TANNARA YELLAND
Associate News Editor

For a range of disorders affecting over 20 per cent of Canadian citizens, mental health is poorly understood and mentally ill people are often marginalized. University students are, by virtue of their age alone, especially likely to be faced with the challenges of mental illness.

I have several family connections to mental health: my mother has worked as a psychiatric nurse for over 20 years and one of my sisters has been diagnosed as mentally ill. As such, the issue holds special importance for me.

Professors give their take
A “Mad Pride” forum held in the library on Nov. 4 offered a suitable starting point for an examination of the realities and effects of mental illness.

Erika Dyck, an associate professor in the U of S history department and Canada Research Chair who specializes in the history of medicine, is skeptical about the role of medication and medicalization in modern psychiatric medicine.

“I’m extremely critical of the notion that a for-profit company should be dictating what constitutes disease or abnormality,” Dyck said. “It strikes me as very frightening.”

Dyck recently sat on the panel of U of S professors who discussed mental illness along with James Waldram, who specializes in medical, psychological and psychiatric anthropology; Hilary Clark, who teaches both English and a women’s and gender studies course on women, depression and writing; and Despina Iliopoulou, a sociology professor specializing in law and social inequality.

The four professors offered their understanding of psychiatric disorders and in particular the “mad pride” movement, in which people who have been diagnosed with mental illnesses are coming together to bring attention to their needs and to remove the stigma associated with having a mental illness.

Clark explained her reticence to either denounce or endorse the mad pride movement wholesale in terms of the ambiguous nature of mental illness itself.

“The stigma for those facing treatment is very real and very hurtful,” she said. “On the other hand, I think the mad pride movement is perhaps a bit utopian.”

Some members of the movement claim that there is no such thing as mental illness and that what is categorized as such is simply human difference others refuse to deal with.

“There are some who argue that there is no such thing as madness,” explained Dyck, “it’s only difference, and differences should be embraced”¦. The movement itself gets this image of being a bit more radical than it really is.”

The professor on the mad pride panel who came closest to agreeing with this view was Waldram, who said, “When talking about mental illness, my response is, ”˜according to whom?’ ”

Clinical explanations of diagnoses
From there Waldram launched into an explanation of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM-IV because it is in its fourth edition.

The DSM-IV divides mental illnesses into five categories, or axes. Axis one includes depression and anxiety as well as attention deficit hyperactivity disorder, and accounts for the vast majority of diagnoses.

“These (disorders) are very dependent on your social circumstances,” Waldram said. “What causes you to be anxious and depressed is learned, as is the way people treat you.”

Waldram went on to claim that many of these disorders “are really problems for everyone around that person,” as opposed to being problems for those who are diagnosed.

First-person perspective
While some diagnosed mentally ill people may agree with Waldram, my younger sister Megan does not. She was diagnosed with depression as a young teenager and has since also been diagnosed with anxiety and bipolar disorder.

“I think that if you are diagnosed with (a mental illness) and you don’t think you have it, you should have some way of working around it yourself,” said Megan. “But personally, I can’t find any way of working through my extreme highs and lows without some sort of drugs, and it’s the same for my anxiety and depression.”

As a child Megan was what people often refer to as “spirited” or “precocious,” but to me she just seemed scary. One moment she hated everything and everyone and was declaring it loudly, and just when the screaming was getting loud enough that I could move it to the back of my mind like the din of an airplane, it stopped and she was off giggling and playing.

But as unsettling as such a life can be for her family, it has almost certainly been more difficult for Megan herself.

“If I hit a low (depressive bipolar episode), I don’t want to go to school or work, I don’t even want to get out of bed and make myself eat. But when I hit a high (manic episode), I can’t sit still. I always want to move, I even shake when I’m driving.”

Megan switched from a public high school to a more structured program after missing almost one third of her grade nine year. Stress, she says, plays a large role in the control of her symptoms.

“My illnesses don’t always interfere in my daily life but”¦ if I’m really stressed out my school work goes right down. I’ll just stop doing it.”

Part of the problem many people suffering from mental illness find is that others have trouble relating to their experiences. What might sound like laziness to someone who has never experienced the gripping lethargy and physical pain of depression is far different from apathy toward schoolwork.

The stigma mentally ill people experience from other segments of society can be almost as damaging as the effects of their illnesses themselves.

“If I go out and try to make friends and then I tell them (about my illnesses), often they freak out and don’t want to associate with me because I’m crazy,” said Megan. “And that’s harsh, because whatever mental illness you have there are ways to work around it.”

The maternal aspect
My mother is in a particularly unique place for commenting on mental illness. She is the mother of a mentally ill daughter, but she has also worked in psychiatry since 1986. She currently works as a counsellor for adults living with mental illnesses who do not require institutionalization, but I remember going to visit her at the Hantelman Building, the Royal University Hospital’s psychiatric ward.

I clearly remember once seeing a patient shuffle up to the pay phone near the nurses’ desk to have a conversation before shuffling away, then hearing someone whisper that there was nobody on the other end of the line. Sometimes my mom would come home with stories about angry patients throwing phones at the nurses.

When I asked her why she had decided to work in mental health, she answered that working with the people in the field was a big draw.

“It is poorly understood by the general public,” she said. “It has been, in the past, an area that is in need of a lot of attention.”

Cinematic phone-throwing notwithstanding, my mother always sought to instill in her kids the idea that mentally ill people are not to be feared or ignored. And while she works in a medical field, my mother has long voiced doubts about whether medication is always the best answer.

“Medicating some mental illnesses is a good thing,” she said. “But there can be a tendency among some individual doctors to over-diagnose and to over-medicate” which can lead to problems.

Some of the main problems she pointed to were the side effects of psychiatric drugs, many of which are unknown, especially when the patients receiving the drugs are children. She also pointed out that people could be tempted to take their diagnosis “as a blank ticket that they don’t need to work on their problems or their issues.”

“They can feel like they have a diagnosis, ”˜it’s a brain problem,’ so there’s nothing they can do about it.”

As a professional in the mental health field, she says there may have been some extra shock when she found out her daughter was mentally ill.

“For a lot of parents there’s a lot of guilt and questioning of your own parenting, even — or perhaps especially — if you know a lot about mental health, about how your parents might have contributed, what you should have noticed along the way, how you could have helped prepare your child to better deal with issues.”

My mother says these feelings faded for her in time, but she understands how terrifying a diagnosis can be for parents as well as for children.

“There’s a lot of fear,” she said of finding out one’s child is mentally ill. “You don’t know how bad it is”¦. You don’t know if it’s going to get better or be a lifelong painful ordeal for them.”

– –
photos: Malik M. I. Williams / Jari Schroderus