Politics and Mental Illness
In a time where everything from the car you drive to the beer you drink is political, when you can’t even pick up lunch without a debate about the carbon footprint of the cars idling in the drive-through lane at Chik-Fil-A, it wouldn’t be surprising if someone made psychiatric disorders political, too. Well, it’s already been done.
Political rhetoric is all about biased information and the language used to present it. In an era beset with misinformation and malleable truth, it’s likely that language is being twisted into contortions that make meaning questionable.
Diagnosing mental illness, too, depends a lot on language. All is dependent on self-report by the patient. There are no signs of an illness like depression, except for maybe affect, so all the psychiatrist has is a checklist of symptoms and the faith the patient is telling the truth. Just like in politics, you can manipulate truth by manipulating words.
And the manipulation of words is rife in modern psychiatry. On the one hand, people in the mental health business want us to accept that all mental illnesses are biologically based diseases treatable with medication. We equate mental illness with physical illness and write and fill prescriptions to treat it. This redefinition of mental illness from what it was just decades ago has been convincing even as rates of mental illness have skyrocketed. Perhaps this is because there’s money in it and diagnostic criteria have loosened considerably.
On the other hand, probably because so many people who fall into the category of the worried well have been diagnosed and put on meds, the mental health business now uses safer words to describe the afflicted. What used to be called patients are now referred to as clients or consumers, as if someone chose bipolar disorder the way they choose a new pair of pants. This contradicts the biological model, but it certainly attempts to normalize diseases of the mind.
But they’re not normal. They’re diseases that can affect people’s behavior and judgment. So while some seek to make mental illness soft or normal, many in the political realm use it to pathologize their opponents. During the Trump administration countless pundits and opposition figures labeled the President mentally unstable and sought to remove him from office under the 25th amendment, as if people with a vested interest in the President’s downfall had the experience, qualifications, or capacity to make such a diagnosis.
But we all know crazy when we see it, don’t we?
This is a terribly dangerous game we play. Besides labeling individuals on the opposite side crazy, we’ve begun to discredit entire political movements as mentally ill, and basic political difference as dysfunctional. I hear over and over again that the whole system is bipolar. Two sides out of alignment with each other. But the system couldn’t be more unipolar on each side.
We with bipolar disorder swing gleefully and desperately between mania and depression, back and forth, with periods of remission that feel like an enormous compromise in which we sit in the middle between the two poles, restful, haunted by the fear that another swing will surely come, as we grasp at what we can, resolute and prepared to get through it once again. The country today is none of that. It’s all one side verses the other, and if all else fails, we weaponize mental illness and declare the other side incapacitated.
I’m uneasy with these trends in mental health. Propagating the mistaken belief that mental illness is normal, as if cancer is normal or a cavity is normal, and then using accusations of mental illness as weapons to destroy our opponents, seems disingenuous. We can’t have it both ways, and there’s immeasurable risk in pitting one idea against the other - risk to individuals with mental illness, the people who care for them, and the possibility of truly healing, both in the activities of daily life and the all-encompassing world of politics.
This risk is pervasive as we try to make something abnormal normal. Suddenly, any outrageous idea or behavior stands equal to objective truth. All becomes relative, and lies supplant the certain. We with severe mental illness and the families who care for us know the evil in this thinking. You can’t be a little crazy, and crazy is not OK.
Evil, too, is the trend to use accusations of mental illness to unseat our opponents. When we use mental illness to demonize the opposition, we by default demonize mental illness itself. This can have grave political consequences, ratcheting up the deadly sport of gaining the upper hand by any means necessary. When the Nazis conquered the Alsace in 1940 they starved the residents of the psychiatric hospital. Residents, many of them declared mentally ill for mere political expediency, were discarded as worthless and burdensome.
In this world of extremes that we live in, let’s hope this remains an extreme example.