Thursday, February 24, 2011

How "symptoms" let jacks stay jacks forever

Salutations, New Mad Nation!

I have a bit more vigor this week than I have in weeks past, and I've been reading up on my social revolutionary texts, so I am quite enthused about today's Madness. This week, I will be addressing the institutional mechanism known as "symptoms," and how this discourse (structure of language and power) allows hurtful, ignorant people to remain that way indefinitely, thus furthering the gap between the Mad and the Chill; the marginalized and the powerful.

To begin with, I'd like to reaffirm a point I have made before and will make again and again: clinical psychiatry is not perfect. It is a very new science in the history of sciences - even in the history of psychology itself - and is based on quite a bit of speculation and other forms of "guess-and-check." As a friend of mine, and strong supporter of this blog, once put it - "It's like people just keep throwing darts of ideas at the wall, and what sticks must be good medical advice..."

Her analogy is incredibly apt. The results that "stick," so to speak, are the ones that seem to effect results, and are therefore labeled medically sound. To give psychiatry some credit, the project is up against some pretty remarkable odds - understanding the inner workings of the human mind is no small feat, so it makes sense that they would have to just try things on occasion. And, many studies are done in an attempt to repeat and verify the results as scientifically accurate. So they do put forth an effort, at least within the realms of their own epistemologies (ways of knowing). But in doing so they often miss things beyond the academy (like more social factors affecting mental health), and my more cynical self wonders is this is deliberate.

The point is, their solutions to problems may be repeatable and demonstrate effect, but not necessarily because their solutions are actually accurate. They are performing a mostly blind guess and check in many actual clinical scenarios, and when something appears to work they call it a success. But is the dart sticking, so to speak, because they hit the right target, or because of some other lucky influence? They will never know, and many of us may never know either. For example, I myself was put on a medicine called Trileptal, which is used predominantly in cases of epilepsy due to its ability to regulate the electrical activity of the human brain. They used this on me while I was in the hospital because of a hunch. "Sometimes this works in certain cases of bipolar, and your EEG's have been a little odd," basically. Except the truth about my EEG scans were that no one could come to any kind of agreement as to what they actually meant!

I "got better" after being put on Trileptal. But was that because of the medicine, or because I had been allowed to live out some of the torment building up inside of me, and was starting to regain my own control? I am beginning to suspect it was the latter, and that all the Trileptal did was make me yawn a whole lot and get me dizzy/cross-eyed on a regular basis. Oh, and make me totally chemically dependent so that missing a dose can cause pretty damn serious problems. Guess what? I've decided to stop taking that stuff.

Now, I have said all of this as a way of illustrating my preliminary point to this blog: medicine gets things wrong. Frequently. Yet for some reason, people on the outside of the system, people who are not being labeled and objectified by Medicine, are completely willing to trust its authority. Someday I will post my complete proto-Marxist Mad Manifesto wherein I fully explain this phenomenon, but for now suffice to say that it makes people feel better to place their trust in something, especially when doing so absolves them of responsibility.

Which Medicine cleanly does, when it comes to the matter of being a good and kind person, which should be every human being's responsibility. But when being hurt by people's cruelty can get labeled as "Depression," why should anyone need to be kind? "You're taking what I said too far...look, don't you think you're being unreasonable? I know you have depression and I just wonder if you've been taking your meds/seeing your therapist/whatever-the-fudge. I'm not going to talk to you like this."

Most women, Mad or not, should be familiar with this argument. It happens over PMS in much the same way - a medicalized situation lists "irritability" and "mood-swings" as "Symptoms." And "Symptoms" mean "Caused by the condition - AND NOTHING ELSE, GOT IT!?" In other words, any behavior you exhibit that can be classified a "symptom" of whatever condition you have, can be completely ignored by all other parties. Your right to emotional agency and adult maturity is completely stripped from you by the word "Symptoms." Because of this, people around you rarely have to change their hurtful behavior towards you. Even if they are "kind" enough to be careful about what they do/say in your presence, they will still think you are being silly and wrong, and this either 1.) Hurts like a mug or 2.) Wears on you to the point that you start to agree with them, which is possibly even MORE damaging in the long run.

To look at a classic example of what I'm describing, let's examine "PTSD" - "Post-Traumatic Stress Disorder." This brilliant little condition is what describes about 2/3rds of people who go through a traumatic event - TWO THIRDS. That is the majority. That, in my mind, means that the "disorder" should be the 1/3rd of people who don't develop this condition. But that would be normalizing distress, and we can't have that, now can we?

