Sunday, April 7, 2013

Striving and Thriving: Mental Health on the Radical Left

I am a person with lived experience with mental illness, diagnosed bipolar since I was fourteen years old, as well as a mental health professional-- as a trained social worker with a master’s degree in social work. I know firsthand how mental illness impacts individuals and our community.
Mental illness is very common. It is estimated half of all people will develop a mental illness in their life time. Currently 50 million people (1 in 5) have a diagnosed mental illness in America (not to mention all those who are undiagnosed). These mental illnesses range anywhere from depression and anxiety to serious psychiatric conditions such as schizophrenia and bipolar disorder. Mental illness is biological, genetic, environmental, and social-cultural. However, I believe if we lived in a democratic socialist society we could see a drastic reduction in mental illness and could even prevent it. This article is written more as a here and now guide to coping, but we need to look at long term solutions as well.
In our society with these mental illnesses comes a lot of stigma. Social stigma is when others treat us as differently and as inferior due to our mental illness. This often leads to shame and makes people not want to talk about it, seek help, nor help others. As activists we need to fight social stigma. The best way to do that is to talk about it. As fellow social worker and shame and resiliency researcher, Brene’ Brown, says, “shame needs three things to grow exponentially in our lives: secrecy, silence, and judgment.” As people with mental illness we need to tell people our stories and help normalize it. It takes courage and bravery to put ourselves out there, but it is necessary. As people in general we need to educate ourselves about various mental health issues and diagnoses, so that we can be more aware and informed. This would also help us to become familiarized with and thus recognize symptoms in others and aid them in getting the help they need. Also as we talk about these issues more we make it okay and not like a dirty secret, and thus the shame and taboo nature dissipates. We all need to become mental health advocates who combat social stigma if we want this situation to get better.
In the radical left, mental illness may be higher, due to stress, anxiety, being overworked, lack of support, burnout, what type of person is drawn to the radical left etc. A life-long commitment to social justice can be a serious undertaking and means a literal struggle, with many sacrifices along the way, both personally and politically speaking, which comes with psychological and emotional consequences. Of course there are positive mental and emotional benefits of being an activist as well, but the commitment to the movement comes with both rewards and challenges.
Furthermore, we know capitalism creates social alienation and enormous amounts of interpersonal, relational, and social stress on individuals and families. Not only must we work hard, often low paying, jobs way too many hours just to survive, we have so many other responsibilities on top of it. We often have families, partners and children, parents, siblings, other relatives, friends, co-workers, etc. we need to help take care of. We have to do chores, feed ourselves and others, and run errands. Some of us barely survive on a daily basis due to being so poor, let alone have the time, money, or energy to take care of ourselves. There is so much to do; we often neglect our own health. Not to mention that the stress causes huge impacts on our health to begin with—both physical and emotional. All we can do in the immediate is try to manage the stress, by finding coping skills and decompressing activities (long term we are all working on transforming the material conditions of life so that this stress doesn’t occur to begin with). The coping skills can include art, exercise, sleep/naps, socializing with friends and family, eating a slow cooked meal, reading a book, yoga, meditation, relaxation techniques such as progressive relaxation (tightening and releasing muscles), deep breathing, focusing activities, taking a long walk or hike, going swimming, among other things. But not everyone has time to incorporate enough of these de-stressing activities. So it can be very challenging to overcome the pressures of everyday life, let alone those of being part of an activist movement and community.
It is important as an activist that one takes care of oneself and that our community supports us. Burnout is common due to folks working very hard for long periods of time. In addition, a lot of work can be put towards our efforts but little to no tangible results could be seen. This can lead to feeling great disappointment, discouragement, and frustration. We have to celebrate often and recognize people’s efforts. Appreciation of others is so important in creating self-esteem and maintaining long term commitment. We can also stave off burnout by taking breaks from our activism and supporting each other through hard times.

Moreover, sometimes our society creates a lot of anger in people, as we witness oppression, abuse, and exploitation and many who perpetuate it get away with it. Often we ourselves are subjected to trauma and crisis. They say anger repressed and turned inward becomes depression. In my own experience I have met many left radicals who have anger issues and are prone to infighting. Unchecked toxic anger, which is not expressed in effective and health ways, can poison a person as well as an organization.
So what is to be done? One thing I advocate is therapy, but it is often cost prohibitive. If one cannot find low cost/sliding scale/income-based therapy, I always recommend workbooks. Workbooks are like a guide book to learning techniques that help people with mental health issues. Workbooks can be purchased online and are generally under $20.

