Wow, this article describes all the things I've been thinking about for a very long time, and how hard it is to properly talk to someone about anything because any discussion just goes to "everyone should see a professional and we can't talk to people".
We made mental issues this unusual thing that only happens to "special" people, rather than something that may very well be part of the human condition and should be dealt with collectively.
Also the issue that getting well seems "odd" in that people get suspicious when a previously ill person gets well and thinks they were never ill.
> She became an evangelical Christian because those were the only people on campus who were actually nice to her.
Oh my, I can so relate to this...
Religion likely used to serve as mental health for many people for a long time, all its issues notwithstanding, but when we did away with it in the secular world, we just replaced it with cold callousness and nihilism, it seems.
One long term solution to this problem could be the normalization of preventative mental health treatment, analogous to a yearly "physical" doctor's visit.
Many mental health issues are (at least in part) a result of reactions to events in everyday life. Sometimes they happen suddenly, or are exacerbated by a biological condition, but in the general population they often exist over time and never rise to a level that requires intervention on their own.
If we could catch potential problems at this early phase, we might be able to address some number of serious issues before they become emergent.
Imagine if insurance covered a yearly mental health checkup. If such a service were available, commonplace, cheap, and considered part of preventative care, we might start to destigmatize mental health care and treatment, addressing little problems early while flagging more serious ones. People who go to their "physical" general practitioner every year aren't usually considered "sick" by their friends. It would take time, of course.
Physical or mental, when the machine's broken you do something to get it fixed. There should never be shame in that. Perhaps we should also do more preventive maintenance.
Imagine if we stopped viewing "pysical" and "mental" health as separate things.
Imagine if we provided comprehensive health care and put wellness before ideology and dogma.
Imagine if we caught and treated problems early, where possible, before they become more serious and entrenched -- and expensive, for society as well as for the individual, family, social circle suffering them.
P.S. Before the Affordable Care Act, having a "mental health issue" severely impacted one's ability to get and participate in health insurance.
If you weren't part of a substantial group policy, one episode -- maybe just seeing a counselor for some "therapy" -- of itself or followed by a "life transition" requiring acquiring new insurance, could leave you unable to purchase health care insurance or leave you with a very poor and overpriced plan.
Mental health issues brought social ostracism not just in individuals' reactions, but from society's systems and social safety nets.
Talk about "kicking them when they are down." The U.S. was absolutely brutal in this regard, with respect to "first world", Western civilizations.
And, as we see now with the latest political transitions, those circumstances are not far away, if they ever were, from being once again realized.
I think the point of this article is kinda "we should be caring for people in our communities" rather than "we should treat mental health as strictly a problem for specialists".
As you note, long-festering mental health issues often build and persist below the threshold of obviously needing intervention. I would add this anecdotal observation: the episodes associated with these long suppressed/ignored issues crossing that threshold seem to often lead to much worse outcomes (breakdowns, binges, harm to self or others) than comparable issues that are chronically at or above the treatment threshold. I think that much like cancer, early detection could do a lot to prevent these devastating outcomes.
> They are teaching kids not to be kind to sad friends, but to report them to the authorities instead.
I've heard that this is a particularly American attitude, that the mentally ill should be isolated with a clinician before doing anything else in life. Can any non-Americans say what their cultural attitude is? I've also heard that Indian culture is pretty much the opposite in this respect.
I am an Indian immigrant living in America. I think what you said is very true.
There is even more stigma about "mental health" issues in India so we might not label many things as mental issues, but people are generally more supportive and social, even a little intrusive into others lives. When a friend is having issues, their social group will actively try to get them to socialize, talk about stuff and cheer them up. They will insist that you don't go under the radar and disappear.
The American attitude of extreme individuality, personal limits seems kind of ridiculous to me at times. Like I don't even understand what the hell a friend is supposed to be if you can't be honest with them when you're down. Someone to share some good times with is a fair-weather friend, but not at all the same thing as a genuine friend. Sometimes it feels like you have to constantly live with a mask on, even with friends and family. And then when you get lonely and tired of the mask, you are supposed to find a soulmate who will be the sole person you are allowed to be honest and seek help from.. sometimes its not enough.
You know a major component in many mental illnesses is letting people isolate themselves. And mental illnesses have been around forever, but they were dealt with by help from society around you. This is an innate, human thing. There is an epidemic of loneliness and isolation in western societies because of the extreme individualism everywhere.
Finally, its fucking ridiculous the amount of trust people have in "authorities". "No we won't talk to you about your mental issues because fuck you, but hey why don't you go pay to talk to a stranger instead"? What? Why is that better? Isn't a friend/family member much better positioned to understand your problems and offer some perspective?
Of course, the Indian way has some problems too. One, a shit-ton of stigma and judgement by broader society if they find out. And at some point you're supposed to just "man up and get your shit together". And mental health doctors are still not trusted at all. Although, given the recent state of psych studies and the replication failures, they might just be right.
/rant
Sorry this is a little hostile.. I obviously don't have a full picture of everything, this is just my biased but honest opinion.
