How Not to Talk To People With Mental Illness, Episode #43,635 – UPDATED

UPDATE: The commenter in question has written a very gracious apology.

This is written in response to a comment on my blog, commenting on the post Some Incomplete Thoughts on Mental Illness and Shame:

I’ve not had a mental illness to my knowledge and no depression so I’m willing to concede I know nothing and should not comment but I’m going to anyway.
I love reading your blog but IMHO you think too deeply about the depression and its not healthy.
My suggestion would be to talk to good friends about this but have a break from writing about it for a bit.
Writing might be ‘burning it in’ to the parts of you brain that think deeply and that might be making it harder to resist because depression sort of gets ‘tagged’ to a lot of other thought processes that you have to use daily as part of your life.
Only write about the good things for a bit or the things that make you angry. (I especially like those.)
But not about being depressed. Just try a break for a bit.
No evidence this might work but didn’t want to stay silent and offer nothing. A big virtual hug.

Dear Commenter,

I know you mean well, and I’ll try to take your comment in that spirit. But if you have no personal experience with mental illness, aren’t a trained professional in the field of mental illness, and by your own acknowledgement don’t have any evidence to support the opinions you’re expressing about mental illness, please don’t give advice to mentally ill people on how to manage their illness.

Writing publicly about my depression has been extremely helpful. It helps me process it and make sense of it. It helps alleviate the sense of shame I’ve been made to feel about it. It helps me normalize it, and frame it as simply another illness, like my cancer or the time I had pneumonia — which also helps alleviate the shame. The fact that my writing about it helps others gives meaning to it, which makes it more tolerable. There is no possible way that I’m not going to “think deeply” about my depression — that’s part of the nature of depression — but writing about it helps keep those thoughts from spinning into a secret, self-perpetuating black hole. It helps give me insight into it, helps me crystallize and focus those thoughts in a productive way, and helps me move on from them. And when I write about my depression, I often get good suggestions and ideas on how to manage my depression from other people who experience it. I’m not the only one, either: many people I know who experience depression and other mental illness say that being more public about it has helped them.

And when people tell mentally ill people not to speak about it publicly, It’s nearly impossible to not hear it in the social context of shame and silencing — even if it’s not intended that way.

When you have a voice in your head saying “I shouldn’t comment,” I urge you to listen to it. If you feel driven by compassion to say something, to “not stay silent and offer nothing,” I suggest you try saying, “I’m really sorry you’re going through this.” If that doesn’t seem like enough, you can add, “If there’s anything I can do to help, please let me know.” But please don’t tell mentally ill people to shut up about our illness. Thanks.

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How Not to Talk To People With Mental Illness, Episode #43,635 – UPDATED
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50 thoughts on “How Not to Talk To People With Mental Illness, Episode #43,635 – UPDATED

  1. 2

    I think this “focus on the positive” meme that is propagating as a “cure” for all kinds of things is really damaging, because what it effectively does is isolate someone suffering even more and tell them if they haven’t the spoons to keep a credible-enough smile plastered to their face that they’re causing their own suffering (see also “professional victim”). It’s really another form of victim-blaming.

  2. 4

    I’m glad you’re giving the commenter the benefit of the doubt — because I’m pretty sure he/she is well-meaning.

    In past lives, I might have come up with similar advice. Now, I just keep my mouth shut. Because I don’t know what it’s like to have mental illness personally. So there’s no way I can know what’s therapeutic or not. That didn’t prevent me from offering an opinion in the past, however. Lesson learned.

    So, hoping that your post is viewed by the commenter as an educational experience and not seen as a “dressing down”.

    And sometimes it’s frustrating, wanting to say something helpful/useful/kind/appropriate, but having not the slightest idea of what that might be.

  3. 5

    Yeah, I don’t know what else to say to that. I’ve taken to visualizing depression as a massive chest wound, because when it’s really bad, it literally feels like it should kill me just from the sheer pain of it. And yet, it doesn’t. The worst part is that sometimes I do know things that would make me feel better—like writing—but I’m immobilized by the depression. It’s the cyclical nature that’s so insidious.

