Monday, February 20, 2012

Halfway out of the Mental Illness Closet

last week, i wrote a post here about my stay in the netherlands to date. in passing, i mentioned going through some minor physical and mental health problems, the latter being a spell of depression.  the rest of the post was  on other stuff going on.

it got few readers, and two of them were old friends who are also psychotherapists,  and who gently but firmly reproved me for calling depression a mental illness.  they have known me and my depression for years, and so have a sort of doubled authority on the subject.  one of them was surprised that i had mentioned it at all, since it's a personal issue; the other thought it might deter some depressed people from getting help, since they would be put off by the thought that they were 'ill.' 

their remarks echoed those of a therapist i had seen many years ago, a wonderful  woman who kept me sane and very possibly kept me alive at the time, in those years when psychotherapeutic drugs were in their infancy.  she too rejected the illness idea, which she thought belittling to people in therapy.

i was unsurprised by my freinds' reactions, knowing as i had their general views on emotional.....shall i say, conditions.  but i disagreed with them, as i had with my own therapist back in the day.

as to the idea that 'illness' has been used as a stigma, i think that it emerged as an anti-stigma [though i should do at least a wiki-search on this], a reassurance that you weren't crazy but instead had an illness, that was treatable, the way the flu or high blood pressure could be treated.  but the language, as is inevitable when changing terminology becomes part of the method of trying to change reality, became itself tainted.  if i tell someone i have asthma, they might mention that i'm sick.  there, the word has no value attached to it--it's a simple generic descriptive.  but 'sick,' in relation to mental conditions, has a very different tone.  "that's sick,' we'll say, in tones of intense contempt.  so that instead of the word changing the context, the context as often as not changes the word.  sometimes the  phenomenon is more complicated.  look at the words white people have used for black people.  'negro,' the way respectful people in the 1950s used in place of 'the coloreds,' by the mid-1960s, 'negro' itself had a patronizing connotation, replaced by 'black,' adapted at first by militant anti-racist organizations and taken on, sometimes reluctantly, by well meaning whites.  but 'black' too became suspect, and grew into the ungainly but to-date inoffensive term 'african american.'  listen to racists use the term 'african american,' as though it were a humorous reference to pretentious second-class citizens who thought they were as good as 'real americans.'

language matters; of course it does. the evolution of the terms for the descendants of american slaves has occurred with the evolution, however incomplete, of legal and social realities.  at least we don't have  separate toilets for 'african americans.'  it matters that adult females are now 'women' rather than 'girls,' that homosexual men are 'gay' and not 'faggots.'  as both a feminist and a writer, i believe in the power of words and the importance of challenging insulting language.

but equally, i see the more subtle uses of denial in some language change.  we have ceased to be old; we are at best 'elderly,' or the really obnoxious 'senior citizens.' 'old' is an insult.  but 'old' is real, if you're lucky enough to live beyond 'middle age.'  being old encompasses some inevitable physical realities--wrinkles, memory problems, joint pain, all that stuff. above all, it encompasses the utter proximity to death.   making up cute words doesn't change that, but it can help us deny it. 

so...mental illness.  i like the concept.  granted, depression isn't as harsh an illness as, say schizophrenia.  asthma isn't emphysema.  a cold isn't asthma.  disease is a fairly large concept.  

for me at least, depression as an illness makes sense.  it pretty much parallels my asthma.  each responds to medication that has made my life bearable.  each manifests in different degrees.  my recent episodes of both have been mercifully mild. both have held on to symptoms, the way a cough lasts long beyond its cold. severe episodes of either are rare if i take my meds.  either could ultimately kill me.  neither is, or should be, a cause for shame.

what i don't have to grapple with when i have asthma is concern that i'll be looked down on. and it's why i refuse to hide behind either denial or soothing language around my depression.

and yet...

i said earlier that i have had only three hits on the post about my castle life.  when i write a post about something i think may interest my former students, i send a flag about it to facebook. this time i didn't. instead i posted a note  saying that i'd written it, but it wasn't very good. and i gave it a title suggesting the same thing.  i've never done this before. i told myself that i was downplaying it because i don't want to cause my current students, some of whom have already become fb friends, any concern about me.  concern...or contempt?  i wish i could be sure of my motives. so this one gets the usual facebook treatment. and i'll give it a funky title. 

what fools we mortals be!


Jim said...

I, too, have dealt with depression all my life. Luckily, I've worked out of the suicidal thoughts and actions of my teens and early twenties, but it still hits, and it still has to be dealt with.

Something I read years ago (I think it was in a "Whole Earth Catalog," back when those still existed and were still good), which put it in a way I liked then, and now. Basically, it came down to this - people say, "I have a cold," or "I have the flu," or "I have cancer." They don't say, "I am cold," "I am flu" or "I am cancer."

So why do we say "I AM depressed?" Why not, "I have a depression?" That would denote it is simply an illness, a condition, a treatable thing. The other, "being depressed," is a state of, well, being. Something we ARE. Instead of something we experience.

Hopefully that makes sense.

Darylle said...

Hi Karen,

I just wanted to thank you for posting this. I've been dealing with an anxiety disorder and mild agoraphobia for a long time, and sometimes I need to be reminded that it is not a cause for shame. Reading this today helped me take a major step: I finally told my boss about it, and felt a huge weight lift from my shoulders. She was nothing but supportive and I am just so relieved.

Your openness helped me to be open. I hope I can do the same for someone else soon.


karen lindsey said...

jim and darryl--
thank you both for your comments. you sound about where i am with depression. i still do have suicidal thoughts when things are bad, but far removed from action. i love the idea of getting rid of the 'am.' it still makes sense in a larger phrase--'i'm in the middle of a depression episode,' and is often what i say of my asthma. and its finity is implied. i had a funny realization about this last mild episode. this was my 'normal' 20 years ago. years of therapy never changed that, though it helped.but what did change it, though i fought against it for months, was paxil.and as pissed as i've been about the pharmaceutical companies, i have to admit that they've been helpful in my life...


your post means a lot to me. i've been 'out' about depression in recent years, b/c at my level and in my life i can afford to do that, and precisely b/c some people can't,either for objectively real reasons or b/c of fear, and it might be useful to them. i'm so pleased to hear it has helped you, and doubly pleased that your boss was so supportive. keep me posted!