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Why it should be OK to tell a friend to take their meds

Tory Shepherd

by Tory Shepherd

14 Oct 05:35am

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Filed under: Health, Mental Health, Mental Illness, Stigma, The Angry Cripple

40 comments

An email pinged into the inbox, asking if I could write a short blog for a new website – Mindshare – an online mental health community.

Van Gogh was, it's fair to say, mentally ill. But his friend Gaugin portrays him painting sunflowers, not cutting off his ear

The email went to the ‘think about later’ folder. And I sort of did think about it later, but my mind kept skittering over the surface of it, like a beetle on a shiny floor. Touching it but leaving it untouched.

When that happens it’s because there’s something I’m a little bit afraid of. When I got a follow up email, I sighed and had a proper think about it. And what I thought was that I’m afraid of the language of mental health: I don’t want to write an opinion piece on it because the language is cold, and fills me with dismay. The language I know goes something like this:  Mental health in crisis. Psychotic abandoned by failing system. Children with mental illness left years without treatment. Suicide cluster. Depression epidemic. Neglect. Danger.

And then there are the shocking statistics.

I’ve penned many stories on mental health; on the breakdowns in the system, on those who fall between the gaps. On suicide, on devastation and distraught carers and a society that leaves people until it’s too late to help them.

And I’ve written earnest editorials decrying the inhumanity of it; the lack of resources, the inability to act until it’s an emergency.

That’s why the email languished. Stepping outside the official language structure and talking personally and honestly about mental health risks offending someone; you can say the wrong thing, break the rules.

Like everyone, I know many, many people with a mental illness, people on a spectrum from easily-controlled-with-cognitive-behavioural-therapy-or-drugs to those-with-devastating-peaks-and-troughs. But with the people I know I’m not constrained by this fear of speaking about it, because in my head they are not defined by their mental illness. They just are who they are.

So I can listen to what’s in their heads without feeling I have to offer platitudes. Or I can tell them to bugger off and take their meds. I don’t need to shy away.

But stigma still exists, limiting the conversation, because when we first meet someone with a mental illness we don’t know the shape of it. We don’t know when it will bob up or what to do when it does. And we don’t really want to prod around in the depths for fear of awakening some kind of beast, so we sort of ignore it, and by ignoring it, ignore the person and too often ignore the broader issue.

At The Punch I was discussing with a contributor the need for more conversations on people with disabilities. From that phone call, the “Angry Cripple” was born, an anonymous persona who could talk about disabilities angrily, passionately and frankly. Yes, the name offended some. But not many, not really. And I learned from that process that it is better to take the risk of offending someone than it is to render something unspeakable except in the narrowest of terms.

That is how an issue drops off the radar, including the political radar.

So this is my blog, my point, for what it’s worth. We need to start to dismantle the stigmas around mental illness through humour, and honesty, and language unconstrained by political correctness. Because stigmas allow us to ignore both people and their problems, and give the powers-that-be more wriggle room to do the same.

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40 comments

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    • acotrel says:

      05:48am | 14/10/11

      @ Tory
      Perhaps you should actually listen to what a person with a mental illness has to say ?  If you look back through history, most of the ‘geniuses’ have been mentally ill.  I suggest that many live in their own world with its own reality - a ‘paradigm shift’ so to speak !  Perhaps we could learn from them ?

      Reply

    • marley says:

      08:12am | 14/10/11

      acotrel - if you’ve ever had a friend, relative or acquaintance who had mental health issues, you wouldn’t be so flippant and dismissive. For them, it’s not another paradigm - it’s suffering, pure and simple.  I would no more consider a person suffering from depression or OCD to be “in their own world” in the sense that you mean, than I would consider a person with rheumatoid arthritis or tinnitis to be experiencing a different physical reality.  Both concepts ignore the reality of pain.

    • malohi says:

      08:16am | 14/10/11

      Most?
      I envy the generation you grew up with acotrel. Where old men could just say anything they want without likelihood of being called out on their rediculous generalisations. The ultimate appeal to authority fallacy, sometimes I think you are starting to believe it yourself.

