We’ve created a hierarchy of mental illnesses. I can’t tell you the number of times I’ve been told, “Well, at least you’re not schizophrenic!”
Welcome to Crazy Talk: a mental health advice column written by yours truly, a mentally ill and queer writer reclaiming his “crazy” to educate and empower. In a world that tries to push us to the margins, I’m all about getting loud and kicking the stigma where it hurts. In this column, we explore what it’s like to live with mental illness without shame or apologies. Expect frank advice, a little self-deprecation and a good dose of humor.
Once upon a time, I was misdiagnosed with bipolar disorder. Back then, everyone took my mental illness very seriously. When I described my depressive episodes — acute suicidality, agonizing emotional pain, inability to enjoy the things I once loved, plummeting self-esteem — I was (for the most part) met with deep concern. It wasn’t my fault, I was told, so people on the whole were more compassionate.
And then it was suggested that I might have borderline personality disorder. Suddenly my depressive episodes were suspect. Was I being manipulative? How “sincere” was this episode, exactly? What was my “end goal?” Could I be trusted? Was I just another lost cause under the umbrella of Cluster B? After all, it was an issue with my personality, so I must have brought it onto myself.
When my history became a little more clear, the language shifted again: clinical depression and complex PTSD. That’s when the invalidation came into play. “Everyone gets depressed sometimes.” “We’ve all struggled at some point or another.” “Life is tough, that’s to be expected.” Nothing about my experience was exceptional or important or unique anymore.
My actual experiences of depression hadn’t changed. But depending on the language I used to describe myself, the kind of concern (or lack thereof) that I would be met with varied significantly. My depressive episodes went from being alarming, to suspicious, to trivial. I was the same person with the same struggles, and yet a single word could be the difference between solidarity and invalidation.
Someone wrote me recently to ask why I thought that some mental illnesses are taken more seriously than others. But it’s first important to note that mental illness, on the whole, is not taken as seriously as it should be. Stigma and invalidation are a part of the package, I believe, no matter how you’re diagnosed.
But it’s also true that we’ve created a hierarchy of illnesses. I can’t tell you the number of times I’ve been told, “Well, at least you’re not schizophrenic!” Some mental illnesses are considered more serious or devastating than others.
And I think that ultimately misses the point: rather than pitting mentally ill folks against each other, we should be advocating for the best possible life for every individual — on their own terms — regardless of what the diagnosis may or may not be.
There are worthwhile conversations to be had around the unique struggles that come with different illnesses. But I think those conversations can be had in a way that doesn’t undermine the seriousness of other disorders, and without invalidating people whose experiences are different but still significant. Unfortunately, in popular culture, that nuance has been totally lost — and we wrongfully exploit the pain of some mentally ill folks to invalidate others.
Even mentally ill folks do this to themselves. They’ve internalized this. I’ve interacted with people who have said things to me like, “Well, my depression isn’t as bad as yours” or, “I haven’t been hospitalized like you.” They feel like they can’t be honest about their experiences without undermining or qualifying them.
I never asked for my pain to be weaponized in a way that dismisses somebody else’s suffering. I never wanted that. And yet it seems like every week, someone feels obligated to tell me that they “don’t have it as bad” before they can share with me that they’re hurting, if they share it with me at all.
Can we just agree that mental illness totally sucks? And can we please do that without footnotes, without the feeling that we have to prove ourselves?
Emotional pain will always be relative. Empathy requires that we understand that very basic fact. Rather than trying to measure those experiences with our own imaginary yardstick, we need to ditch the yardstick altogether and imagine what that pain is like in the context of someone else’s life. If it’s painful for them, that pain is real. Full stop.
I’m not here to suggest that everyone’s struggles are exactly identical. But I do believe that when someone tells us that they’re suffering, they deserve to be believed. Mental illness is always serious — and while it shows up in different ways for different people, that doesn’t make it any less important.
Honestly, if we just listened to people when they explained how deeply mental illness and trauma affects their lives, we wouldn’t be having this conversation. Because if we trusted mentally ill folks when they told the truth of their experience, we wouldn’t be relying on stereotypes to fill in the blanks.