One of the things I loved about getting diagnosed was the unknown name of the disorder. I had never heard of a depersonalization disorder until last year when I came across a BBC article on someone who has the disorder. After reading that article, I was able to do more research and try to figure out what it meant. Without that research (plus the range or resources I had access to whilst studying a psychology masters), I would have put the word in a memory spot labelled ‘random medical stuff I will probably never use.’
One of the challenges of being ill with a psychiatric illness is that you always feel as if you have to justify it. When I was depressed I felt like I couldn’t explain my ill health with the word depression alone. I had to justify it. I had to compare it to other organic problems, like a broken bone. If I left it with “I have depression,” there was always a concern that I would be seen as lazy, or that it was not a big problem.
This justification wasn’t just for other people, it was also something for me. The way mental illness are talked about and stigmatised leads to internalizations of faulty beliefs. I remember not wanting to accept being depressed because I wasn’t weak. There was a battle between what I could know cognitively and what I believed. I could ‘know’ that depression wasn’t weakness, but I really couldn’t believe it.
But the justification was also for other people. I could often get hurtful responses from people when I confided in them that I struggled with depression. Some people suggested that I take a more positive outlook on life and just decide to be happy, as if the depression was caused by a conscious choice of sadness (this theory does make a lot more sense when you realise that I support Newcastle United…). Others would be silent, like a deer in the headlights. Not sure how to respond, so choosing not to. The silence was always loud, deafening, and alienating. The worst response would be those who would blame a spiritual deficiency in myself, or claim that it was caused my being possessed. Thankfully this was the least common response I encountered, but is shockingly common.
All this to say, I love not being able to tell people I have depression anymore. As much as I want to say that I was never ashamed to have depression, that is not true. Whilst I am now much more comfortable talking about my past experiences with depression, I love the new lease of life given from this diagnosis. When I tell people that I have a depersonalization disorder they have no idea what I am talking about. It is free of misconceptions and stigma. It might as well be a more organic issue, like a broken bone. It is great. I no longer feel the need to have to justify my ill health to people.
Having said that, I try to intentionally tell people it is a psychiatric illness. I try to make a conscious decision not to hide behind the terminology of the nomenclature. I don’t want to feel that I have to justify being ill once people find out it is a psychiatric illness. I don’t want to feel that I have to justify being ill to myself because it is a psychiatric illness. I know that if we want to figure out how to stop stigmatising mental illnesses, we need to have painfully honest and difficult conversations from a wholistic worldview. If we don’t, things are going to get better.
And before people chirp in with one of todays favourite phrases, we don’t just need more education (send the devil to Oxford you will get a smarter devil type thing). We need a change of perspective.
Recently, I read a book about conversion disorders (psychosomatic stuff, disorders that convert emotional/psychological distress into physical distress. i.e. depersonalization disorders) written by a consultant neurologist. In it she describes an experience when she and the younger doctors were laughing at a patient who had psychogenic blindness. The patient was blind because of psychological trauma. The author, and her young doctor colleagues thought the patient was being ridiculous and found her blindness amusing. They were well trained doctors. They were well educated and knew about psychogenic disorders far more than your average human being. But as the author notes, the issue wasn’t in expertise, training, or education, it was in the assumptions underlying how they interpreted her suffering. It is an attitude she says persists through to the level of consultants as well.
Worth bearing in mind that this is a very good reason why going to the doctor is scary for those of us suffering.
Education alone is pointless in dealing with the stigmatism of mental illness. It can be important, and is crucial when it comes to medical stuff. But education without humility will just lead to a better educated stigmatism.
My thoughts aren’t clear at the minute because I of my depersonalization disorder. It affects me cognitively and leaves me in a bit of a muddle. But I know that if I can keep having positive conversations about mental health it can help build God’s kingdom, where there is no stigma. The goal is to help others, and help myself, get to the stage where mental illnesses aren’t seen as a second-rate illness.
In the book I mentioned before there is a wonderful passage where the author discusses the ‘rating’ of psychosomatic illness. She says that the way that illnesses are thought of is not consistent with the way in which they cause pain or distress. In regard to scoring the severity of the illness she says,
“It is not necessarily the greater suffering that receives the greatest consideration and sympathy. Illness is not scored in that way. Deadly disease obviously scores higher than others. After that, there is an unofficial ranking system for illness in which psychiatric disorders are the out-and-out losers. Psychiatric disorders manifesting as physical disease are at the very bottom of that pile. They are the charlatans of illnesses. We laugh at them.”
This section at the end of the chapter is explaining why a patient, who has been paralyzed for years with a psychogenic illness, was resisting the diagnosis. Both her and her family were strongly pushing back because it wasn’t just a fight of a diagnosis, it was a fight for dignity. The stigma, and in turn internalized stigma, of psychiatric illnesses mean that they are difficult to accept. Accepting a diagnosis of a psychiatric illness means accepting all the pressure and unhealthy beliefs associated with them. I didn’t want to accept a depression diagnosis because it would be mean I was weak. I felt that if I accepted the diagnoses I would be accepting that I was weak.
I remember being told by someone, who wasn’t struggling with a mental illness at the time, that stigma regarding depression didn’t exist. They were wrong. It does exist. It exists in churches, schools, and it exists among medical professionals. So, please, let us talk about mental illness. Let us have a really positive talk about them. Let’s not make it a fad but normalize it as part of life.
If you are keen, please share this and chat to people about it. Put it on social media. If we don’t actively shape the narrative around mental illness, it will default back to a misleading hurtful one (thanks sin). Or follow the blog on email if you are so inclined.
Before I forget. The book referenced is “It’s All in Your Head: Stories from the Frontline of Psychosomatic Illness” By Suzanne O’Sullivan. Would recommend and will be mentioning it more in future.