Yeah lol exactly. It’s not stigma, it’s sanism. The language of “stigma” was originally used by the psychiatric survivor movement advocating to abolish the use of psych labels — which are inherently stigmatizing — before it was co-opted by the psychiatry itself, thus framing the problem as a “stigma” against the legitimacy of psychiatry/their labels.
I really like this idea. I just hope it doesn’t turn into another case of cultural appropriation & a spiritually-stripped, sanitized, scientized, commodified verson of something sacred– like mental health’s latest darling, McMindfulness & McMeditation…
As an abolitionist, my vision is not for things like this to be integrated into the mental health system, but rather, for them to replace it entirely. To me, the last paragraph reads a bit ambiguously & can be interpreted both ways.
I stand by what I said. What we refer to as “symptoms” can be very real. I am not denying that. I prefer to call them “experiences” or “behaviors” or “manifestations of trauma,” or a myriad of other things.
I don’t know about your older relative in particular, but I am used to hearing anecdotal evidence like this, often framed as appeals to pathos. My answer: Not enough info. You’re telling his story and starting with “secondly.” His condition could’ve been caused by life circumstances, childhood trauma, chronic stress, the bipolar medications themselves (if he was taking any) or a slew of other factors. Again, I do not know or claim to know his life story. I am not denying the realness of his experiences, behaviors, mental/emotional states, or what we call “symptoms.”
As a psychiatric survivor, I gain quite a lot by denying the existence of psychiatric disorders, actually. I don’t feel a need to justify that to you. I do not deny the existence of other medical conditions. Dementia and Parkinsons are not in the DSM; they are considered medical/physical health conditions, not mental ones– even though they may affect mental states. The fact that there is even a distinction should raise some flags to you, but clearly it doesn’t. Not everything that can affect mental states as a symptom is classified as a “mental illness”– from brain tumors to the flu (think fever-induced delirium). There is a reason why there is alarmingly little overlap between neuroscience and psychiatry, and why a distinction even warrants being made between “mental illnesses” and other types of illnesses.
For the record, I was labeled with bipolar myself. I now proudly reject that label. I also have been labeled with an eating disorder. I still use the label “eating disorder” to describe my experiences, mainly for ease of communication, although I do not agree with the conceptualization of it as a “disorder.” That doesn’t deny the bones that were sticking out through my skin, the clumps of hair I lost in the shower, the chronic self-hatred, the meals I skipped, the near-death experiences I had less than 2 years ago, or the consequential digestive issues I still deal with to this day. It doesn’t mean that I am naive to the mental, medical, or behavioral realities of eating disorders. It doesn’t negate the realness of my own experiences, both mental AND medical.
Trust me, I lived it; I don’t need anyone else to tell me. You might wanna hold back on the sarcastic snark next time without knowing anything about a person or their story.
One more thing I just thought of: Fifth of all, even if they are “self-medicating with other things,” you’re literally admitting that self-medicating is just as effective — no, actually, MORE effective! — than prescribed medication.
But for the sake of argument, what’s wrong with self-medicating? Psychoactive drugs are psychoactive drugs, period. Why are they any more “moral” or “healthy” if a doctor is prescribing them vs if a person is self-selecting & self-administering? They have the same effects on the brain & body regardless. Of course, different drugs have different effects on the brain/body depending on the drug, but drugs in general have the same effect. The body doesn’t care which kind is societally condoned or not. In fact, even calling them “medications” is misleading; they are simply drugs. There is nothing medicinal about them; there is no “chemical imbalance” or otherwise irregularity that they are “fixing.” If a person desires the psychoactive effects of these drugs (legal or not, prescribed or not) to help cope with their distress, that is their choice, and only they know themselves best. One may rebuke, “but only a doctor can diagnose and prescribe these medications, because they are a professional! A person cannot simply take that into their own hands!!” The doctor is not running any biomedical tests. They are simply asking a series of questions and then using their own subjective judgment. What gives their subjective judgment any more weight than the patient’s? The doctor simply serves as an authority figure and a gatekeeper. They are the “cop”– of the mind, body, and heart.