>Finally, its fucking ridiculous the amount of trust people have in "authorities". "No we won't talk to you about your mental issues because fuck you, but hey why don't you go pay to talk to a stranger instead"? What? Why is that better? Isn't a friend/family member much better positioned to understand your problems and offer some perspective?
While it is good to have a supportive environment from friends and family, my experience is that they are very poor at solving these problems. A good counsellor can be far more effective. Supportive family members often give very poor advice. They think they understand your problem when they rarely do. They'll give you all kinds of suggestions that, for you, are clearly useless and only serve to highlight how little they understand your predicaments.
Also, keep in mind, that often friends and family are part of the problem (without intending to be).
I can't and don't want to judge American/Western/whatever attitude towards these serious problem, but I've 2 cents to add:
> Isn't a friend/family member much better positioned to understand your problems and offer some perspective?
While full support from your social environment is important, seeking good professional help is even more important. The more serious the mental issue, the less friendliness can substitute proper therapy.
Do we have evidence that "professional" help results in better outcomes than otherwise? I've not seen such evidence, so if someone has hard evidence I'd love to see it.
I'm sure many psychiatrists assert this to be true (pay us, don't use free resources!), but an RCT would be great.
I don't know in general, but I'm discovering a new life thanks to doctors.
The psychologist helped a bit; the first psychiatrist and some chemistry helped much more; the second psychiatrist and less of the same drug made a miracle. I couldn't even imagine life without panic attacks, and there it is!
It's not like psychology chose to be a soft science, it just is because providing the hard scientific evidence required is either impossible, unethical, or both. To prove psychotherapy is effective for depression, you would have to gather up thousands of people with clinical depression, give half therapy and let the others go it alone, which raises serious ethical questions and makes it difficult to find volunteers. And that's just a regular study, how would you go about making a blind study? For pills you can just use a sugar pill, what's the placebo form of therapy? Do you just have a random lay person pretend to be a therapist? Doesn't that raise all kinds of ethical questions?
So we have to content ourselves with correlation studies
To prove psychotherapy is effective for depression, you would have to gather up thousands of people with clinical depression, give half therapy and let the others go it alone, which raises serious ethical questions and makes it difficult to find volunteers
This is no different from an RCT drug trial.
I agree that a blind study is impossible. But yes, I would still love to see randomized trials comparing an actor to a real psychiatrist (as well as to nothing at all). At the very least, if actors are equally effective, we can save billions of dollars by replacing expensive psychiatrists with struggling actors.
The problem with correlation studies - particularly for subjective in-my-head issues - is that the thing which causes people to see a shrink might also be causing them to get better.
Your original post that I wanted to reply to walk flagged so ill do so here.
You might like this lecture by Alan Watts:
>While there are indeed individuals who are certainly able to perform psychotherapy, it is the sheerest arrogance for anybody to say that he is officially qualified to do so. We do not know how it is done, just as we do no know how musical, literary, and artistic genius is done.
Alan Watts - Western Psychology vs World Religions
There's a lot of studies listed there, including a bunch of RCTs, mostly comparing different types of therapy. I couldn't find any attempting to use a "placebo" therapy, but I only really skimmed it. Does that help?
Glad to see that self-congratulatory snark and drive-by skepticism is alive and well! The amount of time it took to post this could have instead been devoted to finding research of the type you supposedly seek in good-faith.
Do you know of a more science-focused link that focuses strictly on high quality experimental evidence? This link might have useful information, but it seems mixed up with a lot of low quality science, ethical stuff, advocacy and other things. Hard to find the good stuff without reading a lot of random unrelated papers.
I was walking past a hospital notice board the other day, and there were in fact quite a few notices about experimental psychological treatments for particular conditions. Some of them looked like they were trying to find drug-free ways to control conditions that would normally have had drugs thrown at them. Seems like a noble aim, and I do hope people took them up on the studies.
It really depends on the kind of mental health issue and the kind of solution.
As I understand it the 'standard' treatment for phobias and panic attacks, for example, is extremely effective compared to 1) earlier psychotherapy approaches, and 2) no treatment.
CBT more generally seems to have decent rates of efficacy, at least with things like anxiety disorders. And at least based on my personal experience and a handful of people I know, it often proved effective where earlier psychotherapy was not, where a good social support system was not, and where doing nothing led to the increasing anxiety levels in the first place.
That said, I'm skeptical of a lot of things in the field, so I don't want to sound like I'm fully defending it.
EDIT: apologies for not providing hard evidence. One book that references studies in regards to this issue is "What You Can Change and What You Can't" by Martin Seligman, but I don't have it nearby.
Agreed for more serious problems. But if you have a milder problem, maybe a little bit of depression or anxiety I think social help is more effective than professional help. And that is the more common case.
>Anxiety disorders and depressive disorders can be bad enough to wreak havoc on a persons life.
I am sure they can wreak havoc, having faced some myself. Not saying they are not real problems.
