I was given 12 psychiatric diagnoses in my ten year journey through and then out of the mental health system. It’s quicker for me to say what I wasn’t diagnosed with that to name all 12 labels. I never got an anxiety or OCD diagnoses, but I got all the other categories. Some of them I agreed with for a while, but others seemed completely bogus. For instance, one psychologist diagnosed me with Asperger’s disorder after a 45 minute interview where she had a very hard getting past the fact that I rode my bike to her office in the middle of winter. She wrote in the report, “Corinna gets very involved with whatever activity she chooses, to the detriment of her social life.”
In a way it’s true. One person said I was an avid cyclist, and I said, “No, I’m really a RABID cyclist.” But tons of the cyclists are my friends, and I’ve slept in their houses, ate lots of meals with them, and told them when I hurt and needed help. I called the psychologist back and said, “I have a great social life. You never asked me about my social life, you just made assumptions.” She agreed to remove the diagnosis from the report. She also did say that I had a big fear of being psychotic, which was true for a long time. I’ll blog pretty soon about how I got past that. This post is about what part of psychiatric diagnoses I think are real, and which are part of the marketing machine and disability industrial complex.
One of the most important messages that I try to share is that all people can recover from a mental health diagnosis. Often the most disabling part of the experience is becoming labeled and losing hope. People have many ideas about psychiatric labels based on media exposure and their past experiences, and much of what is currently out there is not positive. Stigma is a word that has been used in the past to describe this kind of discrimination and prejudice. Stigma reduction is not about making mental illness good, but about making discrimination and prejudice bad. An older method of promoting mental health awareness has aimed to let people know that mental health issues have some genetic and biochemical causes. However, there has also been little scientific evidence for a consistent genetic link for any mental illness illness. Also, no real evidence of any biochemical imbalance has even been shown to cause mental health symptoms. A recent study in the American Journal of Psychiatry pointed out that medicalization of mental illness has not been linked to a reduction in stigma. Instead I advocate for a social inclusion and recovery focused approach to improving outcomes for people receiving mental health services.
The most important thing to recognize is that emotional suffering is a completely normal and human experience. When people have gone through trauma, or when people are having very difficult situations in their lives, emotional distress is a completely appropriate reaction. It can come because one’s life is intolerable, because of a loss of goals or social meaning, because of lack of connections, a disconnect from one’s spiritual life, or from many other emotional rather than physical sources. Sometimes emotional distress looks like the lists or descriptions found in the DSM. Sometimes it looks different. Emotional distress manifests differently in different cultural situations, and different cultures have useful methods of handling emotional struggles. Many of these traditional methods work better than methods currently in use in the United States. I advocate for using human and non-clinical terms to describe emotional distress. I advocate for a wellness approach where people learn personalized strategies for handling difficulties. This might include exercise, mindfulness, gardening, volunteering, building a comunity, possibly minimal and/or temporary use of medication, or any other source of personal power.
Bruce Levine, the author of Get Up, Stand Up, and Surviving America’s Depression Epidemic, says that the BEST way to reduce stigma is to get the word out that people recover from mental illness. Lots of people recover, 58% or more according to the National Empowerment Center. People can recover according to many definitions. The Appalachian Consulting Group’s Certified Peer Specialist Training says that recovery is taking back control of ones’ life on the other side of a diagnosis. The National Empowerment Center says that there are seven criteria that define recovery. Other people think of recovery as working full time, not taking medications, and having no symptoms. Some people meet this definition of recovery, and these kind of people can exit the mental health system and never return. Others say that recovery is a continuing process of emotional growth that never ends. Each person should choose a definition of recovery that motivates them to work hard towards creating their own new life.
I think emotional distress is extremely real. I think that often emotional distress can match with the checklists that doctors use to give us labels. Some of the reason for this is discussed in the Ethan Watter’s book, Crazy Like Us where he discusses that often people can learn how to manifest their emotional distress by education from their society and from the medical practitioners. I think this is one reason why mental illnesses have family links even though no genetic links have been found. When I was in the depths of my pit of despair, I truly suffered. I truly struggled with many issues, and some of the patterns corresponded to psychiatric labels. However, I believe that I recovered with the help of people who acknowledged my suffering and helped me solve my basic needs for connection and contribution. The labels I was given did nothing to address the root cause, and often hampered my ability to build friendships and a meaningful employment situation. The main reason for the labels was to figure out which medications to use and to bill insurance.
So I am starting to conclude that emotional suffering is extremely real, but making it fit within mainstream labels delays solving the actual problems. The labels are so scary that often they make people lose hope. In fact, in the mental health advocate community, we almost never ask each other the question, “What was your diagnosis?,” since we have found that the answer is meaningless. I have found that one thing that is in common on our advocate community is that all of us are extremely tolerant of weird behaviors that are harmless to other people. The rest of the world could benefit well from this lesson on tolerance. To truly help someone in distress, ask them what they are feeling, without using any clinical language at all. Try describing lowered feeling instead of depression, or spiritual ecstasy or disconnection from reality instead of psychosis. Try talking about truama experiences instead of the suffering that they are causing. Try talking about human suffering in human language.
….A smile from a stranger,tell my story,share my passions,we all got struggles,we all need patching,
Don’t give me a permanent label for my temporary problems,
Tell me truth about my emotions,and hold me in your sanity until the morning breaks.
-Corinna West “The Disability Industrial Complex”
Creative Director,Wellness Wordworks