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I have touched on the topic of stigma against the mentally ill before, so I'm taking bits and pieces of research from that previous diary. But I'd like to revisit it here in a slightly different way. There was a statement made in another diary the other day that brought this to mind. Someone here suggested that the mentally ill should be imprisoned "just like sex offenders" until doctors could determine that they were safe for society. I'm assuming that it was not intended as it was written (I certainly hope not), but unfortunately, there are many out there who do actually think this way.


So what is stigma, exactly?


n. pl. stig·ma·ta (stg-mät, -mt, stgm-) or stig·mas

1. A mark or token of infamy, disgrace, or reproach
2. A small mark; a scar or birthmark.
3. Medicine A mark or characteristic indicative of a history of a disease or abnormality.
4. Psychology A mark or spot on the skin that bleeds as a symptom of hysteria.

[. . .]

8. Archaic A mark burned into the skin of a criminal or slave; a brand.


Despite our growing knowledge of a variety of mental illnesses and their myriad etiologies and symptoms, we have not made proportional strides in dispelling public stigma against the people who suffer from them.

To the contrary, over the years we have seen regression rather than progression in the fight against stigmatization.

It is the 21st century, and though evidence-based research has shown us that mental illness is a real medical disorder, stigma is on the rise instead of on the decline. David Satcher, [fmr.] US Attorney General writes, “Stigma was expected to abate with increased knowledge of mental illness, but just the opposite occurred: stigma in some ways intensified over the past 40 years even though understanding improved. Knowledge of mental illness appears by itself insufficient to dispel stigma.”

Mental Health Foundation of Australia

Stigma is a complicated concept within our society. While relatively simple definitionally, the causes, mechanisms, and consequences of social stigma are multitudinous and complex. Much of it seems to be based in fear born out of ignorance. You can find stigma, of one sort or another, most anywhere you look. Stigma will thrive in society wherever ignorance or fear or hatred of that which is "different" are acceptable mentalities. The tendency to stigmatize, label, and set certain groups/individuals apart from the rest of society as "other" is, to an extent, human nature. The need to categorize people, places, and things is normal -- it's just a function of how our brains work. We run into problems, however, when we begin allowing categories and labels to exclude and define people.

Stereotyping, stigmatizing, and treating these people differently creates a vicious cycle for many sufferers. It makes life significantly harder for individuals who are already struggling. Prejudice and stigma negatively impact the lives of countless mentally ill individuals and their families. Stemming from fear, ignorance, and incomprehension, social stigma -- whether relatively mild or outright hateful -- is inevitably harmful to those exposed to it. It can lead to severely decreased self-esteem, feelings of isolation and rejection, feelings of self-loathing, diminished or damaged support networks, high unemployment rates, overt or covert hostility, increased levels of stress, fear of seeking help (even for doctors who are mentally ill), and many other problems, ranging from minor inconveniences to severe hardships. The spectrum of complex, difficult emotions experienced by many mentally ill people due to stigma is broad.

For those with mental illness the stigma experienced can result in a lack of funding for services, difficulty gaining employment, a mortgage or holiday insurance. Ultimately, feelings of stigma cause people to delay seeking help or even deny they have symptoms in the first place.

The Guardian, Crazy Talk: The language of mental illness stigma

We know that stigma is not just a word but a toxic concoction of ignorance and fear, of prejudice and power play, that continues to have a real and substantial impact on the daily experiences of thousands of people, in relationships with friends and family, in attempts at finding and keeping employment, and even in accessing healthcare.

The Guardian, The most toxic issue facing those with mental health problems is stigma

Persistent stigmatization of mentally ill persons can ultimately cause them to stigmatize themselves.
Self-stigma also can lead to isolation, lower self-esteem and a distorted self-image. “People with a mental illness with elevated self-stigma report low self-esteem and low self-image, and as a result they refrain from taking an active role in various areas of life, such as employment, housing and social life,” according to David Roe, professor and chair of the department of community mental health at the University of Haifa.

World of Psychology, When Mental Illness Stigma Turns Inward

Of those who know me well, a small number eventually find out that I am bipolar. It's not something I advertise to the public, and it has, at times, been an enormously debilitating force in my life. Even though I am educated about my problems and know better, many times I have berated myself harshly for my "weakness" or even found fault in my very existence. Early on, I doubted my right to live based upon the difficulties inherent to the disorder, and I have since sometimes felt deeply ashamed of it. Not everyone who has learned of it has been understanding. Not at all. I have been told I was "undisciplined," that the illness was "fake" or "manufactured," that I was "making excuses," that I was "scary," that I needed to "go back to church," that I was "just manipulative," that I "needed a knot jerked in my tail," that I had "taken advantage of loving parents," that I was "just too emotional," that that that that that......

It's NOT just my imagination that keeps me from telling people.

When I do tell someone, I invariably feel naked, vulnerable, and exposed. The occasions upon which I have been "outed" about my illness have brought on intense feelings of horror and helplessness. It's a "closet" I do not step out of lightly without considerable thought. Allowing my illness to become public knowledge could very likely bring about serious negative consequences, especially professionally.

Still, I should know better and advocate on my own behalf and the behalf of others as much as possible.

But I often don't.

For the most part, throughout my life, I have determinedly hidden my mental illness. When I am around people I do not know well, I stuff it away in my most secure closet and lock the door tight. Considering the pervasive social stigma with which mentally ill people are faced, hiding usually it feels like the safest, most palatable option for me.

I have always been a bit of a coward about it all, for a plethora of reasons. I found my first reason when I was about five, and it became one of the defining factors of my life for many years. My "nutty" paternal aunt was diagnosed bipolar, and everyone in the family knew it. My protective mother immediately began watching for similar symptoms in me. She has admitted in recent years that she watched me so closely -- fearful that something was wrong -- that she she sometimes feels she "made me crazy." Of course, that is not the case, but I was well aware of being watched. My mother was always making little comments about how I looked "down" or "depressed," or asking what was wrong with me. I felt like a bug in a jar -- constantly being studied and examined. It wasn't a good feeling for a kid. I became hellbent on hiding my problems. I was going to be normal, by god, no matter how "insane" I drove myself trying to accomplish that normality.

What this determination actually accomplished, however, was a delay in seeking treatment that I desperately needed during my late teens. So afraid of public disapproval and stigma -- and so fearful of disappointing my family -- I hid my symptoms as long as I was able. I cloaked them in socially acceptable activities when I could, and engaged in less acceptable behaviors when I felt that I had to. Consequentially, the bipolar disorder had fully manifested itself in the form of a full-blown manic episode by the time I got any help. Even then, for as badly as I clearly needed treatment, I did not seek it on my own -- and in fact fought it tooth and nail. Fortunately, the people around me could see my need, too, because I could no longer hide my problems.

To a degree, the stigma -- the fear of shame and shunning -- was almost as much to blame for my long-term suffering and eventual institutionalization as the illness itself. I did not get help until it was too late to be preventative. I did not seek help at all, despite my dire need. After over a decade of hiding my problems out of my own shame and ignorance, I had become truly incapable of seeking out aid on my own. I was willing to live in mental and emotional agony rather than go to outsiders for help with my "abnormality."

Such is the power of stigma for some of us... a dark closet of our mind's own making.

Shortly after my diagnosis, I returned to (a different) school, and I began studying psychology. I was interested in the workings of the mind -- mine and others' -- and I wanted to understand the brain better. Over time, this tentative curiosity about the mind transformed into profound empathy and compassion for others who had experienced suffering similar to my own. I chose to pursue a career in the mental health field in order to help the people who needed it -- many of whom society routinely shunned and stereotyped.

I am not much of an advocate. I always hide what I am at work and in school, and I feel uncomfortable in situations where I fear my "secret" might be uncovered. I have tried to educate others while working in the counseling field, but I have done so purely from an academic standpoint. As a rule, I am not much of one to share my story "in real life," even with the people who might most need to hear it. It has always unsettled me a little that I am, from a clinical diagnostic perspective, technically "sicker" than most of the clients and patients I have counseled. I fear that such knowledge would not inspire comfort or confidence in the people I work with. Those of us who have played the roles of both patient and healer have, perhaps, a unique perspective. I hope that in time I will find more effective ways to utilize that perspective and share what I have learned with others, particularly those who are still suffering.

In combating stigma, we walk a fine line. It is difficult to educate an uninformed person about mental illness in a way that will not create negative thoughts/associations, while still acknowledging and imparting the seriousness of mental illness and the detrimental effects it can have on sufferers' lives. To paint a picture of mental illness as "not a big deal" or even as something which does not, to some degree, set the mentally ill apart from others... is to minimize and possibly even trivialize it. Varying disorders differ in their "severity" and their potential to impact the mentally ill individual and those around him/her, and even people with the "same" disorder will experience symptoms in different ways along a continuum. I do not discount the pain experienced by anyone due to mental illness, regardless of the diagnosis, but I will say that some disorders do have greater potential to cause definite harm to the sick individual (and others). Even now, I'm conscious of not expressing myself as well as I would like about this issue. So how do we adequately explain such nuanced concepts to people who don't know and may not even wish to listen?

There are plenty of factors which affect the development, maintenance, and strength of stigma. And indeed, though the mentally ill are often stigmatized and discriminated against as a group, certain mental illnesses arouse more fear and antipathy in the minds of "healthy" individuals than others. Most people rightfully view individuals suffering with anxiety disorders as being quite distinct (in terms of symptoms, treatment, and prognosis) from those living with schizophrenia. There's nothing wrong with recognizing very real differences, and dissimilar mental health problems shouldn't be "lumped together" inappropriately. The problem arises when people assign unrealistically negative traits/characteristics to a group and separate them from "normal" people so completely that the stigmatized individuals are effectively stripped of their humanity in the eyes of the ignorant.

So how do we approach these problems?

People have plenty of ideas about that too. Some tactics include educating others, becoming an advocate and spreading the word, getting involved in changing public policy, eliminating derogatory words (e.g., "crazy," "psycho") from one's vocabulary, supporting anti-discrimination programs like Time to Change, encouraging and supporting the mentally ill in treatment, reframing mental illness by calling it a "brain disease," and supporting efforts to obtain more and better services and treatment for the mentally ill.

Change strategies for public stigma have been grouped into three approaches: protest, education, and contact (12). Groups protest inaccurate and hostile representations of mental illness as a way to challenge the stigmas they represent. These efforts send two messages. To the media: STOP reporting inaccurate representations of mental illness. To the public: STOP believing negative views about mental illness.

[. . .]

Education provides information so that the public can make more informed decisions about mental illness. This approach to changing stigma has been most thoroughly examined by investigators. Research, for example, has suggested that persons who evince a better understanding of mental illness are less likely to endorse stigma and discrimination.

