Faking Mental Illness, Mad Pride and the Survivor Movement

This is a search term that often leads here. I raise my eyebrow at this.

It was implied- nay, flat out said- by some when I started this blog that my “illness” was nothing more than me presenting myself at the doctors with a handful of googled diagnostic criteria. There was even a parody blog, which I won’t link to here as it was embarrassingly misjudged and off the mark, that said of me:

I told them about my really manic depressiveness and tri-polarness, but they don’t believe me. I don’t know why, as I have all the symptoms listed on Wikipedia. Why, I even memorised them like a wet dream from the aurora in the sky.

Hilarious stuff, you’ll agree.

It’s inaccurate for many reasons; first of all, the whole (three entries) of the blog paint me as some keeerrrazy London hipster when I am in fact a skint semi-recluse that only cares about comedy from the 60s and music from the 90s. There has also been a tendency in my lovely internet detractors to make assumptions about my lifestyle based upon who my (far more outgoing, far more successful) friends are. That I go clubbing all the time and stuff. If I did, it’s no-one’s business but I rarely go out now and when I did it was for quiet pints with friends or to the one club in London I get into free because I used to flyer for them.

As well as that, there is also the incorrect assumption that other people have supported me, financially, since I moved to London. In the first six months of living here, this was true, my boyfriend did support me. Since then, though, I’ve worked almost constantly (joys of temping- periods of unemployment but not holidays) until I was too ill to, and have always made slightly more money than the people I have been in relationships with, and paid my own rent. The exception was when I had neither a job nor benefits and my friends thankfully helped me. Of course like any other young person who idiotically fucks off to another country on a whim I’ve had money crisis’ but I usually solved them myself, and I’m quite good at managing my money. Like everyone else, I have needed help (and was prompted into asking for it by other people), but it has certainly not been a regular occurrence. And I am grateful that there are people who have helped me. But I generally pull my shit together in the end.

However, it it mostly incorrect because it assumes that I knew a lot about manic depression before I was diagnosed with it. I did not. My now rather extensive knowledge of it (and a few other mental illnesses) was born out of an obsessive desire to know everything about what I had. If you had an illness that you would suffer from for the rest of your life, wouldn’t you want to know as much as possible about it? Knowledge is power. My ability to deal with my illness stems from my ability to recognise when something is wrong. I am, to steal from Jerod Poore, a “citizen expert” on manic depression. But at the very beginning, when I was diagnosed with Bipolar Disorder Type I, I had to ask what “type I” actually meant.

I wasn’t diagnosed with manic depression because I arrived at a doctor’s surgery and reeled off symptoms. Nor did I diagnose myself. My diagnosis came after a period of hospitalisation when I was very clearly unwell but in which I did not realise I was unwell. Most of my symptoms were relayed by Rob, not me. It was easy to diagnose me, I guess, because I was in a psychotic mixed state, a bells and whistles manic depressive episode. I was conveniently suffering from mania, depression and psychosis at the same time, and had been for ages, so I guess there was really no other diagnosis for me.

Bear in mind that I was actually told that I had manic depression some years before. But I didn’t understand what it was, so did not accept treatment, nor the diagnosis. Oh, I sometimes said I had manic depression but I sure as hell didn’t really believe it, didn’t know it as acutely as I know it now.

It bothers me that people would think I’d fake having a mental illness. If it’s anything, I’ve faked not having one in the past. I did not ask for, nor did I want, to have mental illness. But I do, so!

The thing is, it’s actually fairly difficult to fake having a mental illness. Going to a doctor and telling them you’re sometimes happy and sometimes sad doesn’t cut it- a lot of the time, illness- and especially things like schizophrenia and manic depression- are not diagnosed until the doctor actually sees you in a bad episode. This is both good and bad- good because then a probable accurate diagnosis is made and bad because often diagnosis is not made until a crisis point is reached.

There has been a rise in diagnosis of manic depression. Part of me thinks, hurrah, more people are being helped. The other part of me thinks that people see Amy Winehouse or Stephen Fry and almost aspire to it. This might explain why the rise is prominent in adolescents. I also think that parents put pressure on doctors to name and drug a condition that they themselves cannot control in their offspring.

