Friday, December 27, 2013

You Can Get Better

You can get better.

Some of you may look at such a statement with skepticism. At various points in my life I would have done the same. It's a curious and paradoxical aspect of mental illness, and depression especially, where countless people all think they are alone. At times, we consider ourselves the exception to such positive statements; this applies to other people, it doesn't apply to me, this person doesn't know me.

And I don't know you. I don't know most people in the world. But I do know and have known quite a few people who struggle with mental illness. Their struggles are unique to them, but at the same time there is not as much difference between us as one might think. We fight with pain and self-doubt every day, often to an overwhelming extent. We may struggle to find treatments, or find existing treatments ineffective. Our families may not be sympathetic towards our issues. And all of us live in a world which does not understand us.

But these are all things that can be changed.

Our treatments can improve. Treatment is a trial-and-error process, where we often have to go through many things which don't work before we find what does. Medications vary from person to person, and the effects of any medication cannot be predicted until it is tried. Therapies and therapists also vary from person to person, and there are indeed some therapists who don't work for anyone. We just have to keep searching for one who does.

Our families can better understand us. This often seems like the hardest thing, for we fear that our family members are set in their ways. But they have as much capacity to change as we do. They see us struggle, and they want to better help us, and they are open to learning how they can do that. Of course, some of us have family members who do not want to help us, or who refuse to change.  In those cases, we still have the capacity to protect ourselves from being hurt by them, whether that means tuning out the harmful things they say or keeping enough distance from them that they can no longer hurt us.

And the world can always be bettered. We live in a world that understands mental illness better than at any point in history, and though it is far from perfect, it is getting better every day. We live in a world of unprecedented interconnection, minority voices are more empowered than they have ever been, and the voices of the mentally ill are among them. The mentally ill are becoming more accepted in society, and though it may be slow, and though it may not always be a perfect upward trend, the trend is there.

And it is getting better in large part because of the efforts of dedicated groups of professionals and volunteers, such as the those in the National Alliance For Mental Illness. Some of them may have friends and family who are mentally ill, some may be mentally ill themselves, and some may simply want to contribute. These are good people, working to help us get better. I know some of them, and I know how much they're invested in it.

And their efforts are aided by each of us who chooses to share our mental illness to the world. Indeed, that may even be the most effective of all. It is through the sharing of our experiences, by showing those of us who struggle to be just as human and just as deserving of respect as others, that the harmful and ignorant stereotypes are mitigated, and they are replaced with an understanding of us not as abnormal, but as simply struggling, as all people struggle.

But whether through groups or individual voices, there is one factor, one core foundation, which is ultimately the prime driving force of all that we do, and that is hope. Hope that we can get better, that the world can get better. Hope that our actions carry significance and meaning, even if it does not always seem like they can. Hope that despite the struggles and setbacks of the world, we can still persevere and live a worthwhile life, or find a life worthwhile to live.

And it may not always seem like we are hoping. It may not always seem like we are even able to hope. But we are. Our very lives are a statement of that. Every moment that we maintain our presence on this earth is an active affirmation of hope. As we live, we live in hope. Every breath contains hope within it. For those of us who have contemplated suicide, we especially know that we are not here out of force of habit. We are here out of a conscious decision to to live, and that decision is the purest expression of hope there is.

It is not always easy. Often it is very far from easy. It is often painful, and grueling, and disheartening. But we continue, because we hope that there is that betterness for us, waiting just around the corner.

And it is there.

You can get better.

Monday, December 23, 2013

"I Am A freak": The Sixth Sense And Why Hollywood Can't Portray The Mentally Ill Right

For those who somehow don't know, The Sixth Sense, directed by M. Night Shymalan, is one of the most famous thrillers of the modern era. Hailed for its performances and its now widely-known twist ending, people very often forget to discuss the opening of the film, and next to no one discusses what it implies about the mentally ill.

For those who need a refresher, the opening is below. The sequence I will be discussing occurs between 2:42 and  10:00 in the video.

The film begins with the doctor, played by Bruce Willis, and his wife celebrating his winning of what I shall so blithely call the "Best Psychiatrist Award". After a few monologues and celebratory activities around his winning the Best Psychiatrist Award, we learn there was a time he was not the Best Psychiatrist, when a former patient of his breaks into the house and confronts him wearing only his underwear and carrying a gun.

"I am a freak" the man says. Throughout the scene the man is crying and prone to sudden fits of shouting and violent outbursts. "You failed me!" the patient shouts at Bruce Willis, accusing him of treating him incorrectly, and that the incorrect treatment resulted in him becoming the tormented, violent person he is today. Despite Bruce Willis's attempts to reason with him, the man shoots Bruce Willis and then himself.