    • TChong says:

      08:21am | 14/10/11

      acotrel
      indeed there may be a fine line between mental illness and genius- history and literature can provide many fine examples.
      The only problem is that the “genius” component is often only discovered with hindsight.
      Another equally sad truth , is that the vast majority of mental health patients , just like everyone else, aint ever going to be considered a “genius”.
      So, do we allow someone to go over the edge, not intervening , just in case a true “genius"is denied, ? or do we treat people in a way that keeps them, and everyone safe from harms of all types of degrees and consequences. ?

    • jf says:

      08:42am | 14/10/11

      Whilst I doubt that “most” geniuses have had mental illnesses I’ll concede that many geniuses did suffer from mental illness.

      That doesn’t mean that they aren’t suffering everyday. That doesn’t mean that their suffering should be left unrelieved simply so we can benefit from their genius or “learn from them”.

    • acotrel says:

      08:51am | 14/10/11

      @malohi
      Winston Churchill, Isaac Newton, John Curtin, Vincent Van Gogh, do I have to do your research for you?
      @marley
      I wasn’t being flippant !  Get yourself into a locked ward and talk to a few patients.  The common thing is a move away from reality.  The trouble is that then you have to decide who is mad - you or them. It’s one of the reasons that psychiatrists usually don’t try to unravel patients psychological problems.  If you listen and empathise, you will probably end up ill yourself - they are not often mad without reason. We need more clinical psychologists !

    • acotrel says:

      09:00am | 14/10/11

      @marley
      There is a popular myth that mental illnes is incurable.  Some people go into hospital delusional, and become convinced that the world has changed to fit their own mindset.  They can appear to be perfectly well,  However when released they find out the truth - that the world hasn’t changed.  Then it’s straight back through the revolving door. The fundamental psychological issues must be addressed. The medication only treats the symptoms, and gives a momentary reprieve.

    • acotrel says:

      09:21am | 14/10/11

      @jf
      If you want to help a person suffering from a mental illness, you could listen to them, and if they have good ideas, help them change the world to one that they are comfortable with.

    • Paranoia says:

      10:03am | 14/10/11

      Actually Marley, I’m going to support Acotrel on this one… as a person managing my depression (yes, in much the same way that others manage their diabetes or asthma or cancer) then I can honestly say it is a different reality, albeit one which sometimes is a world of hurt.
      I remember being seen by the doctor on my admittal to hospital - he said “I hear you have a bad plan”.  Actually my plan was very good, and I told him that - the plan would have worked and accomplished what it was supposed to.  The plan was good.  The world was bad and consensual reality had it that if I couldn’t deal with that, then I was at fault - I was wrong, I was imbalanced and I was “sick” and “broken” and should be fixed. 
      Am I?  Because I find that cruelty to animals, and children, and the elderly, and the disabled and those who can’t fight back is abhorrent and I can’t deal with those things and get quite physically ill?  Because I think that violence is wrong and allowing some people to intimidate others because we dare not offend them (either in person or through the law) is wrong and I feel afraid of those people and sick at the thought of our “civilised” society being nothing more than sanctioned bullying?  And the stresses of these and a psychopathic (yes, I’m using that term in a clinical sense) bully being my manager at work, and all the other little stresses getting too much to deal with and my housemate telling me to “grow up and grow a spine” and this “you have to live in this world” mentality you seem to have… all led me to believe I was the one who was at fault, I was the wrong piece here, and thus removing myself from the equation was the only logical answer.
      So yes, it IS another paradigm.  It’s not suffering “pure and simple” because there’s nothing pure or simple in it.  And if YOU ever actually listened to what those people were trying to tell you you’d stop this “holier than thou” posturing and trying to force your worldview on us because consensual reality sucks.

    • marley says:

      10:11am | 14/10/11

      @acotrel - you really haven’t got a clue.  You seem to think that everyone with mental health issues is delusional.  That’s ridiculous. Most people with mental issues are not locked away in psychiatric wards;  they’re trying to cope, day by day, in the real world, facing all the normal stresses that the rest of us do, but with fewer coping strategies.  They don’t want a new reality, they don’t want the world changed, they want to be able to function better in the world they know exists. 

