Mental Illness and Responsibility

There’s something came up in the comments of the post about Mr. Tangent 19 that I meant to turn into a post of its own. Unfortunately, I never quite got around to it. In light of recent events, and the talk about the man who attempted to kill congresswoman Giffords, I think it’s important to talk about this kind of thing, so I’m resurrecting the in-progress post now.

Quite frequently when I write a post about a particularly odd crank, someone will either comment or email me saying something like the following:

How fine a line is it between being a crank and being mentally ill, how do we differentiate between the two, and how should we individually treat those separate cases?

The gist of this line of reasoning is: the target of this post is obviously mentally ill, so why are you being mean picking on them?

When I look at things like this, I’ve got a rather blunt answer: why does it matter?

In fact, I’ve got an even better blunt answer: Why should it matter?

Over the last few years I’ve learned, from personal experience, what mental illness really means. Personally, I suffer from chronic depression (managed, quite well fortunately, through medication); and I’ve also had a lot of trouble dealing with pretty severe social anxiety. It’s not a lot of fun. But it’s also not relevant to anything I do at work, to anything I write on my blog, to any political or social or religious activity that I participate in.

I’ve learned from some of my friends about bipolar disorder and dissociative disorder. And I’ve got a cousin who is pretty much completely incapacitated by schizophrenia.

I’ve learned a couple of things from those experiences.

First: being mentally isn’t a particularly big deal. There’s a good chance that you know a lot of mentally ill people, and if you knew who they were, you’d probably be amazed by just how normal they seem.

Second: there is a terrible stigma associated with mental illness. That stigma is huge, and it colors everything about how we view mental illness and people with mental illness. The way that we look at someone mentally ill and baby them – say that we shouldn’t hold them responsible for what they say and do in public – that’s part of the stigma! And it’s not anything close to benign. As almost anyone with any kind of mental illness can tell you, revealing your illness to your employer or coworkers can completely change the way that you’re treated. You can go from being a go-to person on top of the world, to be an absolutely untrustworthy nothing overnight if the wrong person finds out. Nothing changes, except their perceptions: but because of the stigma that says that mentally ill people are irrational and untrustworthy, suddenly everything you say, everything you do, can suddenly become questionable and untrustworthy. After all, you’re crazy. (Yes, I speak from bitter experience here.)

Virtually all mentally ill people function as part of society, without people around them even knowing about their illness. But the instant you find out that someone is mentally ill, the instinctive reaction is to say: “This person is mentally ill, therefore they aren’t responsible for anything they say or do” – and as a direct corollary of that: “I can’t trust this person with anything important”. I’ve seen this quite directly in person.

It’s total bullshit. Most mentally ill people are just as responsible, trustworthy, intelligent, and reasonable as people who aren’t mentally ill. Even many people with schizophrenia – one of the most debilitating, hardest to treat mental illnesses out there – can be fully functional, trustworthy, and rational people. I’ll guarantee that every one of you reading this knows someone with a mental illness, and there’s a reasonable chance that there’s someone you know who has schizophrenia, but you don’t know it, because they seem perfectly normal.

The thing is, we could know someone mentally ill for years and never notice anything odd. But for most people, the instant we find out that they’re mentally ill, our attitude changes. Suddenly they’re not trustworthy or responsible: they’re crazy.

If you’re well enough to interact with society, you deserve to be treated as a full member of society. And that includes the negative aspects of being a member of society as well as the positive ones.

In terms of that past post: the author of that piece of crankery is a practicing physician. Perhaps he is mentally ill. But apparently he functions quite well in his day to day life as a doctor – well enough to be able to practice medicine; well enough to be able to make-or-death decisions about how the medical care of his patients. He deserves the respect of being taken seriously. He doesn’t deserve to be pushed off into a bin of crazy people who should be dismissed as not responsible fdor their actions. If he wants to put his ideas forward, they should be treated just like anyone else’s – whether he’s mentally ill or just stupidly arrogant and ignorant doesn’t matter in the least. It’s none of your or my business whether he’s mentally ill. He’s a responsible adult. And that’s all that we need to know.

The only time that mental illness matters is when someone has something that they can’t control. And that’s very rare. Most mental illnesses don’t affect our ability to be reliable, rational, trustworthy, functional members of society. We’re not incapacitated. We’re not crazy. We’ve got just got a chronic illness.