    My favorite ever portrayal of depression and how it’s seen by other people is this cartoon, appropriately titled Eat Shit and Die. It’s a thing of beauty, actually.

  4. 6

    Actually, the thing that the above cartoon misses is that I’m usually having those conversations in my own head, rather than with other people.

  5. 7

    Rumination is possibly unhelpful, but I wouldn’t make the leap that posting to a blog about depression is equivalent to rumination.

    The Effect of Rumination as a Mediator of Elevated Anxiety Sensitivity in Major Depression

    The association between rumination and negative affect: A review Abstract:

    A total of 100 experimental, cross-sectional and longitudinal studies on the association between rumination and negative affects are reviewed. Experimental and cross-sectional studies support a positive association between rumination and sadness-depression whereas longitudinal studies show more diverse results. Longitudinal studies sampling clinical populations and with treatment during the follow-up display more null results. Concerning the relation between rumination and other negative affects there is strongest evidence for a positive association between rumination and anxiety, but more studies are necessary to illuminate the relation between rumination and other negative affects. The functionality of rumination is discussed along with possible explanations for the associations between rumination and different negative affects. The need for further differentiation of rumination is highlighted in order to distinguish the concept from other types of repetitive, negative thoughts.”

  6. 8

    I don’t have depression, but my brother does. I don’t give him advice about it. I’m just there for him. I do know that telling him not to dwell on it would be like someone telling me that the way to get over my ADHD is to ‘concentrate more’.

    I actually had a psychologist say something like that to me. After saying that he didn’t know much about ADHD at all, he said that people with ADHD have no problems concentrating during their jobs and that my whole problem was that I had depression and he could tell from my expression that I had depression. Said expression was “Holy crap you are spewing so much bullshit” as well as nervousness from being in a room with a strange and aggressive man I didn’t know who looked at me all of once during the 90 minutes the appt took. And more disgust because he referred to my state board exam for my license as my “big girl test”.

  7. 9

    Hmmm.

    As a sober alcoholic, with long-term mild depression, plus medical crises, plus agonizing grief in the last 6 months etc. etc. My first impulse is to tear your correspondent a new asshole for pushing toxic ‘positive thinking’ memes at the expense of others.

    Of course, he (funny I guess gender so confidently) may only have skidded in the direction of that cliff so I will follow your lead and show heroic forbearance and tolerance. For anyone having trouble keeping their gorge down with all the ‘est-y’ positive psychobabble going round, I want to push this book:

    Bright-sided : how the relentless promotion of positive thinking has undermined America / by Barbara Ehrenreich

    There is a special service involved in reporting on problems in non-specialized, non-therapeutic venues. Other people need to no what the hell is going on in the world. Still, there is another set of gains and value in sharing IN a like-minded community, where we don’t have to be the ONLY ONE who brings problem X to the table.

    No damn’ rules please, and as few ‘helpful guidelines’ as possible.

  8. 10

    I have acknowledged publicly, in my Facebook and blog pages, that I suffered a deep depression last year and was very close to suicide, but I never discussed the details of it. I also made public that I’m slowly recovering and on medication.
    People that do not experience mental illness have no idea, because they are just themselves, I dare say perhaps naively. They seldom have to question their agency.
    People with a mental illness must think meta. Today I look at the world and all I see is gloom. Tomorrow, perhaps under the effect of a magic little pill, the world seems just nice.
    The world is the same, it’s my brain chemistry that changed.
    That calls for a more sophisticated view of the world, one in which one’s actual brain chemistry is taken into account.

  9. 11

    Thank you, ladyatheist. One of the most isolating aspects of mental illness or atypical neurology is the way other people respond to rumination, or verbal expression. It is usually beyond the scope of the average person’s experience, makes people uncomfortable because they have no idea how to respond, Those who battle suicide have an added double blind, many have been threatened with involuntary incarceration for just mentioning it regardless of context. Or fear incarceration if they talk. Talking about one’s experiences is one of the most therapeutic things we can do to reduce the isolation. This is why support groups are so critical to treatment. But support groups are not enough. The general population must become more conversant about mental health. It is the single most expensive epidemiological issue in the world. Depression, bipolar disorder, and schizophrenia are the most debilitating medical conditions in this country. What’s worse is that the delay in treatment often exacerbates the conditions, acutely and in terms of long term prognosis.