I just think that in many cases, support of social groups, exercise etc. are more effective treatments than going to a therapist/psychiatrist or taking medication.
For example, exercise is now proven to be about as effective or more as an antidepressant. Mindfulness is now being talked about as a very effective treatment for anxiety/depression. People have been saying this kind of stuff for years, but they had zero legitimacy and were laughed at before the science came along. Meditation/mindfulness was considered spiritual hippie-bullshit, now all of a sudden its a viable and effective treatment..
So it just makes me think, when we are talking about as nascent and complicated a science as psychology, there is some value in "folk remedies" and "common sense" which are all too often dismissed as not being scientific enough. Yet that still happens. Do we really have to wait for a hundred studies before we accept that there might be better solutions in common wisdom outside of the current science? Particularly given that many of those remedies can't cause any harm, there is no risk to trying it.
Anyways, I am all for therapy and medication if thats what one wants. Just saying that an environment of disconnection breeds more mental illness, like an unsanitary environment breeds more physical illness.
> I just think that in many cases, support of social groups, exercise etc. are more effective treatments than going to a therapist/psychiatrist or taking medication.
I'd be interested to know why you think so.
If I remember correctly, exercise is not proven to be "about as effective or more as an antidepressant", but has been proven to provide some positive effect (i.e. relieve negative symptoms) in those suffering from mild to moderate depression (relative to controls). This might have changed since last I checked though - please correct me if I'm wrong!
Mindfulness has been shown to be helpful in some circumstances, but then in a strictly defined sense - not just any old meditation.
We definitely have to wait for many studies to draw any conclusions, that much is clear.
Common wisdom might as well be common ignorance if we aren't rigorous.
Mind you, I'm not trying to justify past or current practices or societal ills;
I'm just saying that we can't throw epistemology to the wind because of our experiences, wants or beliefs.
My wife is a psychiatrist. She says that for anything less than severe depression anti-depressants don't work. Exercise and forcing oneself to be active and do stuff is more effective than drugs.
Look, psychology just went through a replication crisis where more than 50% of findings could not be reproduced. All science is not equally valid, so it doesn't make sense to take social science results as seriously as say physics because one is a lot easier to study objectively.
Given that, you could call exercising or mindfulness or (new technique) unproven. I say, if it obviously doesn't cause any harm, and it might help why not try it. "Throwing epistemology to the wind" here has no negative consequence. You can't draw a scientific conclusion about whether X is beneficial sure, but you can sure as hell try it and see if it helps you. Thats what I'm advocating for. Taking some control over your own treatment.
Even the point you brought up about mindfulness being shown to be helpful in some circumstances - that does NOT mean any old meditation is unhelpful. In fact, given no other knowledge than that "X type of mindfulness practiced in Y way was Z% helpful" from a paper, wouldn't you be more inclined to believe that something similar to mindfulness would have similar beneficial effects rather than the inverse that its not helpful? Thats my point - we don't have to stick so rigidly to what is "proven" to be true (especially when the field went through a crisis where half of that so called "proven" stuff wasn't so true..)
Ignoring the fact that not treating depression can be fatal for some people we know that some people respond poorly to mindfulness because of the way they've coped with an abusive history.
> Exercise is moderately more effective than no therapy for reducing symptoms of depression.
> Exercise is no more effective than antidepressants for reducing symptoms of depression, although this conclusion is based on a small number of studies.
> Exercise is no more effective than psychological therapies for reducing symptoms of depression, although this conclusion is based on small number of studies.
> The reviewers also note that when only high-quality studies were included, the difference between exercise and no therapy is less conclusive.
> Attendance rates for exercise treatments ranged from 50% to 100%.
> The evidence about whether exercise for depression improves quality of life is inconclusive.
There has been a more recent meta analysis, but it's a bit frustrating to hear people keep repeating the claim that exercise is a treatment for depression, or that exercise is as effective as anti-depressants. The proper claim is that exercise might help with "resilience" - it might help prevent depression or prevent a relapse.
We also have to be wary of the fact in a number of situations for a lot of people their mental disorders may be being negatively reinforced by unhealthy social relationships or physical limitations.
I know you used the "many cases" as a caveat, and appreciate the angle you're taking in making the point, but the notion that "an environment of disconnection breeds more mental illness" wont be the case for a lot of sufferers, and we shouldn't be leading the discussion down an avenue where if someone doesn't have those support networks, ability to get the benefit from exercise or has screwy personal relationships they feel as if that's a personal failure. (i.e. it'd be helpful if we normalised all avenues)
Mild to moderate depression may respond to anti-depressants, may respond to an evidence based talking therapy, may respond to something like a gardening group activity, may respond to debt planning and financial advice.
Treatment plans for depression should not focus on a single aspect of the bio-psycho-social stuff, but should try to address all of it.
That's a bit like saying "if all you have is a sinus infection instead of full on cancer, I think asking your friends for help is more effective than going to see a physician."
