Crazy Does Not Equal Stupid

Part Two of Crazy Does Not Equal...

Full Disclosure: I have schizoaffective disorder and post-traumatic stress disorder. I have suffered from one form or another of mental illness for most of my life, mostly depression in one form or another, anxiety, and various manifestations of PTSD. I am 33 years old, a ciswoman, white and Cherokee, divorced, mother of one completely awesome daughter, owned by two adorable tabby cats, bisexual with polyamorous tendencies, a proud bleeding-heart liberal, an eclectic pagan, and completely out of my tree.

I've always been hesitant to be open with people about my mental condition. Mental illness is still HUGELY stigmatized, and I don't want to be treated as if I'm somehow less than other people because my brain and mind are funky. But I've come to the realization that mental illness will remain stigmatized unless people with mental illnesses are open about their conditions and show the world that we're not what society would have the world believe.

People with mental illnesses are often stereotyped as violent, or, in contrast, figures of fun, to be mocked for “abnormal” behaviors. And if we're not to be feared or made fun of, we're childish and incapable of making our own decisions. Failing that, we're weak-willed or of poor character, often therefore leading to the conclusion that we're responsible for our conditions and could be “normal” if we'd just decide to be. On top of all that, we're often considered lacking in intelligence, which can be part and parcel of the “childish and incapable of making our own decisions” or “weak-willed or of poor character” tropes.

In this post I’m going to address the stereotype that people with mental illnesses lack intelligence or are otherwise incapable of thinking for ourselves or making our own decisions. (Yes, I know, I’m not addressing these tropes in the order listed above. I’m dealing with each stereotype as I damn well feel like it.) I’m going to get pretty personal on this one, because this stereotype is my single most hated of all.

If you ask people with mental illnesses who have received treatment, be it psychiatric (medications, hospitalization, etc.) or psychological (counseling, support groups, etc.), many of them will tell you that psychiatric and psychological health care providers can be horribly condescending. Many are not, and many providers who begin their relationships with patients with that condescending attitude can be brought up short by a patient either refusing to tolerate the condescension and/or showing the provider that, as a matter of fact, people with mental illnesses can be and often are intelligent people. Some providers, no matter what anyone does, are just asshats. Some people are just asshats, and that seems to apply across all lines we draw and all categories into which we place ourselves.

The title of this post and this series of posts actually comes from something I said one time. At the time I was attending a support group for people with affective (mood) disorders. The support group leader had asked permission to allow a few nursing students who were considering specializing in psychiatric nursing to sit it on a group meeting. We did our usual group stuff, and then the leader asked around the room if any of us had any tips for these students. I looked the students in the eyes individually and then said, “Crazy does not equal stupid. PLEASE do not treat your patients like they’re idiots just because you’re seeing them in a psychiatric clinical setting.” Damn near everyone else in the group (all adults with histories of dealing with psychiatric and psychological health care providers) agreed almost immediately.

I guess this particular stereotype irks me so badly because I am intelligent, in fact outright nerdy, and I REALLY hate being treated as if I’m stupid when I know bloody fucking well I’m far from it. I have a high school diploma and a Bachelor of Arts degree in English with a minor in psychology; I was an honor student for most of my academic career. In addition to English I can also speak, read, and write Spanish, and read and write French and Latin. This is definitely anecdata, but I’ve known a lot of people with mental illnesses, and if I’ve met as many smart crazy people as I have, I’m fairly confident that stupidity is not rampant among the population of people with mental illnesses. The films “A Beautiful Mind” and “Shine” seem to have helped with this stereotype a little, as they both depicted people with severe mental illnesses who were highly intelligent and/or highly talented. But there are plenty of people out there, some of them in the mental health care professions, who still believe that mental illnesses render people incapable of logical thought, intelligence, or thinking for themselves.

I’ve been hospitalized for psychiatric reasons on quite a few occasions. One time, I had to go to the county facility because I was severely suicidal, but I had no medical insurance and was too ill to work and was still fighting Social Security for my disability benefits. Having been hospitalized for psychiatric reasons before, in private hospitals covered by medical insurance I had at the time, I packed a couple of changes of clothing, my personal toiletries (soap, shampoo, deodorant, tampons and pads, comb, toothbrush, a few other things like that), and a couple of books to read because I almost never go anywhere without something to read (I think it’s an English major thing). Silly me.

