Crazy people are crazy, throw rocks at them August 22, 2012 10:33 AM   Subscribe

I'm rather new, but I feel there's a disturbing anti-psychiatric trend to Metafilter

It really got me out of my seat on Tony Scott's obituary, when somehow the concept of the stigma was completely reversed (almost like saying swedish girls raped Julian Assange) to claim that considering the notion that Scott might not have made an optimal decision to jump to his death contributes to "the stigma about suicide". I understand that suicide may be rational sometimes -- I always go back to Deleuze, the philosopher of jouissance, who, after he couldn't speak or write and barely move, pushed his wheelchair over the window. But can one even wonder out loud?

People lose their lives unnecessarily to suicide. Terry Pratchett may be doing the rational thing preparing for his Alzheimer's with Dignitas in Switzerland, but not all suicide is a practical end-of-life decision, and while a philosophical argument may be made that one should have the right to end one's life at any point, most failed suicide attempts regret it. I don't think I've ever come across someone who tried it three days in a row.

The problem here is the stigma about mental illness. It's such a taboo to take crazy pills that people never even seek help. Mental illness is just like kidney disease, for all the epistemological stuff you may want to raise. You wouldn't encourage someone with treatable renal illness to sit it out. Can I say Scott was ill? No, but I can say many people in his specific demographic (Hollywood, male, post-middle life) have come out as mentally ill. The stigma is in shutting down the discussion.

But this isn't all. There's the whole shitstorm at the suggestion that pictures of happy trans folk may not be the whole picture and post-op "global outcomes", to use the jargon, should be assessed systematically -- i.e. ask many people whether they're better off or not. There's people trying to find some identiy politics in the transable -- voluntary amputees.

Why do I sound like the conservative nut here?

Because somehow the baseline "stigma" to be fought is the idea that these people might not have reached a rational conclusion. Is there a huge population of cultural studies PhDs trying to find a theme for their dissertation? Are people really aware that we, the crazy, do exist, and resent the notion that suggesting mental illness is an insult?

This is the actual stigma. Mental illness is complex. Sometimes apparently self-destructive choices are rational, like leaving a job. Sometimes you're just manic out your skull and leaving your job because you will start a new business selling cloudbusters. Sometimes you're Gilles Deleuze, have had a goal for your life since young and have reached the brim of your cup, and are incapacitated beyond repair, and you kill yourself. Sometimes, well, the bear kills you.

We can't actually know. Actually, we can't actually know anything about a sane's person motivation either, but certain behaviors, like self-mutilation and suicide are more often than not Vincent van Gogh.

I have one grievance and one worry. The grievance is that claims of mental illness are always taken as just about as likely as a faked death in Scott's case. This is extremely insulting, dehumanizing even. The crazy aren't people, Scott was a person, therefore he couldn't have been crazy. We're a disturbing bunch because you can't do identity politics or write about "crazy theory", there's no equivalent of the "patriarchy". There is the uppercase Stigma, but that mefiites will trumpet it loudly just to acknowledge whatever novelty cause comes along, ach. I felt like a jew in Stormfront.org in the Scott thread.

The worry is that this mentality sinks further and further into people who need help. This may seem sanctimonious, but I know crazy inside my own skull, I've known outpatient manic-depressives and schizophrenics for years -- and you always want to validate whatever you're trying to do, you know? I'm not saying the world should be filtered to the crazy, but "this is crazy, I know crazy" should be a valid response to "look at these brave rational people stepping into new grounds of identity politics".

Anyway, rant off.
posted by syntaxfree to Etiquette/Policy at 10:33 AM (139 comments total) 3 users marked this as a favorite

Just because people choose not to reduce others to their mental state but instead view them as complete human beings does not mean there is a stigma against mental illness here at MetaFilter.
posted by elizardbits at 10:39 AM on August 22, 2012 [26 favorites]


I have a bad feeling about how this is going to go, because there's so much stuff in your post that there will be many individual ideas for people to take exception to without addressing your main point. In fact, I'm certain that unless this is closed quickly, that's what's going to happen, because it is quite unclear what your main point is.

What is your main point/question? What do you want to accomplish? Try to distill it down as much as possible.
posted by Jpfed at 10:42 AM on August 22, 2012 [4 favorites]


I felt like a jew in Stormfront.org in the Scott thread.

With respect, this may say more about your own internal thought processes than how that thread in particular went. You're a very new user and really hot button topics like suicide and mental illness have a long history of discussion and discourse here on MetaFilter which many people may reference in shorthand ways. Obviously this is problematic for new users, but it's also a real thing about how the site operates and is worth maybe spending some time looking through past Meta threads about suicide and mental illness topics to see how they have been dealt with in the past and then seeing how you feel relative to those discussions as well. This is definitely a topic that could be handled better here, as well as every other place on the internet, but I feel like you're seeing a very small part of the picture and drawing some very broad generalizations.
posted by jessamyn (staff) at 10:44 AM on August 22, 2012 [13 favorites]


Yeah, I don’t understand the rant.
posted by bongo_x at 10:44 AM on August 22, 2012 [2 favorites]


For a data point in the other direction: when we were putting together the There Is Help page for the wiki, I noticed that "Go to a therapist" is one of the most common bits of advice given on AskMe for questions about suicide, depression and other related topics. In single threads, it's often suggested by one person and echoed by many other people.

My personal impression is that Metafilter does not skew anti-psychiatric. I could be wrong, though.
posted by zarq at 10:45 AM on August 22, 2012 [8 favorites]


I'm sure the mods will soon weigh in with statistics, but on the basis of what I've been reading here over the years, I have the feeling that you might have been looking a little too hard in a little too few places. I actually have the feeling that Metafilter is one of those few places where there is a rather large acceptance of mental illness being-a-thing-that-can-be-talked-about.
We usually also get rather level-headed discussions when people ask about side-effects and stuff of mental-illness-related medication, or mention that they take meds for some condition or other, or ask about advice when depressed etc.
posted by Namlit at 10:46 AM on August 22, 2012 [6 favorites]


I'm in agreement with elizardbits. I've never felt any stigma attached to mental illness here. Lots of us are dealing with mental illness, and something I appreciate about MeFi is that we can talk openly about it, and not have our illnesses be what defines us to the community.
posted by MissySedai at 10:46 AM on August 22, 2012 [9 favorites]


I don't think there's an anti-psychiatric trend on mefi at all, though some individual users may be more willing to consider suicide rational than most of mefi is.
posted by Greg Nog at 10:46 AM on August 22, 2012 [1 favorite]


(almost like saying swedish girls raped Julian Assange)

I got this far before deciding you, syntaxfree, need to clean up your rhetoric before I'm gonna give it any time or consideration. I don't even
posted by carsonb at 10:46 AM on August 22, 2012 [23 favorites]


I don't read the blue very often..

but on AskMe, "get thee into therapy" is one of the most common answers. People say "the default metafilter answer of therapy applies here"

The question-answerer folks at least have no stigma toward depression or other mental health issues.

Speaking as something who's really struggling right now, I felt no qualms about posting a mental health a question last week. As a matter of fact I expected more support then I got. (I imagine it's because of how I phrased the questions)

Metafilter is my little guiding light, as there are so many people who're going through rough times right now and many that have made it through. It can be very encouraging.
posted by royalsong at 10:50 AM on August 22, 2012 [6 favorites]


I am not a thing. I am a someone*
posted by royalsong at 10:51 AM on August 22, 2012 [4 favorites]


I actually have the feeling that Metafilter is one of those few places where there is a rather large acceptance of mental illness being-a-thing-that-can-be-talked-about.

This is my feeling as well. If anything I've found Mefi to be a pretty usefully educational place about mental illness in terms of folks willingness to discuss their experiences and such.

It's a big, heterogeneous userbase so there's sometimes pretty strongly differing opinions about lots of different issues related to mental illness, therapy, psychiatric treatment, self-determination, etc. for sure and I feel like we see the occasional really hamhanded failure to approach this stuff empathetically, but that's more a reality of large group behavior than a systemic thing on the site as far as I've seen.
posted by cortex (staff) at 10:51 AM on August 22, 2012 [1 favorite]


I haven't read the thread in question, but in general, if Metafilter does have any leaning on mental health, the leaning is to say that mental health is just as serious and real as physical health, and to be strongly supportive of psychiatric treatment. So, this MetaTalk post seems quite superfluous in urging us to do what we've already been doing.
posted by John Cohen at 10:57 AM on August 22, 2012 [5 favorites]


It's a big, heterogeneous userbase so there's sometimes pretty strongly differing opinions

This is certainly true and as I am extremely photosensitive to issues of mental health I have the distorted perspective that Metafilter does with mental health issues incredibly poorly but when I think about it from a little bit further off that probably isn't as true as it sometimes seems. We certainly have our share of 'DFW saw too deeply into life, that's why he killed himself!' bullshit and a great deal of 'Look at Michelle Bachmann's eyes and tell me she isn't off her meds!' and 'Banker? Sociopath' and 'Baptists talk to their imaginary sky friend who tells them what to do, how is that not schizophrenia' and those things really set my teeth on edge and I really, really wish we would get better about lulzy-armchair-diagnoses but on balance we're still probably better than a lot of the internet.

Which is maybe depressing.
posted by shakespeherian at 11:04 AM on August 22, 2012 [13 favorites]


About the only prohibition regarding suicide on metafilter is to ask for information on how best to go about it. Other than that it's pretty much an open game as long as you're not a dick about it. This rule pretty much cover most topics here.

So what you get is thousands of opinions on a topic. Those are not going to be some kind of singular chorus. To say metafilter is pro or anti anything ignores this fact.

I find this place to be exactly the opposite of your observations.
posted by cjorgensen at 11:05 AM on August 22, 2012 [5 favorites]


What everyone else is saying re: this place and psych/mental health issues rings true for me as well. We've had some bitter debates about suicide and there's often too much armchair diagnosing; we've also had some very moving and educational discussions about suicide, and mental health/illness issue in general. It's really remarkable to me how many people (especially but not solely on askme) are willing to really discuss what drugs they're on, what drugs they used to be on, what kinds of other non-medication treatments they have or do use, what they've found most and least helpful.

