My Ten Truths
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My Ten Truths about Mental Illness

 

  • Mental Illnesses are the cruelest diseases that a person can suffer.
     
  • We do not have adequate knowledge and information about mental diseases to be able to fully understand them.
     
  • Because we do not fully understand the source and physical nature of these illnesses, we have been unable to create adequate therapies to treat them with a reasonable degree of success.
     
  • Compared to other illness, there is relatively little compassion for the suffering caused by these diseases.
     
  • Because the diseases are poorly defined and treatments are expensive, societies do not provide adequate services for the care of those who suffer.
     
  • The greatest burden of care falls upon family members and loved ones.
     
  • Most people with mental illness lack insight into the nature of their condition because of their disease and therefore struggle with their recovery.
     
  • Most perspectives about mental illness have been reduced to for or against arguments when the reality is they are far more complex questions that cannot be answered yes or no.
     
  • Recovery, survival and redemption are possible through treatment.
     
  • People with mental illness are often brilliant and beautiful in many ways.

What are your ten truths?

Diane, a blogger, offers up her truths;

I have a few "truths" that reflect my situation/opinion/perception of mental illness:

1. Recovery is possible.
2. We need people who offer hope that recovery is possible.
3. Many people with mental illness do not receive the help they need for a variety of reasons.
4. People who are perceived as being a danger to themselves or others should be forced to take meds and/or receive therapy (under civil commitment laws, that usually means for 6 months).
5. We should view a person with a mental illness as a whole person, not just as someone who is mentally ill.

Those are the things I hold "true" today.

My observations of her "truths."   Perhaps what she has listed as truth number one is what should be number one and guide our philosophy of understanding and treatment.  Clearly one of the concepts that has seemed to differentiate how we view mental illness is that it is a "chronic" condition.  Conventional "wisdom" suggests that once a person suffers from a mental illness, they are condemned to suffer from the condition for life.  While this is true in some cases and perhaps many cases, it is not necessarily true for all cases. 

    My personal experience with type 2 diabetes is a reasonably good example of this concept.  When first diagnosed I had an abnormally high A1c test result as well as a fasting blood glucose level above 125 which qualified me for diagnosis as a type 2 diabetic.  My doctor suggested that I consider losing some weight and following a better diet as well as giving me some prescription drugs.  Over the next 6 months I researched proper diet and food intake, joined the American Diabetes Association, and began walking 30 minutes a day.  After 30 days the blood sugar levels began to decrease and I wanted to test the effects of the diet and exercise without the effects of the medication, so I stopped taking the medication and found that the blood sugar levels were maintained at a proper level.  The end result, an A1c test result that has tested in the "normal" range for over 1 year (more than 1 point less than what the ADA suggests is 'controlled' for a person with diabetes), a loss of 60 pounds of weight, a drop in cholesterol of over 50 points and a ten point lowering of blood pressure to a very acceptable level.  Visits to a podiatrist and an ophthalmologist found no damage other than normal wear and tear "for my age."

Some might suggest that I am cured/recovered/treated.  Whatever the case, what was not functioning properly is now stabilized and functioning well.  Should I return to my soda guzzling and poor diet selection ways, I would surely boost my weight and result in abnormal test results.  But a measure of control for daily life has now been established; However; it would be foolish to assume that the disease is gone forever.

    Similarly, people with episodes of psychosis, depression, mood swings and other psychological conditions have either found effective drug treatments or regimens that maintain their health and function.  Why then, do we view diseases like heart disease and diabetes with such compassion and similarly view mental illness with such distaste?  Do we not recognize the potential for recovery or do we over-estimate the potential for relapse?  Do we blame diabetics for their failure to follow a regimen that might bring many to a place of management of their condition like we blame those with mental illness for failure to maintain stability of their thoughts and actions?  Clearly much more is known about the blood glucose system than the mind, but it seems okay for people with diabetes to continue to eat what they want and spiral down in their disease while the person who struggles with depression is blamed for their inability to "deal with it!"

