THE PERILS OF PSYCHIATRIC PATIENTS

THE PERILS OF PSYCHIATRIC PATIENTS

The New York Times ran a front-page article about the risks politicians face if they reveal conditions such as depression or bipolar disorder. The story in a powerhouse publication and on the front page is progress, if not long overdue. Psychiatric discrimination in politics dates back to 1980 when Lee Atwater attacked a congressional candidate who had ECT treatments in his youth for being “hooked up to jumper cables.” The decision to reveal a psychiatric condition to an employer may seem cathartic, but it is an invitation for co-workers to view your behavior through the prism of your diagnosis. Displays of emotion trigger the question, “off your meds?’ People who don’t know the difference between a psychiatrist and a shaman will dismiss your credibility, call you crazy and unstable, and make jokes behind your back. And everybody jokes about mental illness. From looney toons to looney bins, it’s clear that we think conditions that destroy lives and families are funny.

The medical establishment shoulders much of the blame. Its insistence on the separation of DSM disorders from physical medicine is the root that feeds the weed of stigma. The truth is that these conditions are just as physical as any other affliction. For example, disturbances in sleep and appetite are goalposts that psychiatrists use to diagnose nascent trouble brewing in the brain. Bipolar disorder is a disorder of mood. We feel moods, we don’t think them. But since we can’t see the invader at work in the brain because it is encased in a hard shell, we conclude they must be imaginary products of the patients themselves. Dementia manifests its symptomology by disturbing thoughts and behavior, but since we can see the decay of the brain, we classify it as neurological. Depression does the same thing.

We have also awarded psychiatrists with more power than the police. When they come to hospitalize you, there are no warrants or Miranda rights. There are no preliminary hearings before a neutral tribunal to evaluate the justification for holding you, as there is in almost every criminal court in America. Once that hospital door locks behind you, you can be shackled to a bed by restraints or injected with chemical paralytics, and your fate and your freedom lie in the unassailable opinion of doctors. Even if you do challenge your detention to a judge, how likely is a judge to rule in favor of a mental patient over a board certified doctor? If a doctor determines that you are a danger to yourself, the hospital can legally seize you, but patients who endanger themselves by leaving against medical advice walk right out the door. In other words, psychiatric sufferers are more victims than patients.

The inconvenient truth is there is nothing mental about mental illnesses. Psychiatrists are actually medical doctors, not shamans, but the insistence on separation - the brain from the body, the mental from the physical, the real from the imaginary - perpetuates the second-class citizenry of psychiatric patients. Until there is a bona fide outcry to demand an end to this medical medievalism, Bill Maher will still think it’s funny to ask if Donald Trump gets his news from a passing mental patient.