On the Gender Politics of Mental Illness

In case you can't tell, I am a vocal feminist and also really into mental health.

So today I think we're gonna sit down and have a conversation about the gender politics of mental illness.

Depression and anxiety are both, according to estimates, far more prevalent in women than men.  In fact, hysteria, a previously-accepted term for what we now typically associate with anxiety disorders, comes from the Greek hysterikos, "of the womb."  We typically associate depression and stress with feminine traits.  According to the World Health Organization, women are more likely than men to be diagnosed with depression and prescribed psychoactive medications than men, even when two patients score similarly on standardized depression-screening scales.*

Statistically, however, men are 4 times more likely to commit suicide in the United States than women.**  Clearly, the perceived difference in mental illness does not account for this massive difference in suicide rates -- if women are always more depressed, why are men more likely to kill themselves?

I think a large part of it comes down to the fact that mental illness and mental distress are seen as typically feminine.  As a result, if a woman is experiencing what is considered a typical feminine flaw, they are encouraged to seek help.  Men, however, are socialized to avoid discussion of perceived emotional weaknesses, and as such are taught to suppress feelings of depression and anxiety, rather than seeking treatment or coping mechanisms.

Around the world, however, there are also a number of conditions which create situations in which women are, more often than men, exposed to psychologically-triggering experiences that can manifest in mental illness -- social subjugation, sexual assault, and the stresses of childcare and family provision are all highly-correlated with mental illness, and these problems are more prevalent for women, across the spectrum.

Whether the statistics tell the full story or not, there seems to be a significant interplay between traditional gender roles and perceptions of mental illness, and that presents problematically in the representation of both females and those individuals with mental illness.

Yours,

Rachel Leigh

*http://www.who.int/mental_health/prevention/genderwomen/en/

**http://www.who.int/mental_health/prevention/suicide_rates/en/

On Mental Illness and Identity

Watching a PBS Frontline documentary about the rise in diagnoses and medications for young children with mental illness, I was caught by something.

This documentary, which is supposed to objectively address the controversy surrounding early childhood mental healthcare (particularly early exposure to psychoactive medications) and which featured psychologists, and psychiatrists, experts in the field, was making a glaring error.

"My patients were bipolar."

Your patients are not bipolar.  For a lot of people struggling with mental illness, the recognition that they do not have to be defined by their battles, is a massive step forward in recovery or control.  You would never tell a cancer patient that their diagnosis made THEM cancerous.  We recognize that an illness does not have to fundamentally define the person who has it.

And yet, one of the most stigmatizing things you can do to a person with mental illness is to define them by their illness.  Your patient is not bipolar.  Your patient has bipolar disorder.  Your patient may also have acne, irritable bowel syndrome, blue eyes, or a debilitating disability.  None of these things define that patient.  They are a whole, complex human being, defined by their wants and needs, goals, history, friends, family, talents, weaknesses, and more.  You provide a huge blow to their sense of self-worth to reduce them to their diagnosis.

Especially as a care provider, this kind of stigmatizing language is incredibly unacceptable.  How is a patient supposed to see themselves as something beyond their disorder if you, as the expert who is supposed to help them, cannot?

Identifiably yours,
Rachel Leigh

On Poverty and Mental Health

I've started to think that mental health is a problem for the wealthy.

I don't mean to say that it's a first world problem which doesn't matter for anybody else -- I think just the opposite.  The National Day Without Stigma was this past week, and as always, it just reminded me of how prevalent mental illness is in the world.

And what it really made me start to wonder was about what your options are if you don't have health insurance and can't afford to see anyone.  I've been working a bit with a substance abuse rehabilitation facility in Richmond, and to some extent, it's become clear that for some people, that is their option.

Mental illness does not discriminate based on age, race, or social class.  If anything, being in a poorer situation increases the chances that you will struggle with depression and anxiety.  But the options we have to help people work through these concerns are expensive -- expensive therapies, expensive drugs, appointments with expensive therapists.  The options for those who can't afford those are, statistically, homelessness, prison, substance abuse and rehabilitation (if they can afford it or it's court-ordered), or hospitalization in extreme, high-risk cases.

The fact is that we've created a system that works pretty well for those who have access to it, but we've economically-barred some of the highest-need populations from being able to access mental healthcare.

Mental health advocacy is not simply advocacy for those who have the resources.  It is also advocacy for those who have never had the resources to get the help they need.

Thinking,
Rachel Leigh

On Skins and Adolescence

Last Monday was the premiere of the first episode of the last series of Skins.

For those of you who don't know, Skins has been one of my favorite shows since it first washed up stateside my junior year of high school.  I loved it for a lot of reasons, including, in large part, the fact that Nicholas Hoult played Tony Stonem in the first two series.

But really, what drew me in when it comes to Skins was the way they portrayed people my age.  Yes, the show was racy and definitely a lot more wild than my life (or anyone that I knew, really) was at the time.  But after years of seeing the 16-19 year-old years treated like nothing more than bad grades, shopping trips, and shenanigans learning to drive, it was amazing, to me, to see a show that portrayed its teenage characters as complex, autonomous characters.

The characters in Skins had the complicated backstories that are often associated with much more adult stories -- neglect, abuse, loss, joy, family.  They also had real, complex problems -- depression, suicide attempts, eating disorders, bipolar disorder, anxiety.  Skins was the first show I ever watched that treated my generation more like adults than children.  And it made me feel less alone.