PTSD comes with a horrible reaction called "triggers." Triggers are words, actions, situations, smells, or any other stimulus, that cause the survivor in question to suddenly experience tremendous emotional and mental vulnerability, almost as if they are experiencing part of the trauma all over again - sometimes these triggers will even induce full flash backs. They are incredibly dangerous and it is desperately important that you respect the triggers that your friends who are survivors may have. Chances are you have at least one friend who is, and hasn't shared yet - or may not even realize it. Though PTSD is often associated with surviving war, it is also something that happens to many, many people who survive rape or sexual assault. It can happen to anyone who survives any kind of traumatic situation, even having abusive parents. And triggers can remind people of the experience of that trauma, and that is not something they need or deserve.

However, even while respecting triggers as a significant part of a person's condition, there lies a danger: the dread word "Symptom." Attach that word to the triggers and suddenly, a person having an emotional reminder of trauma is pathologized - it is essentially their own fault for not "putting it behind them," or at the very most gracious it is the fault of some nebulous "disorder" and no one is to be blamed. This will hold even when the person who caused the trigger by saying or doing something triggering was being legitimately hurtful or even invoking the traumatic event. They do not have to look at their behavior and say "Wow, behaving this way can cause people to get that upset? I wonder if I should reconsider my actions." Instead, they look at their behavior and, at best, say "Well, that person has a condition that makes them react that way to what I'm doing. I think I'll just try not to do it or talk about it around them."

This allows people to go on and continue doing hurtful, stupid things to others - people who have a PTSD diagnosis cannot gainsay it because of their "symtpoms," and people without the diagnosis or who have not been traumatized may still be hurt by it, if a little less.

Some triggers do not really require personal inquiry and change. Some people may be triggered by a certain article of clothing; others by a song, or perhaps a certain word. I believe it is fairly obvious that a person should try to refrain from wearing/singing/saying these things around someone for whom they are known triggers, but that is all one should really have to do. But if the trigger is, for example, being overly inquisitive about one's sex life, then we have a bit of a problem. You see, triggers are not always tied to completely irrational causes - sometimes a person can be triggered by a behavior that is a direct foreshadowing of much, much worse behaviors. And the perpetrator may have no intent of committing that worse behavior, but they should still ask themselves: what am I doing wrong, here? How might my behavior be linked to the survivor's trauma, and what can I be doing to change my behavior to avoid situations like this?

Instead, you will get people being totally dismissive; rather than viewing the trigger as a warning sign that their own behavior might be potentially dangerous, they view it as a malfunction on the part of the other person. I believe this is a crucial error: I think that many such triggers are exaggerated (but not inaccurate) versions of the same reactions that many people have, on some level, to the behaviors in question. A "non-traumatized" person might be asked about their sexual practices and feel uncomfortable, but answer anyway because they want to stay involved in the conversation and feel a certain interest at the prospect of this openness. But the "traumatized" person already knows from personal experience that such behavior can be a great way to open the channels for sexual harassment and predation, and so reacts not with discomfort, but violent fear. It is knowledge applied in an acute and rapid manner - it is NOT "just your PTSD."

But as long as the Symptom reigns supreme, people will keep making this mistake, and they will keep doing stupid hurtful things, because the only people smart enough to say anything about their hurtful behavior are bound to be labeled "mentally ill." This labeling renders their arguments pretty much mute. Even my own mother will always assume that "my bipolar" is the cause of something unexpected before she will heed the possibility that I've got a genuine point. To be honest, I don't know if it ever even really gets that far. And, well...that makes me Mad!

Hope I was clear tonight, I sense I probably got a bit ranty, and I tried not to stay too far into my theoretical academical journalabulous fantasticry. Would love for comments, questions, and just about anything else. Next week could be just about anything. But it may be about time for another crash course in care - barring, of course, guest suggestions. :)

To the New Mad Nation, I bid my fondest salutations.


Thursday, February 17, 2011

From the heart.

Salutations, New Mad Nation.

First, apologies again for my tardiness. Better than last week, still not up to snuff. Hopefully I'll get there by next week.

This week the rant will be less of a rant and more of something simple. I want to make it understood that I am not a mania-charged ideologue incapable of basic conversation and honesty. Also, I am a bit too exhausted from my current situation to be too full of bravado tonight.