To connect this to the politics of the moment: lots of folks are pointing out that if you look at Giffords’ shooter, at his troubles in school, at his writings in various places on the net, he’s clearly mentally ill, so clearly no one is responsible for what happened.

I’m not a psychiatrist, obviously. Based on his writings, I’d guess that there’s a fair chance that he’s schizophrenic. And that doesn’t matter.

He’s a murderer. He carefully put together and executed a careful plan for a multiple murder. From everything that we’ve seen and heard, he knew and understood exactly what he was doing. The fact that he’s mentally ill doesn’t change his culpability.

Don’t hold the millions of people who suffer from mental illness responsible for the horrific actions deliberately taken by one individual. And don’t say that this one horrible individual isn’t responsible for what he did.

44 thoughts on “Mental Illness and Responsibility

  1. samantha

    Thank you, and well-said.

    I see it go both ways – “Oh, this person has a disorder; they should be pitied, life should go easier on them, etc.” It’s insulting to me to think that I can’t succeed at life just because the chemicals in my brain are slightly different than the norm. Then there’s the, “There’s something wrong with them, so they have no control of their actions and they should just be locked away before they hurt someone,” approach, demonizing the very fact that a person exists. I’m not sure which is worse, but either way it discredits an individual’s humanity. And as a human, we have choices to make, and regardless of how our brain processes them, they are our choices.

    Reply
  2. DrugMonkey

    Even more importantly in the current scenario is the consideration that external, contextual or environmental influences work on those with mental illness as assuredly as they do on those of us as-yet-undiagnosed. Responsibility for one’s urgings and public statements does not instantly go to zero merely because extreme actions are motivated in one who is otherwise diagnosable as mentally ill.

    Reply
    1. MarkCC Post author

      Yes, I agree. I actually had something like that in an earlier draft of the post, but I couldn’t get the wording right.

      If you influenced someone into thinking that doing something horrible is morally acceptable, then you’re morally culpable for influencing them. Whether the person that you influenced in mentally ill or not is not relevant. The people who’ve been promoting violence as a moral, acceptable solution to political disagreement are absolutely culpable for influencing people to believe that violence is a moral, acceptable solution to political disagreement. People like Sharon Angle talking about “second amendment remedies” if an election doesn’t go your way; or Erik Erickson saying “Were I in Washington State, I’d be cleaning my gun right about now waiting to protect my property from the coming riots or the government apparatchiks coming to enforce nonsensical legislation.” – these people are undeniably trying to influence people to believe that violence is an acceptable solution, and they have no right to distance themselves from the outcomes of their arguments by saying that the guy who acted on their words was mentally ill.

      Reply
      1. Paul LYon

        Even if you don’t consider those statements to be related to this particular incident, they are still reprehensible. You want “second amendment remedies”? Well, this is what they look like.

        Reply
  3. dorid

    “The only time that mental illness matters is when someone has something that they can’t control. And that’s very rare.”

    How nice for you that this is rare in your circle. How splendid that you don’t have to experience people who have multiple hospitalizations for risky behavior, or that you live in a world where psychiatric hospitals are rarely utilized, when so many people wait in emergency rooms or jails for beds. How lovely that those you know with psychosis are in control, and their thoughts and behaviors aren’t tainted by paranoid or violent delusional thought.

    While I agree that most people with mental illness (assuming they have the right treatment, are compliant with medication, and have insurance or can afford medication) are not a danger to themselves or others, it’s hardly RARE that they are.

    I also agree that there is a stigma to mental illness that isn’t warranted. The problem is that people lump all mental illnesses together as if they’re all one thing with all one symptom and all one treatment… and that just isn’t so. It wasn’t too long ago when homosexuality and epilepsy were considered “mental illness”. Someday, perhaps, society will be more savvy about it.

    Now, as for Giffords’ shooter:

    The guy was cleared by a psychologist when he was in college. He tested positive for drugs when enlisting for the army. So was he insane or a drug addict or an individual who made an evil choice? I’m sure there are a lot of people who would want to say he was insane. In retrospect, people tend to come out of the woodwork to say that persons they didn’t give a second thought to before were weird in some way. But the kind of things they say can often be said of any teen, or any loner college student, and hardly indicative of the kind of individual who would go out and kill someone. Assuming he was insane is the easy way out, because our society still allows this kind prejudicial assumption that such behavior is indicative of mental illness.