Now later in the film, we learn this former patient may not have been mentally ill, but may in fact have been seeing real ghosts. However, when the film starts, we don't know that. What we do know is that there a frightening nearly-naked man in Bruce Willis's bathroom with a gun, who was a former patient of Bruce Willis, and accuses Bruce Willis of "failing him." The person we see in those first few minutes we believe to be mentally ill.

It is films like this which are part of the reason why the mentally ill are feared today.

Hollywood is not a medium for subtlety. Forced to keep its films around a two-hour run time, filmmakers have to work to keep the content of the film conveyed clearly and concisely, which means it often has to convey that content in the most explicit and explosive manner possible. To establish Bruce Willis's haunted* past, the film resorts to having a violent and mentally ill former patient say Bruce Willis failed him and then shoot him. The time requirement in conveying that content in a more nuanced and realistic manner (say by showing the former patient in a constant cycle between mental institutions, prisons, and homelessness) is far more risky with keeping the audience's attention than having the patient break into the house half-naked and shoot his psychiatrist. And yet because of that need for efficiency, the mentally ill are further exaggerated and stereotyped.

The Sixth Sense is not an isolated example. The media constantly stigmatizes the mentally ill in television and film, portraying them as violent or otherwise dramatically distanced from society, and while I intend to go into more detail about this later, for now I recommend consulting this and this, among numerous other articles available online, for more exhaustive examinations of mental illness stigmatization in the media. Needless to say, the state of things is far from ideal, and films like The Sixth Sense serve only to further isolate the mentally ill from society and consequently from treatment.


*No pun intended

Friday, December 20, 2013

Don't Go It Alone: Using The Buddy System To Deal With Depressive Episodes And Other Mental Crises

A few days ago, a friend of mine was going through a very severe depressive episode. He was caught within a cycle of negative thinking and couldn't see a way out. After a few minutes of talking, I convinced him to call the suicide hotline. He was not suicidal, but the hotline helped him calm down and figure out how to approach the problems that were challenging and frustrating him at the time.

I had a situation where the roles were reversed. It was the spring of last year, past midnight, and I was trying to sleep. My roommates were still doing work and I was becoming increasingly agitated by their noise. Having Asperger's, I am more sensitive to noise than others, and can react severely to it. I got out of bed and yelled at them about the noise. When they argued the noise wasn't as large a deal as I was making it out to be, I became angry and started to hit myself, smacking my forehead with the palm of my hand. My roommates did not respond to this, perhaps not knowing how to. Upset, I went onto Facebook and found a friend of mine online and told her what had happened. She was only a few rooms down, so I went out and met her in the hallway. We talked for God knows how long, me mostly talking and her listening and offering a kind word here and there. In the end, she offered to let me stay in her room for the night, an offer I accepted.

I don't know what would have happened had she not been there.

When in the middle of an episode of mental illness, it can be very difficult to pull oneself out of it on one's own--how can a distressed mind heal itself when its only tool is that same distressed mind? To do this, another person, sometimes multiple people, is necessary.

Look among your friends for those you feel you can trust with your mental illness and whom you believe can, if necessary, guide you through taking care of yourself when you are in a severe mental episode and are not able to yourself. With these people you can set up a buddy system, where one person helps the other in a time of crisis. They can help talk you through the crisis, give you advice which you may not be able to think of yourself, and look at the situations which are distressing you in a more distanced and objective manner than you are able to at the time.

To do this, however, they need to know what to expect, and what they can do to help. Explain to them what may happen when you are in a crisis, and what is often helpful to do when you are in that crisis. You don't need them to be a therapist, you don't need them to be a doctor. You just need someone who can keep their cool and walk you through what you need to do to get better. You need to do this when you are in a state of clarity, as you'll be relying on them when you're not.

