I think I am very confused about the idea of mental illnesses.
First of all to understand an illness, we need a ideal of health to compare to. Where does this ideal come from and what it is? When I come to LW (or even Reddit) I feel like i am depressed compared to you because I never really had much of a goals or passions or interests in life, so generally being anhedonic and alway have to keep fighting boredom. On the other hand, as far as I can tell, my attitude is not different from that of my parents and family members, I was raised so that they told me life is hard and it is about survival, not fun, and indeed my parents had their two hands full and more with just securing a comfortable middle class existence, they did not really have any energy for personal goals. If my father was alive and I would complain about boredom, he would say "you have it too good, when I was 37 I was standing 12 hours on top of a ladder painting houses so that we can pay off our flat" and things like that. So compared to LW, I am depressed, compared to my family norm, I am normal (except having it too good, obviously). The point is, there is no cast in stone definition of what is healthy. It may depend on culture, on age, on time, on a lot of things how we define the healthy.
A decade or two ago I had a strong interest in Buddhism. And my teachers were of the opinion that what most people consider healthy, in the sense of happiness / non-depression, is still a very low level and we can improve on that. They kept quoting Freud, saying the goal of psychotherapy is to turn abnormally unhappy people into normally happy people. And they claimed to take over from there, to try to turn people into being radiantly happy, through meditation. Their philosophy was that only complete happiness can be defined as healthy.
So, the point is, we do not have a "cast in stone" level of mental functioning that we could call unanimously "healthy", so we cannot really objectively define mental illness as a comparison to that. Pretty much it seems like the question of whether people like me or my parents / family members are depressed or not just depends on whether they want to change their mood or not , seek therapy or not. They can be seen as pretty normal, in a society that not too "dreamy" (i.e. not US-type "follow your dreams" type of society, but a more grim one).
Another weird issue is blame, stigma etc. In my childhood it was very confusing. It is the natural instict of children to be cruel assholes to people who seem to have some deficiency or problem. And then they tried to teach us e.g. "do not make fun of this man who sits in a wheelchair, he cannot help being disabled" so we tried to learn the distinction that sometimes you can be an ass to people, if it is about something they can help, but sometimes not, when it is about something they cannot help. As children we developed roughly this model, a milder defect is usually something that "can be helped" and thus you can be an ass to people who have it, and a harder defect is something "cannot be helped" and thus to be met with compassion. So for example we could make fun of a child for being clumsy, but not if a neurological disorder made him very clumsy. We could call a child stupid as long as he was only little stupid, but someone with serious mental retardation, very low IQ not. Our model of illness was largely a more severe version of normal defects, the kind of normal defects we made each other fun of for. Or bullied each other for verbally. When we grew up, of course we stopped behaving like little pricks about it. Still the essential distinction stayed there: if, for example, a man is only somewhat stupid, you can think "haha what an idiot" and consider this an insult or censure. If a man is very ,very stupid, clearly mentally retarded, then not, then your appropriate atttude is compassion, not censure. Later on I learned that there is no reason why not think that moderate versions of the same problem do not work through the same pathways as illness. So this distinction is not tenable. Since then, I cannot tell the difference if a person is simply an ass or has antisocial personality disorder, is a fucking coward or suffers from anxiety disorders and panic attacks, and so on. I can no longer tell the difference what could rightfully drawn criticism, scorn, censure, and what should be met with compassion. The only consistent solution would be to consider virtually everything an illness, and think "he cannot help being what he is" and meet everything with compassion, but that is an entirely unusual and weird human norm. It is not how people normally feel. If for example a soldier runs away from battle leaving his comrades in the shit, they will not think "poor fellow has anxiety disorder and panic attacks". They will think "fucking coward". This is the normal human attitude. And we are trying to wall it off into illnesses that "he cannot help being what he is" in which cases we do not use this normal attitude but more like think with compassion and understanding. But this distinction is not really tenable. Ultimately the illness and non-illness are very much the same thing. So what is the truly proper attitude? Give up all kinds of censure and criticism? I am really confused by this.
"But this distinction is not really tenable. Ultimately the illness and non-illness are very much the same thing", Sure, if you consider having not having use of both of your legs to be 'very much the same thing' as having two perfectly working legs.
I'd appreciate feedback on optimizing a blog post that shares about my mental illness and popularizes future-oriented thinking to a broad audience. I'm using story-telling as the driver of the narrative, and sprinkling in elements of rational thinking, such as hyperbolic discounting, mental maps, and future-oriented thinking, in a strategic way. The target audience is college-age youth and young adults. Any suggestions for what works well, and what can be improved would be welcomed! The blog draft itself is below the line.
P.S. For context, the blog is part of a broader project, Intentional Insights, aimed at promoting rationality to a broad audience, as I described in this LW discussion post. To do so, we couch rationality in the language of self-improvement and present it in a narrative style.
