mental illness

Living With Depression: Trust

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I’m going to do a series of posts on what it’s like to live with chronic depression, beyond the DSM symptoms that you always hear about. I want to help people understand.

I’m in a particularly good position to do this now because my depression is technically in remission, which means that I no longer fit the diagnostic criteria for it. I’m fine. I’m even sort of happy. However, the complex effects that nine years of depression has had on my thinking style, beliefs, and personality are still there, as are (probably) whichever genetic and neurological risk factors caused this whole mess to begin with.

However, not having a depressive episode means that my thinking is clearer and it’s easier for me to talk about this calmly.

A caveat–none of this is meant to generalize to everyone with depression. Don’t read this and apply it to your friends and loved ones who have it. Instead, perhaps, use it to start a conversation.

So, trust. In one way or another, it’s the backbone of all human interaction. You have to trust that your friends won’t share your secrets, that your partner won’t cheat on you, that your colleagues will pull their weight on the project, that your babysitter will take good care of your kids, that the clerk will give you the correct amount of change, and so on.

People who haven’t studied much psychology might think that trust is based on a conscious, logical appraisal of the person you’re interacting with. But in fact, trust is based on emotional responses to others, and a lot of the time we’re not even aware of those responses.

Although emotions get a bad rap for being “illogical” and for interfering with people’s lives, they–more so than conscious, “logical” cognition–are what help us make good decisions. Fear, of course, is the best example, since it helps people stay out of trouble. So does disgust.

But positive emotions are important in that way, too. For instance, we don’t really choose our partners based on how much money they make or how attractive they are or how many children they want to have; we choose them based on how they make us feel.

So, mood disorders like depression cause emotions to disconnect from experiences, so to speak. As Andrew Solomon wrote in The Noonday Demon, “Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance.”

When I was depressed–and, to a much lesser extent, now–feelings happened to me in a completely arbitrary way. The changing leaves made me feel grief. Being unable to talk to my family made me feel shame. Relatively minor inconsiderate actions, which would merely annoy a healthy person, threw me into a rage.

I learned not to trust my feelings. Often people made me uncomfortable and I’d chalk that up to depression, forcing myself to keep them in my life. This led to continued discomfort at best and abuse at worst. Then, infuriated at the situation, I would overcompensate and kick people out of my life who had merely messed up, as everyone sometimes does.

I learned not to trust others. Even the most well-intentioned person could–completely accidentally–send me into a depressive funk with a single teasing comment. Once a guy misjudged his feelings for me and led me on for a few weeks, and I was depressed for a year and a half after that. And I can’t even count the number of people who argued with me a bit too forcefully for me to avoid jumping to the conclusion that they must hate me from the depths of their souls, and so I cut off contact.

I can’t trust people anymore because I know that anyone–even the most kind, considerate, good person–can unintentionally make me cry for hours or hate myself for months.

And not everyone I meet is a good person.

I learned not to trust myself. If my brain lies to me all the time, how can I? Cognitive distortions make it nearly impossible to know when I’m thinking clearly and when I’m not. I used to keep a list of the most common ones in my binder to remind myself, but it didn’t really help.

Without emotions that are more-or-less based on reality, trusting myself and others is nearly impossible. I can’t tell whether a certain situation is bothering me because it’s a bad situation or because I’m freaking out over nothing. I can’t tell if I don’t want to get a PhD because I really don’t want to get one, or because I feel like too much of a failure to even try. I can’t tell if someone is really lying to me, or if I’m just assuming the worst because that’s what you kind of do when you have depression.

Difficulty trusting others is usually considered a character flaw or weakness. For me, though, it’s a symptom of a mental illness. It’s also an adaptation, because I’ve been too trusting in the past and I’d rather be safe than sorry–that is, than risk a relapse because I let the wrong person in.

The important thing to remember is that people who experience depression this way aren’t distrustful because we’re cynical or misanthropic. It’s because without healthy and adaptive emotional responses, it’s nearly impossible to know who to trust. It is also impossible to trust ourselves.

Living With Depression: Trust
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[guest post] You Are Not Alone: A Shared Story of Depression

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Seth returns again to talk about the response he received to his speech about depression and spirituality. (This is his third guest post. Hmm, maybe he should get a blog already!)