So, yeah. A thing we could do better (pretty much everything is), but also a thing that we mostly do okay at, from what I've seen.
posted by rtha at 11:08 AM on August 22, 2012


Yeah, dude... speaking as someone who has struggled with lifelong mental health issues, and who has family and friends who have also done so, this is one of the MOST favorable places I've ever seen in terms of, 1. Acknowledging mental illness is a real illness, and 2. Suggesting therapy/meds/psychiatry/psychology. I'm not sure how much more acceptance MeFi COULD show, short of donating a quarter to NAMI every time someone favorites a mental health thread...
posted by julthumbscrew at 11:10 AM on August 22, 2012 [3 favorites]


I am all for people. I love people, each and every one of you individually. However, I myself am against Psychiatry and how it is promoted in America. I think a lot of other people on MeFi are also.

Mental illness is just like kidney disease

this is the lie that psychiatry has pushed for Big Pharma for years. This is my honest belief and I do not think I am a crank. The big difference between the two is that, with kidney disease, you can take the kidney out and look at it and see how it's diseased and if you have to put a new kidney back in.

Real people face real problems. The solution to solve these problems is not to throw mood-enhancing pills at them and say "oh, it's just like taking kidney medicine."
posted by rebent at 11:15 AM on August 22, 2012 [2 favorites]


You might want to take a look at this thread, as far as developing an opinion on the userbase's opinion of mental illness is concerned.

The solution to solve these problems is not to throw mood-enhancing pills at them and say "oh, it's just like taking kidney medicine."

Well, except when the problem is due to brain chemistry, in which case that is exactly the solution.
posted by griphus at 11:17 AM on August 22, 2012 [16 favorites]


(Hey, wow, that "except" doesn't belong in there.)
posted by griphus at 11:18 AM on August 22, 2012


Uh, usually people take my expression of opinion as an attack. I don't want people to think I'm attacking their viewpoints in this thread - I just want the OP to know that some people here do take issue with psychiatry, and some of my perspective on it. If you want to talk more about it, feel free to memail me, but I don't want to derail. I hope I have not offended anyone.
posted by rebent at 11:19 AM on August 22, 2012


My experience here echoes julthumbscrew's with regards to acceptance of the issue here. If I were facing such an illness, or knew someone who was, this is probably the first place I'd come for feedback, pointers to additional information, and so on.
posted by jquinby at 11:19 AM on August 22, 2012


There was a time when we could neither diagnose nor treat kidney disease, and if you had pain, you were given some semi-poisonous herbal bullshit (if you had money) and generally told to suck it up and complain less about your whiny boo boo imaginary stomach pain that you couldn't show anyone or prove to anyone. Didn't make kidney disease any less real.
posted by prefpara at 11:27 AM on August 22, 2012 [11 favorites]


GYOB.
posted by desjardins at 11:28 AM on August 22, 2012 [3 favorites]


If you think that psychiatry isn't given a fair shot on Metafilter, look at any and every relationship, mental health, and anxiety issue on AskMeTa. "Therapy" is pretty much considered one of the best ideas since sliced bread here.
posted by xingcat at 11:30 AM on August 22, 2012


I realize that I am not contributing much here, but... is anyone else unaccountably thinking of the word "fedora"?
posted by running order squabble fest at 11:31 AM on August 22, 2012 [9 favorites]


From your post, what you're actually describing is not some sort of anti-psychiatric backlash or mental illness taboo, but people disagreeing with your opinions on two somewhat touchy subjects. Especially your contributions to the happy trans thread were ...awkward, shall we say, as it came across as bogstandard sort of concern trolling.
posted by MartinWisse at 11:31 AM on August 22, 2012


The big difference between the two is that, with kidney disease, you can take the kidney out and look at it and see how it's diseased and if you have to put a new kidney back in.

Just out of curiosity, if we replaced kidney disease and write in type 2 diabetes (because at this point the specific cause is hotly debated with much handwaving, you can't exactly point to the broken bit, or replace it via transplant surgery) would you say that's it's a like that physicians are pushing for big pharma?
posted by Kid Charlemagne at 11:33 AM on August 22, 2012 [2 favorites]


Yeah, the whole "it's not like kidney disease!" argument has two gigantic, gaping holes in it. I don't view it as an attack - I view it as ignorant.

Gaping Hole the First: there is a difference between MENTAL ILLNESS and ORDINARY NEGATIVE EMOTIONS. The former can be debilitating. The latter, not so much. Responsible healthcare practitioners DO NOT generally advocate MEDICATING ORDINARY NEGATIVE EMOTIONS, no matter HOW many free samples Glaxo provided them with this month.

Gaping Hole the Second: just because malfunctions within a system do not occur in a physical, tangible manner, does NOT mean that they don't occur. When your computer's hard drive needs to be defragmented, can you take it out and SEE the fragmentation? Nope. And actually, these days, with advances in medical imaging, we ARE able to see the effects of mental illness (via fMRIs, PET scans, etc). There are definite differences in the brain activity of mentally ill people vs. neurotypical people. Denying that is denying science, and when you deny science, I stop listening.
posted by julthumbscrew at 11:34 AM on August 22, 2012 [26 favorites]


throw mood-enhancing pills at them

Mood-enhancing pills have saved my brother-in-law's life. If he did not have mood-enhancing pills he would be dead at this moment and I would never see him again.
posted by shakespeherian at 11:34 AM on August 22, 2012 [17 favorites]


"Gaping Hole the Second" sounds like a lost Alfred Jarry play.
posted by griphus at 11:36 AM on August 22, 2012 [4 favorites]


Re: mood-enhancing pills, it's a thing ("take this prozac, it will make you more extroverted"), and it's called "cosmetic pharmacology". It's an interesting debate and entirely dissociated from the issue of mental illness, but kind of derailing here.
posted by syntaxfree at 11:37 AM on August 22, 2012 [1 favorite]


I just chalk the mental-illness-isn't-a-thing belief up as something the poster hasn't experienced.

I was a little bit like that before I lost my marbles shortly after high school. That was back when depression was still a hush hush embarrassing thing. I am lucky to be here. That's thanks to a therapist, and not happy pills. (and going back to school)

If you haven't experienced it.. it's hard to acknowledge. Just like once you have experienced it, you find new methods and ways of coping with stress and negative emotions to head off a new decent into madness.
posted by royalsong at 11:40 AM on August 22, 2012


Mental illness is just like kidney disease in that the latter, too, can be pretty darn horrible. Otherwise this type of comparisons typically just make matters worse. They put Some Gunk in the place of the topics that need to be discussed.
posted by Namlit at 11:43 AM on August 22, 2012


"Gaping Hole the Second" sounds like a lost Alfred Jarry play.

It sounds like something on the internets upon which I would never ever click.
posted by elizardbits at 11:43 AM on August 22, 2012 [7 favorites]


"Gaping Hole the Second" sounds like a lost Alfred Jarry play.

I guess, since they cleaned up Times Square.
posted by shothotbot at 11:44 AM on August 22, 2012 [2 favorites]


1) I have a really hard time following what it is you are trying to say in your rant because it does not seem to follow any internal logic.

2) Your choice to use inflammatory rhetoric at almost each available turn hurts your ability to make your points cogently.

1 + 2=This is a bit hard to take seriously as a real attempt at discussion and not a stunt.

3) I work in mental health, I post about mental health, I read almost all things written here about mental health, I care deeply about mental health, its phenomenology, its treatment, and how it is handled in our society.* I frequently think Metafilter is far too credulous about psychiatry. I would never think to describe it as having an anti-psychiatry bent, in either the ordinary or proper uses of the term. There are a few people who are vocal about thinking that medications, e.g., are prescribed too readily and should not be used, but they are very much in the minority. I have no idea what you're talking about, and it makes me think that you need to spend a bit more time on the site before making these kinds of sweeping generalizations (to the extent that I can divine generalizations from your title, mostly).

*I know more about mental health than you can possibly imagine. ;)
posted by OmieWise at 11:47 AM on August 22, 2012 [39 favorites]


I've posted many a question about mental illness here and have read most posts about it. I can say this is the least anti-psychiatry board I read (including all the mental health ones I read). Sometimes it swings too far in thinking that meds cure everything (which ain't true for some of us) and make me feel uncomfortable when I try to opine about how it may be a bit more difficult than switching meds.

I'm on of those people that believe suicide is an option in depression and I think that may be the problem you are seeing. Some of us have struggled with this question for years and see suicide to be a more nuanced issue than just "if you commit suicide then you were crazy". Some of it see it as a valid choice.

But even then people who disagree with me have always been respectful. I can't think of a place on the internet and in my life where people are more encouraging to trying therapy and seeing a doctor first.
posted by kanata at 11:48 AM on August 22, 2012 [5 favorites]


I used to be an advocate for folks with mental illness and have had many experiences related to mental illness. So I'm kind of sensitive to it, perhaps. I can recall two incidents, one involving somebody looking for "time-cube" websites as a funny ho ha ha and another was treating the Hater Elmo in NYC as ho ho ha ha. There was push back in both cases. I think this is a far kinder place to those with mental illness than most places.
posted by angrycat at 11:48 AM on August 22, 2012


There's the whole shitstorm at the suggestion that pictures of happy trans folk may not be the whole picture and post-op "global outcomes", to use the jargon, should be assessed systematically -- i.e. ask many people whether they're better off or not
[...]
Because somehow the baseline "stigma" to be fought is the idea that these people might not have reached a rational conclusion.


Excuse you?
posted by kagredon at 11:49 AM on August 22, 2012 [4 favorites]


There is plenty of stigma against medicating mental illness on this site among some users (and, to be fair, there's plenty of evidence that for many people, physical exercise and diet is actually more effective). However, I don't see much evidence of stigma against mental illness per se. Seems like a significant plurality of the users have directly or indirectly experienced mental illness (particularly depression). "See a therapist" is so routine an answer in AskMe that it's a cliché. Very few people dismiss people with mental illness, tell them to "tough it out", or frame it as some positive gift from above to teach you to have "patience" or "faith" or whatever.
posted by Deathalicious at 11:50 AM on August 22, 2012 [2 favorites]


Also I find the idea that " stepping into new grounds of identity politics " would be considered crazy in your mind? Are you seriously saying that people questioning their gender (I count myself in that group) should be called crazy?? Extremely offensive.
posted by kanata at 11:52 AM on August 22, 2012 [2 favorites]


If I had a mental issue that I wasn't sure how to deal with, I wouldn't hesitate to post a question in AskMe. And I wouldn't be surprised if most of the answers weren't of the "see a mental health professional" variety.

