As the daughter of two doctors, a medical ethicist masters’ holder and the service user of a host of mental health services, I feel that I have a lot to say on misery and its medicalization.
The first comment to make is on treatment. In this regard, misery hasn’t been medicalised in the slightest, to its detriment. Societal expectation dictates that if you are sad, you must ‘deal with it’ and that for many people means locking it away in a ‘deal or no deal’ shaded box. People don’t even consider getting help as an option as they feel it’s something that happens to everyone and they should just get on with things.
The next stage is actually getting help. Anyone familiar with the UK’s NHS GP booking system will know that appointments are few and far between and seemingly impossible to book. Once you get there, GPs being non-specialists ask you a few questions on how you’re eating and sleeping and how you feel which seem useless as it’s clear from your face.
Then, sometimes, if you answered the questions in the ‘right’ way, they will prescribe you a generic anti-depressant and refer you for counselling. I have never successfully received counselling through the NHS because, as with all NHS services, it’s incredibly over subscribed.
But the real question is why do we do this? The answer, to me, should be that when you are having a rough time, you need to look after yourself and that needs more help than you can provide yourself.
That isn’t how it’s positioned either before or after receiving mental health treatment though. Even the terminology around health and illness is unhelpful – you’re ‘mentally ill’ rather than needing help reaching optimal or acceptable levels of mental health.
When treatment has worked, you’re ‘better’, another loaded term which unhelpfully makes it difficult to recognise when you need help. Needing help or needing a leg up is not something which society frowns upon, although in more individualistic western cultures, it can be regarded as a mark of failure.
It’s inappropriate to medicalise mental illness in this way as it is the only area where the individual’s subjective experience is the most important and yet at the same time, the least regarded. We all assume without question that we’re experiencing the same reality which is a huge assumption to make.
When people exhibits signs of other mental states or awareness of a different reality, we immediately patronise them by assuming the ‘shared reality’ version is true without the evidence. Yes, these people need help living in the shared reality version at times, but there is no harm being exhibited in understanding and accepting that their version of reality is equally legitimate, and they need help living in our shared democratic reality, not just that they’re unwell.