Monthly Archives: June 2013

How “radical” am I?


I’ve been doing some really fascinating reading on madness lately.  First of all, there is this xojane article by Mia Steinberg on “how not to be a dick to someone with depression”, which contains a lot of great practical advice on how to be a good ally/friend/loved one to people with mood disorders (as a bipolar person, I can attest to that most of the advice would be applicable to bipolar as well as unipolar depression):  This article is also a quick and easy read (accessible from the computer/tablet/smartphone you are looking at right now!), so I highly recommend reading it when you can.

Then there is the graphic memoir Marbles: Mania, Depression, Michelangelo & Me by Ellen Forney.  As it says on the tin, it is a memoir in graphic novel form of someone with bipolar.  The author happens to be a professional cartoonist by trade, and in addition to recalling the initial years following her diagnosis at 30 and the trial-and-error process of coming to a place of emotional stability and overall fulfillment, she tackles the age-old medical and philosophical question of “are people with mood disorders inherently more creative?”.  I love that not only does she go into detail (in cartoon form!) on her own thought processes in arriving to an opinion on this issue, but she backs it up with research.  (And apparently, there has been a lot of research on this question).

Between Marbles and the article (particularly an interesting discussion that erupted in the comments on whether or not medication is an appropriate treatment method, and whether or not the movie Garden State is offensive because it is critical of psychotropic medication), I have been pondering my own opinions on mental health treatment and how radical I actually am. I would like to take a moment to clarify that a bit, both to you and to myself, because truth be told…I’m still figuring it out.

This first requires defining the term “radical”, which is a pretty difficult task since it means different things to different people, much like attempting to define art. In relation to mental health, it generally means believing that “madness” (the term those in the radical mental health community use instead of “mental illness”) is not a disease, but rather just another way of experiencing and living in this world.  Having strong emotions at times is considered a normal and healthy part of being human, and the fact that some have more extreme and/or frequent mood shifts than others is just a reflection of the natural diversity of humankind.  Mad people are not inherently inferior or superior to people who are not mad, they simply have different skills and different challenges (for instance, depression can obviously limit one’s productivity while in the midst of it, and it is also extremely difficult to bear.  Yet on the other hand, many are able to reflect on both manic and depressive episodes and gain wisdom and creative inspiration from the experience.)

I can absolutely get behind all of this, though at times I feel like it is a bit simplistic.  Having both worked for and been in treatment alongside people with very severe forms of madness or neurodiversity that drastically impacted their functioning, I know that it is not actually true that everyone can function equally.  People need varying degrees of professional and family support to survive (from none at all to being permanently institutionalized, whether in a mental institution or a community-based program like a group home).  Some mad/neurodivergent people, even those with conditions that are traditionally thought of as severe (like schizophrenia), are able to be healthy and happy and productive without medication, and instead manage their condition(s) through support and lifestyle habits and perhaps vitamins and supplements.  Others may need medication as a short-term solution, to allow them to get through a traumatic event or reach a point (internally and externally) where they’re able to put in the really hard work of living a healthy lifestyle.  Still others need to be medicated their whole lives.

Though regardless of how much help one receives, or how much one is able to work (if they’re able to work at all), or what sort of treatment one seeks, or whether or not one is medicated, I still believe that all lives are inherently valuable and everyone contributes something to this world, and as such everyone deserves respect and to be treated as their actual physical age. Bottom line, that is what radical mental health and neurodiversity mean to me.  I also think that while these differences in functioning do definitely exist, it is not always helpful to think about them.  Placing a prognosis on someone can determine the course of the rest of their life, regardless of their actual capabilities and potential.  Being considered simultaneously “severely disabled” and “gifted” (yes, these can coexist in one person! People are complicated!), I have experienced at different points in my life both undue pressure and being held back from my true potential.  This is definitely a complicated issue and it can be very difficult for professionals and loved ones to walk the fine line of providing someone with the support they need, but without supporting them too much (to the point that it is more restrictive and patronizing than helpful).  Ultimately though, I believe that the individuals themselves should determine what sort of goals they want for themselves, and loved ones and professionals should support them in achieving those goals rather than telling them what kind of goals they ought to have instead.

I want to be clear that I support doing whatever is right for you, and trusting your own instincts when it comes to deciding that.  While I really value madness and diversity in general, and would not want to do anything to intentionally reduce that diversity, I absolutely do not believe that seeking traditional treatment inherently means denying your true self.  For some people, medication is what allows them to become their true selves, because they are able to pierce through the fog of crippling symptoms and be creative and productive again, and find joy in life again.  For others it is a temporary crutch that allows their brain to rest and heal a bit, before eventually being able to replace the medication with other forms of treatment.

I don’t think it is helpful, whatever one decides to do for treatment, to judge or pressure. I believe that everyone, even those with the same diagnosis, is different and needs different things to reach their full potential in life (“reaching one’s full potential” also means different things to different people). I am not specifically anti-med or pro-med, or anti- or pro- particular approaches to therapy, or anything really.  I just think that the goal of professionals, first and foremost, should be to help their clients to trust themselves and their own instincts, and to learn (or re-learn) how to use those instincts to then figure out what their own goals are and how to go about reaching those goals.  The results of this process, though, are really none of my business, or anyone else’s for that matter (except the client and their treatment team, which may include a circle of close loved ones).

Perhaps, despite this being a radical mental health blog, these beliefs make me not so radical after all, since I am not championing either traditional or alternative treatment as the be-all-end-all solution.  My answer to most questions on this topic (and many other topics for that matter) would be a wishy-washy “it depends entirely on the specific situation”.  Yet on the other hand, it is unfortunately true that many people would consider even the proposal that all clients have agency in their own treatment decisions to be “radical”. (To me, this is basic respect). This is the world we live in. So I suppose, if I must label my beliefs on mental health, that is how I would label them, though I don’t quite fit perfectly into that label all the time.  This is also always evolving.