[. . .]

Stigma is further diminished when members of the general public meet persons with mental illness who are able to hold down jobs or live as good neighbors in the community. Research has shown an inverse relationship between having contact with a person with mental illness and endorsing psychiatric stigma.

World Psychiatry, Understanding the impact of stigma on people with mental illness, image added

I'm sure you can all think of other things people could do to help combat stigma. Discussing all the many different methods [PDF] people have conceptualized to fight stigmatization of the mentally ill is well beyond the scope of a single diary.

Providing education is important, but as for me personally? I find myself pausing at times. How do I honestly, accurately educate people about someone such as myself without arousing unease, disgust, or fear in the people I am attempting to teach? I was once very sick, and many aspects of my journey are unpleasant to hear or talk about. How could someone tell my story, with or without explicit details, with any degree of truth and still expect empathy and understanding from the "unenlightened"? Perhaps as time passes I will become more comfortable advocating by using my own experience.

When it comes to my current day functioning, I still have plenty of problems. Many of them are unrelated to bipolar disorder, however, and are instead longstanding character defects I just need to work diligently on. With regard to the bipolar disorder itself, I am certainly not asymptomatic, but life is better (thanks in large part to a brilliant psychiatrist who has repeatedly saved my life). I think I am a decent person, and when I do the things I know to do (take meds, hydrate, eat right, exercise, light therapy, counseling), I am pretty damn stable overall.

At first I hesitated to use the word sufferer to describe people living with mental illness, but in the end, I couldn't get around the fact that it is an accurate description of what we deal with day by day. Some days are better than others. Maybe it's not an empowering word, but I believe it to be true. Bipolar disorder does not define me, but it is inextricably interwoven into the fabric of my life and my being. And I have suffered -- and still suffer -- for its presence in my mind. Refusing to acknowledge this reality doesn't make it any less real... so why sugarcoat? This is not to say that I'm miserable, because I don't typically consider myself a miserable person. But there are some hard truths about living with my illness that are sometimes difficult to cope with.  I am very fortunate to have an overwhelmingly strong support network. Not everyone is so lucky. There are things people can do to help, however, and hopefully legislation will gradually move us toward decreased stigmatization of the mentally ill and increased access to affordable services.

Approximately 90% of people with serious mental illnesses are unemployed. This means they do not have an employer-based health insurance plan. If they try to purchase their own insurance, they find many barriers. Currently, insurers can refuse to sell or renew policies based on a person’s health or mental health, deny coverage for any pre-existing condition (thereby failing to pay for ongoing mental health treatment), or issue a policy with limits on the length of covered treatment. Even when such policies can be found, they are often extremely expensive and do not provide good coverage.

The Affordable Care Act addresses these fundamental problems and will significantly improve access to health and mental health care for people with psychiatric disabilities. Under this law:

  • Health insurers will have to sell and renew policies to all who apply (called “guaranteed issue and renewal”).
  • Insurers cannot deny coverage for a pre-existing condition.
  • No health plan can have a lifetime or annual limit on certain benefits.
  • Insurers cannot charge people with poor health more than others — premiums (the amount a person pays to have insurance) may only vary by a limited amount and only on the basis of a few factors (tobacco use, age, geographic area and family size).
  • Health insurers cannot discriminate based on a person’s mental or physical disability.
  • Young adults (up to age 26) must be allowed to remain on their parents’ health insurance, if their parents so desire.

These provisions will greatly improve access to quality health care and to mental health care for people with psychiatric disabilities who either have no insurance today or have insurance that is very limited or very expensive. The law does not require that individuals lose their existing health care coverage.

Bazelon Center for Mental Health Law, How Will Health Reform Help People With Mental Illness? [PDF]

Of course, the mental health cuts that have taken place in many states are a step in the wrong direction. Poor funding for mental health is an onging crisis [PDF], and this is one of the reasons advocacy is so important. My hope is that one day quality, affordable mental health services will truly be available to all who need them. Fighting stigma is an important element of this quest, as increased public support would help influence public policy.

We have a long slog ahead of us.

One last thought on the way the public perceives mental illness... Even when people think they are being nice, the stereotypes they buy into frequently still shine through. I recently had someone tell me he just couldn't imagine me having an "episode," and that I "seem so normal."

"You don't act bipolar at all."

Thanks. That's not sarcasm. Really, thanks -- because it was earnest, and the intent was kind. But the thought processes behind it were still a bit misguided. All I could really think to do was say with a smile...

"The result of lots of effort, support, counseling, and meds. But my treatment team and I thank you."

Originally posted to sricki on Thu Sep 26, 2013 at 10:20 PM PDT.

Also republished by Mental Health Awareness, Kitchen Table Kibitzing, and Community Spotlight.

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Comment Preferences

  •  Here's a link (128+ / 0-)
    Recommended by:
    Kysen, moviemeister76, second gen, annieli, Unitary Moonbat, bobswern, joedemocrat, Rosaura, churchylafemme, Chaddiwicker, FiredUpInCA, dov12348, Denise Oliver Velez, myrmecia gulosa, asym, viral, Dr Teeth, Empower Ink, princesspat, ramara, abbysomething, swampyankee, Wee Mama, Yo Bubba, David54, Horace Boothroyd III, FloridaSNMOM, JayRaye, Brecht, OHdog, tobendaro, peregrine kate, JoanMar, Dburn, vcmvo2, undercovercalico, raina, TomP, Preston S, i saw an old tree today, geebeebee, sdf, HappyinNM, marina, Statusquomustgo, Slightly Wobbly, Alexandra Lynch, young voter, Shakludanto, TX Unmuzzled, karmsy, Portlaw, TrueBlueMajority, mollyd, Vetwife, Laurel in CA, Thinking Fella, cosette, poligirl, Glen The Plumber, Remembering Jello, BlueJessamine, mookins, Norm in Chicago, anodnhajo, remembrance, CorinaR, Brooke In Seattle, I love OCD, Caoimhin Laochdha, Avilyn, JanetT in MD, ArchTeryx, wader, Vacationland, broths, petulans, madgranny, SteelerGrrl, bluesheep, Youffraita, allergywoman, marleycat, grover, sillycarrot, slowbutsure, Lily O Lady, wayoutinthestix, RiveroftheWest, Piren, rubyr, Late Again, underTheRadar, whytewolf, p gorden lippy, Catte Nappe, enhydra lutris, devis1, Portia Elm, mksutherland, aughtomatic, flumptytail, Regina in a Sears Kit House, Satya1, zett, TiaRachel, Corvinus, JekyllnHyde, lunacat, Eric Nelson, Loonesta, forensic economist, alice kleeman, nola2chi, LinSea, gmats, LeoDaLion, worldlotus, yerioy, Powered Grace, shesaid, LilithGardener, imagiste, stevie avebury, atana, Matt Z, millwood, Brit

    to a brief, interesting TED Talk about mental illness, with emphasis on social stigma and stereotyping. It's certainly funnier -- and undoubtedly a lot more entertaining -- than my rather lengthy diary.

    Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

    by sricki on Thu Sep 26, 2013 at 10:18:36 PM PDT

  •  A great diary on an important topic. (42+ / 0-)

    I'm glad to see that you added the information about the Affordable Care Act.

    I think that having proper care easily accessible is a very important step in combating the stigma of mental illness. The more accessible treatment is the more people who need it will avail themselves of it. I am a firm believer in preventative health care...both physical and mental.

    I wish I knew how to educate the dig out and remove the fear and ignorance at its root.

    This diary is a tool to help towards that goal.

    Good on ya.


    Never argue with a fool, onlookers may not be able to tell the difference.

    by Kysen on Thu Sep 26, 2013 at 10:55:02 PM PDT

    •  One thing that repeatedly causes trouble (26+ / 0-)

      is the cost of medication.

      A friend of mine, who is brilliant and witty, also suffers with obsessive-compulsive disorder and fits of rage. This made it rather hard for him to go to college (This requirement is illogical) and to work (I bought my work shirt, what is this one dollar "uniform rental" on my check?).

      He could not work and get insurance due to this quirk in his brain. Without medication, he could not work.

      The cycle was broken by his recieving disabled status. Now he got Medicaid, got on the meds that work for him, and is currently in grad school. Pity he wasted twenty years in and out of hospital and jail.

      When you come to find how essential the comfort of a well-kept home is to the bodily strength and good conditions, to a sound mind and spirit, and useful days, you will reverence the good housekeeper as I do above artist or poet, beauty or genius.

      by Alexandra Lynch on Fri Sep 27, 2013 at 06:55:12 AM PDT

      [ Parent ]

      •  The cost of medication (16+ / 0-)

        can be prohibitive, and as you said, many people (myself included) cannot function at all without it. You make a good point... that some people's inability to work due to lack of medication prevents them from getting the insurance to pay for it. It really is a trap that so many people struggle to escape -- and many are unable to get out of.

        I hope so much that one day necessary medications are available and affordable to the people who need them.

        Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

        by sricki on Fri Sep 27, 2013 at 07:19:48 AM PDT

        [ Parent ]

      •  Or access to it (10+ / 0-)

        A friend of mine is na adult with ADD, & takes Ritalin for it.  It has made a difference in his life.

        First, there is the problem of getting the script. As a Class II substance (Ritalin is, in essence, speed), the patient needs a written prescription, which can only be issued & filled within specific time frames. In other words, one has to wait until a week before one prescription is about to run out before asking the doctor for a new one (prescriptions can't be written with refills), nor can they be written & dated ahead of time. (The government is scared that legal Ritalin users will sell pills to the black market. As if my friend knows whom he could sell it to, let alone manage to actually sell any without getting robbed or beat up.)

        A few years back, there was a shortage of it. Neither of us yet understand what exactly happened, beyond the fact for some reason at the start of the new year the prices would go down & the corporations didn't want to be caught with stock they might end up taking a loss on it. My friend spent a week in early December calling area pharmacies trying to fill his prescription--even though he could easily afford the meds.

        And then there are pharmacists who see it is a Class II medication & keep no stocks on hand, filling prescriptions only on demand--if they will dispense the medication at all. (When my hypothetical friend was scrambling to get his prescription filled a few years back, he had pharmacists tell him they didn't sell it. As if it were something like crack cocaine or RU386.)

        Has anyone mentioned how fucked up the US medical care system is?

        BTW, this is all based on what I've been told. Of  course, I have no personal experience with any of this.

        •  You mention Ritalin. (15+ / 0-)

          This brings up a special pet peeve of mine: the arrogant lay conversations of those who love to discuss how "over medicated" Americans are. I saw one of those on Facebook yesterday by someone who really should know better. I drafted three different responses, ended canceling the last one and walking away.