Here are a few additional pieces of advice for using the Buddy System during an episode:
  • Know thyself. Know what works for you when you are having an episode, but which you may struggle to do yourself while in the episode. Share this with your buddy. For example, if breathing exercises can help you when you are having an anxiety attack, make sure your buddy knows to give this advice when you are having an anxiety attack, as you may not be in the right state of mind to give yourself that advice. If you take prescribed medication during an episode, make sure they know so they can remind you if you forget (as has happened to me). That said, there are a lot of more generic pieces of advice that can help many (BUT NOT ALL) people, and to look into those can be helpful as well. For example, advice to call a Suicide or Crisis hotline is generally helpful.
  • Make sure they know the difference between helping you and indulging you. When in the middle of an episode, it can be very difficult to get out of a pattern of constant negative thinking, ruminating over whatever it is that is distressing you and by ruminating, reinforcing the negative thoughts. We may look for someone to share this with, and while it may seem like allowing us to let off steam, often times it is really another way for us to reinforce our own negative sense of self, prolonging and intensifying the episode. Your buddy needs to know what this looks like, and break that cycle using the methods that work for you.
  • Often times, the best buddies to help in a crisis are those who have also gone through similar episodes in the past, as they are best able to understand what you are going through and what you may need. 
  • If possible, have multiple buddies. Not every buddy will be available at all times, so the more you have, the more likely one will be there to help you.
  • Understand that even when they are available, they may not be able to help you. They may themselves be not in the right state of mind, may be having a bad day, and sometimes may make mistakes. They are only human, just as you are.
In the middle of the episode, it can seem like there's no way out. That's what makes the support of loved ones so vital. We may not be able to see a way out, but they can, and they want nothing more than to show it to you. Don't be afraid to trust them. Mental illness may be suffered in isolation, but it is healed with the support and company of others.

Tuesday, December 17, 2013

How I Deal With A Depressive Episode (Written While In A Depressive Episode)

As I write this I am in the middle of a minor depressive episode. I say minor because its effects seem relatively weak, especially in comparison with more intense episodes I have felt in the past. Throughout the past few days I've felt increasing lack of satisfaction from entertainment and hobbies, had difficulty sleeping, and felt a sense of aimlessness and ennui I struggled to remove. I am currently writing this at midnight, after laying in bed for twenty minutes unable to sleep.

Interestingly, the onset of this depressive episode coincided with the end of my Fall semester. I can think of a few reasons for this, among being the sudden lack of work and pressure on me. On the one hand, work can be a very fulfilling and I would argue even necessary part of life, and a life full of productive work can provide great satisfaction. However, at the same time work is a hell of a drug. There is a reason such a thing as a "workaholic" exists. With constant focus on work, it becomes very easy to put aside ill thoughts and focus solely on whatever task is at hand, and when the tasks cease, I have greater difficulty distracting myself from the ill thoughts.

Another component I feel is the absence of social interactions. At school, while I was by no means a social butterfly, I had access to constant social interaction through my classes and my work which took me outside of my room. Now at home and separated from many of my college friends, and lacking the same convenience of socializing as I did at school, I have a tendency to stay too far within myself, and as a result can become depressed.

It may also be the result of a certain degree of existential angst, which seems to come in waves and is something I'm sure most people my age are familiar to. Various questions of existence, such as "what is my purpose in life", "do my actions matter", "is there a God", etc. are an excellent source of constant stress, as they lack easily accessed answers. Such angst appears and disappears rather randomly, and it may have simply come at a time where these other issues were also prevalent and thereby intensified the stress felt. This is lessened by the fact that I have certain responses to these questions which I tend to fall back on, and so their impact is not as significant as the others. I raise the questions to myself, give myself the answers I have given before, found myself satisfied by those answers, and move on.

However, the focus of this post is not meant to be why I have a depressive episode, but what I do to manage it.

Years ago, I was jogging through a forest near my house. I was not the most in-shape at the time, and it was at times painful to run. As I was rounding a bend, I began to think about the pain I was experiencing, to intellectualize it. I began to separate the thoughts of my mind from the sensations of my body, and for a very brief period of time I viewed the pain as an observer would, and thus its effects were numbed on me.

This technique proves very difficult to do reliably in terms of physical pain, but I've found that intellectualizing emotional and psychological pain helps considerably to reduce the intensity of the harm. Hence, in part, why this blog exists. When going through a depressive episode, I must bear in mind that the pain I feel right now is solely within the intersection of my brain and mind, and that the world outside of my head is not affected one iota by what goes on in it. My therapist has emphasized to me identifying "false beliefs"--unhelpful thoughts within my head that are not substantiated by reality (such as me being a bad person, or that I fail at all tasks I try). The depressive episode is nothing more than a series of numerous false beliefs in rapid sequence. Their relationship with the actual world is tenuous at best, and if there are any links at all, they are greatly exaggerated, and things are not as nearly as bad as my depressed mind makes them out to be.

I remind myself that in addition to my depressive episodes sometimes having concrete causes, they also are caused by chemical imbalances in the brain, which occur outside of my immediate control. They can be allayed with medication and proper nutrition, but the primary cause of the depression is not my fault. I am not to blame for feeling as I do.