  10. 12

    The post kind of reminded me of Charlotte Perkins Gillman’s work The Yellow Wallpaper, which is about a woman who is isolated and refused stimuli in order to treat an illness she’s told is imaginary. The story is based on the authors own experience with 19th century medicine and misogyny. Both the character, and the author, were forbidden to write.

  11. 13

    With respect to the commenter quoted in the OP, he or she meant well. Just clueless. If the standard tricks for altering one’s mood worked for people with mood disorders, we wouldn’t have mood disorders. It’s kind of the defining characteristic.

  12. 14

    @2: This this this! It’s one of the problematic aspects of ‘survivor culture’ as well: throwing giant fucking parties (or ‘thons – Komen for the Cure can burn in hell) for everyone who weathered some sort of trauma and came out just fine is implicitly marginalizing to those who didn’t make it through in one piece (figuratively or even literally). I have no problem with people preferring to self-identify as “survivors” (of cancer, rape, domestic/relational violence, depression, whatever), but the moment one starts insisting on that label for anyone or drawing in-group lines, one has gone too far. Those actions carry implicit stigmatization in that if one isn’t an empowered “survivor”, one isn’t doing enough or the right thing or whatever. As deoridhe says, it’s another form of victim-blaming. People’s coping strategies differ (and are sometimes non-existent), and they all have to be accepted as okay, as long as they don’t harm others. Mine, for example, is recognizing that the world is an awful, awful place for many people and engaging in activism in meatspace and virtual spaces to try to change that. Focusing on the negative and on failure can have immense productive power, and ignoring it to try to clean up a group image for the sake of the comfort of others or even as a means of soothing self-delusion helps perpetuate the status quo. When things are fucked-up, we should feel bad about them – that’s what motivates change.

  13. 15

    Even when I’m feeling good I have a tough time picturing how devastating my depression feels. No way someone that hasn’t felt has the slightest clue.
    It’s like telling someone that is drunk to just shake it off and think straight. It is a fucking chemical situation – at least – if not brain wiring as well, that is going on.
    johnthedrunkard, same life situation here, to a ‘t.’

  14. 16

    (Not advice, not generalizable to others)
    There’s an effect that runs opposite to the one that the commenter posited.

    I’ve spent a bunch of time learning to actually feel my uncomfortable feelings without letting them control me. This is helpful to me because it means that I don’t experience as much need to engage in potentially harmful or self-defeating avoidance behaviors.

    I agree wholeheartedly with our host. The OP probably meant well, but xir advice is unhelpful on the merits and is doubly unhelpful when considered in the shame-loaded social context.

    Shame is also, for me and perhaps for some others, a more powerful driver for undesirable behavior than is sadness per se.

  15. 17

    My own experience with depression supports the commenter’s advice, at least in part. Humans are idiosyncratic, however, so I am neither stating nor suggesting that it should, can, or will work for anyone else.

    If I didn’t know better, I’d guess there’s some ironic subterfuge at work here: is it just me, or did the commenter prompt you to write about “the things that make you angry (I especially like those.)”? You do seem to be taking that part of the commenter’s advice. In any case, I think it’s rather unnecessary to publicly target and lambast someone who

    – Is responding to a question in a published blog post;
    – Is clearly well-intentioned;
    – Frames their response with complete humility.

    Unless, of course, you find writing in anger therapeutic — in which case, have at.

  16. 18

    Kevin Nielsen @ #17: How, precisely, was this post “lambasting” anyone? I said that I understood that the person’s intentions were probably good. I calmly explained why, precisely, their behavior was nevertheless problematic. I offered a constructive suggestion for how they might behave instead in the future. And I did all this in a civil tone. I even said “please.” Twice. If you think this constitutes “lambasting,” I suggest you find another blog to read.

  17. 20

    I think this “focus on the positive” meme that is propagating as a “cure” for all kinds of things is really damaging,

    It really isn’t so different from telling someone they just need to “pull themselves up by their bootstraps”, is it? Kind of like the old expression “lacking moral fiber.”