           Mention your kid is on Ritalin or that you take Prozac, and people will tsk tsk often right to your  face. They'll second guess your wisdom, often try to undermine your physician -- even if she's a board-certified psychiatrist-- and accuse your child's school of trying to create a zombie.

          It's disgusting.

          I don't have kids. I don't have major depressive disorder. I don't have a dog in this particular fight. But I have many friends who have struggled for years and years to have reasonably normal lives for themselves and their kids. They're exhausted. They've tried everything. Now they're trying Rx meds.

          And then these alleged "friends," family members, coworkers, other miscellaneous cohorts, even members here, are smug in their absolute knowledge that Rx medicines are a scheme of Big Pharma and not good for this individual.

          They do more harm than they know. The illness has beaten the individual and parent down. Now theyre beaten down some more. They don't fight back. They're even more wounded thanks to their family and friends. Silence in response to being berated isn't agreement. It's pain.

          Unfortunately, we have quite a few of these conversations on this site.

          Great diary. Tipped and recc'd.

          © grover

          So if you get hit by a bus tonight, would you be satisfied with how you spent today, your last day on earth? Live like tomorrow is never guaranteed, because it's not. -- Me.

          by grover on Fri Sep 27, 2013 at 10:48:28 AM PDT

          [ Parent ]

        •  Oh, yeah. I am supposed to be on Ritalin as well. (9+ / 0-)

          The problem is finding someone to write it.

          They would apparently prefer that the shrink who diagnosed me writes it.

          Which is $300 for two intake interviews/meetings, and another $125 every month to see the shrink when I don't have any need for talk therapy, plus the $60 for the Ritalin.

          I can't get around paying $60 for the drug, but I'd rather just pay $25 once every three months to have my doctor look at me.

          When you come to find how essential the comfort of a well-kept home is to the bodily strength and good conditions, to a sound mind and spirit, and useful days, you will reverence the good housekeeper as I do above artist or poet, beauty or genius.

          by Alexandra Lynch on Fri Sep 27, 2013 at 12:43:02 PM PDT

          [ Parent ]

        •  I am suddenly so very grateful to live in a (5+ / 0-)

          country with (partially) socialized medicine.  Yesterday I picked up asthma and migraine scripts and found that I'd gone over the limit for the year, meaning that from now until January 2014, I get all my drugs free apart from admin costs ($20 to get a script for multiple drugs).  This means that I can hold down a job, which means that I can pay taxes (and spend ridiculous amounts of money at local shops on history magazines and cute socks).

    •  I am glad (8+ / 0-)

      that your friend was willing to take medication, and keep taking it.

  •  Tipped, rec'ed tweeted (26+ / 0-)

    thank you thank you.

    "If you're in a coalition and you're comfortable, you know it's not a broad enough coalition." Dr. Bernice Johnson Reagon

    by Denise Oliver Velez on Fri Sep 27, 2013 at 12:16:48 AM PDT

  •  I hide my own issues (36+ / 0-)

    I have major depressive disorder, which I never tell coworkers or even friends about.  I go so far as to take medication at various time, to avoid people asking what I'm taking.

    Mind you, I am not ashamed of my illness.  I've lived with it long enough to understand it is a biological reality.  I hide it from my employers and people in general, because discrimination is socially accepted when it comes to mental illness.

  •  RE: "you are not alone" (27+ / 0-)

    some people are, pretty much. It is true that enormous accomplishments are possible with the right support, the right "wind beneath your wings"...people still loving you and believing in you when you don't believe in yourself. Your description of the self judgement is very apt and useful to see...I used to say I felt like I had an arm growing out of my head...felt so very abnormal that all could see, which made me feel unworthy and guilty.

    Mental illness alienates people, as I can see you are well aware of. I am sure many end up without a support system. and also in the place of not believing in themselves enough to stand alone and advocate and fight for themselves. We could say the same about any serious or life changing physical illness, except that usually your self esteem remains relatively more intact and quite possibly your "behavior" didn't push away people when you needed them the most. That is what happened to me.

    It's a really great diary otherwise, I just wanted to address something that felt a bit pat to me to see as someone without a support system or the ability to create one very well. I'm sure the reminder to people that do have one can be useful and I get it's good intent.

  •  Thank you so much (17+ / 0-)

    Having dealt with mental illness as patient, therapist, and family member, I find this subject so very important. I will have to come back to it for a closer reading, but it's an excellent look at how we do and don't deal with the subject or with the people involved. It's one of the things that most bothers me about the whole gun debate, the feeling that the mentally ill should lose their privacy by going on a registry.

    Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

    by ramara on Fri Sep 27, 2013 at 02:08:30 AM PDT

  •  Outstanding. This should be front paged and (28+ / 0-)

    not just read but put into practice by everyone here.

    Is it true? Is it kind? Is it necessary? . . . and respect the dignity of every human being.

    by Wee Mama on Fri Sep 27, 2013 at 04:41:34 AM PDT

  •  Excellent diary. (11+ / 0-)

    In the time it took Adam Lanza to reload, eleven children escaped. What if...

    by Sixty Something on Fri Sep 27, 2013 at 06:11:15 AM PDT

  •  Great Diary (8+ / 0-)


    “ Success has a great tendency to conceal and throw a veil over the evil of men. ” — Demosthenes

    by Dburn on Fri Sep 27, 2013 at 06:12:43 AM PDT

  •  truly outstanding diary (11+ / 0-)

    Thanks for sharing something so personal and for educating us.

    What do you think of TV shows like Monk that features a detective with OCD and Perception with a schizophrenic professor who helps solve crimes? I admit to liking both because I'm a fan of detective dramas.

    Pah. Deaf with a capital D.

    by raina on Fri Sep 27, 2013 at 06:27:13 AM PDT

    •  Gooooooooood question! (10+ / 0-)

      I can't speak for other people AT ALL, and honestly I don't think I've ever asked anyone who suffered from those disorders what they think about the shows. I have never seen Perception, but I did like Monk.

      My feelings on this kind of thing are a bit mixed. On the one hand, media portrayals have the potential to do harm -- either by painting overtly negative pictures of certain disorders, or just by reinforcing existing stereotypes (therefore making them more deeply ingrained in the public conscience). The average TV viewer probably doesn't have a firm grasp of causes and symptoms of most disorders. Because of that, such shows may have tremendous impact in terms of the way people perceive mental illness. There is no one way OCD manifests itself, but to a lot of people, I imagine Monk is now what they truly imagine OCD people to be like.

      How this influences a person's feelings about a particular mental illness is variable. In Monk's case, it was quite comical. I guess an argument could be made that it "trivialized" the pain and difficulty experienced by many of those suffering from OCD. On the other hand, I kind of felt that it "humanized" the disorder. It made it -- even if the show portrayed a pretty stereotypical case -- more "familiar" to the public, and therefore perhaps less "weird" or "scary."

      When shows portray mentally ill individuals as human -- capable of very common, human feelings -- who suffer from very human problems in addition to those unique to the illness, I think it can be beneficial. But I guess the answer to this question depends very much on the person asked.

      Anyone else have an opinion?

      Excellent question, and I'd love to hear what other people think.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 06:57:16 AM PDT

      [ Parent ]

      •  I understand you don't represent (7+ / 0-)

        every person with mental illness, but thank you very much for sharing your view.

        Perception is on TNT and is a bit more serious than Monk. This from wiki:

        Dr. Daniel Pierce, a talented but eccentric neuropsychiatrist, is enlisted by the Federal Bureau of Investigation to assist in solving some of its most complex cases in Chicago. Dr. Pierce works closely with Special Agent Kate Moretti, a former student who recruited him to work with the FBI. Also on the team are Max Lewicki, Dr. Pierce's teaching assistant and Natalie Vincent, a delusion manifested as a result of his schizophrenia who also serves as his best friend.
        Episodes typically begin with a scene of Pierce giving a lecture to his students about an aspect of the human brain; one that becomes significant within the plot of the episode. They also typically end with obsevations to students about the paradoxes of human perception.

        Pah. Deaf with a capital D.

        by raina on Fri Sep 27, 2013 at 08:22:05 AM PDT

        [ Parent ]

      •  Homeland (7+ / 0-)

        The main character (well, one of the two main characters)  on the TV series Homeland is bipolar, and a CIA agent.  The show does a good job of portraying the stigma (at least in the first season, which is all I've seen so far) -- she hides her illness, gets her medications through her sister, because she is afraid she might lose her security clearance if her condition was known by the agency.  

        But that's only one facet of her character, and I think the show does a good job of portraying her as a complex human being.  Hopefully seeing more fictional characters with mental illnesses portrayed in realistic ways -- where their illness is not the sole definition of their identity as a person -- will help get more people to think beyond the stereotypes.

        Thanks for posting this, definitely hotlisting for future reference.

  •  Really well done, sricki (11+ / 0-)

    Be prepared to publish an edited version of this after the next gun incident, especially when the Second Amendment people start to claim that gun limits aren't necessary but better mental health screening is.

    I'm really glad Community Spotlight picked this up.

    Seneca Falls, Selma, Stonewall

    by Dave in Northridge on Fri Sep 27, 2013 at 06:48:07 AM PDT

  •  I Live With My BP Girlfriend (12+ / 0-)

    .....who is increasingly disabled by a variety of health problems.  I also recently worked for a bipolar boss, but I was lucky enough to miss what is now being described as "the reign of terror."

    My GF would be able to find a job if she were physically healthy, but she would not be able to hold one for a couple reasons:
    1) She can't follow directions.  This isn't too much of a problem since I rarely tell her what to do. She'll ask me what to do about a persistent problem and I'll tell her "We've been repeating that conversation for 5 years, and my advice is still the same, and since you know what it is, I'm not going to repeat it. Best of luck with your problem."
    2)  If she's the least bit manic, everything I do is "wrong," and I am always doing the wrong thing at the wrong time, and I should drop whatever I'm doing because she knows better.. There is a lot of aggression in that.
    3) Mania shows one of the central conflicts of mental illness - the inability to be with other people and the inability to be alone.  There is a lot of aggression in refusing to respect other peoples boundaries. There have been times when I was studying where I threatened to go get a motel room just so I could do homework.
    4) Deadlines cause her to completely unravel. Somatic illnesses caused by stress are common.  She would not be able to hold any sort of demanding job   because she'd develop IBS.   My former boss destroyed an entire business unit by having  total meltdowns over deadlines.  In a panic she would destroy man years of work, substituting her own mania driven products, that the clients would reject.
    5) Denial of aggression is central to the condition, and most of the freudian defenses are in play.  This is true of any mental illness - there is layer upon layer upon layer of denial regarding their aggression towards others. This is true of any person, but the more aggressive someone is, the more likely they are to see themselves as a martyr.
    6) Listening to mania is excruciatingly boring.  It's repetitive, it's not creative, and it's brutally not funny.