Thus, because I am not to blame for these feelings, the focus should not be in how to make myself stop feeling this pain, but rather on what treatments I have done before. Even if I do not feel that the treatments will be effective in the middle of the depressive episode, the mere habits I develop dealing with them give me something to fall back on to allay my feelings. For myself, when I have a depressive episode, I have learned to combat it through numerous means, among them:

  • Taking my prescription Xanax
  • Taking a nap to offset any existing sleep deprivation, as well as to mentally refresh myself
  • Feeding myself properly, as malnutrition can often intensify if not outright cause a depressive episode (normally this involves eating fruit. For whatever reason I don't seem to eat enough fruit).
  • Calling my therapist to talk about the issues on my mind at the time, if they feel too overpowering for me to handle on my own
  • Finding something enjoyable that I can do while I ride out the episode

As I write this, I find the fog of depression lifting somewhat, though whether this is temporary as a result of distraction or longer-lasting through the writing of this post I'm sure I will find out soon enough. Regardless, this episode will pass, as all of the ones have before it. And that is the most important thing to remember. This depression will end.  While in the middle of the depressive episode, it can be very easy to feel as though one has reached a point of no return, a state of misery which at the time feels inescapable. The best way to combat this feeling is through reminding oneself that you have had such experiences in the past, and that they too ceased. The feeling of endlessness which the depression provides is an illusion easily refuted by evidence from memory. I have felt this before. It has ended before, and it will end again.

Monday, December 16, 2013

Van Gogh's Ear Lied, Or Why You Don't Need Mental Illness To Be An Artist

Consider the following strip:

Many of you have seen it before. This infamous (and fake) Calvin and Hobbes strip influenced me when I was first considering taking prozac in high school. That day, during drama club, I had a public breakdown. On the way home, I told my mother and she believed I should see a doctor about medication. This distressed me: I had been influenced by imagery like this, imagery which said my imagination, my creative ability, who I was would be taken away by medication.

Prozac did not do that. What it did do was make me better able to cope with my depression. My breakdowns became more infrequent, I became happier, and combined with treatment my mental health improved. But the influence of that strip stayed with me. Even as much as a few weeks ago, I still had doubts, wondering if my depression were to go away completely, would I still be able to write, to create art?

Why do I think this? Why does a comic like this exist and is so popular and well-known?

In 2011, a study of over one million Swedes attempted to examine a possible link between creativity and mental illness. Here is a summary of their findings:
Except for bipolar disorder, individuals with overall creative professions were not more likely to suffer from investigated psychiatric disorders than controls. However, being an author was specifically associated with increased likelihood of schizophrenia, bipolar disorder, unipolar depression, anxiety disorders, substance abuse, and suicide. In addition, we found an association between creative professions and first-degree relatives of patients with schizophrenia, bipolar disorder, anorexia nervosa, and for siblings of patients with autism.
Now consider how these findings were represented in the news. Specifically, consider the headlines.

From the BBC: "Creativity 'closely entwined with mental illness'."

From LiveScience: "Creativity linked to mental illness, study confirms."

While technically true, it is obvious these headlines were trying to go beyond what the study itself said, implying not merely that some artists are more likely to have mental illness or have relatives with mental illness, but that there is a direct link between mental illness and creativity. It's a sentiment that ties in neatly with the popular concept of the tortured artist, or someone whose pursuit of art leads them to mental torment, or whose artistry is caused by their tormented state.

Van Gogh is perhaps the most notorious example of this "tortured artist", who cut off his own ear in pursuit of his art, or so the popular story goes. His "tortured" nature was such that he was believed to have shot himself. Indeed, from Hemingway to Cobain, the artist's suicide has become a trope in itself. No one ever talks about the why of these suicides. There's an implication that such actions are a given. There seems to be some sort of shorthand going on that equates mental illness with improved creative ability, or conversely that artistic pursuit makes one mentally ill.

At first, this seems like a positive revelation. It seems fair that people who struggle with it would be compensated with increased creative ability, and indeed I have used that very reasoning to justify my own mental illness, as though I participated in some trade-off of mental health for creativity. Such reasoning, however, ignores the vast majority of people who struggle with mental illness yet who do not feel inclined towards such artistic professions. If the most this study can say is writers are more likely than the general populace to have mental illness that leaves a large amount of people from the "general populace" with mental illness who are not artists, and thus, gain no advantages from it.

Additionally, this reasoning seems to suggest that it may even be better to maintain mental illness and leave it untreated, because it can bolster one's creativity. Certainly, I used such reasoning in my reluctance to take prozac. Imagine my surprise when, after taking it, I found my creativity had not changed one iota. In fact, my improved mental state made me more willing and able to write, whereas before I would be so stricken with anxiety over writing that I would put it off, again and again.