Perhaps you just need to spend more time reading the posts and comments here before you criticize the people who make them.
posted by tommasz at 11:54 AM on August 22, 2012 [1 favorite]


crazy gets what it deserves. crazy was asking for it. crazy can quit anytime it wants, all it needs is willpower.
posted by quonsar II: smock fishpants and the temple of foon at 11:57 AM on August 22, 2012


/sarcasm?
posted by royalsong at 11:59 AM on August 22, 2012


I have no idea what you are talking about.

I am someone who is alive because I take medicine that keeps me from having constant suicidal thoughts. I've talked a lot about it here, and I generally feel comfortable about how my experience is received and with the feedback
I get from fellow MeFites.

Coincidentally enough, I've also had the experience of taking meds for (temporary, luckily, in my case) renal insufficiency. The experience of diagnosis and treatment was really similar in both cases for me, except that with the kidney issue my doctors had the added tool of urine tests as a diagnostic. But nobody took my kidneys out, or even imaged them; just like with my depression, it was an empirical diagnosis based on what I reported about feeling terrible and on how the medication helped me.
posted by Sidhedevil at 12:01 PM on August 22, 2012 [14 favorites]


To pick up on what Deathalicious said, I think there can be a bit more bias toward "try to manage depression or anxiety with lifestyle changes" than toward medication for those issues on the site. And every now and then someone will write something like "You can knock that right out with B6 and fish oil," which is just as bullshit as "you need Paxil" would be.

But overall, I think people are eager to share what's worked for them, and mindful about encouraging people to work with professionals to find what's right for them, whether it's meds or talk therapies or lifestyle changes or any combo thereof.
posted by Sidhedevil at 12:07 PM on August 22, 2012


This is also a situation where people's self-reported life experiences get dismissed very readily by people who have no idea ("I felt super sad one time and then I was like, I decide not to be sad!, and then I felt all better, drugs are for the weak"). Resonates with some other conversations that are being had on the site right now.
posted by prefpara at 12:08 PM on August 22, 2012 [2 favorites]


rebent: " Mental illness is just like kidney disease

this is the lie that psychiatry has pushed for Big Pharma for years. This is my honest belief and I do not think I am a crank. The big difference between the two is that, with kidney disease, you can take the kidney out and look at it and see how it's diseased and if you have to put a new kidney back in.
"

How is that relevant? We can't do brain tranpslants because a) we don't have the technology and b) patients must be brain dead before you can use them for organ donation. Assuming transplants were possible, the fact that consciousness is centered in the brain adds a complexity that makes it more a philosophy question than anything else.

Nonetheless, we actually have a pretty good idea of how the brain works and how medications can be used to help fix messed up brain chemistries. It's literally no different than giving someone medicine because their thyroid is not creating the right hormones. Heck, it's no different than giving insulin to a diabetic to help them handle their blood sugar levels. At the end of the day, we are giant sacks of interacting molecules.

My dad, a psychiatrist, works with people with profound mental illnesses. Without his work, hundreds, maybe thousands of people (and their related families) would be dealing with the serious ramifications of schizophrenia, depression, mania, and worse. People who were at the end of their rope, who were literally ready to kill themselves, chose not to because of medications my father prescribed to them. My dad is bound by patient-doctor confidentiality but over the years every so often he'd tell me stories of people he'd met who were at the bottom and were able to find their way out, and how they'd thank him for it, sometimes they even brought him things like cookies or momentos. The work my father has done has saved lives and improved the lives of many, many people.

He's a fucking hero; you're a crank.

Another awesome thing about my dad: some psychiatrists genuinely only prescribe pills. They talk to their patients for maybe 5 minutes if they talk to them at all. He actually sits down and talks to them about the problems they're having (it's not a full therapy session; maybe half an hour but he still offers suggestions on how they might deal with their problems. etc). I remember one time I came into the TV room and my dad was watching The Wall. He told me he was watching it because one of his patients had said they strongly identified with the main character of the film, and so he was watching it to get a better understanding of his patient. He does stuff like this all the time. I'm super proud of him.
posted by Deathalicious at 12:08 PM on August 22, 2012 [45 favorites]


I am also totally with kanata on seeing suicide as something that may be a rational choice for others experiencing suicidal depression. It was not my choice, but I strongly believe people have the right to refuse treatment even where it hastens the end of their life.

Mr. Scott's suicide angers me because he exposed bystanders to concern, fear, and trauma. But his choice to end his life was his to make, ultimately.
posted by Sidhedevil at 12:11 PM on August 22, 2012 [4 favorites]


Uh, usually people take my expression of opinion as an attack. I don't want people to think I'm attacking their viewpoints in this thread

You could have just come in here and said, "I personally am against psychiatry" and given a couple of cogent reasons. Instead, you suggested that an entire field of medicine is a lie whose purpose is to push corporate interests, and that "Real people face real problems" which implies that
  1. Mental illness isn't a real problem and/or
  2. "Real" people shouldn't take pills to handle this problem
If you don't want people to think you're attacking their viewpoints, don't attack their viewpoints. Looking back, I'm sorry I swore and I'm sorry I called you a crank. You're probably not a crank. You're someone who holds views I disagree with and views which I personally think are detrimental to the long term mental health of our larger society, but you are allowed to hold them. I would hope that you would express your viewpoints in a way that is part of a dialogue rather than an attack or dismissal.
posted by Deathalicious at 12:19 PM on August 22, 2012 [11 favorites]


Oh, hey, three cheers for Deathalicious' dad because damn we need all the psychiatrists who sit there and listen that we can get.
posted by griphus at 12:25 PM on August 22, 2012 [10 favorites]


Here's the other thing that always bothers me (and then I will step away because I suspect I am getting a little too emotional).

Let's examine the "harden the fuck up" hypothesis. Say mental illness lacks the "realness" of kidney disease, everyone who claims mental illness is dealing with the same level of emotional pain as people who cope adequately, and psychiatry is an Orwellian corporate leechery. In that case, we've got two kinds of people: people who are hard as nails and can deal with the shit that they feel inside, and the soft, weak people who crumble under pressure. We tell the weak people to harden up. They try and fail. Right here is where you lose me. In a world where some people are incapable of dealing with life and instead suffer endlessly because they are weak, I want to prop those people up with crutches and give them special help and special tools so that their suffering stops. I don't understand why you see a weak, suffering person and say to yourself, "this is as it should be. The suicidal despair you feel is your just punishment for being a sissy. The weak should suffer, they should experience despair, their anguish is right, all is well." Why do you want to occupy this Darwinian hellscape of the psyche? So they're weak, who gives a fuck, why does their ability to feel less miserable, or even happy, fucking bother you?

I am saying that if I believed, as some apparently proudly do, that people who say they are mentally ill are actually just weak sissies using happy pills to cheat their way to happiness, I would say GO FOR IT SISSIES! Happiness is not a zero-sum contest where the Prize Is Only For The Strong. I do not want to live in Happiness Thunderdome. If you can cheat your way to happiness, please, with my fucking blessing.
posted by prefpara at 12:31 PM on August 22, 2012 [43 favorites]


I think there can be a bit more bias toward "try to manage depression or anxiety with lifestyle changes" than toward medication for those issues on the site.

If I could walk that way I wouldn't need the talcum powder.
posted by Splunge at 12:32 PM on August 22, 2012 [3 favorites]


He's a fucking hero; you're a crank.

Maybe consider that you may not be the most unbiased judge here. It's pretty self-serving to call your dad a hero.

From the most recent issue of the British Journal of Psychiatry:
From the Editor's desk
Peter Tyrer
British Journal of Psychiatry (2012), Vol 201, p. 168
The end of the psychopharmacological revolution

The time has now come to call an end to the psychopharmacological revolution of 1952. This term is normally a reference to the discovery of chlorpromazine, described recently as ‘one of the greatest advances in 20th century medicine and history of psychiatry’.1

Although this was a clear advance at the time, and was serendipitously followed by the introduction of antidepressant and anxiolytic drugs, the claim that these drugs were responsible for the demise of the mental hospital and the growth of community psychiatry, has been disputed2 as the wind of social change was already blowing the cobwebs away from the corners of the old custodial institutions. Yet there is no doubt this was a time of great optimism in psychiatry and the new drugs played a major part.

But nobody in the 1960s and 70s could have predicted the words in the editorial in this issue by Morrison et al (pp. 83–84) suggesting that it is time ‘to reappraise the assumption that antipsychotics must always be the first line of treatment for people with psychosis’. This is not a wild cry from the distant outback, but a considered opinion by influential researchers who help to formulate NICE guidelines.

And the reasons for the change in view are not just, as some evidence suggests, a consequence of biased representation of drug treatment in the mass media,3 but an increasing body of evidence that the adverse effects of treatment are, to put it simply, not worth the candle. The combination of extrapyramidal symptoms, dangers of tardive dyskinesia and the neuromalignant syndrome,4 weight gain and the metabolic syndrome, sedation, postural hypotension, and interference in sexual function (but also note the important balancing paper by Reis Marques et al, pp. 131–136, that suggests drugs are not entirely to blame here), would need to be offset by massive symptomatic and social functioning improvement to make the benefit/risk ratio positive. Of course, it often is, at least in the short term, but for many the risks outweigh the benefits.
Fucking cranks!
posted by OmieWise at 12:35 PM on August 22, 2012 [6 favorites]


I recomend CBT. And DTMFA.
posted by fixedgear at 12:35 PM on August 22, 2012 [3 favorites]


I did not like the little thing about trans people you put in there at all.
posted by crabintheocean at 12:37 PM on August 22, 2012 [18 favorites]


Maybe I am missing something but I don't see how saying it is not equatable with Kidnay disease makes someone a crank. I have never found the comparison by doctors and others of depression and diabetes or such to be at all effective. It offends me and makes me feel as if meds are seen as a cure all. That's not saying that meds don't help but making people here uncomfortable to even raise the possibility that there is more to this illness than a chemical imbalance serves no one.
posted by kanata at 12:40 PM on August 22, 2012 [1 favorite]


It offends me and makes me feel as if meds are seen as a cure all.