    Reply
    1. MarkCC Post author

      The overwhelming majority of people with mental illness are in control. The people who aren’t are rare. I’m not saying that they don’t exist, but even among the very worst, least treatable mental illnesses, like schizophrenia, the number of people who truly have no ability to control themselves, to recognize right and wrong, to distinguish between reality and delusion, is incredibly small in comparison to the number of people who have the illness.

      It is very rare for people with mental illness to be dangerous or inappropriately violent. Even among schizophrenics, the rate of violence is only around double the rate for non-mentally ill. Remember: 1 out of 100 people in america suffers from schizophrenia. How many of those people are unable to manage their illness? How many of them engage in violence?

      That doesn’t reduce the tragedy for the people who need treatment and don’t get it. It doesn’t make it any easier or better for people for whom treatment fails. But the fact remains that those people are a tiny minority of the people who have mental illness, and it’s completely wrong to use them as a barometer for judging everyone with mental illness.

      Reply
    2. Marianne

      Over here in Norway, the government did a stipulation a couple of years ago, to see if they needed to increase spendings on mental health care. The outcome was that about HALF of the population will have a condition that will be classified as a mental illness at some point in their life. I don’t see half of the population of Norway running around lacking control of themselves.
      Remember: A mentally ill person can have any illness ranging from fainting when seeing or thinking of spiders, to the person in straghtjackets in movie.

      I’m sorry you have experienced bad shit in your circle, but your circle is not representative of the entire population.

      Reply
  4. Sean C.

    To lump the sort of mental illness which might cause someone to rave about nonsensible math theories in the same group as garden variety depression (or even controlled severe depression) is not a helpful analogy.

    You are absolutely correct that most mental illness isn’t a very big deal, just as most of the mild disorders we all live with (bad backs, bum knees, asthma) aren’t really a big deal either.

    However, your particular hobby of seeking out mathematical ravings is a huge selection bias for people who do have a mental illness that is on the more severe end of the spectrum. So I think you need to re-examine this question more carefully, leaving aside the fact that most mental illness is relatively benign and manageable.

    Reply
  5. D. C. Sessions

    There’s an enormous range to “normal,” and dismissing someone you disagree with (all too often a reflexive response) as “crazy” is a disservice to everyone, not just the person being so lightly dismissed. Or others who are dismissed a priori because they are “crazy.”

    I just can’t, quite, take that to the extreme though. Schizophrenia in particular raises the question of GIGO: when the delusional reality is far enough from the one most of us seem to inhabit, does it make sense to judge the process that leads to the output?

    NB: for a very disturbing fictional treatment of the subject, read Larry Niven’s “The Ethics of Madness.”

    Reply
    1. MarkCC Post author

      Even among schizophrenics, the vast majority (somewhere between 80% and 96% depending on which statistics you trust) are able to distinguish reality from delusion. Most people don’t believe that, because we hear about the rare exceptions – the people who are suffering from severe delusions, and who are completely unable to distinguish their delusions from reality.

      But the real stats are astonishing. At least one person out of every 100 in America has schizophrenia – and since schizophrenia is vastly more common in males, it’s actually close to 1.7 out of 100 or so. That’s a huge number of people: we’re talking about around 3 million people with schizophrenia in the US today.

      When you really absorb that number – 3 million people in the US alone!! – it makes you realize that even the most severe, hardest to treat mental illness is incredibly common, and that you almost certainly know at least one fully functional schizophrenic, without ever knowing it.

      Reply
      1. D. C. Sessions

        I don’t argue the numbers (although I’m not totally convinced that schizophrenia is anything like the worst, it’s really not germane.) However, that leaves those 40 ppm who don’t know that their perceptions are not reliable. I would expect that those 40 ppm are disproportionately composed of the young males (like Loughner?) who haven’t been so much as introduced to the concept in the first place.

        Which leaves the GIGO question unresolved.

