Monday, March 07, 2016

Stop using mental illness terms improperly

Bernie Sanders has my vote, which I plan to cast later this week during Illinois' early voting period. But I was disappointed by his remark in last night's debate: 

We are -- if elected president -- going to invest a lot of money into mental health. And when you watch these Republican debates, you know why we need to invest in that.

No, Bernie, no. What we see in the Republican debates is rudeness, childish behavior and ill-tempered name-calling. Those do not point to mental illness. Traits like insensitivity and self-absorption might be part of personality disorders such as sociopathy and narcissism, but those aren't mental illnesses. Sanders conflated a lot of complicated disorders with his glib remark and I did not appreciate it.

It's a sign of our cultural ignorance about mental illness when people use mental illness as an insult or to describe annoying, antisocial, rude or unpleasant behavior. Often people are just assholes, not "off their medication." And as someone who requires daily anti-depressants, I beg everyone to stop the jokes about someone "being off their meds." It's really not funny and such jokes (spoken, posted and in memes) are insulting to those of us who use prescription drugs to successfully manage our disorders.

Americans also show ignorance about mental illness when we use terms like "OCD," "depressed," "schizophrenic," "bipolar," "PTSD" and "panic attack" in ways that aren't clinical at all. People use these terms as shorthand for behavior that has nothing to do with mental illness, and that isn't just ignorant, it's damaging. I like how Rebecca Fuoco puts it in her Huffington Post piece called Let's Stop Using Mental Illnesses as Figures of Speech:

The more the names of mental illnesses occur in our conversations as facetious self-diagnoses and misappropriated adjectives, the more difficult we make it for those with clinical diagnoses to speak out and be heard.

So let's review:

OCD (Obsessive Compulsive Disorder) - includes obsessions and compulsions that can occupy more than an hour of each day, interfering with one's daily life. And the compulsion may have nothing at all to do with cleanliness or tidiness. Being fastidious about your clean apartment or making sure all the files at your job are always in place are not signs of OCD.

PTSD (Post-Traumatic Stress Disorder) - can include flashback episodes, nightmares, emotional numbing or detachment, feeling like you have no future, insomnia, guilt, impaired memory and more. It's not induced by doing badly on an test or watching a scary movie.

Depression - a persistent state of disinterest or detachment, often accompanied by despondency, anger, irritation, self-hatred or numbness. It's not an emotion like sadness! It's a clinical state. It affects how you feel, behave and perceive reality and can lead to a variety of emotional and physical problems. Your new car getting scratched isn't depressing. It's upsetting or saddening and might even make you cry, but it's not depressing. Events don't cause clinical depression. Brain chemistry does.

Schizophrenia - is a severe illness that interferes with one's ability to think clearly, manage emotions, perceive reality, make decisions and relate to others. It can include delusions and hallucinations. Politicians who change their minds are not schizophrenic. An unpredictable stock market is not schizophrenic. 

Bipolar Disorder - describes someone who experiences periods in which they feel overly energized and confident (mania) and other periods when they feel sluggish and hopeless (depression). These episodes have little to do with outside events or influences and a person can alternate between the two periods with alarming frequency. It's called "bipolar" because of the two "poles" of moods. Manic periods can include sleeplessness, impulsive decision-making, delusions, talking very quickly and high activity. Depressed periods are similar to those experienced by people who don't have the accompanying mania. Someone who changes their opinion a lot isn't bipolar. Weather that goes from very warm to very cold isn't bipolar. People who just act weird in a general way aren't bipolar.

Please! Let's stop using these terms in any way other than to describe actual clinical disorders. Making light of a disorder causes misunderstanding of what that disorder is. Tossing these terms around diminishes their seriousness and demeans those of us who suffer from these illnesses. If you say that "everyone is a little OCD" or that "everyone gets depressed," you make it harder for us to be taken seriously. It can even cause us feelings of guilt and failure. 

And let's definitely stop describing rude and otherwise unpleasant behavior as mental illness. Some of the most intelligent people you know manage a mental disorder and some of the biggest idiots have no mental illness in their family at all. They're just jerks.

No comments: