By Lucinda Jewell
The Hollywood spotlight on the successful film Silver Linings Playbook and hit HBO series Homeland is finally depicting people who experience mood symptoms in a more positive light. In the first, a fulfilled life is created in spite of symptoms and in the latter, an extraordinary career is made because of symptoms. However, how we view people who have had mental health symptoms or are living with them tends to be inaccurate, stigmatizing and demeaning.
The unfortunate pairing of gun violence with mental illness in the past year, post-Newtown, has been an unfortunate one given that the current argument would make it seem that “madness” is at the root of all of it, and that if we could just lock up the “crazies” and keep guns away from them then gun violence would subside. We know this is not true, and that most gun violence among people experiencing symptoms involves self-harm and/or death by suicide. The raging ex-LA cop Christopher Dorner, South African Olympian/Para-Olympian Oscar Pistorius, and the tragic shooting of a young Chicago girl in her home city after a triumphant cheerleading success in the Inaugural Parade all point to the obvious — gun violence and violence in general is a social pandemic far beyond the limits or easy label of “mental illness.”
Mental illness is a biologically based, neurologically expressed brain state that results in diminished capacity for self-care, daily activities, work, goals and accomplishments. It can be the result of various neurological differences as described by psychiatrists/neuroscientists in the DSM or the result of brain trauma from a number of quarters, post-surgery/anesthesia/adverse drug interactions, toxins, hormonal and nutritional imbalances, to name a few.
A mental health condition is a brain state expressive of a spectrum of neurodiversity considered different by the bio-medical and larger cultural community. People living with mental health conditions ranging from what scientists have described as Asperger’s Syndrome to Bipolar Disorder II can live their entire lives “passing” successfully within society. Many harness the strengths and resiliencies of these conditions to excel. While others, whose behavior or thought patterns stray outside what is understandable or acceptable, may be labeled, feared and ostracized. An MHC can be a lifetime experience of on-again, off-again symptoms or a one-time or limited time experience. (See Quantum Change: When Epiphanies and Sudden Insights Transform Ordinary Lives by William R. Miller and Janet C’deBaca )
Articles that continue to focus solely on the debilitation these brain differences can cause contribute to the stigma by ignoring the just as real strengths, resiliencies and gifts some of these states make available. BY continuing to label all as “disorder” and “disease” makes it simple to compartmentalize and overlook the complex differences between individuals and a degree of neurodifference that can allow not only for a life well-lived but for a great life.
Indeed psychiatrist Norman Doidge’s book, The Brain that Changes Itself points to possible exciting directions for mental health research and treatment that could create self-practices/programs for mental wellness without the side effects which plague current allopathic treatments.
In support of this, I propose that transforming the conversation for mental health begins with the language we use. For example, no longer is it acceptable to equate a diagnosis of a mental health condition with mental illness — “illness” should always have been, and now will be reserved exclusively, for symptom states that negatively impact a person’s goals, work, relationships and quality of life. No longer will it be acceptable to dismiss the insights and vision of people who have experienced depression and/or mania as “delusional” because they discovered them in a transcendent or revelatory state, just as it would be ridiculous to dismiss the experience of love because of its reality-altering brain chemistry.
I offer the following as a place to begin re-languaging the conversation, and hope that you adopt the reframing context and terminology where appropriate in your daily life. Let’s take responsibility for the world we create in language and make a new world for mental wellness:
• Mental health condition vs. Mental Illness (with the exception of describing periods of a mind state that debilitates engagement with life)
• Death by Suicide vs. Committed Suicide
• What’s right (strengths and resiliencies) vs. What’s wrong (pathology)
• Neurodiversity/Neurodifference vs. Disorder/Illness
• In order vs. Disorder
• Mental wellness/positive psychology vs. Mental Illness/pathology (with exception of quality of life symptoms mentioned above)
• Thriver vs. Survivor
• Contributor/Peer vs. Consumer/Patient (except when hospitalized/ill)
• Procovery (present-based, proactive approach to creating wellness now and for the future) vs. Recovery (trying to recreate a remembered past that may or may not be accurate, or helpful in living a great life now)
What else could we say instead to transform perception of who we are? Where can you see using language or reframing conversations that would make a difference in health and wellness?
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.