Content Warning: mental illness; mentions of suicide; mentions of hospitalization; ableist language; mental health stigma
The other day my therapist told me that she tends to “under-diagnose” people because of privacy concerns. She doesn’t want a stigmatizing diagnosis to follow her clients around, opening them up to discrimination. She said she would approach diagnosing mental illness differently if we cut insurers out of the loop and everyone self paid.
In a similar vein, my previous therapist said she didn’t believe in diagnosing at all, and only put down what was needed to get treatment paid for by the insurance companies, while the therapist I only saw a few times said that he recommended that everyone self pay due to privacy concerns.
There is no doubt that mental health stigma still rages on, practically unchecked, and most of what we do to “overcome” it is to share stories of those who have made it out the other side. Frightening and bizarre stories with satisfyingly happy endings like The Eden Express and Girl, Interrupted. Stories of recovery found on blogs and in magazines and on daytime TV talk shows. The stories of those who worked hard, or got lucky, and now they are well again, and when they share their stories with us we say “wow, you’re so brave,“ and then we go back to our lives, safe in the knowledge that we are good people who have done our part to fight mental health stigma.
But what about the others?
What about the people who aren’t better yet? The ones who struggle to get up every day, who can’t work or go to school, the ones who haven’t found the right meds or the right therapy yet…
What about the ones you’re afraid of? The ones who talk to themselves, who see things that you don’t, whose lives are made up of anger and pain and things that make you too uncomfortable, so you don’t think about them…
And what about the ones who won’t ever get better?
I told my therapist that I wasn’t worried about privacy because I am very open about my mental health, but as I said it, I realized that I wasn’t being truthful. Yeah, I tell people that I was hospitalized a long time ago, that I’ve tried to kill myself a few times. I tell them about how messed up I used to be, and while I don’t ever say it, I let them assume that I’m “better” now. I let them assume that I’m one of the cured ones, the safe ones, the ones you can point to and say “wow, you’re so brave.”
I’m not though, and I might not ever be.
I have a serious mental illness, the kind that isn’t expected to be curable. Yeah, I’m a lot better than I was, and if I keep working hard and have the privilege of finding the right combination of medication and therapy, I’ll probably be able to function. I plan to be happy someday, or at least OK, but I probably won’t ever be “cured.”
For so long I’ve been afraid that no one could ever like me, not if they knew the real me, the crazy me, but I’m sick of hiding; I’m sick of pretending; and most of all, I’m sick of listening to the voice in my head that says that I’m broken, shameful, frightening, unlovable. Now I’m not scared: I’m angry.
I’m angry that for so many years, I’ve kept my story locked away, telling myself that there was no room for stories without happy endings, ashamed that I didn’t have a neat little bow to wrap everything up with and say “…but that was all in the past, I’m much better now, thanks for asking.” I’m angry that I have tried so hard to mold myself into who others wanted me to be, to not make waves, to not scare people away, to be one of the good crazy folks.
I’m angry that we laud those who have managed to overcome adversity, often to the point of objectification, turning them into inspiration porn to make ourselves feel good, all the while heaping scorn and derision on those who haven’t made it yet and on those who never will. People who say words can’t hurt you probably haven’t felt them used as weapons, or borne the weight of false narratives designed to demean and dehumanize. Words can remind you, everywhere you go, that you are not like other people: you are different, other. Words can make you feel like you’re wrong and sick and bad, and you’re not welcome among normal people unless you shut your mouth and keep your shameful secrets to yourself.
Secrecy breeds stigma and fear. The only solution is to drag it out into the light and face it. No more hiding.
If you don’t think we should talk about mental illness, or you don’t believe the stigma is real, and that it hurts real people who are already struggling, then maybe you should be afraid of us, afraid of our words, because we won’t be silenced any longer. We are going to tear down this wall of guilt and shame you have built around us by any means necessary.