Our Culture and Mental Illness-A Vent

Is it just me, or does it seem like with all the talk around Donald Trump’s mental health status, there are people who think they’re trying to dispel myths and stigmas who are actually unintentionally perpetuating myths and stigmas about mental health? I see people throw the term “mental illness” around or repeat what they’ve heard or read from articles online, but they don’t seem to actually comprehend or understand the meaning behind what they’re saying. I think the one that bugs me the most are the people who, while trying to dispel stigma, actually perpetuate the stigma that someone like me who has my diagnoses are fragile creatures who should be pitied and there is nothing that I can do for myself. That somehow, I can’t handle hearing about someone else’s possible mental disorder or that I should be ashamed of possibly being associated with someone like Donald Trump because he might have a mental disorder. Some of these people have good intentions and just don’t realize the meaning behind what they are saying. Others throw around terms like “ableism” at people who they think are perpetuating stigmas.

I hate the term “ableism”. No, I loathe and despise that term.  The ignorance of the so-called “ableist” is much easier for me to deal with than someone who thinks that advocating for me is to view me and portray me as someone who is fragile, should be pitied, and is a victim.

I am by no means a victim. I resent being portrayed as a fragile victim deserving of pity because casting me in that light is a means to an end–attention and validation for yourself. It makes you feel good if people perceive you as being my advocate and my ally, but you’re neither to me.

Yeah. I said it.

If you were really my ally, you would not be speaking about me or people like me in terms of fragility or pity. You would acknowledge that I am a strong, capable person who can function in regular society. You would focus on empowering people like me by raising us up instead of holding us down. You would acknowledge that while I can personally thrive, I still do face some struggles, mainly that which involve people’s attitudes and lack of knowledge about mental health issues and our mental health care system.

We need so desperately to be talking about mental health issues, but at the same time, this conversation must be led by people who have some expertise or experience in this area–the therapists, the psychologists, the people who live with mental disorders, their loved ones, their caretakers, the nurses and the techs who all work in the system, the caseworkers. We all live this directly or indirectly every day. We’re the ones on the front lines. We’re the ones who actually knows what it feels like to experience the stigmas associated with mental health.

Someone from this group must hold the media accountable for their part in perpetuating stigma and stereotypes about mental illness, because they are the biggest culprits in perpetuating stigma.

We can’t even begin to discuss mental illness, mental health, and related topics until people begin to understand what they actually mean. Mental illness, for one, is a legal term, whose definition is set by the individual states. Mental illness and mental disorders are NOT synonymous at all.  A person with a diagnosis of Panic Disorder has a mental disorder, but they most likely do not meet the legal definition of having a mental illness. Mental illness, as a term, is used in criminal proceedings to describe a defendant’s mental state at the time of a crime. Or it is used in civil commitment cases where the family is petitioning the courts to have a relative involuntarily committed because they will not seek treatment for their mental disorder voluntarily AND this disorder affects that person’s ability to take care of themselves and/or that person may be a danger to themselves or to others.

Insanity is another legal term that people get wrong. Insanity isn’t even a clinical term. When people say “stop calling people with mental disorders ‘insane'”, it’s not because they’re being oversensitive or politically correct. It’s because you’re using the term wrong. 

 Another thing that’s bothering me lately is this confusion about narcissism and Narcissistic Personality Disorder. Narcissism itself is a personality trait. Narcissistic Personality Disorder is a Cluster B Personality Disorder where, in order to receive a diagnosis, a person must meet a minimum of 5 of 9 criteria. Trumps narcissism is pathological. I noticed this back during the primaries and mostly because I was taking Abnormal Psychology during the spring semester.

Which brings me to another thing that bugs me–how the public just accepts that because someone made a strong case in favor of Donald Trump having a personality disorder, it’s the same as an actual diagnosis by a psychiatrist. It is not.  I could make a very strong case that Donald Trump has NPD. But just because I can make a case by going through all nine criteria and citing examples of his behavior that support my argument, it doesn’t mean he actually has this. Personality disorders happen to be very tricky to diagnose properly because of the fact that they have very high rates of comorbidity with other personality disorders. I’m sure I could get out my Abnormal Psych book, which does list the DSM-V criteria for various mental disorders, and make a case that Donald Trump also has Anti-social personality disorder or Histrionic Personality Disorder, too. But just because I can make a case for it, doesn’t mean he has it.  I read an article today where the author was trying to make the case that Trump shows signs of mania. One of the signs the author listed was his random, stream-of consciousness, speech patterns. I could take that and make the case that Trump might have ADHD.

