A Personal Plea: Two Kinds of Mental Illness


By Anonymous

There are two kinds of mental illness.

1. Mental illness as a personal battle with your own mind.

2. Mental illness as an assigned social status.

Many people in America have the first kind of mental illness. Far fewer experience the second.

Both occur on a spectrum. Depression, inattention, anxiety, paranoia, addiction, obsession… they run from mild to extreme. Lots of people live with these difficulties, even as constant companions, and still manage to live outwardly “normal” lives. Their difficulties are mostly invisible to others, because the struggle is internal.

These people, the ones who “pass for normal,” sometimes experience the second kind of mental illness: mental illness as a social status.

They bump up against it when people find out they take pills to help manage their thoughts, and someone sneers. Or when they go on a job interview and have to explain away a hole in their work history, from that time they just left a job out of overwhelm without having another lined up. Or they go to an emergency room for physical pain, only to be wrongly sent away when a doctor sees a mental health diagnosis in their medical history.

But there are also people who are assigned the social status of “mentally ill” on a more continuous, longer term basis. People who cannot work and get approved for social security disability help. People living in group homes. People living on the streets or confined to state hospitals.

A lot of people think they understand mental illness if they experience the first kind–the individual struggle. But they do not necessarily understand the second kind.

When society labels someone permanently mentally ill, the prejudice increases exponentially. The struggles aren’t just internal, they are external, too. And the external, visible battles make it even easier for society to recognize you as “other” and despise you.

For some people: The fight to keep a roof over your head and stay clean. The fight to afford socially acceptable clothing. The fight to stay fit and trim, because the doctors force you to take the pills, because you’re on SSD so you have to follow treatment plans… and now the pills made you gain 50, 80, 150 pounds.

And so for these people, multiple prejudices–prejudices against poverty, against obesity, against homelessness, and yes, against symptoms themselves like hallucinations and hopelessness and mania and compulsions– wrap themselves together into one huge monster. The monster of Stigma.

They are designated a permanent underclass. And they are despised by much of society.

Once people have been assigned by society to this (supposedly) permanent underclass, it is often difficult to escape.

These people, I think–the ones who experience mental illness as a pervasive assigned social status–these are the people the rest of society (including people who only experience mental illness as a personal struggle) are willing to sacrifice.

When a mass shooting happens and people say, “We have to keep guns out of the hands of the mentally ill,” I sense that they are thinking of THOSE people. The REALLY ill ones. The REALLY crazy ones.

When legislators write bills to give “the mentally ill” fewer HIPAA privacy rights, it’s with THOSE people in mind.

The problem is… THOSE people are really not as different from everyone else as society would like to believe.

They’re not really more dangerous.
They’re not really more stupid.
They’re not really less human.
And they’re not really less deserving of their human and civil rights.

Mental illness–whether the personal struggle kind or the socially assigned status kind–just is not a good proxy for character. It’s not a good stand-in for determining dangerousness. And it’s not a good method of discrimination.

“The dangerous mentally ill” is a meaningless phrase, in discussions about gun safety.

To keep society safe, what we have to do is keep guns out of the hands of dangerous people. Period. Regardless of whether that dangerous person has a mental illness or not. It’s simply irrelevant to add the words mental illness. Saying “we have to keep guns out of the hands of the dangerously mentally ill” is like saying “we have to keep guns out of the hands of dangerous cancer patients.” It’s nonsense. It’s like, okay, yeah… and shouldn’t we also keep guns out of the hands of dangerous non-cancer patients? You think?

Except it’s worse than nonsense. Because it’s more like saying, “We have to keep guns out of the hands of dangerous Muslims.” Maybe you threw the word dangerous in there to indicate you don’t think ALL Muslims are dangerous. But a Muslim person might rightly wonder why you had to single out Muslims at all.

And meanwhile, other people might hear you singling Muslims out, and the already prejudiced, harmful association of Muslims with danger gets reinforced.

It’s the same with mental illness. Stop singling us out. Please. Please.

The truth is mental illness does not help you identify danger. Not the first kind of mental illness, and not the second kind either. Just like a person wearing a hijab does not indicate danger. Just like a person wearing a cross doesn’t indicate danger. Just like having red hair doesn’t indicate danger. Just like being a cancer patient doesn’t indicate danger.

So this is my plea:

Please, please stop adding to the burdens of people in that socially assigned class of mental illness. They have enough struggles without also being perceived as dangerous. They have enough fights without also having to fight for their rights to privacy and to equal treatment under the law.

And do not assume that just because you know one kind of mental illness, the personal struggle kind, you understand it all.


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