28
votes
I was the poster girl for OCD. Then I began to question everything I’d been told about mental illness.
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- Authors
- Rose Cartwright
- Published
- Apr 13 2024
- Word count
- 3382 words
This seems closer to home than a lot of articles I’ve read, but it still swings across at the end to a satisfying conclusion, and I think that’s a problem.
I understand why it does - the very act of thinking experiences through leads us to want a neatly wrapped up lesson and the comfort of closure, the act of writing them down makes that doubly true, and the act of writing for an audience practically requires it. But if we want to have a more meaningful conversation around mental health we need to admit that for now, we (i.e. humanity) are still way out of our depth.
That’s no reason to give up, or to undervalue the massive scientific and social progress in the field over the last few decades, but it’s important to acknowledge how much we don’t know. Give it 50 years, maybe 100, and I expect things to be radically different. Hell, 50 years ago there were no MRIs, no gene sequencing, no SSRIs, certainly no real spaces to openly talk about mental health issues - we’ve really only just developed the tools to even attempt to figure out and fix what the hell is going on inside our heads, so it’s amazing we’re already as far along as we are. But for me, at least, hearing “we haven’t figured it out yet, but we’re with you for the long haul if you’re willing to keep trying” would have brought far more comfort than being told time and again that this new round of treatment would be different, the last 15 has just been mistakes but this is correct, only for everything to collapse again a few weeks or months later.
I did, eventually, hit on a medication that seems to work extremely well for me. I’m immensely grateful to the patient, caring, extremely intelligent medical professionals who tried to help me along the way. But the fact remains that most of them didn’t actually manage to help. It still took over a decade, a huge chunk of good luck, and ultimately one or two pretty significant coincidences for it to work out. I’d rather we collectively admit that than trying to convince ourselves that this time, surely, we’ve got it figured out.
First of all, congrats on getting to a good place! I'm wondering, if in retrospect, you have any "lessons learned" from your luck and coincidences that people might benefit from. Not that we should try to reproduce your luck, but something like, "I never could have thought to do X if it weren't for Y" but maybe other people can intentionally do Y. If you're not comfortable sharing details, I understand!
I'm about 14 years in on MDD, managing it with anti–depressants and therapy, but I feel like I'm "just" managing it, even after all this time. I've seen online and heard in person that a lot of people have seen benefit from the psilocybin trip, but I've never done a drug harder than caffeine, so I'm still feeling pretty cautious about it.
I agree, the last paragraph felt so incongruous with the rest of her writing. Especially after this phrase, which I felt was very impactful
I really wish she'd ended talking about what this means for her instead of the neatly tied off moment with her mom with no intrusive thoughts. I think that we see this binary of healing too often in the medical system. Fixed or not fixed. Reduced or increased. Just like when the author discovers that one biological change is the not the cause for her suffering, the parallels with healing make for a much more interesting thought.
All that said I really appreciated this article and it mirrors a lot of my experience with long-term chronic "illness" even though we have very different stories.
From what I understand, it implies fixing her environment is what it means to heal, so that her symptoms go away. As in, her "mental illness" was actually just a healthy body's reaction to an unhealthy/dangerous societal circumstance (or set of circumstances).
I was a little concerned when she translated, "There may not be a biological marker (aka a thing that could show up on a test/scan) for OCD" as "OCD isn't real and I have done this to myself," and it makes me question her entire healing process before that. That is an OCD spiral, recognizable, identifiable: why did she take that as face value even now, writing about this?
Which isn't to say the entire thing is bad, of course not. I like that she understands there is an inherent connection between environment and mental illness. It reminds me of a one-panel comic that was going around for a while that I cannot for the life of me find now, of a patient talking to a psychiatrist, saying "Can you give me something to make me forget the world is ending?" or some such.
In college a couple years back, I took a really interesting course titled The Philosophy of Mental Illness.
One of the sections of the course was looking at the DSM 5, and how both it and earlier iterations affect mental health treatment.
My main takeaway from the course was that, while the DSM is useful as a way of describing the symptoms one could be experiencing, there still is a lot we don't know about the actual causes of mental illnesses - and whether they should really even be classified as illnesses - but that the DSM allows for treatment under the USA's crappy medical system, and without the generalized classification of mental illnesses as mental illnesses, getting help or treatment would likely be even harder or more expensive.
I'd love to find some more current research on these subjects, since some of the articles I really liked from class were originally published in the early 2000's.
In my DSM class in grad school, it was made clear then (and reiterated since) that diagnosis is only really useful when it serves the client. Some people feel empowered by a label - they finally understand what they're experiencing, they know they're not alone. Some people (basically all in the US) need it for insurance coverage of their therapy/medication or to open the door for supportive resources, especially for kids.
Others really don't want the label. It'll be distressing. It doesn't give them internal peace. It will inhibit them from academic or career goals. It will lead to them being restricted from gender affirming care. The label itself doesn't really explain how the world isn't accommodating and possibly is aggravating their distress.
I don't have the time at the moment to find links and share more information, but I wanted to share that this is, historically, a massive difference between psychiatry and social work.
Systems theory (of social work) looks extensively at environmental factors and has a much bigger, better overall view of health. Family systems theory should be obligatory for anyone working with children and, I think, anyone practising in mental health period.