Second of all, there is no rule that people who are taking medications may not also be “self-medicating” at the same time. Why do you suspect that those who are unmedicated are more likely to “self-medicate” than those who are medicated? Why are you so quick to be more suspicious of unmedicated Mad people than medicated ones? Sounds like some sanism you might need to unpack there…
Third of all, if you are implying that they are not “really recovering” if they are “self-medicating,” then if in both cases recovery is chemically induced, then why is a prescribed medication-induced recovery any more valid than a “self-medication”-induced recovery? Or on the flip side, what makes a recovery due to “self-medication” invalid if you see a recovery due to prescribed medication as valid?
And last of all, why do you seem so eager to scrounge for reasons why a Mad person could not *possibly* be genuinely recovered & happy without medication? That it *must* be because they are doing something else (implied to be “improper” in your eyes) in order to cope, and that’s the *only* possible explanation for better outcomes? Just some food for self-reflective thought…
How is this relevant to the article? Congrats, I guess? For already falling in line with the mainstream narrative…? I mean, I’m genuinely glad you found something that helped you… I just don’t understand the need to announce it here.
A platform like Mad in America is meant to center the voices/perspectives/experiences of those *outside* the mainstream narrative, i.e. those who are marginalized by the mental health system… So you are welcome to be here if you’d like, but don’t be disappointed when you find out that this space is not *for* you or will cater to/align with your personal experience. Your experiences are not being invalidated by the fact that others may not share the same experiences and yours are being validated by the mainstream constantly, yet our experiences have been systematically invalidated & devalued. Let us have a space, too.
Side Note: Also, how can you ever really know that it was the medication that “saved” someone’s life? Maybe there were other factors that changed in their life that happened to coincide with when they started taking medication. Maybe the medication simply provided hope, or a placebo effect, and that itself was enough for a person to keep going or to relieve them of their distress. And furthermore, how can you know with 100% certainty that they would’ve died (presumably by suicide) if they hadn’t started taking medication? Furthermore, if we want to be completely fair, we must account for all the deaths that *do* happen due to the medications themselves. Many, if not all, psychiatric medications come with a black box warning of increased risk of suicide and self-harm. Perhaps there are people who find that their suicidal inclinaitons dissipate after starting antidepressants, but there are others (statistically more, read here: https://www.madinamerica.com/2025/02/observational-studies-confirm-trial-results-that-antidepressants-double-suicides/ ) who become *more suicidal* after starting antidepressants. The latter may come in two forms: 1) pre-existing suicidal inclinations may intensify, OR 2) in the absence of pre-existing suicidality, patients may begin experiencing suicidal inclinations for the first time. Of course, many will rebuke this with, “well isn’t that just their underlying mental illness?” and if I answer with, “well then why would they begin experiencing symptoms that they never had before?” then I’ll usually get hit with a “well because that must just be the natural progression of their illness,” and some will even say, “well maybe those who are prescribed medication had more severe depression in the first place.” While it does seem like a plausible explanation & difficult to separate what’s caused by the “illness” vs what’s caused by the meds themselves, multiple studies using comparisons of medicated vs non-medicated patients with the same diagnoses and equally matched degrees of severity have concluded that medicated patients experience *more* decline over the same amount of time than their non-medicated counterparts, and have a *higher* risk of suicide overall. Meaning that not only do their suicidal thoughts & feelings increase, but their rates of attempting suicide & dying by suicide increase as well. Of course, these are *averages*, they won’t be reflected in the experiences of every single *individual.* But those who claim to benefit from meds are actually just a loud minority (whose voices are amplified even louded by psychiatry itself as “success stories” and “proof”). Aligning with the mainstream narrative doesn’t necessarily mean you’re in the majority, just as being marginalized doesn’t necessarily mean you are a minority. Women make up half of the population, and yet we’ve been marginalized by society for centuries. It has way less to do with numbers & way more to do with who’s given a voice & a seat at the table. Unfortunately, with the “mentally ill” (or as we like to say, Mad), anything we say, think, or feel that doesn’t align with the mainstream mental health narrative can be attributed to our “underlying mental illness” and therefore dismissed as invalid. Quite clever, really– in a warped, twisted way.
