How People Treat Mental Illness vs. Physical Illness.

By Haejin Park over at Buzz Feed.

Suicide is not selfish.

I was introduced to Feminista Jones through a podcast I listened to featuring her. She's a sex-positive, intersectional feminist and black rights activist, who works in community activism and social support systems.

In her interview she talks about mental health and suicide, and mentions a past article of hers I'd like to link to, and talk about here. Jones mentions a colleague who recently died by suicide, and how disappointed she was to see the online community victim-blame and refer to her suicide as "selfish."

Jones discusses the issue from the perspective of a black woman, and describes the ways in which the culture of being a black woman in America is extremely loaded:

... for Black women, experiences with depression and trauma are often directly related to our being women and being Black and carrying the weight of this duality in a society that “others” both identities. Factor in religious expectations that require "more faith," intraracial expectations of loyalty and secrecy (when experiencing abuse), and the persistent disconnect between Black people and mental health care, there are so many things to consider when a Black woman takes her own life.

Intersectionality is an important part of not only a feminist analysis of the world, but of a considered, logical one. Context exists. It matters. There have been numerous articles and media coverage of PTSD and the black experience over the last few months, especially in relation to state-violence and gun violence. What about gender and sexual violence? What about being a black woman, who experiences both of these things but might also live with a disability, or face homophobia? Everything matters.

Personally, I have a lot of difficulty reading pieces about suicide that are written by people outside of the mental illness community. I don't think suicide is selfish. I think it's a painful result of a really painful time. It's seen as the only out. It's the only solace. I get that. It's turning it all off. Lights out. Peace.

Feminist Jones describes this well, here she's comparing losing someone to suicide as opposed to cancer:

There is something different about a person committing suicide, though, which elicits a different, almost angry feeling of betrayal. Many people think it is selfish to end your life when so many people love you, rely on you, need and want you around, and can’t imagine their lives without you. The angry feelings are often centred on what people need from you… for themselves. Some people make your life, your whole being, and your entire purpose more about what works to make their own lives better. People are concerned more about what they can no longer take from you and less about whether or not you were living your life happily for yourself. When someone takes his/her own life, that person is posthumously blamed for causing so many other people pain with little recognition or empathy for the pain that likely led to the suicide itself.

She goes on to refer to it as an act of "freedom and mercy" for the self, and is critical of how unsympathetic some are when discussing someone dying by suicide.

No one has the right to determine what another person should endure. We don’t get to tell other people that “it will be OK” and they “need to have more faith”. We have no right to tell someone that their pain isn’t as bad as others, thus negating their experiences and isolating them further away from actually getting help that might make things better. We don’t get to make other people’s lives about US and demand that people live for us and our wants and needs. We have no permission to dictate the choices of others and expect that their choices consider our feelings before their own. That is the epitome of selfishness and we need to end that way of thinking.

She ends her peace in a devastatingly poignant statement:

I’ll leave you with this: When I hear “Suicide is selfish,” I think of every Black woman held in bondage, whose body was ravaged daily, whose womb was exploited for profit, whose children were stolen, whose back was lashed for not meeting the requirements of her owner, who was sterilized, and whose mind was irreparably destroyed after years of torture who took the only path of freedom for which her earthly body could not be further punished.

 I can't speak to the black experience. I can only speak to my own variations of pain.

And pain, kills. And wanting to escape that pain, should not be faulted. Especially when the services and the accommodations offered to us to help live with that pain are lacking and in most cases, all-together non-existent.

If you want me to live, help me.

If you can't help me, let me die.

If you can't let me die, try and empathise with why I would want to.

It all brings me back to a quote from Martha Manning's Undercurrents:

I didn't want to die because I hated myself; I wanted to die because I loved myself enough to want this pain to end.

I know that must be really dark and unimaginable for a healthy person to understand, but at least try.

Quotes: Martha Manning in Undercurrents.

All from Undercurrents.

Undercurrents: A Life Beneath the Surface.

I just finished Undercurrents: A Life Beneath the Surface by Martha Manning. I'd seen the book on a few mental-illness themed book lists, I read it in under a week, it's a pretty quick read. It's a memoir written by a woman who by day is a psychologist. A woman in her 30's who slowly becomes increasingly depressed, as expressed in her journal. There are a ton of quotes that I highlighted, so I'm going to write them here, and respond to them.

She talks about the initial conversations she had with friends, and how their attempts at encouragement often alienated her even more.

I love them for caring, but I want to run from it. I have lost their language, their facility with words that convey feelings.

I know language, and the ability to really express what I'm feeling, and what how it feels is something I've struggled with. I kept reading, and I became fascinated by language and learning as much as I could vocabulary wise in order to be able to represent my struggle successfully. But when I'm down, when the depression sinks in, that part of me shuts off.

Some struggles are so solitary that they drown in words.

I often try and use the term guttural. It becomes so deeply basic, so harshly, brutally, pre-human. How do you represent it? Manning references physical pain, and a swollen ankle as something that almost relieved those around her:

It is a preference relief to have a "real," visible hurt. A hurt that people can recognize and understand. They wince in sympathy and know just what to do and what not to do. People can deal with this kind of pain. It all makes sense.

