A small disclaimer: these are my personal views on how mental health vs mental illness applies to me. Nothing is implied as to how anyone else should feel or cope.
This is an open week on SB4MH and it gives me an opportunity to give some thoughts to a great post from early October by @DeviantSuccubus discussing Mental Health and Mental Illness are not the Same Thing.
Devi writes incredibly well, with great openness and pathos about dealing with mental illness. Let me quote the beginning of her post to save me floundering about pedantically trying to describe what she says so well:-
I have an issue. Okay, I have many issues but I’ll get to that later. I have a problem with how people use the terms mental health and mental illness interchangeably. And I am not the only one. There are a plethora of articles and forum entries about just this. And the reason is not that anyone wants to devalue the pain of those that are struggling, the reason is that if you use those terms interchangeably, then you devalue the struggles of those who actually suffer from serious mental illness. See, the same as poor physical health is not the same as physical illness, poor mental health is not the same as mental illness.
Let me start with saying that I am coming from quite a biased perspective. I am diagnosed with Dissociative Identity Disorder, Bipolar Disorder, Complex Post-Traumatic Stress Disorder and Generalized Anxiety Disorder. I am seriously mentally ill.
For 50 years of my life I had little thought about how mental health or mental illness applied to me – as far as I was concerned, they didn’t. The closest encounter I had was our neighbour who was a senior psychiatrist. He was notable because he had no understanding of the real world having just retired from a career in the Navy begun in the early 1940’s.
For much of those 50 years to be associated with mental illness was high stigma. Admit to depression at work and you would find yourself shunned and probably fired. Male society especially dealt harshly with any weakness, as if it was threateningly contagious – I don’t just mean mental ‘weakness’, it also applied to homosexuality and effeminacy. Let’s face it, being fired for having depression is not exactly a first order cure. So many people suffered in silence.
Whilst I had a fairly fixed male-centric view that mental health / illness would never personally impinge on me, I did have the good fortune over the last 20 years or so to know very good female friends with mental illness. I say ‘good fortune’ because it’s an invaluable lesson to realise that these are such good friends because of who they are. They’re not Jekyll and Hyde, the mental illness doesn’t have a switch. They are the same person whether they are bouncing happily or crying on your shoulder. When they go through hard times it in no way invalidates them as a person.
Of course, over the years it’s hard not to notice the changing public perceptions and the ever louder discussions on being aware of and maintaining mental health.
I’ll come back to this after a deviation talking about personal changes.
About 4 years ago my gender dysphoria was truly released. Note, I don’t say ‘started’ or ‘triggered’, it had always been there, only occasionally bubbling up to the surface. In being released it rose to the surface and has never sunk back down again.
The watershed moment came about 2 years ago. The female persona made a bid to become the primary in control. I’ve made a few posts on the blog about this struggle. Whether it’s the struggle between the male and female personas or that it’s an intrinsic component of the female persona that’s now in control, I now know what anxiety and depression are like from the other side.
I was reminded earlier this week that I wanted to write this post. I’ve been free of depression/anxiety bouts for a month or so. Having just had a wonderful day off to see my domme, I was in bed, awake in the very early hours of the morning with insomnia when out of nowhere I had a full blown anxiety panic attack about going back in to work.
For quite a while after I first encountered depression and anxiety I denied that what I was feeling was related to mental health. It was all new to me and annoying as fuck, but there were enough of the conditioned residual male responses still inside to determinedly try to ignore it. The wake up was realising that my mind was riffing on suicide ideation. Not to act on it, just as nice warm thoughts of how to make it all go away.
Do I have a mental illness ? Depending on the age of the diagnostic manuals you consult, gender dysphoria was long described as an incurable mental illness. I’m ambivalent about this. It’s something I’ve lived with all my life and even though it’s now very strong, it feels such a natural part of me that I don’t consider it an illness. Others may probably see it differently.
There’s occasional hilarity when a new reader of the blog gets confused that there are two of us posting on the blog and think we’re one and the same person. I always say that there’s no way anyone could make up SwirlingFire. A while back this led to an interesting conversation with someone who asked if I suffered from DID. Since I also write about the conflicts between the male and the female persona’s I can understand the conclusion the other person came to. I don’t entirely reject the idea that I have a form DID, I just don’t find it terribly important.
When I consider the newness of the anxiety (annoying) and the depression (occasionally frightening) the old male stoicism is reluctant to assign self stigma in calling these mental illness. When they hit, I (so far) remain functional. I’ve seen how debilitated my friends can be and there’s no way I can (nor want) to equate with that. I’d rather brush my own experience off as an inconvenience than attempt to equate with or invalidate what I have seen in others.
I can be very pedantic about definitions and I certainly hate labels. And this is where I come back to mental health and part of the thrust of Devi’s post. I consider that the medical profession and the pharmaceutical industry have perpetrated a great fraud on the public when it comes to mental health. A human being is a complex range of emotions derived from the imperative of survival. It is entirely mentally healthy to experience and process that whole spectrum.
Where I think we’ve been conned is the idea that being mentally healthy is equated with being happy. I think we’ve been led astray by the US Declaration of Independence when it assigns “Life, Liberty and the pursuit of Happiness” the attributes of unalienable rights. This is interpreted in the modern world that there is an unalienable right, even duty, to be happy as the default state of mind/emotion.
When Devi talks about the “Karen’s” of this world I’m sure this is where most of them fit. The idea that “I’m not happy” means poor mental health seems to be prevalent. And what a wonderful thing this is for those selling happy pills or selling counselling by the hour.
It is, perhaps for this reason that I consider my own issues to be ones of mental health rather than mental illness. To me, mental health is a personal responsibility that does not, and should not, have a medical intervention. Counselling and therapy are potentially useful, as they can be for any aspect of coping with life. I want to experience all the moods of being human, not just the chemically approved ones handed out by an over worked doctor who has no time to actually listen to first world problems. I want the reality of my system naturally compensating as I move up and down the emotional spectrum. It’s just as valid to feel like shit as it is to feel elated.
Intervention for mental illness is a totally different ball game. The internal extremes become too much for the system to naturally compensate, they need help.
I’m not trying to put a dividing line here. There is no hierarchy or ‘top trumps’ when it comes to mental needs. A person copes the best they can with the cards they are dealt.
For me, and this is purely personal, I do see the road where mental health goes beyond basic coping and becomes identifiably mental illness. When the anxiety and depression are active, I probably reach the grey area in between. Others may disagree one way or the other but you’re not going to judge me, are you ?
And that becomes my cardinal rule when reading SB4MH posts. You simply can not judge someone else about what they are feeling when it comes to mental illness. Mental health – I take with a bit more nuance.