found in the classical psycopath. It started off as post-partum depression when I was seven and she became gradually worse from my mid-teens. Intellectually I know that she was ill, that she couldn't help it, but that doesn't really help much. Her illness lead to mental abuse, especially of me, but also my brothers.

Luckily for our family she died of cancer almost ten years ago. Dying early is the only really decent thing she did in her life. I'm sure children who grow up with parents who have cancer also carry their share of emotional scars, but I would choose cancer over severe mental illness any day. My children would be better off with a dead mother than a mother like mine.

Mental illness is not just illnes for me.
blamebramptonblamebrampton on August 12th, 2014 01:56 pm (UTC)
It is hard. Do you think that some of the worst fallout could be because these are often illnesses we don't recognise and don't treat? I confess, I just don't know what to do about psychopathy – the rational response is to say 'Look, you can be a merchant banker, where your skills will serve you well, but no getting married or having kids, because you'll just fuck up lives.' Alas, that's unethical.

But I am heartened by a scientist I saw interviewed. As part of a study, he had his brain scanned. It came out showing signs of classic psychopathy. He was startled, but as he talked to his family and examined his life, the pieces fell into place for him. The diagnosis changed him, made him aware of his actions, made him work at things. It made him a better person, a better father, a better husband.

My hope is that by turning to a more straightforward disease model (including a 'that's just the common cold' level, because a lot of mental illness isn't grim), people would be more likely to seek diagnosis, to get treatment, to work for wellness.

But that doesn't stop me from wanting to slap your mother.
ecosopherecosopher on August 12th, 2014 01:59 pm (UTC)
I'm so sorry to hear about your childhood and how it was affected by your mother's mental illness. Yes, intellectually, we can recognise that it's the illness that does the damage, but it doesn't completely stop the barbs from stinging.
la_marianela_mariane on August 12th, 2014 02:07 pm (UTC)
That's really hard. I think mental illness (like many other things) has degrees. Some are relatively minors (which doesn't mean they don't need medical attention) and some are major. I know that, where I live, when someone is a danger to others, they are hospitalized without their say so. But it comes with its own problems. Still, I hope protecting others from mental patients is a priority among mental health specialists.

Also, the label "mental illness" is really vague. Depression is different from alcoholism, and from schizophrenia,... I know that when I had a depressive episode, I became withdrawn, apathetic and uncommunicative, but I was not dangerous to anyone. I don't know how I would react if it turned out depression made me aggressive, as it happens to some people.
la_marianela_mariane on August 12th, 2014 01:56 pm (UTC)
Many people think that depression is not a real illness, it's just someone being weak and pampering themselves. Whenever there is discussion of mental illness, I try to be as open as possible (I had depression twice, and I know what to look out for in my case) but there is still lots of judgement. I'd certainly never tell my boss outright.
blamebramptonblamebrampton on August 12th, 2014 02:10 pm (UTC)
As a manager, this makes me furious about corporate culture. In most Western countries we have legal obligations to our staff and yet we have created a culture so filled with illogical prejudices that we create problems and sometimes illness for our staff. And, of course, not just with the depressed, but with the anxious, the sick, the pregnant …

It's so wrong. The one good thing I have seen in the last 10 years is that a number of brave people have taken these issues to court and so HR departments are more aware of the needs of staff members and companies' obligations to them. Fear of being sued is a good motivator in this case!
la_marianela_mariane on August 12th, 2014 02:21 pm (UTC)
Let me bask in your indignation for a moment.

And I would not be fired, because I'm a teacher, and I have civil servant status, so they need to prove I've done something wrong before they can fire me. But the thing I fear is more insidious : whispers, good work being overlooked, lost oppotunity for advancement, being stuck with the shitty jobs ... Also, the language of the higher-ups is clear : whatever illness you have, it's your fault when it's depression. Big corporations have done a lot of efforts with that (especially after lots of people commited suicide at work a few years ago) and they have formed their executives to look out for anxiety. But the governement is not ready to implement in its own departments what it has forced companies to do. Hypocirsy of the highest order.
blamebramptonblamebrampton on August 12th, 2014 02:41 pm (UTC)
You can bask if I'm allowed to share in your righteous anger :-)

It's just such a narrow way of thinking. If nothing else, use people to their strengths! I had a great Aspie sub who I could give all the proofreading to: she spotted everything. Yes, someone with depression might need the odd week off. So do parents now and then. They're also the people who have great loyalty to companies that give them those weeks off, and who focus on connections that flightier people like me miss.

