When the Going Gets Tough

One of my favorite things about consciousness is the mind’s ability to make meaning from seemingly disconnected experiences. While out on a long run this morning at the crack of dawn with my rad new running group (thanks, Run Far!), I began to reflect on my professional world. My role as a social worker has nothing to do with running; in fact, running is a helpful escape from thinking so intensely about the struggles of social justice work. It’s painful in a different way, i guess, and maybe that’s why my brain clicked into gear this morning.

I was thinking about how feeling pain makes me want to quit. When I’m out running and lose my breath on a hill workout, or my toes start to ache from rubbing my shoes for too many miles, I want to stop immediately. The pain is sometimes unbearable, especially since I’m a newer runner, still adjusting to what this feels like in my body. I can feel tears welling up in my eyes and all those deeply held insecurities about my body shape or my pace start rushing to the forefront. I start believing that I’m not good enough. I want to give up.

At work, I’ve noticed a similar thought process. Of course I love what I do: there is no greater pleasure than to truly be with another person in their suffering and help them navigate a path to recovery. But never ending phone calls and case notes, compounded by the frustration of working with a broken, oppressive system takes its toll. Sometimes there are too many trauma narratives to hold in my heart. When I work with someone who’s experiences parallel my own and begin to reflect on how difficult my journey has been in the past, I have to take time away. Some days that means crying in the bathroom or my supervisor’s office. Others it means eating a cafeteria pudding cup for lunch and going to bed at 7 PM. It almost always unleashes a plethora of negative thoughts and emotions. It makes me question my competence and wonder if I can stay in this profession for an entire career. I know so many incredible clinicians who seem to burn out and transition into something else. And these huge social problems of poverty, homelessness, mass incarceration, and authoritative mental health systems are simply not going away; that’s why our profession exists in the first place.

When I get caught up in the enormity of human pain and suffering, I start surfing the job boards, imagining that there might be a better employment option out there. Something a little less stressful with better benefits. With less direct contact with that raw, human emotion that causes me to critically deconstruct the way the word works. But I’ve come to realize that this is a fantasy. There’s nothing better out there. I’m already working the greatest job possible for me; the pain is just wearing on me and getting in the way of recognizing the merits of what I’m doing. Social work is hard work, and I’m still relatively new to it.. It’s normal to want to give up, because facing the reality of the everyday plight of humanity is hard fucking work.

The most effective way to work through the pain, in both running and social justice, seems to begin with the breath. It involves rallying in community and encouraging each other to continue on this difficult path we’ve chosen. And reminding ourselves that we won’t solve these complex social problems in one lifetime, and that’s okay. If at the end of our lives we have helped move the cause even just a little bit further toward progress, we will have succeeded. 

like a boss running GIF

Try, try again

Remember that time I was going to start a bi-monthly mental health reform blog, then wrote in it one time for the entire year? I’d like to try again in 2018.

I know, I know! Resolutions are dumb and my track record is lousy. But I really want to challenge myself to routinely write and share my work. That’s the only way I’ll get better at it! And along the way it’ll help me process my thoughts and feelings about working inpatient and affecting community change. Those of us living with mental health differences know how helpful creative expression can be. 

These posts will likely be shorter, but definitely more frequent than last year. Want to help keep me accountable? Ask me how my writing’s going. Subscribe and share with your friends!

Let’s give it another go! Thanks for hanging with me. I’ll see you in the new year!

I Don’t Believe in Mental Illness

I don’t believe in mental illness.

dorothy-oh-my-wizard-of-oz

Well, I don’t believe that mental health challenges should be classified as medical conditions.

Hear me out on this! I agree that emotional wellness should be taken just as seriously as other aspects of health. And I’ll advocate for parity all day long, because that means funding for programs that support people in times of crisis (particularly people living in poverty and other marginalized groups). But I don’t believe in diagnosable “mental illnesses.”

I often hear mental health challenges compared to chronic health conditions, like diabetes or high blood pressure. A psychiatrist might say, “Just like a diabetic has to check her blood sugar and take insulin regularly, you’ll have to take your meds and check in with your doctor every three months for the rest of your life.” Such expressions normalize the experience of emotional distress and offer a simple plan of action. They remove blame from the person having a hard time. But it’s not that simple.

