Don't Treat Us Like We're Fragile

If you deal with a psychological disorder that has "gotten you in trouble", chances are that your loved ones have reacted with concern. This is a natural response. The severity of your illness scared them, and they just want you to be safe and happy.

They want you to avoid another hospitalization, another suicide attempt, another psychotic break, so they treat you differently. They are gentler towards you. They remind you to take your meds.  Most relevant to this post, they encourage you to limit yourself, to pursue a low-stress, low-risk lifestyle to avoid a relapse. 

There is nothing wrong with the motivation behind these acts of concern. Your family and friends love you. They are trying to protect you. But this attempt to shield you from further suffering just isn't effective, and may even be counterproductive.

For one thing, it doesn't always work. Even if you don't get a high stress job and live in your parents' house and don't date and don't stay out late and don't drive fast and don't drink alcohol and don't skip a single dose of your meds and basically don't do anything strenuous or stressful ever, you may still relapse. Most psychiatric illnesses follow a relapse-remitting course-you will have periods of increased symptoms and periods of relative health. That is just what happens. Yes, environmental factors can precipitate a relapse, but biology is just as likely of a culprit. 

Secondly, not everyone who takes risks is guaranteed to relapse. There are successful people with psychiatric disorders in every field. Doctors, lawyers, professors...they may have to be careful to take their meds and regulate their sleep schedule, but they can still live symptom-free for long periods of time.

Furthermore, the world suffers when neurodivergents (people who deal with mental illness) limit themselves to low-skilled, low-stress jobs. Many of us are intensely intelligent and creative. We do excellent work, and we have the ability to go out and do a lot of good. 

Ironically, in their attempt to limit you for your own protection, your loved ones may make you more vulnerable to relapse. Let's face it: a stress-free, safe life is boring. Not being allowed to pursue your dreams is depressing. Never leaving your hometown for fear that the world will not be kind to you is discouraging. If you don't take risks, then you have nothing to live for. 

Even Good Therapists Are Guilty-The Evil "S"-word

Something really disturbed me yesterday. Those of us dealing with mental health issues face a lot of discrimination. Some of us have lost friends when we decided to be brave enough to disclose our diagnoses. Some of us have been fired from work for taking time off for a hospitalization, or have had professors knock down our grades. Almost all of us deal with internalized stigma, feelings of being not strong enough, sane enough, worthy enough…and it is no wonder that we feel this way about ourselves, given how prevalent stereotypes of the mentally ill are. Every time there is a shooting, people jump to the conclusion that the shooter is “mentally ill”; horror films have been made around the theme of the spirit of an unstable suicide victim who haunts a “normal” family’s home…

The truth is, of course, that we are not any less intelligent, strong, or non-threatening than our neurotypical counterparts. This is the message that we have to spread.

It is expected that we will encounter examples of the ugly stigma from our family and friends, but it is disturbing when professionals hold prejudiced ideas concerning those of us who struggle. 

Yesterday, my therapist and I were talking about various mental health conditions, and what they look like in actual patients. We do this often, as I am interested in psychology, and she is happy to share her wisdom. I will preface this by saying that I really like my therapist. She is a caring individual who is good at what she does, and she and I have a good relationship. 

During my session, we began talking about personality disorders. Personality disorders are mental health conditions that cause chronic, low-grade distress, and usually stem from how the patient sees himself and the world. Examples include narcissistic personality disorder, in which the patient is exceptionally self-absorbed, avoidant personality disorder, which is like an extreme version of social anxiety, and schizotypal personality disorder, which includes psychotic-like symptoms such as illusions (misperceiving sensory information) and ideas of reference (thinking that something has a special meaning to the patient). 

One personality disorder that gets a lot of attention is borderline personality disorder (BPD). BPD is complicated, and has symptoms like fast mood swings, abandonment fear, suicidal tendencies, and paranoia. Some people think that it is on the bipolar spectrum, some people think that it is an atypical form of PTSD, and some people are certain that it belongs right where it is, classified as a personality disorder. 

Because I sometimes have extremely fast mood cycling as part of my bipolar disorder, I have sometimes wondered if I might have some BPD symptoms. I asked my therapist about this.

She said, and I kid you not, “You definitely don’t have BPD. I’d want to kill you if you did.”

Unacceptable. I love my therapist, but it is unacceptable for her to have that kind of attitude towards a group of patients.

BPD sufferers are known to be difficult, occasionally even abusive people. Their suffering and unstable moods sometimes combine to create volatile, unpredictable individuals. However, all their symptoms stem from an illness. An illness that is just as real as bipolar disorder or schizophrenia. An illness that none of the patients chose to have. 

They deserve our compassion, not our contempt. 

I don’t want to bash my therapist; again, she is very good at what she does. But it will take me some time to get over the prejudice she holds towards my BPD friends. 

Have you ever encountered prejudice against people with mental illness? How about from a professional? How did it make you feel? What do you think could be done to decrease the stigma towards certain diagnoses among mental health clinicians?