A few days back, I wrote a piece titled “The Dharma of Depression,” wherein I talked about the experience of depression and the way my spirituality has interacted with that. I must confess myself quite overwhelmed and flattered with the response that it’s gotten.

But I’m not here today to toot my own horn. There’s plenty of other times to talk about how awesome I am. No, the thing that’s stuck out to me about the response I’ve been getting is how many people have said that I spoke to a personal experience in their lives. By contrast, I’ve only had one person tell me that they’ve never experienced what I was talking about.

This is important.

It’s important because depression is an incredibly lonely disorder. One of the many thoughts that depressed people tend to get stuck in is the idea that they’re completely alone—maybe there are people who care, but there’s nobody out there who understands what they’re going through well enough to be able to help them. This has been my experience, and it’s also something I hear a lot from other people who talk about the experience of depression. What seemed to be happening in response to my piece, based on the comments I’ve been getting, is that having somebody describe an experience similar to the one they went through suddenly challenged this sense of isolation and opened up the possibility of somebody else being able to relate to how they felt.

What’s ironic is that even in the middle of this isolated feeling, there are many more people
than you’d expect going through a more or less similar experience. Certainly, for me, there were more people than I could’ve imagined even just among my immediate friends group who could relate to my pain. I expected two or three people in my audience to be familiar with the feelings I described; based on the number of people who have talked to me, I’d rate the actual number to be closer to fifteen or twenty, out of no more than fifty.

So. To those of you who are all too familiar with the feelings I described, I have something to say to you. And despite my usual tendency towards wordiness, I’m going to be as concise and blunt as I can, because it’s incredibly important for you to understand.

You are NOT alone.

You are NOT some kind of emotional freak.

Most importantly, you are NOT a hopeless case.

You have a problem, yes. But this problem is not unique to you. It’s not a problem that
everybody will understand, but neither is it a problem that nobody will understand. It is a problem that has been lived through. It is a problem that has been studied. It is a problem that, at this very moment, thousands of individuals are working to find a way to treat.

You can find support, and you can find help. I know there are bad breaks and well-meaning idiots out there, but if you just hold on and keep looking, you will eventually find somebody who understands what you’re going through. There are more of them out there than you think.

You can survive this.

Seth Wenger is a senior neuroscience major at Earlham College and a practicing Buddhist. He can usually be found on Facebook, snarking about life, current events, and politics.

[guest post] You Are Not Alone: A Shared Story of Depression

Faith is not a Mental Illness

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I’ve been seeing a disturbing tendency among atheists to compare religious belief to mental illness. Sometimes this comparison is made explicit, as in this article. Other times, however, the comparison is more implicit–for instance, when words like “crazy” and “delusional” are used to describe religious people or their beliefs (hi Dawkins).

These comparisons are inaccurate and offensive to both religious people and people with mental illnesses.

First of all, being religious is a choice. Being mentally ill is not. While it’s a bit arguable whether or not faith itself is a choice–I certainly can’t make myself believe in god, but perhaps others can–the existence and success of religious proselytism proves that choice is at least part of the equation. Only a completely ignorant person, on the other hand, would attempt to proselytize mental health (although it obviously does happen).

Regardless of whether or not you can choose to believe in god, you definitely get to choose whether and to what extent you observe a religion (unless you’re a child, but that’s different). People with schizophrenia don’t get to choose which hallucinations they have and how often. People with OCD don’t get to choose their compulsions. People with phobias don’t get to choose which phobias they have or how they manifest themselves.

Second, suggesting that religious people are mentally ill is sanctimonious and offensive. It insinuates that they are incapable of consciously and purposefully choosing to be religious, and that their religious beliefs are just as meaningless as a symptom of mental illness. It reminds me of when I used to bring up concerns with friends who would respond, “Oh, that’s not such a big deal, you just feel that way ’cause you’re depressed.”

As I mentioned, being religious is a choice. For most people, it’s a choice made with one’s own best interests in mind. Comparing that to a schizophrenic delusion is a wee bit condescending.

(Of course, delusions that are religious in nature do exist. Some people with schizophrenia believe that they are possessed by religious spirits of some kind, that they have spoken to god, or that they are the messiah. However, this is vastly different from the way most religious folks experience their faith, and is obviously a symptom of mental illness.)

Although I’m an atheist who kinda sorta wishes religion didn’t exist, the fact is that it does, and I refuse to believe that all of the billions of religious people in the world are just mentally ill. No, they’re onto something. It’s just not something that I’m interested in myself.