        At some point, we really do run up against the question of competence (Alzheimers, anyone?) I’m an emergency medic, so I’m personally (and painfully) familiar with the extent to which we weight the scales in favor of a presumption of competence — but there are limits. We can’t just categorically ignore any case that exceeds them.

        Reply
      2. Peter Gerdes

        Just because the illness is common doesn’t prove anything about the ability to distingush delusions from reality.

        Many skizophrenics control their affliction through the use of anti-psychotics and many others are simply non-violent. I’ve met a fair number of homeless people who are absolutely convinced of their delusions but simply don’t have any violent tendencies.

        Moreover, the idea that a skizophrenic is like a normal person but with some hallucinations (as suggested by movies like a beautiful mind) is utter nonsense. Indeed, it is thought that the voices skizophrenics here are equally present in all of us but the rest of us simply recognize them as part of our internal mental dialogue rather than mistaking them for an outside agent.

        However, this is all highly irrelevant. What matters is whether someone in that circumstance is subject to deterence. If the punishment in a given case isn’t discouraging people from committing the violent act there is no point to inflict it.

        Reply
  6. anyedge

    Precisely right again Mark. As I wrote in the commentary of the previous post where this came up: I have a chronic, progressive, incurable, terminal mental illness. I am an alcoholic. However, I am perfectly functional in society, and as a scientist, because I don’t drink anymore. I have treatment that I go to, a community which assists me. But if you met me in the street, you’d never know. Because I am utterly ordinary. Despite my mental illness.

    And I am responsible for all my actions, those I perpetrated while I drank, while I was drunk, and all those today, while I am sober. It’s an illness. Not an excuse.

    Reply
    1. anyedge

      With regard to the influence of a ‘climate of hateful rhetoric’ or whatever:

      I deal with a climate of public glorification of alcohol every single day. And it doesn’t make me want to drink in the slightest. Individuals, even mentally ill individuals, are responsible for their actions if they are capable of even basic self-care.

      Reply
      1. Joseph

        It’s tangential to the blog topic, but congratulations on fighting alcoholism! Addiction is a tough row to hoe.

        Reply
        1. anyedge

          Thanks! Truth be told, I don’t have to fight anymore. I’ve been sober nearly three years, and while I am diligent in my treatment regimen, I don’t miss alcohol in the slightest.

          Reply
  7. Peter Gerdes

    I think you totally miss the point.

    Why punish someone at all? The punishment can’t undo their deeds and taking away someone’s freedom just to satisfy feelings of righteous indignation would be as awful an act as this recent murder was.

    No, the only good reason to punish the guilty is to deter future violence. The only justification for inflicting suffering is the prevention of even greater suffering. The reason we shouldn’t punish the severely mentally ill is because such punishment would have no deterrent value.

    This is why the legal system doesn’t ask whether someone is mentally ill. They ask whether they are capable of understanding the difference between right and wrong which is a poor way of asking whether they understand the likely punishment society will impose for their actions.

    Just as it would be pointlessly cruel to punish a dog for firing a gun so too would it be pointlessly cruel to punish those who are so out of touch with reality that they are beyond deterrence by punishment. Now there might be something to say for trying to deter violent mentally ill patients from going off their meds but that is an entirely separate question.

    Reply
    1. Richard

      Peter Gerdis wrote:

      If the punishment in a given case isn’t discouraging people from committing the violent act there is no point to inflict it.

      and

      No, the only good reason to punish the guilty is to deter future violence. The only justification for inflicting suffering is the prevention of even greater suffering. The reason we shouldn’t punish the severely mentally ill is because such punishment would have no deterrent value.

      The goal of punishment is to try to prevent the behavior from reoccurring. If this goal is accomplished by the perpetrator internally making the connection between action and consequence and choosing not to act that way again, then so be it. However, if someone is not capable of that train of thought then other methods must be used to prevent acting again.

      I find the notion that mentally ill people be treated differently in the court system to be yet another aspect of Mark’s post. The fact that a shooter is mentally ill has no bearing whatsoever on the fact that he shot & killed someone.

      Putting someone in jail or some other institution in this case isn’t so much for “they will have time to reflect on what they did wrong and it will deter them from doing it again” but rather for “since they don’t understand that their behavior is unacceptable we will confine them to physically prevent them from acting that way again.”