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Coming Out of the Mental Health Closet
My hand jerked back, as if the computer mouse had turned into a real mouse. I just couldn’t do it. Would they think I am crazy? Would they whisper behind my back? Would they never trust me again? These are the kinds of anxious thoughts that ran through my head as I was about to post on my Facebook profile revealing my mental illness to my Facebook friends, about 6 months after my condition began.
I really wanted to share much earlier about my mental illness, a mood disorder characterized by high anxiety, sudden and extreme fatigue, and panic attacks. It would have felt great to be genuinely authentic with people in my life, and not hide who I am. Plus, I would have been proud to contribute to overcoming the stigma against mental illness in our society, especially since this stigma impacts me on such a personal level.
Ironically, the very stigma against mental illness, combined with my own excessive anxiety response, made it very hard for me to share. I was really anxious about whether friends and acquaintances would turn away from me. I was also very concerned about the impact on my professional career of sharing publicly, due to the stigma in academia against mental illness, including at my workplace, Ohio State, as my colleague and fellow professor described in his article.
Whenever the thought of telling others entered my mind, I felt a wave of anxiety pass through me. My head began to pound, my heart sped up, my breathing became fast and shallow, almost like I was suffocating. If I didn’t catch it in time, the anxiety could lead to a full-blown panic attack, or sudden and extreme fatigue, with my body collapsing in place. Not a pretty picture.
Still, I did eventually start discussing my mental illness with some very close friends who I was very confident would support me. And one conversation really challenged my mental map, in other words how I perceive reality, about sharing my story of mental illness.
My friend told me something that really struck me, namely his perspective about how great would it be if all people who needed professional help with their mental health actually went to get such help. One of the main obstacles, as research shows, is the stigma against mental health. We discussed how one of the best ways to deal with such stigma is for well-functioning people with mental illness to come out of the closet about their condition.
Well, I am one of these well-functioning people. I have a great job and do it well, have wonderful relationships, and participate in all sorts of civic activities. The vast majority of people who know me don’t realize I suffer from a mental illness.
That conversation motivated me to think seriously through the roadblocks thrown up by the emotional part of my brain. Previously, I never sat down for a few minutes and forced myself to think what good things might happen if I pushed past all the anxiety and stress of telling people in my life about my mental illness.
I realized that I was just flinching away, scared of the short-term pain of rejection and not thinking about the long-term benefits to me and to others of sharing my story. I was falling for a thinking error that scientists call hyperbolic discounting, a reluctance to make short-term sacrifices for much higher long-term rewards.
To combat this problem, I imagined what world I wanted to live in a year from now – one where I shared about this situation now on my Facebook profile, or one where I did not. This approach is based on research showing that future-oriented thinking is very helpful for dealing with thinking errors associated with focusing on the present.
In the world where I would share right now about my condition, I would be very anxious about what people think of me. Anytime I saw someone who found out for the first time, I would be afraid about the impact on that person’s opinion of me. I would be watching her or his behavior closely for signs of distancing from me. And this would not only be my anxiety: I was quite confident that some people would not want to associate with me due to my mental illness. However, over time, this close watching and anxious thoughts would diminish. All the people who knew me previously would find out. All new people who met met would learn about my condition, since I would not keep it a secret. I would make the kind of difference I wanted to make in the world by fighting mental stigma in our society, and especially in academia. Just as important, it would be a huge burden off my back to not hide myself and be authentic with people in my life.
I imagined a second world. I would continue to hide my mental health condition from everyone but a few close friends. I would always have to keep this secret under wraps, and worry about people finding out about it. I would not be making the kind of impact on our society that I knew I would be able to make. And likely, people would find out about it anyway, whether if I chose to share about it or some other way, and I would get all the negative consequences later.
Based on this comparison, I saw that the first world was much more attractive to me. So I decided to take the plunge, and made a plan to share about the situation publicly. As part of doing so, I made that Facebook post. I had such a good reaction from my Facebook friends that I decided to make the post publicly available on my Facebook to all, not only my friends. Moreover, I decided to become an activist in talking about my mental condition publicly, as in this essay that you are reading.
What can you do?
So how can you apply this story to your life? Whether you want to come out of the closet to people in your life about some unpleasant news, or more broadly overcome the short-term emotional pain of taking an action that would help you achieve your long-term goals, here are some strategies.
1) Consider the world where you want to live a year from now. What would the world look like if you take the action? What would it look like if you did not take the action?
2) Evaluate all the important costs and benefits of each world. What world looks the most attractive a year from now?
3) Decide on the actions needed to get to that world, make a plan, and take the plunge. Be flexible about revising your plan based on new information such as reactions from others, as I did regarding sharing about my own condition.
What do you think?
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Thanks in advance for your feedback and suggestions on optimizing the post!