Tuesday, March 20, 2012

Mental Illness

The difference between a healthy person and one who is mentally ill is the fact that the healthy one has all the mental illnesses, and the mentally ill person has only one.
—Robert Musil

The thing to keep in mind is that "mental illness" is a label. It's a label we use to categorize and define certain behaviors. It should be clinical and neutral, nonetheless it stigmatizes people. A label like this makes you look at people with doubt, with paranoia, with questions. And sometimes not with compassion, not with understanding, and not with friendship.

I've been suffering from depression for awhile now. But let's see: Is it mental illness? is it "clinical depression," or "chronic depression"? or is it situational depression?

In fact, it's situational. Some of it can be traced to PTSD (post-traumatic stress disorder). In the past five years, my life has been extremely stressful, challenging, and turbulent: I gave up my own career and income to move back in with my parents to be their live-in, full-time caregiver until they died. They died, and I immediately was diagnosed with a chronic illness, ulcerative colitis. That illness almost killed me last year, when I almost bled to death and had major anemia which I still am recovering from, and this past year I've gone through the first of three surgeries to cure and correct the problem. I'm still recovering from that first surgery—and even though physically my strength is better than it's been in years, and even though I have an immune system again and managed to not get the flu, bronchitis, or walking pneumonia this winter, for the first time in a dozen years—some days I'm really depressed. Just like I used to be.

It turns out I've had this chronic illness for a couple of decades, but it wasn't diagnosed till recently. Looking back, I can see how UC caused a lot of problems that, at the time, my family, many of my friends, and even myself thought were caused by a bad attitude (tired all the time), a lack of ambition (UC drains your energy, will, and life-force), and being unable to focus (having a wide range of career choices, but never knowing what I wanted to do when I grew up; in fact, there are mental and cognitive consequences to being anemic and exhausted all the time, one of which is being unable to focus some days). These were the favorites amongst other psychological explanations that it turns out were a smoke screen. In other words I was sick for twenty years with a physical illness that had consequences for my mental stability and cognitive resources. Was I mentally ill? No—but many people treated me as if I was. And I believed them.

Reframing this experience now, I can see clearly how the last two decades of my life had been overshadowed by a physical illness that ruined me, but which everyone thought was a mental or psychological problem. Or even an attitude problem.

So if you want to leap to conclusions and label people you know as mentally ill, well, go ahead, that's your right. As Eric Frank Russell once remarked, "Every man has the basic right to go to hell in his own way." But just in case you might have leapt too quickly to a conclusion that's unwarranted, you might occasionally want to step back and take a look at your own assumptions about what "mental illness" means.

What most people actually mean, when they talk about mental health, is a social rather than psychological expectation that people conform to social norms and values and don't act weird. It means get a job, be a normal person, don't stand out, conform to the social normative ideas of what "success" means. Don't be different. Don't be of all things an artist.

Being an artist means being different. And being born gay means being different. It's no wonder so many gay men have mental health issues, when we're raised in a culture that hates and fears us, and still treats us a second-class citizens, and tries to deny us civil rights and social equality. The high incidence of gay men who support political candidates that would strip away their civil rights, given a chance, speaks to a high incidence of lingering and inarticulate internalized self-hatred. Whenever people vote against their own best interests or highest good, you can be sure there is, underneath their rhetoric, some lack of self-esteem, some insecurity.

"Mental health" is a normative concept; it usually means that you're supposed to think and act like everyone else, not be "eccentric" or "weird" or somehow not part of the usual narrative mythos of the American Dream of economic individualism at all costs, or the Dream of Technological Progress, or other sociopolitical myths that we're all supposed to believe and conform to. Individualism vs. collectivism are modern social myths that drive many people's unconscious self-destructive choices.

But every aspect of this is wrong. Socially normative "mental health" is a narrative of conformity and subjugation. The myth is that mental health is a stable steady state. The fragility of this self-image is evinced by the relentless social (tribal) peer pressure to conform to the norm.

Genuine self-esteem does not fear diversity or disagreement, and does not attempt to enforce conformity. Genuine, actual mental health is a state of flexibility and adaptability, being able to cope with change and hardship, being able to celebrate joy and love. Genuine mental health allows for eccentricity and individual variation. Mental balance and psychological/ecological dynamic health accepts the inclusion of dark days as well as happy ones, and celebrates both as authentic to the fully-nuanced, full-range human experience.

For myself, I've affirmed many times, and it's still true, that art-making is a positive force in my life that has kept me alive, that has kept me sane. For me music is medicine, music is sanity.

One of the only really useful definitions of insanity I've ever heard is a very simple, pragmatic one. It goes like this:

The definition of insanity is doing the same thing over and over again, and each time expecting an outcome different than the last time.

This definition speaks to individual mental health, to common sense reasoning, and flexibility in the face of changing circumstances. It speaks to how people can get stuck in social and political ideologies that create a bubble of unreality that everyone but the person inside the bubble can see. And it speaks to the group pathology of socially-enforced normative conformity, ranging from peer pressure to fascism, revealing these to be inherently insecure and unstable.

It speaks to the truth that when you are a sane person living in an insane world, the rest of the world labels you as insane, when in fact the opposite is true. It speaks to the truth that lots of times you're right and the world is wrong. Nothing crushes self-esteem more readily than the social need for conformity to normative social expectations that the person cannot live up to (or down to), and is unable to follow.

And it is underlined by a bit of wisdom from everyone's favorite genius uncle, Albert Einstein: "You cannot solve a problem by using the same kind of thinking that created the problem."