Finally, these comparisons trivialize the suffering that people with mental illnesses experience. The distinction between mental health and mental illness is not that mentally healthy people do not believe in supernatural things and mentally ill people do. The difference is that (most) mental illnesses interfere with the person’s functioning and make them feel, well, bad.

Religion, for all its flaws, often does the opposite–it provides people with community, teaches them to behave morally and charitably, and helps them cope with illness, death, and other challenges in life. (A caveat: I’m talking about religion at its best, not at its worst, and these same effects can be found elsewhere.)

So when you imply that the definition of mental illness is believing in things without evidence, you miss a lot about what it’s like to be mentally ill. Namely, you ignore the emotional pain, cognitive distortions, thwarted goals, ruined relationships, physical fatigue, and all the other things that are part of the experience of mental illness.

There are many interesting, intelligent, and non-offensive ways for atheists to argue against destructive religious ideas (for instance, here’s an example I read today). Calling religious people mentally ill is not one of those ways. Let’s put that kind of useless rhetoric back on the shelf where it belongs.

Faith is not a Mental Illness

[guest post] The Dharma of Depression

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My friend Seth, who has guest-posted here before (read it, it’s awesome), returns to talk about depression and Buddhism.

Note: The following is a transcript of a speech given at the weekly College Meeting for Worship at Earlham College.

Good afternoon, and thank you all for coming. It means a lot to me that people have come to hear me talk about this.

For my entire adult life, and most of my adolescence, I have struggled with depression.

Sorry to drop the heavy stuff on you right away, but this must be understood if anything is to come of the rest of my talk.

In many ways, I have been very lucky. I have never had to take medication; I know people who have. I know people who would not be with us today if they hadn’t had medication. I know people who are no longer with us. I have attended memorials for those people in this very meeting house.

Depression is a terrible, terrible disease.

Other diseases ravage your body; depression ravages your mind. It tears away at you will, your hope, at everything that makes you, you.

Let me be clear about this: depression is not sadness. 24/7 sadness would be incredibly obvious to everybody around you. But depression is much more insidious than that, and in my experience, it often takes your friends and loved ones by surprise when it crops up.

So what is depression, then?

Well, I obviously can’t speak for everybody, but here’s my experience:

Depression is being trapped in a slow, steady downward spiral of negative thoughts. Depression is thinking that the biggest mistake you made all day was getting out of bed. Depression is the feeling that you’re slowly falling to pieces, and the inability to pick yourself back up and put yourself back together. Depression is the irrational yet inescapable idea that your life means nothing to anybody, and that nothing would change if you just suddenly vanished from off the face of the earth.

The worst thing about depression, though, is that it devours the very resource that is necessary to fight it: your willpower. Sure, maybe you know that you should try talking about it to a friend you trust, or make an appointment to see a councilor, and that might help. But how in the world are you going to do that when you’re lucky just to have the ability to pry yourself out of bed in the morning?

All this is very important to understand. Partly for my story, because this is what I mean when I say that I was depressed. But also because you may well meet somebody suffering from depression in the future, or maybe you already know somebody who is. It will help both of you if you have at least some idea of what they’re going through.

But back to my question, because for far too many people, it isn’t rhetorical. How do you fight something that destroys your ability to fight?

Like the experience of depression, the key to overcoming it is different for each individual person. For me, the key was faith, which is why I’m here talking to you all today.

It may surprise some of those here that know me when I say that I consider myself a deeply religious person. Part of that is probably because I’m not extremely outspoken about my religious beliefs, and when I do talk about them I tend to frame them as a general philosophy about the world rather than a spiritual belief. Part of that is probably a cultural tendency to assume that “religious” means Christian, or at least Abrahamic, which I am neither. Nor is the religion I wound up devoting myself to the same one I was brought up with. Nevertheless, I consider myself religious because my personal philosophy and sense of morality are, if not directly taken from my religion’s teachings, very much in sync with them.

Allow me to explain.

Continue reading “[guest post] The Dharma of Depression” →

[guest post] The Dharma of Depression

What We Talk About When We Talk About College

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It’s been rather quiet around here lately.

I’ve just started my senior year, and with that came a lot of reflection–what I want this last year to mean, how I can improve on the years that came before it, and, perhaps most importantly, why it is that my time at Northwestern has been so fucking painful?