I can relate tot his, tremendously. Sometimes I fantasize about physically hurting myself, in order to have a physical, exterior focus to my pain. I remember as a teenager often pushing things too far when it came to pain toleration to the point where it would disturb my friends. But for me, it came with a kind of satisfaction. I relished it.

Manning also describes her relationship to suicidal ideation that sounds very similar to mine:

I find myself preoccupied with thoughts of death. In some moment of emptiness or pain, an image of dying comes to me: a car accident, a heart attack, a vicious and quick-killing disease. In the psychiatric vernacular these are called "passive thoughts of death." But in my mind these thoughts are quite active. Rather than feeling the revulsion and fear that would have resulted from thinking about these things several months ago, now I find them strangely comforting.

I would never kill myself intentionally. I couldn't do that to my family, my friends... But to have fate step in and give me a shove, that's a different matter. Then I have the exit, without the guilt. I am ashamed of myself for thinking like this. But more than anything, I am frightened that it makes me feel so much better to think about it. Somehow it eases the terror, the sense and I am condemned eternally to this hell.

And she describes how an understanding of suicide isn't necessarily hate and anger based`:

I don't want to die because I hate myself. I want to die because, on some level, I love myself enough to have compassion for this suffering and to want to see it end. Like the spy with the cyanide capsule tucked in a secret pocket, I comfort myself with the thought that is this ordeal gets beyond bearing, there is a release from it all.

This is the quote that initially had me googling her name:

Depression is such a cruel punishment. There are no fevers, no rashes, no blood tests to send people scurrying in concern. Just the slow erosion of the self, as insidious as any cancer. And, like caner, it is essentially a solidarity experience. A room in hell with only your name on the door. I realize that every person, at some point, takes up residence in one or another of these rooms. But that realization offers no great comfort now.

Once you start understanding your depression, coming to terms with it remains a struggle. Sometimes, I feel as if my depression is all that I am.

I think about the difference between having something and being something. They are only words, but I'm stuck by how much they convey about the manner in which the short-hand of mental illness reduces the essence of people in ways that labels for other serious illness do not.

How much of this disease is me? How much of it is my character? Are there any redeeming qualities to the disease?

All the romantic nonsense about depression somehow making one into a creature of unique sensibilities is easy to agree with when I feel good. Then I'm sharper, superior for having weathered something terribly difficult, or just plain pleased at having narrowly gotten away with something once again--like the snow day after the night's homework I didn't do. All of it stands up to the light, but it's bullshit in the shadows. I don't care about unique sensibilities. All I care about is surviving. My goal in life is just to get through the days.

Interesting comment on religion and existential dread:

She tells me that in AA they say that religion is for people who are afraid of going to hell. Spirituality is for people who have already been there.

A truth for me:

... my baseline for awful will never be the same.

The value of quiet. Something I was just talking to Ranjana about. How it isn't necessarily only a coping mechanism, but something that I enjoy.

I find myself growing quieter over time. But I'm so unused to it that I still equal it with being overwhelmed or depressed--a default in the continual cycle of inundation and backing off. And yet the quiet is part of who I am. Not just a result of the circuits blowing and the computer shutting down. It has merit all by itself.

The book definitely has interesting passages that spoke to me. Last weekend while staying with my brother, a friend of my sister-in-law's came over. She was discussing the state of her 20 year-old-son, who doctor's say was pushed into some type of psychosis due to extreme drug use. She said after hospitalization and electro-shock therapy, he is now back at home.

What I knew as electro-shock therapy is now referred to as electroconvulsive therapy or ECT. This was a shock to me, since I didn't know this was still in use. I thought it was out-dated and barbaric, since it's often the way it's represented in books and film that discuss mental-illness-related hospitalization. I've never seen One Flew Over The Cuckoo's Nest, but I know the seminal electro-shock scene well. Funnily enough, I just saw an article about how much damage was done to the reputation of ECT because of it.

Manning's book also goes into detail about ECT. She was hospitalized (willingly) and underwent five treatments. It seems to be the turning point of her depression. This affected me in a way I didn't expect. It's almost as if it opened a window. Maybe if things continue to be bad, it's an option for me.

It comes with risks. Memory loss. Confusion. But potentially also relief. It has a success rate of about 50%. And it is not a cure, but a treatment.

Historically it also seems to have been a treatment for "hysteria," if you're at all well-versed in feminist literature, you know that hysteria was a catch-all when treating women medically for hundreds of years, and was often used to silence and discredit women, and often hospitalize them against their will.

I'm going to ask my doctor about it when I see him next. It might be a viable option if things get worse.

"Depression is such a cruel punishment."

Just came across this quote from Undercurrents: A Life Beneath the Surface by Martha Manning.

Depression is such a cruel punishment. There are no fevers, no rashes, no blood tests to send people scurrying in concern. Just the slow erosion of the self, as insidious as any cancer. And, like cancer, it is essentially a solitary experience. A room in hell with only your name on the door.

I now desperately want to read this book.