    All of this leads to Diane's second truth that we need more people to believe in recovery.  That is why the stories of people are posted on this web site.  It is terribly difficult to find representative samples of people in recovery mostly because often they do not wish to be found out.  The stigma attached to publicly coming forward is incredibly strong, but if more stories are told, more people will understand.  With understanding will come compassion.

    Truth number three need only review the material on the health care access page for a story which is repeated in various forms far too often.  The problem is that most people do not want to hear about the story because there is a mistaken belief that something like that would not happen to them.  One need only to look at bankruptcy statistics and discover the role that medical conditions play in that process.  It is a terrible indictment upon the care system that functions so well, yet so poorly in our country.  Combine the access issue with the stigma surrounding mental illness and it is a recipe for disaster.

    The truth of forced treatment I am in agreement with (with restrictions), probably because I have seen the devastating effects of non-treatment.  I have had dinner with a lovely couple who lost their daughter because she locked herself in her apartment and refused to take food and water and lost her life due to her inability to provide for herself.  It is difficult to imagine what those parents suffer through.  Two of my more favorite "patients/consumers/survivors" both are in favor of forced treatment because their psychosis resulted in tragic events that left them in the state mental hospital.  In spite of those events, they have returned to the community and serve with distinction on mental health committees and are benefits to the community.  Without treatment the results could have been far worse.  There are the cases that can be cited for the abuse of forced treatment and bad results.  On balance, however; I would agree in the principles of forced treatment with some limitations.  The phrase "greater good" rings true as long as the phrase "now and forever" is not paired with it!

    Truth 5 is very profound.  Many people, even many within the mental health field, have the tendency to view people with mental illness like they are a pronoun. "Them" and "They" are terrible labels by which to be referred.  Statements like "They are all like that" and "You know how they are" or "People like them" are used to described people with illness as though their condition somehow makes them less than human.  One friend of mine lamented how his son was always told that he was not trying hard enough to make effective use of his talents in school.  He was an "underachiever."  Looking back upon the experience now, Mark reflects upon how hard his son really was trying to do the right things and live up to those expectations.  Ultimately, young people who experience that frustration of being labeled as someone with "great potential" become frustrated and view themselves as failures and someone who has no value to society.  In this case, my friend's son took his own life, failing to see the value in what he may have been able to contribute to society.

    In this case, even though the intent was to help, not being able to help the young man to see his worth and only see his difficulties in reaching his potential was not enough to save his life.  Senator Gordon Smith of Oregon similarly recalls how his son's last thoughts were that "people could finally forget about him."  Both of these stories are tragic examples of how the person with an illness failed to see their value as a person and their importance to their families.  Perhaps that reflects upon the delicate balance between encouragement and pressure that so often seems to be thrust upon people especially at a young age.

    The fifth truth also reflects upon the "whole person."  Far too often the person is evaluated only by the behavior that is currently expressed by the person and not the totality of their person.  The jazz musician, Tom Herrell, does not reflect a persona that connects with people as an on-stage presence, but music lovers can still connect with his brilliance as trumpet player.  In his case, the flat affect that he exhibits from his disease is overlooked for the qualities of his musical skills.  Unfortunately, many people who suffer from mental illness do not possess a more visible skill like Tom and are labeled by how people see them from their most observable characteristic.

    The need to look past the behavior that is problematic and view the entire person is what is necessary.  The characterization that the person is the behavior and does not have any other characteristic worthy of consideration is one of the worst mistakes that we all make in our societal view of those with mental illness.  Categorizing people as symptoms and not as complete beings is the root of many expressions of stigma and prejudice.  All of us who deal with matters of the mind will be better served when we see not just the disease, but the totality of the people who suffer from the effects of the disease.

 

    Thank you Diane, for your thoughtful truths.

 
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Last modified: 07/01/08