I may never know the answer to that question, honestly. I have a few answers, but I don’t have the answer. The answers seem so banal when I list them, and they cannot do justice to my experience here: the depression, the social atmosphere, the pre-professional orientation, the year wasted in journalism school, the quarrels with the administration, the lack of adequate mental health services, and so on and so forth. None of these things, on their own or in any combination, can explain it.

I still remember the pervasive sense of loss I felt when I realized that I was never going to get what I came here for. That beautiful, glossy image of college that I’d been sold would never be my experience. Some days I love this school, but I will never be able to look at it with that fondness with which most older adults talk about their alma maters.

But the truth is that it’s not just me. This time is not universally wonderful. It is not the best time of everyone’s lives. For some people, it is a sad or boring or lackluster time. For some it isn’t really a big deal either way. For others, as we were reminded so horribly last week, it is a tragic time.

What we talk about when we talk about college matters. While I don’t think we should be unduly negative, we should not be unduly positive, either. Painting college as an unequivocally wonderful time–implying, therefore, that if you aren’t having a wonderful time, you are to blame–doesn’t do anybody any good, except perhaps for those who stand to gain from increased tuition revenues.

When we make college out to be the best four years of our lives and push all the unpleasant stuff under the rug, we let down students who are suffering. We let down those for whom the stress and loneliness triggered a mental illness. We let down those who suffer from substance abuse problems, and those who have been robbed, harassed, stalked, and assaulted. We let down those who can’t keep their grades up, who see their friends post Facebook statuses about their 4.0’s at the end of every quarter and think they are the only ones. We let down those who can barely afford to be here. We let down those who miss their families every day. We let down those who have been bullied or taunted because of their appearance or identity–because, yes, that happens, even on a “liberal” campus like ours.

Does this stuff suck? Yeah. Is it unpleasant to talk and read about? Yup. I don’t care.

Here are some things I went through while I’ve been at Northwestern. I’ve been depressed. I’ve been suicidal. I’ve cut myself. I’ve taken antidepressants. I’ve been so tired I couldn’t sit up. I’ve broken down crying in the garden by Tech. I’ve been harassed and assaulted. I’ve been bullied. I’ve been robbed. I’ve lost close friends. I’ve failed tests. I’ve had panic attacks. I’ve tried to starve. I’ve hated myself and the world and wanted to quit.

And then I got lucky, and I found a second family and figured out what to do with my life and got good at the things I love to do. I found feminism and atheism and activism. I got lucky. But I will not shut up about what college was really like for me, because to do so would be to abandon those who haven’t found what they need here yet, or won’t find it ever.

A few weeks ago, a writer for xoJane wrote a piece called “When College Isn’t Awesome.” She discussed her own decidedly not-awesome experience and then published the stories of others. When I read it, I found myself wishing that it had been written years ago, when I was a freshman. The author wrote:

While reflecting on my less-than-picture-perfect college adventure, I asked other folks to share their own stories of college-era emotional and psychological struggles. My hope is that some suffering student will see this post and feel less alone. Maybe she or he will even be more inclined to reach out to the student counseling center, friends, or other resources for help. Or maybe she or he will just feel less like a freak for wanting to stay in bed and cry while seemingly everyone else excitedly skips off to the football game.

That is exactly why I keep talking about how difficult these past three years have been for me. It’s not just because it’s a relief for me to share my own story rather than trying to keep it to myself. It’s also because I want others to know they’re not alone.

What we talk about when we talk about college matters.

What We Talk About When We Talk About College

[storytime] At The Edge Of The Known World: What It's Like To Consider Suicide

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Somebody, somewhere in the world, kills themselves every 40 seconds.

Set a timer on your phone or watch for 40 seconds. When it beeps, another precious, beloved life is gone.

Yesterday, September 10, was World Suicide Prevention Day. Although suicide prevention entails important things like improving mental health screening and treatment, increasing access to mental health services, and decreasing the stigma of admitting and treating mental health problems, I think there’s another part that we usually miss when we talk about prevention. And that part is understanding what being suicidal is really like.

Those who kill themselves (or wish to do so) are not selfish.

They are not weak.

They are not simply having a bad day.

All of these tropes about suicide, and many others, are wrong.

