I suffer from periodic depression and based on my experiences with the condition I am convinced the general public at large has very little understanding of mental health issues.
“What are you so depressed about? There’s people that have it way worse in life than you do.” “You should stop being so sad all the time and appreciate what you have.” “Just stop thinking about depressing things all the time.” “They’ve got pills to treat that now, you should take some so you don’t have to worry about that anymore.” “I have no sympathy for people that want to sit around and feel sorry for themselves all day.”
Have you heard any of the aforementioned statements before? I have, and can tell you these are pretty common sentiments/attitudes. I think many people’s views on mental health could be summed up like this - if you have a mental illness you should will yourself to stop being crazy. Or if you can’t, take some pills and then you can live happily ever after..
With regard to mental health issues, what do you think can be done to raise the level of public awareness and understanding?
a) We scare the shit out of the general public. I think we’re the original “uncanny valley”; societies tend to have laws that flat-out prohibit various acts and conducts and behaviors, but then there’s those of us whose minds just don’t seem to run in the same channels as other folks’, either with regards to emotional state or of cognitive state. There are, and always have been, pseudo-laws for what to do about the disturbing people. What to call us, and where to put us.
b) The general public has been told one set and then another set of lies about who and what we are and what is to be properly done about us. For several centures now, they’ve been reassured that the folks officially dealing with us are helping us, and that has been a more comfortable belief than the previous belief that we were wicked or demon-possessed or something. But these more kind-soundling lies are not particularly more truthful than the witchcraft and demon-possession explanations.
c) The upshot of it is that people are afraid that whatever-the-heck has made us as they perceive us could happen to them too. That seriously interferes with more than superficial empathy.
d) Recipients of psychiatric services also get lied to, of course. Whether it is the promise that a year on a Freudian shrink’s couch will “fix it” or the promise that if you take these prescribed pills your problem will go away, the promises are not well-supported by actual outcomes, generally speaking. They don’t really know how to fix us, which again feeds into why our situation scares the shit out of people.
I think the one useful and positive public relations campaign is for us to be organized and speak for ourselves. To put real faces to these phenomena. To have advocacy groups composed solely OF (not merely “for”) people who have been given a psychiatric diagnosis and/or self-identify as having these kinds of problems.
Historically my diagnoses have been schizophrenic and bipolar (with variants within those large groups), never been tagged with “depression” as a diagnosis. We all need to work together though regardless of the specifics of our situation. User-run self-help as well as political organizing as a movement is a good thing. You learn you can help others and be supportive of others, and THAT’S a good thing.
I’ve been chronically depressed for over 55 years, and I’ve heard all the stupid lines in the OP. Plus one more:
“Now that you’ve gotten the promotion, you have no reason to feel depressed. Now that your heart surgery is over, you must be feeling great. Now that you’re happily married . . . now that candidate X won the election . . . now that the Supreme Court has . . . etc., etc., etc.”
People need to realize that though these issues may exacerbate or alleviate the depression, the cause is internal. And it’s no different than being diabetic or having cancer. And it sure doesn’t mean you’re “crazy.”
What has helped me most is having a loving, supportive spouse. But he’s not my doctor or therapist, and I try not to lean on him too much. The fact remains that we need societal support, we need to confront society’s prejudices and misconceptions, and replace people’s ignorance with understanding. People need to be educated from an early age.
I think this is the most effective way to fight ignorance on mental health, by likening it to other illnesses or partial-faults in other organs that people generally understand. To convey that the brain is another important organ that can malfunction, just like a heart, lung, stomach, pancreas, testicle, or ovary can malfunction. And that while we do have drugs and other treatments available to combat mental illnesses, just as in other cases of illness, the treatments are not always effective.
To be fair I can take everything the OP said and replace depression with “cold” or “allergies” or some other minor “physical” condition and pretty much get the same answers.
“Why are you complaining about a cold, some people have cancer?”
"They have pills to treat your allergies, why don’t you take them?
“It’s just a few pimples, stop being so vain.”
And so forth. You can’t take the fact that you have a mental illness and think that your experiences are simply unique to that and no other illness. I’m sure to those people with the pimples, allergies and colds feel the same way as you do.
Add to that, depression is a common term and is not what most laypeople mean by a clinical depression.
Add to that mental illness are not as exact as physical ones. I am a licensed psychologist, though I work as a social worker. Most times my colleagues and I will agree on a patient’s diagnosis. But there are a good number of times, when we’ll be very far apart.
In a “physical” illness you have this type of thing much less often.