I think that I get cross about it because I was hit in the head with a two-tonne taxi. I have an acquired brain injury as a result. It's nothing horrid: my handwriting gets a bit muddled when I'm tired, my speech a little aphasic. I spent six months without most of my nouns and I still don't recall most of 1994. Over the course of two years, I worked really hard to reconnect a lot of what the taxi knocked loose. Some came back differently, some better, some (notably my French and Italian) worse.

Because I had been hit in the head, I had a straightforward healing narrative. Yet there is not a lot of difference between my broken brain and other broken brains. Brains change. We can change them. And people are astonishing, it really shits me when we waste perfectly good human potential!
Samena: SPNsamena on August 12th, 2014 01:58 pm (UTC)
God, this! So much! I have lost so many (job) opportunities, friends, family members, been shunned, avoided, bullied, been kicked out of schools, just because I was "different", or "difficult". I've been battling with depression all my life it seems, and later on I got some added disorders, borderline among them, and I've seen dozens and dozens of shrinks, counselors, therapists, etc, to little avail. Nowadays nobody will treat me anymore, because my problems are "too complex", or so they say. I just sit at home and have basically given up, no hope for the future. I'm not suicidal, but sometimes I wish I was dead, or never been born. I just want to live my little life, but it's so hard, and the outside world doesn't give a fuck or lend a hand either. All they do is criticize and judge. If I could accomplish one thing in my life, I wish I could improve mental health care, and understanding of mental illness, a little bit. Give some hope to other people like me.

Edited at 2014-08-12 02:04 pm (UTC)
blamebramptonblamebrampton on August 12th, 2014 02:16 pm (UTC)
I think you're probably achieving that goal, you know. Because you have had such strength to talk and to look for help. It's fucked up by the fact that we're sort of at the leeches and urine-investigating stage of medicine in many ways, but we've seen such leaps and bounds in recent years that I do have hope! And I think you're pretty amazing.
ecosopherecosopher on August 12th, 2014 02:00 pm (UTC)
Yeah, it was something that occurred to me recently--that it's an illness, and some people get better, and some people don't :(
blamebramptonblamebrampton on August 12th, 2014 02:17 pm (UTC)
Quite a lot of my life has been spent raging at biology.

And gravity. But mostly the unfairness of biology.
Catscatsintheattic on August 12th, 2014 02:17 pm (UTC)
Yes, yes, yes to all of this.

Why is mental illness the greater stigma? Maybe because we live in a world that values the mind over the body (while at the same time standardising physical beauty to the max). We act as if our psychological set and our physical set are two different things where our mind controls our body or the two are not even related. So many observations point in a different direction, but they get conveniently ignored.
blamebramptonblamebrampton on August 12th, 2014 02:21 pm (UTC)
I think it could be historical. For a long time, mental illnesses were diseases of the soul, then, more recently, the mind. It's only with the recent ascendency of hard neuroscience that they've been seen as most often diseases or disorders of the body. It's letting go of the mind/body dichotomy that we seem slow to do. Because it involves letting go of so many other ideas about ourselves, I suppose.
Catscatsintheattic on August 12th, 2014 02:27 pm (UTC)
I think it was back at the age of Enlightenment when the idea first came up that the mind controls the body.

It's high time that we let go of the mind/body dichotomy. But yes, that's scary to a lot of people, since it means giving up the assumption that we can lay waste to our bodies, or that our minds can control everything. Even the way we sit and move says something about who we are. It not one or the other. Body and mind are connected. And that's a little more complicated than most people like it.
tudorpottudorpot on August 12th, 2014 03:51 pm (UTC)
Great post, thanks for expressing so well what I have been floundering at trying to say. I've shared a link on my journal. Re hard neuroscience, my sister has panic disorder - a form of OCD, which is now being considered a genetic disorder.
woldywoldy on August 12th, 2014 03:02 pm (UTC)
Great post. We have such a long way to go in attitudes, support, and funding for mental illness.
Mabmab on August 12th, 2014 03:17 pm (UTC)
You put it succinctly. There is such an enormous stigma surrounding mental illness. I would love to see a surge in support of challenging it after this loss.
Iulia Linneaiulia_linnea on August 12th, 2014 04:32 pm (UTC)
Hear, hear.
connorblondconnorblond on August 12th, 2014 07:02 pm (UTC)
You certainly have a point there. The thing is, though, while mental illness might be "just" an illness - it is far more scary because it can change our perception. Not just of the world, but of ourselves. It can change our personality. And so can the med that are used to treat them.
Plus, research when it comes to medication of mental illness is a sad, sad story. A lot of meds given to patients aren't even for the problems they have, because there is such a lack of medication it is a disgrace.
I think it is a combination of all that makes people so afraid.
Chiara Castelnuovo-McKenziecmcmck on August 12th, 2014 07:04 pm (UTC)
I worked for a time with mentally ill folks and I wish the media would get its head round the fact that people ore still inividuals when they are mentally ill and can't be dropped into neat definitions.
celestlyncelestlyn on August 12th, 2014 08:46 pm (UTC)
Thank you for posting this! Depression needs to be pulled out into the light and exposed for what it truly is, a complex, multi-faceted illnes capable of taking down anyone it touches. It waxes and wanes, it strikes quickly or gradually, and it can make one unable to get out of bed or make even the simplest decisions, or it can exist as a low-level, dysthymia that may not cause havoc in your life, but it does suck the joy out of living and makes each day a bit of a struggle. Sometimes people just get tired of fighting it.