I can only speak for myself, not for any of the other millions of people who have struggled with this most ultimate of dilemmas. But for me, at least, here is what it was really like.

Continue reading “[storytime] At The Edge Of The Known World: What It's Like To Consider Suicide” →

[storytime] At The Edge Of The Known World: What It's Like To Consider Suicide

The Circular Logic of Internet Misogynists

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Yesterday–the same day, incidentally, that I discovered that I’ve inspired my first pathetic little hate club–a blogger I respect announced that she’s taking a hiatus from blogging after enduring constant abuse and harassment for daring to be a woman with opinions on the internet.

Jen McCreight wrote:

I wake up every morning to abusive comments, tweets, and emails about how I’m a slut, prude, ugly, fat, feminazi, retard, bitch, and cunt (just to name a few). If I block people who are twisting my words or sending verbal abuse, I receive an even larger wave of nonsensical hate about how I’m a slut, prude, feminazi, retard, bitch, cunt who hates freedom of speech (because the Constitution forces me to listen to people on Twitter). This morning I had to delete dozens of comments of people imitating my identity making graphic, lewd, degrading sexual comments about my personal life. In the past, multiple people have threatened to contact my employer with “evidence” that I’m a bad scientist (because I’m a feminist) to try to destroy my job.

[…]I don’t want to let them win, but I’m human. The stress is getting to me. I’ve dealt with chronic depression since elementary school, and receiving a daily flood of hatred triggers it. I’ve been miserable….I spend most of my precious free time angry, on the verge of tears, or sobbing as I have to moderate comments or read what new terrible things people have said about me. And the only solution I see is to unplug.

 

In case you don’t follow Jen’s blog and aren’t familiar with what’s been going on, here’s an example, and here’s a post she wrote about it once. I don’t really have the words for how awful and unconscionable this is, so I’ll just quote JT Eberhard: “the people who have harassed her into quitting are inhuman shitbags.  As the atheism movement gets bigger, the tiny percentage of just rotten folks will continue to be comprised of more and more people who would sooner destroy a person than an idea. Those people don’t deserve this community.”

But what I really wanted to talk about was these misogynists’ reactions to Jen’s decision to quit blogging (for the time being). Sure, some of them made the typical “good riddance” comments, but others actually blamed her for being “unable to take the heat” and claimed that the only reason she quit was to get sympathy.

The interesting thing is, these people purposefully harassed Jen–you know, to make her feel like shit–and then blamed her for being too “weak” to take the harassment without quitting.

This sort of circular logic completely baffles me.

(It’s not the first time I’ve seen this convoluted reasoning in a community that prides itself on its supposed ability reason clearly. An idiot once saw fit to inform Greta Christina that he had lost all respect for her after she released a naked photo of herself for a good cause—a photo that he masturbates to. Somebody explain this.)

What many of these misogynists seem to be saying is that the fact that Jen quit retroactively justifies their treatment of her. Because she wasn’t able to “deal” with their harassment, the harassment was justified. Ridiculous.

Also, it disgusts me how clueless these people seem to be about mental illness. People who stop doing something because that thing is giving them a mental illness are not being “weak.” They aren’t “letting the trolls win.” They aren’t “flouncing.” They aren’t “looking for sympathy.” They’re taking care of their own health.

And that comes first, even if their mental illness was caused by something that seems like no big deal to healthy folks. For instance, if dating makes you depressed, you’re completely justified in staying away from dating for a while. If your job is making you depressed, you’re completely justified in finding a new job. But what happened to Jen, by the way, is not something that should seem like “no big deal” to any halfway-decent person.

I likewise take issue with people who refer to what Jen went through as “trolling.” There’s a difference between trolling and harassment. When I make a blog post and someone comments “lol your an idiot, go fuck yourself and stop writing,” that’s trolling. When someone continually harasses someone on various internet channels (email, Twitter, the target’s blog), recruits more people to help with that, writes their own blog posts trashing the target, impersonates them in a derogatory way, that’s not trolling anymore. That is harassment.

Trolling is usually mindless and casual, something done by an immature, inconsequential person who’s bored and wants to mess with someone. Harassment is calculated, targeted, and done with a purpose. Trolling is annoying and stupid; harassment is harmful and can be scarring.

Trolling is something we all run the risk of when we put our work out there on the internet. Serious political posts get trolled; silly YouTube videos get trolled. Delete the comments and move on.

