Invisible Things

It appears I have forgotten how to blog. I also have a paper draft ostensibly due tomorrow, and I have every kind of mental block going. I’ve got three blog post drafts, too, all unfinished. So now, I am writing, to prove that I can. Still. Write.

I have been thinking a lot about invisibility lately. Sort of. Part of it has to do with the higher visibility of excessive force used by law enforcement when dealing with disabled people. Part of it is that I have a few friends and acquaintances who have invisible physical ailments. Coeliac, fibromyalgia, migraines, encephalomyelitis/CFS… all sorts of things. I know these things are real, and I do my best to disabuse people of the notion that such illnesses are imaginary, or not serious, or not debilitating. I also know an awful lot of people with various mental illnesses, some more serious than others. You may recall that there have been a bunch of articles over the last few months about depression and the effects of stress on academics, etc. Lots of my acquaintance have linked to these pieces and more. Ironically, perhaps, but not entirely surprising, some of the people who are most outspoken about their invisible physical illnesses seem to be far less sympathetic about mental illnesses. I’m always slightly surprised at the amount of victim blaming that goes on, even as we claim to understand that mental illness is real, and comes in lots of different sorts, some of which are treatable and/or temporary, and some that are not. It also interests me as to how we treat various disorders, labeling some ‘serious mental illnesses’ and others ‘conditions that normal people have,’ or ‘disabilities’ By ‘we’, I mean people in general, the media, etc. So, for example, ADHD is a disorder. It can also be a disability, and as such, is covered by the American Disabilities Act. But it’s not that common to hear people talking about ADHD as if it were some sort of illness. And somehow, perhaps because it’s more often diagnosed in children, it doesn’t seem to attract labels like ‘crazy’.

That doesn’t seem to be the case for many of the other sorts of pretty common forms of disorders that come under the umbrella of mental illness. Depression, anxiety, and stress disorders come in many different types. One can look a lot like another: diagnosis can require a lot of tests, and generally a lot of time. As far as I can tell, and this is just via personal observation and anecdata from friends and colleagues, it seems easier to diagnose more severe cases of things like depression than it is something like generalized anxiety disorder. It’s not surprising; after all, there are an awful lot of things out there that can cause a person to have trouble concentrating and affect short-term memory, including dehydration and lack of sleep. A couple of years ago, at what was close to a climax of a very stressful several years. I was fortunate enough to undergo all sorts of invasive tests and massively nasty medications as the doctors tried to figure out why my digestive system had gone to hell. They ruled out everything scary and still couldn’t figure out what was wrong with me. It was only by chance that I happened on an article about sleep requirements, and asked the doctor if she thought my inability to get more than about two hours of undisturbed sleep at a time might have something to do with it. Three weeks of sleep meds later, and all the symptoms were gone. Stress-related, or so they said. Get away from the stress, or learn to deal with it. Easy.

But what if it’s not easy? As at least one of the pieces I linked above notes, we tend normalize stress and bad work or personal environments to a point where not being able to deal with it is seen as abnormal or weak. Normalizing stress also makes it difficult to think outside that framework. In other words, if an environment or relationship is known to be stressful, then it’s easy to assume that what is going on is just … stress. Most people aren’t trained to make psychiatric or psychologic diagnoses, after all. We hear a lot, and are familiar with terminology, but words that seem synonyms for stress to a layperson might mean something else to a clinician, and vice versa. It might not even occur to a person to wonder if their inability to handle ‘normal’ stress is itself normal. They might indulge in some self-blame and try to hold it together. After all, everybody else seems to be doing so. Not everyone feels that way, though. Imagine the person knows both that the stressful environment is not normal AND that their reaction is something more than not handling the stress. That something more? is OMG mental illness. Slip a disc, and no one expects you to help with the heavy lifting. Diagnosed with some sort of mental disorder that makes it hard to handle certain situations? New can of worms, that is.

For those few people not on some form of social media beyond the blogosphere, take my word for it that not a week goes by without at least a few stories in your various timelines that are focused on enlightening people about what depression is like, and how it can’t be cured by Moar Willpower! or how disorder X is on the rise, or that there’s a new drug available for anxiety, or whatever. On a societal level, we seem much more willing to accept that these things are illnesses that can be mild or severe, and can be treated, and sometimes ‘cured’. But as individuals, we aren’t so good at it. People, and maybe even especially people who work with people and do thinky work, who are willing to talk about their mental health issues often take the risk of being blamed for a stressful environment or relationship — after all, we all knew it was sort of crazy, so all of the crazy must be the crazy person’s fault. Not surprising that many people try to make that part of their lives invisible to others. And face it, it’s fairly easy for most people. Everybody has a hard time coping with stress, right? as long as a person copes most of the time, it’s the stress that’s the problem. It’s sort of like my migraines: people know I have them, but they also know that most of the time I can take meds and keep going. For a long time, I was so good at hiding all but the worst of the migraines that even people who knew I got them, and knew that there were certain triggers, like strobe lights or rapid temperature changes, would regularly ask if I wanted to go clubbing. There are times we are complicit in hiding our illnesses. After many years, and meeting many other migraine sufferers, I finally stopped trying to hide them. Migraines may be invisible, but they are also Real.

It’s not the same with mental illness. It seems that for many people, Real = “so crazy anybody can see it.” The more invisible, the less real. Cope fairly well? prepare for a well-meaning friend or family member to challenge the diagnoses. This is not actually surprising, given how many people seem to think a five-minute test on a website can correctly identify anything! Nevertheless, even when the diagnosis has been made by an expert, an awful lot of people who aren’t experts are willing ignore or contradict the expert and the person who has consulted the expert. People I know with coeliac or allergies or diabetes often face similar attitudes, but ignoring those sorts of invisible illnesses can result in very visible physical illness, and even death. Once that is made clear, only serious asshats will not keep the illness in mind and act accordingly, asking about acceptable foods, etc. – it’s amazing how epi-pens and insulin pumps can change a person’s attention to detail. In contrast, a person who has an invisible mental illness, especially if they have been receiving treatment for years, may be every bit as aware of things that will make them worse, or that might put them at risk of a panic attack, or send them into a depressive state. They may be very articulate about it, and even try to explain what’s going on, and how others can help to minimize potential setbacks (if you’ve seen As Good As It Gets, you’re on the right track, although that’s orders of magnitude beyond what I’m talking about). But despite that groundwork, the people who seem to be coping despite their invisible mental illness aren’t likely to go into sudden shock, or die, if people ignore their needs. Couple that with general suspicions regarding the authenticity of illness in people who seem more or less fine, if stressed or a little down — not to mention that thinking about others and how their experiences and illness might shape their reactions to certain types of situations can feel like catering to someone who is just being difficult — and it’s not too hard to make the person as invisible as the illness.

I’ve got no real conclusion here. It’s just something that’s been rolling around in my head for a while. Inconsistencies and weird hierarchies of privilege will do that.