Instead, I'd like to simply relate a few thoughts to you.

When I was 14 I was diagnosed with "bipolar." This is largely because of journal writings I had made while on a trip to Spain with my Spanish class, writings which had scared my mother who read my journal without my permission. She took that violation upon herself because she saw my journal open on a desk while in my room and was worried by what she saw, and so read the rest. The writings were full of frightening things, to be sure, and so she sent me off to a psychiatrist, who shortly pronounced "bipolar." My brother had recently been diagnosed as well and because of the "strong genetic component" associated with the "disorder," it seemed a likely situation to them.

Meds made me feel a bit better. I think. Or did they just block out the unpleasant thoughts without actually allowing me to process or deal with them? The latter seems more likely to me now. Especially because problems still bubbled up, and with more ferocity than previously. The response to this problem? A new medicine, to be taken "as needed." This medicine was even more of a steamroller than the previous, managing to effectively tranquilize me during the violent periods without actually dealing with the issues at hand.

Where, during any of this, was the inquiry into what was causing these violent emotions, these feelings of despair and rage? It was largely buried under the assumption that it must be chemical. Eventually we began exploring therapy options but they never seemed to get at anything really important. I believe this is because my feelings were considered "inappropriate" by default, since they were distressing me. Even most therapists would rather view their patients as people who are reacting incorrectly to the world around them, rather than people being troubled by an incorrect world. Naturally, I didn't improve much in this scenario.

If this has ever happened to you...I am sorry for your suffering. If you have ever been seen by a psychiatrist or therapist, I encourage you to consider the possibility that this has been happening to you.

Medicine (psychiatry, therapy, etc.) is almost universally trying to "fix" us, not help us. They view our feelings as a problem, something to be changed, rather than the situation itself. I suppose social workers may be an exception to this on occasion...but there must be a limit on what one can do in a situation like that. I mean, come can a paid professional be expected to improve society itself for the sake of their "patients?" They can't, really. But they could at least be expected to recognize the situation for what it is, and offer advice and counsel for how we can change the realities in which we are stuck, without suggesting we feel differently about things that are legitimately Maddening (enraging, horrifying, despairing...whathave you).

My therapy situation is better, but still not even nearly enough, I think - for reasons I can guess at, my therapist remains eloquently detached from all subjects requiring a personal stance on her part. I suppose that's better than shooting me down directly.

My psychiatrist, on the other hand, asks and judges me about the content of my social life. "Things okay? You're getting out and seeing friends?"

Honestly, Doc? No. I'm not. Because I don't really have that many friends, and I'm busy dealing with shit that most people aren't prepared to comprehend, much less deal with as friends. But occasionally I do seek support from the few people I call my friends through the channels that are available - mostly the internet. And it's enough. Would you accept that? I don't know and I'm not really willing to take the chance. I've had docs before that wouldn't. Why should I trust you?

Maybe I'm being paranoid but something about the guy just irks the hell out of me. Maybe it's the fact that when I called bullshit on the notion that you should have to report a sexual assault at work, he started trying to lecture me to the opposite effect. (If you think that people should be expected to report, please see my earlier rant about victim blaming in the justice system). So yeah....not going to happen.

Their systematic attempts at integration by undoing what is different and challenging is terrifying to me. It makes me feel like a hated outsider who must be converted or purged. It's a freaking crusade against unhappiness and rebellious thought. I hate it. I'm so unbelievably glad that I have managed to gather an ally or two who understand where I'm coming from...without them...I don't think I could wage this fight.

And make no mistake, New Mad Nation. We are waging a fight. I have said before that I would never force my ideas of Madness on anyone - I stand by that. If you do not think you are Mad, then you are not Mad. But if you are Mad, as I have described it and you believe, then the systems in place are basically out to undermine the fabric of your existence, and we must unite as a community and stand against that onslaught of medical discourse and invalidation. Whatever uses those systems may have - and as I have explored previously, they are not entirely without use - they must recognize their place, as service to those in distress, not as a service to those in power in order to contain those in distress. We must resist the tendency of mankind to categorize into what already exists, and embrace the new, the challenging, the rebellious and radical. That is the nature of evolution and it is only in this way that we will ever reach a society that is truly caring and understanding of its constituents.

The line between "madness" and "genius" is success...once our movement becomes successful, if we keep hold of the title Madness, then the two will become one in the same...a silly dream of symbols perhaps, but nonetheless a dream.

