Tuesday 22 November 2011

What is mental health? "You're just a drunk!"

In recent times this is one of the most hurtful things anyone has said to me. It was most hurtful because of the person who said it.

This piece is about addictions but I'm going to talk more about myself than the research. I admit this isn't my specialist area so I'm just going to try talking a bit about it with reference to what I've written over the last few weeks.

I know very little about the good quality research into addictions. It's strange because many people would call me an addict. I've been denied help when I needed it because of my addictions.

I've had half a bottle of wine. It's half past noon. Normally I don't break the cardinal rule of functional drinking. Nothing before noon except hair of dog. Today I just did.

For most of my adult life I've been drinking and smoking cannabis, usually with a daily frequency.

I find it hard to accept I'm an addict. I'm just a person who likes to drink and get high regularly, but some people...okay...a lot of people don't like my lifestyle.

Is it detrimental to my life? Hell yes. I am poor and spend most of my money on booze and herb. I live a basic life because most of my money is spent on my addiction. The booze will damage my liver, the rest will destroy my lungs and give me cancer. My cognitive faculties...well...I don't know if I still retain my potential.

My life outcomes are poor and my lifestyle choices, choices which I find hard to break but have little personal volition to try to, have cost me a lot.

I've picked what is perhaps my least desireable feature - of which there are many - to expose. I've described it in a way which asks not for compassion, at least not the compassion of mental illness.

I called it a choice. I called it something I wouldn't change unless it was forced upon me. My life is fucked up and strange. Perhaps I am too. I was fucked up and strange before I got into drink and drugs.

Addictions have high levels of stigma and moreso than other mental illnesses. For a start many professionals don't treat addicts in the same way as they treat other patients.

It is worth noting briefly that the psychiatric profession creates addicts. Too often patients end up on psychiatric drugs for life.

Anyway, addicts are stigmatised like those with depression and they suffer worse outcomes. It is of no consequence if someone tells an addict to stop using. People in mental health circles know not to tell a depressive to cheer up. Most people wouldn't tell a gay person to be straight.

Addicts are singled out because of the assumption, and evidence base, of causation of other mental illnesses. No effort is made to understand the individual. Treatment is simply to 'manage' which really means cease doing what they enjoy.

People do understand what it is like to have an addiction, to love and enjoy something or someone who people don't want you to feel that way about. People don't understand how people like me medicate and self treat their subjective experience of unwellness by their addiction; it is easier to allow a doctor to prescribe a drug addiction for misery, which is what a lot of people get when they get an antidepressant prescription. People aren't told about the studies which show binge drinking to be an alternative to antidepressants and as effective.

Addictions are a stigmatised mental illness which is often left out of modern consensus debate because the people who have the power stigmatise this particular illness.

Stigma is a powerful and subtle force. It is why the paradigm of mental illness came into existence. The impact of stigma before psychiatry was ...a secret oppression the Nazis would be proud of, and took part in. The German pscyhiatry association apologised this year for its conduct during the Nazi regieme. The society factors which create the prognosis and the forces which create new pathologisations and treatments...they're all part of systems of power which get pushed on people.

The power of labelling as a mental illness asks for compassion but it also asks one thing: we must treat you. Treat means change. Treat means change. This is so important I said it twice.

The paradigm of mental illness applied to individuals means the label assigns treatment. Treatment means change. If you're gay be straight. If you're an addict be sober. If you're depressed then be happy. If you're crazy then be normal.

This is fundamental. My experience of wanting help for depression and suicidality is just an illustrative example. I went to my GP and self-referred myself to the national psychological therapies scheme. My GP acquiesced. 6 months later a psychologist assessed me and afterwards she forced me to engage with drug treatment before help for my depression and suicidality. I didn't attend the addiction service so was refused help, the help that I asked for and the request I made which was possible for the scheme. It is al.most amusing that I did a bit of volunteering for the campaign for the scheme.

I'm an addict though. The system which doesn't understand me and labels me as abhorrent enough to change won't help me with what I want to have changed when I wanted it.

I ask a lot I guess. I ask for the right to be an individual and I ask to use mental healthcare. As an addict I do not have this privilege.

Sent from my smartphone

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About Me

We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"