Your friends aren't efforts in how the brain works. Depression isn't just "feeling sad because something bad happened to you." Depression is a disease and it doesn't have to have an external cause. Indeed, it's often the perception "what do I have to be sad about" than keeps people from seeking treatment.
Can't wait for some psychiatrists to come in here and say something about, "yeah, unless you've got a big site like Facebook, you should probably just ask your friend who is sort of good with computers to make it for you."
The only example I can think of where that's obviously true is bipolar I disorder, where the most effective treatment (lithium) is very dangerous, but leaving it untreated can be very dangerous too. For other conditions professional treatment often does more harm than good.
Those can be successfully managed with community support. American culture favors medicalizing those conditions, but I've not seen any convincing evidence that it results in better outcomes. BP-I is different because lithium very effectively stops mania, but effective dose is almost as high as the toxic dose, and long term treatment has a high risk of causing kidney damage even with accurate dosing. This unique combination of danger + effectiveness makes medical supervision mandatory IMO.
> Finally, its fucking ridiculous the amount of trust people have in "authorities".
True. Some people would even call the police to handle a psychotic episode.
> Isn't a friend/family member much better positioned to understand your problems and offer some perspective?
Not at all, they can be the worst advisor. Being emotionally involved and not trained as professionals makes them very biased. Having relations that extend in the past and future makes it even more difficult to be unbiased, not judgmental and honest.
British system: there's still a large element of "stiff upper lip" and refusing to talk about it, but that's changing.
Non-acute care: go to your GP. You get a fairly time-limited interview, following which you can sometimes get on the waiting list for CBT or other forms of therapy but will far more likely be prescribed an anti-depressant.
Acute events: the police are often the front line here, as in America, but unlike America are unlikely to shoot the person they've been sent to help. The police complain that this kind of work takes a lot of their time. Once danger to self and others has passed in a situation, the person will end up in hospital for a while before being passed on to social services, who may or may not have time to follow up.
People who are unable to look after themselves long-term due to the severity of their condition: might get lucky with social services, might not. It helps a great deal if you have someone who can advocate for you here.
Where I'm from the attitude is mostly "If you have time for this, it must mean you don't have real problems in life. Ain't nobody got time for mental health when shit hits the fan and there are hungry mouths to feed"
I like the "don't be a victim" attitude, but it's a very trial by fire kind of thing. We have one of the highest suicide rates in europe.
Both the general attitude and the suicide rate have been improving in the recent decade or two. Emphasis is on therapy rather than pharmaceuticals.
Irishman here. I think you've heard correctly. Over here, everyone either has or knows someone who has some kind of mental health problem, in the same way that everyone either has or knows someone who has some kind of autoimmune disease. It sucks, but it's an unavoidable part of life and not usually considered grounds for putting someone in the loony bin. The society described in the article sounds like a nightmare dystopia.
This article hit home for me, really hard. To the point that I'm considering writing an email to the author, which is something I've never done before.
I don't have a mental illness, but I watched my roommate / best friend in college succumb to schizophrenia, and the university's reaction, at an Ivy League institution. And the paragraphs this author wrote there are 100% spot on. If anything, she could have been much more vitriolic, but I think wisely chose to not delve into that issue, for risk of detracting from her major points.
The thing is, though, its most certainly a socioeconomic issue. I remember for years, I used to drive 4+ hours to visit my friends at Rutgers University. My friends there didn't have those same attitudes as the Ivy League. The people there didn't have that attitude. I often used to genuinely wonder if a certain percentage of the kids I knew from the Ivy were genuinely taught that sort of behavior as some sort of corporeal manifestation of ideal capitalism or something, because it just seemed inhumane, and I could never square how it could naturally arise without being taught.
Even now, 10+ years later. Most high school friends have drifted away, but I still keep in contact with many of my collegiate friends. And out of all the friends I've made since, my collegiate friends, the ones I've known for over a decade, are the only ones that have that sort of calculating distance the author describes.
> I often used to genuinely wonder if a certain percentage of the kids I knew from the Ivy were genuinely taught that sort of behavior as some sort of corporeal manifestation of ideal capitalism or something, because it just seemed inhumane, and I could never square how it could naturally arise without being taught.
These institutions were founded by puritans and perpetuate the puritan work ethic. Toughness, discipline, not softness. It's very similar to toxic masculinity.
I had an odd conversation with a Afghani immigrant recently regarding mental health. He claimed that Muslims are less likely to suffer from mental illness than non-Muslims. But rather than over crediting his religion, he stated it is because Muslims take a physical position that rushes blood to the head during their multiple daily prayer sessions.
While mediation has been shown to improve mental health (so I assume prayer would too), I'd be curious if there were studies that combine meditation and slightly inverted positions.
I personally think that mental illness is the rule and not the exception for human beings. It's just functioning mental illness which is validated vs. dysfunctional mental illness which is not validated. Most people, if not every single person, is mentally ill in some way. It's just when they start being dysfunctional that we call it out as mental illness and then they have to do a whole ritual to try to get rid of it or figure out ways to diminish its effects on the person.