The problem is that people suffering from disruptive mental illness are less likely to be stable enough to have enough spare money and/or insurance to afford mental health care (at least in the US.) I am pretty sure the general consensus around here is that psychiatry should be paired with therapy if one can afford such things, but for particularly disruptive mental illness, psychiatry comes first.
posted by griphus at 12:48 PM on August 22, 2012


Yeah, the trans stuff is what pushes this over from humorous fedora to "dude, really?" territory.
posted by running order squabble fest at 12:49 PM on August 22, 2012 [5 favorites]


Setting aside all sorts of problems with the framing and communication of the post, I think MeFi handles this problem unevenly.

When the subject is about mental illness, I think the community generally does a good job of listening, sharing, and providing resources. There's normally a sensitivity here that's often not present in comparable online communities (although as this thread shows it can be uneven and we can always do better).

When the subject is not directly about mental illness, there's less thoughtfulness. That's why you're likely to get comments arguing that all bankers are sociopaths in threads about finance, but not mental illness. Without being directly primed for this topic, many of us say stupid things - often off-topic.

I don't know if the context-switching is obvious to others, but it's long felt that way for me. I'd like to think that the first set of discussions makes this a community with supporting but there's little question that we can't do better overall and especially on the second set.
posted by allen.spaulding at 12:50 PM on August 22, 2012 [7 favorites]


Nonetheless, we actually have a pretty good idea of how the brain works and how medications can be used to help fix messed up brain chemistries. It's literally no different than giving someone medicine because their thyroid is not creating the right hormones. Heck, it's no different than giving insulin to a diabetic to help them handle their blood sugar levels. At the end of the day, we are giant sacks of interacting molecules.

You know, this is also really really wrong. I don't want to get in to too much of a back and forth here, but what we know is that some medications help some people feel better some of the time. We know some of the things those medications do (but by no means all). We DO NOT know that people have "messed up brain chemistries" that are "fixed" by the medications any more than aspirin helping a headache means the pain was caused by a lack of aspirin in the body. Mental states are very complex, and despite the best efforts of biological psychiatry, we have not identified specific causes for specific mental illnesses. It makes much more sense, because it fits the evidence better, to see mental illnesses as contextual, and the treatments as contextual. Medications are part of that, but they are part of the context of treatment, the treatment episode, and they work as such, not as a specific cure for an identified and understood specific ill. This does not diminish either the seriousness of mental illness, the effectiveness of medications for some people some of the time, or the "realness" of the phenomena we're talking about.
posted by OmieWise at 12:50 PM on August 22, 2012 [6 favorites]


I am not at all clear on what you're trying to say here but as a crazy past-suicidal person with trans people whom I love I am offended on all our behalves.
posted by Mizu at 12:56 PM on August 22, 2012 [2 favorites]


The usefulness of an analogy of more physical ailments is that accepting treatment for them doesn't carry the kind of stigma that accepting treatment for mental illness does. (Even therapy - look how often in mass media is someone being in therapy used as shorthand for weakness.)

I use "you wouldn't walk up to someone in a cast and say 'throw away that support - it's just a crutch!'" and it's not helpful to second-guess medication that way either. Some people heal on their own, some people need a crutch for a while and get better, and some people wind up using a cane for life. Some folks do fine without meds, some use them over a rough patch and then can stop, and some folks wind up taking medication for life. The point is that taking medication shouldn't carry any more stigma than a walking aid, and the decision about whether it's needed is best made by the person affected in co-ordination with a professional, not judgmental bystanders.
posted by Karmakaze at 1:01 PM on August 22, 2012 [2 favorites]


Oh my god, fuck everyone ever who has condescendingly referred to psych meds as "happy pills".
posted by Coatlicue at 1:01 PM on August 22, 2012 [9 favorites]


I've certainly "fought" the stigma battle on Metafilter, poor word usage, insultingly casual diagnosis and general bad associations can abound at times, while I would not be as optimistic as to declare that there is no stigma regarding mental health issues on Metafilter, it is my impression from being here a fair length of time that Metafilter does a much better job on this than the population-at-large. Not to say there isn't room for improvement, there absolutely is, but I wish American society in general was a far along as MeFi.

The rape and Jew analogies are more than a little over the top and do a lot more to distract from the conversation/topic then actually add to it.
posted by edgeways at 1:08 PM on August 22, 2012


Empirical treatments sometimes work for reasons other than those commonly believed to be true at one stage of research and clinical knowledge. Back when people believed gastric ulcers were universally caused by stress, many patients' ulcers resolved with the Sippy diet, rest, and antacid combo prescribed by doctors up until the mid 1980s. Turns out that, for some patients, those measures supported their immune systems in fighting back their H. Pylori populations to more manageable levels.

Similarly, colchicine, today's go-to medication for gout, was used in herbal form to treat the same disease in the Middle Ages, even though the disease was then believed to be caused by an imbalance of the four bodily humors.
posted by Sidhedevil at 1:13 PM on August 22, 2012 [4 favorites]


Huh. You linked my comment, but I can't for the life of me figure out what you are saying about it. Should I be outraged?
posted by lazaruslong at 1:14 PM on August 22, 2012


and yeah really no need for the rape analogy. thanks.
posted by lazaruslong at 1:14 PM on August 22, 2012


Deathalicious: "
You could have just come in here and said, "I personally am against psychiatry" and given a couple of cogent reasons. Instead, you suggested that an entire field of medicine is a lie whose purpose is to push corporate interests, and that "Real people face real problems" which implies that
  1. Mental illness isn't a real problem and/or
  2. "Real" people shouldn't take pills to handle this problem

All I mean by "real people/problems" is that they are very close to home for all of us. I don't like using the term "mental illness" for other deraily reasons, so I've replaced it with "real problems." As in - I can't find my novel - not really a problem; I can't find meaning in my life - really a problem. I didn't mean to imply that mental health issues are not real, or that that "real people" do/don't need a certain amount of help because we are all real people. Fake people are in commercials and in movies.


If you don't want people to think you're attacking their viewpoints, don't attack their viewpoints. Looking back, I'm sorry I swore and I'm sorry I called you a crank. You're probably not a crank. You're someone who holds views I disagree with and views which I personally think are detrimental to the long term mental health of our larger society, but you are allowed to hold them. I would hope that you would express your viewpoints in a way that is part of a dialogue rather than an attack or dismissal.
"

I'm sorry I insulted your dad, even though it wasn't my intention. I'm still practicing the whole "express my viewpoints" bit.

griphus: "Oh, hey, three cheers for Deathalicious' dad because damn we need all the psychiatrists who sit there and listen that we can get."

I totally agree with this.

prefpara: "Here's the other thing that always bothers me (and then I will step away because I suspect I am getting a little too emotional).

Let's examine the "harden the fuck up" hypothesis.


I, ah, really hope you didn't think I was saying that. If anything, I think our culture needs to soften the fuck up and realize that we should be helping everyone de-stress, talk about issues, etc., and care for each other's emotional well being instead of expecting everyone to fit within a set boundary of "this is normal, or else!"

In a world where some people are incapable of dealing with life and instead suffer endlessly because they are weak, I want to prop those people up with crutches and give them special help and special tools so that their suffering stops.

I totally agree. I just disagree about what those crutches are. I see drugs as more along the lines of blood letting than crutches. That's all.

I don't understand why you see a weak, suffering person and say to yourself, "this is as it should be. The suicidal despair you feel is your just punishment for being a sissy. The weak should suffer, they should experience despair, their anguish is right, all is well." Why do you want to occupy this Darwinian hellscape of the psyche? So they're weak, who gives a fuck, why does their ability to feel less miserable, or even happy, fucking bother you?

That's not me.

Happiness is not a zero-sum contest where the Prize Is Only For The Strong. I do not want to live in Happiness Thunderdome. If you can cheat your way to happiness, please, with my fucking blessing."

I totally agree that people should be happy and that they should be allowed to take drugs to do it. But there's a difference between recreation and medication. That's all.
posted by rebent at 1:14 PM on August 22, 2012


ah.. that's probably directed at me isn't it.

I didn't mean it condescendingly. I use "happy pills" as an endearing term. It's just the term I got to calling psych meds.

I was trying to say that the therapist is what helped me more then anything. I don't know if the medication I was on helped me get better, I only know they stopped me from getting worse. They didn't make me happy either.

Anyways, the point was that I suffered from mental illness and I feel like the two reasons I got better was via my therapist and going back to school.

I wasn't on meds for a long time, and then during one session with my therapist.. in which I remember that I just didn't care anymore. I was done. About anything. He FREAKED out and pretty much insisted I go see a psychiatrist right then and right there and wouldn't let me leave the office until I had set up an appointment with one that very day. Then he called the next day to make sure I went.

Evidently I gave him some kind of Big Red Flag.

anyways, looking back on it now, had I not had the therapist, or one who was so insistent, royalsong might never had the chance to find and join metafilter.
posted by royalsong at 1:15 PM on August 22, 2012


I don't know if the context-switching is obvious to others, but it's long felt that way for me. I'd like to think that the first set of discussions makes this a community with supporting but there's little question that we can't do better overall and especially on the second set.

I think it's a really good observation, yeah. And the thing is I think it's a pretty natural product of just topic-based self-selection in who is responding to a thread in general; it makes total sense that people engaging on the explicit topic of mental illness will be more likely to have nuanced opinions about or direct experience with mental illness issues, and so you get that generally higher level of sensitivities to the various facets and fundamentals and touchpoints of the subject. When mental illness is a tertiary angle on the actual subject, there's less of that likely induction of nuance.

Which of course goes for everything—people interested in or invested in or experienced with x will be more likely to speak up in a thread about x and so the average level of experiential knowledge or practical expertise will be higher—but it's more noticeable (and more noticeable when it goes sideways) for something like mental illness than it is for e.g. musical genres, because the stakes for folks involved are a lot higher or the weight of the thing being discussed much greater.

