# The mental illness closet. **URL:** \ **Category:** In My Humble Opinion\ **Created:** [February 17, 2005, 11:34am UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511 "2005-02-17T11:34:53Z")\ **Posts on this page:** 7\ **Page:** 4
**Author:** ![AHunter3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ahunter3/32/368_2.png) [@AHunter3](https://boards.straightdope.com/u/AHunter3)\ **Post date:** [February 21, 2005, 10:34pm UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/61 "2005-02-21T22:34:24Z")
> [@](#): > > With HMOs these days, we can barely get the most suicidal person inpatient for more than 72 hours, unfortunately. In order to be committed for a three day hold, you need to be imminently dangerous to yourself and others… [Bullshit](http://www.ect.org/thomasupdate.html). If, in the opinion of a psychiatrist (which doesn’t need laboratory confirmation, at any time, ever), you are “mentally ill” and a danger to yourself or others, you can be held, and for considerably more than 72 hours. Retention hearings give us (the patients) the theoretical opportunity to testify that we aren’t dangerous and do not need involuntary treatment but obtaining release [is not exactly a slam-dunk](http://intotem.buffnet.net/mhw/v1i5_01.html). Y’know, I understand about not wanting the stigma of being thought “lazy” or “immoral”, or “you know, you could just ‘cope with stuff’ like others do”, etc., but not all of us think it’s this great social improvement to have everyone running around parroting the line about how we now know it’s biochemical, a medical illness, and that with the wonderful efficacious treatment available courtesy of the psychiatric professionals and the pharmaceutical industry that they’re in bed with, life is wonderful. It may or may not be, or may in part be, biochemical or otherwise in some sense a medical illness, but the state of psych research is still sufficiently deplorable that it shouldn’t be claimed as fact. The treatments do seem to help some people but other people find them horrible and far more debilitating than the conditions they are designed to treat. And in a world where forced treatment is still very much a reality, and where people with psychiatric diagnoses who don’t like recommended psych treatements are thought to be too delusional to realize how badly we need those very treatments, I find it important and necessary to keep reminding folks that it’s still a fucking snake pit. They’ve just got better anteroom furniture at the pit opening. ---
**Author:** ![Zoe](https://avatars.discourse-cdn.com/v4/letter/z/a4c791/32.png) [@Zoe](https://boards.straightdope.com/u/Zoe)\ **Post date:** [February 22, 2005, 2:35am UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/62 "2005-02-22T02:35:26Z")
I understand people wanting to remain quiet about their personal lives. And I have been treated sometimes with kindness and sometimes with absolute cruelty by the people I worked for in the school system when I continued to have trouble with depression. The problem that strikes me is that when intelligent, productive people remain quiet about their mental health issues, how will we ever educate the public? ---
**Author:** ![Cat\_Whisperer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cat_whisperer/32/4839_2.png) [@Cat\_Whisperer](https://boards.straightdope.com/u/Cat_Whisperer)\ **Post date:** [February 22, 2005, 4:48am UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/63 "2005-02-22T04:48:51Z")
> [@Q.N. Jones](#): > > Here’s the thing: facing your anxiety doesn’t eliminate it for every anxiety disorder sufferer. > > My mom has GAD. She’s worked on it in therapy and has tried very hard to apply what she’s learned to everyday life. She is now very good about identifying situations where her anxiety will crop up. She can do the self-talk that will rein in her anxiety enough for her to function. But it hasn’t gone away. When in an anxiety-provoking situation, she feels like she’s just barely hanging on to control. And sometimes, no matter how hard she tries, the anxiety still gets the better of herShe’s reached a point where there’s nothing more for her to try, cognitively and behaviorally. I believe she’s trying her hardest. There is a strong history of mental illness, including anxiety disorders, in her family. Where does that leave her in your scheme?. There are people in my self-help group that have been coming for years, and reach about 75% better, and plateau there. I am by no means a therapist; I don’t know why some people completely leave anxiety behind, and some don’t. > [@](#): > > Additionally, for some people, confronting their depression and using CBT is enough to get them to recovery. Is depression also not a mental illness, then? The most recent school of thought on anxiety and depression says that anxiety and depression are two sides of the same coin. What works for anxiety very often works for depression, too. > [@](#): > > I adhere to the diathesis-stress model of mental illness. For some people, there is little diathesis (biological predisposition) for depression or anxiety. CBT or “strength of will” will often be enough to get them to recovery. Others have a larger diathesis for anxiety or depression. These people will probably not be able to recover with CBT and “self-will” alone. Medication often helps, but some people will continue to suffer despite all efforts. Like I said before, I don’t know why some people recover completely and some don’t. A biological explanation makes sense here. My problem is with only treating anxiety and depression with drugs for the rest of the patients’ life, and never even mentioning CBT, which is my story. > [@](#): > > Furthermore, there