A Client’s Perspective on “Mental Illness”

A very important and compelling article was posted on Mad in America on June 18.  It’s by Andrew L. Yoder, and is called An Open Letter to Persons Self-Identifying as Mentally Ill.  Here are some quotes:

“My physician was not so cautious.  He was a very pleasant man that always seemed to take his time with me and did not talk down to me.  Yet as I described some of the emotional distress I was experiencing, and the ways it was affecting my life, he told me with great certainty that mine was a totally common experience.  He told me that I had a biological condition in my brain, one in which certain chemicals were ‘imbalanced.’  He told me that there should be no stigma about asking for assistance from him.  Specifically he told me, ‘Trying to not be depressed is like telling a diabetic to just make more insulin.’  He prescribed an antidepressant medication, saying that this was no different than taking medication to regulate blood pressure or manage cholesterol.  I was told of the likelihood that I would need to remain on some form of medication for an indefinite future.”

“I believe that anyone, given the right context and circumstances, can experience even the most extreme forms of cognitive and emotional distress.”

“However, I believe that treating the term ‘mental illness’ as a literal truth does more to harm that hope of recovery than it does to help it.  You see, along with the popular claim that mental illness is a literal organic brain disease ‘just like diabetes’ is a set of other dogmas unproven and unsupported by evidence.  These include, being regularly told that not only do you have a disease but that this disease also has no cure and that you will struggle with it for your entire life.  I have trouble imagining anything more hopeless than that.

It also includes being told that you must take psychiatric medications, and often many different psychiatric medications for the rest of your life, and you should never ever consider stopping them.”

“Looking back now, I wish the physician who prescribed me anti-depressants would not have told me stories of ‘chemical imbalance’ that are simply not based in science.  In truth, most psychiatric medications alter normal brain activity, and there’s no evidence of an identifiable chemical imbalance of any sort at the root of emotional suffering.  Research suggests that there are some risks associated with long-term use of antidepressants, including the possibility of decreasing benefits from the drug and something referred to as ‘treatment resistant depression.'”

“Those of us challenging the evidence-absent medical model and the objective ‘mental illness’ label that goes with it are not trying to take away something hopeful and healing from you.  Instead, we wish to counter the false-hopelessness of a system that sees you as second-class people who will never be ‘normal.'”

“We know that mental and emotional suffering is a real experience that many, many people face.  We also know that nothing good comes from convincing people that they have a biological disease when no evidence supports that.  Questioning the legitimacy of ‘mental illness’ doesn’t make the reality of the pain any different.  But it does help people avoid the pitfalls of misinformation and powerlessness in their own recovery and wellness.”

“I am not saying that you are not hurting.  I am saying that you are not broken.”

Andrew has managed to express, in candid yet empathic terms, so many of the issues that are central to this debate.  Please read and pass along.

  • andrew

    I have great concern, with this types of article. In sum, they always seem to have the same simplistic thematic. Primarily, depression is not always easily defined in terms of polarity (ie complex patterns of behaviour of emotions, thoughts and behaviour that is representative of disorder imitation at one end. Conversely, a disease mechanism of interneuron impulse deficit states between synaptic gaps at the other end). A nascent perspective within many patient populations is – the broad category of depression maybe a social construction that must take into account many individual elements. As such requires a combination of complex medicinal and social interventions to unlock these complex elements. However, many naïve readers may still believe this simplistic thematic, because it fits a pre-constructed agenda or personal vista that allows them a sense of power over vulnerable people.
    In closing, before the usual zealots come out with the usual claims, I would also like to state – this type of article has been cited by at least 36 individuals as a causal factor in them stopping medication, and carrying out non-fatal suicidal self-harm. As such, I would like to hear others views on such simplistic articles and possible damaging effects.

  • Francesca Allan

    I’m not sure I understand this part of your comment: “However, many naïve readers may still believe this simplistic thematic,
    because it fits a pre-constructed agenda or personal vista that allows
    them a sense of power over vulnerable people.” In general, it’s the believers in biological psychiatry who adhere to a simplistic thematic (i.e. that emotional distress equals brain pathology) and who use that model to wield power over patients.

    As for such articles being a causal factor in stopping medication and later self-harming (if we’re going to assume that one follows from the other), I think we also have to consider those who report being terribly harmed by the bioreductionist model. I could find you a lot more than 36 people who have had this experience!