I don’t think they’re arguing that there’s anything wrong with suicidality itself, just that “assisted suicide” or psychiatric euthanasia is ethically ambiguous at best for numerous complex reasons. There’s nothing morally wrong, in my opinion, with having suicidal feelings yourself; the problem arises when other people offer to act on those feelings on your behalf. If this followed along the same lines as the rest of psychiatry, this would very quickly be misused and exploited, devolving into a eugenicist practice while still being heralded as “for the patients’ own good.” The ultimate step in the mental health industrial complex’s evolution into the prison industrial complex: the addition of the death penalty.
Since there is no such thing as so-called “bipolar disorder” as a real, discrete medical condition, I think citing those statistics is barking up the wrong tree. However, I do think there’s a place for non-carceral, autonomy-affirming suicidality support. Not pro-suicide, not anti-suicide, but suicide-neutral care. Spaces where people aren’t *encouraging* each other to kill themselves, but they’re also not afraid to say the word “suicide” out loud, for fear of either a) being locked up against their will or b) winding up responsible for someone’s death. These spaces do exist. I think you might wanna check out StrongerU Wellness, as well as warmlines such as Wildflower Alliance or THRIVE lifeline. Resources and communities like this are harder to find in person, depending on where you live, but they are growing, and it is possible to find one in your area (or create one).
I agree to some extent, but I think it’s important to bear in mind that not everybody has the luxury/privilege to just quit their job/find a new one, or take a break until they feel better. Ideally, everyone would have that option, but unfortunately in our current economic system, it’s gonna depend on other factors like a person’s financial stability.
I relate to what you said, and I, too, have questioned at times whether or not I am “autistic” or an “HSP” or both or neither. One key difference is that autism is in the DSM, while HSP is not. HSP is not considered an official “diagnosis” and it’s not necessarily seen or treated as a “disorder” (however, it may increase your likelihood of being diagnosed with *other* disorders because others may tend to see you as “too sensitive” and society may have a tendency to pathologize you for having a reasonable reaction to its cruelty, cold callousness, and injustice). The fact that autism is recognized by the DSM and HSP is not doesn’t necessarily make one more “real” than the other. It’s pretty arbitrary overall, what ends up in the DSM vs what doesn’t, but I’m sure there are probably complex sociocultural and historical contextual factors that determined the evolution of these labels and this distinction between them (just like any other labels in the DSM/psychiatry), however, I will not get into all that now. Basically, both are real, and neither are real, at the same time. The experiences/symptoms/traits are real, but the labels are made up. They’re just determined by clusters of symptoms/traits, which 1) largely overlap, 2) change depending on who you’re asking, and 3) it’s not required that you have all of them in order to meet the criteria for diagnosis/labeling. That second one is especially of interest here; autism is one of those diagnoses that really depends who you ask and seems to have especially morphed and evolved over the years (especially among the “late diagnosed” or self diagnosed) to basically just mean whatever people want it to mean. It’s interesting how in this article, the author cites her emotional bandwidth and ability to empathize as a symptom of her autism, however, the traditional conception of autism (as well as what’s in the DSM) includes an inability to empathize or relate to the emotions of others, and a narrow emotional bandwidth as hallmark symptoms of autism. It’s interesting how two completely opposite experiences can not only be included under the same label, but are both considered keystone “symptoms” (or “proof”) of it.
What is your point here? That it’s “on them”– the employees– for not being “healed enough” or “emotionally well” enough? How can you expect someone to heal when their conditions are constantly subjecting them to chronic stress? Healing isn’t an independent project; it doesn’t occur in a vacuum. It’s chicken and egg here: employees are supposed to change their own working conditions by just “setting better boundaries” which requires them to be emotionally “healed”/recovered from burnout enough to do so, but employees can’t emotionally heal/recover from burnout (and therefore have the ability to set better boundaries) until their conditions improve.
Yeah lol exactly. It’s not stigma, it’s sanism. The language of “stigma” was originally used by the psychiatric survivor movement advocating to abolish the use of psych labels — which are inherently stigmatizing — before it was co-opted by the psychiatry itself, thus framing the problem as a “stigma” against the legitimacy of psychiatry/their labels.