is at least one poster here at the SDMB who treats her bipolar disorder with CBT alone (no meds). She will tell you that CBT has even eliminated symptoms (like cycling). Does that mean bipolar disorder is not a “real mental illness”? > > I think your idea for reshaping the definition of “mental illness” leads to a big ol’ mess. Here’s a radical thought: mental illness means simply a disorder of the mind (emotion or thought). It doesn’t mean that the disorder is biologically based; it just means that the disorder leads to substantial impairment in your daily life. Causes and treatments may vary. This is pretty much the current standard definition of “mental illness,” and I think it works well. I would not argue with your definition of mental illness. I would like it if all less-than-optimal brain/emotional functioning was treated with compassion and respect, regardless of cause or treatment. ---
**Author:** ![roger\_thornhill](https://avatars.discourse-cdn.com/v4/letter/r/d9b06d/32.png) [@roger\_thornhill](https://boards.straightdope.com/u/roger_thornhill)\ **Post date:** [February 22, 2005, 4:51am UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/64 "2005-02-22T04:51:22Z")
> [@Zoe](#): > > The problem that strikes me is that when intelligent, productive people remain quiet about their mental health issues, how will we ever educate the public? A good question. But first I have a quibble about the use of the word ‘educate’\*. Not only does the word itself have a rather patronising air about it, but I think it raises a couple of other questions. First, do the public need educating inasmuch that the public comprises many people (perhaps a majority) who suffer at times from mental illnesses? Is it not perhaps the case that the public are just like us inasmuch that they both suffer and _also_ feel equivocal about discussing it openly? Second, is it not the case that for many people the knowledge they need is already within them, lying as it were dormant? Now, in the sense that education means drawing out of people what they already in some nascent form held, then I would probably accept that the public need educating. And we’re all members of that public - it’s more than a truism to say that there should be no ‘us and them’ attitude regarding the human pysche, the human brain. One of my major misgivings, as someone who suffers from depression, is the way in which the illness is being presented. There seems to have been a pendulum swing from the old days of “he can snap out of it if he really wants to” to what I consider some of the babble that is served up these days. One harmful side-effect of the “scientificisation” of mental illness is that it alienates a lot of the public. Given the PC age in which we live, their true feelings - and indeed any real questions they might have about mental illness - are in danger of being driven underground. Thus, exactly what we don’t want is likely to happen. At the same time, on _Oprah_ or whatever a kind of glorified, fake mental illness will become sexy, and no doubt it will be fashionable to wear ribbons or bracelets for a while until the fad goes away. Of course, the cause of the mentally ill will be advanced not a whit through this process. It would indeed be nice if advocacy of mental health was in the hands of intelligent and productive people. But that phrase too is problematic to me. I’m reasonably intelligent, but I’m never productive when I am depressed. Not in a way that I would call productive, anyway. My productivity kicks in as a result of the depression lifting. Now if this happened to be the case for others, then someone who speaks out when they are in a state of depression is indeed taking a very big risk. If (s)he speaks out when (s)he’s no longer depressed, then the validity of the whole exercise is put in some jeopardy. When I’m not depressed, I’m not some kind of super-caring individual, I just get on and live. Of course, the experience and understanding of others may be very different from mine. Some people, especially manics, appear to be able to do pretty well while on medication, while for me medication is pretty useless. My situation is black and white, either in or out, down or up - whatever. Anyway, I just throw this out. Of all the subjects in the entire world, I probably have more first-hand experience of depression than of anything else. And yet I have virtually no answers. Just coping mechanisms and the desire one day to be whole. - In what follows I won’t use much hedging or tentative language (and will eschew my normal habit of peppering my contributions with lots of brackets - and dashes!). So, I may sound more blunt than really reflects reality, and I may sound as if I am misunderstanding you, or deeming you simplistic and patronising, when that’s neither the case nor the intention. ---
**Author:** ![Q.N.Jones](https://avatars.discourse-cdn.com/v4/letter/q/3da27b/32.png) [@Q.N.Jones](https://boards.straightdope.com/u/Q.N.Jones)\ **Post date:** [February 22, 2005, 10:11am UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/65 "2005-02-22T10:11:01Z")
> [@roger thornhill](#): > > A good question. But first I have a quibble about the use of the word ‘educate’\*. Not only does the word itself have a rather patronising air about it, but I think it raises a couple of other questions. First, do the public need educating inasmuch that the public comprises many people (perhaps a majority) who suffer at times from mental illnesses? Even people who suffer from mental illnesses can be relatively ignorant about them, or have unfair prejudices about the mentally ill. I know that when I think of “educating,” I mean that I think we need to (somewhat