Man is born free, but everywhere he is mentally ill
On the predominance of mental illness and surrounding cultural commentary.
In a superficial sense, mental illness is a part of the culture wars. There are believers: mental illness is a disability and ought to be treated like a physical ailment. Others, particularly older generations, are sometimes skeptical of this (though not always). Bootstraps mentality dictates one simply “gets over” their problems - particularly if it involves mental states that we believe to be in our control.
But it doesn’t stop there, and it doesn’t neatly fit into a culture war side when we go beyond the above superficiality. Mental illness is a part of politics now - but also not part of it in the right ways, which I will explain - and we cannot remove it. Mental health campaigns are everywhere. References to mental illness is everywhere.
Sometimes, “mental illness” is used as a pejorative, while other times, people openly identify as “mentally ill” and believe in reducing its stigma. Sometimes mental illness fosters a community, and those without the correct way of expressing symptoms are shunned from the in-group. The other day, people were fighting over who really has autism on Twitter, and I couldn’t help but be baffled - especially when I saw it blended with cultural appropriation discourse.
So now mental illness becomes a matter of projecting the right identity. You’re not mentally ill in the right way, you don’t get my plight and hence don’t get to claim the label that was once pejorative.
But my question recently has really been “is anyone not ‘mentally ill’?” After all, mental illness encompasses a broad range of mental states, from anxiety to psychosis.
I don’t say this to be funny, and I don’t say it to insult anyone. Part of the reason why I say this is anecdotal: virtually everyone I am close enough with to discuss these things have either diagnosed mental illnesses or live in a mental state that could be classified as “mentally ill.”
Nontheless, I am just one person, and can’t really speak for any other personal experiences with the system, and I also do not want my argument to be personal. I am simply stating that the predominance of mental illness that I have encountered has prompted me to think about this subject.
As I said, I couldn’t help but notice how widespread mental illness is. We almost aren’t allowed to say this, though, and I understand why. If someone comes forth to talk about their mental illness and I respond “well, everyone is mentally ill”, it looks like I am All Lives Mattering the person’s mental illness.
However, one of the points of mental illness is that your condition isn’t quite unique. Mental illnesses all have a generalized set of behaviours and mental states - diagnostic criteria, if you will - that identify patterns. While we do not all experience the world in the same way, we all live in the same world with a limited amount of outlets and options.
Is everyone mentally ill?
In Capitalist Realism, Mark Fisher observes this issue:
“In line with [Oliver] James's claims, I want to argue that it is necessary to reframe the growing problem of stress (and distress) in capitalist societies. Instead of treating it as incumbent on individuals to resolve their own psychological distress, instead, that is, of accepting the vast privatization of stress that has taken place over the last thirty years, we need to ask: how has it become acceptable that so many people, and especially so many young people, are ill? The 'mental health plague' in capitalist societies would suggest that, instead of being the only social system that works, capitalism is inherently dysfunctional, and that the cost of it appearing to work is very high.”
Obviously mental illness is more than just “stress”, and “stress” is often used to dismiss peoples’ claims of mental illness, e.g. “you’re just stressed from school - it’s normal!”
But the predominance of stress-based illness makes perfect sense under our current social conditions. Society is increasingly less stable and provides less assurance for people. You cannot rely on a college degree to give you a secure job; you probably won’t be able to own a house anytime soon like your parents did (if they did!), and a significant amount of available work is incredibly precarious (contract work, gig economy, etc.).
Anxiety is exacerbated by uncertainty. To continue with Fisher:
“As the organization of work is decentralized, with lateral networks replacing pyramidal hierarchies, a premium is put on , flexibility' […] The values that family life depends upon - obligation, trustworthiness, commitment - are precisely those which are held to be obsolete in the new capitalism. Yet, with the public sphere under attack and the safety nets that a 'Nanny State' used to provide being dismantled, the family becomes an increasingly important place of respite from the pressures of a world in which instability is a constant. The situation of the family in post-Fordist capitalism is contradictory, in precisely the way that traditional Marxism expected: capitalism requires the family (as an essential means of reproducing and caring for labor power; as a salve for the psychic wounds inflicted by anarchic social-economic conditions), even as it undermines it (denying parents time with children, putting intolerable stress on couples as they become the exclusive source of affective consolation for each other).”
This also means that we have grown up with expectations - or assurances - of what our life is supposed to look like. However, unless you are inheriting a large amount of wealth, the securities promised to you are dwindling and on shaky grounds (if they’re even there to begin with).
Yet, contextualizing mental illness in our ways of life is frequently seen as dismissing both the science of mental illness (its physiological components, for instance), and those with mental illness. A common saying among progressives when it comes to mental illness is to treat it like you would treat a broken arm - that is, as you would a physical ailment.
But this depoliticizes mental illness. Of course there are physiological causes and effects of depression and anxiety, but (as Fisher has noted as well), we still need to explain why those processes exist in people to begin with. Just as post-traumatic stress arises out of events or repeated occurrences in one’s life, our experiences cannot be divorced from our mental illnesses. A broken arm can happen in a freak accident, but to treat mental illness in the same light is to essentially mute what could be meaningful critiques of the way we socially organize ourselves. That is, should we not be prompted to investigate the way peoples’ livelihoods are insecure and uncertain?