Here is just one example:

They are often written by mental health professionals and teach people step by step about the condition which they may have. They also teach techniques and strategies to help increase the quality of life for folks. Some of the workbooks address topics such as depression and anxiety, and teach techniques such as cognitive-behavioral approaches (mind/feelings-actions), dialectal behavioral approaches (looking at extremes in emotions and thinking and trying to find acceptance and balance), mindfulness based approaches (combining feelings and thoughts in a harmonious way in order to act from a centered place and practicing non-judgment of self and others), among others. These strategies have been proven effective through research testing their effectiveness on people (we call this evidence-based practice). If one technique doesn't work for you, try another. There are so many to choose from. Most therapists would teach these techniques in therapy but you can learn them on your own for a fraction of the cost. Implementing them into your daily life takes work, practice, and time but it's worth the effort to try, as they have been shown effective in helping people to cope with their mental health struggles, decrease anxiety and depression, reduce stress, as well as improve the quality of their daily lives.
Another thing therapists provide that is helpful is the time and space devoted solely to you and a time to talk/vent and be listened to and validated. You can't find this in a book. But you can find this in other people-- friends, family, co-workers, and comrades alike. Find some trusted individuals who are willing to hear you out, use reflective listening skills (repeat back what they heard you say so you know you were heard), provide empathy (relating to a person based on common feelings or experiences, feel "with" a you and put themselves in your shoes, which goes beyond feeling sorry for you--sympathy), and validate (telling you what you are feeling and thinking is real and true). Just by providing a sounding board of unconditional support can make a world of difference for people.
I always recommend the rule of threes. Find three reliable people you can go to in a crisis or when something happens that brings you down. Tell your story and process it with those three people, three different times. At the end, you will have released and expressed those feelings and thoughts, most likely feel better, have come up with some solutions to work through your issue and problem-solve, and be ready to move forward with life.
Of course there is one thing a therapist can provide others can't-- and that is education, training, and experience in treating and healing major trauma and psychiatric challenges. There really is no substitute for this. So if you need this, try your best to get it. Oftentimes the expense paid to get this is worth the necessary sacrifices.
Another avenue to increase mental health is using medication. There is much debate about the use of psychotropic medication. As someone who has bipolar disorder, I know my medication saves my life, both literal and quality-wise. Every individual has to make their own choice whether to try medication and see if it helps. Not everyone has to take medication long term, but some do. I have to take mine the rest of my life, but I am glad there is something out there that profoundly helps me. Yes, medications are often over-prescribed and developed by big pharmaceutical companies, which are profit-motivated. Yes, doctors can sometimes be pushers because they are getting kick-backs. That is why finding a good doctor to prescribe the right medication for you is important. This would often be a psychiatrist, who usually does not come cheap. If you can try to find a lower cost psychiatrist, but if you can't a general practitioner can prescribe lots of the same medications. The caution is they are not trained as well in psychiatric conditions and would not be able to monitor you as well as a psychiatrist could.

Our mental health system is far from perfect and is overburdened and too expensive for most people. That is part of why we work as left radicals to change this system into one that works for all people. Unfortunately, in the meantime we have to deal with how things are now. Another thing to look at, that can often be a less expensive way to help, is herbal remedies and Eastern/alternative medicine. There are many helpful remedies out there worth looking into from vitamins, supplements, teas, essential oils, to acupuncture, acupressure, bio-feedback etc. As well as looking at changes in diet, sleep, and exercise.
Individuals also need social support. If you're in a left radical organization develop internal systems to provide this support. Some people think this is "touchy-feely stuff" and they are a "serious" organization “above” that sort of thing. That attitude is grave mistake. We are doing what we do to better all humanity and we better be prepared to walk the talk right now and practice what we preach in our everyday lives with fellow activists. This means we need to be able to turn to each other in times of need. This prevents burnout and can be a powerful source of intervention in times of crisis. We need to get more involved in people's lives, pay more attention, and be willing to have, sometimes uncomfortable, conversations with people. We need to focus most on compassion, understanding, and empathy. But we must always remember that people ultimately have their own self-determination and thus they alone get to make decisions for their own lives. This may mean if a person is very disruptive to the group and will not seek help, they may be asked to leave the group. This is a hard and painful decision but people need to know there are consequences for their actions and their choices. All we can do is provide support and encouragement and hope that motivates people.
Another possible strategy radical left organizations can implement is conflict-management, non-violent communication, and peer counseling. If our organizations used these techniques and taught these skills to all of their members they would be better served by doing so. Learning how to communicate assertively and not passively, passive-aggressively, or aggressively is very important for any individual or organization. Our success is wrapped up in our ability to resolve conflicts and reconcile differences.

We can help each other to survive and get through the day, and combined with all of the above I have described, an individual can begin to improve their functioning. The hope is recovery. 60% of all those with mental illness recover and we can increase that number by working as individuals and as groups towards increased mental health and well being. We need each other if we are to begin to strive and thrive.
No one gets through this life on their own—we are all interdependent social beings. So let’s live our radical values in the here and now and transform ourselves and our organizations to serve each others needs. Our organizations can become a model going forward for society and be a source of strength to make us more effective activists. Indeed this can be a protective factor for those with many risk factors for self-harm, homelessness, and suicide. We can be the difference and we are responsible for starting to implement these suggestions now. I hope this helps individuals and groups going forward.