As I write this, I can only begin to imagine the number of people who have jumped to the conclusion that the shooter at the Charleston AME Church was mentally ill. By this time tomorrow, even if the shooter has not been caught, we will hear the pundits debating what kind of disability afflicted the shooter. Undoubtedly there will be more calls for Forced Outpatient Treatment.
There are a few things to keep in mind before we turn Charleston into our reason-to-support-Murphy’s-Law-of-the-day:
We have no idea who the shooter is at this point, except that he is white and in his twenties or thirties.
South Carolina has “Assisted” Outpatient Treatment. So even if he was mentally ill, the much ballyhooed program sure as hell didn’t prevent anything here.
The man had a gun that let him kill a lot of people including a state senator.
White supremacist activity has been on the rise.
Rest assured that the NRA — which backs the Helping Families in Mental Health Crisis Act — will blame this on mental illness at the earliest possible press conference. We’re the scapegoat for this kind of thing every time it happens.
Buzzfeed calls itself the largest humor site on Facebook. It reaches nearly 500,000 people, many of whom are impressionable teenagers and young adults.
Recently, it published quizzes purporting to identify whether the test taker was bipolar or OCD. There were many problems with these quizzes.
The first was that many of the questions — especially on the Bipolar quiz — had nothing to do with the disease itself. People with bipolar disorder who have taken the test have been told that they don’t have the disease. Others who don’t have it, have been told that they have.
Second, they make light of syndromes that wreck the lives of those who struggle with them.
Third, the results may give the people the illusion that they have the disease when they don’t or don’t have it when they do. This can lead people to unwisely abandon their treatment or eat up valuable time at the psychiatrist assuaging their fears that they have the illness when they do not.
Fourth, the test has no medical disclaimers to the effect that it is no substitute for accurate diagnosis by a medical professional.
Fifth, the staff at Buzzfeed has been disingenuous about these harms and refuses to remove the tests from their site on the grounds that they are “just entertainment”.
We who live with mental illness live with the hardship of stigma. We are treated like children. We are told that we are faking our symptoms or that they “really aren’t that bad”. Buzzfeed’s arrant insensitivity must end.
I avoided medications of all varieties for much of my adult life. When I was 36, I had had too much of my depression and opted to start taking Prozac under the care of a psychiatrist at Redwood City Kaiser. I stayed on anti-depressants alone until I was 47 when I finally acknowledged my bipolar disorder after a suicide attempt and added mood stabilizers to the list of drugs that I was taking. Why did I go so long before I sought relief? Mostly because of a prejudice that had been drummed into my head by my mother, a registered nurse, who believed that medications should be avoided at all costs and that my depression and manic swings were character flaws. When I stopped listening to her, the quality of my life improved and I was able to be the person who I always knew that I was.
Many people feel that people who refuse to take medications should be forced to take them. They cite incidents such as a New York City man who went off his meds and started hitting people with a hammer or a schizophrenic woman who killed her baby in a fast food restaurant’s bathroom. The recitation of such litanies by certain advocates who favor forced medication is stigmatizing because the vast majority of people who go unmedicated don’t commit such crimes. Their struggles are worse than those of us who don’t take them, but it is important to understand their reasons for refusing.
Rethinking Positive Thinking: Inside the New Science of Motivation by Gabriele Oettingen
I don’t know how many times I have listened to people in support groups declare that they have decided to apply positive thinking to their lives and then watched them crash and burn. People declare all kinds of objectives for their affirmations. They will lose weight. They will master their drug problem. They will control their anger. They will grow rich. Money will come to them without effort. They will find a millionaire and marry him. They will find a fabulous new job and leave all the cares of the old one behind them. Some goals are realistic. Others are simply fantastic.
Studies show that plain old positive thinking drags people into a depressive rut. Oettingen cites the example of her work examining the attitudes of East Germans versus West Germans. East Germans spend a lot of time thinking positively. They see themselves as rich, as coming into opportunities of a lifetime which change their life situation for the better. But they still end up at bars trying to drink their melancholy away, and they never get anywhere with these plans. West Germans set reasonable objectives, put in the work, and succeed. Even though their goals are less grandiose, they are happier than their former Communist counterparts.
Recovery from bipolar disorder is almost like a religion or an ethical system. Certain devotions must be part of our lives if we are to recover our balance.
I shall hold myself accountable for all works of my body and my mind including those which I wreak when I am in episode.
It is important, I feel, not to separate the illness from ourselves. We did the things that happened while we were in episode. There was no second soul seizing control of our bodies. Our mind is a stream that flows continuously, sometimes over rough ground, sometimes in placid stretches, and sometimes over cliffs. We own all these states of our being.
I shall never use my illness as an excuse.
Our episodes explain what we did. The difference between an explanation and an excuse is this: An explanation asks only for forgiveness. An excuse entitles us to both trust and forgiveness. We do not deserve the former until we have earned it.
Many people in bipolar support groups counsel the newly diagnosed not to feel shame for things they did while they were in episode: it was the disease that did it, not them is the reasoning. This cleaving of the self, I think, does not help us get a handle on the illness and its effects on others in our life. In fact, it strikes me as downright irresponsible: you never have to make amends for anything you did.
Denial of the damage we cause is linked to this exculpation due to mania. Some say that making amends has nothing to do with apologizing. Warped logic causes it to mean nothing more than admitting to yourself what you did without making restitution or apology to those we harmed while addicted or in the throes of mental illness. I find this cheap recovery and I am suspicious of anyone who flaunts it.
Too often, I have seen people who insist that their sickness absolves them relapse repeatedly. Perhaps it is due to the fact that they do not understand the seriousness of their disorder. Or maybe they desire license to act on impulses that they would reject on moral grounds if they were in their better minds.
I take a different approach: I am responsible for my actions even when I do not remember them. Because of my denial of my illness, I harmed others. Therefore I either make peace with them or avoid them so they are not disturbed or shocked by my return to their lives.
(Families might find it better for their sanity to forgive things done in episode for the sake of their sanity while expecting the patient who now knows better to take proper steps to minimize further recurrences.)
But there is a bonus: because I am accountable, I get to own the good things I did with more resolve. I get to own the steps I have taken towards resilience.
Here is the grim truth: if I do not take ownership of the bad things I did while in episode, I cannot own the good things I accomplished. To claim otherwise invokes an irresponsibility that case workers and other mental health practitioners best not encourage.