The characters in Skins made real, complex decisions and those decisions had consequences.  Even now, with the final series and the reboot of some of the original characters in the specials Fire, Rise, and Pure, the characters, who have aged since the last time we saw them (Effy Stonem, for example, is now working for a high-powered investment bank instead of wreaking havoc on her high school/college), are facing adult issues with real consequences.  And I'm excited to see where it all heads.  In the meantime, I'm glad there is at least one show that presents adolescence as something more complicated than just that awkward time between when you're a little kid and when you become a full-fledged grownup.

I am speaking, of course, to the UK version of Skins.  The American adaptation that MTV tried to pull off was a laughable shadow of its British counterpart.

Culturally yours,
Rachel Leigh

Photo credits: 
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTYBodWpgle0hIMbsYTKZBIef1lk_al7HdSIl0M9y3YbcrKztrbOcs6rS6h_ljjHLyNVLRd4iLTTgeWdtjDvERAPRbmnP9ZaJmXw828mlGSCHE33zQT4n42ELHwRHwuXRjuQ_h43CcT9hr/s400/skins-cast-nagy.jpg
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOULGUtYct73gRdOX-Vqi0l4R-2m0WmNU-oxEkc1fmGUQ_PoZMromuPK7GvPTRjtj-ntC0VXmpVc7JF6hN-zfRfCS35S1EyeAIdVrEmTwJIwr2n5Q1Ni39Krh0I1AFyKy4qk60OpDARib6/s1600/article-0-0CA776D4000005DC-732_634x429.jpg

On Mental Health and Confessions

Back when I started this blog, I anticipated a lot of late-night rambles.  I think, however, that this is only the second late-night post I've written since I started this.

One of my big blogging idols, who runs the blog Hyperbole and a Half and is easily one of the funniest and most talented bloggers I have encountered in my time on the internet, has made two of her most recent posts (although one of them was admittedly about a year ago) about depression and how depression has impacted her work.

If you've followed me at all, you know I am a huge mental health advocate.  I can talk to you about what a comprehensive mental health policy on a college campus looks like (and what it doesn't, here's looking at YOU, Cornell).  I can tell you that 1 in 4 Americans will suffer from a mental illness in their lifetime, that many of those who do not get help will consider or attempt suicide, and that 1,000 college students will take their own lives this year.  I can also, and will, tell you that your mental illness or mental health concern does not define you, nor does it make you any less whole or less worthy a person, and that no one worth having in your life will love you any less because of it.

But I will admit, I am ashamed of my mental illness.  Anxiety disorders, severe confidence issues, and intermittent depression have dominated my interactions with myself, my work, and others for as far back as I can remember.  I have also come to realize that when any of those concerns become stressed, I have a hard time maintaining a healthy relationship with food -- I either eat far too much and cannot control myself or I find the idea of food so unappealing that I may not eat all day unless I force myself to.

I'm making this post not to force my issues on others -- I do have a small group of people in my life who have been absolutely wonderful resources for me to work through my issues -- but because I feel, as someone who pushes so strongly for people to not see mental illness as a failing of character or something to be ashamed of, that I have been terrible when it comes to practicing what I preach.  I have no right to push for people to own their battle scars if I cannot do it myself.

Yours,
Rachel Leigh

On NEDA Week

This past week was Eating Disorder Awareness Week, and Active Minds (which I have definitely talked about before) as a national organization supported NEDA’s mission to raise awareness of the prevalence of, and health risks associated with, eating disorders.  This led to an interesting dialogue with one of my friends, whose first reaction (well, second, after he offered to buy me curly fries) was that he was tired of everyone saying that society is the problem.

(image credit: National Eating Disorders Association, 2009)

I mean, don’t get me wrong, society’s image of what people should look like is really screwed up.  The media does put up these generally-unattainable, Photoshop-happy photos and images of girls with waists the size of pill bottles and men with muscles larger than their heads.  And, fun fact, because these images are disseminated into society, these highly unrealistic expectations of normality ­become what people perceive as “normal.”  And, for the love of god, do not get me started on Barbie unless you want the same regurgitated list of fun facts about what a little girl’s first toy does to her sense of body image.

And yeah, the media’s presentation of body image has a lot to do with the development of eating disorders.  But it’s not like we deal with it exactly right either.  Because then the first response is always “you’re perfect just the way you are,” which is absolutely true for a lot of people.  But the United States IS facing an obesity epidemic, and that’s not healthy, either.  Obesity leads to diabetes, heart disease, cancer, and a whole other host of serious medical problems, and that’s not good.

The problem is that in both cases, the focus is on image and not health.  There are healthy and safe ways to lose weight, get in shape, build muscle mass, etc.  But the emphasis on the one hand is that those ways won’t have the same drastic change to your image that disordered eating or over-exercising will.  But on the other hand, emphasizing that everyone is perfect is again about an image.  All bodies are beautiful, I will absolutely agree – the human body is an amazing and beautiful thing, regardless of its size or shape.  But beauty and perfection aren’t the same thing.  But if you’re trying to change things about it, it should be because you want to be healthy, not because you want to look different.

A healthy mindset is all about loving your body because it’s YOUR body and it’s an absolute miracle regardless of how it looks…but loving your body means taking care of it, staying in shape, treating it right, and giving it what it needs.  I’m all for self-improvement, but only if it’s healthy.

Yours (with thighs that touch),

Rachel Leigh