Over on FriendFeed, there are some discussion threads about people with diagnosed mental illness serving in positions of authority. If you’ve read this blog for very long, you’ll know that I have a diagnosis of Type II Bipolar Disorder (though this diagnosis has been called into doubt in the last couple of years), was hospitalized for a major depressive episode three times in 1998 (the third time following a suicide attempt), spent 27 months (yes, that’s more than two years) trying and changing and tweaking medications until we got the right combination to manage both symptoms and side effects, endured almost every side effect in the blasted book (including gaining 90 pounds), spent five more years on that combination, and was free of both psychoactive meds and depressive or hypomanic episodes for three years.
So. Could I serve in a position of authority? Could I captain a Federation Starship? Could I be President?
When I began work for my current employer, over five years ago, I applied for a Top Secret clearance. Because I have a mental health diagnosis, I was interviewed (as were several others). About the time I thought everything was in order – and this was last summer! – I received a letter from the investigating agency demanding records of every psychoactive drug I had been prescribed, with dosage, frequency, and begin/end dates, and every visit to a mental health professional… over the ten-year period that a TS investigation covers. I was about to leave town for a four-day meeting followed by a six-day vacation, so I figured I’d act on it when I got back home – in part because the intrusiveness and sheer pain-in-the-buttedness really annoyed me – but I had failed to notice that I was given only twenty days to comply with this demand. I’d gotten in touch with my doctor, but there weren’t even any appointments available with those twenty days. I received a certified letter later, telling me that my application for a clearance had been denied, and that I was ineligible to apply for another clearance for a period of one year.
I don’t know whether a President is automatically cleared, or how much investigation is done. But at the point when I received this letter and the following denial, I had been symptom-free for more than five years, and I had been medication-free for more than two. I have never tried to hide this diagnosis; nobody could use it to bribe or blackmail me, because I’d just tell whoever they were threatening to tell myself! And yet, because I failed to essentially submit my entire chart from the psychiatrist’s office and from the hospital, my application was declined.
There is a deep mistrust that Americans hold toward people with mental illness; the stigma runs deep. If you don’t really get how deep this runs in us, just check the NAMI Stigmabusters Archive. Yes, I’ll admit that sometimes the Stigmabusters can seem a bit knee-jerky in how they respond, and it may feel like political correctness gone overboard, but they have a point. When you talk about the looney bin, I can say, yes, I’ve been there, and it quite literally saved my life. When someone calls me psychotic, I can say, no, I’ve never displayed symptoms of hallucination or delusion, thank you very much. These words become common parlance, and we don’t realize how deeply they can cut someone who has a mental health diagnosis, because we wield these words without ever realizing they are weapons. You know that lesson one of owning and using a gun is that you never point it at anything unless you intend to kill that being. I believe most people never realize that words carry the same degree of responsibility.
Most mental illnesses are completely invisible. You know that they say one in four people has a mental health diagnosis. Think about that. If you work in an office of 30 people, that means probably eight of them have had depression or generalized anxiety or obsessive-compulsive disorder or bipolar disorder or a diagnosable phobia or maybe a substance abuse problem or even schizophrenia or dissociative identity disorder. In Congress, we have 535 people serving, so more than 100 of them are likely to have a mental health diagnosis. In 2004, there were more than 30,000 employees of the Department of State; the Department of Defense employeed 700,000 civilians (175,000 mental health diagnoses) and 2.3 million military personnel (575,000 mental health diagnoses – without taking into account the hypothesis that PTSD likely raises the ratio for military personnel). Heck, the US population was estimated at over 300 million last July, which gives us more than 75 million people with mental health issues in the nation.
Since 2000, I’ve participated in and followed a study performed by Boston University, which has followed persons with mental health diagnoses and their ability to be employed and stay employed, as well as the effects that employment has on their mental illness and vice versa. I hope you will click on the link, which shows the baseline results, because the information there is pretty impressive. More bipolar patients responded than those with any other diagnosis. Of the respondents, 91% had been employed for at least 18 of the prior 24 months; of the respondents, 53% worked in professional or technical jobs and 24% worked in managerial or leadership roles. So we already have leaders out there who have a mental health diagnosis and are successfully working and maintaining their jobs. I found the report very positive, at least for those with depression or bipolar disorder.
So could I be President?
From personal experience, I have learned that many who have been diagnosed with a mental illness become very responsible for it and its effects on their lives. We learn so much more about personal choice and responsibility – we learn that the illness and its symptoms may colour our decisions, may make good decisions harder, but that we still bear the responsibility for our decisions and their consequences. We learn to monitor our moods and what triggers them. We learn to watch our thoughts, our sleeping patterns. For a bipolar person, sadness or grief is always tinged with thoughts of “Am I too sad? Am I slipping into a depression?” just as joy and happiness are always coloured with fears of “Uh oh, am I a little bit too jubilant here? Am I getting manic?” We learn what happens when we stay on our meds and go to the doctor; and we learn what happens when we capriciously decide to stop taking them.
If I knew of a person with a mental health diagnosis who was running for office, or in line for a leadership position, there are some questions I would want to ask.
- Do you consider yourself a victim of mental illness? I’ve learned that there is a huge difference between those who think of themselves as victims and those who think of themselves as survivors.
- Do you say, “I am bipolar/schizophrenic/dissociative,” or do you say, “I have bipolar/schizophrenic/dissociative disorder”? The first says that the illness is one’s identity; the second reveals that it is part of you, but by no means your core self-image.
- How do you know when you need help or support from others? This means you are reasonably self-aware, and that you are not threatened by interdependence with others, including family, friends, doctors, therapists.
For myself, I most definitely, thoroughly, and completely believe that a mental health diagnosis alone should not disqualify anyone from anything – up to and including the US Presidency. And I would like very much to see other people convinced that this is true. Having a President with a mental illness is not much different from having a President with diabetes or a thyroid disorder or fibromyalgia. What it means is, that person is much more in touch with his or her humanity, the places where he or she needs others, the places where he or she can find understanding, sympathy, compassion for other people who struggle or suffer.
So could I be President? I certainly hope so. And I hope you could, too.