When I entered the facility, my purse and the tote bag in which I had packed my clothes, books, and toiletries were both confiscated from me, which in and of itself did not particularly surprise me, but I thought that they were just going to lock my purse in a safe (usual procedure with patient valuables in any hospital) and search my tote bag to make sure there wasn’t anything in there I could use to hurt myself or someone else or any illegal drugs or whatnot like that. No. They took my tote bag, gave me my housecoat, a change of trousers, two paperback books, and put me on the ward, keeping the rest of my belongings locked up at the security desk. No change of underwear, no toiletries. I asked the next day if I could please have an actual shirt, clean underwear, and my toiletries so that I could, oh, I don’t know, take a shower. I was told that somebody would do it and bring my stuff to me but nobody had time to do it right then. Okay, fine. I went into my room and read. Several hours later, I asked again if I could please have a shirt, clean underwear, and my toiletries so that I could shower. Again, I was told nobody had time to do it right then but somebody would and they would bring me my stuff then. The next day, I asked again. Third verse, same as the first. Later in the day, FOURTH verse, same as the first. I went to bed for the second night in a row without being able to shower or brush my teeth or comb my hair, and still wearing the same shirt, bra, underpants, and trousers I’d worn when I’d checked in two days previously.

The next day, my period started, which I had been expecting, as you might have guessed by my decision to pack tampons and pads. I asked, yet again, if I could PLEASE have clean clothes and my toiletries so that I could shower. Can you guess what they told me? At that point, I lost my temper completely, screaming that I’d been asking for something as simple as MY OWN CLEAN CLOTHES and MY OWN TOILETRIES so that I could take a fucking shower on multiple occasions for TWO FUCKING DAYS. Various employees tried to tell me to calm down and be reasonable. I screamed that I’d been reasonable and calm for the last two days and it wasn’t fucking working and that it shouldn’t be this much trouble to get a fucking shower. I then screamed that my period had started and I’d like to bathe or at the very least not bleed all over everything. They gave me a pad from behind the nurse’s station, of a cheap brand that irritated my vulva and upper inner thighs (I have sensitive skin, and nowhere is my skin more sensitive than in the lady bits). When I was finally discharged, I told my then-boyfriend (who had insisted I be hospitalized because I was suicidal) that I’d seriously rather commit suicide than be there again.

This experience was probably an intersection of prejudice against people with mental illnesses and against people with no medical coverage and no money, because never before had I been treated that way by mental health professionals. Apparently, people with mental illnesses who have no medical coverage and/or money don't deserve to have their own clothing nor use their own toiletries whilst hospitalized for psychiatric reasons, and, should they dare to request their own clothing and toiletries, they are being unreasonable, because no person with a mental illness could possibly be so reasonable as to want soap, shampoo, and deodorant to take a shower and clean clothing to wear after showering.

After that, I found out about a program at a local private hospital called Charity Care, which helps pay or entirely pays hospital bills for people who need hospitalization (not just for psychiatric reasons, anything really) but have no coverage and/or no way to pay. Thereafter, I went to that hospital, and was treated like a human being who just needed some help.

The private hospitals aren’t perfect either. I’ve seen plenty of psychiatric nurses and nursing assistants who seem surprised when psychiatric patients show intelligence or critical thinking skills or anything that might make you think, “Holy shit, this person is smart (or at least not stupid).” I’ve known plenty of psychiatrists, psychiatric nurse practitioners, clinical psychologists, and counselors of various stripes to do the same, and, although the “Wow, she’s intelligent and articulate” reaction of surprise and the usual subsequent change in behavior is annoying, it’s better than continued condescension.

It seems like the general public also tends to think that people with mental illnesses are lacking intelligence or the capability to think for themselves. Honestly, there are times when the latter is true, even of me. I’ve had several episodes of psychotic behavior during which I wasn’t capable of thinking for myself or making decisions for myself. However, for the great majority of my time, even though I experience psychotic symptoms on a more-or-less daily basis, I am perfectly capable of driving a car (even a stick shift), cooking meals, shopping for groceries, reading and comprehending what I’ve read, writing coherent (and often complex) sentences (betcha hadn’t noticed that), carrying on an intelligent conversation, and otherwise not being an idiot. I’m not an idiot, and I’m not the only person with mental illness who isn’t an idiot. Please don’t treat people with mental illnesses like they lack intelligence; chances are, they don’t.

Or, to quote the Roman Stoic philosopher Seneca, “Nullum magnum ingenium sine mixtura dementiae fuit,” which translates as “There has never been any great [talent or genius, the word can be translated either way] without an element of madness.”