    The worst time for her was when both her parents died and she had severe mania.  i physically ejected her from the house with instructions to drive straight to a mental health unit where her one of her counselors worked.  She called me 48 hours later from the clinic.  They had taken one look at her and whisked her inside to be treated for severe depression.  

    Anyway, GF and I love each other.  She has a full schedule taking care of her various illnesses, and he physical health has plunged in the last 5 years. She attends AA and Al-Anon a couple times a week and has been sober 25+ years.  Mostly she's doing pretty well.  She's a wise person with lots of insights that I respect, but she would not be able to hold a job in a tough economy.  

    Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

    by bernardpliers on Fri Sep 27, 2013 at 06:49:52 AM PDT

    •  I have IBS and ADHD. (9+ / 0-)

      I have to eat very carefully and avoid stress, and even so, any physical upset means my gut will go haywire too. The ADHD is a huge problem with potential employment. I cannot learn things if I cannot give the attention to the learning it demands. And it's not that I don't want to give it, it's that I literally don't have it to give.

      It causes chaos in the rest of life too. I'm not as impulsive as my husband is, but I'm bad at telling him no, because he yells, and doesn't fight fair, and I really can't handle that over a simple breaking of the budget every time.  I lose bills. I forget to mail them or to pay them or to sign up for budget billing, or call someone back for assistance.  It is terribly stressful to have this and be the person who's supposed to be the healthy and sane one, which I am if only by comparison.

      When you come to find how essential the comfort of a well-kept home is to the bodily strength and good conditions, to a sound mind and spirit, and useful days, you will reverence the good housekeeper as I do above artist or poet, beauty or genius.

      by Alexandra Lynch on Fri Sep 27, 2013 at 07:01:40 AM PDT

      [ Parent ]

      •  My GF Also Has ADHD (8+ / 0-)

        This was recently confirmed by a neurologist because we were concerned that there might be a physical problem.

        So many people with cognitive problems also suffer autoimmune disorders like IBS and fibromyalgia.  I'm surprised a clearcut genetic link has not been found already.

        Sometimes I rub my GF's shoulder and there will be a big hard knot that I can massage out. It's not a "disease," but it's got to hurt.

        Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

        by bernardpliers on Fri Sep 27, 2013 at 07:15:19 AM PDT

        [ Parent ]

        •  It does hurt, but it's so much better once you've (5+ / 0-)

          got it out! My boyfriend and my husband have both been taught to work on my knots, and yoga helps a lot to stretch and soften the muscles.

          When you come to find how essential the comfort of a well-kept home is to the bodily strength and good conditions, to a sound mind and spirit, and useful days, you will reverence the good housekeeper as I do above artist or poet, beauty or genius.

          by Alexandra Lynch on Fri Sep 27, 2013 at 12:46:13 PM PDT

          [ Parent ]

          •  Fibromyalgia + Bipolar + IBS etc etc etc (0+ / 0-)

            This seems to be a package deal of cognitive problems and inflammatory syndromes (but not quite autoimune disease) for so many people.

            Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

            by bernardpliers on Sat Sep 28, 2013 at 07:38:56 AM PDT

            [ Parent ]

  •  I guess I 'out' people (5+ / 0-)

    My mom is a schizophrenic. She was diagnosed before I was born. My dad always told me that it wasn't my fault and that it wasn't her fault. I understood, at a very early age, that she was just sick. When I got to college, if for some reason it came up, I would always mention my mom being a schizophrenic. I did this sort of for the same reason that glbt come out. (My mom wasn't coming out on her own; she still insists she's not ill.) I welcomed the questions from people (except that I got annoyed from so many people asking if I've seen a "Beautiful Mind", which I haven't and I don't see why I should).

    This leads me to my ex-boss, whose wife has some sort of physical ailment that causes chemical imbalances which affect her brain. That's how my boss described it. Never heard him say she had a mental illness, and I can see why it's ambiguous. But boy, if she didn't act crazy sometimes... At any rate, a friend of my boss's described a run-in she had with the wife. I mentioned the illness to explain the woman's behavior. It felt right to offer an explanation, but I also wondered if maybe I shouldn't have done that.

    In my universe, we're beyond locking up our crazy relatives in the attic and never mentioning them again. As your diary shows, I guess we're not entirely out of the attic. And with mental illness looming behind every mass shooting.. well, I'm worried.

  •  Very true, unfortunately (9+ / 0-)

    Often you can tell your friends or co-workers that you have a physical illness, like diabetes, but not a mental illness. That is much more stigmatizing.

    It is not always just malice or prejudice. There is a lot of ignorance out there: people have ideas in their heads about it, but they're not accurate.

    I have some experience with this .. family members with anxiety and depression, and a nephew who is bipolar. The nephew had a real hard time until he was diagnosed and got on meds that work for him.

  •  NAMI has (had) a wonderful series of classes on (7+ / 0-)

    the brain. It was said that recent research has been devoted to the brain (the Year of the Brain). As a result, new medications have emerged. Finding the proper medication for each person is key. One size fits all isn't applicable when it comes to the brain.

    It's going to take a great deal of education for society to link illnesses of the brain with illnesses of other parts of the body. Maybe the first step would be to stop isolating "mental illness."

  •  Thanks for posting this fine and important (12+ / 0-)

    diary. You are right that mental illnesses of various kinds still carry enormous stigma, and the lack of adequate and affordable treatment doesn't help any.

    I wonder if you are aware of this self-help/advocacy group, The Icarus Project? Here is their mission statement:

    The Icarus Project is a radical mental health support network, online community, and alternative media project by and for people struggling with extreme emotional distress that often gets labeled as mental illness. We envision a new culture and language that resonates with our actual experiences rather than trying to fit our lives into a conventional framework. We believe these experiences are dangerous gifts needing cultivation and care, rather than diseases or disorders. By joining together as individuals and as a community, the intertwined threads of madness, creativity, and collaboration can inspire hope and transformation in an oppressive and damaged world. Participation in The Icarus Project helps us overcome alienation and tap into the true potential that lies between brilliance and madness.
    I met some activists at a conference three years ago who impressed me very much by their honesty and compassion (much as you did in your diary here). The posts on the site are also seriously fierce and honest while still loving. Perhaps it will be of interest to you or someone else reading; perhaps not.

    I wish you luck and serenity in your own experiences, both on your own behalf and as you are able to give to others.

    Support Small Business: Shop Kos Katalogue If you'd like to join the Motor City Kossacks, send me a Kosmail.

    by peregrine kate on Fri Sep 27, 2013 at 07:08:12 AM PDT

  •  Really important diary. Many thanks. nt (7+ / 0-)
  •  "You just have to push yourself harder." (13+ / 0-)

    LOVE that one.

    Thank you, clueless nitwit. You just made me feel so much better.

    I feel a lot of compassion for people with mental illness. Part of the problem, honestly, besides social stigma, is that psychiatry is still so primitive. No, we don't do lobotomies anymore. But we still prescribe medications that were around in the 1950s. And while these may make life liveable for some sufferers who otherwise wouldn't have a life, their side effects can be close to unbearable. So, when somebody "goes off their meds" and stops bathing and drops out of society, can you totally blame them?

    We need more enlightened treatment for mental illness. Part of that comes down to pharmaceutical research, which has to become a priority.

    It's here they got the range/ and the machinery for change/ and it's here they got the spiritual thirst. --Leonard Cohen

    by karmsy on Fri Sep 27, 2013 at 07:25:27 AM PDT

  •  Thank you so much (10+ / 0-)

    for this thoughtful and informative diary. I'm bipolar as well, and have 'hotlisted' this diary for future reference. The stigma, particularly those peddled by the NRA types, is really disturbing to me.

    And yes, I have been robbed and assaulted twice....both assaults came while I was in a manic state although I wasn't acting violently at all....

    •  oh (9+ / 0-)

      and your discovering of being bipolar experience is extremely similar to mine. I avoided treatment/help for 10 years until I had an extreme manic episode that resulted in my hospitalization...although I didn't fight it much, I felt invincible and signed whatever papers they gave me etc., not really knowing what I was

      I agree that the stigma and a misunderstanding of what bipolar was (I thought of it as simply everyday moodiness) kept me from getting diagnosed much earlier which would have been very helpful. Still I wish colleges had people looking out for these sorts of things...I mean I would go from getting straight As to barely getting by with Cs from semester to semester...kind of an obvious sign to a professional looking for those sorts of things I would think.

      •  Yeah, my behavior (9+ / 0-)

        got me noticed in the span of just a couple of years. I went from "golden child" and "model student" to... a total disaster. Also, since we had bipolar disorder in the family, my parents knew to take me to a psychiatrist after things got really bad. I keep saying I'm lucky and fortunate to have had my family around... and I can't emphasize it enough. I wouldn't have made it this far without them.

        Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

        by sricki on Fri Sep 27, 2013 at 07:40:27 AM PDT

        [ Parent ]

  •  Very well written and important diary (9+ / 0-)

    Thanks for posting!

  •  Thank You very much for this. n/t (8+ / 0-)
  •  Don't talk to a therapist, to keep civil rights (2+ / 0-)
    Recommended by:
    llywrch, Kasoru

    There is a court case happening in the Chicago burbs, a man is suing over civil rights violations, violation of his 1st, 2nd and 4th Amendment rights, in addition to violation of doctor-patient confidentiality.

    A man was talking to his therapist, working out some issues.  Details have not been released.  One of the man's statements was interpreted by the therapist to be "threatening" in nature.

    The therapist called the cops.  The cops then, without a warrant, without due process, invaded the man's home and began stealing his possessions.  They confiscated 3 unloaded antique guns.  When the man complained and demaned the Constitution be respected, the police called an ambulance and ordered the man to submit and be taken to the hospital (at his expense).

    The doctors at the hospital immediately cleared him for release, rulled him not a danger to himself and others.  The man is now suing the police to get his guns back, and to punish them for warrantless siezure of private property.

    The takeaway lesson:  Don't tell a therapist anything.  There is no expectation of privacy.  Anything you say can and will be used against you by the government.  But not in a court of law.  You will be presumed guilty and a defense will not be allowed.

    Personally I'm hoping for the police to lose to the tune of millions of dollars.  A note from some quack does not overturn the Constitution.