That is not to say that some medication for mental illness does not have side-effects on some people that is more deleterious than the mental illness themselves. Such cases exist. However, the problem is when these effects are associated not with specific people with specific medication, but with treating all mental illness. It creates the perception that any treatment of mental illness will diminish the person's artistic ability. Treatment is not meant to take away our ability to express ourselves. It is meant to make us better able and equipped to deal with the various challenges of our lives, and by and large, it does this.

Even if mental illness uniformly made the sufferers more creative, and even if treatment of mental illness took away that creativity, it would not be worth it. 

Society does not recognize this. Society has built up a cultural system which venerates the art created above the artist, and what the artist did to achieve it. I go to film school. I have seem numerous examples of this. Much praise is heaped upon Alfred Hitchcock for his mastery of the art of cinema, and for the impressive films made in his name. Much less attention is given to how he abused his actresses and ruined their careers in the making of his films.  Last Tango in Paris is considered one of Bernardo Bertolucci's best films. The fact that he had his actress raped in the making of the film is regularly glossed over in the praise.

I emphasize this: Regardless of what society says, art is never more important than the person who makes it. Art is meant to be a tool used by people to make their own lives more fulfilling, not a parasite which drains the person in order to improve its own subjective quality. Art for art's sake is a meaningless concept. Art's purpose is not itself. Art's purpose is in the interactions between the art and the creator and the art and the observer, and it is the interaction between art and the creator which matters most. No effect of art is so important as to justify the involuntary suffering of the artist. Art is meant to free us, not imprison us.

Friday, December 13, 2013

Do You Struggle With Mental Illness? Share Your Experiences Here (And Anonymously)

When I started this blog a few weeks ago, I thought of it mainly as a way to express myself, to show people what it is like to be mentally ill, and show that despite my mental illness, I'm still human and still deserving of as much respect as anyone else.

I was surprised at how overwhelmingly supportive others were. After my blog posts, I received messages from people showing their appreciation for what I'm doing, and telling me of their own issues which they struggled with. Reading through those, I realized that many people have the same desire I have, to talk frankly about our mental illness, but fear talking about it in a public sphere. We fear being judged, amd we fear valued relationships or even whole careers changing if we disclose our mental illness.

Unfortunately, those fears are often true. In the modern era, mental illness is stigmatized and the sufferers denigrated, and people risk a lot if they disclose, though many times they find after the fact that they risked much less than they thought. While prejudices can still be very much alive on more wide and abstract levels, once we know people who possess the traits we so often stereotype, our views soften, if only to accommodate them. We envision that these people are something dramatically different from ourselves, a belief which so easily falls apart when we see that these people are people, and not that different after all.

In addition to the positive reactions from others, I found myself more satisfied from the blog work than I thought I would be. I found writing these pieces stimulating and invigorating. But more than that, I felt happy that I made it. Writing this, I felt as though I were opening up some part of me which I before tried so exhaustively to suppress. I felt the muscles of my mind relax, no longer having to hide this part of me, or to fear the repercussions. It was out. My mental illness was known. And I was no worse. Quite the contrary, I was much, much better.

Of course, that is not to say my experiences are the same for everyone. I am only one person. My writing on mental illness are filtered through my own experiences only. There are other people, with different experiences, with just as much to share. On this blog I would like to dedicate time to them.

I would like to post on this blog other people's experiences with mental illness. I would like to share what other people have struggled with. They don't have to share anything they don't want to, and they can choose to put their name to it or leave it anonymous. They and I can work together to determine what to post on this blog.

It could be a single experience, it could a be a longer story with many experiences, it could be bits of advice accrued over a lifetime of experience. It could be from someone with mental illness. It could be from someone who knows and cares for a loved one with mental illness. It could be from someone who sees the mentally ill every day, even if only at a distance. The end goal is to give those of us with mental illness a human face, to show what it is like to be mentally ill, not as some far-off concept, but as people.

The more people know about these experiences, the more people understand. And the more people understand, the more society understands. The more society understands, the better respected, better treated, and better satisfied we become.

As I've said, my email is . If you would like to share your experiences, please email me there and we can talk about this further.



Wednesday, December 11, 2013

Depression Quest--Or What It's Like To Have A (Specific Form Of) Depression

Depression Quest is a game about depression. For some people.

The story centers around an average twenty-something male struggling with depression while trying to balance work, family, and relationships. The depression lessens or intensifies based on decisions the player makes (do you accept therapy or decide against it? Do you spend time with your girlfriend or stay home alone?)

The game is an exercise in despair. From the melancholy and increasingly dissonant soundtrack, to the often hopeless-seeming situations, to its exploration of the psychology of the protagonist, this is a game which attempts to explain what depression is like--or at least a certain form of it.