gently) diffuse into our culture a few ideas. First, that mental illness is a legitimate medical condition (using the “medical” term rather loosely). Second, that almost anyone can become depressed or have anxiety given the right circumstances, so that people who have these problems recognize that yeah, that could be what’s wrong with them. Third, that most people with mental illnesses are functional and contributing members of our society, and are not necessarily incompetent. How to do that? I’m not sure, really. One idea is that general practitioners need _much_ better training about what depression and anxiety look like, and should be discouraged from simply prescribing a pill. That practice just encourages people to ignore the seriousness of those conditions, and pushes meds on people who often would do better with a few sessions of CBT. Another idea is that I’d like to see at least one character on a TV show who was mentally ill and yet a contributing member of society. On ER, for example, we see schizophrenics running around killing people and bipolar people refusing to take their meds and consequently traumatizing their kids. Just once, I’d like to see a character who is, say, bipolar, but manages their condition well and is still competent. We see portrayals of alcoholics who do this–Captain Cragen on “L&O: SVU” comes to mind. Stuff like that would go a long way toward getting the idea into peoples’ heads that “mental illness” /= irredeemably crazy. > [@](#): > > Is it not perhaps the case that the public are just like us inasmuch that they both suffer and _also_ feel equivocal about discussing it openly? Second, is it not the case that for many people the knowledge they need is already within them, lying as it were dormant? Now, in the sense that education means drawing out of people what they already in some nascent form held, then I would probably accept that the public need educating. That’s pretty much my goal. Studies show that refusing to talk about the stuff that makes you depressed and anxious makes the condition worse, not better. Hey, that’s a fourth idea I think people really ought to know. > [@](#): > > One of my major misgivings, as someone who suffers from depression, is the way in which the illness is being presented. There seems to have been a pendulum swing from the old days of “he can snap out of it if he really wants to” to what I consider some of the babble that is served up these days. One harmful side-effect of the “scientificisation” of mental illness is that it alienates a lot of the public. I hate seeing people claim that we “know” depression is caused by a biochemical imbalance in the brain. _We do not know that._ But I see that kind of distortion and “babble” outside the psychological professions. I don’t know any practitioners who say they “know” the cause of mental illness. Almost all of them admit that they don’t, and that psychiatry is largely an art, not a science, when it comes to figuring out the right treatments. > [@](#): > > If (s)he speaks out when (s)he’s no longer depressed, then the validity of the whole exercise is put in some jeopardy. Why is it less valid to have a recovered person talking about depression? In fact, hearing from recovered people often gives hope to those of us who haven’t gotten there yet (myself included). > [@](#): > > Some people, especially manics, appear to be able to do pretty well while on medication, while for me medication is pretty useless. This is kind of rolled into my point about training GPs, but research shows that talk therapy works as well as medication in people with mild to moderate depression. It often only takes 6-8 sessions in CBT. The idea that medication is salvation, and that talk therapy is a waste of time in which the therapist will accuse you of being a latent homosexual who hates his mother, is really entrenched in our society. That picture is really distorted. ---
**Author:** ![Cat\_Whisperer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cat_whisperer/32/4839_2.png) [@Cat\_Whisperer](https://boards.straightdope.com/u/Cat_Whisperer)\ **Post date:** [February 22, 2005, 4:13pm UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/66 "2005-02-22T16:13:20Z")
I agree completely, **Q. N.**. I would love to see anxiety and depression as well as any other mental condition portrayed accurately in the media, rather than played for laughs or exaggerated. They’ll probably stop stereotyping “mental” people the same time they stop stereotyping fat people. :rolleyes: ---
**Author:** ![Prancer](https://avatars.discourse-cdn.com/v4/letter/p/8dc957/32.png) [@Prancer](https://boards.straightdope.com/u/Prancer)\ **Post date:** [February 22, 2005, 11:46pm UTC](https://boards.straightdope.com/t/the-mental-illness-closet/290511/67 "2005-02-22T23:46:07Z")
I agree with the call for more accurate depictions of people with mental illness in the media. The friends and family I’ve shared my bipolar II diagnosis with have all been surprised, mostly because it’s not commonly known that there are three different types of bipolar disease. The only one most people are familiar with is biplar I. That type includes mania and sometimes psychosis. And even then, media depictions of this disease are usually limited to people who refuse or are not able to take the appropriate meds. Plenty of people who have bipolar I, and those with either bipolar II or cyclothymia, function quite well in society for the majority of their lives. Also, I guess a Law & Order episode about a person functioning in society with a controlled mental illness wouldn’t grab too many ratings points. [Previous page](https://boards.straightdope.com/t/the-mental-illness-closet/290511.md?page=3)