    •  "Details have not been released" (12+ / 0-)

      This should not be a story used to illustrate what will happen to you if you seek counseling.  Those suffering from mental illnesses need help and therapists provide much needed support and direction.  I am sorry for this person who has lost their property and a trip to the hospital, I hope the police force do cover his expenses and return his property IF he is not talking about harming himself or others.  However, I am angry that you would urge others to NOT reach out and try to get help.  
        It is hard enough for those of us who don't want to believe we can't handle it on our own.  This is not the place to introduce the whole "big brother" and/or "communist government" crap

      •  Do you want mental illness stigmatized or not? (1+ / 0-)
        Recommended by:

        Shouldn't a person who has some mental health issues be secure in talking to a therapist and sharing their feelings without having to worry about being ratted out to the cops?  Do you want every statement you make during therapy held against you, outside of a court of law?  Do you want your therapist to just decide on his own, BAM, that the Constitution no longer applies to you, because he decided that you're crazy?

        Given what happened in this case, how can I in good conscience suggest that anyone be honest with a therapist?  There is no doctor-patient confidentiality, no presumption of innocense, no 4th Amendment protections.

        What if that man had been smoking a little weed, to self-medicate anxiety rather than take xanax or other big-pharma shit?  Should the police be allowed to sieze all his property, destroy his life and leave him homeless if they find a little pot?  Because they can, you know.  And what do you think his mental state will be after that?

        If you want to get angry about something, be angry over the fact that therapists can no longer be trusted, the mentally ill really don't have anyone they can trust, and any person seeking help can be labeled a crazy, dangerous criminal without trial or due process.

        A diary about the stigma of mental illness is exactly the place to discuss this.

        •  Those unreleased details (7+ / 0-)

          Since they aren't released we don't know what they are. But they could make all the difference in the world. The therapist is bound by law to report anyone they have good reason to believe is an imminent danger to themselves or others. And patients are apprised of that.

          In short, the message shouldn't be "don't seek therapy". It should be "don't tell your therapist you are going to go home and kill your noisy neighbor with your antique gun, unless you really mean it". And if you really mean it, thank your lucky stars your therapist followed both law and best practice, and did what was necessary to prevent a tragedy.

          “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

          by Catte Nappe on Fri Sep 27, 2013 at 01:19:04 PM PDT

          [ Parent ]

        •  I am sorry that you feel that way (1+ / 0-)
          Recommended by:

          Truly and without sarcasm.  I do not wish that kind of existence where someone feels the need to talk but only comfortable speaking on certain topics and not others, for fear of reprisal.
            There is only one reason that a medical personnel may disclose any part of a patient's information without consent and that is if they verbalized an intention to harm themselves or others.  If a health care professional has reported for any other reason then they are ABSOLUTELY in the wrong and should be punished to the fullest extent of the law. . .however that blame lies on the person who is the therapist, not the profession.  
            And I fully agree that not all people are trustworthy nor are all therapists trustworthy.  If you do not feel comfortable talking to your health care professional, PLEASE find someone else who you do trust.  Take care of yourself.  

    •  You are not helping (9+ / 0-)

      Therapists are required by law to tell the police if they think a patient is a danger to himself or others. Everyone who seeks help knows that. The fact that the police took his guns seems to indicate that he told the therapist he was either suicidal or thinking of killing someone else. It is the therapist's job to tell the police in this case. And  some doctor at a hospital who likely had never met him releasing him as mentally fit means nothing. Mentally ill people are experts at pretending to be "normal." We all know how to effectively lie to doctors to make them think we are all right.

      Time is of no account with great thoughts, which are as fresh to-day as when they first passed through their authors' minds ages ago. - Samuel Smiles

      by moviemeister76 on Fri Sep 27, 2013 at 11:41:38 AM PDT

      [ Parent ]

      •  Fine, I'll put it on the police then (0+ / 0-)

        That's where the lawsuit is going. But anyway, the end result is the same.  No doctor-patient confidentiality. And since the cops are happy to violate the Constitution at the drop of a hat, that's it, no civil rights, no due process.  Insane until proven sane is it?  And how exactly does one declared insane prove that he isn't faking being normal?

        So question for you, do you want the lawsuit I mentioned to succeed or not?  If a therapist decides a person is crazy, do they instantly lose 4th Amendment rights without due process?  Or does a judge at least have to grant a warrant based on the therapist's testamony before the cops start searching and seizing private property?

        What if a man admits to his therapist that he smokes weed?  Since according to the war on drugs that's one inch from being a heroin adict, does the therapist have a duty to inform the police about that as well, since he's clearly a danger to himself and others?

        It's just, why would anyone talk openly and honestly with someone who can just unilaterally declare them guilty and insane?  You know?  A man wants to work thorugh some anger management issues, and instead of helping the man, the therapist just tells the cops "go arrest that nut"?  How does that help people with issues get the help they need?

        •  No, doing drugs does not constitute a danger (4+ / 0-)
          Recommended by:
          sricki, fearlessfred14, Kysen, Matt Z

          to oneself or others.  When we say danger to self or others it is as a threat to life.  Drug use would only be reportable if someone were to tell their therapist they were planning to overdose on ____ with intent to end life.  I don't think marijuana qualifies :P  
            I agree with moviemaster 76 that if the police showed up and removed his guns, but was not really interested in the owner of the guns, he must have threatened to shoot someone other then himself.
            I would like to point out too that the man was suspected to be unstable, taken to a hospital where he was evaluated and apparently found fit and released.  

    •  The ethical/legal duty to warn varies (0+ / 0-)

      by state.  
      1.  As much of the particulars are confidential, you are speculating and assuming much.
      2.  Unless incompetent, the therapist didn't just take one offhand comment and run with it to the police.  We've all made idle threats.

      There was a conversation that covered means, intended victim (including self), time, plan, living environment, etc.  With the seriousness and validity of the plan and client's state of mind assessed.  Other professionals  may have been consulted prior and concurred.

      3.  See Tarasoff Warning (Tarasoff v. Regents of University of California).  While suicide is not included in/covered  this legal decision, therapist has a duty to take steps to reduce likelihood of self-harm (Bellah v. Greenson)

  •  Lenghty, but well worth the read (8+ / 0-)

    very informative.  And the "You can't catch it by being kind" graphic brought tears to my eyes.  

    The Girl Who Loved Stories
    I’m a feminist because the message is still "don’t get raped" not "don’t rape"

    by Avilyn on Fri Sep 27, 2013 at 09:00:38 AM PDT

  •  Excellent diary. (11+ / 0-)

    I can cite some of it chapter and verse, being an Asperger's sufferer.  Asperger's, however, has the stigma weirdly reversed in some ways: outing myself as one is MORE likely to get me the slack I need from employers, as it is a bright-line announcement that I have a disability, and am not just a "difficult personality".

    The last job, I made the mistake of not telling HR that I had Asperger's, and I approached a layoff, I had a single bad morning, raising my voice to an assistant that made a $2000 mistake.  I asked my boss what to do, and he said, simply, "apologize" so I did.

    Two days later I was suspended without pay, and fast-tracked straight to a termination hearing.  There, I revealed my disability, and all of a sudden the narrative changed from "why shouldn't we fire you?" to "what can we do to accomodate you."

    My answer was simple: "You can start by not firing me."

    I escaped with a written warning.

    There is a moral to my story but I am not entirely sure what it is: it certainly isn't something I'd do for a lot of mental illnesses.  My depression problems, for example, are kept extremely tightly under wraps.

  •  I've suffered bi-polar disorder for 48 years. (14+ / 0-)

    What looks like OCD to friends and family is actually learned behavior, skills that help me manage an out of control brain/emotional system.  I see it as a huge plus, now, but it used to be simple survival techniques that cost a lot of energy.

    My first suicide attempt and hospitalization occurred at age 15.  My records are extensive enough to have gotten me on SSDI in record time.  They are also public enough to make SSDI necessary- I haven't been employable in the open market for years, my resume is laughable, and self-employment only works between manic and depressive phases.  

    I've also been sober for 38 years, unusual for a bi-polar person according to various shrinks.  I'm fully out of the closet in my community because I am the only survivor- every bi-polar friend and relative has died, suicide actively or passively after returning to drinking/drug use.  

    I'm too pissed any more to give a shit about stigma.  My family has been my salvation, I have learned to find friends who love and support me, I'm earning survival money as a church organist and I'm loved and valued there, despite my alcoholism and mental illness.  That was a fluke, a miracle IMO.  

    I will never hide again.  I've been punished, fired, emotionally abused, sexually exploited, rejected, shunned, mocked, and dismissed.  Fuck them, I'm a survivor.  

    I've studied my illnesses, found effective ways to manage them, laughed about them, railed against them, and ultimately created a very fulfilling and meaningful life on the fringes of our culture.  I have zero interest in being around people who find me strange or scary and am pretty sure I'm the least dangerous person most people will meet because I'm fully aware that I have serious issues I can't ignore or take lightly.  

    Public outing of myself is the only advocacy I can achieve- my goal now is to teach other bi-polar people that living fully is possible, and rewarding.  If I succeed with one person, if one person lives a complete life span because of me it's all worthwhile!

    I'm not looking for a love that will lift me up and carry me away. A love that will stroll alongside and make a few amusing comments will suffice.

    by I love OCD on Fri Sep 27, 2013 at 09:16:27 AM PDT

    •  God, that's a hell of a road you've walked (9+ / 0-)

      My first manic episode was when I  was 7 or 8; I went undiagnosed and untreated for nearly 20 years until my fiance insisted I seek help and go on the meds.

      (I've since gotten divorced and found a better way to manage my condition without sleepwalking through life on the anti-psychotics, but that's another story...)

      One of the first things that my shrink taught me was to be honest about my condition--she literally said, "If you were diabetic, would you hide it?".  I was pretty good at hiding and pretending and it was safe that way--but I was only myself when I was alone.

      I told my family first, and then friends--much later I leveled with my new employer, and just a couple of years ago, when she was old enough to understand I told my daughter.  I've "come out" to everyone who matters--and many who don't.

      But it's hard and lonely work sometimes--I fight my clinical paranoia every time I need to tell someone...although these days I'm liable to joke about that too (my coping mechanism used to be alcohol, now I prefer humour)

      You have my sincerest respect ILOCD--it's been easier for me, but we're each different.

      Thanks for the diary sriki.



    •  You truly have my (3+ / 0-)
      Recommended by:
      Kysen, worldlotus, I love OCD

      admiration. I really hope that I learn to work through my fear of exposure and "concerns" about my professional life (are they concerns or just excuses?) enough to  advocate the way you do. I find your words and your story very inspiring, and I am amazed at what you have endured and the courage you demonstrate.