      -Richard

      Reply
      1. khms

        True, but incomplete, and it so happens that the difference is currently in the political debate over here in Germany, since the ECHR just told us the previous way of doing things was wrong.

        There are two different considerations here.

        One is punishment, which western justice is mostly agreed only applies to those who are able to use the probability of punishment as deterrence (though often enough they aren’t willing so it still doesn’t work).

        The other is public safety, which means keeping dangerous people away from the general public. Now this is a serious restriction of their rights, therefore really unless it is absolutely hopeless, society owes it to these people to provide treatment.

        And while both can result from a trial for some offense, occasionally there’s the need to impose the second without an actual offense having happened, and we can’t just do that as if there had been an offense – it needs a different kind of court process. (The part that got us in trouble with the ECHR was the practice of expanding the second kind of treatment when the person in question was still considered dangerous toward the end of the original court-imposed part. Can’t justify that as part of the sentence, as that has already been decided on – must justify it a different way. Now we gots us some brand-new laws on that and are in the process of deciding where to treat those people we had to set free, and often have watched around the clock by lots of policemen right now in the hope of avoiding another victim.)

        And just for completeness I should add there’s also the consideration of deterrence of third parties, which obviously needs the sentence to look “sufficiently awful”. This one’s probably the most tricky. Oh, and fourth, which seems much stronger in the US than in the rest of the western world, there’s the attempt of placating the victims. Victims or their relatives and friends clamoring for hard sentences, especially on camera …

        Reply
  8. Kyle Szklenski

    I’ve seen this mentioned a few times, but perhaps not in the comments here, nor in the the original post, so I thought I’d ask you about it, Mark: Do you think the shooter should have been prevented from purchasing the gun that he used? I suppose, put another way, what are your thoughts on gun laws and restrictions for them?

    Reply
    1. MarkCC Post author

      I’m a pretty bad person to ask about gun laws. Personally, I’m strongly in favor of gun control.

      Should he have been allowed to buy the gun that he used? Given the way that courts have ruled about gun ownership rights, I think so. I think it’s unreasonable to expect a shop-owner to collect psychological profiles on every customer who walks in the door. If it’s legal for people to buy guns, and you’ve got a guy who’s never been in any kind of trouble before, then he should be allowed to buy a gun just like anyone else.

      Should he have been allowed to buy an extra-high-capacity ammunition clip? Fuck no. No one should.

      If he’d been in trouble for violent behavior before, then I’d say he shouldn’t be allowed to buy guns. Not because of any mental illness, but because of the history of violent behavior.

      Reply
  9. Kyle Szklenski

    I agree wholesale. I’m glad you caught that I wasn’t implying the mental illness angle – after rereading it, I thought you might and get annoyed. No, instead, I have read some statistics on drugs and alcohol raising violence rates (rather than schizophrenia, in the case of the stats I’d read), and I thought that maybe because he couldn’t get into the military due to drug use was one possible way that this could have been prevented.

    I don’t think you’re bad to ask about gun laws – just biased. 🙂

    Reply
  10. ix

    I think there is a separate possibility for why people are bringing this up that you are not talking about (totally on board with the rest though), which is this:
    If this person is obviously mentally ill, even to a layman, how useful is it then to still spend time and energy debunking him?

    Presumably you are writing for the benefits of yourself and your readers, especially those that seek a deeper understanding of mathematics or simply don’t know what to think of a certain theory. As long as you’re arguing with things that regular folk might plausibly still believe, well, fine.. But if the thing you’re debunking is so off the wall crazy that we find it hard to even come to grips with what exactly its author thinks he’s saying, it’s likely more drudgery than it’s worth.

    This is exactly the reason why you don’t argue politics with people with severe mental illness. Presumably, you’re having an argument because you a) want to educate them, or show them at least that not everyone agrees, b) want to convince other people that you’re right (okay, it’s all about dominance). Most people will know that you’re at least more right than the guy with severe paranoid delusions (the type of mental illness is important here of course), and there is no way you’ll ever get through to him, so why bother?

    Reply
  11. R1S1NG

    I’ve just started taking medication for my depression, and I agree that there’s too much of a stigma attached to mental illness. Most of my close friends at college know that I have depression, but some of them still say that I shouldn’t go and kill myself when I post something on Facebook that has a negative connotation. Just because you have depression, doesn’t mean that you want to hurt yourself.

