The other day in the car with a family member, we were having a discussion about how hard it is to access adequate healthcare (specifically pain treatment) when you are mentally ill.
“Is it?” they said.
“I’ve seen it happen countless times with other people I know, and it certainly has been for me,” I said.
They looked at me with confusion. “But you’re not mentally ill?”
I was gobsmacked.
I asked them what they meant, since they knew I was being treated for bipolar, and they said, “But you’re not crazy crazy.”
It’s a weird thing that family and friends do — even if they can bring themselves to acknowledge your diagnosis, they still don’t lump you in with (what they imagine to be) the raving lunatics who get locked away in mental wards. The thing is, not everyone who is mentally ill ‘looks’ like a raving lunatic. But some do. And some people can be both of those things. The point is, you do us a disservice by trying to candy-coat our disorders.
It’s not that I want to come down too harshly on the people that support us, the mentally ill. A huge number of people in our lives (possibly the majority) will turn around and walk away because they simply can’t handle being around someone who is mentally ill. Maybe because all they see is the stereotype of the maniac. So the last thing I want to do is alienate those who can see past their own fears and are game to stick it out.
But you also don’t get a free pass for your ‘altruism.’ I mean, when it comes down to it, caring for and about your family members or best friends should just be a normal thing that you do. The fact that they suffer from mental illness is certainly a challenge, but we all come with our own bits of baggage and as long as your mentally ill friend is a putting work into the friendship too, the fact that they are mentally ill shouldn’t be something they need to constantly apologize for.
If you are going to support someone who has mental illness, you need to acknowledge all of their parts. Glossing over their illness or pretending it’s not really there isn’t helping them.
This whole business of playing down people’s mental or physical disabilities seems to be something that is culturally ingrained. Parents play down illness when kids complain because they think they’re just doing it for attention. Doctors play down symptoms and refuse to apply labels because they are convinced that it will become a self-fulfilling prophecy and patients will develop somatic complaints or hypochondriasis (the nocebo effect). But this can have a devastating effect on people with genuine complaints who end up feeling like no one believes them, which in turn can lead to self-harm and avoiding much-needed medical attention.
When you care about someone, avoiding using labels or acknowledging their mental illness feels like you’re being kind. Certainly the last thing you want to do is to bring it up every time they behave erratically or use it as a weapon in arguments. You can’t blame everything that someone does on their illness. So it might seem like the kind thing is to avoid the label entirely, to prove that you see the person beyond the illness.
The problem with acting like their illness doesn’t count or that they are some special case is that it a) is not recognizing the whole person, b) suggests that you think that part of them is somehow unacceptable, c) makes it extra hard for them to get help or talk to you about their illness.
In terms of c), getting help can be in big ways or little ways. It can mean that they feel safe calling you when they need help getting to the hospital, or it can just mean that they feel safe telling you that they can’t meet up today because they feel extra anxious. It is really hard maintaining friendships when you have bipolar and anxiety, for example, for the simple fact that you end up having to cancel or reschedule plans based on your mood. If you are someone I feel I can trust I would simply explain what my issues are that day and reschedule. If you are someone I don’t trust with my mental illness, I just might not make plans at all, for fear of disappointing you or having to deal with uncomfortable questions.
There is a growing trend for public acceptance of mental illness (depression specifically), with lots of public campaigns to increase ‘awareness.’ I remain slightly skeptical about such campaigns, mostly because what I see is a lot of people sharing memes and pre-scripted platitudes with very little actual one-on-one support of people in need. It seems to me that we’ve traded the public erasure of mentally ill people for public awareness and private erasure. Now when people try to speak up about their mental illness, other people pipe up with “well I have depression too, so you’re not special.” It’s great that more people are coming forward with their own struggles, but the last thing that should be allowed to happen is for it to result in a watering down of the significance of mental illness. That more people are experiencing mental disturbances should not make it less significant. It should make it even more apparent that it is an important issue.
It is crucial that we do not create a further hierarchy or caste system of mental illness (depression, anxiety and bipolar are treated in a much more favourable way than schizophrenia or Tourette’s, for example), and playing down someone’s illness as if it is not ‘one of the bad ones’ or ‘doesn’t count,’ hurts not only them, but the mentally ill community at large.