      Some of them respond to psychotherapy; some don’t.  Some respond to, need, medication;  others don’t.  There are no simple solutions, no one-size fits all. But to suggest that we should just accept them as they are, without doing everything we can to relieve their pain, is callous.  And by the way, I’ve known a few people with various types of mental health issues over the years - and none of them was a genius - they were just ordinary folk trying, sometimes not very successfully, to cope.

    • acotrel says:

      10:41am | 14/10/11

      @marley
      You seem to have a ‘pull yourself together’ mindset.  Your seem to beleve that you live in the ‘real world’, and that change never happens.  The fact is that some people have real issues with the way the world is, and find they cannot live with it.  If they are stressed then a shift away from reality can occur.  If you take the stance that they should conform, and medication, ‘psychotherapy’ as you call it is the answer, you condemn them to a life of misery.  Clinical psychology can help people adjust, but it must be a two way street.  The ideas of the ill person must be somehow accomodated - they nust be helped to change the world !

    • acotrel says:

      10:44am | 14/10/11

      @paranoia
      I’d point out that our OHS laws changed a few years back to a risk management regime.  And this year in Victoria, we introduced anti-bullying legislation.

    • acotrel says:

      10:56am | 14/10/11

      @marley
      ‘you really haven’t got a clue.  You seem to think that everyone with mental health issues is delusional.’

      How can you be certain that you are not delusional ?  You live in a world that can change in an instant.  You might be so programmed and comfortable that you cannot see the risks ?
      ‘Normal’ people have highs and lows.  If they are stressed a shift away from reality can occur which can sometimes be very permanent.  The ‘delusion’ spectrum often ranges from schizophrenia to manic depression, and those two are probably extremes of the same disease. When I speak of ‘delusion’  I mean the way people interpret information.  Some mentally ill people interpret what you say to them in a totally different way to what you might expect, and that is why paranoia is dangerous.

    • jf says:

      10:59am | 14/10/11

      acotrel says:10:21am | 14/10/11

      “If you want to help a person suffering from a mental illness, you could listen to them, and if they have good ideas, help them change the world to one that they are comfortable with. “

      To suggest that we should address the concerns of a small number of people and change the world to suit their needs rather than help them to adapt to the world as it is not a sensible or realistic approach.

    • malohi says:

      12:18pm | 14/10/11

      Wow, 4 people who had talents in certain areas and were hopeless in others. I am sure those people account for the majority of geniuses in your eyes.

      Please do not do my research for me. I would prefer fact over the baseless pontifications of an old man seeking relevance.
      Remember how the article was about not making sweeping generalisations about the mentally ill? 
      Well your sweeping generalisations, and their implicit affirming the consequent fallacy, follow the same logic as the problem.

    • marley says:

      12:59pm | 14/10/11

      @Paranoia - I’m not quite sure how you reached the conclusion that I was engaging in holier than thou posturing or trying to impose my worldview on anyone.  I was merely stating that the people I know who have mental issues are different from the ones alcotrel was describing.  They are living in this world as much as I am - seeing the same wrongs and injustices that we all do, and which are very real - but responding to them differently.

      My friends aren’t geniuses living in an alternate reality - no, they’re just ordinary people struggling to cope with existence, and finding it very difficult.  And in my opinion, it’s a cop out to suggest that oh, they’re just living living in a different reality - that means we have no responsibility to try to help them when they’re in pain.

    • acotrel says:

      01:28pm | 14/10/11

      @marley
      ‘And in my opinion, it’s a cop out to suggest that oh, they’re just living living in a different reality - that means we have no responsibility to try to help them when they’re in pain. ‘

      I don’t understand how you reached that conclusion.  The rest of us are responsible for the way the world is, and have the ability to join together and change it.
      For centuries our workplaces were run on military principles.  We ended up with prescriptive OHS legislation to reinforce that.  These days things have changed and our duty of care is prescribed in terms of the need for appropriate risk management.  If someone is bullied, isolated, excluded, exploited, discriminated against we all have a duty to do something about it.Most of the things Paranoia mentioned,  seem to fall within that ambit..  The often declared intention in large organisations, is that workplaces should be based on teams of people working with each other, and encouraging creativity. - Is your world like that ?