So, go ahead. Judge others as "mentally ill." You might even be right, some of the time. No more than that, though. Because lots of folks who we judge as mentally ill are in fact just having a hard time living up to your expectations of who they're supposed to be, and how they're supposed to behave.

Some wise man named Yeshua bar Joseph once quipped, "Judge not, lest ye be judged." If all the people who claim to speak for Jesus, who claim to speak in his name, would just remind themselves of his actual words, "Judge not," imagine what kind of world we might actually be able to make for ourselves.

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Blogger Elisabeth said...

I agree Art, so much of the business of mental illness is about the abel, and labels are social constructions.

I saw this TED this afternoon all about vulnerability. I found it helpful. You might, too. If you're interested take a look: http://www.youtube.com/watch?v=iCvmsMzlF7o&feature=player_embedded#!

The other thought I have here is that when someone dedicates themselves for a period of time to nursing someone else who is sick,over a longish period of time, particularly when that someone is a parent, it takes an enormous toll, as clearly it has for you.

I enjoy Musil's quote. It speaks to me of the truthfulness of the notion that we are all a little mad in different ways, but some of us get stigmatised for it while others are better at concealing their foibles.

12:10 AM  
Blogger Jim Murdoch said...

How would I define mental health? Ultimately being happy being you without having to conform to other people’s expectations. I hate the word ‘normal’ because no one is. There is no such a thing and yet so many of us aspire to be it. We are all individuals, all islands. Some of us cluster in archipelagos, others are content to sit alone in our own puddles. All of us are similar but none of us are identical. It’s hard not to judge other people’s islands though. There are some parts of yours that I envy, other bits not so much.

I have had a lifetime’s worth of mental problems. A part of me blames it all on either the meningitis of the fact that my mum left me on a table when I was a baby and rolled off, probably both. Who knows? For the most part my depressions were all caused by me not being willing to accept my own limitations and working myself into the ground. I treated burnout as a natural consequence of my chosen lifestyle and learned to live with it until the last breakdown which, as you know, took me years to get over IF I have.

I have for a long time felt that there’s two of me, the conscious me and this other me who sometimes puts sticks through my spokes and at other times tosses me a great idea or two to get on with. I dislike the lack of control I have over him. Since the start of December the brain fog has returned with a vengeance but really that’s the only symptom I have and, like literal fog, if falls suddenly and dissipates just as suddenly. Yesterday I had the first completely clear day in weeks and I wrote 3000 words. Today, much to my surprise, I’m still fairly clear although not as clear still I’m able to work. And that’s all I really want to do.

The thing about your kind of depression is that it’s pretty much a natural response to what you’re going through. Who wouldn’t be depressed? It’s like grief or love: who really has much control over either of these? The more I read about how our minds work the more I wonder about that other me and what his agenda is. I have to believe he’s doing his best for me and why should the mental stuff be any different to the physical stuff? He sends me aches and pains to tell me I need to exercise more so maybe he sends me brain fog to tell me to shut the lid on this damn laptop and go for a walk. I don’t know.

7:40 AM  
Blogger Art Durkee said...


Thanks for the TED talk by Brene Brown. I find it very appropriate. Here's the TED page with more quotes from her:


There are 3 quotes that really stand out to me as principles:

"Vulnerability is our most accurate measurement of courage.”

“Vulnerability is the birthplace of innovation, creativity and change. ”

“Vulnerability is not weakness. And that myth is profoundly dangerous.”

I agree with all of that. It brings to mind the truth that social conformity is rigid: you're deemed sane only if you conform to a rigid standard of social normativity. Any eccentricity, any deviation is suspect. But what Brown gets at is that to be creative and alive you have to be flexible, adaptable, courageous.

I am also reminded of the famous John Wayne quote: "Courage is being scared to death and saddling up anyway."

Being the live-in caregiver for my parents really did take a toll: a physical and financial one, not just a mental one. I'm still not over it, although I deal with it the fallout much better now. Some of the post-caregiving depression was very much tied up with grief, with losing my parents within a year of each other, and the discovery of my own illness. Sometimes I still find it hard to cope when it feels like life is throwing "one godsdamned thing after another" at me.

Can you believe that recently, since my own surgery and recovery, a couple of people have asked me to be their caregiver, to do that all over again? I found it easy to say "No" (although I was annoyed at their apparent blind selfishness in asking me), because I feel now like I've paid my dues. "Been there, done that."

9:04 AM  
Blogger Art Durkee said...


That's a good definition of mental health, thanks. I like the island archipelago metaphor, too, it makes sense on several levels. It can occasionally seem like other islands are nicer than one's own, but I think we all feel that way sometimes. One thing I've learned in all this is that comparisons can get you stuck in envy or judgmentalism, neither or which are very useful.

Have you read Julian Jaynes "The Origin of Consciousness in the Breakdown of the Bicameral Mind"? It's a great book on psychology, it reads like literature, and it's about the kind of doubled consciousness, the doubled mind, that you discuss here. The ancient Greeks actually formalized that "other me" into their belief system, calling it the daimon, and connecting it to our perception of the divine, and to creative intuition. Jaynes connects the ancient beliefs to modern psychology by showing how our evolution of self-awareness has changed our labels, but not necessarily the relationship we have to our unconscious mind. It's fascinating reading.

I've spent a lot of time learning about the daimon, about the duende, about the ancient Greek idea of being "taken by the god," because my own creative life has been very much like that at times. Maybe the only difference between your island and mine is simply that I've long accepted that the "other me" has sometimes got more knowledge than I ("I") do, and I do well when I trust the material that comes from there. (I include those aspects of my dream life that turn into poems, music, etc. I think that's connected to this.)

9:14 AM  

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