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mental health mondays :: crazy etiquette

talking to crazy peeps 101. class is in session.
a friend of mine has been having a really hard time at her job because she suffers from depression and
has an immediate supervisor who thinks that means it's her time of the month. chances are, if you've had any kind of mental health issues, you've also had to deal with someone who doesn't appreciate how serious these problems can be or even that they are, in fact, real. so in the hopes of enlightening a few people [which won't happen, because such people probably don't read this blog and wouldn't listen to me anyway], i present

shit you should never ever ever ever say to someone with a mental disorder:

1. "you just need to think about something else/ pull yourself together/ get over it"

yeah, let's start with a classic. this is probably something that everyone who has suffered from depression, or any variant of mental illness that involves feeling lower than low, has had to deal with. it's #1 on my list because it's common, but it's also #1 on my list because it's just about the stupidest thing i can think of to say. do people who say this seriously think that someone who is profoundly depressed just hasn't tried hard enough to feel better? oh thank you, supposed friend, i didn't notice that my morbid depression had an off switch. i'll just flip that and everything will be better. silly me.

here's the thing: even if there seems to be a cause for their depression, if someone really is clinically depressed, it isn't about any one thing. there isn't any single event that they just need to get over. being severely depressed means constantly feel like you are living through the day when the love of your life accidentally ran over your favourite pet while humping your best friend in a car that you bought for them that then crashed into your home and set it on fire, destroying everything. there are a lot of things to deal with before you can just "get over it".

2. "if you're strong enough, you should be able to deal with this kind of thing on your own"

remember the episode of "the office" where dwight brags that he can lower and raise his blood pressure at will? congratulations, ignoramus, you're dwight.

who are you to decide that "strength" is what determines whether or not you can deal with mental issues? what kind of strength are we talking about here? because i think what you mean is that if you ignore something and pretend it isn't there, things will be fine. that's always been capital health advice. i'd like to fracture your collarbone and tell you that you can deal with it alone if you're strong enough. after all, a broken bone isn't life-threatening? what's the matter, pussy? aren't man enough to heal yourself?

if you're about to tell anyone you care about that their ability to deal with their mental problems is somehow tied to some notion of "strength", i think you need to take a  big dose of shut the fuck up and think about what you're really saying- that the problem isn't really serious. what's your basis for saying that?

3. "is there some kind of test that can prove it?"

a very popular response to any psychiatric diagnosis. because if you can't take a photograph of it, you debate whether or not it really exists.

you know what? people did not always have access to magnetic resonance imaging, or even x-rays and they still got sick and even died. when people first started sewing up wounds sustained on the battlefield, they were mystified that a lot of people died even though they were theoretically all patched up, because no one suspected the existence of invisible demon bugs that were causing infection and killing them off in a slower way. the fact that technology has not yet caught up with the complexities of the human brain enough to be able to show you a visual representation of bipolar disorder doesn't mean that it doesn't exist.

if you insist that you won't believe in anything you can't see, i suggest that you stop breathing. because oxygen isn't visible, so clearly, you don't really need it. once you've regained consciousness, perhaps you'd like to have a nice conversation about the incredible complexity of the human body on a molecular and chemical level.

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4. "medications are just a way of controlling your behaviour/ making you act like everyone else/ turning you into a zombie"

ah, the eternal debate. to medicate or not to medicate. do psychiatric drugs allow people with mental disorders to live happier and more productive lives? or do they turn them into overmedicated zombies with weight problems? sadly, the answer is "a little of both".

the sharp increase in prescriptions of anti-depressants, anti-psychotics and mood stabilizers is certainly a cause for concern, because it's very difficult to tell if they're being doled out because that many people actually need them or because pfizer and merck-frost need a better return for their shareholders. and again, the answer is probably "a little of both".

but that in no way means that people shouldn't take their meds. because you know what? there are lots of studies that show that people who are really fucked up do better when they take medications. they can do things like leave the house and carry on conversations and take public transit. a lot of people with mental disorders can't do that shit on their own, because they're too depressed to get out of bed [why bother?] or too anxious to leave their home. i once sat on the stairs in my apartment building holding my head and moaning for ten minutes because the idea of just walking out the door and going out there with them was more than i could handle. not for any specific reason, it just filled me with the kind of dread that most people get when they think they're about to die. or when they have to give a big public speech.