And often it's the environment that makes people mentally ill. It's not even the person. So how can you treat the effect without changing the cause? You can't.
Dave Chapelle here is talking about mental illness caused by Hollywood, he says calling someone mentally ill is dismissive, it's not the people ... but the environment. https://www.youtube.com/watch?v=NRzqsfO8F4U
"It's just functioning mental illness which is validated vs dysrunctional mental illness which is not validated"
To be fair, this is the very thing that makes mental illness ... mental illness. It isn't that normal folks don't have some abnormalities and illnesses, but the fact that it affects their lives and prevents, to some extent, them taking part in a normal life. Sometimes it plagues folks.
In a way, it is kind of like blood pressure. Everyone has blood pressure, some higher than others. A few people that run a little high don't need to do anything. Some people take meds, and some do diet and exercise and such things. This all depends on what their blood pressure responds to and what the cause is - some folks get it genetically, others through diet and lack of exercise.
Edit: It is an easy example only, not trying to minimize mental health issues.
>To be fair, this is the very thing that makes mental illness ... mental illness
True, but the use of the word "illness" is troubling. I had relatives who kept pushing for me to go for a diagnosis. I refused for years as I did not want treatment. My condition may have its downsides, but it has its upsides that make me perform better than others. People only see the downsides.
Mostly, though, I think it was because they want to justifiably apply a label to me, and I was not willing to oblige them ;-)
I go back and forth on the "illness" thing. I don't have a better term for it: In a way, it is the best term, despite folks using it as a label and way out.
"My condition may have its downsides, but it has its upsides that make me perform better than others."
This is often true and a normal feeling, from what I've read - which is why I think the best course of treatment is sometimes none at all outside of working to strengthen the positives and minimize the negatives. It really just depends on the flavor of the two and your lifestyle.
Sidenote: I hope you were able to keep some of the upsides even if you got treatment - or at least are otherwise happy.
I'm pretty distant from societal mean myself. Most of this is my choice: I'm an immigrant, I listen to odd music at times. I spend a lot of time producing artwork. I have blue-green hair, obviously it isn't natural. I'm also bi-sexual (which, weirdly, might have been a mental illness at some time) I probably fit into a few sub-cultures better than society at large.
But I don't have much trouble doing normal life stuff, outside of what can be expected with the language and cultural difference, without too much undue stress or worry.
Comparatively, some folks have trouble leaving the house., even though it they have nothing outwardly wrong. Have trouble speaking up enough to buy needed items, have trouble with basic hygeine or getting out of bed. Some can't deal with the stress of work or household chores for a time: Some folks opt for suicide. My ex cycled through many of these plus some.
The diagnosis depends greatly on societal norms as a basis for behavior, as well as one's own struggle to meet some of the minimum requirements for living. The goal is to be fit enough to do this stuff.
We all believe delusional things. Right now you more than likely have multiple if not many beliefs that are not rooted in reality. Even the smartest people have these.
Society validates some illnesses or disorders and shuns other (sometimes for good reason). We often see success in and of itself as a validation, when people can become successful in spite of flawed thinking or behavior.
Society can breed mental illness and it might be doing that right now.
> The mantra taught to young people today is “If you’re having trouble, get professional help.”
This is the same thing you often hear in my country. You're always told to seek help, but talking to professionals is almost entirely useless due to some sort of total societal inhibition. As in, the media and lobby groups will push a message that "we all find it hard to talk about mental health, so if you have an issue, go to a pro"....but it seems like pros find it just as hard. They almost definitely will not prescribe medicine, public waiting lists for therapists are long, the private costs for professionals with medical qualifications are prohibitive, and people can call themselves counsellors with almost no qualifications leading to a poor array of options.
Unless you're afflicted to the point that you've already committed a crime, you're probably not going to get much satisfaction from doctors.
I grew up with major depression and a major mood disorder. My doctor thought I was autistic but when she gave me an IQ test I was high functioning and in 1975 they didn't discover high functioning autism until later in the 1990s. So I was diagnosed(misdiagnosed) as depressed. I was picked on by bullies, physical, mental, emotional abuse, etc. Just because I was different in some way, called an Oddball because of X or Y, that is something the other kids didn't have.
I managed to graduate high school and college and was working a good job until I developed schizoaffective disorder in 2001. It is like bipolar with schizophrenic cycles. Less than 0.5% of the population suffers from it and it is very rare so not everyone knows about it.
In 2003 I ended up on disability as I could not find a job, and could not hide that I was mentally ill. ADA says one cannot be discriminated against because of a mental disability or mental illness, but I was called overqualified or any other reason to reject me. As I grew older I also have age discrimination.
I wish I can say it gets better, but it is like fighting with demons in your head to keep the negative thoughts away. The thought that say you are worthless, or that you will fail, nobody likes you anymore, you are past your prime, etc. The medicine helps treat a chemical imbalance but not all mental illnesses are due to chemical imbalances. Getting a good doctor is hard as well.
I'm 48 and have been suicidal about 14 times in my life. I'm still alive to talk about it, so I survived somehow.