It’s also worth remembering that manic depression is a spectrum illness- there is a wide range of severity. The spectrum aspect of it is fairly new- bipolar disorder is no longer the rigid types of I, II and cyclothymia. So more people who would have been diagnosed with major depression are now diagnosed with bipolar disorder due to the presence of hypomania. And you don’t have to have had multiple episodes to be diagnosed. Just one depressive and one hypomanic, which seems leisurely to the rapid-cycling me. I don’t really believe that classifications indicate severity- for example, it’s most often said that Bipolar I is the most severe form of manic depression, but consider the fact that, on average, people with bipolar I have nine episodes in their life, compared to the chronic, unremitting symptoms of “mild bipolar” like cyclothymia and you’ll see what I mean. My illness is treated as severe because of many factors, mostly the extent of my rapid cycling, resistance to medication (it has, admittedly, reduced the severity of my episodes but not the occurence) and the tendency for my moods to “switch” rather than lapse into normality, not because it’s bipolar I. People close to me know how much it affects me and that I struggle quite a bit with it but I’ve seen worse in others. Especially in those who have substance abuse problems as well as mental illness. It’s pretty much the worst combination in the world.

As for faking it, you might get past the GP but you probably will fall at the hurdle of a good psychiatrist. Although it’s not difficult to amass information about the symptoms of illness, people are trained to spot the unspoken things. Saying, “Oh balls, God talks to me” isn’t enough. Mental illness is often the last diagnosis made- lots of mental-type symptoms can come from other things- stress, for example, or drug misuse. But it’s undeniable that sometimes diagnosis are made willy nilly because it’s easier to treat things with medication than expensive therapy, but that’s the fault of the institution, not the individual.

I struggle to understand why anyone would want to fake mental illness- maybe it’s the somewhat point-missing idea that it makes you interesting, unique and, above all, excusable for your bad behaviour. I do remember people in my teens who saw their medications as a sort of status symbol, irrefutable proof that something was wrong with them. I guess that can be comfortable, however, to have a name for what is wrong in your life and therefore a treatment plan and a solution. And let’s face it, people like sympathy and attention.

Then there is Mad Pride, who malign the term “suffering” when attached to mental illness. Well, fuck that. I swing between thumb twiddling having mental illness but there are a bounty of times in my life, like now, when I sure as hell do suffer from it and it sets my teeth on edge that I should think of it as a gift from the gods.

I admire Mad Pride’s activism and their intention to reclaim stigmatising language like “bonkers” but I loathe their twee assumption that everybody with mental illness is a colourful little sunflower who trembles with creative energy. It bothers me even more that they consider people without to be “normal” while we are “abnormal”. I think that that idea is stigmatising in itself- rather like “Big is Beautiful” which sets fat people apart from their “normal” counterparts. People with mental illness are normal- they’re just people with mental illness. We’re not some sort of exotic subspecies. While there is certainly a culture of mental illness (art and writing, namely), it should not be a bad thing that this culture explores the darker part of living with mental illness. People are too individual, however, to be purely one thing or the other. Some people-gasp!- with mental illness are complete bastards! Like people without mental illness!

As a person who lives with mental illness, yes, I do feel somehow part of a community. But I resent the homogenization of this community. And I reserve the right to say that it fucking sucks sometimes having mental illness, and that I often feel that having manic depression has been a hugely negative force on my life. I mean, I dropped out of school, lost jobs, my home and various opportunities due to my illness. I am consistently unstable, unreliable and often un-talkable-to-ble because of it. And the attention, though flattering and very heartening, that this blog gets is no penance for that.

It’s the “because” that bothers some people. How could anything happen because I have mental illness? Surely you let that happen? Well, it comes back to “excusable” behaviour. I don’t think any behaviour is excusable because of mental illness- maybe with the exception of acts carried out when in a psychotic state. When I’m manic, I am unequivocally a loud, embarrassing pain who thinks she’s brilliant and that everyone else is brilliant. In my recent, quite bad mixed episode, I was rude, aggressive, irritable, despairing and don’t-sleep-don’t-eat obsessive. Yes, I am not normally that way- it is symptomatic of my illness. But if I excused myself every time, I’d never take a medication again. It’s an unhealthy motivation but fear and the desire not to alienate everybody I love is the reason I take medication.

