The first time I told someone that I was mentally ill, they reacted with disbelief.
“You?” they asked. “You don’t seem that sick to me. Be careful not to play the victim.”
The second time I told someone that I was mentally ill, they invalidated me.
“We all get depressed sometimes,” they replied. “You just have to power through it.”
Countless times, I’ve been made to feel like my mental illness is my fault. I wasn’t trying hard enough, I needed to change my perspective, I wasn’t looking at all of my options, I was exaggerating how much pain I was in, I was only looking for sympathy.
If I wasn’t mentally well, they implied, it was obviously an issue with me that had nothing to do with the systems that fail mentally ill people each and every day. My “failure” to live a functional and happy life had nothing to do with the biological, psychological, and sociological factors that contribute to mental health. Instead, it always seemed to circle back to me and an apparent lack of willpower that kept me down.
For a while, this kind of gaslighting – the denial of my struggles that made me question my own reality – had convinced me that my mental illness wasn’t valid or real, and what was intended to be “tough love” from the people around me only made things worse by leading me to blame myself instead of advocating for the kind of treatment I desperately needed.
Like many mentally ill folks, it was impossible for me to move forward in my recovery until I stopped blaming myself and started seeking out the right kind of support. But it can be impossible to do this when the people around you are convinced that you’re doing something wrong.
A culture that routinely traumatizes mentally ill people by interrogating the severity of our illnesses and the sincerity of our efforts – effectively blaming the victim – is a form of psychological violence that keeps us from accessing the care that we need.
And yet it’s the norm in this society. People seem to have a lot of opinions on the choices that mentally ill people are and aren’t making while staying silent about the systems that force us to make less than ideal choices in the first place.
Personally? I believe that any choice made in an effort to survive is not necessarily a “wrong” choice, and if we care about mentally ill people, it’s our job to expand those choices by increasing their efficacy and accessibility rather than punishing mentally ill folks for doing their best to navigate their illnesses in circumstances that will never allow them to thrive.
As a mentally ill person, I have struggled within a culture that compulsively critiques the choices that I’ve made rather than advocating for the availability of better choices. And these critiques leveled against me, perhaps with the intention of motivating me, have ultimately hurt me.
I want to unpack those criticisms. The reality is that they harm not just me, but the millions of people that grapple with these illnesses every day.
And unfortunately, it’s a conversation that is increasingly necessary as support and resources for psychiatrically disabled people are only disappearing under the new administration, fueled in part by these prevalent beliefs about mentally ill people.
Here are four ways mentally ill folks are blamed for what they’re going through and what we can learn from these harmful assumptions.
1. We’re Expected to Pull Ourselves Up By Our Bootstraps
I remember when my old therapist told me, “If your mental illnesses were just an attitude problem, wouldn’t you have changed it by now?”
When I hesitated, she added, “I don’t think you’d make yourself suffer this deeply and this much if the solution were that simple.”
And she was right. I was doing everything that I could. My struggles were not due to a lack of effort on my part. I would’ve done anything if it meant finally getting better.
People who haven’t experienced mental illness personally often buy into the idea that if you try hard enough, mental illness is something you can overcome. With one brushstroke, it’s depicted as a lack of willpower and a personal failing. Myths like this disempower mentally ill people because they take the focus away from creating resources to help us and instead place complete and total responsibility on the person who’s suffering to make solutions appear out of thin air.
But if we could single-handedly ease our suffering, wouldn’t we have already done it? It isn’t fun, and for many of us, it disrupts our lives in significant and even unbearable ways. In fact, it’s the leading cause of disability worldwide.
When you place the burden on mentally ill people rather than advocating for a system that supports us, you put our lives in danger. Not only are we less likely to seek out help if we’re expected to go it alone, but legislators won’t think twice about slashing funding if it’s treated as an attitude problem rather than a legitimate public health issue.
No one wins when we abandon mentally ill people.
2. It’s Assumed That Treatments Will Be Accessible, Quick, and Effective
It took me over a decade from when my symptoms first appeared to get the right treatment.
And that bears repeating: over 10 years.
My case is exceptional, too. Most people will take at least ten years just to seek out help for the first time, and many will never receive treatment at all. This gap in care can account for the significant rates of drop-outs, hospitalizations, imprisonment, and homelessness that are a staggering reality for people with mental illness in this country.
It is incorrectly assumed that if you’re struggling with mental illness, a good therapist and a pill or two can easily remedy the situation.