    The loss of ability to focus on or even to see the positive, if not exactly synonymous with depression, is certainly diagnostic of it, in my opinion.

  18. 21

    @19

    So, I read your response, and then I clicked on the health tag, to find citations, and … I got lost.

    As far as I can tell, the central point of your response is that psychological illnesses are not the same as physical illnesses and that equating them as such is stigmatizing them, and there is no scientific backing for equating them.

    I then looked at the health tag, and read through about half the entries on the page that showed up – the more recent half, I assume, and it seemed to be about Erich Fromm and his views on love, fulfilling needs, and ethics. And I’m not really certain how this relates to the central point of your response. I’m not sure if it was supposed to, and I’m not sure if that was because those works were actually supporting a different point in your response, or I was supposed to be looking at other works for your citations? And, on the whole, I found the entire citation process in your response to be unhelpful in determining which points have been made by other people, and when and where they made them.

  19. 22

    Greta Christina @ #18: I meant lambast in the second sense of Merriam Webster’s definition: to attack verbally; to censure. You’ve devoted a blog post in its entirety to humiliating and silencing a single commenter, and (a worse offense in my opinion), your use of the word “please” reads as patronizing. Twice. I hold my ground on issues of definition.

    I will happily refrain from commenting further if you wish — this is your blog, after all. However, I do not typically allow others to determine which published material I will choose to read. Sorry!

  20. 23

    So, I read your response, and then I clicked on the health tag, to find citations, and … I got lost.

    I can see how that could happen. My apologies. Here are a few (the second and third are the most relevant ones):

    http://saltycurrent.blogspot.com/2012/06/why-psychiatry-is-important-skeptical.html

    http://saltycurrent.blogspot.com/2012/06/psychiatry-skepticism-social-justice.html

    http://saltycurrent.blogspot.com/2012/07/joanna-moncrieff-myth-of-chemical-cure.html

  21. 24

    I then looked at the health tag, and read through about half the entries on the page that showed up – the more recent half, I assume, and it seemed to be about Erich Fromm and his views on love, fulfilling needs, and ethics. And I’m not really certain how this relates to the central point of your response.

    It really does. Later this week, almost all of Fromm’s books will become available for Kindle. They’re entirely relevant, and everyone should read them. The gulf between Fromm’s arguments and contemporary adjustment psychiatry is immense.

  22. 26

    As someone who does have a mental illness, my first thought when I read, “I’ve not had a mental illness to my knowledge and no depression so I’m willing to concede I know nothing and should not comment but I’m going to anyway,” was something along the lines of, “Oh no. This cannot end well.”

  23. 28

    Salty says:

    The gulf between Fromm’s arguments and contemporary adjustment psychiatry is immense.

    The gulf between J.R.R. Tolkien’s Middle-Earth stories and our contemporary understanding of history is also immense. This does not make the existence of hobbits more probable.

    Personally, I find your response even more insulting than the original post. You’re claiming not only that a method of treatment is wrong, but that despite decades of clinical work and mountains of studies, that the entire model is wrong, based on nothing more than the writings of one man and your assertion that ALL of the people who work according to that model have been corrupted by corporate capitalism.

    So that leaves us… where? People who think they’re depressed just need to cheer up and look on the bright side of life?

    As people frequently say around here, extraordinary claims require extraordinary proof. You’ve got fuck-all, except the claim that every psychologist and psychiatrist to practice in the last 75 years has been irredeemably corrupted by corporations.

    Do you even realize the scale of what you’re proposing? Do you realize how many people, how many institutions would have to have been deceived and corrupted for your claims to anywhere near correct?

    The fact is that there are some definite problems with the way that mental health is diagnosed and how care is administered. A lot of it has to do with the interests of political and economic powers, and I’ll welcome a critique of those things. But to just march in here and dismiss everyone who believes that depression functions as an illness is not only wrong on a basic level of argumentation, but grossly insulting.

  24. 29

    Greta Christina @ #18: I meant lambast in the second sense of Merriam Webster’s definition: to attack verbally; to censure. You’ve devoted a blog post in its entirety to humiliating and silencing a single commenter.

    Kevin Nielsen @ #22: ?????