And it's a hard problem, because getting folks who don't know that something is complicated or don't know that saying something glib about mental illness is going to hurt people is a huge job. People don't know that they don't know, don't know that they're being careless, etc. So trying to sort of do fellow-user education in a thread that's not about mental illness but has people saying someone's "crazy" is tricky and bound to be bumpier than talking about it in a thread where that's actually the context in the first place.
posted by cortex (staff) at 1:18 PM on August 22, 2012


...this is the lie that psychiatry has pushed for Big Pharma for years. ...The solution to solve these problems is not to throw mood-enhancing pills at them and say "oh, it's just like taking kidney medicine."

Mr. Tom Cruise, please pick up the nearest white courtesy telephone. Mr. Tom Cruise, please pick up the nearest white courtesy telephone.
posted by ericb at 1:24 PM on August 22, 2012 [7 favorites]


fuck everyone ever who has condescendingly referred to psych meds as "happy pills".

Yeah, it is super fucking annoying that my daily meds are used by thousands of people solely to get high, because so help me if someone is going to assume I am one of the people taking this shit for the lulz I will come to their house and touch all their stuff.
posted by elizardbits at 1:28 PM on August 22, 2012 [20 favorites]


I totally agree that people should be happy and that they should be allowed to take drugs to do it. But there's a difference between recreation and medication. That's all.

Explain the bolded part, please? Because it sounds like you're saying people who take medication to help their mental health are doing so for recreational means and I take exception to that.

I also take exception to your idea that "people should be happy and ... they should be allowed to take drugs to do it." I have the feeling that you have the wrong impression of psychiatric medications. I don't take an SSRI to "be happy." I take it because when I don't, I can't get out of bed, I can't parent my children, and I can't be the partner my husband married. It's not that I don't want to, or that I'm 'not happy.' I literally cannot, and it goes so much deeper than happy I don't even know how to describe it.

With SSRIs, I can get up, go to work, get angry at the political crap happening right now, hang out with my kids, cry at funerals and the Olympics, and I can see my future being long and fulfilling. That's not "happy." That's living and I'll take it, thank you very much.
posted by cooker girl at 1:29 PM on August 22, 2012 [24 favorites]


Ah maybe it is my Universal Health care filter but I see too much emphasis on meds as a cure all here and that's why I get offended at the constant reference to other medical issues. I do not have to worry about choosing insurance and meds over therapy. That's just a given to me. I have had to push to qualify for therapy so I see the medicalization of mental illness as the struggle.

It is my Canadian privilege I suppose. Meds are a given yet I am made to feel like needing more than that is excessive.
posted by kanata at 1:30 PM on August 22, 2012


*I know more about mental health than you can possibly imagine. ;)

Fedoras for all! ; )
posted by ericb at 1:34 PM on August 22, 2012 [6 favorites]


It's really difficult for me to not react to your comments angrily, rebent, but I'm going to try.

Issue #1 - the "big pharma" conspiracy. I don't even....look, you might think that mental illness medications are overprescribed, you might think they are glamorized, whatever. But to suggest that an entire industry is intentionally mischaracterizing a morbid and fatal fact of many people's lives as a disease comes across as profoundly ignorant. Mental illness is a real disease, it is treatable, and some of us need that treatment. We aren't being lied to by some shadowy Big Pharma conspiracy. We're seeking modern evidence-based treatment for debilitating disease.

Issue #2 - The implication that because mental illness isn't a 'real disease' and therefore the medication prescribed for it is 'recreational' is dismissive and insulting. It might not be real to you. Congratulations. Your life must rock compared to some of ours.

Issue #3 - I see drugs as more along the lines of blood letting than crutches. Well, that's fine. You're welcome to that opinion. You should know, however, that you are wrong. Just plain, flat-out, wrong. I hope that you choose to learn more about mental illness drugs so you can discern the difference.

Gah. I can't even type anymore. Whatever.
posted by lazaruslong at 1:36 PM on August 22, 2012 [6 favorites]


Ah maybe it is my Universal Health care filter but I see too much emphasis on meds as a cure all...

I don't think that is necessarily a Canadian POV, I've worked (professionally) with people for 18 years (in the US) and have family members who have taken psych meds, and while I am by no means anti medication I am strongly of the opinion they are over prescribed and are often used as a band-aid without significant effort made towards anything besides medications. I think the potentially serous long term side effects of some psych meds are down played in some cases in favor of maintaining the status quo of relative stability.
posted by edgeways at 1:37 PM on August 22, 2012 [1 favorite]


All of us (myself included) who are having our feathers ruffled: *hugs*
posted by royalsong at 1:40 PM on August 22, 2012 [3 favorites]


sorry, again! I didn't mean to say that people who get prescriptions for drugs are basically recreational users. What I meant was that the standards to which we hold people who prescribe drugs to cure illnesses are different than the standards we hold people who sell recreational drugs.

Basically, I'm going to be a lot more angry at someone who tells you "you are sick and this drug will heal you" when in fact it won't, than I will be at someone who tells you "if you want to have a fun time, this drugs a good choice." That's all I meant by the distinction.

Anyway, I'm going to drop out of this conversation and just say that if you want to know why I think the way I do, it's in large part due to Irving Kirsch's book "The Emperor's New Drugs." Kirsch has come up before, but a lot of posters here disagree with him.
posted by rebent at 1:46 PM on August 22, 2012 [2 favorites]


Why is this open?
New user doesn't understand or misreads Metafilter and spews an incoherent rant in which he / she manages to introduce stormfront, rape, suicide, Jews, stigma, trans people, at a quick count. Either the poster is off their meds / sarcasm, or this is some type of poorly thought out performance art managing to piss most people off.
posted by adamvasco at 1:59 PM on August 22, 2012 [5 favorites]


Either the poster is off their meds / sarcasm

Don't do this.
posted by shakespeherian at 2:00 PM on August 22, 2012 [10 favorites]


Why is this open?

Because, crappy framing of the post notwithstanding, people are doing an okay job of having a discussion about inter alia how they perceive the topic of mental illness to play out on Metafilter and why. Trust me, I've been keeping an eye on the thread ever since it went up in case it went weird.

The default outcome of a Metatalk thread is that it stays open.
posted by cortex (staff) at 2:02 PM on August 22, 2012


Mental illnesses are illnesses, rebent. That's why they have "illness" right in their name.

I have had a boatload of illnesses in my 47 years on this earth, but the only one that has ever put me in the ICU was depression. I don't think it's the one that will kill me, but it's the one that's tried hardest to date.
posted by Sidhedevil at 2:08 PM on August 22, 2012 [5 favorites]


I mean, fuck, some guy wrote a book. This is my life.
posted by Sidhedevil at 2:09 PM on August 22, 2012 [6 favorites]


Really?
posted by adamvasco at 2:13 PM on August 22, 2012


Yes, really. If you have a more specific question based on some sort of comparison you are making between that thread and this one, please do explain it because I do not understand it at this point.
posted by jessamyn (staff) at 2:16 PM on August 22, 2012


Really what? Yes, the default really is for them to stay open. The numbers will bear this out. Mod practice bears this out. Go sift the Infodump if you think otherwise, the data is all there. I'm fine with your opinion being that this one should have been closed but I'm not sure what you're going for with that other than insisting that you have an opinion on the subject, so maybe elaborate if there's something more to this for you.
posted by cortex (staff) at 2:16 PM on August 22, 2012


My reading was of the phrase "the default outcome".
I am not looking for an argument. There have been enough of those recently and I can understand that you the mods, are feeling a bit hair triggered and raggedy. I was just indicating that what is stated as the default is not always so. No big deal.
posted by adamvasco at 2:31 PM on August 22, 2012


...default just means the basic setting without going in to the options menu and changing your personal preferences. Default does not mean absolute or always.
posted by maryr at 2:36 PM on August 22, 2012


"Default" implies that the outcome will be different in any number of cases. So pointing to examples of individual threads isn't much in the way of evidence that MeTa threads staying open is not the default.
posted by MoonOrb at 2:37 PM on August 22, 2012


To be clear, I called it the default to specifically acknowledge that it's not the universal outcome, but is still the common/normal one. You linking to another thread that had been closed felt like a non-response, like I was somehow unaware that we have ever closed threads and needed to be reminded or something. Not looking for a fight either, I just don't have any idea what your point was.
posted by cortex (staff) at 2:38 PM on August 22, 2012


"All MeTa threads stay open unless there is a compelling reason to close them" is the way I'd paraphrase this.
posted by jessamyn (staff) at 3:07 PM on August 22, 2012


Aside from a board specifically designed for and aimed at people who have manic depression (and those affected by another persons manic depression), this is the most open community w/r/t mental health issues that I've ever come across.

By open I guess I mean educated, non-judgmental, understanding.

Threads here which are related to suicide, psychiatric medication, depression, manic depression, schizophrenia, schizo-affective disorder, just mental illness issues in general, from what I've seen here (and experienced here; you'd best believe that I can feel it when someone is discounting some poor bastard suffering mental illness, in fact I can feel it so acutely that I can sometimes feel it even if it's not present), from what I've seen here, most everyone is wide awake, and if they don't know or understand what another is going through it generally appears that they are cognizant of not knowing and/or understanding it and cop to it, which, outside of very small circles, is very unusual, and very refreshing.
posted by dancestoblue at 3:40 PM on August 22, 2012


Basically, I'm going to be a lot more angry at someone who tells you "you are sick and this drug will heal you" when in fact it won't, than I will be at someone who tells you "if you want to have a fun time, this drugs a good choice." That's all I meant by the distinction.

I have never had a doctor tell me "you are sick and this drug will heal you".

I have had doctors say "it sounds like this depression is making it impossible for you to function. Let's try this antidepressant and see if it helps. I'll want to talk to you over the next few weeks to see how you're doing."

I have had doctors say "Are you thinking about harming yourself? No? Will you promise to tell me if that changes?"

I have had doctors say "Hmm… that medication didn't work. Let's try this one, which seems to work via a different mechanism. It might help where the first one didn't."

I have had doctors say "It sounds like those side effects are causing you distress. Let's adjust the dosage and see if that decreases them."