To the New Mad Nation, I bid my fondest salutations.


Friday, February 11, 2011

Madness vs. Mental Illness

Salutations, New Mad Nation.

My profoundest apologies for being a day late. Being Mad can take its toll sometimes. For example, I am addicted to a drug. That drug is called Trileptal. Under advice of psychiatry I started taking it to help me deal with my "bipolar II" symptoms. I am no longer convinced that this drug is actually helping, at least not in the way I want it to - I don't consider a total steamrolling of an issue to be dealing with it. Bury your demons in concrete if you like, but they'll still be there when the terrain shifts, and they'll be mad as hell that you put them there.

So, sometimes, my frustration leads me to not want to take my medication, or not care enough to stick to it, or to say "well maybe it's good to find out what I will find out if I go a day without." Often, I do learn something valuable when I do this, but it comes at a heavy cost: the withdrawal from the drug can shock my systems pretty badly, as they did last night, and it rendered me incapable of the thought-forms necessary to make Madness. Tonight, however, I am back on track, and I would like to use this opportunity to clarify the differences between Madness and Mental Illness, and why I think this is so important.

Though I detest the term "Mental illness" because of the images that it invokes, I recognize that there are some emotional/thought conditions that stem primarily from medical causes. There seems to be quite a bit of evidence that the condition known as "AD/HD" is primarily medical - caused by the body's inability to produce certain chemicals that aid in ability to focus, chemicals which can be supplied through medication to increase that focus. Personally I would never call this an illness, because the terminology just seems wrong to me - but I wouldn't necessarily call it "madness" either. A person with the AD/HD condition, if they are lucky and get decent meds, may live a pretty "normal" life. They may even get out of it without being completely flattened out by those meds. In this case, the word "Madness" need not apply. It would seem they have a medical condition that can be cured by medical means, so more power to them for seeking that route.

To be perfectly honest, I don't know how much I believe that such a scenario actually exists, but I suppose that without much evidence to the contrary at present, I have to concede its possibility. Some conditions termed "mental illness" are primarily medical, and so Medicine may do what it likes with them (though I would still prefer they not call it a 'mental illness.') But if we are going to have this Mental Illness language, it should apply exclusively to things caused only by purely medical issues. And, conversely, the language of Madness need not apply to all of those who are thus dubbed "mentally ill."

I have said before that Madness is a rallying cry for those whose emotions, whose thoughts, are "disturbed" by the world around them. To expand on this, anyone can be Mad, if they have been ostracized, otherized, or downright ignored because of the way they think and feel. Anyone who has tried to bring their concerns to the table, tried to validate the pain or fear of their existence, only to have it shot down: these are the Mad people. Many of them have probably been diagnosed with a "mental illness;" some of them may even have a legitimate medical condition that causes that "illness." But not all of them.

"Mental illness" happens to people who seek help from psychiatry. Some of them are wise to do so; others are merely desperate. It happens when you need answers and you are given one in the form of a diagnosis, something that comes packaged with a pre-approved treatment scheme. It is not (necessarily) the only way of understanding or processing the feelings that lead you to seek help.

Madness means you have a problem that society is not recognizing properly; it may see your dissatisfaction, your fear, your pain, your hate, or whatever other "negative" feeling you have, but it will probably invalidate it by calling it "illness" and trying to medicate/therapize it away. Rarely will prolonged, seriously felt feelings be given validity once the possibility of "illness" has been invoked.

Madness means you look at things very, very differently than those around you, and they dismiss your ideas out of hand. Perhaps they do this because you sound "crazy"; perhaps they do this because they know you have a diagnosis, and the diagnosis is an easy way for them to not have to listen to anything you have to say. This is one of the reasons I hate diagnoses.

The most important point that I have been building to here, however, is that not only can one be Mad without being "mentally ill" (diagnosed or otherwise), but one can have a "mental illness" without being Mad. Many with a diagnosis are totally complacent with the system; they feel understood, at least by psychiatry, or they agree with those around them that their own feelings are incorrect and that they need more treatment. Perhaps they are totally fine; perhaps they have that purely medical condition that requires a purely medical solution. There is nothing social about it. They are not Mad, they have a treatable condition.

I am not terribly interested in those like this. Why? Because they already have advocates. They are taken care of by a system that is working actively to legitimize their conditions as normative, nothing to be afraid of or stigmatize, etc. etc. Groups like NAMI and even the NIH work every day to protect the medical sanctity of such issues, and for those who really are experiencing a purely medical phenomenon, that works great.