This video is well worth a watch for anyone and everyone. I think I'll post it on my site, as well.

https://www.youtube.com/watch?v=-Qe8cR4Jl10
Jaeenchanted_jae on August 13th, 2014 12:58 am (UTC)
You are the most sensible person I know; bless you.
makes me mellow right down to my soulfrances_veritas on August 13th, 2014 01:01 am (UTC)
thank you so so much for putting this in a different perspective for me. just...thank you. your brain is great. i love your brain. i wish there were more humans like you.
bubblegumlocksbubblegumlocks on August 13th, 2014 04:14 am (UTC)
As someone who suffers from depression all I can say is amen. And thank you!!!
anna_wing on August 13th, 2014 04:24 am (UTC)
I think some of the problems in conceptualising mental illnesses comes from the persisting fallacy that the mind and the body are separate things. Many people still don't accept that ultimately mental illness has organic causes like any other illness, just usually more obscure and to a great extent still unknown ones. And of course the fact that the lack of knowledge of causes also leads to problems with treatment is a separate though connected problem.
valkyrie17valkyrie17 on August 13th, 2014 06:39 am (UTC)
I have noticed quite a lot of discussions about this topic and quite a few postings with links to get help, or to open up more discussions about mental illness as a result of Mr William's death. I think that it may encourage some people to seek help…I HOPE so.
leecetheartist: topsyturvyleecetheartist on August 13th, 2014 03:12 pm (UTC)
Super post, I am sharing it, thank you.
l.m.: got;; missandeiincandescent on August 13th, 2014 03:14 pm (UTC)
This is an amazing post. So eloquent and persausive, and really worth rereading and thinking about. I'm not sure why we talk about different kinds of illnesses differently, but all I can think is that a physical illness effects you, while a mental illness can (to those around you) change who you fundamentally are. People are scared to lose their sense of self. You're right. We need to find a more even and effective way of talking about this. This post is a great start.
Meredythmeredyth_13 on August 13th, 2014 09:07 pm (UTC)
I've been working recently with a terminally ill young lady, who has been doing a lot to try and change how people treat those with any kind of terminal or serious health condition - and she objects violently to language such as 'fight' and 'battle'.

She says that it puts the onus of survival or success on the person suffering - that there is this societal expectation that they must be brave and do everything in their power, regardless of their personal needs or capacity, to overcome their illness and 'survive'. Not live, not thrive, simply keep breathing, no matter the cost or suffering involved.

And with that comes the whole 'they lost their battle' - as she says, she's not a loser. She is going to die, and that is not something that can be changed. That she has made the choice to stop palliative chemo now, after several debilitating rounds, does not mean she's 'given up'.

I think she's right. While we should support people facing these challenges and life choices, our language across the board puts so much pressure on the people most vulnerable.

If a person chooses to see their illness as a fight, then that should be their choice, not the result of expectation. And for those who don't, we should respect their decisions without judgement.

Ultimately, no one should be made to feel like they've failed, simply because death isn't always something we can 'fix'.
mrsquizzicalmrsquizzical on August 17th, 2014 03:51 am (UTC)
i agree with this so much.

my family has a lot of degenerative illness, and the idea that people should be 'fighting' all the time is very draining and discouraging. it also does have that blame attached to it. when someone just wants to catch a breath, and simply live rather than being on the offensive all. the. time. for the rest of their lives, however long that may be. then that can be seen as giving up, giving in.

<3
(Deleted comment)
blamebramptonblamebrampton on August 16th, 2014 07:16 am (UTC)
All public posts are OK for sharing :-) Oh god, the horror of moving: you've caught me at a 5pm ache break. And we have to get the cats and computers over there tonight because we've moved the bed and sofa, so there's nowhere to sleep here!
mrsquizzicalmrsquizzical on August 17th, 2014 03:52 am (UTC)
i love the way you have thought this through and expressed your ponderings. <333