Let’s Talk: The Language of Mental Illness

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“Bad enough to be ill, but to feel compelled to deny the very thing that, in its worst and most active state, defines you is agony indeed.”

― Sally Brampton, Shoot The Damn Dog: A Memoir Of Depression

So today is Bell’s Let’s Talk Day (There’s also the Time to Talk Day based in the UK on February 6th, not sure why we didn’t all join forces). I firmly believe that talking about mental health is a critical to improving the well-being of individuals and society as a whole. We have gotten a lot better about talking to mental illness and becoming more accepting of those with mental illness, but there’s still an echo of the belief that individuals with more common disorders such as depression and anxiety are “making it up”/”making a problem for themselves” or that they just need to “cheer up” and “stop worrying.” So we have all these campaigns aimed at decreasing stigma and increasing awareness, but our language shows that we haven’t quite reached our goal. Outside the awareness days, we still often make like if we don’t see it, it doesn’t exist. If we don’t call it depression it’s not depression. There are at least three problems with this attitude:

  1. It hurts to be ignored. Being ignored while you’re in pain and asking for help really is just salt in the wound.
  2. Ignoring it doesn’t actually make it better. If you ignored the fact that your credit card statement was past due, it wouldn’t suddenly decide to pay itself. No, the consequences would pile up.
  3. The silence is isolating and speaks volumes. If people feel they won’t get help, will be called weak, or had their problems minimized, they will often elect to suffer in silence. This just makes the suffering more lonely and shameful. Doesn’t fix anything.

Fortunately here in Canada, we are working to reduce the stigma and improve access to treatment, albeit we are still lacking services and attention in more rural and northern areas including in Iqaluit and the North-West Territories (for more info click here). Even in areas where there is bountiful access to services, almost half don’t seek help (source). But there are many countries around the world where individuals lack access to desperately needed services. In fact, according to the World Health Organization (WHO) more than 75% of individuals worldwide do not have access to the necessary mental health services (source). Problem is that as quickly as we work to break down the barriers, we carelessly build new ones.

The language of mental illness is sort of the problem. Or at least the way we abuse it. 

George Orwell

Have you ever been talking to a friend, describing something really silly or stupid or been miffed by someone’s apparent lack of two neurons to rub together and thrown own the R word? What about had a bad day or been tired and frustrated and declared “Kill me now.” or “I’m ready to kill myself.” Maybe when you realized How I Met Your Mother was cancelled or you suffered another disappointment you declared “I’m so depressed.” Perhaps after watching the Victoria’s Secret Fashion Fashion Show or seeing a really skinny/beautiful person you sighed to a friend “I wish I was anorexic” or labeled anorexics as “lucky”?

I could go on but I’m pretty sure you get the point. We use this type of language so colloquially and inappropriately that we cheapen it’s meaning. We can’t begin to understand the thoughts, emotions, and experiences of individuals with depression if we apply “depressed” to describe our feelings about minor disappointments, such as being unable to go out on a Friday due to homework or shows being cancelled. We make the person with depression feel silly. We cheapen their suffering. By using labels and terms so flippantly we may as well shout at them

I don’t understand you and I don’t really want to

Additionally,our language shows that we frequently forget that people with mental illness are still people and instead label them as their illness. Their label becomes their identity. Which is one of the fundamental grounds for the debate against using diagnoses – they create a stigma, an identity, and a self-fulfilling prophecy. People have depression, they are not only their depression. This distinction becomes more noticeable in cases such as autism and schizophrenia. In my classes they press upon us the importance when writing of not saying things like “Schizophrenics reported…” or “in a study with autistic children…” reminding us to remember their people-hood and say “Individuals with schizophrenia…” or “children with autism…” It may seem like a silly and minor distinction, but I think that this is critical to changing how we view and treat mental illness as a society. Making people their labels makes their illness their whole world, they have nothing else but their mental illness. 

I don’t pretend to be perfect. You would think I of all people would be more sensitive in this department. I remember in high school when kids made jokes about suicide in my class I went to the bathroom and cried from the painful memories their insensitive jokes had dragged up; horrified that they could be so cruel and uncaring. I do try to be more conscious in my use of mental illness terminology, asking myself, “Would I say this to a person actually suffering from this disorder?” (i.e. would I say “I’m so retarded sometimes” to someone who was mentally disabled?). If I wouldn’t say it to someone who knows what it’s like I try to find a more accurate way of describing my feelings and thoughts, and I challenge you to do the same.