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I really like this idea. I just hope it doesn’t turn into another case of cultural appropriation & a spiritually-stripped, sanitized, scientized, commodified verson of something sacred– like mental health’s latest darling, McMindfulness & McMeditation…
As an abolitionist, my vision is not for things like this to be integrated into the mental health system, but rather, for them to replace it entirely. To me, the last paragraph reads a bit ambiguously & can be interpreted both ways.
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I stand by what I said. What we refer to as “symptoms” can be very real. I am not denying that. I prefer to call them “experiences” or “behaviors” or “manifestations of trauma,” or a myriad of other things.
I don’t know about your older relative in particular, but I am used to hearing anecdotal evidence like this, often framed as appeals to pathos. My answer: Not enough info. You’re telling his story and starting with “secondly.” His condition could’ve been caused by life circumstances, childhood trauma, chronic stress, the bipolar medications themselves (if he was taking any) or a slew of other factors. Again, I do not know or claim to know his life story. I am not denying the realness of his experiences, behaviors, mental/emotional states, or what we call “symptoms.”
As a psychiatric survivor, I gain quite a lot by denying the existence of psychiatric disorders, actually. I don’t feel a need to justify that to you. I do not deny the existence of other medical conditions. Dementia and Parkinsons are not in the DSM; they are considered medical/physical health conditions, not mental ones– even though they may affect mental states. The fact that there is even a distinction should raise some flags to you, but clearly it doesn’t. Not everything that can affect mental states as a symptom is classified as a “mental illness”– from brain tumors to the flu (think fever-induced delirium). There is a reason why there is alarmingly little overlap between neuroscience and psychiatry, and why a distinction even warrants being made between “mental illnesses” and other types of illnesses.
For the record, I was labeled with bipolar myself. I now proudly reject that label. I also have been labeled with an eating disorder. I still use the label “eating disorder” to describe my experiences, mainly for ease of communication, although I do not agree with the conceptualization of it as a “disorder.” That doesn’t deny the bones that were sticking out through my skin, the clumps of hair I lost in the shower, the chronic self-hatred, the meals I skipped, the near-death experiences I had less than 2 years ago, or the consequential digestive issues I still deal with to this day. It doesn’t mean that I am naive to the mental, medical, or behavioral realities of eating disorders. It doesn’t negate the realness of my own experiences, both mental AND medical.
Trust me, I lived it; I don’t need anyone else to tell me. You might wanna hold back on the sarcastic snark next time without knowing anything about a person or their story.
If you would like to know my story better, I suggest you read my narrative essay that was published on here recently: https://www.madinamerica.com/2025/03/sick-enough-paradox-eating-disorder-treatment/
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One more thing I just thought of: Fifth of all, even if they are “self-medicating with other things,” you’re literally admitting that self-medicating is just as effective — no, actually, MORE effective! — than prescribed medication.
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Irrelevant question.
But for the sake of argument, what’s wrong with self-medicating? Psychoactive drugs are psychoactive drugs, period. Why are they any more “moral” or “healthy” if a doctor is prescribing them vs if a person is self-selecting & self-administering? They have the same effects on the brain & body regardless. Of course, different drugs have different effects on the brain/body depending on the drug, but drugs in general have the same effect. The body doesn’t care which kind is societally condoned or not. In fact, even calling them “medications” is misleading; they are simply drugs. There is nothing medicinal about them; there is no “chemical imbalance” or otherwise irregularity that they are “fixing.” If a person desires the psychoactive effects of these drugs (legal or not, prescribed or not) to help cope with their distress, that is their choice, and only they know themselves best. One may rebuke, “but only a doctor can diagnose and prescribe these medications, because they are a professional! A person cannot simply take that into their own hands!!” The doctor is not running any biomedical tests. They are simply asking a series of questions and then using their own subjective judgment. What gives their subjective judgment any more weight than the patient’s? The doctor simply serves as an authority figure and a gatekeeper. They are the “cop”– of the mind, body, and heart.