      I really hope I one day have half the guts you do. For as much as I worry about a career in the mental health field being "damaged" by public knowledge of my illness, the reality is quite likely the opposite. You are probably familiar with Kay Redfield Jamison. For those here who don't know, she is a brilliant psychologist and author who has bipolar disorder. She has written several books, and one of my favorites is her memoir, An Unquiet Mind. I have admired her tremendously since I first read it. She is brave and willing to put herself on the line in order to achieve the most good. Rather than destroying her career, her revelation has helped it flourish. She has used her experiences to help others, and her candid account of her struggles with mental illness gave me hope when I very much needed it. I am sure others have had similar reactions to her work.  

      I absolutely worshiped that book from the moment I laid my hands on it and read the first few pages. It was the first book of its kind I had ever encountered, and I was floored by it. The bipolar aunt I mentioned in the diary gave it to me within a week after my diagnosis of Bipolar I. I was held in thralldom throughout Jamison's journey, and while reading I often felt as if I might be looking into a mirror. So many good quotes and bits of insight and wisdom. One of my favorite lines, which I related to completely:

      Looking back I am amazed I survived, that I survived on my own, and that high school contained such complicated life and palpable death. I aged rapidly during those months, as one must with such loss of one’s self, with such proximity to death, and such distance from shelter.”
      "I aged rapidly during those months." That sentence hit me like a kick in the gut the first time I read it. It holds great meaning for me now. Because I know what it is to age unnaturally in a brief period of time. I know the body- and mind- and soul-weariness of it. And I know... truly know to the core of my being... that here is a woman who understands -- who has walked in my shoes and traversed paths even rougher than my own.  She is a symbol for much of what I aspire to in life.

      Your words have great impact as well. Thank you for sharing your experience and your perspective.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 09:08:43 PM PDT

      [ Parent ]

      •  That book took a long time to read, it was so (2+ / 0-)
        Recommended by:
        nchristine, sricki

        spot on I had to take breaks.  It came along at a time when I was bloody fucking tired of various rejections and slights, and empowered me to keep telling the truth, no matter who didn't want to hear it.  Thanks for mentioning it, I might need a refresher course soon!  

        I don't fault anyone for avoiding the shaming, shrinking away, and outright punishment mentally ill people are subject to, I'm just too angry with the disease to care.  I've watched brilliant, creative, loving, generous, amazing people reduced to bare survival before death became the clear solution for them.  They're my reason to fight back.

        I'm not looking for a love that will lift me up and carry me away. A love that will stroll alongside and make a few amusing comments will suffice.

        by I love OCD on Sat Sep 28, 2013 at 01:16:27 PM PDT

        [ Parent ]

  •  Thank you. (10+ / 0-)

    I'm outing myself as a person with anxiety disorder.

    I have also suffered from severe depression.

    This is important, thank you.

    Maybe - just maybe - our foremothers and our forefathers came to this land in different ships. But we're all in the same boat now. - Rep. John Lewis

    by bluesheep on Fri Sep 27, 2013 at 09:38:03 AM PDT

  •  IMO a lot of the difficulty lies in (11+ / 0-)

    social interaction.

    (Take the following as some not-exhaustively-thought-through observations from someone who's spent most of his life wrestling with subclinical depression and ADHD & was medicated for one or both for a number of years.)

    Bipolar disorder does not define me, but it is inextricably interwoven into the fabric of my life and my being.
    --which is true for all of us with some form of mental illness (emotional problems, brain dysfunction,call it what you will). People develop methods of dealing with others that they they internalize & apply without conscious thought--the equivalent of burning a program into memory--& those methods generally don't work very well when they encounter someone in that sort of personal situation. It's like the burned-in program generates an error message but there's no way to debug it & reboot.

    I've been fortunate enough to be able to step back at times & understand just how hard it is for people I know to deal with its effects. (E.g., being around someone whose view of life is through relentlessly-deep-blue-colored glasses. I'd often hear folks say, You have such a good life compared with so many others, how can you feel so badly about it? Try to explain to them that you understand this perfectly well on an intellectual level, but there's something about the way your brain works that keeps that understanding from getting through to the sense-of-well-being centers. It doesn't keep their frustration from mounting as they realize that there's really nothing they can do about it--because there's damn little you can do about it other than keep on keepin' on--& you're still Gloomy Gus...)

    But beyond (or maybe before) something like that there are all sorts of difficulties--verbal cues that aren't picked up, eye contact or lack thereof, conversational niceties that get taken literally (e.g., responding to "How are you?" with a 10-minute disquisition on how the respondent actually is)...

    (Think of Sheldon Cooper from The Big Bang Theory. How much of the "humor" in that show turns upon conversational interactions folded, spindled or mutilated as processed by his high-functioning-Asperger's? Not something I'm comfortable with as a source of laughter--but I digress...)

    It can be especially difficult for someone on the political/cultural Right to deal with this, because they are inflexible in the way they perceive reality, & their conversational style is deeply embedded in that perception, & if the asymmetric responses they get from someone whose mind just doesn't work quite the same way as theirs can be taken as challenges to that perception reality & produce nervousness & even hostility.

    You'd think just treating someone with mental/emotional issues with (un)common decency would be the answer, but that risks misinterpretation as an invitation to push farther into your personal space than you care to have them, & the eventual rebuffs can be hurtful...

    Maybe "normal" folks (hell, everyone) could benefit from a bit of advice on how to recognize & interact with someone with the different sorts of systemic mental/emotional difficulties...

    --does this make any sense to anyone? As I said, it's not as if I've spent enough time organizing or clarifying these notions...


    by Uncle Cosmo on Fri Sep 27, 2013 at 09:47:17 AM PDT

    •  I have heard this (5+ / 0-)

      many times:

      I'd often hear folks say, You have such a good life compared with so many others, how can you feel so badly about it?
      Definitely not helpful to someone who is struggling. In my case, it always just added an additional level of guilt to the pain I was already experiencing (IF, that is, I was still "sane"/grounded enough to feel guilt or any other halfway normal human emotion at all).

      To this day, I feel guilt over this sort of thing. My MIND has made my life difficult. If I hadn't been severely mentally ill and experienced all of the suffering (of a hundred varieties) that goes along with it, one probably could have said I'd led a charmed life. My family was not wealthy, but I was raised in privilege through the sacrifices of my parents and grandparents, who wanted to make sure I always had the best possible opportunities to succeed in life. My support network is incredible and always has been. I have insurance. I was told I could be anything I wanted to be. I was pushed to excel, and with regard to academics and career aspirations, I was supported very step of the way. Things have gone awry in my family many times, but I am so very lucky. They still love and support me immensely.

      I have it a lot better than most people, and when I am not sick I am aware of it -- and make a point to remember it. But when I begin to slip... I lose sight of it -- lose my perspective -- and become mired in the cesspool that my mind becomes. It is during such times that many people "can't help" but point out that I am so well-off compared to most of the world. They are right, of course. But during those periods, I cannot internalize their words in any meaningful way. So they end up frustrating and upsetting me further.

      People don't seem to understand this. And I can absolutely see why they are perplexed.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 09:21:42 PM PDT

      [ Parent ]

  •  My great-aunt (6+ / 0-)

    had a "complete mental collapse" when she was in her early thirties (sounds to me like schizophrenia, but I don't know) and spent the remaining fifty years of her life in a mental hospital. She was alive well into my teens but no one ever talked about her, other than that my grandfather, her brother, went to see her every few months.

    Sometime I'd like to find out what she was diagnosed with - not just out of curiosity, but because there are others in the family that have (or had) anxiety, depression, and/or bipolar disorder. I don't suppose the hospital records still exist ...

    The thing about quotes on the internet is you cannot confirm their validity. ~Abraham Lincoln

    by raboof on Fri Sep 27, 2013 at 09:47:40 AM PDT

  •  Thanks for your insight (11+ / 0-)

    My brother-in-law was bipolar and died, homeless, on Christmas Day a few years ago. After his original diagnosis he was confined to a mental hospital and eventually a halfway house. He lived for 30 years with this disease and I wish I could have been more helpful. When he was under supervision and taking his meds he was an interesting and creative guy. During the various budget cuts to mental health facilities, he was determined to be well enough to live on his own with SSDI and some voluntary counseling.
    Unfortunately, he would not take his medicine unless he was supervised. So he fell into a pattern of self medication with alcohol and street drugs followed by hospitalization and release to begin the cycle all over again. Off of his meds, I wouldn't talk to him or have him in my house. He was violent and delusional. I wish we could have done more but there was nothing we could do since he didn't want help and he wasn't sick enough by someone's standards to force help on him.

    I recently had a conversation with a friend of a friend. Her son had a manic episode which resulted in the police putting him in a facility for observation. He's been diagnosed as bipolar. She wants this to be temporary and blame it on the drugs he was taking. She is afraid of him getting labelled as mentally ill and ruining his whole life. She sees the stigma of mental illness as worse than the illness. She's wrong. Until she and her husband face up to the fact that he will never be "cured" he runs a terrible risk of having an outcome like my B-I-Law. I told her my story and warned her that without grasping the reality of her son's diagnosis they run a very real risk of him spiraling out of control. They will need to support him as much as they can and intervene if they have to, but he won't "get better" just by going to AA.

    •  I am so sorry about your brother-in-law (6+ / 0-)

      It sounds just like my brother's illness, and I am afraid he is on the way to the same fate.

      •  Not much to be done, unfortunately (3+ / 0-)
        Recommended by:
        Portia Elm, viral, worldlotus

        I really wish we could have helped him but that wasn't possible.

        I came home from work once to find him waiting on the porch. I never pulled into the driveway but just kept going. I called my husband and told him that I wouldn't be back until he was gone. He was THAT frightening and violent. After their mom died and he had nowhere to stay after he'd burned through his money by mid-month, things got very bad for him. His health got bad and he bounced in and out of the hospital for psychiatric episodes and drug and alcohol abuse.

    •  I agree that living with the illness (5+ / 0-)
      Recommended by:
      Kysen, gmats, worldlotus, Portia Elm, SeekCa

      (in its active, untreated form) is worse -- many times over -- than learning to cope with the stigma associated with diagnosis and treatment. To me, there is no greater hell than being in my own head without my medication.

