A Different Way of Thinking

Saturday, 27 September, 2014

Illustration by Minna Leunig

A friend rang me the other day to complain about running into my ex-boyfriend in a club the night before.

“It was so fucking awkward,” he told me. “He was as unengaging and rude as always.”

I tried to talk around this, but he was firmly stuck on the subject of my ex’s social indiscretions.

“Can’t he just, like, look you in the eye and have a proper conversation?”

I sighed. This really wasn’t a discussion I wanted to have. “It’s hard for him. He’s not… mentally well.”

Instantly, my friend’s tone softened. His frustration was muted, replaced with an apologetic confusion: “Oh, I didn’t realise. I mean, like, you mentioned that ages ago but I thought he dealt with it then. Like it was sorted.”

This exchange highlights a relatively new problem evolving in our conversations about mental illness. My friend reacted how anyone would have having realised they’d just mocked a person suffering from mental illness—by back-pedalling and over-compensating with compassion. We are now in a place where we are so afraid of offending sufferers that to speak ill of them publicly is social-suicide. Just ask Gene Simmons. While this attitude might be justifiable, it is, in my opinion, seriously unhelpful in moving the conversation about mental illness to where it needs to be.

My friend’s response, however, is equally a positive indication of how far we’ve come. Changing attitudes towards mental illness have substantially reduced stigma and increased the understanding afforded to sufferers. According to the Australian Bureau of Statistics’ 2014 Cause of Death Report, suicide remains the most common cause of death for Australians between the ages of 15 and 24, and the seriousness of this is now being rightfully acknowledged. But the change has undesirable consequences as well. Political correctness is preventing frank discussions that could expose the shaky foundations of diagnosis and treatment.

The problem is this: however lovely the sensitivity, my friend’s words placed mental illness in the same category as physical illness, and this is a response that may have serious and negative repercussions.

Don’t get me wrong, I am sensitive to the struggles endured by sufferers. My experiences of seeing mental illness in friends and family have not been insignificant, and I have not been immune to depression in my own life. My purpose in advocating for a change in how we conceptualise, discuss, and feel about mental illness stems from a place of compassion.

Mental illness is not the same as physical illness; the complexities of the human body are trumped only by the intricacies of the human mind. Not just that, but appropriate recognition of mental illness, and therefore diagnosis and treatment, has been taking place for only a relatively short space of time. Much goes undiagnosed, misdiagnosed or mistreated.

When we conflate discussions of physical and mental illness we run the risk of adopting an ‘it’s treated’ attitude. We no longer look at the unique nuances of diagnosis and treatment—we see a problem and a doctor who can provide us with a cure.

This attitude is flawed. Some people experience episodes and then recover indefinitely, but many more suffer from ongoing or reoccurring problems. Schizophrenic people don’t experience a cure that allows them to stop taking medication. Chronically depressed people don’t experience some good fortune and leave their woes behind. Antipsychotic drugs are not chemotherapy. Anti-depressants aren’t surgery. The mind is not so easily cured as the body that carries it.

Taking on this attitude means we approach treating mental and physical illnesses in the same way. Note my friend’s thought process: you told me he had a problem, so he must have been diagnosed and treated by a doctor, which means he then got better. This narrow view of treatment (as opposed to a more realistic rehabilitation and management-based approach) creates difficulties for mentally ill people seeking help. Another friend of mine recently left the Unimelb Health Centre with a prescription for antidepressants after a fifteen minute appointment. It would take me as much time to get a prescription for antibiotics, and probably even longer for birth control.

Perhaps our normalisation of mental illness in language is having an unexpected consequence on the behaviour of medical practitioners. The popular pressure to de-stigmatise is so great that doctors are forced to treat mental illness like it’s no big deal—not out of step with the problems of the physically unwell patients who walk through their door. So they adopt a quick-fix approach; one-size-fits-all. Careful and considered diagnosis and treatment plans are replaced by a standardised mental illness questionnaire: score high enough and it’s on to the prescription pad. There is a clear vested interest for pharmaceutical companies to normalise chemical treatments, and the link between these corporations and prescription-happy doctors is well-documented.

On a more basic level, depression and other mental illnesses are not prompting the panic-stations approach that they probably should. Approaching a doctor and saying, “I think I’m depressed” should be taken as seriously as “I sometimes drink and drive” or “this mole on my back is growing at an alarming rate” because the likelihood of it causing death or permanent damage is just as severe. It should not be an in-and-out appointment akin to any old problem a person takes to the GP.

We should be capable of taking mental illness as serious as physical illness without placing the two in the same category. Sensitivity is a magnificent thing, but political correctness inevitably runs the risk of derailing confronting yet ultimately vital conversations.

If you need a non-judgmental and safe space to talk about something that’s worrying you, lifeline operates 24 hours a day on 13 11 14.
You can also chat online to a crisis support volunteer from 8pm to 4am every day.
Volunteer training is open each semester, with the next round of training to be advertised on the lifeline website later this month.
If you or someone you know is in danger or needs immediate medical attention, call 000.