In my experience, doctors never say "this will heal you", regardless of what they're talking about. "Qualify and disclaim every statement you make" seems to be one of the first lessons young doctors are taught.
posted by Lexica at 3:40 PM on August 22, 2012 [8 favorites]


Well I did have a doctor tell me if I wanted to be happy to go buy some speed....
posted by kanata at 3:54 PM on August 22, 2012


But yeah, I hope no one thinks that I think meds aren't the answer when I question the focus on them. I am on some myself and they have kept me going enough to fight my way through to proper therapy and I will probably been on them for the rest of my life.
posted by kanata at 3:56 PM on August 22, 2012


I've also found this site to be rather open and accepting to those of us who are mentally interesting. I'm not on the blue very often, so maybe it's different there, but on the green and the grey, I've never had a problem with anyone and I've always openly acknowledged that I have bipolar.
posted by patheral at 3:57 PM on August 22, 2012


I echo others in saying that MeFi is a very enlightened community, in most respects, when the topic is mental illness, most of the time. And psychiatry is hardly the only framework within which mental health or illness can be understood, discussed, or addressed in practice. I say that as someone sympathetic to medical psychiatry and as a beneficiary of its protocols. Psychiatric reductionism would be no better than anti-psychiatric reductionism, and find very little of either here on Metafilter.
posted by spitbull at 4:04 PM on August 22, 2012


OP: It's such a taboo to take crazy pills that people never even seek help.

Calling them "crazy pills" certainly doesn't help.

I felt like a jew in Stormfront.org in the Scott thread.

Go away now.
posted by tzikeh at 4:36 PM on August 22, 2012 [5 favorites]


I don't think MetaFilter is immune from gawking at a person's mental conditions and "othering" or belittling them because of it. I see comments all the time about "sociopaths", "idiots," "narcissists," and people in "infantile" emotional states, etc. Often times when it seems apparent from someone's writing that there may have an issue of some kind. A lot of MetaFilter meanness comes out this way. The thing that bothers me about it is the implication that a person is fully responsible for the state of their mental health, as if its something they chose for themselves that deserves to be ridiculed and belittled, and not a problem they have to live with. Infact, this is something that bothers me about some psychology I see in general. I personally don't believe that psychiatry or psychology or neuroscience has advanced far enough to really understand mental health problems and their causes. It irks me to see a person's personality disorder or mental illness used as an insult. I'd like to see less meanness. Not that I'm immune from doing it myself. That being said, I believe, and have read in the green, that there is good empirical data to show that medication and therapy are effective and helpful.
posted by Golden Eternity at 4:42 PM on August 22, 2012


Dude. Go and have a lie down.
posted by Decani at 4:47 PM on August 22, 2012


rebent: "Basically, I'm going to be a lot more angry at someone who tells you "you are sick and this drug will heal you" when in fact it won't..."

Yeah, so? My asthma inhaler hasn't cured my asthma but it does keep me from suffering every day. Same deal for people who take psych meds.
posted by workerant at 5:55 PM on August 22, 2012 [7 favorites]


"I always go back to Deleuze, the philosopher of jouissance..."

Thanks, this is the most pretentious-sounding thing I've read all week.
posted by Eideteker at 6:12 PM on August 22, 2012 [5 favorites]


I was thinking how strange and ironic it was to see Deleuze citing twice and approvingly in an appeal to pay more respect to medical psychiatry. (I detest Deleuze's influence on modern social thought, full disclosure.) Then for fun I went and found this, [PubMed] from:

Nursing Philosophy 2006 Oct;7(4):191-204.

Gilles Deleuze: psychiatry, subjectivity, and the passive synthesis of time.
Roberts M.

Department of Philosophy, School of Humanities and Social Sciences, Faculty of Arts, Media and Design, Staffordshire University, College Road, Stoke-on-Trent, Staffordshire, UK. marcwarenroberts@aol.com

Abstract

Abstract Although 'modern' mental health care comprises a variety of theoretical approaches and practices, the supposed identification of 'mental illness' can be understood as being made on the basis of a specific conception of subjectivity that is characteristic of 'modernity'. This is to say that any perceived 'deviation' from this characteristically 'modern self' is seen as a possible 'sign' of 'mental illness', given a 'negative determination', and conceptualized in terms of a 'deficiency' or a 'lack'; accordingly, the 'ideal''therapeutic' aim of 'modern' mental health care can be understood as the 'rectification' of that 'deficiency' through a 're-instatement' of the 'modern self'. Although contemporary mental health care is increasingly becoming influenced by the so-called 'death' of the 'modern self', this paper will suggest that it is the work of the 20th century French philosopher, Gilles Deleuze, that is able to provide mental health care with a coherent determination of a 'post-modern self'. However, a Deleuzian account of subjectivity stands in stark contrast to 'modernity's' conception of subjectivity and, as such, this paper will attempt to show how this 'post-modern' subjectivity challenges many of the assumptions of 'modern' mental health care. Moreover, acknowledging the complexity and the perceived difficulty of Deleuze's work, this paper will provide an account of subjectivity that can be understood as 'Deleuzian' in its orientation, rather than 'Deleuze's theory of subjectivity', and therefore, this paper also seeks to stimulate further research and discussion of Deleuze's work on subjectivity, and how that work may be able to inform, and possibly even reform, the theoretical foundations and associated diagnostic and therapeutic practices of psychiatry, psychotherapy, and mental health nursing.


. . . and I experienced a Proustian moment of abject and repulsive nostalgia for graduate school.
posted by spitbull at 7:03 PM on August 22, 2012 [4 favorites]


to see Deleuze citED, not citING, sorry
posted by spitbull at 7:03 PM on August 22, 2012


MeFi has actively helped me understand and look after several members of my family's battles with mental health issues. I think MeFi has overall dealt with mental health issues in a sensitive and thoughtful manner.

I contend that your thinking on this stems from not reading enough and respectfully suggest that you lurk more before trying this again.
posted by arcticseal at 7:48 PM on August 22, 2012 [3 favorites]


to see Deleuze citED, not citING, sorry

I am now imagining an alternate universe in which Deleuze gets banned from Metafilter for self-linking.
posted by en forme de poire at 9:12 PM on August 22, 2012 [6 favorites]


Read everything three times. "Stigma" now nonsense word. Can't grasp what hell OP's point is.
Too far down rabbit hole. Find want write long convoluted sentences. Delete! Must stick to keywords!

Conversation about mental illness stigma ≠ stigmatising mental illness!

Happy trans comment "shitstorm" not Silencing just appalled your comment very bad manners!

Corinth nailed.

Phew.
posted by Catch at 3:15 AM on August 23, 2012


That out of the way, I was surprised by the reaction to crayz' comment in the Scott thread.

He's done a good job of explaining his position, but there was some uncharitable jumping to conclusions about his meaning.

My father killed himself to escape terminal bowel cancer, so I guess that gives me a minority point of view about this. My immediate reaction to crayz' comment was to assume that he had some similar personal experience concerning euthanasia.

I don't think that the Scott thread was the greatest place to have a euth/suicide debate, maybe this thread isn't either. I guess I am just used to seeing a level of awareness of different p.o.v's on MeFi, and thoughtful posting, especially when discussing sensitive subjects, and, so, yeah, surprised.
posted by Catch at 3:33 AM on August 23, 2012


Deleuze approved of the use of medication in psychiatry. Cf. "L'abecedaire de Gilles Deleuze", his last/only recorded interview.

Deleuze was a 68-er, and a close friend to Foucault, and probably shared the same disgust of the power relation that the medical establishment throughout establishes with the patient. (The heart doc that tells the patient how to eat, how to drink, how to exercise, how to live. "Don't worry too much about things, you're worrying too much"; dude's not even a psych doctor, he takes care of the blood valve). He had also been always treated by (lung) doctors for his lung condition, and came to abhor them.

In "L'Abecedaire" you see clearly the distinction of "medicine" as an encompassing power and "pharmacology", which is the endeavour to heal through sience. ("Power" according to Deleuze is that which interrupts you from realizing your potentials (pouissance) -- quite nietzschean in that; joy (jouissance) is the full realization of pouissances).
posted by syntaxfree at 7:24 AM on August 23, 2012


Revisiting the We Happy Trans thread, wow, that shit was just weird.
posted by ArmyOfKittens at 7:30 AM on August 23, 2012 [1 favorite]


(Sorry for typos above and here, the keyboard is dying on me; I already bought a Kinesis Contour, so I'm suffering through it until the new one arrives)

That said, let me just share something I just saw IRL that didn't quite faze me -- it's so fucking common -- but establishes what the stigma does.

As I came out of my bus commute to work, I was briefly brushed by a guy talking to himself and yelling to whoever was near. I tried to keep up with him but he was taller and walked fast and just went into the street on a green light, which I didn't dare to. Dude was shaved and cleaner than me -- I haven't showered in days -- and didn't look like a street person at all (though so many street people are clearly mentally ill.)

So I went and talked to the nearby municipal cop (there are municipal cops, who don't serve much function except standing in uniform, and military cops, who do the heavy lifting but are scary to talk to) and told him "could you maybe call the emergency people, that dude over there is having a psychotic break. He doesn't look dangerous to me, but he needs help, he's walking over traffic, I know these things.". Cop was apparently helpful, picked up his talking thing (police radio, I guess) and I told him I had to get going for work. Instead, I wanted to follow him and either keep him at the cop's eyeshot or talk him into following me to the psych hospital not far (I'd have to take a cab, but fuck it, I was in crazy savior mood from yesterday).

I had to wait for the lights to open up (three lanes, not always in sync) and watching him closely, and he started to signal for a bus. I can't see from my POV if he got on the bus or not.

I finally get to that lane, crazy dude's gone, and when I ask the people who were still there waiting for the other buses, they shrug their shoulders.

It's not the first time I've seen this, it's not the first time I've talked to authorities about such an event. It's the first time a nice cop was nice about it. Maybe I look crazy enough now to believed in "I know about these things". I wear funny hats after all.