      I have had bouts of noncompliance, and I paid dearly for them. As recently as two years ago, I stopped taking my medicine briefly "by accident." At least, it started accidentally because I was so distracted and upset by a new job fresh out of my master's program, but I ultimately decided that my medication was harmful and "making things worse" and stopped taking it altogether. Within a little over two months, I was on the brink of suicide. I couldn't take it much longer. I was trapped in a mixed episode and couldn't figure out what was wrong with me. Despite my education and despite my past experiences, once I started getting sick again, all logic and reason abandoned me. I was incapable of rational thought. I was saved by my therapist, who laid eyes on me for the first time in several months and instantly said, "Ohhh... you're not taking your medicine." He convinced me to start taking it again, and although I did not believe it had anything to do with the way I was feeling, I did as he asked. It wasn't long before my mind began clearing.

      Once cleared, I was utterly shocked and horrified at what I had done. And I couldn't figure out why I had done it or how it could have happened, with all of my academic and self-knowledge.

      There are so many reasons people are noncompliant with their meds, and there is so much suffering as a result. I am happy for the people who can manage their illness with talk therapy and living a healthy lifestyle. I am not one of those people. Some of us need medication, and as you suggested... no amount of self-help or AA or therapy or self-medication will improve our symptoms in the long run.

      Some of us have no quality of life without medication. Some of us would have no life period without medication. I count myself among that group, and the gratitude I feel for my support system and my ability to obtain therapy and medication is... immeasurable. It is tragic that so many people have no access to these things.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 09:38:28 PM PDT

      [ Parent ]

      •  I wish he had been as strong as you are (1+ / 0-)
        Recommended by:

        Good luck to you and it sounds like, while things may not be entirely smooth in your life, you have a very good handle on it. I just hope the young man who has the recent diagnosis can come to the same realizations.

        Sadly, the mother struck me as someone who wants to pray it all away.  

  •  it is not my intention (9+ / 0-)

    to negate anything said here.  I want to present my experience.

    My 300+ lb elder brother is bi-polar, definitely manic-depressive, and other things.  I took him into my home not having been told by my parents the extent of his illness.  My parents came to live with me also.
    I told him he had a home with me for as long as he needed one, but his insecurity and fear of being homeless (he was on SS disability) prompted him to scare the crap out of me and threaten me however he could, corner my parents and take their cash (my father hid his money in abouty 5 places).  We tried to get him treatment, and he refused to take his meds, and went out and bought drugs of his choice on the street.  Finally, he threatened to kill me if I did not sign my house over to him.  He was institutionalized by the Sheriff's dept. (my father got him released), and told he had to leave the state.  My parents in the meantime said they had never heard him threaten to kill me, though they were standing right there.  My parents took him to live in Washington State, and there, he beat my 78-year-old father nearly to death one day.  THEN my father had him committed.  Due to budget cuts and his halfway-house facility burning down, he is now wandering around the country, homeless, getting arrested for yelling at people, etc.  My older siblings refuse to face the facts about him, saying he is not a danger to himself or others.  I hope he does not know where I am.

    I have not told a tenth of what happened when he was living with me.  I see psychosis and the potential for violence everywhere now having been sensitized.  I had to get hypnotherapy for PTSD.  I do not blame him, but I can not be around him. I have letters, photos from our childhood, he could be good fun.  When he is possessed by these behaviors, he needs to be kept away from anyone or anything he could harm.  Yes, I am afraid of him, from personal experience.  I don't think the Google search choices are helpful, though.

    •  It's a real problem (8+ / 0-)

      I am so sorry you have been through such a traumatic experience.

      I think the main problem is that a lot of concretely different mental illnesses are usually stuffed into one category because we know so little about it. For instance, my mom and I have both been diagnosed as bi-polar. Yet my mom is emotionally and sometimes physically violent and often suicidal. I'm not like that at all. Yet we were diagnosed as having the same thing. It makes it difficult to actually help people or even explain to others who have no experience with mental illness except through the media what you are going through. It's one of the reasons I can't stand the show Homeland. The portrayal of someone who is bi-polar on that show is not remotely similar to my life experience.

      Some people like your older brother and my mom need a lot more institutional help than our society seems willing to give.

      Time is of no account with great thoughts, which are as fresh to-day as when they first passed through their authors' minds ages ago. - Samuel Smiles

      by moviemeister76 on Fri Sep 27, 2013 at 11:34:04 AM PDT

      [ Parent ]

    •  Disorders With Anxiety Drive Controlling Behavior (3+ / 0-)
      Recommended by:
      Portia Elm, zett, Corvinus

      Just to go on a bit of tangent - anxiety from a variety of disorders drive attempts to control and manipulate others.

      And depression is "the great imitator."  Lots of people are depressed but,for a surprising number of them, depression is expressed as violent rage towards others.

      Another point that I've made before - being "sick" is also a privileged status that has its own power ("secondary gain").  One my friends has borderline and bipolar traits and he is often enraged when people fail to say the perfect thing that would supposedly comfort him.  That's why he always has an excuse for his rage.  His counselor of 10 years finally told him "You are either going to stop doing that specific thing or you are going to die." This seems to have made an impression.

      A patient can from being in total denial about their condition to having insights that lets them use their status as being "sick" to their advantage.  "I can't help myself!" when in fact they are quite capable of avoiding punishment while being horribly abusive behind closed doors.

      This would lead to a much longer discussion of sadism, personality disorders, sociopathy, and child abuse.  Keep in mind that many of these people are completely unable to accept responsibility for their own behavior.

      Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

      by bernardpliers on Fri Sep 27, 2013 at 03:42:08 PM PDT

      [ Parent ]

      •  It was interestting that my brother (3+ / 0-)
        Recommended by:
        Corvinus, zett, bernardpliers

        would say "the voices told me to do that" when he did destructive things.  I once said to him, "you don't have to do what the voices tell you to do."  and he stared at me and said "Oh."  I got the distinct impression that he knew that excuse was not going to fly any more.

        •  This, this... (2+ / 0-)
          Recommended by:
          Portia Elm, zett

          No, you don't have to do what the voices say.  Through the neo-pagan sort-of-'shamanic' community, I know a lot of people who hear voices of various sorts.  The responsible ones are very careful about which voices they accept advice or instructions from; the ones who aren't so responsible often seem to have a lot of other stuff going on that screams 'abusive personality'.

        •  Also Real Life "Enablers" And Codependents (1+ / 0-)
          Recommended by:
          Portia Elm

          A lot of those voices are very real, and let's not forget there are plenty of people that are irressistabley drawn to abusive (mentally ill) people because of generational mommy/daddy issues.

          Mostly it's because these enablers have zero self esteem so they need someone whose problems can make them feel superior.

          I have written a bunch of diaries about this.

          Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

          by bernardpliers on Fri Sep 27, 2013 at 06:54:11 PM PDT

          [ Parent ]

      •  I also found out something else (0+ / 0-)

        that was valuable to me--he got violent when he was feeling blocked in some way--so if I learned to recognize the signs, I could open a way temporarily to let that energy flow and avoid a blowup.  Quite exhausting for me, and he finally cottoned on, and that tricksy illness definitely has a learning curve to perpetuate itself.  He actually would come up to me and say, "OK, Let's do battle."

    •  I am so sorry for the traumatic (4+ / 0-)
      Recommended by:
      Kysen, Portia Elm, worldlotus, Matt Z

      nature of your experiences. I don't think anyone can justifiably "blame" you for your fear, especially with regard to direct contact with him.

      I was never violent in the way you describe, but I do know I was, at times, a physical and emotional threat to everyone around me when I was unmedicated. Though rare, violence is unfortunately sometimes a dangerous component of a given individual's unique manifestation of a mental illness.

      The important thing with regard to society at large, of course, is that we do not generalize these experiences as being typical for people suffering from mental illness. Though it can be a difficult endeavor, it is vital that we regard each case as unique and avoid broad-brushing what is truly a very diverse population.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 09:54:09 PM PDT

      [ Parent ]

      •  thank you--I think anyone who (0+ / 0-)

        presumes to define themselves as "normal" is missing that whole point, as we all have to recognize that we have the same feelings and impulses at times.  It is becoming conscious of ourselves and being able to make a choice at all times that is so important.

  •  Thank you!!! (11+ / 0-)

    I had to go to bed soon after you posted this early this morning, but I made sure to rec it in case I forgot to come back and comment.

    I have several disabilities, both physical and mental, but all of them are invisible to the human eye. So I spend much of my life trying to "pass" as normal. However, when my physical disabilities keep me from doing something, I feel far more comfortable disclosing those disabilities than my bi-polar condition. Primarily because most people don't seem to understand what bi-polar is or if they have some rudimentary understanding (usually through movies or tv), they don't understand that it's not the same for everyone.

    So in the end, everyone I am close with knows I am physically disabled. Very few know I am bi-polar. It's pretty stressful, especially when it comes to school. Being unable to explain to my professors why I went from getting As to getting Cs is depressing.

    Time is of no account with great thoughts, which are as fresh to-day as when they first passed through their authors' minds ages ago. - Samuel Smiles

    by moviemeister76 on Fri Sep 27, 2013 at 11:48:45 AM PDT

    •  Best of luck to you, (3+ / 0-)
      Recommended by:
      Kysen, churchylafemme, worldlotus

      in your struggles and throughout your journey. Seeing people like yourself persevere through mental and physical suffering is inspiring.

      It is a sad reality that most people still do not have a clear understanding of mental illnesses like bipolar disorder. Most, in fact, probably don't possess even rudimentary knowledge of it. Media and academic institutions have not effectively educated the public, and I actually don't see the widespread ignorance as being a "failing" of the average American. A lot of people don't necessarily have time to "do their research," and I find it difficult to blame them. They work and take care of their families, and many of them naturally swallow the stereotypes fed to them by the media and by other uninformed friends, family, coworkers, etc.

      I hope things gradually turn around. In the meantime, use your best judgment with regard to disclosure, and know that there are others who have shared in your pain and stress.

      Take care of yourself.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 10:03:15 PM PDT

      [ Parent ]

  •  Thank you, sricki, for this excellent diary (5+ / 0-)

    and thanks to the commenters too. There's some of this in my family too, though thankfully not as severe as for many here. It's good that progress is being made; it's clear that there is still a long way to go, both medically and socially.

  •  Thank you. (11+ / 0-)

    Thank you so much for this diary, Striki..  I cried so hard when I read it.  Somebody really understands.  I am not bipolar, but I suffer from PTSD.  I was in intensive care in a coma for 6 weeks due to acute viral phenomena. After that I was sent to a rehab facility to get off the ventilator and learn to walk and talk and work with cognition.  An  orderly charged with my care molested me.

    My husband is a godsend.  He tries to understand, but at times he gets tired like so many caregivers do.  Friends send flowers and cards, and then drift away.

    A day without sunshine is like, you know, night. ....Steve Martin

    by Piren on Fri Sep 27, 2013 at 12:26:40 PM PDT

    •  If this diary helped you (3+ / 0-)
      Recommended by:
      Kysen, churchylafemme, worldlotus

      I am very, very glad that I posted it.

