The mental illness closet.

In My Humble Opinion
41

Yes, thanks. I didn’t mean to accuse you of anything; I was mostly concerned that there was some avenue for finding those things out that I hadn’t considered.

I know how hard it can be to find employment after a long break in work history. Not from personal experience, but I remember what my mom went through when she tried to go back to work after 20 years as a stay-at-home mom. It was brutal. Take heart–the right job may eventually come along. She’s now an assistant professor at a university. It took her 5 years of rejections to get there, though.

I think breaks in work history matter more in some fields than others. Also, I wouldn’t exactly call freelancing to be “not working.” Do people in your field see it that way? If so, I’m stunned (but not especially surprised) by the narrow-mindedness.

Oh, heck, these groups overlap. My mom fits into both.

And there are more of them, too.

The third group is a bunch of people who believe too much in the miracle of modern chemistry. They believe all you have to do is pop a pill, and then you’ll be better. If you’re not, you’re malingering. (Truth is, many people with the more serious forms of mental illnesses will never find a med that makes them “all better.”) I’ve actually found these people to be just as bad as the others. This group includes my dad and my former bosses.

Stay in the closet at work as long as you possibly can. I eventually had to come out because I wound up disabled from doing my job at all. But if the intrusion on your work is relatively minor, all you have to do is be non-specific about the medical conditions that necessitate time off for sick days and doctor’s visits.

42

This seems a little bit like your trying to apply your own selective prejudice to the prejudice your subjected to, it hearkens to that whole “field slave”/ “house slave” thing within the black culture.
Don’t misunderstand me, I’m not judging. I’ve done the same thing. It just sucks that people with mental illnesses have to do this kind of “social reasoning”.

43

While I can understand this viewpoint, it concerns me that this is an attempt to “ghettoize” certain mental illnesses, and to claim that some others aren’t “legitimate” medical problems.

My mom has GAD. Her mom had GAD. I have a friend with OCD who’s dad has OCD. Is there a biological component to anxiety disorders? The jury’s still out, but the educated guess of the experts is “yes,” there is a biological component. So why is it not a “real” mental illness?

The truth about almost every “mental illness”–be it schizophrenia, depression, anxiety disorders–is that research indicates that both biological and environmental influences combined cause the disorder.

So why draw the line? I suspect it’s only because people with anxiety disorders and depression don’t want to be lumped in with the “real crazies who can’t function,” like bipolar disorder and schizophrenia. As a person with bipolar disorder, I find that really offensive. This attitude marginalizes people with those “real mental illnesses” by suggesting that they’re “not like regular people,” whereas people who “only” have an anxiety disorder or depression are just folks with everyday problems.

Bingo. I’m going to hope that because you recognize this, you aren’t making the distinction you did above for callous or malevolent reasons.

44

In my personal experiences, and hearing those of others, it’s clearly a matter of ignorance. And stubborness. There are people out there who are trying to educate, and maybe some day they’ll be succesful. But it’s a tough fight when the ignorant just know that people with anxieties are just weak or “choose” not to be better. This is extremely offensive, never mind ignorant. Thanks to bombardment from the media, everyone knows that a “psycho” is some guy who pushes people in front of subways or hits women in the heads with bricks. Of course, there’s a significant difference between a “sociopath” and a “psychopath.” The latter is rarely a danger to others. But these fools, who have told me that doctors make stuff up and that I’m really okay, know better.

On top of all this, thanks to newspaper reports and various studies, we now know, beyond a doubt, that taking Prozac can cause you to probably committ suicide. Doesn’t it all make sense - I mean, some kid is depressed with suicidal tendencies, is prescribed a medication that will take weeks or months to show full effect, if taken properly according to doctor’s orders, takes the regimen for a day or two, doesn’t realize any improvement, stops taking it, continues to suffer, jumps off a building to answer his pain. Yep, it was the Prozac that made him do it.

I too agree with the overwhelming majority of opinions here that you should be careful about disclosing, particularly at work. But coming out of the closet, any closet, is an extremely courageous thing to do. I’ve known many people who have done so and am proud of them. Of course, their coming out was not necessarily in work situations.

I’m glad to have come across this discussion because it’s good to know that I’m not the only one wrestling this very heavy dilemma. I do hope, however, that it gets easier.

