"Depression/anxiety is not a malfunction but a symptom of unmet needs." Thoughts?

Speaking only for myself, and not reading any other replies to your questions…

Not really. The first thing you said was prickly, but you clarified your view. Way better than people who come in and don’t want to learn or budge an inch.

None of the above.

A little of both, right? Ideally, we’d all be trying to learn from one another while making room for opposing viewpoints.

No, in my view, you’re either right or wrong, how you present yourself doesn’t impact your rightness or wrongness.

No doubt about that. And as I am often prone to saying, being an asshole and being mentally ill are not mutually exclusive concepts.

Full disclosure: Severe, debilitating mental illness runs in my family. My uncle was schizoaffective (that’s schizophrenia with bipolar), couldn’t hold down a job, routinely kicked out of apartments due to violence against imagined enemies, banned from several grocery stores - absolutely no contact with reality, like stereotypical homeless guy muttering in the street crazy. One conversation with the guy would leave you reeling. I was perplexed by the expectations some people seemed to have of him, as if his mental illness were a character flaw rather than a biological condition. The dude thinks people are actively trying to kill him on a regular basis, is subject to daily auditory and visual hallucinations and has been hospitalized eight times in one summer. Yet the conversation around him was always how lazy he was because he doesn’t do his laundry or whatever. What, exactly, did they expect? (He has since passed away.)

In addition to my uncle, there is my mother (Borderline Personality Disorder), calling her functional is a stretch, she’s one of the people who harped the most about my uncle’s laziness and now she’s on disability for a back injury. I really doubt she could hold down a job at this point, while possibly able-bodied she lacks the emotional regulation required to interact with people in a consistent and stable manner. I haven’t spoken to her in two years but it sounds like she’s becoming increasingly more delusional and paranoid even though she’s not as violent as she used to be.

My great-grandmother was bipolar and I think also had PMDD (a little-understood disorder in which hormones profoundly affect mental health - think PMS from hell. I have it too but fortunately, I live in the era of monophasic BC. People do not take this seriously at all, but it is absolutely debilitating when untreated.) She was permanently institutionalized and sterilized, and my grandmother went to a girls’ home for the remainder of her childhood.

Compared to these people, I am in great shape. I have recurrent major depressive disorder, PMDD, PTSD, Anxiety Disorder NOS (Not Otherwise Specified), and inattentive type ADHD. I know, it sounds like a bullshit number of disorders, right? But no, I am the real deal. I’ve been living with it and in treatment for these things for almost 20 years and I have been under the medical care of experts. I have a good breadth of knowledge in all of these issues including some graduate school education in mental health treatment, and I’m married to a clinical psychologist who has a very low tolerance for bullshit. You’re going to have to take my word for it that these are all accurate diagnoses. I am just that lucky.

People on the outside cannot comprehend this struggle. I look excellent on paper. I’ve been married for 12 years in a highly stable, loving, violence-and-conflict free marriage (my Mom has been married 5 times, I take a lot of pride in my marriage.) I have a Master’s degree despite big (1+ years or longer) interruptions in my education due to depression. I’m friendly to people, I have no obvious social dysfunctions, I can control my temper, I’m reasonable. I do not seem like a person who struggles with mental illness (the fact that there is an assumed ‘‘type’’ is a society problem I’m working on.) It’s almost funny how well people assume I can function compared to how well I actually do.

I guess the question I would posit to you, Dinsdale, is if I am so lazy (and I’m not saying you’re accusing me of being so, I’m engaging in a thought experiment with you), why did I even bother going back to school at all? If you look over my life history, this is what you see: intensive periods of effort, high achievement, followed by frequent interruptions of a year or longer in which I became virtually non-functional, withdrew from college, lost my job, watched my life fall apart, became suicidal, and then I dusted myself off and resumed where I left off. My brain came with some great gifts as well as curses, so all I can think about when I discuss this issue is how much better I could be if I didn’t have to deal with this shit. I’ve done some cool stuff, but I was capable of so much more. I’m a valued member of my team, but if I wasn’t mentally ill, I could be running the organization I work for. (Whether I would want to is another story.)

Life has been good for the last two years. Very little by way of serious depression. Last night I was so anxious I woke up at 2am and haven’t been able to get back to sleep. My entire day is now fucked due to PTSD, I certainly couldn’t drive to the doctor without risking a collision due to sleep deprivation, so there’s another piece of my self-care puzzle knocked out of whack. I can’t eat when I’m sleep deprived, so there goes nutrition. Since I have chronic insomnia and cannot easily recover from a disrupted sleep schedule, this is going to affect, at a bare minimum, the rest of my week. I’m already feeling depressed about it, and panicked as I have people coming over in five hours and feel totally unprepared for what’s coming ahead tomorrow and so on.

This… is typical. Standard. Everyday life for me. Good life for me. This is my life when things are going well.

I have a part-time job. It seems that every time I attempt to go without meds, I end up unemployed. The last medication I took was effective but it lowered my seizure threshold to the point that I had three grand mal seizures in one day and then I couldn’t drive for six months. Kinda puts a ding in the old employment plans, right? Fortunately, I could work from home. Except the anticonvulsant they put me on made me acutely suicidal. After six months of trying to make that work, I was put on an anticonvulsant that does wonders for my depression. Go figure.

I now work part-time. Part-time is better because it can prevent the depression from spiraling out of control without affecting my employment status. Most people don’t have the luxury of part-time. I have no intention to apply for disability or anything. I’m just trying to give you insight into the life of a smart, capable person who really, really, really tries, and still falls flat on my face on a regular basis, because I have several chronic illnesses, and many of them are psychological. Given what I’ve been through since the age of 13, it’s hard to blame people who suffer from similar problems for wanting to step out of this productivity game once and for all.

Even my husband, the enlightened mental health professional, forgets this sometimes. I haven’t talked to him yet today, but I predict he’s pissed at me for not going to sleep last night, given the fact he whacked me in the nose with his sock this morning and muttered a terse, “Be good.” (he means: “Be good to yourself.”) He knows how much it messes me up when I don’t get sleep. As if you can possibly sleep when you feel threatened and feel like you have a gallon of coffee circulating through your system. I will point this out to him, he will remember, and there will be no harm done. But not even he can fully understand this at times. Nobody gets it until they have lived it. And I’m deeply influenced by sleep deprivation right now, but my general take on chronic mental illness is that it’s sheer hell.

All over the world, readers were being told that…

… by some author who was being paid by the word, not for getting their facts right.

In the USA, the most popular view was, for a very long time, that it was all in your head. And American doctors needed to be repeatedly told that there were effective drug treatments for mental conditions. Some had always believed that. More came to the realization. But it has never been the case the “all over the world” or even “in America” that “all doctors” believed anything in common about mental health.