Note the quotes around physical, as clinical depression is a physical illness, and is not meant to imply otherwise.
No matter what you do in life, you’re going to have barriers and you’re going to have to choose how to get over those barriers.
It’s because empathy is impossible when it comes to mental health.
If someone has an obvious physical condition like being confined to a wheelchair or being blind, empathy is pretty straightforward, because we can reasonably simulate those conditions. We know how hard it is to walk around with our eyes closed, and so we have at least some tiny appreciation of what it’s like to be blind. Not completely–but enough.
But people without mental health issues have no idea what it’s like to have them. How could they? There’s no way to simulate the condition. The best you can do is form rough analogies, like depression = being really sad. Which is, as noted, inaccurate and counterproductive. The alternative is just not trying at all.
So to be honest, I don’t think there’s any real solution here. Empathy is a core part of human interaction and it’s just not possible here if you haven’t had the issue in question. People with differing conditions themselves can’t even really empathize with each other; someone with schizophrenia has no more understanding of depression as someone with normal mental health.
The best we can do is just accept the objective evidence that these are real diseases and not something people can escape through force of will. But that’s not the way people usually approach problems.
Don’t these people who say such things ever actually THINK about what they’re saying? Do they think the person with a mental health issue LIKES being the way they are?
Jeez. Oh, golly, thanks, I think I’ll just “snap out of it” now. How silly of me not to realize that.
Do they go around telling diabetics not to be so whiny and just excrete some more insulin already?
Unfortunately, many mental illnesses have names identical to transient moods of varying severity. Nearly everyone has experienced a depressed mood, which makes many of them feel they are qualified to opine about clinical depression. Further, mental/emotional conditions exist on a broad continuum with poorly defined increments.
Much of society urges “perfection.” if someone considers themself unsuccessful or unhappy, there is an industry ready to persuade them that there is something wrong with them that needs to be treated. There are tremendous incentives for someone to wish to be diagnosed as having a depressive/anxiety/personality/etc disorder, rather than simply being a fuckup or an asshole.
Most mental illnesses lack objective diagnostic criteria. When combined with a for-profit healthcare industry, that increases the possibility for self diagnosis, symptom magnification, and excessive diagnosis/treatment.
I consider there to be significant comparisons to the chronic pain industry. Some people accept the existence of a certain level of discomfort and find ways to deal with it. Other folk define themselves by it. Mental attitude can have a significant impact on how different people deal with similar difficulties.
None of this is to suggest that mental illness is not “real” or that it is not profoundly incapacitating for some folk. However, my personal, non-medical opinion is that debilitating mental illness is far less common than purported.
Honestly, for me, what’s it’s come down to is the realization we’re all in it for each other. We have to help each other out because there will always be people who don’t understand, and it’s so fucking exhausting to talk about dealing with mental illness with people who don’t get it. You have to explain everything. With people who experience it, you don’t have to explain shit. You don’t have to justify how you feel. You don’t have to explain ‘‘why.’’ They intuitively get it and it feels so much better knowing there are others dealing the same stuff. People need to know they are not alone.
I’ve suffered from severe depressive episodes throughout my entire life, and my anxiety manifests itself in so many ways they finally just slapped the label Anxiety Disorder NOS on me. That’s in addition to PTSD… I’m fucking crazy. I’ve had good times but I’ve had times I couldn’t work or eat or bathe or function in any meaningful way. Everybody knows what it’s like to be ‘‘down,’’ not everybody knows what it’s like to have to deal with a debilitating chronic mental illness that steals entire chunks of your life. I chased the elusive ‘‘cure’’ for years, tried 13 different medications in various combinations, had every conceivable kind of therapy - and certainly benefitted from the evidence-based ones like CBT and prolonged exposure, but the big ‘‘AHA’’ moment was when my ACT therapist looked me straight in the eye and said, ''You realize this isn’t going to go away, right? You have a biologically based mental illness. You are going to be dealing with this for the rest of your life."
People who aren’t crazy get upset when I say that I’m crazy, like I mean it in a self-deprecating way, but I don’t. I think I might act more normal than I feel inside. I’m inside my own head, I know it doesn’t work the same as others, and I am more or less at peace with that. Calling myself crazy is a good reminder that this is just a permanent part of my life (in a good way, in the sense that I don’t have to panic every time I start to feel depressed and try to ‘‘fix’’ a thing that is a part of me) and also that in any given moment I might not have the most rational view of things - may in fact be viewing things through a negatively distorted lens. It helps me. I’m not really ashamed of it.