I also challenge you to speak out. If you have suffered mental illnesses before, tell the world without shame – everyone needs help sometimes, you wouldn’t be ashamed to tell someone you broke your leg, or had heart disease. The brain is an organ too, it’s part of our body, and it can break sometimes. If you haven’t suffered from mental illness, odds are you know someone who has – go talk to them, ask them about their experience and how they are doing now, give them a hug and an hour of your time. If you are suffering in silence, go get some help – it doesn’t have to be professional, it can be a friend, or even a helpline – but speak up – shout if you have to and don’t stop screaming until someone gives you the help you need. If someone opens up to you – listen, do SOMETHING, and say thank you, because they trusted you with a very fragile and vulnerable part of themselves, and they trust you to care.

“When you’re drowning you don’t think, I would be incredibly pleased if someone would notice I’m drowning and come and rescue me. You just scream.”

― John Lennon

It’s okay, to not be okay.

So I’ve been thinking a lot about social protocol lately. What is the normal human reaction to things? Is what I’m feeling ok? I’ve meditated a lot on emotions (clearly. Since I wrote about it Monday), and tried to wrap my head around the public and private emotional domains.

Something that struck me was how cultures around the world seem to shy away from displays of sorrow. We only want the good. And we only want people to think we have our lives together and that they’re awesome, but that isn’t always the case. Life isn’t only what shows up on Facebook. Sometimes things aren’t okay. And that’s okay too.

I find it rather amusing in a tragic way that I used to find it difficult to even tell my therapist that I was not okay. Every time she asked me how I was, I would say good. Thankfully my nonverbal cues gave me away, and I mean if everything was totally fine why would I be in a therapist’s office in the first place? But I am totally caught up in this social script that goes like this:

“Hey! How are you?”
“I’m good! You?”
“I’m good!”

Because to say “to be honest my life is a hot mess right now” would be too much for us to handle. I’m in psychology and I don’t even know if in that instant I would know what to say if someone said that to me right now with a straight face. I say it sometimes, usually accompanied by a 🙂 or “hahah”, because God forbid I be serious.

But that’s the problem. Saying you’re happy and being happy are two different things. And I think we get very caught up in the should-be’s – the social scripts of how we should think and feel. And I think that’s part of the problem with mental health – feeling depressed isn’t okay, so we suffer in silence. We feel alone and unacceptable so we feel more depressed and isolated and unloveable. We tell ourselves that we shouldn’t feel sad, that we can’t be ourselves, and the pressure crushes us.

The other problem? We too often think we’re alone. Out of this understanding that our sorrow violates the norms of human functioning comes a belief that we are the odd ball out, we are failing being normal. You are not failing anything, and you are not the only one suffering. Imagine how freeing it would be to accept this?

I read an interesting passage by Ernest Becker in The Birth and Death of Meaning, in it he talks about how we know ourselves first through others (me) before we know ourselves (I). This struck me because we essentially put ourselves on the hands of others, we become what they want us to be. We talk about self-fulfilling prophecies in a lot of my classes and yet this thought has never struck me. Am I only me as I exist in others eyes? Is it then the discrepancy, the knowledge that our me and I don’t match. We feel split and confused.

I thought about this a lot because I am very much an open book, ask me anything and I will generally give you an honest, albeit potentially partial answer. I don’t come with much of a censor system. And I am a huge advocate for mental illness being something okay to talk about; for stopping the silence and shame of mental illness; and increasing the awareness. But I live a double life.
There’s the me that has my shit together. That knows exactly where I’m going and what I want. Then there’s the part of me that knows what it is to suffer, that cares too deeply. That questions if I’ve got it all figured out.

When I started applying to graduate studies I was told that the number one rule was to not talk about my experiences with mental illness. I felt like I had been punched.

Number one rule of Fight Club? Don’t talk about Fight Club.

I get it. Sort of. We want rational psychologists – the depressed can’t tell the depressed how to be less depressed. And I don’t want to get into grad school out of the professor’s pity – I do want them to see me as competent, intelligent, and caring. But at the same time I am mildly disgusted. I heard of a student who was forced onto a leave when the faculty found out he had a mental illness. I was told that even if the issue was resolved the faculty would still look at you differently. And I just want to scream – this doesn’t mean you’re broken and defective.

And so, despite my general openness, and my advocacy for awareness and acceptance. I don’t talk about this. But I want things to be different, I want it to be okay to walk up to someone and say, “I need a break. I’m not ok. I need help,” and have that person respond “That’s ok. You’ll be ok. Let me help.”

A few months ago I signed the “It’s Time To Talk” pledge. And you know what happened? I didn’t talk. I kept my mouth shut. Yeah I talked vaguely on here about body image and depression and suicide. I joke about cheering people up, I know that I am accepting of mental illness in others but I never opened up to the world, that I, a twenty-something woman with my life together, have known mental illness. I have seen its painful effects.