Harassment is not something we all run the risk of. Harassment is targeted at people who are being “uppity,” who don’t “know their place.” A feminist on the internet–and especially a feminist in the atheist blogosphere–is one such person.

I don’t care how strongly you disagree with someone’s ideas–harassment is unacceptable no matter what. There is no justification. The fact that your target developed a serious mental illness and had to quit is certainly not a justification. The fact that you disagree with their vision for atheism is not a justification, either. If you think harassment is an appropriate response to ideas you disagree with, then guess what–you’re a terrible excuse for a human being.

I rarely make statements as categorical as that one, so you know I really mean it when I do.

The Circular Logic of Internet Misogynists

[In Brief] How to Talk About Mental Illness Recovery Without Shaming

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Lucy Hale covers this month’s Cosmo.

Remember that post about celebrity gossip I just wrote? Well, here’s an example of how reading that stuff can be useful and enlightening.

I’m reading an interview in the September issue of Cosmo with Lucy Hale, a 23-year-old actress most known for her role on Pretty Little Liars, a guilty pleasure of mine. In the interview, Hale opens up (apparently for the first time) about the eating disorder she struggled with as a teenager:

But behind the scenes, Lucy developed a dangerous habit all too common among young starlets. ‘I’ve never really talked about this, but I would go days without eating. Or maybe I’d have some fruit and then go to the gym for three hours. I knew I had a problem,’ Lucy says of the issue that plagued her for two years. Luckily, unlike some actresses who have been unable to escape the downward slide, Lucy had the strength to turn herself around. ‘It was a gradual process, but I changed myself,’ she says.

Except for the following paragraph, in which Hale talks about cutting damaging friendships out of her life, no other details are given about how she recovered from her eating disorder, and I won’t assume. However she did it, it’s awesome and she deserves to feel great about having accomplished that.

However, the Cosmo writer takes it a bit further with this sentence: “Luckily, unlike some actresses who have been unable to escape the downward slide, Lucy had the strength to turn herself around.”

Wait…what? So people who succumb to the “downward slide” of eating disorders, or who need professional help to recover, just lack the “strength” that Hale has?

Obviously, I disagree.

If Hale really did recover without any professional help–which, again, she does not make that clear–there are many potential reasons for that. Perhaps she had a great support system of friends and family. Maybe she’s not genetically predisposed to eating disorders. Maybe her parents have healthy eating habits that they were able to model for her. She might’ve not had as serious a case as others do. Or perhaps she just got lucky.

None of this means that actresses who are “unable to escape the downward slide” have any less “strength” than Hale did. It means, probably, that they had different circumstances. Different lives.

So, how does one talk about people who have recovered from mental illness on their own without putting down those who cannot? My answer would be, by not comparing them to each other. Hale recovered? That’s awesome. Another actress didn’t? That’s a tragedy, and she deserves help and support. Their illnesses are not comparable, even if they happen to share the same name.

As Leo Tolstoy said, unhappy families are all unhappy in their own way. Similarly, people who suffer from mental illness all do so in their own way. Just because one recovers and another does not doesn’t mean that one has more “strength” than the other.

P.S. Before anybody goes all “but it’s just Cosmo, who cares!”, Cosmo has a circulation of over 3 million in the United States and is also distributed in over 100 other countries in 32 languages. Readers of this blog probably think Cosmo is silly and not something to be taken seriously (which it’s not), but the truth is that many people around the world probably get most of their information about things like mental illness from media like this. So it’s definitely worth examining and critiquing.

[In Brief] How to Talk About Mental Illness Recovery Without Shaming

Abortion and Suicide: A Spurious Link

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In South Dakota, it is now legal to require doctors to tell women seeking abortions that they are putting themselves at risk for suicide.

This move is brilliant from a PR standpoint. Unlike banning certain types of abortions entirely or, say, forcing women to undergo invasive screenings that are medically unnecessary, this seems completely apolitical when you first look at it. Don’t people deserve to be informed if they may be increasing their risk for suicide? Don’t we all agree that suicide is a Bad Thing?

However, something tells me that this is actually another attempt to scare women out of (what should be) a normal, socially acceptable medical procedure.