The game's narrative is structured so that numerous people with Depression can relate to it. However, it at times risks becoming too all-encompassing. Quotes like "there are some days you hardly feel like getting out of bed" can apply to numerous people, not just with depression. Everyone has bad days, and certain parts of Depression Quest can seem like its simply showing those bad days and calling them symptoms of depression.

But what differentiates Depression Quest, and depression in general, is the sheer, constant onslaught of mental, emotional, and spiritual exhaustion. There is a palpable sense of entrapment, a lack of energy to do anything besides simply be, even if it is to the detriment of your work and social life, that is so familiar to so many with depression. "insurmountable", "unmotivated", and "tired" are but a few of the adjectives at the game's disposal. Indeed, the exhaustion is so intense that there are many times where options one knows to be the best options are crossed out--the character cannot take those options because they simply do not have the energy and morale to attempt them.

Playing through the game, I and many others attest to its power to make one feel there, truly suffering, and truly empty. Everyone has bad days, but in Depression Quest the bad days are the only days, and that is very true to life.

For some people.

For other people depression comes and goes. It manifests not in a constant entropy but in starts and dramatic stops, or in certain moments, or certain triggers. Depression Quest's depression does not seek to encompass those, and should not be viewed as an exploration of all depression, only some forms.

The main thing to remember about Depression Quest is that in addition to demonstrating only a singular form of depression, it advocates only a singular treatment. The depression in Depression Quest is not caused by trauma, not caused by grief or a sudden change in lifestyle. The depression in Depression Quest has biomedical cause--it is caused by chemical imbalances in the brain, which while a true cause for many people with depression, is not the sole cause of depression, and should not be viewed as such. The solutions in Depression Quest are very generic forms of medication and therapy. "You are not currently seeing a therapist" and "you are not currently taking medication" are considered absolute negative states in this game. To "win" the game, one must accept medication and therapy and pursue them fully.

While for a great many cases medication and therapy are good solutions, they do not apply for all people. Some people have very adverse reactions to medication, or find nothing useful out of therapy. Again, each person's Depression is a uniquely personal thing, and to ameliorate someone's depression necessitates knowing the person themselves, not simply throwing them at medication and therapy and seeing what sticks.

Still, the game serves to illustrate depression to people who may not understand it, even if it does not illustrate all kinds. It's a game I feel deserves to be shown to others, to explain to them just what it's like to have depression.

For some people.

Monday, December 9, 2013

Mental Illness Is Not Weakness

Years ago, a friend of mine, a very good friend, told me that people who commit suicide were weak. Her rationale was simple: she had been depressed, she had wanted to commit suicide, and yet she didn't, so why couldn't other people do the same?

It's a rationale I've seen used not just with suicide, but with mental illness in general. For people who do not have a mental illness, they often view mental illness as a weakness of will, a cowardice or selfishness where the sufferer refuses to pull themselves up and better themselves. They use phrases like "get over yourself" or "why can't you just be happy?" They'll try to convince the sufferer of the errors of their way through comparisons ("there are starving children in Africa, what do you have to be sad about?") or give anecdotes of their own lives where they were upset and made themselves better.

By and large, the errors in their reasoning are egocentric--they assume that because they have been in problematic or upsetting situations which they were able to get out of, those with mental illness are able to do the same. When the mentally ill person is not able to get out of it, they conclude that person is simply being "weak".

Weak is a very easy concept. It allows us to assess the dilemmas of others and find their reactions wanting not because they are unable to easily solve those dilemmas, but because they refuse to try and solve them. It's a very affirming concept--this person is suffering, and I am not, so I must be stronger than they are--and it plays to one of the fundamental misunderstandings of mental illness.

To put it simply, mental illness is not about willpower. It is about many things, among them traumatic incidents, chemical imbalances in the brain, or the loss of a loved one. But it is not about willpower. Any person with a mental illness would love to be able to will themselves out of their pain. But they know that's not enough because they have tried to will themselves out of it.

Sometimes, when in a depressive episode, I tried to force myself happy. The techniques I used were given to me by others who had not experienced depression or did not know how to deal with it. I tried to force a smile. I tried to remind myself of how privileged I was and how much worse off others were. I even tried to essentially grit my teeth and turn myself happy. All of these failed. When I smiled, the smile felt hollow and unearned. When I reminded myself of my privilege I felt guilty because of how upset I was even though I had those privileges. And when I tried to make myself happy I became frustrated because I couldn't, I just couldn't. It was exhausting and stressful and ultimately changed nothing.