Now. What does this tell us about stigmas? Unshakeable ideas from peoples's minds that were in action here. (And I'm not being paranoid, I work with LGBTq folk who are open-minded to pretty much anything, and they react the same).
  1. Crazy is crazy. You can't do anything about it, just protect yourself from possible violence (crazy people are victims of violence significantly more often than perpetrators
  2. Hospital? Why would you take him to a hospital?
  3. Dude is probably just a street person, and
    1. Street people don't matter
    2. Psychotic = street person, despite him being well-groomed
  4. He'll probably take a shower and sleep a bit and be back on the streets, because
    1. Crazy isn't treatable
    2. It's not like they have 30-day shots of Risperdal in the hospital. The free hospital from our universal health care system where you don't even need an ID for emergency services. Walk in, tell your name, wait a shitload in shit chairs to get surprisingly good treatment, sometimes with free medication. Oh, did I mention this is specifically a psych hospital, used to be a lock ward, now takes members of the public who claim to be depressed?
      • Ah, but all brazilians are happy, no such thing as depression. Didn't you see us at the closure of the London Olympics?
    3. It's not like a street person -- which this wasn't -- can't pick himself up and, fuck, if the medication makes him stupid, bag groceries at a supermarket.
  5. Waste of police resources. It's not like these weren't the standing, unarmed, nice cops. I guess helping an old lady that collapses is public service, but helping someone who is having a serious health crisis with possibly irreversible effects isn't.
    1. Because dude's like talking to himself and shouting incomprehensible things at strangers.
    2. That's barely even a person.
  6. I'm weird from trying to get a crazy person in crisis to a hospital for a fucking (one-day) Risperdal shot or something.
  7. I said "I know these things". I'm either
    1. Full of shit (reasonable assumption re: a stranger
    2. Someone who's already had a psychotic break like that (I've been close, but not lost-in-the-streets psychotic)
    3. A head shrink, who are crazy themselves (actually, they often are, but that doesn't entitle you to dismiss a competent professional)
You think there's institutional racism? You think there's a patriarchy? Try a world where PCOS is taboo and even talking about menstruation is verboten. Because no one decent menstruates.
posted by syntaxfree at 7:56 AM on August 23, 2012


syntaxfree, I appreciate you're trying to talk about your lived experience here, but what does any of that have to do with Metafilter? Can you please try and reframe this in terms of what if anything concrete you're troubled by on the site (links to specific examples is ideal here, or at least concrete summaries of specific situations you recall playing out on the site) if this is actually supposed to be site-related? Because it kind of feels like you're just using Metatalk to talk about something non-mefi-related that you feel like venting about, which, I sympathize but that's not really what this place is for.
posted by cortex (staff) at 8:15 AM on August 23, 2012 [6 favorites]


By the way. someone said I wasn't helping my case by calling psych meds "crazy pills". I don't want to look up and see the name because I don't want to be prejudiced should I continue to hang out on mefi. (Most likely will; you'll notice I even posted a FPP after the Scott thread, and tried to keep calm and carry on for a while)

Anyway, directed not to that person, but to that general sentiment, which may have been an accident on that person and entrenched on people who didn't say it: fuck you.

I have every possible right to use "crazy" (I'm not like "depressed"), and a vantage POV on whether it's being used in reasonable jest or colloquial sense, or whether it's trying to pin random stuff on mental illness.
posted by syntaxfree at 8:18 AM on August 23, 2012


You think there's institutional racism?

Yes.

You think there's a patriarchy?

Yes.

Try a world where PCOS is taboo and even talking about menstruation is verboten. Because no one decent menstruates.

I would hope that we would have compassion for all the people who are suffering under institutionalized prejudice. That example sounds like it was upsetting to you and I don't think people here are denying or minimizing the very real challenges that mentally ill people and their allies deal with on a regular basis. Many of us have either personal experience with this sort of thing or close friends and family members who are having similar struggles. While MetaFilter can sometimes be a microcosm of the larger world in some ways it skews slightly more understanding and wise because of people's closeness to the topics. Not always, but sometimes. If you see this sort of thing happening here on MeFi we can talk about it and this is the place to do it. However the fuck you stuff to people who have differing viewpoints is unhelpful and everyone should probably knock that off.
posted by jessamyn (staff) at 8:19 AM on August 23, 2012 [4 favorites]


Well, this was an IRL anecdote because someone earlier on was confused about what the term "stigma" even means. Do I really have to do some kind of derridean close reading of long metafilter threads here? I do have a day job I'm shirking from right now.

That whole story was another stab at getting people to understand the sentiment behind the original post, because apparently they hadn't been acquainted with the term "stigma". Compare it to someone finding a post sexist, not being quite understood and then elaborating on the patriarchy.

The original post was very compressed because I was expecting more background knowledge. But look, sometimes you legitimize things without fully understanding them. I will never understand the feeling of being a victim of misogyny, but I acknowledge there's such a thing.
posted by syntaxfree at 8:23 AM on August 23, 2012


There's absolutely stigma around mental illness in this country. I don't think anyone here disputes that. There does seem to be consensus that right here on metafilter, people are generally not as dismissive/assholish about it. Usually.

It's interesting that you told a story in which you felt comfortable diagnosing a total stranger with a very specific disorder (and that you determined that no one did anything about the guy because you didn't see anything happen, and they didn't do anything because of a long list of bullet points). I live in San Francisco, which has a large homeless population. Many people (homeless and not, as far as I can tell) talk to themselves and jaywalk (we have a very high rate of pedestrians being hit by cars/buses). Some of them also shout at random people. Are they all, in that moment, having psychotic breaks? I have no idea. I have "diagnosed" people as being not-in-this-world because of the self-talking/shouting thing, and a surprising number of them turn out to be talking on their phones via a bluetooth device.

And I still don't know what your metafilter-specific point is.
posted by rtha at 8:32 AM on August 23, 2012 [2 favorites]


I said this before, but now it's even more painfully obvious. GYOB.
posted by desjardins at 8:34 AM on August 23, 2012 [3 favorites]


People pick up on your wordings and they too have a right to their own view, and since you opened this thread in a forum that discusses things, that's what you'll get: people discussing what you initially wrote.

And then there's still this: your IRL experience may very well say something about how society works around where you live (or works in general - both as seen by you, and in general), but... you're addressing the culture of this site in particular, and it would be so much better if you'd use examples fetched from this place alone, and would perhaps acknowledge what some people with a little longer site history are contributing here.

And then:
Do I really have to do some kind of derridean close reading of long metafilter threads here? I do have a day job I'm shirking from right now.

Nobody forces anyone to have to do anything here except perhaps sort-of not steering completely off the road of a civil exchange [variations in culture accepted]. If you have work to do, by all means, be better about it than all us hundreds procrastinators who hang out around here because we want to feed our writer's-block-monster with something worthwhile.
posted by Namlit at 8:39 AM on August 23, 2012


"...contributing here, too."

Sorry
posted by Namlit at 8:40 AM on August 23, 2012


Syntax.. I think it's obvious this is something you're passionate about. (maybe because it hits close to home?)

But I seems like that passion is clouding your judgement a little and making you project these concepts onto other people.

I don't think many people here will deny that here are stigmas in the world. And that the world sucks and isn't nearly as loving, forgiving, and selflessness as we would all like it to be.

But for this topic, Metafilter is not a reflection of the world. We're more of an exception.
posted by royalsong at 8:44 AM on August 23, 2012


Some people report the experience of the psychiatric system abusing them and/or pushing them into pharmacological regimes they felt very damaging, whereas other people report the experience of the psychiatric system saving them from a life-threatening or otherwise very serious illness.

Reality is compatible with both of these being accurate reports.

I think mefi gives a reasonable voice to both, as well as an airing of the medical-institutional opinion (which tends to side with universalizing the latter experience). I do not feel mefi is unusually unbalanced on this topic, at least among forums that are constructed from the voices of individual people, rather than PR firms and corporate media.

It is a topic on which people will report their experience, and argue for its relevance in guiding subsequent decisions (eg. advice on whether to seek medication), quite strenuously. Many feel (rightly) that the decision was or is a life-and-death matter for them. This is to be expected in an environment that legitimizes both the radically-helpful and radically-harmful experiences people have had with the psychiatric system.
posted by ead at 8:46 AM on August 23, 2012 [1 favorite]


Someone suggests that calling medication crazy pills is maybe not a good way to advance your point, and your response is "fuck you"? Really? Wow.
posted by lazaruslong at 9:27 AM on August 23, 2012 [4 favorites]


syntaxfree, with all respect, I do not see what the fuck you are getting at.

I also would remind you that people who are the targets of racism and people who are the targets of sexism can also be people who are the targets of prejudice against the mentally ill, and as such are better informed than you about the relative impacts of those prejudices.

I may be misparsing your post, but what I'm taking away from it sounds uncomfortably like the "last acceptable prejudice" nonsense people spout that invariably turns out to be "the one prejudice that specifically affects me."

There's a good chance that I was diagnosed with mental illness before you were born, and to be honest, your coming here with wall o' words rants about this stuff as though you are John the Baptist spreading enlightenment to the benighted masses of MetaFilter is pissing me off.
posted by Sidhedevil at 9:28 AM on August 23, 2012 [16 favorites]


You say yourself that you are "rather new" so maybe you don't know, but on Metafilter maybe the primary Not Okay thing to do is tell someone else in a thread "fuck you".

Give the mods and yourself a break - it's obvious that you have a lot of passion and a lot of information about mental health and the social stigma surrounding certain states thereof, particularly from a non-American perspective. I think that would make a great blog. I don't think using MeTa to vent your grievances is as nearly as good a use of your time and passion.

I also think that, given your own blog and a platform as large as you want to make it, you can justify and explain statements like "Because no one decent menstruates." Because while, after about three read-throughs of your comments, I am finally figuring out the extremely harsh tone of your writing, it is immediately jarring and offensive to me to even read things like that, let alone figure out that you don't mean them to be true. We're often encouraged to be concise on MeFi, thank goodness. I don't know that you benefit from this.
posted by Mizu at 9:41 AM on August 23, 2012


Anyway, directed not to that person, but to that general sentiment, which may have been an accident on that person and entrenched on people who didn't say it: fuck you.

What response are you hoping to elicit from the "general sentiment" by saying that? You start a thread talking about how metafilter should change in some ways in how we address things, then someone suggests you should should change some of your words as well, and you say fuck you?