45

I’m so glad you posted your experience. I have had to confide in HR for similar reasons in the past. I understand the mixed emotions.

/Ms Cyros

46

I suffer from depression, and have for many years. My psychiatrist diagnoses me with atypical depression, whatever that means. I keep this from everyone except those that I trust implicitly, and even then I am reluctant to share. I learned this from experience. The general perception of depressives is that they are “sad” and “can’t function”. The truth for me is an inability to prioritize. I have always put work first. Even in the midst of my most severe episode, where I was sleeping 18 hours a day, I would work my five hour shift, go home, sleep, get up and go to work. Nonetheless, since my depression is chemical and not situational, people tend to assume that I should just suck it up and get better.

I hate having to hide this side of my life, because I think so many elements of my work ethic are offshoots of this condition. I’m excessively devoted to my employers and I work very hard. I have also worked extremely hard to manage my condition and I am very proactive about preventing a relapse. I think this should be an asset, not a detriment.

47

Yes, the labels are man’s mere efforts to categorise the uncategorisable. The silly thing about this particular label is thay atypical depression is actually more common than typical depression. For what it’s worth:

typical = can’t sleep, don’t want to eat
atypical = sleep a lot, eat a lot

Sorry if I’ve confused you with technical terms. It’s deep stuff is depression.

48

Because unfortunately, there is a stigma attached to mental illness that isn’t attached to the other things you mentioned.

There is a stigma attached to things other than illness, too. A friend of mine made the mistake of telling his bosses and co-workers he was gay; it took them three years to get him out, and they were relentless. He performed his job perfectly, but that didn’t seem to matter. The lawsuit is pending.

49

Ah, yep! I’m atypical alright. Most of my friends say that they have never met someone who can sleep as much as I can. I really thought I was narcoleptic for a while!

Thanks for the clear up.

50

I had started a job at a company that will go unnamed (very large…you would know it if you heard it.). It was a very lucky thing that I got hired in there and I stood to make a very good living.

About a month or so into the job, I started having some symptoms of anxiety and depression. I had to call off a day because of this. I went to my Doctor and he prescribed Prozac.

I had just started taking the meds and I was feeling very strange and having weird tactile hallucinations and feeling very dizzy while working on the line. I went to the company doctor and explained to him what was happening and that I had just gone on Prozac and asked to lie down for a while. I started feeling better after a while and went back to work.

A couple of days later I found myself moved to a different department, this was not unusual in itself as I was rotated from department to department to fill in for other people. Turns out this was the department for all of the other “special cases”. I never left that department, and was informed that I was being let go on the day that my 90 day probationary period was up.

51

I can see what you’re saying (and devilsknew also), and it was not my intent to say one mental illness is worse than another, or “ghettoize” any conditions. In my recent experience with my anxiety flare-up, and voracious research into anxiety disorders, however, I have learned that anxiety disorders basically are not like other mental illnesses. I consider anxiety disorders to be an emotional disorder, not a mental disorder. Someone with schizophrenia cannot think their brain biochemistry imbalance away; someone with anxiety can (i.e.Cognitive Behavioural Therapy). This is my opinion, backed by a lot of research. It is also very controversial. Most doctors don’t agree with this view of anxiety disorders either, but the people in my Freedom From Fear self-help group who consider themselves cured don’t agree with the medical and pharmaceutical communities about this.

Here are some of the books I’ve read, and some websites to visit:

Self-Coaching: How to Heal Anxiety and Depression – Dr. Joseph J. Luciani, Ph.D.
The Power of Self-Coaching – Dr. Joseph J. Luciani, Ph.D.
From Panic to Power - Lucinda Bassett
The Feeling Good Handbook – Dr. David D. Burns, M.D.
Anxiety and Phobia Workbook – Edmund J. Bourne
Coping with Anxiety: Ten Simple Ways to Relieve Anxiety, Fear, and Worry -
Edmund J. Bourne, Lorna Garano
Power over Panic - Bronwyn Fox
Hope and Help for Your Nerves - Dr. Claire Weeks
Most of these authors also have websites that you can visit:
www.stresscenter.com - Lucinda’s site
www.panicattacks.com.au - Bronwyn’s site
www.self-coaching.net - Dr. Luciani’s site

