Mental vs Physical Illness: Stigma and Disability

By Roiben

I know a lot of people who struggle to see Mental Illness as a disability. Some of this is due to years of Stigma, perpetuated by a media and government which all too easily labels people as scroungers. We are accused of not trying hard enough, of just needing to pull our socks up and get on with it, and in doing so to, somehow, magically get better.

In my opinion Mental Illness is more often than not a Chronic Condition and very much fits the criteria of a disability. By way of an example, I have Type 1 Diabetes, which I manage with medication and changes to, and monitoring of, my diet and wellbeing. I have times when it is well controlled and pretty much routine day-to-day. I have other times when it is less controlled and I need to seek the advice of medical professions and maybe even go into hospital. I have been diabetic since I was four years old and it isn’t going to go away anytime soon.

I was first diagnosed with a Mental Illness when I was twelve years old. I have had times when I have been well, when my symptoms have been controlled with medications. I have had other times when I have been in crisis and needed medical intervention, changes to medication and therapy.

In my view, my Mental Illness does not go away in those periods when I am well. I am not cured. Instead, it is managed and controlled and therefore less problematic.

It astounds me that there is Stigma around the idea that people with Mental Illness can just choose to be well. It is rare for someone with diabetes or a sprained wrist to be told to think themselves better, so why do we do it with Mental Illness? Why does it have to have a time-scale before the person is clearly not putting the effort in to get better?

I would not choose to have the sometimes horribly disabling symptoms of my Mental Illness any more than I would choose to go into Diabetic Ketoacidosis (DKA). In either case I opt for medications, simply because that very medication is lifesaving.

We as a society need to realize that the mind, as complex and confusing as it can be, is a part of the body and has physical and psychological manifestations just like any other part of the body. The fact that my pancreas fails to produce insulin should not be any more believable or important than the fact that I have a Mental Illness.

Why do people have to be in absolute crisis with their Mental Illness before they are taken seriously and believed? Why is the emphasis placed on people actively acting on suicidal urges. Surely there should be recognition and a pathway for treatment long before someone attempts to act on them?

Surely there should be a prevention rather than cure model, like there often is for physical ailments? Shouldn’t we be doing more to view Mental Illness as an illness of a part of the body, as we do with Diabetes and Asthma? Both are chronic conditions that, despite facing their own Stigma, get much better treatment by medical professionals than someone who presents with a Mental Illness related issue. They also get much better treatment by the media, by the government and by society as a whole. Yes, Stigmas are still present, but people are much more rarely told to “just get over it” when they are hypoglycemic or having an asthma attack.

Mental Illness is a disability, and a very complex one at that. It requires far more understanding of nuances and individuality than illness with other parts of the body may require. The situation is the same, though. A part of the body is malfunctioning and may always malfunction going forwards. It requires appropriate treatment, attitudes and support. Without those treatments, healthy attitudes and support, the malfunction will get worse not better. Ultimately the person may stop attempting to get the help they need and very much deserve.

 

About the Author

You can find Roiben on Twitter (@roiben).

 

Visual Spaces

By Roiben

I write this, looking back over a lifetime of not fitting into boxes. I have a severe hearing loss. I am Type 1 Diabetic. I have a mental illness. I am bisexual. I am many things that do not fit the “norm”.

Today though, I want to talk about the thing I probably spend the least time talking about. I am visually impaired. I had cataracts as a baby, which permanently damaged my vision. I am blind in my left eye. It notices change in light and movement — but it can’t tell what is moving. My right eye has some damage to the cones and rods which mean I find it hard to distinguish between certain colours and shades. I also have Astigmatism and, as the right eye is doing all the grunt work, it can get tired easily. I also, thanks to years of Diabetes, have Stage 1 Retinopathy.

Ultimately, this means I lack stereoscopic vision — I am not able to judge distance or speed of objects and have no depth perception. I am one of those people who need markers on steps and curbs to get around in my day to day life.

What does this have to do with boxes, I hear you ask. Well, although I am visually impaired, I am classed as having too much vision in my right eye to be legally classed as Partially Sighted. The regulations and checks require a significant loss of vision in both eyes to count. So, despite being fairly severely visually impaired in lay-man’s terms, I do not fit into the legal box-ticking exercise that could enable me to get more assistance.

According to the Royal National Institute of Blind People (RNIB), the UK’s leading charity supporting blind and partially sighted people, there are over 200 eye conditions — and there are many, many people, like me, who do not fit the boxes. As is the case with many such boxes, there are many people falling between the gaps, who perhaps actually need the help the box checking would provide. It is perhaps more well known in the case of Mental Health, where someone can literally be told they are too ill, or too chronic to get the help they so desperately need. In this instance, I wonder how many of those people who do not fit the regulatory definitions and limitations could actually really, really do with the help?

As things stand, my vision in my right eye is deteriorating. The Astigmatism is getting worse and I have had to change my glasses prescription to match. I have to keep a close watch on my blood sugars as well, because that affects my retinopathy — which is always at a risk of getting worse.

Maybe one day, I will fit into that box. Maybe I never will. Either is okay. I am me, and I have grown up with all these things and in doing so have put in place my own coping mechanisms. I learn routes and places. I am a creature of habit and often put things in the same places, or walk the same route from A to B. I know how many steps there are on certain staircases and with practice can walk the ones I know with ease. I have learnt to keep a clear route between my bed and the door, kitchen and toilet.

The main problems come when there is a change. A diversion. Shoes left out in my “path” or a chair moved. When walking unknown places, or a different route, I tend to slow down, to take more notice and be more cautious. I trace my route along walls and banisters and follow any signs or maps I can find. Then I remember it, in case I have to take the same route again.

As with all my disabilities, I have adapted and learnt ways “around” it in order to continue living life the best I can. I just worry for those who perhaps have not yet learned adaptations, or who struggle in their own ways and could do with getting more help.

 

About the Author

You can find Roiben on Twitter (@roiben).