This is my brother Troy, he would have turned 29 last week, 12 years ago today, he took his own life.

This is my brother Troy, he would have turned 29 last week, 12 years ago today, he took his own life.

People don’t suspect that of me – in society we have this idea that those with mental illnesses are completely nuts, total hot messes, a sobbing mess in the corner, or else freaking out/hallucinating. Sometimes that is true, but the majority you might not even suspect. I went to class, I went to prom, I dated, I worked. Didn’t mean I wasn’t hurting.

Life hurts sometimes.

Sometimes it hurts really bad.

But pain is subjective.

And if everyone cries; if everyone is sometimes overwhelmed with the agony that sometimes comes with life; if everyone needs someone to tell them it’s going to be ok – why can we not accept this? Because maybe it means that if all these normal people can suffer depression, and anxiety, and eating disorders then what does this say about us? That we too may break down? Well damn, thank goodness there’s all these understanding individuals all around…

Acting like there’s something inherently wrong with the mentally ill doesn’t protect you and it doesn’t help anyone. Reach out, love everyone. It sounds preachy and cheesy, but you never know what someone is hiding. You don’t know what they’re going through, so smile at them because sometimes that can make the difference. If you’re suffering from a mental illness I’d love to hear from you – you’re not alone and only through talking about it can we break down all this shame.

I saw this video a few months ago, and it really inspired me.

Why People Are Not Adjectives

So I hear there’s this big thing about time flying when you’re having fun? I think this must be a bad Google Translate from some Swedish proverb that actually translates to “Time flies when you’ve got a lot to do.”

I honestly have no idea where on earth September went. I can tell you what I did yesterday, and the day before that. Probably as far back as two weeks ago. Where September went I don’t know. We are now well into the school year, I’ve got my first midterms in about a week and a half, I’ve managed to spew textbooks and notes into every corner of my house, and I haven’t been this tired since last April. And aside from missing reading for pleasure, I’m loving it. Anyone suffering from insomnia pick up any textbook, I guarantee you’ll be out before the third page. It’s not that the material isn’t interesting, it’s just that most of the time the authors manage to bore you with details and otherwise suck the life out of the material. It’s the profs that bring it back to life. Really those folks are miracle workers. Though I have had a few that just beat the dead horse.

A big topic lately that seems to have come up in class and for me personally is labels. Not the helpful kind that, for example, tells you that the door you are approaching is a push door not pull, but the kind that applies to a person. That people use to be miserly and presume to know people without actually knowing them. Or that takes a behaviour and turns it into a trait.

Labels

In my classes, we’ve talked a lot about the pros and cons of labeling someone with a mental illness. Theoretically there should be all or mostly pros – the person can get the love and support they need, doctors and therapists know what to do to help you. But there are also a lot of cons – people look at you differently, like a giant post-it note has covered your face. That label can follow you, you may become isolate and ashamed. The cons are mostly a product of our society, and to give it credit we’re working on breaking down the stigma. We’re getting better at opening up, which maybe eventually will break down the stereotypes.

For now, I’m going to stick to my guns. Labels are only useful for inanimate objects. If I admit that labels have a use why do I hate them so much?

labels and understanding

I get it. We as humans seem to have this idea that if we name something we can understand it. We can know exactly what to expect. Like when you get a new prescription and it comes with the possible side-effects bible. While all of the side-effects are extremely unlikely, we know what could happen and what we should panic about.

This theory works great usually, I mean you label a box “cereal” and you can expect there to be cereal in the box. Label a lecture “chemistry” and odds are carbon and oxygen will be mentioned at some point. Does it work with people? Not so much.

Saying two people are a couple tells you next to nothing about their relationship. You can’t even conclude how they necessarily feel about each other. You don’t know what brought them together or what they enjoy doing on Sunday afternoons. All you really can say is that they have apparently made some sort of commitment to one another. But we think we get what their relationship is like.

Saying someone is Anorexic doesn’t mean we know anything of their own personal brand of hell. You don’t know what their trigger foods are, what their safe foods are, if they have either, if they are restrictors or binge/purge subtype, if their vice is exercise, or how they feel about their family. You don’t know how they got there (odds are neither do they really, it’s kind of complex and sneaky). But you know the stereotype, so you assume they’re crazy, they’re just doing it for attention, they could eat but don’t want to, they don’t eat at all.

Calling someone selfish helps us come to terms with the fact that someone didn’t help us and allows us to place the blame on their defective character. Maybe they were behaving selfishly, maybe so were you, but it doesn’t make either of you selfish people. Maybe you were both just standing up for yourselves.