What I’ve learned to do is basically not have relationships with people who refuse to get it. My closest friends are all crazy like me. I can text my buddy and say, ‘‘I feel like shooting myself in the head today’’ and he’ll be like, ‘‘yeah, me too’’ and honestly the rest of society can just fuck right off. If I’ve learned one thing in the last year it’s that people are going to judge you for stupid bullshit no matter what, so they might as well judge you for who you are vs. who they imagine you to be.
I’ve always talked openly about my depression in the interest of fighting stigma, and then in March 2016 I was diagnosed with epilepsy. I talked about that and got a lot of sympathy, but the truth is what makes it particularly hard to deal with epilepsy is the medication complications with my depression. I became acutely suicidal following my seizures. So I started talking openly about that. One ‘‘concerned relative’’ of my husband sent an email to my father in law telling him he’s concerned I’m posting about having depression on Facebook because he thinks I could lose my job if they find out I’m depressed. This is so fucking stupid I don’t even know where to begin. I made a choice to work for an organization that is aligned with my values, that devotes a huge amount of its resources to treating mental health and the aftermath of trauma, whose CEO celebrates the life of her nephew who suicided every year with random acts of kindness… I’m not going to lose my fucking job for talking openly about depression in a Friends Only Facebook post.
Fuck him. I unfriended him. I don’t give a shit any more. You either get me or you don’t. You’re either with me and my crazy-ass friends or you’re not. If you’re not, just stay the fuck out of my way. I don’t need everybody to like me anymore. This has been a crazy-ass difficult year for a lot of reasons but the one beautiful thing epilepsy gave me was truly not giving a shit what people I barely know think about me. If you can truly judge the value of a person by the company she keeps, I’m Gold Fucking Star, because the people in my life are awesome, fun, interesting, intelligent, beautiful, useful, compassionate, fascinating people that I love with my whole heart.
Let your freak flag fly, love your brothers and sisters, Mad Pride!
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There are tremendous incentives for someone to wish to be diagnosed as having a depressive/anxiety/personality/etc disorder, rather than simply being a fuckup or an asshole.
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Yes, such glorious incentives as people assuming you are secretly a fuckup or an asshole and not actually mentally ill. Thank you for underscoring my point.
I think it is tiered. The public do not respond well to any mental illness, however I’d say they respond best to depression & anxiety. That is because most people can relate to these feelings. However people do not really understand the difference between regular anxiety and a severe panic disorder. Someone once said having panic disorder is like if someone chained you up, locked you in a refrigerator and threw you in a lake and now you have to pretend everything is fine and normal as the water starts seeping in.
Beyond that, then you have disorders like schizophrenia, bipolar, etc. The public are less understanding of those IMO, but they still have some empathy. However for the most part people react with fear.
Beyond that, illnesses that people associate with weak character get it worst. BPD, NPD, etc. Granted, I do not want those people in my life either, but they are mental disorders that are due to a mix of genetics and traumatic upbringing.
Anyway, what can be done? I do not know. I used to speak out about my history of mental illness, but decided to quit doing that. I just don’t like people enough to talk to them about those things, and I’m tired of being judged.
It reminds me of a Calvin & Hobbes cartoon after Calvin gets beat up by a bully.
That is where I’m at. My mental health journey is not a proud one. I grew up in a very dumb part of the country where people dealt with mental illness by ignoring it and being afraid of it (and telling the cops to attack anyone who acted mentally ill). When you are mentally ill people feel sorry for you, or laugh at you, or attack you. But rarely do they help you.
Empathy is something increasingly more lacking in today’s society but I don’t think people should get passes for being unfeeling assholes. I feel general empathy for people who suffer differently than i do in many ways. I can’t even begin to fathom what it’s like to lose a child, but that doesn’t stop me from caring about what people go through when they do. I had a friend lose her husband to cancer, an experience I again cannot fathom, but I listened and learned from her experience a lot about what the grief process is like. With mental illness specifically, my uncle’s schizophrenia and the way society treated him is what made me so determined to speak out about my own issues. Having seizures made me think critically about other neurological disorders and I now have more empathy for people who have suffered strokes or other brain disturbances.
Empathy is in many cases a choice. It comes more naturally to some people than others, but at some point people have to take responsibility for refusing to put themselves in the place of another. Some people have a bad experience and take the ‘‘nobody should ever complain about anything because they’ve never had it as bad as me’’ route, and others have a bad experience and think, ‘‘Jeez, now i have a tiny bit more insight into this thing I never considered before and have a greater sense of gratitude and awareness.’’ The world is better if we strive to be the latter sort of person.