      Yes, there are people out there who understand. Among us, no two situations, illnesses, or lives are identical. I cannot speak for everyone because many people's experiences and feelings are beyond my comprehension due to the number of dissimilarities. But for some of us, there is much we have in common, even though our experiences are not exactly the same. They may, in fact, be vastly divergent. Still, there is an unspoken, inexpressible understanding between some of us, simply because we have known a certain "type" of suffering that is impossible to adequately describe. Our perspectives may differ, our reactions may differ... but for a lot of us, there is a thread of commonality that makes meeting someone who "gets it" almost... comforting, in a way.

      Thank you for your words, and take care.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 10:14:49 PM PDT

      [ Parent ]

  •  Excellent diary. Thank you. n/t (7+ / 0-)

    "Southern nights have you ever felt a southern night?" Allen Toussaint ~~Remember the Gulf of Mexico~~

    by rubyr on Fri Sep 27, 2013 at 12:53:39 PM PDT

  •  Thank you. You just 'outed' me. (11+ / 0-)

    I haven't logged in or commented here for a better part of the year, even though I spend hours on Daily Kos every day. Never a moment goes by when I have something to say, but my erratic thought process gets truly overwhelmed with words and ideas leading to avoidance of interaction in the end.

    Having been diagnosed with everythimg under the sun, right on up to schizophrenia, then abandoned by doctors unwilling to take a difficult case, I've just been drifting aimlessly physically & mentally, wondering what to do next.

    This diary has been a great moment in my life. Going it alone has been hell.

    Thank you Daily Kos!

    •  I hope you are able (3+ / 0-)
      Recommended by:
      Kysen, churchylafemme, worldlotus

      to find firm footing and get through that sense of "drifting aimlessly." I know it's not a comfortable feeling, and I'm sorry things are hard for you right now. Hang in there, remain vigilant about your thoughts/moods/feelings, and -- if you have the means -- please continue diligently seeking a doctor who is willing to work with you.

      Good luck in everything.

      Your knowledge of what is going on can only be superficial and relative. - William S. Burroughs

      by sricki on Fri Sep 27, 2013 at 10:21:07 PM PDT

      [ Parent ]

  •  One thing that seems to be better is that (4+ / 0-)
    Recommended by:
    viral, sricki, Kysen, worldlotus

    "plain" depression is not as stigmatized as it used to be.  I jokingly call my unipolar "good ol' vanilla" sometimes because I realize that compared to so many of the brain-ill (maybe we should quit calling it mental illness) I have it easy.

    Thank you for this diary.  

    •  I'm not sure I'd agree entirely. (4+ / 0-)

      At certain times, the stigma around unipolar depression can spike sharply. This has been especially true after mass shootings. I was personally kicked out of medical school literally the day after the Virginia Tech shootings, for allegedly "endangering the campus," because someone who knew that I was an Asian-American with depression reported that I might fit the profile of the shooter. That was in 2007, not very long ago. And in part because of the stigma around depression, it took me six months to find a lawyer willing to take my case even though it was extremely winnable. (The university was throwing money at me in literally the first phone call from my lawyer.)

      Fast-forward five years, to where I was a law student interning at the Bazelon Center for Mental Health Law (one of the organizations mentioned in the original post above). One of the lawyers there mentioned something that helped explain why I'd had such a hard time. Through informally speaking with other lawyers, she'd discovered that the single most frequent reason they rejected clients with mental illnesses -- including unipolar depression -- was that they assumed the clients would be difficult to work with. Some expressed the sentiment that no amount of money could get them to work with such "difficult clients." That was 2012. I still see plenty of stigma around unipolar depression.

  •  Also noteworthy is that (4+ / 0-)

    the myths about mental illnesses are internally inconsistent. It really makes no sense to believe BOTH that people with mental illness are violent and that mental illness isn't real... and yet that's exactly what a large percentage of the public still believes.

  •  The "I'm A Born Leader" Delusion Ruins Activism (0+ / 0-)

    I wrote a diary on the Adlerian model of compulsive neurosis and why activism and especially online activism attracts Adlerian neurotics and antisocial personality types like moths to a flame.

    Some of the screechiest voices on Daily Kos are people who are mentally ill, and they are here all the time because they are lonely and disabled.   Mental illness is the root of most of the cliquish behavior here. Being online lets them gain validation because they can compare their tallies of recs (from other mentally ill members of their cliques) and hrs (also from their cliques), and this gives them a sense of "superiority."  This is probably why clique members are so obsessed with these metrics.

    Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

    by bernardpliers on Sat Sep 28, 2013 at 08:04:42 AM PDT

  •  Any Illness+Antisocial Peronality Traits=Trouble (0+ / 0-)

    For example, a person can be depressed and quite nice, but many people are depressed and also have antisocial personality traits.  This is true of many people who are diagnosed with mental illnesses, but also people who are skating through life quite happily.

    Simply describing someone as "depressed" doesn't say if they have borderline traits, in other words it does not say whether or not they are aggressive and sadistic.  A person who is strongly antisocial would try to take advantage of being called "depressed" as a form of camouflage

    We're dancing around an eternal philosophical problem - What is the nature of evil?  

    A psychologist wouldn't say this, but we can identify three groups:
    1) People who are mentally ill but seemingly all good (many saints were clearly batshit insane)
    2) People who are mentally with a dash of evil (like an average joe)
    3) People who are mentally ill with a lot of aggression and sadism (and is this all "mental illness" by definition or is there such as distinct evil separate from mental illness?)

    What makes this tricky is that in groups people are easily led or coerced by sociopaths to do things they would never do individually.

    Antisocial (Dissocial) Personality Disorder is a personality disorder characterized by a pervasive pattern of disregard for, or violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. There may be an impoverished moral sense or conscience and a history of crime, legal problems, impulsive and aggressive behavior.
    The American Psychiatric Association's Diagnostic and Statistical Manual (DSM) and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems' (ICD) (F60.2 Dissocial personality disorder.[1]) have similar but not identical criteria. Both have stated that their diagnosis has also been known as psychopathy or sociopathy, though the criteria are different to some other commonly used assessments.[2][3][4][5][6] Antisocial personality disorder falls under the dramatic/erratic cluster of personality disorders.[7]

    Men are so necessarily mad, that not to be mad would amount to another form of madness. -Pascal

    by bernardpliers on Sat Sep 28, 2013 at 08:27:31 AM PDT

    •  "Good" and "evil" are not scientific concepts (0+ / 0-)

      and this way of thinking shows the danger of mingling societal police functions with a field that aspires to be science-based medicine.

      In practice the police functions of psychiatry have lead to a history of horrific human rights abuses, ranging from the forced sterilization of low income immigrants for "feeblemindedness" to the gender policing and medicalize punishment of LGBT children - which still goes on today.

  •  The huge nimbers of memtally ill people are the (1+ / 0-)
    Recommended by:

    very defintion of failed, ill advised or shoddy help options for those suffering from these health challenges.  The stigm attached to mental illness is a big factor in this tragic human consequence.

    •  There are huge numbers of *ill* people in America (1+ / 0-)
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      and it is a result of a failed, profit-crazed, medical system. The failure of US mental health is part of the broader failure of US medicine since Ronald Reagan created HMO medicine.

      Americans are propagandized to believe they have the best medical care in the world, when they actually have the worst care in the developed world.

      And it is not only medicine that has declined from lack of public spending, it is also the basic biological research that ultimately supports medicine. Most research now is profit-driven, as is most scientific education, leading to shortages of people with needed skills that are not the highest-paid skill. There are constant and increasing drug shortages for once cheap and common drugs because they are not high-profit items. The system is disintegrating because of greed -- not just in terms of access to care, but also in terms of quality of care.

  •  A wonderful piece! Thank you. (1+ / 0-)
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    I spend every day with these beautiful people.  And would spend every dollar.  But prefer days to dollars.  As they are too often short, 'fewed' against disease, but priceless.

  •  Several reasons for increasing stigma (0+ / 0-)

    1) The US has become more authoritarian during the last 40 years. Authoritarian societies value conformity (at least among the serfdom) and pathologize difference.

    2) The American Psychiatric Association (APA) is directly responsible for much of this. Each new edition of the Diagnostic and Statistical Manual (DSM) of mental illnesses is larger and identifies more types of "mental illness". These new "mental illnesses" represent expanded drug markets and billions of dollars for US pharmaceutical companies. Big pharma pays large "consulting fees" to shrinks on the DSM committees and takes them on lavish junkets. The DSM process is so corrupt with drug company money that the National Institute of Mental Heath has announced that they will no longer use DSM in their research.

    3) It would be very valuable to do a cross-cultural comparison of stigma regarding mental illness to sort out how much of this increase in stigma is an exclusively American (or American-Canadian) phenomenon.

    For example, much of the world has rejected the DSM diagnosis of ADHD and it's "treatment" with Ritalin. From an evolutionary point of view, it is simply absurd to think that a large fraction of children have brains that cannot function correctly unless they are supplied with a manufactured pharmaceutical.

    Rather what is happening is that American society has decided that children must all sit still for a large fraction of every day. This is not something children's brains evolved to do. We know from animal experiments that the neural networks of the brain require motor activity to develop properly. Children vary in how well they can conform to the social expectation of sitting still for long periods of time, but this variation does not automatically imply pathology requiring drug intervention.

    However American pharmaceuticals who make immense profits off the sale of "ADHD" drugs have convinced Americans that there is a real pathology here and that millions of children must take their products. Other societies and their scientific organizations have not been convinced of this, and should not be convinced of it.

  •  THANK YOU for a very important diary (1+ / 0-)
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    My daughter has Bipolar II with rapid cycling and has struggled with this since about age 8, but was finally correctly diagnosed at age 14 after a very brief (3 week) stint of trying to self medicate.  Luckily, we were able to afford top notch treatment and she has been stable (and sober) since then and is now almost 22, finishing college next May and already licensed and working as a Realtor too.    I like to say that she has Bipolar but it doesn't have her, since she takes a very active role in managing it, including strict dietary, sleep schedule, exercise, and other stabilizing actions.

    You are so right about the cost -- her meds alone are $600 a month and that is WITH fairly good insurance.

    She freely acknowledges her illness to others; maybe sometimes too much I think after reading this article.  You've given me something to think about and discuss with her -- I'm going to send her a link to this diary!

    The GOP -- Hating Women, Gays and People of Color since 1854

    by Former Chicagoan Now Angeleno on Sat Sep 28, 2013 at 01:39:38 PM PDT

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