What we have done over the years is discard social critique in the name of embracing cold hard science that attempts to reduce mental states into solely biological and chemical functions. This is convenient for progressives that want you to think mental illness is just like a broken arm, but it is also convenient for the status quo. Why? Because it pathologizes and medicalizes sets of behaviours and mental states that are perfectly understandable under unstable economic and social relations. It treats these mental states as aberrations (the existence of mental *illness* implies a mental normalness that is both desirable and achievable under current conditions).
I have seen this quite a bit with eating disorder discourse as well. Like depression and anxiety, a less large but significant chunk of people I know have struggled with eating disorders. The same discourse has followed; “it’s not about looking thin,” it’s a personalized and deviant mental illness that can be explained by chemical and biological processes.
Like all mental illnesses, anorexia has arbitrarily drawn its boundaries based on pattern observation. However, I do think anorexia discourse is letting “society” off the hook by following the same problematic pattern in depression/anxiety discourse: it is pathologizing and medicalizing behaviours that are inevitable under our current system. A girl deliberately losing weight can be indistinguishable from anorexia, and increasingly so: by pathologizing women’s habits and behaviours as health aberrations, anything she does could be a medical condition, and the social causes are deemed unimportant.
This has become the preferred explanation, particularly when compared to the explanation that girls just want to look like the models and celebrities out of a vain desire. But we don’t even need to look at it through the lens of vanity. It’s okay to admit that there is an incentive to look thin, and that you are socially rewarded for doing so. And it’s okay to admit that there are societal factors that, often times, incentivize women to deliberately make themselves thinner. Are these behaviours all necessarily eating “disorders”? What is the model (no pun intended) of normalcy here when women are by and large responding to rational incentives? Would a non-disordered eater simply be a woman that is unconcerned with their figure and with food? If a large majority of women are dissatisfied with their bodies and would rather be smaller, we ought to diagnose this as a societal condition under which norms incentivize certain patterns of eating and bodily upkeep. Women that go on restrictive diets have these behaviours pathologized when they’re reacting rather normally to the world around them.
I don’t write this to shame those experiencing these issues. Like I said, they are largely responding rationally to current social conditions, and are under extreme amounts of pressure much of the time. I write this because I think biological determinist takes on mental illness, which the progressive left has embraced, precludes the possibility of cultural critique in service of the status quo. Obviously, there are limited avenues when seeking help for mental illness, and individuals aren’t to blame for seeking diagnoses and attempting to treat mental illness in this fashion.
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What is to be done?
While I approach mental illness discourse and the psychiatric/psychological disciplines with skepticism, I do not advocate for halting mental health programs nor do I think you should retire your medications if they help you function. What I do think is that our classifications of mental illness cannot be reduced to purely biological states, nor can they be divorced from the contexts they arise in.
It is practically blasphemous to suggest that some environmental or personal changes can impact one’s mental illness. Common mental illness discourse in progressive spaces often derides the idea of someone coming in and going “hey, have you tried yoga to cure your depression?”
But this inhibits the possibility of genuine reflection on our environmental conditions and what behaviours and patterns could actually impact our negative states for the worse. In our current economic system, many of us are precluded from moving and standing enough throughout the day, and are incentivized to purchase cheap, fast foods due to lack of time and energy. Why is this not up for critique? Exercise, which many are deprived of, is a genuine anxiety reliever and is good for mental health. Researchers have found connections between diet and depression.
People are averse to this kind of critique because they think arguing things like “exercise helps with depression” treats depressed people who don’t work out as moral failures. But we don’t need to make this a matter of shame. Instead, we can look at why people have less opportunities to be active, whether they are struggling single parents or tired, 9 to 5 middle class office workers that sit for the majority of their day.
Further, I don’t think we need to make microspecific, medicalized categorizations of personal behaviours. Instead of creating more criteria and more categories of mental illness, we need to ask: “What is normal? And why is that so? Could there possibly be non physiological factors in our lives that influence us to behave in certain ways?”
And most importantly: can we think about how we socially organize ourselves and recognize the ways it is not conducive to personal wellbeing? Are there changes we can make that ease peoples’ uncertainty and give them easier avenues to wellbeing? That’s the kind of conversation I’m interested in having.
Image: Toolshero, 2018
Thanks for reading!
Ms. Ghorayeb, this is a wonderful articulation of your ideas, delineating a nice balance between opinion and facts. VERY relatable personally on many layers.
I really enjoy your writing, having discovered it only recently via "Unacceptable," you and Ken interviewing Nihal El Aasar. I grabbed the whole pod on Spotify!
Your piece in Passage published last week was so spot on, too. Cathartic and sobering at the same time. I'd love to subscribe to "Pro Democracy" with Alex and You but Rofkin doesn't offer PayPal as payment option. Yet?
Peace and keep up the inspirational work, Mila!!
-ME