Willpower is not enough. Willpower is not even relevant to mental illness. All willpower is doing is throwing the person at the same ineffective solutions over and over again until they run out of energy or the problem goes away on its own. To blame someone with a mental illness for not being happy is akin to blaming someone with a broken arm for not moving a couch.

And therein lies one of the problems of society's view of mental illness. It's invisible. It lacks the clear indicators of an arm in a sling or a walking cane. All the problems of mental illness occurs in the recesses of the brain and mind, and most of us don't have the ability to see that. And because we can't see that, we conclude it doesn't exist. This person isn't depressed, we think, they just don't want to be happy. This person doesn't have bipolar disorder, they just refuse to control their emotions. This person doesn't have schizophrenia, they just want the attention.

To those of us who have mental illness, know that if someone tells you to force yourself better, they do not understand how mental illness works. To those of us without mental illness, know that you cannot force mental illness away, in the same way you cannot force a broken arm to heal or a flu to disappear. To truly combat mental illness, one needs a combination of medication, therapy, and social support, the specifics of which vary from person to person.

Mental illness is very real, but many of us refuse to recognize that. Because we refuse to recognize it, the mentally ill do not get the treatment they need. To change that, we need to make sure that we as a public are informed and knowledgeable about just what mental illness entails, and what does and does not work to treat it.

Monday, December 2, 2013

What It Means To Be Mentally Ill

Before I start on this post I want to take the time to thank all the people who read my first post and who spoke with me about it. I can't overstate how I appreciate the support and how it motivates me to continue writing this.

Additionally, if anyone has any questions, additions or critiques on the content of the blog, I strongly encourage them to comment or message me about it. In discussing mental illness, communication is paramount, and I don't pretend to know all the answers. There are always things for me to learn, better ways to present my points, and parts of the dialogue which others can contribute to better than myself, and if anyone thinks they can help me in those respects, I welcome it.

In my first post I introduced myself and the nature of this blog and why I feel the need to talk about mental illness. In this post, I seek to outline just what it means to be mentally ill in this day and age.

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To be mentally ill is to hurt. Often and without knowing why. We find our thoughts and feelings warped beyond our control, and often it seems like the most we can do is suffer through it. We are hurt not only in the thoughts and emotions the mental illness brings us, but in the actions we do as a result of it, and the regrets we feel in their aftermath. We are hurt in how our actions affect others, and in how we see our social circle shrink the worse we get.

My depression intensified in high school. There were days I would wake up with no motivation to go to school, to do things I enjoy, or even to eat. But I had a friend then. To this day I maintain it is one of the best friendships I ever had. After a time I began to worry about the friendship, to obsess about it. I began to overanalyze everything I did, everything I said to my friend, and worried that with the slightest mistake our relationship would fall apart. I would not only worry about it, but spread my worries to the other person, ask them if I was doing something wrong, apologize for things they hadn't noticed or hadn't bothered them, and do these things again and again and again until eventually it became too exhausting for the other person to handle and they pulled away. As they pulled away I became more upset, and at the same time thought I could still be able to salvage it if I just kept doing what I had been doing before, trying to talk to them, trying to apologize for things I'd done which never bothered them in the first place, and every time I did it I pushed them further and further away. Now they do not respond to me when I try to contact them, and I don't blame them. I still hurt over it.

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I'm better now than I was in high school, and I intend to continue to get better. But it is not easygoing, and I suspect it will never entirely be. Mental illness is not like other sicknesses, which have concrete physical cause and solution. To be mentally ill is to face a sickness which one cannot see or touch. It is a condition which takes place only in the ambiguous corners of the brain and mind and the even more ambiguous locations where they intersect. With mental illness, those untrained in its workings are left constantly wondering to what extent the actions they do, the thoughts they have, the emotions they feel are caused by the illness or are truly their own.

For the longest time, I was not aware of even the vaguest notions of this division between the illness and the self. When I had depressive episodes, I would be upset and frustrated and would have no idea why, and so I came up with reasons of my own. I thought I was weak, that I was selfish for being so upset, even though I had no reason to be. People told me that no one but yourself can make you happy or sad, so I extrapolated that it was my fault for feeling so awful, and that only made me feel worse. I became self-loathing, and with the self-loathing I felt worthless, and with the feeling of worthlessness I wondered why I kept going at all.

Later, as my treatment helped me become more aware of my mental illness, I was able to identify with some level of success when and how my mental illness was affecting me. When I became upset, when I felt despair about my future and my skills and my ability to ever feel happy again, I recognized that I was suffering from a depressive episode, and that it would go away with medication, with a change of scenery, or simply the passage of time. I learned to separate my mental illness from who I was. Many people do not know how to do that. Worse, their friends and loved ones do not either. The mentally ill can be blamed for things that are not their fault, and others may be hurt or frustrated by the seemingly unreasonable and distressing actions the person exhibits.