so in a way, yes, medications are  supposed to make you like everyone else. they're supposed to turn you into the kind of person who doesn't mind going outside and seeing strangers around them. they're supposed to make you into the kind of person who doesn't get all stabby because they think the person across from them on the metro is looking at them a little funny. there are times, folks, when it's not a bad thing to be like everyone else.

the thing is, unless you have a medical degree or have done a lot of advanced study on the subject: you don't know what the fuck you're talking about. some people do a lot better with medications. some don't. the ones that don't probably never needed them and can find relief in other ways. party on and don't turn into a judgmental, holier-than-thou douche-canoe who assumes that if something works for you, it will work for everyone. now who's trying to make everyone fit the same mould?

5. "you just want attention"

this is actually the only one of  the "foul five" that i haven't had said to my face, but i'm sure that people have thought it.

yes, there are people who are going to claim to have a mental disorder to get sympathy and attention. that's gross and if you're doing it, you should be ashamed of yourself. the same way that you should be ashamed of yourself if you tell people that you have to go in for "emergency surgery" because you have an ingrown toenail, or any other such exaggerated bullshit.

but the fact remains that mental disorders are still highly stigmatized and generally held suspect [see points 1-4] by the majority of the population. who would invite that? most people who have mental disorders are made to feel ashamed of their medical state. most are told that they're imagining things or that their problems aren't real. no employer will give you days off for being crazy. no family is going to want an update on your treatment over thanksgiving dinner. hell, chances are that even your doctor is going to give you the stink-eye if you tell them you think that something is seriously amiss in the attic.

if you just want attention and sympathy, there are a lot less painful routes to go. like applying a power drill to your ankles.

6. [bonus round] "but you seem totally normal"

people said that about ted bundy, asshole. move on.

so we've gone over what not to say, but what the hell should you say? well, it depends on the person. here are a few suggestions that i have [or would have] appreciated:

"what does the diagnosis mean in? how will it affect your day-to-day life?"

helping someone think about the practical implications of being told they have a mental disorder and aren't just weak/ lazy/ useless can help them see how the disorder might be shaping and changing their life.

"how do you feel about your diagnosis?"

it's a pretty heavy thing, being told you're crazy. on top of the fact that your circuits aren't functioning right, you've essentially just heard that you have brain gonorrhoea. people need to process that shit. be a friend and let them.

"what is something that would make you happy?"

seriously, never underestimate the power of this one. even the act of describing how seeing someone's head impaled on a pole while their family weeps and begs for mercy can be cathartic. if they can get that far, they can start to climb towards the light.

but really, the number one thing that you can say to someone with a mental disorder is this:

"what can i do to help?"

the answer may be "nothing". it may be "go out to lunch with me". it may be "nothing" followed by a soliloquy on their mental state that's actually incredibly helpful for the person to just put out there. but until you get over the idea that you know best, or that the problem isn't serious, you're not going to be able to do anything constructive at all.

so now that you know what not to say... don't say it.

Comments

Martin Rouge said…
Yeah, in my case, I couldn't bother walking out of the house because the theoretical people, complete strangers that only existed in the realm of possibility were already getting in my way and pissing me off. It's pretty fucked up, to be pissed of at theoretical people for something that they could potentially do. Kinda puts a damper in the day.
stara66 said…
Yay Kate! I suffer from depression and probably BPD as well. I've heard some of these comments from acquaintances and colleagues. It is very refreshing to see an article that also outlines appropriate comments as well as the absurdity of many commonly held beliefs. Thank you.
Kate MacDonald said…
Glad to offer some perspective. On Facebook, another friend made the comment that he's also offended by the "we're all a little bit crazy" line he's gotten from many people. Being eccentric and feeling like you have people who live in your head telling you secrets about the world are two very different things. And most people I know who have gone through a mental illness have no trouble distinguishing between the harmless eccentricity and the kind of crazy that causes damage.

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