Generation-X is called the suicide generation because of so many of my generation killing themselves or getting suicidal. It is like life is so hard to live, you are on expert mode and struggling just to wake up in the morning and get ready for work, and by the time you get to work you used up most if not all of your mental energy to get up and get ready.
Mental Hospitals as shown in that above link, are not always for helping mentally ill people and some are run like prisons and they keep you there until your insurance runs out to maximize their profits.
A mental illness is an invisible disability, when companies think of disabled people, they think of someone in a wheel chair, a deaf person, a blind person, someone missing body parts, etc. They never consider a mentally ill person or accommodating them. If the stress is too much and it is making you sick, other employees will do things to you to see how angry they can make you. Just because you can't smile due to flat effect paralyzing your face muscles, some employees think you might be up to something because you have a 'poker face' and didn't wave back to them when you walked in during the morning because you are too busy fighting demons in your head to see people wave at you.
There is no cure, no magic, it does not go away, you just try to learn skills to cope with it and find ways to screen out negative thoughts and maybe try a different medicine and see if it works better.
I am not 100% recovered, but I am making progress and trying to get back into programming. I am writing this to let people know that there is no magic bullet to kill the mental illnesses, and that we are not all violent like those public shooters they call mentally ill but they are sociopaths and most of us are not, we are just dysfunctional in some way.
This is why I don't seek professional help. In the US we treat depression as a clinical disease, but more a massive weakness. If you get diagnosed, it's hard to keep living a normal life. The State comes in and never leaves. You can never get back to normal. They will say your depression is in regression.
I know how you feel. I'd rather preserve my right to kill myself than have it medicated, occasionally by force, by the State.
>This is why I don't seek professional help. In the US we treat depression as a clinical disease, but more a massive weakness. If you get diagnosed, it's hard to keep living a normal life. The State comes in and never leaves. You can never get back to normal. They will say your depression is in regression.
This is the extreme scenario, and relatively rare (at least for adults).
I spoke to my PCP about my potential issues. He said I had two choices: Medication or counseling. I chose the latter. Nothing pushy.
Both the counselor and my PCP also recommended against a formal diagnosis of what condition I thought I had, because:
1. There is no cure.
2. The non-medicative treatments (i.e. counseling, behavioral therapy) is exactly the same for people who have my condition as those who do not but only have some symptoms.
3. Given the above two, why bother with a diagnosis? (Additionally, without a diagnosis, it can't be on a record anywhere - not my concern but it addresses yours).
4. My condition was causing problems in my life, but from a doctor's standpoint, was not too serious (i.e. not about to harm myself or others).
This whole "State coming in and never leaving" is rare. Probably more common for children, though.
I have a number of friends with serious, diagnosed mental health issues, and it has not been my experience with any of them that the State has come in at all, let alone refused to leave. What in your experience suggests otherwise?
> and it has not been my experience with any of them that the State has come in at all, let alone refused to leave.
My friend got trapped with a court order for treatment - see my comment history. Most of the drugs her psychiatrists force her to take actually cause the conditions they supposedly treat. The doctors pretend that her condition was not caused by the street pharmacy, or by her efforts to counteract the akathisia (restlessness caused by neuroleptics aka tranquilizers aka "anti-psychotics").
http://www.psychrights.org is a great resource for those who are concerned about being stripped of the right to refuse ineffective medical care.
I believe you. That said, my friend just tried to kill herself because she couldn't get anyone, including the State, to help her with BPD.
There's also a TON of literature about how the inability to voluntarily commit family members is horrific for everyone around them, including innocent bystanders. This is probably the most moving:
The acute mental health care system in the US is a travesty, something I believe we'll look back on in 50 years with horror. I don't doubt it has some effectiveness and that it ultimately helps many people, but I wouldn't want to be the person mounting the argument that it is blameless or unfairly maligned; it isn't maligned enough.
But: acute mental health care happens for a pretty short period of time, and then, from what I can tell, "the State" gets completely out of the picture.
> But: acute mental health care happens for a pretty short period of time, and then, from what I can tell, "the State" gets completely out of the picture.
This is not what I've observed. If you have a court order for outpatient treatment and miss your appointments, they'll issue an arrest warrant, for example.
I really, really wish that was true. I have done a ton of work with the homeless, and so many have very serious mental health issues. Where I worked, we had a holistic approach with therapists, case workers, social workers (for benefits and housing), and sometimes the police - it did basically nothing. In the thousands of people I worked with, I never once saw what you described, despite the pro bono effort of high-power Manhattan lawyers.
People who are not acting under their own volition can be dangerous, and it's a travesty that there's no functioning mechanism to return their agency with things like mandated medication.
> People who are not acting under their own volition can be dangerous, and it's a travesty that there's no functioning mechanism to return their agency with things like mandated medication.
I think there is a bit of an ethical quandary here. Perhaps the person prefers their unmedicated state and although their life is a mess from your perspective, they are in fact acting under their own volition.