Second of all, there is no rule that people who are taking medications may not also be “self-medicating” at the same time. Why do you suspect that those who are unmedicated are more likely to “self-medicate” than those who are medicated? Why are you so quick to be more suspicious of unmedicated Mad people than medicated ones? Sounds like some sanism you might need to unpack there…
Third of all, if you are implying that they are not “really recovering” if they are “self-medicating,” then if in both cases recovery is chemically induced, then why is a prescribed medication-induced recovery any more valid than a “self-medication”-induced recovery? Or on the flip side, what makes a recovery due to “self-medication” invalid if you see a recovery due to prescribed medication as valid?
And last of all, why do you seem so eager to scrounge for reasons why a Mad person could not *possibly* be genuinely recovered & happy without medication? That it *must* be because they are doing something else (implied to be “improper” in your eyes) in order to cope, and that’s the *only* possible explanation for better outcomes? Just some food for self-reflective thought…
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How is this relevant to the article? Congrats, I guess? For already falling in line with the mainstream narrative…? I mean, I’m genuinely glad you found something that helped you… I just don’t understand the need to announce it here.
A platform like Mad in America is meant to center the voices/perspectives/experiences of those *outside* the mainstream narrative, i.e. those who are marginalized by the mental health system… So you are welcome to be here if you’d like, but don’t be disappointed when you find out that this space is not *for* you or will cater to/align with your personal experience. Your experiences are not being invalidated by the fact that others may not share the same experiences and yours are being validated by the mainstream constantly, yet our experiences have been systematically invalidated & devalued. Let us have a space, too.
Side Note: Also, how can you ever really know that it was the medication that “saved” someone’s life? Maybe there were other factors that changed in their life that happened to coincide with when they started taking medication. Maybe the medication simply provided hope, or a placebo effect, and that itself was enough for a person to keep going or to relieve them of their distress. And furthermore, how can you know with 100% certainty that they would’ve died (presumably by suicide) if they hadn’t started taking medication? Furthermore, if we want to be completely fair, we must account for all the deaths that *do* happen due to the medications themselves. Many, if not all, psychiatric medications come with a black box warning of increased risk of suicide and self-harm. Perhaps there are people who find that their suicidal inclinaitons dissipate after starting antidepressants, but there are others (statistically more, read here: https://www.madinamerica.com/2025/02/observational-studies-confirm-trial-results-that-antidepressants-double-suicides/ ) who become *more suicidal* after starting antidepressants. The latter may come in two forms: 1) pre-existing suicidal inclinations may intensify, OR 2) in the absence of pre-existing suicidality, patients may begin experiencing suicidal inclinations for the first time. Of course, many will rebuke this with, “well isn’t that just their underlying mental illness?” and if I answer with, “well then why would they begin experiencing symptoms that they never had before?” then I’ll usually get hit with a “well because that must just be the natural progression of their illness,” and some will even say, “well maybe those who are prescribed medication had more severe depression in the first place.” While it does seem like a plausible explanation & difficult to separate what’s caused by the “illness” vs what’s caused by the meds themselves, multiple studies using comparisons of medicated vs non-medicated patients with the same diagnoses and equally matched degrees of severity have concluded that medicated patients experience *more* decline over the same amount of time than their non-medicated counterparts, and have a *higher* risk of suicide overall. Meaning that not only do their suicidal thoughts & feelings increase, but their rates of attempting suicide & dying by suicide increase as well. Of course, these are *averages*, they won’t be reflected in the experiences of every single *individual.* But those who claim to benefit from meds are actually just a loud minority (whose voices are amplified even louded by psychiatry itself as “success stories” and “proof”). Aligning with the mainstream narrative doesn’t necessarily mean you’re in the majority, just as being marginalized doesn’t necessarily mean you are a minority. Women make up half of the population, and yet we’ve been marginalized by society for centuries. It has way less to do with numbers & way more to do with who’s given a voice & a seat at the table. Unfortunately, with the “mentally ill” (or as we like to say, Mad), anything we say, think, or feel that doesn’t align with the mainstream mental health narrative can be attributed to our “underlying mental illness” and therefore dismissed as invalid. Quite clever, really– in a warped, twisted way.