Now I’m not saying that he has any of this. My point is that you can’t just randomly pick out criteria from the DSM-V and say someone may have Disorder X without having an understanding of what you’re talking about. We can’t be treating the DSM-V like it’s the Psychiatric version of WebMD and that is what I’m seeing people who have little or no background in psychology or mental health doing right now.

Which brings me to another stigmatizing thing: this petition Representative Karen Bass started that is calling for Donald Trump to be forced to undergo a psychiatric evaluation.

First of all, there are no legal grounds for this. There is nothing in the US Constitution that requires that anyone running for POTUS has to go a psychiatric evaluation.

Second of all, while I have the knowledge and self-awareness of my condition to know when I should seek help, I have to recognize that not everyone else does. I do struggle with this, mainly when I see things that others don’t and I am baffled as to why other people can’t see it.

Third, this sort of thing harkens back to the 19th century and the abuses that brought about laws regarding civil commitment and involuntary commitment. No one person should have the power to have another person committed to a psychiatric facility for no good, valid reason.  You must build a case and present it to a judge, who then decides if that person should get a psychiatric evaluation. Then the judge uses the results of the evaluation to determine if involuntary commitment is even warranted.

While NPD is one of the ten personality disorders recognized by the DSM-V, it is highly unlikely that a judge would find that Donald Trump would meet the legal criteria for involuntary commitment. Delusions of grandeur are not even in the same category as the delusions or hallucinations that someone with schizophrenia might experience.

And fourth, civil issues pertaining to mental illness, like voluntary commitment, are handled by the individual states. Each state defines the legal term “mental illness”. Each state defines the procedure that must be followed if a family member wishes to pursue having a loved one involuntarily committed.  The Presidential election is a Federal issue. Which state’s definition of mental illness would apply in this case?

One last thing that bugs me about the way people are talking about Donald Trump and the possibility of his having a mental disorder: NOBODY is bringing up that, if this is indeed a case of someone in the public eye having a mental disorder, the behaviors that we are seeing are the hallmarks of UNTREATED mental disorders.

Many people who have untreated mental illness don’t believe there is anything wrong with them. Or they suspect something is wrong, but they don’t know what or can’t put a name to it. Or they even know something isn’t right, but are unable to get help until they hit their breaking point, which often means they are in the stages of sucidial ideation (thinking about the idea of suicide), considering suicide, or actually attempting suicide.  Or they have a breakdown in public.

Because most people don’t realize that they are having an episode or in the throes of a mental disorder at the time they’re experiencing it, and this happens in public, we just dismiss the behavior as weird or eccentric instead of showing compassion and trying to see that they get the help they need. And then when this person goes public with their diagnosis, we’re quick to dismiss them as seeking attention or trying to avoid responsibility for their actions.

People who have been diagnosed and who live with this every day should be able to talk about it, especially if talking about it aids in their own recovery.

There is treatment available. Granted, much of the issues surrounding mental health is the access, affordability, and availability of treatment for people who wish to seek it. But it is out there. People need to understand that showing signs or getting an actual diagnosis is not the end, but the beginning. They need to understand this in order to help advocate that anyone who wants to seek treatment can get it and not have to wait until they are suicidal or can no longer care for themselves.

I did seek treatment for my smorgasbord of mood disorders. My treatment consists of medications and putting into practice the coping skills I learned through behavioral management, cognitive behavioral therapy, and dialectical behavioral therapy. I learned how to recognize what might trigger a panic attack. More importantly, I learned that avoiding those triggers just made things worse. I learned how to face them, but more importantly, I learned how to recognize when to push and when to back off with the intention of trying again later. Two years ago, I could not go into a grocery store on a Friday afternoon because of my anxiety. Today, I barely even think about the crowds and the sensory overload around me that fuels my anxiety.

Now if I had to pick one thing that I wish people would understand, it is understanding that I don’t view mental disorders as something I should be ashamed of–not having one (or three), nor being associated with someone who has one, nor the possibility of being associated with someone who shows the behavioral signs of having one but has not been diagnosed nor is being treated for it. I am not ashamed of the term “mental illness”, either.  I feel that people need to understand this so that they stop mistakenly using shame in trying to quell stigma. When I see people who think they’re helping me by telling someone else that they’re shaming me, all I see is that person projecting their own shame and embarrassment onto someone else.

I get it. Mental health is an uncomfortable topic. I wasn’t always comfortable talking about it myself. But the rest of the world is just going to have to get over their discomfort because we really need to talk about this topic.

If I have nothing to be ashamed of, then neither do you.