The act of feeding someone pills against their will because you're sure it's better for them is...ethically treacherous.
It is treacherous, but really you're just capturing something basic about mental illness and the extent to which it disrupts our sense of agency. Rescuing someone from suicidality also involves intervening against a patient's agency, but we generally don't feel alarmed about that.
> I don't believe you get a court order for outpatient treatment as a result of being voluntarily admitted to a hospital.
The hospital can "petition" you for court-ordered evaluation if they find an excuse. It happens all the time. (Edit: usually for depressed/suicidal patients, I think.)
In my friend's case, she had cocaine metabolites in her initial bloodwork. Her mother had told the "crisis team" that my friend had "disappeared" for the weekend, and when she came home she was psychotic. She was actually with me for that weekend, and ran out of alcohol [methadone-induced alcoholism, methinks] when she got home.
My friend signed herself in to the hospital while acutely psychotic from alcohol withdrawal. After a week+ she'd come out of it, but they wouldn't let her go.
The first mental health court case was dropped because she'd mostly recovered with a month of sobriety. But the drugs they made her drinking problem worse, and she got re-petitioned for court-ordered evaluation a month later. That time they injected her with Haldol (neuroleptic/tranquilizer) just before letting her out. She later said it "hit her like a truck", and was back at a real emergency room a few days later, due to trying to undo the akathasia the only way she knew...
I don't have any experience with people engaged with the mental health system for chronic substance abuse problems and have no trouble believing that the system overreacts to them.
If you have a registered firearm some jurisdictions will demand the weapon. If you refuse, you get Baker Act'ed. Once they take the firearm, they hold it because they do not view a depressive as mentally fit, ever, for it. You can also go on a registry of mentally defects which prevent you from purchasing another firearm. Some employers covertly access the same list making it hard to get gainful employment in more sensitive tech areas.
The article you linked isn't as dire as you make it out to be. It doesn't say that anyone treated for mental health issues is ineligible to own firearms, just the much narrower segment of "anyone involuntarily committed to a mental institution or found to be a danger to self or others." Which seems pretty reasonable to me.
If you're holding back from seeking treatment for mental health issues because you're worried about losing your guns, don't. I can't speak for every jurisdiction, but I live in Virginia, I've suffered from and received treatment for depression, and I've had zero problems purchasing and owning firearms.
> anyone involuntarily committed to a mental institution or found to be a danger to self or others
That "or" is crucial, and it's what makes this hideously unjust. Involuntary admission can be completely unrelated to your mental state or actions.
A close friend of mine was committed because she was talking to another friend about her depression, and her phone died. He panicked and called the police. They committed her on the strength of the friend's testimony. She never intended to kill herself, she never had a plan to do so, but she spent three days in a closed psych ward regardless.
Short of overt fraud, very little distinction is drawn between "I guess you're not a danger now" and "you were never a danger at all to anyone". As a result, commitment can mean lifelong restriction of rights without any health basis at all.
I'm in New York, which probably has the toughest gun laws in the country outside of maybe California. I've had a pistol permit and a .380 for over 3 years.
I also go to a psychologist monthly for CBT and a psychiatrist every 3 months for medication. I've never harmed myself or others and I don't intend to, but I do have depression and anxiety due to some traumatic events in my past.
>He was discharged with a diagnosis of “depression, insomnia” and then returned a short time later for a 48-hour stay. The lawsuit says that during that visit, staff erroneously listed him as an “involuntary admission,” triggering the SAFE Act reporting provision.
Yeah, since it was an error in this case he shouldn't have had his guns confiscated. If your mental state is at the point where you legitimately need to be committed, however, then I agree with some of the other comments here and taking away your guns is justified.
But if you're not feeling well about your job or your sex life or exhibit any general depression symptoms, gun owner or not, a story like this shouldn't dissuade you from scheduling an office visit with a mental health professional. Apples to oranges.
Hey: since you're still commenting, can I ask again for a pointer to the $300 background check I can buy as an employer that will tell me if someone is legally allowed to purchase a gun? I'm serious about replicating this.
In a number of states, there's a short-term prohibition on firearms purchases by people who voluntarily admitted themselves to a mental health institution. On information and belief: pretty much anyone who goes to the hospital with a panic attack, a PTSD episode, or a concern about profound depression will end up "voluntarily admitted" to a mental health institution, so this is a lot of people.
I believe one of the things that makes these prohibitions constitutional is that they expire pretty quickly.
This is part of many government background checks. If you work directly as a contractor, or as a sub to the government, it is possible (likely) that this is pulled. Fun thing about discrimination: they don't tell you they're discriminating. Pretty much any company could access the same report for $300.
Can you point me in the direction of the $300 background check I can run that would disclose someone's mental health status? I'm an employer, I have a EIN, and I have friends who have diagnosed mental health conditions and thus would be flagged by a gun buying check, and we'd like to run the experiment.
I promise you, that is a harmful and completely untrue conspiracy theory. Please, please do not discourage people from seeking help. The people I know that go on meds and get therapy have flourished, those afraid to - often because of half-truths like the above - have wasted their lives in emotional prisons.