The problem with this medical spin is that there is no evidence to suggest an underlying genetic difference behind what we define as mental illness. In my view, “mental illness” is an invention of modern psychiatry used to exert social control over vulnerable individuals and communities. There is no “chemical imbalance” in the brain that needs fixing. Much of the literature touting a biological basis for psychiatric disorders is funded by drug companies trying to make a profit. And unlike diabetes, rates of psychiatric disorders are not improving, despite so-called innovations in treatment.

In the 1800s, mental health issues moved from being defined as a moral or spiritual concerns to biomedical diseases. Emil Kraepelin, German psychiatrist and pioneer of the diagnostic labels for psychiatric disorders used in today’s DSM, was one of the first to attribute “mental illness” to biochemical pathology. Asylums developed as the first institutions designed to house and treat “sick” individuals with socially unacceptable behavior. And although we have made strides in the quality of care for people labeled as mentally ill (we’ve done away with lobotomy and stopped shackling psychiatric patients to the floor en mass), our understanding and treatment of the mind has not changed much in decades: it continues to harm instead of help.

Long-term use of antipsychotics has a number of understudied, serious side-effects and does not facilitate recovery over time. We also know that the highest rates of suicide occur in the two weeks following hospital discharge and that patients of our current mental health system die, on average, 25 years sooner than the rest of the population. No other medical specialty would settle for outcomes like these. Moreover, psychiatry is the only discipline that has its own dedicated survivors group. Not survivors of the condition itself, but survivors of poor care and mistreatment by the system.

Many of us want to believe that mental illness is real. We want a quick antidote to our suffering. I spent years seeing therapists and taking medication because I wanted a simple cure for my suicidal thoughts. But this perspective overlooks social factors (trauma, poverty, marginalization based on gender, race, sexual orientation and expression, and other cultural differences) that contribute to our experience of the world. It narrows the range of acceptable emotional states encountered throughout the course of human life and development.

In the end, it wasn’t the right regimen of medication and therapy that made my life worth living. It was connecting with others who had gone through similar experiences as me, and finding new purpose in life (becoming a social worker). I came to understand that I may be a sensitive person who experiences significant highs and lows, but I am not sick or damaged. I am strong and resilient, having made it through the darkness. And discovering that for myself was much more empowering than any of the labels given to me by medical providers.

So now, I try to stay away from medical language altogether. Instead of saying “mental illness,” I say mental health difference or challenge. I talk about emotional wellness, which is one facet of holistic health. Instead of “symptomatic” or “decompensating,” I explain that someone is just having a hard time. Because suffering, whether we like it or not, is simply part of being human.

And I Will Tell You Mine

Greetings! Welcome to my new blog. I’ve daydreamed about starting a project of this nature for some time, but I’m finally ready to dig in.

Here’s the story: When I was growing up, I experienced significant mental health challenges. Self-injury, emotional outbursts, depression, anxiety. No one could figure out what was wrong with me for years. I tried therapy, support groups, pharmacology, and exercise, but nothing seemed to help. I always returned to feelings of overwhelming angst and despair. This all culminated in a suicide attempt and hospitalization in my early twenties, which was horrific and traumatizing.

I came out of there feeling damaged and worthless, but wanting to do everything in my power to ensure no one else would have to endure such dehumanizing treatment. I applied for social work school, which completely changed the course of my life. I learned to live (and think) independently. I surprised myself by coming off (and thriving without) medication. My peers and teachers showed me all the things that were right with me, and I graduated at the top of my class.

Now that I’m working in the field, things aren’t going according to plan. ***Spoiler alert*** Systems change is hard! My idealistic fantasies get brushed off by the apathy of “the way we’ve always done things.” It’s nearly impossible to remain hopeful and grounded when deficit-based is the norm. I try to balance the  enthusiasm of my own lived experience with the learned clinical skills of my seasoned coworkers, but it’s never easy. I’ve been silenced and dismissed a lot. I’ve learned to live with disappointment. No one likes to be told they’re harming others when they’re only trying to help. 

So, Tell Me About Despair will be a space in the cloud for my hopes and dreams of progressive mental health reform. It’ll be an opportunity to explore the uncomfortable two-hatted-ness of being both a survivor of psychiatry and a professional helper. There may be more than a few angry rants about our broken system. All I can promise is that my writing here will be completely honest and authentic. And, if all goes well, I may even inspire you to think critically about our flawed mental health system.

Two posts a month is all I’m agreeing to, but if we’re lucky the Muse will strike more frequently. Consider it a New Year’s resolution. Subscribe and share with anyone who might be interested! 

P.S.: Thanks, Mary Oliver, for writing beautiful poems worth naming things after.