Whatever you are hoping for is not coming closer to happening here. You need to think about people being able to hear what you are trying to think about. Speaking only for myself, my desire to give you a respectful hearing dropped a few notches.
posted by shothotbot at 9:45 AM on August 23, 2012


OP, sit down and listen to your ol' Auntie Julthumbscrew: this is a WONDERFUL website, and a wonderful, diverse, bright, funny, caring, lovely bunch of people. Seriously. I've received help with all sorts of issues through AskMe. I've had people mail me discontinued tampons, recommend local places to purchase esoteric things, invite my son and I to tour their workplace because they thought he might enjoy it. I like to think that I've contributed, too... maybe helped some people work through their confused feelings, or feel less alone... or, hell, even learn how to make a delicious vegetarian one-dish meal.

The point of all of this: the overwhelming majority of users of this site - some of whom have been here for over a DECADE - are able to converse with one another civilly, sensibly, logically and without relying on "fuck you". Even when they disagree. That is a rare and wonderful quality in an online community (thanks, mods! Thanks, Mefites!).

If you, a new user, have caused a shitstorm of this magnitude (100+ comments, almost none of 'em agreeing with you, or even acknowledging that you make an understandable point), you might wanna take a look at yourself, rather than this community.
posted by julthumbscrew at 9:50 AM on August 23, 2012 [5 favorites]


I would only amend Julthumbscrew's comment to note that almost all of the comments are in complete sentences without emoticons. Surely that is worth something.
posted by shothotbot at 9:58 AM on August 23, 2012


syntaxfree, pretty eponysterical handle there; to quote someone somewhere Enough already. Lurk moar.
posted by adamvasco at 9:59 AM on August 23, 2012


For a brief, shining moment after viewing his profile, I suspected that the OP MIGHT be Fedora-Guy. A cursory web investigation proved that he was not. I'm a little heartbroken.
posted by julthumbscrew at 10:08 AM on August 23, 2012 [1 favorite]


Please do not denigrate Fedora Guy in such a way. I prefer to think that he is off living an enlightened, hat-only-occasionally existence.
posted by Mizu at 10:13 AM on August 23, 2012


Please maybe do not make "how much are you like or not like Fedora Guy" some sort of weird poking-two-different-people-at-once sort of thing to do in Metatalk threads. It's okay to think someone's argument or use of Metatalk or whatever is problematic, but let's not be jerks about it.
posted by cortex (staff) at 10:20 AM on August 23, 2012


I too remain confused as to what syntax free is trying to communicate.
posted by prefpara at 10:46 AM on August 23, 2012


Please maybe do not make "how much are you like or not like Fedora Guy" some sort of weird poking-two-different-people-at-once sort of thing to do in Metatalk threads. It's okay to think someone's argument or use of Metatalk or whatever is problematic, but let's not be jerks about it.

Sorry, that was my fault. I didn't actually mean it as a terrible condemnation - I thought fedora guy was probably a pretty nice guy, and good company in moderation. He just seemed to be young, and a little excitable, and trying to show how smart he was, both to MetaFilter and the women he wanted to meet, without getting how that was coming across. All venial and usually self-correcting sins.

This, on the other hand, has gone kind of dark. So, yeah. Sorry.
posted by running order squabble fest at 10:58 AM on August 23, 2012


Hi. I mostly lurk, but I feel really compelled to respond to this.

(This will get to a site-specific point, bear with me.)

I have a long and somewhat thought not especially idiosyncratic relationship to mental illness. I grew up in a household with a father who suffered some combination of major depression, anxiety disorders, and borderline personality disorder (various diagnoses at various times). I knew at a very early age that he was not, for lack of a better word, functional in the way most fathers are. It turned a very classic case of parentalizing the child. I also got to watch him go on and off meds, occasionally therapy, self-medicating the whole time. He never hit me, but by the time I hit adolescence, verbal and emotional abuse was an every day thing.

To put it simply, I did not wish to grow up to my father.

Coming out of adolescence, it pretty quickly became clear to me that I was experiencing depressive episodes. The only possible outcome, in my mind, was that I would be my father. I did not want this. I went into a very profound denial about the state of my mental health. I would tell myself stories about how I was making it up (keeping in mind that I never expressed any of this to anyone, I claimed I was making it up to myself), that it wasn't that bad, whatever.

This went on until early this year, when I had a full on nervous breakdown that very nearly resulted in the loss of both my employment and my spouse. I went into an outpatient program. At this point, I was 100% convinced that I was now doomed. I was on a one-way train to Harry Chapin land.

The relevant piece: Metafilter, and AskMe in particular, were a deeply profound source of comfort for me. Reading people speak so compassionately, humanely, and honestly to people in situations similar to mine, and moreover, *reinforcing that I was doing the right thing*, made a huge difference in my recovery. AskMe was a major piece of me coming to understand that there are other possible outcomes. That I was not doomed to wind up unable to make it through the most basic of human interactions without risk of BadThing.

In particular, it taught me that my father's interactions with psychiatry are not the ideal. (I'm still working through what I think about the intersection of agency and mental illness, so I'm avoiding the word choice.) That, in fact, he didn't try everything. He didn't even try most things.

So: in conclusion, Metafilter is so non-stigmatizing that I credit for helping me in my recovery.

(Also: I love my meds. They help me not do the mental behaviors that I thought were normal but turned out are anxiety. Granted, I've had the smoothest experience of anyone I know, in that pretty much everything worked first time out the gate, no major side effects, but still. The meds make it much easier for me to not engage in destructive cognitive behaviors.)
posted by PMdixon at 1:36 PM on August 23, 2012 [15 favorites]


I stopped doubting meds worked the first time I saw one of my clients with schizophrenia without them. I do think there is conversation to have around the commercialization of medication and health care, but I think that's a much broader conversation than just mental health, and that horrible stigmas about mental health are very likely to show up as tools used to discredit one or the other side if mental health is used as the battlefield. Personally, I think focusing on something less fraught with prejudice is a good idea if you want to have a conversation about whether the commercialization of health care is a good idea.

Conversations about psychiatrists who over-precribe are common, but usually restricted to staff meetings in my experience, and can get very doctor specific. I love our psychiatrist because he is of the "one symptom, one med" model, and regularly winnows down extreme medication lists to a much smaller number. He does it slowly and carefully, and so far that has meant no need for hospitalizations on my caseload for med changes (yay!).

In regards to people with symptoms still being on the street... yes, they are. My clientload includes several people who are notable in some manner by standing out from the general population in a way which can be off-putting. For a couple of them, near as I can tell, the off-putting is a feature, not a bug - one smiles when I point it out. The standard for involuntary holds of adults (children are different) in the USA is 1) gravely disabled (cannot feed, house, cloth self), 2) danger to others, and 3) danger to self. I know talking on the street can seem off-putting, especially if it's loud, but it doesn't fall under Criteria and police will only get involved in cases 2 and 3 (though locally we're now required to call them for case 1 which can get interesting since they rightly percieve it as a waste of their time).

I personally would like to see a higher degree of cultural tolerance for people who deviate outside of the norm, even in odd ways like talking to the self. When I can, out in the community, I try to enforce this. This includes refusing to be The Person a store employee talks to so that they don't have to talk to The Other Strange Person. People are largely receptive to my redirection and seem to respond to the level of respect I try to express for my clients.

Finally, mental illness is an issue for the homeless population. So is drug abuse. We have far too few programs for either and the general political field right now is hostile toward both and has been cutting funding for both for years, with a strong tendency to cut therapy first. This has led to a larger population of people not meeting criteria but also unable to find housing or safe places to go during the day even with case management (for the record, I'm a case manager and have been for quite a few years; I have an advanced degree). I love any support at all for people trying to get stable funding for programs which will last more than a year or two, but the situation is very complicated and besides Sudden Loads Of Money With Everyone On The Same Page I don't see easy solutions.



royalson: Evidently I gave him some kind of Big Red Flag.

I don't know if it's helpful to hear from the clinician side, but yes - huge big honking red flag jumping up and down and saying 'Look at me! Look at me!'. A lot of people feel bad/depressed/sad and have what we call "suicidal ideation", which is fancy words for "think suicide might be a good idea". The actual "you are on your way to a plan (DANGER!)" is when the person feels nothing. The step after that is a plan, after which people tend to seem happier, and sometimes giving away things. Then come attempts, which vary on success rate. Frankly, I try to keep my clients as far from "attempts" as I can while still keeping suicide as an ok topic to discuss. I'm helped in the latter because I have been suicidal, so I'm actually really comfortable talking about it, the reasons for it (many of which are rational), and then I'm honest when I tell my clients, "I really, really, really don't want you to. Can we make a plan to try to keep you alive?" Usually they go along with me, thank the gods.



elizarbits: I will come to their house and touch all their stuff.

Best. Threat. Ever.
posted by Deoridhe at 8:27 PM on August 23, 2012 [8 favorites]


kanata: Amusingly enough, I'm actually prescribed speed for various things, I'm on such a high dose that my psychiatrist is actually somewhat uncomfortable with it, and it still doesn't make me happy.

--

Actually relevant to the thread at large: Every time I post to anywhere on MeFi about my mental illnesses, I always expect to get castigated, ridiculed, criticized and shunned. That's my experience with trying to share certain aspects of my life with the world "at large."

It's not limited to the general public, either. Even experienced medical professionals (not in psychiatry), who you think would encounter this kind of thing occasionally even if it's not their focus, look at me strangely after seeing my med history. "You? Seriously?" I'm not even making up their words for them, I've had actual general practice doctors who had never met me before argue with me about my mental health diagnoses because it was impossible that someone so apparently high-functioning could need to be on multiple anti-depressants, an antipsychotic and anti-anxiety medication.

(Funnily enough, that particular med combo was one of the few that has ever actually done anything. Shame that it caused me to have problems necessitating multiple surgeries.)

I have never been castigated, ridiculed, criticized, or shunned for exposing my personal mental illness history on MetaFilter. On the contrary, people quote things I've said in their own comments or send me MeMails supporting me or thanking me for my advice. Many times I get the luxury of being ignored, not in a mean way, but in a way that makes it clear that what I'm saying is so obvious or so much in agreement with other people in the thread that it's not even necessary to comment on it.

That kind of response is more than amazing to me, and I think other people agree with me, based on this post.
posted by saveyoursanity at 6:53 AM on August 28, 2012 [2 favorites]


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