Mental illness, social justice and privilege
An anonymous writer shares his story of living with mental illness, and highlights the social forces which impact on personal experience.
“Stories matter, many stories matter. Stories have been used to dispossess and to malign. But stories can also be used to empower and to humanise. Stories can break the dignity of a people but stories can also repair that broken dignity… When we reject the single story, when we realise that there is never a single story about any place, we regain a kind of paradise.” Chimamanda Adichie
“There’s really no such thing as the ‘voiceless.’ There are only the deliberately silenced, or the preferably unheard” Arundhati Roy
It is April 2014 and I am the happiest I have ever been. I am soon to graduate, have travelled to five continents and have beautiful friends and family in my life in Australia and abroad. This is a very different situation to that I was in back in 2010 when I was hospitalised for the second of three times, was alienated from the world and myself and finally diagnosed with bipolar disorder.
I want to convey the social, economic and health impacts of what is nominally a severe mental illness but something which, under certain circumstances and with the right support, is a wonderful opportunity to renew one’s commitment to life and relationship with oneself. I do so because mental healthcare and healthcare in general is inextricably connected with social justice. I also know from my experiences with the mental healthcare system that the way I have been able to navigate myself to better health largely relates to social privilege. For this reason the social dimensions of mental illness cannot be ignored: the sad reality is that many people who live with serious mental illnesses languish in hospitals, on the street, in prison or are even dead.
Living with mental illness is life altering, something that takes years to learn how to manage. It puts you on the back foot and forces you to have time out from school, the workforce, relationships and it makes you change your self-expectations. Your capacity to understand what is going on in your life and how you can improve your health is affected by physical symptoms, often the need to manage and modify numerous psychiatric medications and the unfortunate situation that many people simply don’t care about those with mental health disorders or are actively prejudicial.
However through living with mental illness for some years, I have learnt that effectively managing mental health is also heavily linked to having the right work-life balance and making the right lifestyle choices. For this reason, beyond interpersonal factors those who face structural barriers to accessing social institutions due to class, race and gender inequalities often have their mental health disorders exacerbated by the injustices they face on a day to day basis. This means that the choices we make as a society, and as individuals who inevitably have family members and friends living with mental illness, are crucial in supporting journeys to wellbeing. I know this from experience.
When I was hospitalised for depression in 2010, I was unable to function in any sense of the word. I had withdrawn from uni for the semester because I didn’t have the faculties to cope with it. If you’re severely depressed you’re unable to concentrate enough to complete one reading, let alone an entire course. The depressed person looks at their course reader with glazed eyes, and struggles to understand even the text’s central arguments. The mind is thick and obtuse, willful and defiant in its sluggishness. During that time I attempted to continue working my casual retail job, but one day was unable to remember how to operate the cash register system that I had used for around five years so decided to quit. Depression is also a very physical illness, so in the morning I was unable to pry myself out of bed, seemingly super-glued to the mattress and absorbed in listlessness more so than negativity. I struggled to connect with any hopes for the rest of my life, nor could remember any positive experiences from my past, leaving me socially withdrawn, upset or volatile. And my body seemed just as lethargic, tired and broken as my mind: when the hospital psychiatrist evaluated me as requiring admission I remember shaking uncontrollably as if freezing despite the warm Autumn weather.
Only a couple of months later, I barely avoided hospitalization again, this time for mania. The manic mind is unpredictable, powerful and wholly inspired, but in reality is unsafe for the person suffering mania and those around them. When I was manic in 2010, I had travelled to Melbourne and was dating someone I really liked, travel and interpersonal upheaval often being triggers for mania because of the stress associated with them. Daily I would wake up at around 4am, I would barely have any sleep and I would make my way into uni where my mind would be overflowing with ideas. When manic everything feels urgent and one’s sense of self is inflated beyond all logical proportions. You feel incredibly attractive and magnetic, and want to share your energy with everyone and everything around you, and get frustrated if you can’t do so. When you’re manic you often upset those around as you struggle to have the concentration span to listen and take in their perspectives, and so interpersonal fallout is a common result of mania. Essentially you have no filter and so you can cause irreparable harm to your reputation socially, professionally and within your relationships. This in turn causes immense distress to the person with bipolar disorder, feelings of alienation and misunderstanding, and often a roller coaster descent into deep depression as you deal with the consequences of what happened during mania and lose all of your previous energy.
It is both of these states – depression and mania – that I have had to learn how to manage on a day to day basis as they have presented themselves to a lesser or greater degree over at least the last five years of my life. But my ability to learn how to do so has been due to the immense structural and social support that I have received more than my individual ‘willpower,’ though that remains a key part of managing one’s mental health. Class privilege allowed me to take time off university, not be worried about student debt, and attend group therapy at a private psychiatric hospital one day a week to learn how to manage living with bipolar disorder. Coming from an upper middle class family also meant that there was enough spare money for my mum to work part time and drive me to the hospital every Tuesday. Living in a political economy which provides universal free healthcare has allowed me to visit a general practitioner who has treated me as a person not a disorder for seven years with charge, as well as giving me access to many rebated sessions with a professional and intuitive psychologist over a shorter term period. Being racially privileged in a society which structurally confers power and legitimacy in Anglo-European citizens above all others has allowed me to expect and receive mental healthcare free from discrimination, in a context where language issues will not present themselves, and meant that I have never been stereotyped as lazy, stupid or morally lacking. Being privileged in terms of gender identity has meant that I have never had to face therapists who actively or tacitly condone slut shaming, transphobia or institutional sexual abuse in the way too many women or trans folk do. And being the son of an academic has meant that I have always been perceived as someone capable of completing tertiary education, intelligent and driven.
So at this stage in my life having completed my studies, I view myself as very fortunate. But Australia is also at a political turning point. The same lecturers who treated me as a person, acknowledged and cultivated my strengths and were a genuine source of support for me along with friends and family as I learned how to live with mental illness are increasingly overworked and unable to respond to student needs in the deregulated and neoliberal tertiary education environment. Proposals to implement in the May Budget compulsory co-payments for visits to the doctor will affect the socially disadvantaged most detrimentally, including those living with mental illnesses. And any genuine claim that Australia makes to being a nation which respects human rights must be rejected in light of the continued treatment of asylum seekers by Australian governments over the past ten years, which were declared “mental illness factories” by former Australian of the year Patrick McGorry.
If we are to take mental health seriously as a social justice issue, as we move into the future we have to consider the way wider social and economic policies affect our community’s most vulnerable. We owe it to them to do so, because living with mental illness or experiencing social disadvantage need not be a death sentence.
Thank you for sharing your story! Plan to Thrive would like to acknowledge that there are many different perspectives on mental health, and many different words to tell those stories. We welcome discussion and story-telling to enrich understanding and analysis.