  • andrew

    Please let me explain further my comment “However, many naïve readers may still believe this simplistic thematic, because it fits a pre-constructed agenda that allows a sense of power over vulnerable people” (sic). In doing so, I must first agree Cochrane data has shown standard medication to treat depression has shown harmful effects within a minority of cohort studies. This in part maybe due to the generalised nature of them. I must re-state that my post did not support any form of bio reductionism as per your inference, it called for a middle ground. As such it is this form of over generalisation – that is my primary driver to use such language. In-order for the reader especially the patient population (who are often forgotten, but such language games have real outcomes) to re-frame and consider this type of thematic as political. That said, many patient populations are questioning anti-psychiatry and to tell you the truth many I have discussions with – see it as bad as biological psychiatry to wield power over individual distress.

  • Francesca Allan

    Thanks for clarifying, Andrew. I read your first comment a couple of times but couldn’t quite grab the gist of it. I agree that the answer doesn’t lie at either end of the spectrum. I also agree with you that some sectors of the psych reform movement are almost as domineering as the forces they oppose. It’s not surprising that some of the rhetoric turns patients off. It certainly turns off a lot of the public, including of course those who could have been valuable allies.

  • Rebecca Smith

    The only problem i have is that people start to take everything people say and twist it to what they can bash. In most of the articles I read on here, most who oppose the articles including this one feel that there is a big bad opposing side that is gonig to get everyone in trouble if they don’t take theiir meds. Can I ask the ever so wonderful question of, when did we lose our rights to schoose what we want and if we have bad experience with meds…when does it give the for psych groups to say we are wrong. there is no wrong or right in saying how we had been on a drug. I cannot take those supposed good psych meds. They make me three times worse. It took me over ten years to get through to the psychiatrists that I have a problem with that. Am I being bad because I posted this as against meds. I am not against or for. I think we all ahould remember one thing when people get hurt it takess time and therapy to deal as welll as tthose pills they give instead of therapy. Some do not tell patients they need therapy. Why is that? see we could argue all the way around but it won’t solve any issue to actively over argue the use of meds. They do and can hurt worse than not takeing them for a lot of people. I don’t give numbers because they never really did a trial of the side effects in people they just want to sell as many drugs for people of all kinds. and that is the problem.

  • The Right Hon. Cledwyn B’Stard

    You’re not anti-medication are you? (joke)

  • Phil_Hickey

    Rebecca,

    Well said! Psychiatry is truly on a mission to suppress information that conflicts with its core message. And various individuals and groups are helping them to achieve this.

  • jorge_videla

    all good. as rfk quoted upon the assassination of mlk, from Agamemnon:

    “even in our sleep pain which cannot forget
    Falls drop by drop upon the heart,
    Until, to our own despite, and against our will,
    Comes wisdom by the awful grace of God.”

  • jorge_videla

    but isn’t there a subset of depression which really is for no apparent reason?

    and i think cocaine, amphetamine, and sometimes alcohol withdrawal can produce a “purely physical” depression. no?

  • jorge_videla

    well mitazapine + venlafaxine worked for me and instantaneously. and nothing else did. or rather it sort of worked. my outlook didn’t change at all. i was just able to stop thinking about certain very depressing things.

    i’m still an unemployed, unmarried drunk and loser. i just don’t care anymore.

  • Phil_Hickey

    Jorge,

    Thanks for coming back.

    You write: “but isn’t there a subset of depression which really is for no apparent reason?”

    The only response I can make to this is:

    1. I’ve never experienced it personally.
    2. I’ve never seen it in others.

    During my career, I’ve worked with hundreds of people who were severely depressed. But I’ve never worked with anyone to whom I couldn’t honestly say: if I were in your shoes, living your life, I would be depressed too.

    Psychiatry promotes the concept of “out of the blue” depression because it suits their purposes. Depression, for psychiatrists, is an illness which can strike as arbitrarily and as capriciously as cancer, pneumonia, kidney failure, etc…

    Tragically, a great many people have bought this, primarily, I believe, because it is a soothing lie. The message is: You don’t have to do any soul-searching; you don’t have to make any effort; you don’t have to change any habits; all you have to do is eat these pills.

    But comfort bought at the expense of the truth is usually a poor bargain.

    Best wishes.

  • jorge_videla

    Thanks for coming back.

    well at least you’ve still got a sense of humor.

    as capriciously as cancer, pneumonia, kidney failure, etc…

    but even those have their risk factors. an igf promoting diet, old age, hypertension and diabetes,…all of which are recent to the human experience, that is, the result of the very artificial circumstances called “civilization”.

    Psychiatry promotes the concept of “out of the blue” depression because it suits their purposes.

    and necessarily. it’s the logic of business, and no two developed countries are more business influenced, more business run, than the us and the uk. psychiatry and clinical psychology are businesses before they’re anything else. (the uk is now the poorest germanic language speaking country in europe. thanks maggie.)

    if only more mental health professionals were Cynics in the ancient sense. i can imagine that even hearing voices would be “cured” by a year on a desert island.