Problem is that once you know the label, you assume you know the person, and interpret everything in light of that. For a slightly humorous example check out the Rosenhan experiment.

labels and self-fulfilling prophecies

I could explain the social psychology behind labelling and what the way we describe ourselves supposedly says about your values, beliefs, and attitudes are. I could also tell you the social psychology of why people will change to fit labels, especially those that they have identified with. We assume that others see us better, so they must be right, and we will change to fit their beliefs. Guess Descartes was right… cogito ergo sum.

If you tell someone they are crazy, they will start to act crazy. Eventually they may actually become crazy. Yes this can also work in a positive light, but it’s much more potent in the negative. Once someone has adapted a negative label, it’s a lot harder to get them to believe the positive. Or that you were wrong. Words can do a lot of things, choose wisely.

For another totally awesome psych example, Google the “Stanford Prison Experiment.”

people are not static

Every year who I am changes. A year ago, I didn’t really drink Starbucks, last week my Gold Card came in.

A year ago I wouldn’t have touched sushi, tonight I am going to sushi lessons.

Two years ago I didn’t even like coffee, now it is part of my daily routine.

Get the point? I have changed. I am always changing. Which is both terrifying and awesome at the same time.

People change. It’s part of our biology. Labels, to me, imply that a person is static and unchanging. People change and grow, just because Jessica from accounting was suffering from Anorexia, doesn’t make her anorexic, and it doesn’t mean she will suffer from anorexia forever. She is still Jessica. Names are the only static label allowed. People act differently in different situations. Behaving selfishly in one situation or context does not make someone a selfish person.

complete descriptions

After many years of clinging to one label or another I had no idea who Niki was. I only knew her in the context of other people, events, and self-destructive behaviours. So I shredded every label, or tried to, for a while there I was just stuck with a wad of sticky notes. And then I started to get to know me again.

Ask anyone to describe themselves and I can almost guarantee they will use multiple words. Be it describing social connections, hobbies, their career, their physical appearance, usually a combination of these things.

I am a runner. This doesn’t mean that that is all I do. I am also a girlfriend, a sister, an aunt, a daughter, a friend, a cousin, a niece. I do not fill any of these roles all the time, familial relations are somewhat more permanent, but being an aunt doesn’t mean I run around chasing everyone on campus threatening to eat them up or attack them with the tickle monster. I am a student, but I still occasionally have a life outside of my classes and textbooks. I am a baker/chef, but I don’t just sit around cooking and eating.

Only by combining all the pieces of the puzzle do you get the whole picture.

labeling yourself

A few days ago I got a nervous flurry of texts from a good friend back home asking if they were a good person? If they were selfish? Dramatic? Stubborn? Did they care about people? (Which how I was supposed to know the answer to the last one I’m not sure). The list went on. And after a quick response: Yes, no (though we can all be at times), occasionally yes, ditto, and I presume yes. I summed it all up with:

“[…] stop doubting yourself, you are a good person, capable of anything. Stop doubting and if anyone’s got a problem, f*** em. Who cares what people think? That’s what life comes down to. I saw a quote once, you could be the juiciest of peaches and there will always be someone who hates peaches.”

This makes me sound so invulnerable. I do care what people think, often times too much. But something I’ve learned in the last few years, is that the harshest labels are the ones we apply ourselves, and the labels that others apply that hurt the most, are the ones applied in the heat of the moment.

You are in charge of you, so if you think they might be right, change it, if you think they’re just being a cranky T-Rex, give em a mental kick in the shins and walk away. People should be judged on their global behaviour – not just the bad moments. Overall, I believe that people are generally good. I think there’s probably a psych principle for that, but it’s true.

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Just because someone says you’re selfish. Or your introverted. Or extroverted. Or girly. Or obsessive. Or whatever else someone may tell you you ARE. It doesn’t mean it’s right. You can always reject the label. Or place conditions on it. Whatever floats your boat and makes you happy.

negative labels

Unless we’re talking the crazy psychopaths on Criminal Minds, people are generally good. Focus on the good. Let those be the static traits. And let those be the labels you apply. Rather than worrying about telling the jerk in line that he’s a jerk, tell the guy that held the door he’s a nice guy. Rather than tell yourself you’re a failure because you botched a midterm, realize that you are a smart person and maybe you just didn’t study enough.

The school system has this thing for report cards where they are supposed to list two strengths and an “area for improvement” on the report card. Seems like a fair formula. But remember, at the end of the day you are more than a word from the dictionary.

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