First of all, the inconvenient truth here is that credible research consistently shows little or no link between abortion and poor mental health. One 2008 study reviewed the literature and found that the only studies that seemed to show such a link had very flawed methodology, whereas the studies that were well-designed showed no links. (Damn liberal academics!) And here’s another study that showed no such links. And here’s a thorough debunking of a study that did claim such links:

Most egregiously, the study, by Priscilla Coleman and colleagues, did not distinguish between mental health outcomes that occurred before abortions and those that occurred afterward, but still claimed to show a causal link between abortion and mental disorders.

In other words, that study actually tried to use mental health pre-abortion to confirm a hypothesis about mental health post-abortion. This is simply not how you do science. And it’s especially bad here, because according to the American Psychological Association, guess what the best predictor of mental health post-abortion is?

Across studies, prior mental health emerged as the strongest predictor of postabortion mental health. Many of these same factors also predict negative psychological reactions to other types of stressful life events, including childbirth, and, hence, are not uniquely predictive of psychological responses following abortion.

That’s right. Shockingly enough, the best predictor of mental health is, well, past mental health. And poor mental health predicts poor response to all sorts of stressful events, of which abortion is only one example. Another one being, for instance, childbirth!

Compounding the bad science here is that, unlike physical side effects,suicide isn’t something that just happens to you suddenly and without warning. People don’t just suddenly wake up one morning and decide to kill themselves. Suicidality is a complex process that involves factors like genetics, family history, environment, social support, mental illness, and life circumstances. For instance, here are some things that, according to research, actually increase one’s statistical risk for suicide:

As you can probably surmise, not all of these correlations are also causations. While mental illness and drug addiction can actually cause suicidal behavior, being intelligent and being LGBT probably cannot. In the latter case, the causative culprit seems to be (surprise surprise) institutionalized discrimination and homophobia. Before I get too off-topic, let me point out the irony in the fact that, despite this well-known risk faced by LGBT youth, I don’t see any of these pro-lifers advocating for an end to homophobia.

That’s why something tells me that nothing about this court ruling actually has anything to do with suicide prevention.

Although the court’s ruling does at least acknowledge that abortion probably doesn’t cause suicide, it nevertheless states that “conclusive proof of causation is not required in order for the identification of a medical risk.” This is probably true, but it only makes sense from a physical health standpoint. If studies show that people who get a certain elective medical procedure are much more likely to, say, experience headaches or nausea or numbness, you don’t necessarily need a causative study to conclude that there’s a reasonable chance that these symptoms were caused by the procedure (assuming, of course, that there was no illness present that might be causing them). Furthermore, there’s a difference between saying “This procedure may cause you to experience cramps and headaches” and saying “This procedure may cause you to kill yourself.”

The truth is, mental health doesn’t work that way. A person who gets an abortion might experience mental side effects because of the stress of having gotten pregnant accidentally and been forced to decide what to do, perhaps without the support of a partner or family. Furthermore, any invasive medical procedure can be stressful and worrying for many people–especially one like abortion, which is consistently portrayed as more painful and dangerous than it really is.

And this is all made even more complicated by the fact that the faulty studies in question were actually studying mental health before the abortion. Perhaps a person with poor mental health is more likely to seek an abortion in the first place–say, if they feel that they aren’t mentally capable of raising a child at the moment.

Ultimately, decisions about what to tell a patient should be left up to the people who know most: doctors (with, of course, a reasonable amount of regulation to prevent malpractice). If a doctor can tell that a person seeking an abortion is going through a lot of mental distress, then that doctor may want to gently recommend counseling and perhaps give out some hotline numbers–and training doctors to recognize signs of mental health troubles is always a good thing.

But doctors should not be mandated to fearmonger to their patients. They should especially not be mandated to serve a pro-life agenda.

Abortion and Suicide: A Spurious Link

[Guest Post] An open letter to the woman who said I wasn’t skinny enough to have an eating disorder

Miri, , , 8 Comments

Another guest post, this time by my friend Kate.

You are the mother of my greatest friend. Your house was my refuge in high school. I wanted to surprise you and share my happiness with you when I got into my dream college. By my senior year, I spent almost every day after school at your house. You offered to cover for me, to be a hiding place when I simply could not deal with my family…and you became someone I trusted. You knew me in the worst throes of my starvation. I was skinny then. I was too skinny, and faint and malnourished and mentally ill. You didn’t know it then, but your son guessed, and for that, he has my eternal gratitude. Without him, I do not know that I would have survived to this point. That is not hyperbole.