I don’t disagree that people could, and should be more empathetic in general. But I do want to clarify my point.
I am taking a strict view of empathy–one where it’s impossible for one person to empathize with another unless they’ve actually experienced something similar to the other person.
For instance, I have not lost a spouse. But I have lost close family members, and I think what I’ve felt is not so far off from losing a spouse. Maybe not quite to the same magnitude, but it is at least the same kind of feeling. And so I believe I can genuinely empathize with people who have lost a spouse.
But I have never been depressed. I’ve been sad and unmotivated, but these feelings are not a good approximation for being depressed. It’s not just a different magnitude, but an entirely different direction. So no matter how hard I try, it’s just not possible for me to genuinely empathize with the depressed.
I can sympathize, sure. I can offer what help I can as a friend or otherwise. And I can go with the attitude that it’s a disease, not a moral failing. But I can’t feel what the other person feels, because my brain just doesn’t work that way. And neither can anyone else that’s not depressed.
In a way, it’s the empathy itself that’s the problem–the fact that it’s a generally reliable tool in human interaction. We want to know how to treat another person, so we try to imagine ourselves in their shoes. It usually works reasonably well. But it fails here because we can’t imagine ourselves in the other person’s shoes. We have to go to other sources like scientific publications.
This is actually a pretty profound question. My mother has Borderline Personality Disorder, you may have seen my posts in the past advocating compassion for people with Borderline Personality Disorder and trying to correct the misconception that it can’t be effectively treated. I staunchly believe discrimination against people with this disorder is a serious problem both in and out of the mental health field.
That said, I ended my relationship with my mother this summer. I finally accepted no amount of compassion I had toward her could change the fact that she is abusive.
So the answer is both. People don’t get a pass for hurting other people but that doesn’t mean I don’t have compassion for them. No amount of empathy I have for her can change the fact that she is so mentally ill, it hurts me. I wish love was enough, I really do. But it’s not.
That’s actually a pretty interesting perspective. And I realize I can’t effectively evaluate it because I’ve lived in and around mental illness my whole life. What I have a hard time understanding is how people aren’t mentally ill. Like it’s clear to me that people suffer in life regardless of whether they have a mental illness, whether that be due to loss or pain or just the general stress of life. But I don’t understand the nature of that suffering or how it differs from my own. The closest I ever got was a two year period I spent almost totally free of depression, and man, it was fucking bliss. I felt like I could do anything. I experienced pain and stress like a normal person but that’s all it was, pure pain and stress. When I was sad, I would cry, and that was it.
Sometimes at my very healthiest I can tease apart the difference between a normal, healthy emotion and disordered thinking, but I am unable to just purely feel pain without my mental illness somehow getting involved, I think. For example, when I had a miscarriage in 2014, i had a few weeks of what was probably normal, healthy grief, where I cried a lot, and felt sad, and then I plunged into a year-long depression where I didn’t work or care about anything. I’ve been depressed before, but it’s usually an unpleasant experience – this was the sheer fucking bliss of not caring about a damned thing. It was like living in a magical bubble, watching my life fall apart and being totally okay with that. I lost $30,000 in savings due to unemployment and it nearly destroyed my marriage. When I finally ‘‘snapped out of it’’ (read: went back on medication) my life was in shambles and I suddenly cared, which then plunged me into a months-long bout of suicidal ideation as I fixated on all my failures, and the only thing that really got me out of that was my husband screaming at me that not killing myself was not a sufficient contribution to our marriage. Only after getting a job and piecing my life together was I finally able to get to a place where I could grieve. And after all that nightmare the grieving part is comparatively easy.
That would be people who have themselves been to counseling (same as with people who choose to go to doctors when ill). People who work with the public as a career. Teachers, counselors, policemen, salespeople, managers/supervisors, parents of many kids, etc.
People who are NOT mentally healthy are those who refuse to go to counseling.
So find some new people to hang around with! And if you are hanging around with someone who says something negative, you don’t have to stand there and listen to it! Simply walk away, hang up the phone, whatever. If they can say positive things, then chat all day with them.
I go to counseling and would not consider myself mentally healthy at this time.
I agree a lot of people make it worse by refusing to get help.
It’s just, some of us spend our entire lives actively working on managing our illness and trying to mitigate the damage and learn new skills, and all of that can help, but it never goes away completely. Perfect mental health is not a thing for me. It’s like managing diabetes or - well, or epilepsy. It’s a part of life.
(You sound like you are doing the right things to me - someone I would prefer to hang around with - as opposed to someone who has problems and refuses to seek help.)