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.

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