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I especially loved those last three paragraphs! Beautiful!
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I don’t think they’re arguing that there’s anything wrong with suicidality itself, just that “assisted suicide” or psychiatric euthanasia is ethically ambiguous at best for numerous complex reasons. There’s nothing morally wrong, in my opinion, with having suicidal feelings yourself; the problem arises when other people offer to act on those feelings on your behalf. If this followed along the same lines as the rest of psychiatry, this would very quickly be misused and exploited, devolving into a eugenicist practice while still being heralded as “for the patients’ own good.” The ultimate step in the mental health industrial complex’s evolution into the prison industrial complex: the addition of the death penalty.
Since there is no such thing as so-called “bipolar disorder” as a real, discrete medical condition, I think citing those statistics is barking up the wrong tree. However, I do think there’s a place for non-carceral, autonomy-affirming suicidality support. Not pro-suicide, not anti-suicide, but suicide-neutral care. Spaces where people aren’t *encouraging* each other to kill themselves, but they’re also not afraid to say the word “suicide” out loud, for fear of either a) being locked up against their will or b) winding up responsible for someone’s death. These spaces do exist. I think you might wanna check out StrongerU Wellness, as well as warmlines such as Wildflower Alliance or THRIVE lifeline. Resources and communities like this are harder to find in person, depending on where you live, but they are growing, and it is possible to find one in your area (or create one).
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Well said.
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I agree to some extent, but I think it’s important to bear in mind that not everybody has the luxury/privilege to just quit their job/find a new one, or take a break until they feel better. Ideally, everyone would have that option, but unfortunately in our current economic system, it’s gonna depend on other factors like a person’s financial stability.
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I relate to what you said, and I, too, have questioned at times whether or not I am “autistic” or an “HSP” or both or neither. One key difference is that autism is in the DSM, while HSP is not. HSP is not considered an official “diagnosis” and it’s not necessarily seen or treated as a “disorder” (however, it may increase your likelihood of being diagnosed with *other* disorders because others may tend to see you as “too sensitive” and society may have a tendency to pathologize you for having a reasonable reaction to its cruelty, cold callousness, and injustice). The fact that autism is recognized by the DSM and HSP is not doesn’t necessarily make one more “real” than the other. It’s pretty arbitrary overall, what ends up in the DSM vs what doesn’t, but I’m sure there are probably complex sociocultural and historical contextual factors that determined the evolution of these labels and this distinction between them (just like any other labels in the DSM/psychiatry), however, I will not get into all that now. Basically, both are real, and neither are real, at the same time. The experiences/symptoms/traits are real, but the labels are made up. They’re just determined by clusters of symptoms/traits, which 1) largely overlap, 2) change depending on who you’re asking, and 3) it’s not required that you have all of them in order to meet the criteria for diagnosis/labeling. That second one is especially of interest here; autism is one of those diagnoses that really depends who you ask and seems to have especially morphed and evolved over the years (especially among the “late diagnosed” or self diagnosed) to basically just mean whatever people want it to mean. It’s interesting how in this article, the author cites her emotional bandwidth and ability to empathize as a symptom of her autism, however, the traditional conception of autism (as well as what’s in the DSM) includes an inability to empathize or relate to the emotions of others, and a narrow emotional bandwidth as hallmark symptoms of autism. It’s interesting how two completely opposite experiences can not only be included under the same label, but are both considered keystone “symptoms” (or “proof”) of it.
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Ugh, same. I’ve come to hate the word “resilience,” along with so many others.
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What is your point here? That it’s “on them”– the employees– for not being “healed enough” or “emotionally well” enough? How can you expect someone to heal when their conditions are constantly subjecting them to chronic stress? Healing isn’t an independent project; it doesn’t occur in a vacuum. It’s chicken and egg here: employees are supposed to change their own working conditions by just “setting better boundaries” which requires them to be emotionally “healed”/recovered from burnout enough to do so, but employees can’t emotionally heal/recover from burnout (and therefore have the ability to set better boundaries) until their conditions improve.
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