    You don’t have to do any soul-searching; you don’t have to make any effort; you don’t have to change any habits; all you have to do is eat these pills.

    well…but…it may be that at the end of that soul searching one finds nothing, and because there’s nothing to find.

    then what?

    it was 18 years ago, i think, that a man which the “american ideology” might expect to be a great success (he was very smart) was discovered instead to be a terrorist. i know i’m sounding crazy, but i was turned onto this man’s “manifesto” when i was in school by a friend. he’s the world’s most famous living Cynic.

    i read it. i expected a word salad. it was anything but.

    society is “too much”, too big, too unwieldy to change. the individual must be “fit” to it or leave it for vanuatu or some such place. this “fitting” becomes more and more procrustian.

    that same man was declared a paranoid schizophrenic by court appointed psychiatrists. he was definitely an eccentric, but nothing more. or so said one of correspondents (a former harvard classmate) in the Atlantic.

  • I was just thinking about Theodore Kaczynski a couple weeks
    ago. I even glanced at his manifesto again. But I couldn’t shake the years of conditioning and again saw it as the ravings of a lunatic. Actually, I doubt I read more than a sentence of two. That is how well programmed I had become.

    This time I actually gave him a chance and read a couple
    pages. He was no lunatic when he wrote:

    “The industrial-technological system may survive or it may
    break down. If it survives, it may eventually achieve a low level of physical and psychological suffering, but only after
    passing through a long and very painful period of adjustment and only at the cost of permanently reducing human beings and many other living organisms to engineered products and mere cogs in the social machine. Furthermore, if the system survives, the consequences will be inevitable; there is no way of reforming or modifying the system so as to prevent it from depriving people of dignity and autonomy.”

    While I may disagree with the last of his conclusions, all
    of his thinking was clearly rationally based. I suspect we could find similar passages in the writings of Emerson or
    Thoreau.

    Was Kaczynski right in thinking that “1984” came without us seeing it? Are we taking Orwell too literally and our imagination is failing us? Is dissociation (cognitive dissonance) blinding us to our mass enslavement? Sort of, yes, and yes.

    Now try to put yourself in Ted Kaczynski’s shoes. You can start by considering his personality type, the INTP. Typing is not perfect so he naturally has aspects of other types as well, but introverted thinking with extraverted intuition is the primary thing demonstrated by his writing. With his actions he demonstrates something more akin to my own personality type—the INFJ/INTJ.

    The INTP is the most at risk for “schizophrenia” followed by
    the INFJ. Why is this? Could it be that they have trouble with their vision—they see too much?

    How did society react to Ted Kaczynski’s eyesight? As a child not well, but many have overcome much worse. What I find most disturbing in Kaczynski’s history is the fact that he was involved in government funded mind control experimentation. http://www.theatlantic.com/past/docs/issues/2000/06/chase.htm

    But what if Kaczynski was right and we have become enslaved by the industrial-technological system, and as a consequence hundreds of millions are tormented with great physical and psychological suffering? I am again reminded of the words and actions of another home grown “terrorist”, the “terrorist” John Brown. (INFJ)

    Speaking to his captures the “terrorist” John Brown said, “I think, my friends, you are guilty of a great wrong against God and humanity, and it would be perfectly right for anyone to interfere with you so far as to free those you willfully and wickedly hold in bondage.”

    The only pathology in the brains of Brown and Kaczynski is
    that which I suspect we can’t yet even see. It is the normal genetically acquired pathology associated with their
    personality. I can’t believe I am saying this but I now see Kaczynski as rational thinker.

    I can’t put my finger on the basis for my thinking, but I think Brown acted rightly and Kaczynski wrongly.

  • jorge_videla

    ted k belongs to an ancient tradition that began with antisthones and diogenes of sinope.

    he killed people for media attention for a political message, and he got it. that’s my definition of terrorism. you’d never have read his ravings if he hadn’t killed people. which isn’t to justify it.

    i don’t agree that “the system” is unreformable. i do agree that the last 200 years has put many human beings into very unnatural circumstances.

    during the 19th c in england working hours increased and quality of life declined for most people.

    i remember telling someone how perfectly natural “social anxiety” is given that only very recently did people come in contact with strangers on a regular basis. in the band or tribe and on the medieval manor in europe, everyone knew everyone else.

    his response, “times change.”

    can you believe that?

    he though it a perfectly good idea to simply define a mental illness like “social anxiety” because it was maladaptive in present day america.

    stupid sheeple. what’re ya gonna do?