You saw me this summer, back home for the worst summer I’ve had. I have gone off therapy for these three months, because you see, my parents don’t use modern medicine, and I cannot trust them to care for me. I am dependent on the kindness of my university to have treatment in the first place. This summer, all I have are friends, and my own will to do anything to keep from slipping back into a hell of calorie counting and obsessive thoughts and the nightmare of reflective surfaces. I used to hate myself, you know. It still creeps up on me and strangles and pulls at loose skin, until all I can do is hold off from screaming and curl up in bed.

You don’t know this. I would have told you, had you asked. I speak about my cesspit of destructive behavior, because you can’t tell when you look at me. That is true of most eating disorders, and someone has to talk about it. I will be that person.

You can’t tell that some days I realize all I’ve had is a cup of coffee in twenty-four hours, and I am blisteringly happy. You can’t tell because I force myself to hold a normal weight. I have for four years, and on especially good days, that is a source of pride.

That number on the scale isn’t the weight I want, but it is healthy. It is perfectly in the range for my height, a muscular build that runs and leaps and cartwheels, but it isn’t skinny. It isn’t skinny, and that is all you see. I am not starving, and so I cannot possibly suffer. I should get over it.

I’d like to, but if the past six years are any lesson, I won’t. I will always depend on alarms to remind me when to eat. I will plan my workouts ahead of time, because when I don’t, I become obsessive, and exercise until I cannot see straight. I will never eat with abandon. Meals will be planned for. Eating out will be stressful. I will have an uneasy truce with food.

And there will be people like you. I hate saying that because, until yesterday, when I said that I meant people who would care, and make me laugh, and be one of the solid ones. There will be people like you, who think I’m making a fuss, playing victim. You were one of the good ones, once, so I’d like to set the record straight.

I am recovering from an eating disorder. For two years, I averaged less than 800 calories per day. I danced intensively, as much as four hours a day. I lost too much weight. I was starving and bony. I did permanent harm to my body.

I have bradycardia. That means my heart beats too slowly; it doesn’t speed up enough when I exercise. If I push too far? I’ll faint. I do not trust myself to exercise outside of a gym. I cannot know when my vision will narrow, but in a building, I at least know that if I stay unconscious, someone will be there. I want you to consider that my safety net is the kindness of strangers to notice if I do not wake up.

The rate for attempted suicide in those with eating disorders is as high as three times that of the general population. Everyone quotes statistics, but I want you to take a hard look at that one. If you combine the neurotypical people out there with those who have PTSD, with those who have major depression, with everyone else who has considered their life not worth living, they attempt suicide at one third the rate of those with eating disorders. You know what makes me hurt so badly I want nothing more than to make it stop any way I can? When people I trust decide some number on a scale measures the weight of my claims, when they reinforce the horrible things I believe about myself. I just never thought one of them would be you.

I want you to know something important about your son. Your son cared for me without knowing any of those facts or statistics or numbers. He just thought I was worth time. He thought I was too skinny, that I was maybe hurting myself, and so he did what he could. He held me and took me to dinner and made sure I ate. He never demanded justification—he waited until I told him I had an eating disorder—the first person I ever confessed to. He smiled, and said he knew, and then we went back to life as normal. We talk every day, because we take care of each other.

I want you to understand something, more than anything else in this letter. You
said I didn’t really have an eating disorder. But that wasn’t the worst thing. You also told my greatest friend, your son, that he should back away from me. You said he shouldn’t ‘have’ to take care of me. You wanted him to back off, because I was being whiny. I cannot forgive that.

I can forgive your careless misunderstanding of my eating disorder. You won’t be the last. You hurt me badly, but it’s ignorance like the words you spoke that keep me speaking up. I cannot forgive your wish to destroy my support.

You spoke selfishly. It is the selfless spirit of your son, and his love that quite literally, saved my life. I’m sorry you can’t see that. I’m sorry I don’t want to see any more of you.

Relevant citations: here and here.

Kate Donovan is a junior studying psychology and human development at Northwestern University. She is the president of Northwestern’s Secular Student Alliance and a writer at Teen Skepchick and the Friendly Atheist blog.

[Guest Post] An open letter to the woman who said I wasn’t skinny enough to have an eating disorder