    • marley says:

      02:06pm | 14/10/11

      @acotrel - I reached that conclusion by reading your first comment, which amounted to washing your hands of the problem.

      And your comments about changing the world all relate to an extremely narrow framework - the workplace in an industrialized economy.  What about all the people with mental health issues who’ve never had an OHS issue?  There are teenagers who’ve never even been in the workforce but are struggling with mental health issues;  there are people in perfectly benign workplaces suffering from mental health issues;  old folks homes are full of people suffering mental health issues (and I’m not talking Alzheimers).  Your view of the causes of mental health issue seem to relate almost entirely to workplace stress, and that’s just not the case of many,many people.  My own grandmother had some mental health issues, and she was never employed in her life.

      The fact is, we could convert every factory and workplace in the world to a feel-good, non-authoritarian structure and there would still be people suffering from mental health issues.  We don’t know what causes mental illness - or what cures it.  We can help people with counselling and psychotherapy, and sometimes with drugs, we can improve their work environments, but none of these is in itself a cure.

    • acotrel says:

      09:20pm | 14/10/11

      @marley
      ’ We don’t know what causes mental illness - or what cures it.  We can help people with counselling and psychotherapy, and sometimes with drugs, we can improve their work environments, but none of these is in itself a cure. ‘

      When you say ‘we’, you are speaking for yourself.  The easy answer is to blame all mental illness on a ‘chemical imbalance’ - that solves everything !
      Most psychiatrists know very well what the causes are.  They also recognise the impossibilty of changing the world so that prevailing paradigm minimises the ill effects on mental patients.
      My comments to Paranoid were about his own particular circumstances.  There have been plenty of instances where family members have caused breakdowns in other members of the same family, but the workplace thing is widespread.

    • acotrel says:

      09:54pm | 14/10/11

      @marley
      ‘We can help people with counselling and psychotherapy, and sometimes with drugs,’

      You’ve mentioned three things.  I understand psychological counselling, and medication.  By psychotherapy, are you referring to electroconvulsive treatment and surgery ?  You say we can sometimes help people with drugs. -  Medication is the major treatment used to treat the mentally ill these days. Psychological counselling is not readily available in most areas.  We don’t train many clinical psychologists, and the profession is sometimes almost treated as being second rate.  The Gillard government has moved funding away from this critical area.  The other two treatments I mentioned are very rare these days.

    • acotrel says:

      10:09pm | 14/10/11

      @jf
      ’ That doesn’t mean that their suffering should be left unrelieved simply so we can benefit from their genius or “learn from them”. ‘

      I don’t believe that listening to them equates with exploiting their illnesses.
      I believe it was the composer Schumann who jumped into a river to commit suicide ?  He had composed beautiful music for many years while suffering mental illness.  He had his second breakdown, and never composed another piece. - Might have been Rachmaninov , he was another.  Neil Young’s music is largely a result of his schizophrenia.  Artie Shaw had to give up music because it was the thing he obsessed about during his illness.
      If you had met Sir Isaac Newton and listened to his ravings, you would probably have become a leader in the scientific world ! And I believe that Albert Einstein was similarly afflicted. If you actually listen and understand what’s said by these people, some of it is pretty spectacular, especially when they are having an episode.

    • PsychoHyena says:

      02:24pm | 15/10/11

      Acotrel is actually right and here is why: Geniuses can see the world for what it is and what it should be, when they try to tell others of this they get shot down. Acotrel isn’t saying that all mentally ill people are geniuses, rather that geniuses tend to be “mentally ill”.

      I remember a number of discussions I had with people regarding the ability to transform brain-waves into electronic signals, e.g. turning a vehicle on and off. I was laughed at and humiliated, 10 years on and we are 90% of the way there with improvements in technology. There is now software out there that using an EEG can translate thoughts into the written word so that people who have lost the ability to communicate can communicate.

