dispatches from crazyville

People like Tom Cruise perpetuate the stigma of mental illness. The idea that there’s no need for psychotropic drugs. His rant on the Today show was caustic. When people spout that train of thought, I feel despairing, like they’d rather me just be dead. These are powerful, mind-altering drugs. Yes. And that happens to be what I need to stay alive. Vitamins and exercise? Check. Not cutting it. Individuals need to decide for themselves what works. No matter how Tom Cruise perceives himself, he is not an expert on what I do or do not need. What he believes in works for him, and I don’t know his life.

Some of the students I teach cut themselves. Thin lacerations glare from their arms and I burn with shame and sadness and rage. And an embarrassing envy. I want to tell them to stop it, to grow up, to talk, to slow down, to breathe, to do something small and nice for someone else and stop obsessing about themselves. That there are other ways to cope. That if you have to hurt, there are other ways: run, squeeze ice cubes, dunk your head in a sink full of ice water.

I am talking to myself.

Several staff members were standing in the office during lunch one day in my second year of teaching, and one teacher said, “Did you notice S’s arms? She’s cutting herself.”

I suddenly felt claustrophobic.

“She’s just doing that for attention,” said an administrator. “It’s not even cuts, it’s like scratches.”

As though self-harm is nothing to worry about unless the harm is severe. Or it’s nothing to worry about if a person does it just to get attention.

I burned with shame and sadness and rage all over again. A lot of people believe the behaviors that are byproducts of illness, such as self-injury, are dramatic ways of getting attention. There’s some sort of weird social contract to ignore the flawed logic of that line of thought: healthy people don’t use such elaborate measures to get their needs met. And truly, if someone needs attention that bad, why would you ignore or dismiss what they’re doing and continue to deny them attention? My recovery has been inhibited by me internalizing society’s views. I’m just as guilty: I still judge myself and others based on misconceptions about mental illness.

Physical illness is more quantifiable. No one would say people with diabetes’ inability to control their blood sugar is a lack of self-control that they can overcome with some self-discipline. It’s widely accepted that people with diabetes need their insulin to function. To survive. No one says they’re just trying to get attention. Or to just get over it. After all, if they’re able to function, they’re not in a coma, right?

That mental illness is so stigmatized is problematic on many levels. The individual costs are significant. Guilt and shame often accompany symptoms that are difficult to manage in themselves. People are reticent to talk about it for fear of being dismissed by others, especially after celebrities’ troubled lives–like Brittney Spears and Anne Heche–become subjects of public ridicule. The “public” often fears the “mentally ill” because of media images like Sybil and Hannibal Lecter, et al. Then, when mental illness looks like Girl, Interrupted, then the attitude shifts to “get over yourself,” which, to my knowledge, has never helped anyone’s recovery.

But the problem is also systemic. A lot of people–47 million Americans–don’t have access to health insurance, making preventative mental healthcare–therapy, counseling,medication–financially unviable for them. Many people who do have insurance are allowed 20 or fewer visits per year to therapists and psychiatrists combined. Emergency services exist, but if help had been available along the way, the person might not have ended up in emergency care.

I am lucky enough to work in a place that offers health insurance. Another problem with insurance is the list of available providers. When I was searching for a psychiatrist and called the providers on the list, either they were not taking new patients, or they were not accepting my insurance plan. Even though they were on the list, they said they’d stopped accepting Anthem. Other problems I ran into are that many don’t schedule appointments after 5 pm, which means I would have to miss work for appointments, or that I couldn’t get in to see a doctor until four months from when I was calling. I ended up at the university outpatient hospital, a training ground for new psychiatrists. I know doctors have to train on someone. However, it means that I get a new doctor every year. I’ve seen four different doctors in the past four years. It’s really hard to start a new relationship every year, to go through the painful stuff I’ve already rehashed yet again, and to develop trust that they will help me to stay healthy.

I don’t know what the solution is. More access to mental healthcare, mental health information being available to the masses. But what all people need–the ill, the well, the in-between–rather than a pep-talk, or, worse, bullying, is understanding and compassion. It doesn’t take anything away from you to offer someone else compassion. Please.