    I devoted a blog post to criticizing the ideas expressed by a single commenter — ideas that, unfortunately, are not unique to that commenter — and pointing out why these ideas were problematic. I did so calmly, civilly, and politely — much more so than I felt like, in fact, given just how offensive, patronizing, and harmful I think these ideas are. I did not humiliate this person, and I am entirely baffled as to how you think I silenced them. I disagreed with them. If you think disagreement is the same thing as attacking, censuring, humiliating, and silencing, then again, I suggest that you find another blog to read. You are perfectly free not to do so, of course — you are perfectly free to continue reading this blog as long as you like — but if you don’t like it when I express disagreement with commenters and point out why I think their ideas are mistaken, patronizing, and harmful, I think it’s likely that you will be happier elsewhere.

    Also, please do not tone troll me in my own blog.

    Your concerns are noted. Thank you for sharing.

  25. 30

    Kevin Nielsen:

    You’ve devoted a blog post in its entirety to humiliating and silencing a single commenter, and (a worse offense in my opinion), your use of the word “please” reads as patronizing. Twice. I hold my ground on issues of definition.

    I’ve often had people explain, politely, why they believe I’m wrong about something. I don’t find this a “humiliating” experience: I find it thoughtful and useful.

  26. 31

    Personally, I find your response even more insulting than the original post. You’re claiming not only that a method of treatment is wrong, but that despite decades of clinical work and mountains of studies, that the entire model is wrong, based on nothing more than the writings of one man

    You’re very confused. Fromm was a brilliant critical-humanistic psychiatrist in the 20th century. He didn’t live to see the psychopharmaceutical era. I mention him in this context because of his writing about adjustment psychiatry – which the current approach exemplifies – and his alternative vision.

    So that leaves us… where?

    With a greater understanding of reality.

    People who think they’re depressed just need to cheer up and look on the bright side of life?

    Absolutely not what I’m saying. (But even if it were, that wouldn’t make the brain disease model any more valid.)

    As people frequently say around here, extraordinary claims require extraordinary proof. You’ve got fuck-all,

    I provided a link above to a post in which I recommend several books, each replete with citations. Maybe begin with the articles by Marcia Angell and then read the books by Kirsch, Moncrieff, and Whitaker.

    Do you even realize the scale of what you’re proposing?

    I do, but it’s not an original “proposal” of mine. It’s well established and widely acknowledged. It’s not a shocking revelation.

  27. 32

    I’m getting really tired of “but I meant well” as a response to doing something callous or actively harmful or even just totally thoughtless and uninformed. If you mean well, then you should mean well enough to take a minute to think about what you’re saying before you think about it. Otherwise, it’s as useless as saying “I’ll pray for you”. Except worse, because it’s actively bad instead of just useless. If you find yourself saying “I meant well”, that’s a clue that you need to stop and not do things that will cause you to have to say that later.

  28. 33

    I just read my response at my blog again, and it reads as callous and unkind. I apologize for that. I stand behind the arguments I made there, but I’m sure I could have presented them more thoughtfully. (It’s difficult because I very much want to raise this issue in the community, but it seems like the only openings are personal posts about people’s own struggles and their use of the drugs, and in that context challenges to the model seem like dismissals of people’s suffering, which is not at all what I’m trying to do. Alas.) Ironically, I’m writing a series of posts on the ethics of debunking. I guess I’ll leave the post up – I can use it as a negative example.

    🙂

  29. 34

    Salty Current. I have ADHD. Of the sort where we don’t produce enough of a particular neurotransmitter AND the blood vessels of my brain constrict, decreasing oxygen, when I concentrate.

    This is absolutely, 100% a PHYSICAL ‘disease’. It is visible on fMRI the decreased oxygenation and shutting down of parts of the brain. The brains of my family look like swiss cheese on the scans. It produces physical effects, such as being literally painful to think and severe confusion/disorientation.