      I hypothesised the ability to power vehicles by converting water into its atomic components and using this to power vehicles, once again laughed at, and I read now about this very technology being pursued. I wrote papers and everything on this throughout high-school and college.

      Even at work I have come up with processes that are scorned, however a few months down the track it is found that if those processes had been implemented it would have avoided problems that then arise.

      So yes, many people call me insane, geniuses are those that aren’t afraid to look past Occam’s razor.

    • Wendy says:

      02:28pm | 15/10/11

      For the first time I actually agree with you Acotrel.
      I experienced postnatal depression which began as the usual sadness and then I started to wonder if I was really here or whether I was in a coma and my experience wasn’t real. It was frightening and I couldn’t snap out of it. The hormones wore off and I was lucky to just go back to my happy bubbly personality. I look back now and I still wonder though if I’m really here and whether this reality is real or the other one is. It’s strange and interesting at the same time.

    • Mahhrat says:

      05:59am | 14/10/11

      Awesome article.  Nothing to add but support.

      Reply

    • stephen says:

      08:09am | 14/10/11

      That you were unsure of the language of sanity is always what people say about these stigmas of mental health, but what they’re really afraid of is that deep down, when we’re on our own, we may be all just a little crackers, which, of course, in this country, where someone who mows his/her lawn unmechanically is classed as a fool, is not too healthy for our inclusiveness, and perhaps inclusiveness, or what we feel is our ‘pack’, is part of the problem, and that if many of us spent a little more time on our own, we may not have to glean a second opinion on our mind.
      We have become, in my opinion, too social, and everything we do we now feel the need for a context.

      Reply

    • acotrel says:

      09:48am | 14/10/11

      @Stephem
      Some of us worry too much !  It’s easy to ask yourself if you are in touch with reality, and you can ask other people if they think you are mad.  The stigma thing is only a problem if you watch period movies, and see mad people portrayed as raving lunatics.  The truth is, that is rarely the way mental illnesses present themselves these days. The main thing is to get help for anyone around you who is showing symptoms, before they have the breakdown.

    • Ashley says:

      01:39pm | 16/10/11

      @ Stephen , well said. The comments and article on this thread are quite enlightening.  Its a fine line between stability/sanity and a malaise of the psyche. And in some cases where people are labelled metally ill, the ’ are you sure its a ‘me’ problem ’ is a valid and justifiable question.

    • JS says:

      10:45am | 14/10/11

      *SIGH* political correctness has so much to answer for.

      When we are all too afraid to discuss such an important topic for fear of offending someone we know it’s gone too far. Its time to teach people to stop being such princesses, its not all about you.

      Be offended, but we are having this conversation. whether you like it or not.

      Reply

    • acotrel says:

      11:00am | 14/10/11

      @Tory
      I’d never TELL a mentally ill person to take their medication !  However I would ASK them whether they have taken their medication. Never appear as a threat, you don’t know what you are dealing with !

      Reply

    • Gomez12 says:

      03:54pm | 14/10/11

      Yet my best mate in the world is the one person who wasn’t afraid to risk my wrath and flat out told me to take my pills - And when I responded that I wasn’t on pills - she made me go get some.

      Best thing that ever happened to me. Life’s a whole lot easier, more pleasant and more rational when you don’t have to try and deal with the things your mind just flat out makes up. 

      I take my pills every day - I don’t care who knows I’m on them and am always very open about it - Mainly because people seem afraid to ask, they don’t want to offend me, but I want people to know that it’s just medication, it sorts out my imbalances the same way panadol deals with headaches. There should be no stigma attached to it.

    • acotrel says:

      10:23pm | 14/10/11

      @Gomez12
      There is no shame in taking medication.  As we get older it is an inescapable part of life.  You just do what you need to do, to maintain your quality of life. What I was referring to in my coment to Tory was the possibility of firing up someone who is paranoid, by giving an order.  You never know how that can be interpreted by someone having an episode.