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Because of this, to be mentally ill is to be a pariah. The mentally ill face stigmatization borne from the collective ignorance of a society which does not understand them. They are stereotyped, often paradoxically, as prone to violence while also being too weak to exercise control over their own minds; as having nothing to contribute to society and as having untapped creative potential, as is the case for many artists whose mental illnesses have been romanticized as integral to their artistic success.

The prejudice against the mentally ill is helped in no small part by media representations of mental illness, which often place the mentally ill on the outskirts of society, be it as criminals or eccentric geniuses or inpatients suffering from the most extreme of cases. To describe in sufficient detail the extent of these representations is beyond the scope of this blog, though later on I intend to analyze a few films and the stereotypes they reinforce about the mentally ill.

The prejudice against the mentally ill not only impedes our comfort in society, but makes us more reluctant to seek treatment. We internalize the stereotypes, and believe if we admit we are mentally ill (say, by going to therapy or purchasing medication) we admit to ourselves that we are abnormal, broken, and dysfunctional. As a result, many people refuse to seek treatment, and their condition worsens. When the prospect of taking medication first came to me, I did not want to take it, in part because of those stereotypes. I feared being outcast more than I already was, and I feared the medication changing me in some fundamental way. Mainly, I feared admitting to myself that I was broken, and that my own will was not enough to save me. In the end, I accepted treatment and my control over my mental illness was improved because of it. It's not hard to think of what might have happened had I not accepted treatment.

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To be mentally ill is to be alone. Seemingly.

When faced with such internal struggles as mental illness, and faced with the pressures of society to keep such struggles hidden it is often easy to believe there is no one who can help you but yourself. This is not true. There are whole communities of people who want to help you. Advocacy groups, support groups, even friends and family who have struggled with such issues but, like ourselves, do not talk about it

And even your loved ones who have not experienced it, who do not know what your mental illness entails, want so very much to help you, they just need to know what they can do. They need to know how to tell between what is yourself and what is the mental illness. They need to know of the methods you use to treat yourself, and when they should step forward and when they should give you space.

But to do these things, we need to talk about mental illness, and that is perhaps the most difficult thing to do. When faced with a society that encourages us to hide our mental illness, it is the hardest thing to go against the grain. But it can be done, and it needs to be done, if the status of the mentally ill, of each of us, in society is to be improved.

Monday, November 25, 2013

An Introduction To This Blog

In High School, as in Middle School and College, I had sometimes tended to break down crying at the end of class. I would wait until all of my peers were gone, and it was either me alone or me and the teacher, and I would then let go of whatever I had pent up in the interim.

In one of these cases, it was senior year. This was when I was in my second high school, as I had left the first one due to depression and self-harm which the environment seemed to prompt. The same thing sometimes seemed at risk for happening at the second high school as well. I went to my teacher and told him how isolated I felt in class, how I felt like I was constantly struggling to push myself into the conversations of others, how I felt like I never truly related to them, and they never truly related to me. What he said to me afterwards tends to stick with me, even two years after it happened.

He took his hands, held both parallel to the floor. "The class is here." He said, holding one hand at chest height. "You're here." He held the other hand at about chin height.

I don't try to think of myself as somehow being superior to the people. I'm not. I just operate on a different wavelength. But often times I don't even think of that. Often times I think of myself as being not only not on the same wavelength, but that I'm on a lower level than the rest of my peers. That I'm deficient. Not unintelligent, but deficient. Incapable of socializing properly, of being a friendly or interesting person. I look at other people going to parties, going out with friends, then sitting and chatting with those same friends in class, and I feel sometimes like I'm looking at something I can never be a part of, and perhaps don't even deserve to be a part of. That I'm "lazy" or "cowardly" to not socialize like other people do.

So when I get someone who says I'm not just at the level of my classmates but above the level, that says to me not that I am superior to them, but that I have something unique to contribute.

So that's basically why I'm here.

I have Asperger's Syndrome. I've struggled with depression. Sometimes I've struggled with body-image issues. I've hurt myself in the past. Sometimes I've had suicidal thoughts. One time I contemplated acting on them.

I have few close friends, and many acquaintances that I'd like to be close friends that I can never seem to make close friends. I sometimes feel lonely, and hurt, and self-loathing.

I've wanted to be a genius. I've wanted to be a brilliant artist. I've wanted to be healthy. I've wanted to be normal.

I'm none of those things. I simply am. And I suppose that's as good a reason as any to write about just what "I" am.

So here I am.