  30. 35

    One of the problems with our culture’s shameful lack of scientific literacy is the lack of specificity in the language we use to discuss the attending phenomena. If Mr. Nielsen (#17) found that his depression was alleviated through the use of various cognitive processes, that’s great. It’s also an indication that he might not have been suffering from clinical or major depression. Most people with clinical or major depression (heavy on the suicidal ideation, usually life long), or depression as a co-morbid condition, or facet of bipolar, typically are not so lucky. And the idea that “it worked for me so it must valid advice” is ridiculous. If one has acute depression (I am admittedly assuming), it’s not even remotely the same thing as major depression or depression as one of two poles. People with Bipolar II (no psychosis) run some of highest risks for suicide. Suicidal ideation is not usually fixed with cognitive processes alone. In these cases, there is a great deal of harm in telling someone one to censor themselves. It increases the risk of self-harm, reinforces isolation and isolating behaviors, and places real obstacles in the path of treatment and recovery. Furthermore, it’s kind of a kick in the teeth – it’s like telling a man with no legs to just “run it off”.

  31. 36

    I should have said “think about what you’re saying before you say it”, obviously. Even I don’t have such high standards that I expect everyone to think about it before they think about it.

  32. 37

    Greta Christina @ #29: duly acknowledged. In rereading the post I see much more civility than I did on my first pass through. And thank you for introducing me to the term “tone troll,” whose urbandictionary entry is in dire need of expansion.

    And to joeylusk @#35: your distinction between types of depression is entirely apropos. To be more specific about my experience (since you use it as fodder for your position), I had two episodes of major depression in the course of a much longer experience with “mere” dysthymia, and cognitive behavioral therapy did assist me in reaching a more stable and less depressive plateau — specifically, it was a variant of Family Therapy applied to different fragments of an individual’s cognitive processes. I didn’t entirely buy into the ideology behind the particular form of therapy, but that didn’t prevent it from helping; I didn’t dare look the gift horse in the mouth.

    I’m sure you didn’t overlook my “I am neither stating nor suggesting that it should, can, or will work for anyone else” disclaimer. The reason I got involved is not because I am defending the commenter’s advice, but simply because I disapprove of smacking down well-intentioned ignorance — and also, evidently, because I’m a tone troll =/

  33. 38

    Kevin Nielsen, #37, my apologies – a paragraph break might have been helpful. That last half of my comment was more of a general nature. But exactly. Dysthymia is not major depression. It’s not “mere” but it is considered less severe. No mood disorder is easy. But people who have unipolar or bipolar depression, suicidal ideation, etc, rarely find respite with purely cognitive therapies. While one might object to the tone, I personally find the response far more helpful than the original comment. There is a great opportunity to learn about how to respond in an informed and conscientious manner to comments about depression. What the commenter said is exceedingly detrimental, regardless of intention. Most of us are tired of hearing the same trite and useless responses (as in the OP). Ignorance needs to be addressed, and if it must be addressed curtly or not at all, I vote, overwhelmingly, for curtly.

  34. 39

    Sounds like this person is conflating what they would prefer—not to think about sad things like depression—with what’s good for you. Projection, nothing more. They really should be more careful to understand the difference between what’s in their head and what is real. Strange for a skeptic!

  35. 40

    Kevin’s comments seem to stem from the general belief that the job of the oppressed or un-privileged—in this case, people suffering from mental illness—is to make the privileged—in this case, those who are mentally well—comfortable, even at the cost of letting the privileged continue to be deluded. This is why even the gentlest critiques of sexism get you called a feminazi and the slightest suggestion that racial prejudice still exists gets you accused of playing the race card.

    Ironically, hand-wringing over the tone of the oppressed disincentivizes being gentle in our critiques. If I’m going to be called a bitch, cunt, lambaster, or feminazi no matter what I do, then I might as well just say what’s on my mind without couching it.

  36. 41

    As the person responsible for the comment that provoked this thread, I accept that I’m thoroughly rebuked and I apologize if I’ve unintentionally made things worse. I also wish to assure Greta that my comment was well intentioned and I’m upset that I’ve entered into something I should I have kept out of. Not saying anymore in case I put my foot in it again.

  37. 43

    As a person in suffered from depression in silence for a long time, I personally have been helped by hearing people like Greta and other atheists in the community talk about their experiences. Thank you, Greta for being brave enough to write about something very personal.