    • Ross H says:

      12:08pm | 14/10/11

      I’m seeing several themes coming through here.

      When you are released from psychiatric care, at least in the public system, you are NOT ‘well’. Often you are little more than judged not to be a danger to yourself or others. It’s a numbers game due to lack of bed space. Been there, done that. But there is still this b.s. idea in workplaces that having been hospitalised, you must now therefore be ‘well.’ I spent two years trying to get my then-employer to acknowledge I had a disability - my mental health. And I conspicuously failed to do so. Yet the employer - the Aust Bureau of Statistics - used that disability to get me invalided out. My file had plenty of these ‘should be well’ comments because I had been hospitalised. Making it worse, workers comp case linked the mental health problems to the workplace, only for the ABS to blatantly deny that finding ever occurred. And nobody in authority anywhere gave a rats arse about that unlawful denial. And ever so much of that nonsense extended from this hospitalisation = cured idea.

      There is still a real stigma attached to mental health issues and do not let anyone ever tell you otherwise. At the Civic Pub in Canberra, tonight, 7:30 pm, (14/10) there is a comedy gig as part of ACT Mental Health Week designed to help remove that stigma, featuring new comics with mental health histories.

      Reply

    • Ian Campbell says:

      01:35pm | 14/10/11

      Thanks for the article Tory.

      My names Ian and I suffer from depression and anxiety.

      If a situation becomes difficult I have a panic attack. I am 56 yo but, unfortunately, I was not diagnosed until 6 years ago by a doctor who took the time to ask questions and actually cared. I see a psychologist and through her have found my problems go back to when I was 5 yo. However I have very little memory of my life up when I was 13 or 14 and the memories that do come back are not good.

      I lived in a time when talking about mental illness was taboo, so I told only a couple of people about my illness. Then 2 years ago I had a breakdown and had to let people know my problems. I was shocked that almost all those I would have called close friends couldn’t deal with it and one by they were gone as friends. Now I have no one I would call a close friend and am to afraid to try and make new friends. So I when it’s all to much I just crawl back into my bubble. It’s not a happy place but it is a safe place from the outside world. It’s a big step backwards though and almost always leads to thoughts of suicide.

      I won’t be able to move forward until I can deal with the past. Even then I don’t believe society will accept me.

      Reply

    • acotrel says:

      09:30pm | 14/10/11

      @Ian
      I believe you should try to develop more faith in yourself, and work on building your self-esteem.  It’s easy to go around with the word ‘victim’ clearly written on your face.  Getting involved in social activities can help if you do it slowly.  Perhaps some volunteer work, such as serving food for one of the charities ? The thing to remember is that your illness is all in your mind and it is better if you are not self-absorbed.

    • Grant Dewar says:

      03:30pm | 14/10/11

      @Ian thanks for speaking up.  For a great peer support program for people who have a similar experience in mental health contact GROW Australia 1800 558 268 or http://www.grow.net.au it is a program developed by people with mental health problems for those with mental health problems

      Reply

    • Ian Campbell says:

      07:08pm | 14/10/11

      @Grant thanks for that, I will have a look at the site.

    • Markus says:

      08:24pm | 14/10/11

      @Tory,

      Well and clearly said. People with mental illness are just people. Some are geniuses, most are not. They’re just people. All my support to you.

      Reply

    • acotrel says:

      09:36pm | 14/10/11

      @markus
      I suggest the most likely candidates for a stress related breakdown, are the highly intelligent, sensitive, conscientious, and caring people !  Once they are ill they can appear to be slow because of their unusual thought processes.

    • baal says:

      11:09am | 15/10/11

      @Tory.
      I wish you luck but just remember people like to say they are supportive until they have too change their lives around a damaged person.
      After 19 years of suffering I have lost faith in my fellow humans for the most part a
      nd know that people for the most part really do not care as much as they claim.
      Such is life.

      Reply

    • Jailyn says:

      10:21am | 17/10/11

      I was so confused about what to buy, but this makes it undesrtadnalbe.

      Reply
 
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