For this year's #BellLetsTalk I want to delve a bit into the "Mental illness is no different than diabetes or heart disease" trope.

The greatest value in this analogy is that it allows mentally healthy people to understand mental illness as ILLNESS & makes them less inclined to dismiss the struggles of the mentally ill. Emphasizing the chemical aspects of the illness makes it seem more 'real.' #BellLetsTalk

That's no small thing. It helps make the abstract more tangible & gives mentally healthy people an accessible frame of reference. Depression isn't sadness, it's sickness. It has known scientific causes & often responds to chemical interventions (i.e. medication). #BellLetsTalk

This framing can also help mentally ill people ease up on themselves by removing the sense of self-blame that so often comes with mental illness. Now and then I make someone - either a loved one or a therapist - reassure me that I'm actually #SickNotWeak. #BellLetsTalk

There's a reason @heylandsberg chose that name for his mental illness initiative. We all need to be reminded that just bc the illness is in our heads doesn't mean the illness is 'all in our heads.' My brain malfunctions just like a diabetic's pancreas malfunctions. #BellLetsTalk

The problem: Mental illness isn't diabetes or heart disease or anything you can see in labs or x-rays. It has a chemical component but not an easily measurable one. And while many diseases have straightforward treatments, mental health treatment is rarely uniform. #BellLetsTalk

(It's important here to note that "mental illness" describes a huge range of diseases, some more measurable than others and some more reliably treatable than others. Most often, though, mental illness is characterized in part by its unquantifiable nature.) #BellLetsTalk

The danger in forcing the square peg of mental illness into the round hole of other physical illness is that if we get too attached to the analogy then it's almost guaranteed to fall apart in a potentially harmful way. #BellLetsTalk

At some point we're going to have to confront the fact that you can't simply prick your finger and find out if your bipolar disorder is under control. A deeply depressed person can't be pulled out of despondency by a defibrillator. #BellLetsTalk

If we're too attached to the diabetes analogy then the more abstract characteristics of mental illness can redouble our self-doubt. And if our loved ones are too attached to it then they might start demanding visible evidence that simply doesn't exist. #BellLetsTalk

The point: Mental illness IS physical illness, but it doesn't act the way we expect physical illness to act. Use the diabetes parallel when you need to, but don't lose sight of the ways in which mental illness differs from other illnesses. #BellLetsTalk

Don't demand - & don't let anyone else demand - proof that simply doesn't exist. Be kind to yourself. Or, if you can't, then think of it as being kind to the rest of us with mental illness & then add yourself to the group. Your illness is every bit as real as ours. #BellLetsTalk