52

http://www.usdoj.gov/crt/ada/adahom1.htm

This is a good starting point for people with any type of disability. I had to put my specific requests and accomodations in writing - since my company is so small they weren’t required to comply because it could affect them financially, but so far (almost 3 years) I have only had one minor incident that might be deemed as harrassment, and it was well documented by me and my supervisor. I was on full scale disability for a few years awhile back, and it sucked (IMHO). But getting on the right meds has allowed me to work two jobs now for several years. And yes, even in my field of work (nursing), there are idiots who make the “suck it up” comments. I think people are really really scared that mental illness shows up in everyone’s family, eventually. I’m a lot less paranoid than the GUMs (great undiagnosed masses)! Best of luck to you and welcome to others who have been lurking until now.

53

Somehow I missed your post the first time through.

I’m bipolar, and eventually had to do what you’re doing now–go to HR and explain the situation. I’ve been out of work on disability for a year now. Fortunately, I have very good insurance.

Going to HR is a mixed bag. On one hand, if you aren’t performing up to snuff at your job, it’s probably better to go claim your disability benefits so your performance doesn’t get blamed on simple laziness. If you only tell HR, they’re supposed to keep that information confidential. On the other hand, disappearing from work is going to be an obvious signal, and if news gets out, some employers will be in a hurry to get rid of you.

I’m bipolar I, but was misdiagnosed for a long time as having major depressive disorder. The meds they gave me made me really unstable and it became obvious at work. Now that I’m on mood stabilizers, things are getting better…slowly.

I’m considering starting a bipolar support group for people from the SDMB. Keep an eye out!

54

Can you explain this distinction further?

My problem with this is that depression, bipolar disorder, etc. are called “affective disorders” or “mood disorders.” And, most of the time, these people are not psychotic. Where do they fall in your scheme?

Are you saying that anxiety disorders are akin to personality disorders? Personality disorders are often described as being “maladaptive coping mechanisms” that are very extreme and go beyond the situation the person originally attempted to cope with. Personality disorders are not “mental illnesses”–they fall on Axis II in the DSM scheme, not Axis I with the mental illnesses. Do you think anxiety disorders belong on Axis II?

I think there’s something to what you’re saying, but my research indicates that most scientists believe there is a biological component to anxiety disorders. I’m sure you’ve seen that information–what do you make of it?

55

There is a total stigma against mental illness of all types. I’ve been on both sides of the issue, both as a therapist and as a client. I personally don’t use that term to describe myself or the people I treat. It’s a loaded and judemental term.

I’m not going to give a complete background to my story, as it’s private and not appropriate in this forum. But I will “come out” and say I have had struggles with the following:

  • dissociative issues
  • major depression, recurrent
  • PTSD (totally treatment resistant, I went through everything from meds to CBT to experimental therapy. Luckily it is now 90% better. :slight_smile: )
  • OCD
  • Postpartum depression & postpartum OCD (the most terrifying thing I have ever gone through)

The clients I treat tend to be those with trauma issues, particularly rape/sexual assualt. I’ve also focused on personality disorders (borderline and the like), bipolar, and schizophrenics. However, I’ve seen everything from spider phobia to drug addiction to anxiety disorders at the low-fee clinics I did my training in.

I applaud the people who can say, “I lived through this, and I’m a fabulous member of society.” I think the media, fear, shame, and stereotypes combine to make people afraid to talk about what they’ve been through and resistant to getting help. I think movies also play a big role here in keeping people afraid (I actually ran a study on this and got some interesting results).

The two biggest myths I’d like to bust are:
a)** schizophrenia=multiple personalities**. No no no no. Schiz. is german for “split mind” which in this context means a person having a psychotic break where they hear voices, have delusions, etc. They “split” from their normal well state. It is a bad translation problem. Schiz. is caused by a combination of chemical and physiological changes in the brain. It has nothing to do with parenting or upbringing or anything like that. Multiple personality dx (now called dissociative identity disorder) is a reaction to severe trauma in early life. It happens usually before age 5, and absolutely before age 7. After that the ego is too formed to allow such sectioning off. Basically the person cannot possibly withstand the abuse any longer and so they section off parts of themselves to survive. They literally do not recognize all of their psyche as belonging to themselves. However, it still does. DID is treated through therapy, not meds. It has an excellent prognosis, whereas schiz. tends to be a lifelong disorder of the brain.