But it doesn't work so great for those of us who have social aspects to our Madness, aspects that get more or less ignored, or otherwise totally rescripted according to the Medical model. Every feeling we have is second-guessed as stemming from some nebulous "depression" or "bipolar" within us, when the reality is that our depression and "bipolar" is more likely than not a result of the actions taken around us. And every step taken towards the dominance of Mental Illness is a step taken towards reinforcing that second-guessing; it is a step away from acknowledging that people can be seriously fucked up by the cruelty of others. It is a step towards ensuring that all dissatisfaction, all dissent with authority, can be neatly categorized as a "mental illness" and treated into oblivion.

Perhaps I sound like an Orwellian apocalypse crier right now, but I don't think the possibility is too far out there. Children who don't obey their parents are sometimes diagnosed with "Oppositional Defiant Disorder." SERIOUSLY? That's not a mental illness, that is a child not wanting to listen to their parents. Maybe the parents are making wholly reasonable demands; maybe they aren't. Parents can really suck. Most of the time they give in to despair or frustration because dealing with a human child is damn near impossible. So yeah, maybe your kid doesn't want to listen to you. Even if you are being totally reasonable, they may have their own reasons for not wanting to listen. Maybe this shouldn't be treated as an illness, but rather the sign of a strong thinker in the making; an independent soul capable of changing the rules to better suit their vision of the future.

Oh, but the academy and the institutes wouldn't like that, would they.

Psychiatry works for its funders. That is primarily the concerned parents, the government, and other big corporations like Universities. Think about it. They can try all they want to be objective, but some bias is bound to slip in. It always does, no matter the field in question, the task is always to determine what that bias is. With such authoritative figures behind them, psychiatry has no choice but to view "deviation" as "aberration" and to do everything it can to undo it.

Okay, there are some exceptions to this, I'm sure, especially in things more like humanitarian psychology. Good; maybe they will stand by me some day when the Mad seek recognition. For the most part, however, Psychiatry supports Mental Illness and in doing so takes legitimacy away from the condition of Madness. I believe there are many people who are "mentally ill" who are, secretly, Mad themselves, but afraid to admit it because of the challenge that is inherent in that reality. Perhaps others are so glad to have some kind of relief from their pain that they are willing to accept the drawbacks, the side-effects, the sense of lacking, because they don't believe there is anything else; they have accepted the theories of medicine as ultimate truth. Some with "mental illness" may not even have need of Madness; their truth is as simple as the theories say and they are content.

And some, "mentally ill" or not, stand in fury against the way in which "mental illness" is still used as a social discourse to annihilate the legitimacy of social deviance. If children can be diagnosed with ODD, how long before adults can get the diagnosis for having revolutionary ideals? The principle criteria for "mental illness" are supposedly that they caused distress to the self and to others. Being a revolutionary is nothing but distress when trapped in a broken society; should one accept their feelings as incorrect and bow down to the status quo, or stand up for their beliefs? When does this kind of idealism become "mental illness?" It's all in the eye of the beholder, my friends.

In my eye, it makes you Mad. And I like Madness.

Hopefully this clarifies a bit what I mean when I use this two different terms...Madness is social, Mental Illness is medical. They can overlap, but they certainly don't have to - however, currently, most who are Mad will be considered Mentally Ill because that is how society currently understands emotional dissatisfaction with society. Mental Illness upholds the status quo as "normative" and all deviations from that as "ill." Madness suggests the opposite.

My fondest salutations to the New Mad Nation tonight; remember that the above are merely my proposed definitions and thinkings and suggestions and ideologies; I am not trying to define your existence, for to do so would make me as bad as Psychiatry. But if you like what I'm saying, well, let me know - the more Madness, the better. :)

See you next time.


Thursday, February 3, 2011

Crash Course in Care - Step 2: Being an Advocate

Salutations, New Mad Nation.

First of all, a heartfelt thanks to Sara Hendrickson of for our stellar new header design. She is a tremendous supporter of our work and I encourage anyone who needs anything designed, from business cards to personal logos, websites, or just about anything else, to contract her. She's fresh out of college and needs the work!