But that’s assuming:
- The stigma and cultural norms have not discouraged you from seeking out help
- You have geographically and financially accessible options
- Treating neurodivergence as an illness is a framework that serves you OR alternatives that resonate with you can be accessed
- You have adequate insurance OR access to resources designed for folks without it
- You understand how to navigate these systems and can find what you need
- You can safely take medications and you respond to the medications prescribed to you
- You were accurately diagnosed
- You have the necessary self-insight to recognize your triggers and symptoms and can convey them to a clinician
- You have the stamina and time to endure years of testing out different treatments to figure out what works
- You have trusting relationships with the clinicians directing your recovery
…which only happens after you are willing to sit on a waiting list for weeks and even months to see those clinicians in the first place or can seek out crisis services (like the emergency room) sooner.
Does it sound like a lot? That’s because it is. And this isn’t even a complete list by any stretch.
Of course, if you’re multiply-marginalized, forget it. You not only have to wait for a clinician to see you, but you need a culturally competent one that understands the context of your unique struggles.
This is damn near impossible for many of us, as psychiatry as a profession is still dominated by clinicians who hold a lot of privilege and can replicate these hierarchies in their work. Instead of addressing the laundry list of reasons why mentally ill people don’t get treatment, it’s just assumed we’re not trying hard enough or that we don’t want to get better. This is a fallacy designed to prevent us from accessing care and perpetuates a broken system that does not serve us adequately or compassionately.
3. We’re Not Allowed to Feel Discouraged or Defeated
Behind all of the pressure to “keep trying” and all the suggestions that we’re never quite doing “enough” to get better is the implicit message that mentally ill people are not allowed to feel defeated. We’re not allowed to momentarily give up, hang up our gloves and say, “This isn’t working, and I’m tired.”
If we aren’t constantly “on” and working at recovery, it’s suddenly our fault that things aren’t improving. If only we’d just put in the effort, things wouldn’t be this way. Never mind that we’re human beings, and sometimes it’s just too overwhelming or painful to keep going.
A culture that treats mental illness as a lack of effort is a culture that says mentally ill people aren’t allowed to be fully human and vulnerable. It dictates that the effort is our sole and constant responsibility, and that we aren’t allowed moments in which we can grieve, give in, or be afraid.
The expectation that mentally ill folks are doing something wrong if they aren’t constantly in motion is an unrealistic and unfair burden to place on us, especially because the level of dysfunction that mental illness can present can make it nearly impossible to advocate for ourselves in the first place.
Feeling discouraged is valid. Feeling afraid is valid. Feeling exhausted is valid. There is a full spectrum of emotion that comes with recovery, and part of humanizing mentally ill folks requires that we hold the space for those emotions.
Recovery is a discouraging, scary, and exhausting process that can wear down the most resilient among us. This has nothing to do with mentally ill people’s personal failings and everything to do with the fact that these illnesses can be difficult to live with.
If you blame us for not trying harder or trying enough – demonizing those moments when we feel most vulnerable or defeated – what you’re saying is that if we aren’t superhuman and invulnerable, our pain is deserved.
This is untrue. We don’t deserve this. And we certainly didn’t ask for it.
4. We’re Either Too Functional to be Sick or Too Dysfunctional to be Helped
Here’s one of those ways in which mentally ill folks can’t win: we’re either too “functional” by appearances and therefore making excuses for our shortcomings, or we’re too “dysfunctional” and we’re a burden on society that can’t be helped.
Either way, rather than acknowledging the impact mental illness has on us, people tell us that in both scenarios, the problem lies with us.
It personalizes our struggles in a way that is dehumanizing. We’re seen as either dishonest or insane, and in either case it’s our responsibility to deal with it rather than society’s collective responsibility and ethical obligation to set up systems that allow us to heal.
And as with all of the myths we’ve broken down in this article, this is how oppression operates at its most insidious level: by decentering the systemic origins of human suffering and instead placing the responsibility and blame on the individuals who are suffering. If we categorically write off mentally ill people by either invalidating the authenticity of their struggles, or pushing them off to the margins as irredeemably lost, we no longer have to be accountable for what happens when our systems fail them.
Though attitudes like these remain the status quo and might initially seem benign, they create a protective shield that obscures what’s really at play.
It’s ableism, plain and simple.
Victim-blaming folks with mental illness is not just a matter of stigma, though we can easily recognize it as such. It’s also a form of violence; it directly upholds a system that harms the psychiatrically disabled and deflects accountability for that harm.
We can all do better than this, and it starts by putting the blame where it really belongs – not with mentally ill folks who are only trying to survive, but with the systems that fail us, a society that gaslights us, and the violent attitudes that embolden them both.
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This piece that I wrote originally appeared at Unapologetic Feminism.