The fact that you may wind up in the FBI's NICS database is completely true. In this era, I'm not sure why a person would be confident about how that database will be used, now or in the future.
At this point you're pretty close to arguing that people should be cautious about getting medical help of any kind, because all medical interventions create medical records that could be abused.
That's in fact a rational concern (for instance: seeking medical help for a variety of symptoms, even if nothing is diagnosed, can impact your ability to get health insurance in the future), but we don't generally dignify the logical conclusion that people should avoid doctors as a result.
I think it's a particularly troublesome loophole in the common expectation of medical privacy. A whole amendment in the bill of rights doesn't apply to you anymore, maybe because an ER doctor who doesn't know you wanted to play it safe. I think that's a lot to put at the discretion of a random doctor.
I don't openly discourage people from seeking help. I do recommend anonymous groups and paying cash if possible. Try to keep things off the official rosters.
I applied to Intergraph once, and they wanted me to sign a release for a consumer profile report. I wrote onto the form that they had to give me a complete copy of the report, struck out a few objectionable lines, initialed the changes, and signed the form.
They immediately ended the interview process. They could not give me a copy of any portion of the report due to "confidentiality agreements".
I deciphered that as they were using information to discriminate between qualified candidates that is at best shocking to the conscience, and at worst blatantly illegal.
You cannot know if the company is breaking the law if they rigorously suppress any evidence of it.
I have some experience with background checks, since I ran a consulting firm and had major financial firms as clients, all of which do this kind of background checking, and while I don't think it's at all unreasonable to withdraw from consideration over credit checking (I would too), I think you probably overreacted --- because it is in fact true that you're contractually not allowed to share background check reports with their subjects.
That seems like a convenient way to get away with libel. My real name is so common that every state likely has a person with the same name and surname with a criminal record. There was another person with my name at my high school. There is another person with my name at my current employer. In the past, there were three people with my name in the corporate email directory.
With credit reporting, if a company gives you less than their best offer as a result of derogatory information on your credit report, they are obligated to furnish you with a copy of it at their expense.
So you might understand why I might like to know if a company is passing me over for consideration because of information given them by a third party that I cannot see, verify, or rebut. I have zero faith that companies that perform background checks never make mistakes.
That confidentiality clause for background check reports is ethically similar (but less vile) to a clause in a murder contract that requires the payer and the murderer to keep the existence of the contract secret from everyone, particularly the intended victim. You can't contract your way out of culpability for libel.
Besides that, they were the ones that told me to go pound sand just because I wouldn't give them carte blanche permission to investigate me.
I'm not saying you should be OK with background checks.
I'm saying that they're commonly used, especially in the financial industry (for regulatory reasons), and that the people who procure them really are (at least, often) prohibited from publishing the results.
I was background checked almost a dozen times at Matasano and never once got to see a report.
You're totally within your rights to be irritated by these checks. I'd refuse many of them too! But I think your argument about why you didn't get to see your report is overdetermined.
It may contain potentially non-factual statements that may be sufficiently derogatory to cause harm to my reputation and livelihood. I consider the attempts to keep it a secret to be an attempt to evade accountability for incorrect reporting.
I trust the HR departments of most employers and the background check companies to act ethically about as far as I can kick Jupiter with my bare feet. Which is zero meters. I trust them zero. None.
If I cannot see what they are doing behind my back, I naturally assume that they are discriminating on the base of race, age, sex, religion, family relationships, sexual orientation, hairstyle, and shoe quality, while cramming every rejected candidate into either "unqualified" or "bad cultural fit" piles, for plausible deniability.
I understand the need for background checking. But I have also been cleared by the US federal government, and they have a process for handling derogatory reports that would allow someone who might be negatively impacted to speak before a federal judge. If there was ever a problem with a government background check, the person affected always got to see what it was, and rebut or appeal through an established process.
If a private background check says I not only eat babies, but do it in a racist and fiscally irresponsible way, I can't tell whether the company cuts off contact and never communicates with me again because of that report, or because it is just a company that does that in general.
My opinion is that you are insufficiently suspicious and overly trusting of the companies buying and selling private background checks.
Besides all that, I would wager a trivial amount on the hypothesis that many companies that pull background checks do so to learn spending habits and salary history, so they can initially offer the candidate the lowest salary they would likely accept.
I agree that it's more productive to advise students to be wary than to express outrage at an institution. This should be read by all incoming college freshmen.
We made mental issues this unusual thing that only happens to "special" people, rather than something that may very well be part of the human condition and should be dealt with collectively.
Also the issue that getting well seems "odd" in that people get suspicious when a previously ill person gets well and thinks they were never ill.
> She became an evangelical Christian because those were the only people on campus who were actually nice to her.
Oh my, I can so relate to this...
Religion likely used to serve as mental health for many people for a long time, all its issues notwithstanding, but when we did away with it in the secular world, we just replaced it with cold callousness and nihilism, it seems.