That said, it's time to get down to business. The long-awaited Crash Course in Care Step 2 is here at last. There are many other things on my mind tonight, but I sense they are just going to have to percolate a while longer before I can do anything useful with them, and the crash course must keep crashing. The title for step two is "Being an Advocate." This is because, in order to take care of someone, we must realize that we are doing more than treating a series of symptoms, but actively working to protect our friend or loved one from harmful influences. Just as one works to create a sanitary environment for someone healing from a serious illness, one must work to create a friendly and supportive environment for someone struggling with their mental or emotional health.
You may note, here, that I have made a direct and deliberate comparison between physical illness and mental/emotional distress (sometimes called "mental illness"), but I must stipulate that I have only done so because in this analogy, the contagion for mental/emotional distress is social factors, factors that you, as a care-giver, must protect your friend from. Thus, you must be an advocate.

How does this look in the context of giving someone care?

Well, let's say you are sitting at home, "chilling" (or not) on Facebook, when your friend IMs you and wants to know if they can come over for a while. You say sure; alright, they come over, and suddenly they are way more upset than you are used to. You can tell that there's a dangerous situation developing here. First things first: remember step 1. Check your privilege at the door. Remember, first and foremost, that them even being here, allowing themselves to be upset in your presence, puts you at a huge privilege advantage - they are making themselves vulnerable, and it is up to you to decide how to handle the situation. As you go through the list of other privileges you may have over this person, make sure your decision is step #2 - Be An Advocate.

Listen to your friend's situation, giving them their whole truth. Question it only if it seems necessary to avoid serious conflict, and even then, do so gently; or perhaps if the upset is based on incorrect factual information. For example, "I don't know what to do because I think the prof hates me," when you have heard the prof praise that student; you can share this information, but do so without directly contradicting them - say "Well, I guess I can't be sure, but I heard the prof say that you were actually a really good student." This opens up the possibility for conversation where you are on their side, helping them to figure out what's going on, rather than telling them.

Advocacy really comes in as you reach the end of the story, trying to figure out where to go next with your friend in their road to handling their distress. Much of it will be personal, and will require you to offer them opinions that they may process in their own time at their own rate, and may conclude - correctly - to be invalid. As an advocate you must be prepared to work for your friend. They are the boss of their own mental health. So, for instance, if your friend feels persecuted by someone else, someone you don't think is persecuting them, you may offer that opinion, but do so very gently, and with full and stated recognition that you may be wrong. Add on to this that you are willing to work through the situation with your friend to find out what is going on and/or how to handle it.

Many proponents of more traditional therapies and "mental illness" models would look at a situation like this and try to interrupt the "patient"s cognitive cycle, because they start with the assumption that the person feels persecuted because they are depressed, rarely acknowledging the possibility that it goes the other way around. But even when a person or institution does acknowledge that depression may be stemming from feelings of persecution, the response to this is often in the form of suggestions for how to cope with being persecuted internally, while not actually stopping the persecution. I view this as an inherently flawed approach; it is like giving medicine to a sick person who is still exposed to the infectious disease. (Again, medical analogy, but only because the contagion is social factors.) Don't get me wrong: developing the internal faculties to be more resilient to persecution is incredibly important and absolutely worth pursuing - but not at the cost of complacency towards being persecuted.

That's where you, The Advocate, come in. It's not enough to say "Hey, I don't think they meant to hurt you, try not to take it personally. I think they just were making a joke, you know?" It's probably not enough, in most cases, to even say "Man, those people are totally jacks, you shouldn't listen to a thing they say. They don't know what they're talking about." You have to acknowledge that someone has hurt your friend, if indeed they have - whether they meant to or not - and then, where it makes sense, challenge that hurtful behavior. As an advocate, you should be challenging behavior patterns that make it possible for people to say hurtful things, even if they aren't meant to be hurtful.

Many hurtful things are said out of ignorance, for example. We see this kind of advocacy being championed for all kinds of causes, especially women's rights, anti-racism, and GLBTQ activism. We are taught that to be an advocate is to actively fight the kind of atmosphere that allows hurtful behavior to go on; things like ignorance and callousness are to be fought. It's not enough to say to someone who feels ostracized because of their gender, race, or whatever else, that "Hey, they don't really mean it, try not to let it get to you." You have to be willing to stand up to the people in question and expect them to change.

Why do I bring up these other categories of advocacy? Because mental health conditions such as depression or anxiety can very easily result from issues like these, and so they are inherently linked. However, there are unique categories of advocacy for the condition of depression (and other unique distress patterns) itself. There is stigma and misunderstanding towards behavior patterns associated with depression, and hurtful behaviors can result from that. As if it isn't hard enough to be struggling with depressive seeds (for whatever reason), social factors can make this infinitely worse by lampooning the feeling and behaviors of depression itself.