  38. 44

    It’s funny that you just wrote this piece and NeoGAF just had a thread about “Why do People Make Fun of Other People’s Phobias?” I just came back from San Francisco with an awesome support group for Paruresis. While mine was the most mild out of the group, it felt great relating to people in real life and helping others make progress. I’ll eventually “get over it” as “normal” people say, but not without a lot of time-consuming intensive work.

  39. 45

    Kevin’s comments seem to stem from the general belief that the job of the oppressed or un-privileged—in this case, people suffering from mental illness—is to make the privileged—in this case, those who are mentally well—comfortable, even at the cost of letting the privileged continue to be deluded.

    In this particular case, I don’t really think so.

    Most people often conflate the state of “being depressed” with actual, clinical depression, and think that what works for the former will work on the latter.

    I did think this also before I had my own endocrine-related experience with it (one piece of advice that might actually be useful : if you think your mental state is unusually dark and sleep more than usual, it might be a great idea to get a TSH test done, if your doctor didn’t think about it right away).

    But I found out that both are actually very, very different – as different as a sprained limb is from an amputed one. The sprained limb gets better on its own with time and exercise, the amputed one not so much, at least not without a good deal more work and help.

    Also, the people who keep insisting that you not think about it so much, or go as far as deny that there is a problem ? Annoying and frustrating (well, to the extent that you can actually feel annoyed or frustrated while clinically depressed). There is also a good deal of misconception about the symptoms. Yes, there are people who spend most of their time crying. But the most crippling thing is that utter lack of motivation or feeling about everything, be it getting up in the morning, working, or even your own death.

  40. 46

    I admit that I know nothing about depression, mental illness, cancer, blogging, women, lesbians, lesbian-women or cats, but I suggest that you-… You don’t want my advice? Why not???

  41. 47

    I’m afraid this was my experience often when I was ill. The fact that I was young made it worse. People, usually family members, would decide that they knew what was best based on no expertise whatsoever and proceed to tell me that my coping mechanisms were wrong or that I should really try [alternative medicine of choice].

    So often I’d get advice and if I didn’t take it I opened myself to accusations of not helping myself. I think that a lot of the time people actually needed to persuade themselves that it was all easy to cope with really, that they would know what to do. I’ve observed that response to other people’s problems often.

    The fact is, it is silencing. It is also infantilising. You are mentally ill so you cannot know what’s good for you. So people treat you like a child, for your own good. Somehow that doesn’t help those feelings of powerlessness and inadequacy.

  42. 48

    Being defensive shows you have not dealt with your mental illness.

    Writing can be a useful tool in psychotherapy – if said writing is evaluated by an objective third-party. But if you are mentally ill, you should not be blogging. Blogging allows you to fall deeper into mental illness by way of “folie a deux” on a massive scale. Saying whatever seems reasonable to you, then removing all voices to the contrary, inevitably leads a sick mind further down the rabbit hole.

    You describe yourself as a “mental health professional”. Whether it is true or not, you are violating one of the central rules of the health profession: never be your own doctor. MDs always submit themselves as patients to other MDs, because they know that health is a deeply personal and emotional issue, and that an MD is as susceptible to personal bias as anyone else.

    It’s true in all professional fields. Lawyers, same thing; a lawyer has the skill to plead cases, but no competent attorney is going to plead his own defense, rather than hiring on an objective colleague.

    Ms Christina is a sick woman who needs professional help. Simple as that.

  43. 49

    Ethan Farber has been put into comment moderation. His commenting here is bordering on theeadjacking and comment hogging, and he’s starting the same argument in multiple threads — all of which are prohibited by my comment policy,. (Also, this [artocular comment reveals a unique inability or unwillingness to read for comprehension.) And I’m at a conference and don’t have time or energy to monitor conversations as closely as I normally do. So any further comments from Ethan Farber will have to be approved by me before they’re posted. Thanks for your understanding.

  44. 50

    The comment “have a break from writing about it for a bit” reminds me of “The Yellow Wallpaper”. I would have hoped people would have more sense than such ridiculous 19th Century views, but some of these follow up comments only remind me that my hopes are utterly naive. I’m sorry you get such ignorant comments on such wonderful posts, Greta. You are wonderful.

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