But it is true that it was because of my illness that I dropped out and etc. I went from a violent, long suicidal episode of depression that lapsed into an even more violent and long episode of mania. It is not conducive to, well, anything. It does not mean that I excuse it.

But Mad Pride would admonish me for believing that my illness hasn’t bought me much in the way of loveliness or made me a particularly better person. And I resent the implication that having mental illness makes you better than someone else. They don’t even like the term “mental illness”. Again- why not? I think it is the least stigmatising way of describing it as it is rightly on the linguistic par of physical illness. And isn’t that what mental illness is- worthy of being treated with the same respect, the same diligence as physical illnesses?

I also think Mad Pride sees mental illness as a positive character trait rather than a real illness, and what’s the point? It makes me feel guilty for feeling that my mental illness is not a positive trait. It’s not a negative either- it’s not a trait to me at all. It’s part of who I am, certainly, and a large part, too, part of my identity. But then again so is writing, or loving Peter Cook so much I want to resurrect and marry him.

And I have my own bugbears with things related to mental health; like that it pisses me off when I see Livejournal icons of “I don’t suffer from insanity, I enjoy every minute of it” and bloody wrists and stuff. The written phrase “Triggering”, though helpful, especially for people with PTSD, always irritates me. I hate melodramatic poetry rhyming “night” with “plight” or whatever (although when I was a teenager, I wrote my fair “share” about “despair”, so, if you’re under the age of 20, I forgive you). Anybody without a sense of humour, especially concerning themselves, is not somebody I would ever wish to interact with.  I don’t fully understand Borderline Personality Disorder and other personality disorders.  And even though I know what it’s like to suffer from psychosis, I still get a bit scared when someone on the bus starts shouting at someone we can’t see and hear.

It also incorporates the “survivor” movement, which I also occasionally find insulting.

I don’t dispute that people with mental illness are discriminated against. Believe me, I have experienced it in abundance. Part of the reason I keep this blog is to shake awake someone, anyone, who has a stereotypical idea of someone with mental illness.

I’m not a champion of mental health services, having found them mostly to be incompetent chancers. Psychiatrists do have too much power and are also subject to the human prejudices of all of us. And I know that medication and hospitalisation has ruined peoples’ lives and this needs to be known. I also believe that mental health legislation is increasingly draconian.

But I take medication for mental illness, like one would take medication for a physical illness. The survivor movement progressively, I feel, looks for alternatives but it invalidates the idea that mental illness can sometimes require medication, placing the person with it as responsible for having the illness, which is not the case for physical illnesses. It invalidates the idea that mental illness is real and I think this is totally counter productive.

Again the language is exclusionary. So some people are survivors and what, the others are victims? Why place people in these roles? Some people find such language empowering, which is cool.

But I don’t like the implication that those who don’t are weak, that they don’t take responsibility for their lives. Positive language, at this point in time, does not dig me out of depressions or make me face the world with a grin when I feel like topping myself. I don’t think that positive language means you can “decide” to be better by choosing to see it that way.

I don’t consider myself a “survivor”- I haven’t “survived” mental illness and being treated for one, it’s an ongoing process and I wouldn’t smugly consider myself a “survivor” anyway. For those who have really been wronged by the system, or society, then yes, a survivor is an apt term. I don’t object other people using the term for themselves but I would rather it not be implied that because I place my faith in my CPN and psychiatrist (and, most importantly, myself) that I am a victim. I’m not, I don’t think of myself as one. Neither am I proud, though, to have mental illness, the same way I don’t expect somebody with epilepsy to collect their prize at the Well Done You Awards.

What I am proud of in myself is my ability to keep going and to so far have not ended up killing myself. Starkly, it has been the likeliest of outcomes for over a decade and, to my friends and family, is still in their mind somewhat of a foregone conclusion. I am proud that despite the amount of shit I have dealt with, I am here and am not totally embittered and cold. And that is enough for me.

I do support Mad Pride’s attempts to change the public perspective of mental illness- to remove the idea that we’re criminals, or violent, or the dregs of society. I just don’t think their alternative view that we’re all creative, altruistic rainbows is particularly helpful either.