Be willing to make a stand for your friend or loved one, ESPECIALLY if it means challenging your own friends. If your own friends seem responsible for hurting the person you are trying to care for, then you will seem responsible by association if you do not challenge them.

On a deeper level, it is important to recognize the possibility that your "friends" may actually be doing hurtful things with a bit more venom than you would like to believe. This can be very difficult and isn't always necessary but it is important to consider the possibility. Many people have prejudices towards others - ever hear the word "emo" being used negatively? - for their emotional state of being, prejudices that may be kept hidden pretty well, but exist nonetheless. The same is true for racism, for example. Always leave room for a little bit of doubt.

The general rule of thumb here is that after you leave your privilege behind, you be willing to take on a share of your friend or loved one's problems as if they were your own. You can coach your friend on resilience if you have any genuine insight, but also try to view their concerns as really as you can.

Most importantly, always, always, ALWAYS, is this: listen to the person you are caring for, talk with them as an equal, and work with them to figure out what you can do to help. They may not need a fighter, yet, or ever; they may need one right that second. Maybe they need someone to give them a nudge, maybe they need someone to let them just be. Find out by working with them. This may also mean that sometimes, even though they seem to need your help, you will have to leave them alone. Try to intervene if you sense something unbelievably horrible about to happen, but otherwise, it is usually best to give people their space.

Allow me to provide a counter-example of how NOT to be an advocate.

If a friend has come to you for some kind of solace or advice because they have been thinking about self-injury, do NOT try to make them promise not to do it. This may seem like you are advocating for them, but all you are doing is contradicting and denying them their truth. You can ask them not to if the knowledge of it causes you pain, but you must respect and understand their pain as well, and be willing to let them hurt themselves if they need to. This is incredibly hard, but you can't really be an advocate if you try to force a person not to do something. That removes their agency and is belittling.

To be perfectly clear, I do NOT encourage self-injury. To whit, I find cutting, burning, smoking, most drinking, most drug use, and anything else that causes harm to the body or mind to all be fairly bad ideas, whatever your reasons. However, I also understand that sometimes it cannot be avoided, and attempting to extract a promise to the contrary is basically forcing someone to add lies or total defeat to a situation that is already painful enough. Encourage a person not to hurt themselves, but don't take the hard-line of "I want you to promise me" or "I'm not leaving until" or anything like that.
Unless, of course, the person in question has previously expressed to you some sentiment that leads you to believe this approach would help them. For example, a person might have violent urges for self-destruction that they are very afraid of, and may have asked you or tried to ask you to help keep them safe from this. In this case, you advocate for the person by helping them fight their compulsion by being with them or doing whatever else you have to in order to protect them.

The common theme here is working with  your friend or loved on. Advocacy happens when you work with and for the person in question. Obstinancy and oppression happens when you work for your own comfort and what you perceive to be important for the other person.

The ONLY exception to the above is when your friend is planning to commit suicide. Even though I myself am of the opinion that people should be allowed to make the decision to end their own lives after careful deliberation and a reasoned conclusion that there is no worthwhile or possible way to improve their situation, I believe that it is very rare for a person to attempt suicide having actually gone through all of these considerations. Moreover, if the attempt should fail, the person will be put in a hospital where they will more than likely be traumatized even further by the staff. (If this sounds hard to believe, wait until I post a full rant on the subject of the hospital locked ward.) Therefore, if a friend is planning to commit suicide, then and only then would I say you have the right, as their advocate, to try to talk or otherwise force them out of it - BUT DO NOT CALL THE POLICE UNLESS ABSOLUTELY NECESSARY. As I said, going to the hospital can be unbelievably traumatizing and you should try everything you can to intervene on your own before your resort to this.

Well....I suppose that's about it for today. The specific examples of how and in what ways one can advocate for their friend are largely circumstantial. Perhaps some day I will post a few full-length tellings of the process of giving care, through the various steps. For now, the take away message is that you should always let your friend have control over the care-giving process, and always be willing to take their problems on as your own - put their needs before your own when possible.

Just make sure you can still take enough care of yourself to actually be able to care for them.

All thoughts welcome, just remember the rules. Thanks as always for your attention, everyone.

To the New Mad Nation, I bid my fondest salutations.