and

b) Shrinks can and will lock you away forever. 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. Thinking about suicide doesn’t cut it. Getting high doesn’t cut it (although we will recommend rehab). Having weird thoughts about your poodle doesn’t cut it. Hearing voices rarely cuts it. We need to be convinced you will do someone in within the next day or so for us to be able to commit you, and then only for 72 hours. There are some extreme exceptions, such as Hinkley, but he tried to shoot the president. For that type of commitment you need a judge’s order, and that takes some pretty extreme behavior (like shooting the president). You’d know if you were at that stage because there would be lawyers involved. It doesn’t just happen after 1 visit to your local therapist.

A lot of people don’t seek help because they are afraid of option b. And that’s really sad.

I will cease my ranting now. Blame Mr. 2 Buck Chuck. :smiley:

56

It’s difficult to find an absence of stigmatizing beliefs even in mental health professionals. Over the years I have thought that this is in part, perhaps no small part, due to the fact that we have intimate relationships with what we call “mind,” much more so than those parts of us, say, that we call “arm” or “leg” or “adrenal gland.” As a result, doubt continuously creeps in that something we have such intimate contact with should respond to our wishes. That doubt needs frequent realignment for mental health care professionals wishing to remain compassionate in their work.

I am fortunate to work with a group of individuals who are expert at realigning one another, through long recognition and habit. I too have been on “both sides of the desk,” and cannot honestly say that my peers communicated stigmatizing notions at the time, or since.

There is nothing that brings a personal sense of bounty more than assisting the truly needy, and this is also true of those who are needy of mental health care. As the old saw goes, how we deal with the most troubled among us is a measure of who we are as a society.

57

Originally Posted by featherlou
I consider anxiety disorders to be an emotional disorder, not a mental disorder.

Describing anxiety disorder as maladaptive coping mechanisms is pretty accurate, in my opinion. People with anxiety scare themselves and are afraid of their own emotions and thoughts, and lack confidence in their natural ability to handle life. I don’t know if I would put anxiety disorders on Axis 2 with personality disorders, however - they certainly fit some of the criteria, but I wouldn’t call them “very resistant to change.” The DSM-IV has anxiety disorders grouped together as their own category, it appears - that may be the best interpretation of them.

Scientists and doctors believe that people with anxiety disorders are lacking in serotonin, a neurotransmitter I’m sure you’ve heard of, but they don’t take it any further into why you have low serotonin levels. The CBT school of thought believes that you get low serotonin levels from constantly scaring yourself and thinking negative thoughts. There has been scientific research done that indicates that positive thinking activates the same areas of the brain that serotonin affects. Supplementing your serotonin levels with SSRIs certainly works; decreasing your scary, negative thoughts and increasing your confidence in yourself and thinking healthy, realistic, positive thoughts also works (this is where CBT comes in) and gives you coping skills for life.

For me personally, I’ve been working with CBT, a self-help group and bibliotherapy for the last nine months after my anxiety flared up again (I had been on medication for anxiety for 13 years prior to that). I have learned that I can cause myself anxiety with just a thought, and I can also calm myself with other thoughts. I’ve also learned that when you stand up to your anxiety and don’t run from it or fight it, it just disappears. That’s why I don’t like to refer to anxiety disorders as a mental illness; illnesses don’t disappear when you stand up to them and look them in the eye.

58

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 her.

She’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?

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?

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.

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.

59

We don’t really know why neurotransmitters associated with other illnesses are “off,” either.

Schizophrenia is associated with too much dopamine in the brain, but we don’t know why that happens.

Depression is associated with low serotonin and norepinephrine levels…but we don’t know what makes that happen.

Bipolar disorder is associated with “off-kilter” levels of serotonin, dopamine, norepinephrine, and GABA, but we don’t know what causes that, either.

There’s a “chicken or the egg?” problem with all of these mental disorders. It’s not unique to anxiety disorders.

60

Um…does masturbation release dopamine into the brain of a 12-30+ year old? ‘Cause, y’know…I’m just askin’ that’s all. :rolleyes: