I don’t believe in mental illness.
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.