Why won't they Believe I'm Ill?
|Copyright (c) 2008 by Kevin Thompson.
Why are some people dismayed to learn that a friend takes medication
for a mental illness, saying, "It's all in your head?" The expression
is disdainful, because it implies a lack of willpower or toughness. The
question that should be asked is not whether the illness is real, but
what is the most effective combination of willpower, therapy, and
medication for treating it.
The volume of debate over how to deal with mental illness depends on how severe and exotic the symptoms are.
Debate is less intense intense when symptoms are
exotic, meaning of a type that most people never experience.
Hallucinations, for example, are understood by most to stem from
abnormalities in the brain. Whether the patient can cope with such
symptoms well enough without medication is something that depends on
their severity, but there is a general understanding that one cannot
make hallucinations vanish through willpower or talk therapy.
Debate is more intense when the symptoms sound
familiar. Someone who suffers from depression or mania can describe his
symptoms in terms that seem familiar. Everyone can relate to "feeling
sad" or "feeling hyper," so there is a natural tendency for the
listener to assume that he understands how the other person feels. This
belief can lead to thoughts such as, "Hey, I feel like that sometimes,
and I don't take drugs. If I can deal with it, he should be able to
deal with it. He shouldn't need drugs."
What the listener in this example does not realize
is this: It is impossible to imagine an emotional state that you cannot
Let me repeat that: It is impossible to imagine an emotional state that you cannot experience.
That simple statement is profoundly important. We
understand another person's emotions by comparing them to our own. We
have a "gut feel" about what it means to be happy or sad, which works
well enough in most situations. Yet the reality is that Major
Depressive Disorder and Bipolar Disorder produce emotional states that
do not exist in normal human experience. Someone who does not suffer
from such an illness truly cannot understand what it is like.
So here is the answer to the question I posed above:
People who treat mental illness dismissively do so because
A) They are not capable of understanding it in terms of their own experience
B) They are not willing to put aside their
prejudices and transcend the limitations of their "gut feel" by
studying the subject
Sadly, the belief that the skeptical listener does
understand what the sufferer feels can have a serious impact. The
impact can range from friction, to the destruction of friendships, to
creating insurmountable barriers to treatment.
The moral to this story is that people who suffer
from serious mental illness bear the burden of coping with disbelief
and obstruction from friends, family, and employers, as well as the
illness itself. They are well advised to exercise discretion in
disclosing the details of their illness, to educate themselves about
their needs, and to refuse to let ignorance and prejudice interfere
with their treatment.
Ph.D. is the author of Medicines for Mental Health: The
Ultimate Guide to Psychiatric Medication
You can find information about treatments for depression, bipolar
disorder, schizophrenia, and sexual problems on his Web site at