Mental Illness, Medication, and Social Attitudes

This is a society that hates mentally ill people and wants nothing more than to suppress craziness in all its forms. Whether it’s forcibly committing people to institutions, excluding people with mental illness from society, or pushing for exceptional legal treatment to make it easier to abuse mentally ill people, there’s a long history of actively hating mentally ill people and putting that in force not just de facto but de jure. Thus, it’s no surprise to see hateful attitudes about mental illness prevailing culturally, with many people believing that mental illness is a wrongness, and that mentally ill people are inherently bad.

Mental illness is casually and readily used as a metaphor for evil or bizarre behaviour, it’s treated as the root cause for any kind of social deviance, and it’s feared and hated across society. Numerous people express an unwillingness to date, work with, or socialise around mentally ill people, perhaps fearing that mental illness is contagious or that they’ll be viciously attacked while innocently compiling spreadsheets or dining out with friends.

At the same time that society hates mental illness, though, it’s surprisingly vocal when it comes to the use of psychiatric medications and therapy to manage mental illness. Taking pills makes you ‘weak’ and not able to ‘just handle it,’ while therapy is useless and suspect, something that people are only brainwashed into thinking is useful. People who pay to talk to someone for an hour (or more) a week are clearly, well, you know. Crazy, and the entire mental health profession is obviously raking it in by deceiving all these people with their silly notions of ‘treatment’ and ‘management.’

The disdainful attitude when it comes to managing mental illness is at utter odds with social attitudes about mental illness. If crazy people are so awful, if we’re told that it’s ‘okay to be crazy so long as you act sane in public,’ how are we supposed to be less crazy if we can’t actually get any treatment? This paradoxical attitude is widely in force in society and people don’t seem to realise how absurd it is; if they think that, for example, schizophrenia is a scary and dangerous disease that turns people into monsters, uh, wouldn’t they want people with schizophrenia to be able to access whichever treatments help them manage their mental health condition most effectively?

Why is taking meds ‘weak’ and evidence of poor moral and social fibre, but being ‘off your meds’ a bad thing? Why is it bad to be crazy, but ridiculous to take medications that can (sometimes) easily and effectively help you manage the chemical imbalance in your brain that causes symptoms of mental illness? Why are mentally ill people a subject of mockery, but those who develop coping skills and tools in therapy pathetic people dependent on ‘quackery’? Why are people criticised for self-medicating behaviours like drug and alcohol abuse instead of being provided with access to safer and more stable treatments such as therapy, medications, and other tools that might help them?

The quandry experienced by mentally ill people in a society that hates us no matter what we do can be acute. We’re bad if we take medications: We should just try yoga, deep breathing, meditation, a vegetarian diet, something else, something natural, we should just try harder, everyone has bad days sometimes, it’s not that big a deal if you feel sad/angry/edgy sometimes. We’re bad if we go to therapy: We can’t think independently, we’re letting someone with a meaningless degree tell us what to do, we’re wasting money on pointless therapy appointments.

But if we don’t ‘control’ our mental health conditions, then we’re bad. We’re acting ‘crazy’ and people can’t trust us. We’re not dating material, we can’t be trusted to look after children, we can’t be allowed in the workplace, we’re not welcome in social circles, our communities will shove us to the fringes because we can’t be full members of society. Not when we’re all crazy, and especially when we’re ‘off our meds,’ acting ‘insane,’ being ‘batshit.’ When we reach out for help because we’re struggling, you’ll stick us in institutions or shoot us, because we’re crazy, and we don’t have any social value.

Psychiatric medications are treated as frivolous and pointless. They’re one of the few classes of medications that are regarded as unnecessary[1. Another class of drugs treated this way is, as I’ve noted in the past, pain relief for patients with chronic pain conditions.]; no one questions why organ transplant patients take anti-rejection drugs, for example, understanding and accepting that such medications are needed to survive. It’s generally understood that when you have a severe bacterial infection, you should take antibiotics to kill the causative organism, prevent the spread of infection, and protect your body from potential complications like damage to your organs. And so on.

Yet, psychiatric medications aren’t treated as critically necessary drugs that may help people stay alive, and definitely relieve the symptoms of their conditions, exactly as intended. Like other medications for people with chronic health issues, they must be taken for life, and may require periodic adjustment to compensate for changes in the patient’s condition and response to the medication, but that doesn’t make them less valid. Needing to go to therapy for an indeterminate period of time isn’t evidence that therapy doesn’t work or that counselors are ripping off their patients.

Everyone needs to manage their own health in the way that works most effectively and appropriately for them. That includes mentally ill people, some of whom find medications and/or therapy helpful. It’s odd that in a society where outward signs of mental illness are so feared and hated, the very tools people can use to manage those symptoms are so disdained. Oh, wait, it’s not odd at all: it’s a consequence of ableism.