    My mom has bipolar disorder, and I was terrified last year that I might have it. I didn’t want the stigma of it attached to me, and I didn’t want to be what my mom was. I was more worried about how people would see me than how the illness would affect me. This is part of why I didn’t go and seek treatment for my depression for so long.

    Reply
    1. Melissa G

      Heh, and here I sit, a bipolar person, soaking up the stigma you’ve just attached to me!

      I’m bipolar, I *do* suicidally ideate on a regular basis, and yet I am still in control of myself and functional in society, thanks to my very helpful medication regimen.

      Reply
  12. Sean

    It’s a troubling situation. As you say, a person may be judged dramatically differently if the truth concerning their mental illness is suddenly revealed to the masses.

    The “Masses”, were therefore unable to see the truth before hand, and thus the “Masses” were clearly not directly in touch with the reality of the situation to begin with, and thus the “Masses” were not in touch with reality in the first place.

    And so it is important to realize that the many people of this world are not in touch with reality.

    Not being in touch with reality leads to incompleteness. This “incompleteness” therefore allows change to occur, and thus allows a sudden change of opinion of an other person to actually occur.

    Reply
  13. Jud

    The fact that he’s mentally ill doesn’t change his culpability.

    And don’t say that this one horrible individual isn’t responsible for what he did.

    Well, that depends. Thankfully the legal system requires evidence regarding this particular individual, not what is true of most (or any) other people with some type of mental illness. Certainly all the studies done on the mentally ill indicate that as a group they perform fewer violent acts than the “sane.” But a trial (unless there is a plea agreement, or agreement that defendant’s mental state precluded legal responsibility, and I’m not sure how likely that is in this high-profile case) will determine whether this individual could not judge whether his actions were right or wrong. (A standard that is also used in some states is “irresistible impulse,” that is, one knows one’s actions are morally wrong, but one is nevertheless driven to them.)

    I suppose each of us can judge for ourselves, if we are so inclined, whether the perpetrator was morally responsible/culpable. Whether he is legally responsible/culpable will be up to a jury based on specific evidence about this particular individual (unless the prosecution agrees, based on psychiatric examination(s) of the defendant and other relevant evidence, that he wasn’t legally responsible – as I noted above, in a high profile case like this, I don’t know how likely that is).

    A comment about how mental illness may play into the incivility theme: For a while I had a roommate who was schizophrenic. He would frequently “clean” by walking around the apartment with a can of Glade held above his head in one hand and a can of Lysol in the other, spraying both continuously until they were empty. I speculate that this could have resulted from his inability to apply the sort of “reality filter” most of us might use when watching Glade and Lysol ads about how clean and fresh they make everything. I wonder to what extent the perpetrator in Tucson might have lacked a “reality filter” to apply not only to political discourse, but to the stories we as a culture tell ourselves and our kids in so many TV shows, movies, books, etc., where the hero uses violence to save the day. (Even Harry Potter triumphs through superior force.)

    Reply
  14. Kea Giles

    Fantastic post! Thanks for expressing my thoughts so well! : ) BTW, I think about & appreciate your “I am a racist” post from April 2010. Just retweeted it for folks at this year’s ScienceOnline conference.

    Reply
  15. EmpiricalWin

    There is a constitutional and ethical reason for the legal precedent of the “insanity” defense. I agree most schizophrenics can function with help and effort, but a paranoid schizophrenic, as it seems the shooter is, cannot distinguish reality from fantasy and fear. Legally, this indeed “changes his culpability.”

    Here is an excellent video on the subject by an ACLU lawyer:

    Reply
  16. angie

    Thank you for writing this!!! It has given me more peace with my illness and i dont need to be locked away! This article is written very well and anybody struggling with mental illness should read this!!!!! THANK YOU!

    Reply
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  20. jdoc123

    Well said! Thank you. Brilliant post!
    I tell you what peeves me off more than the fact that I am mentally ill, that I can deal with, its this preconception that the world has that once you illness is out in the open that you are not the person you have been all the years that you have suffered from a mental illness and its not known. Its the idea that you are no longer a rational person, even though I seem to suffer from a list as long as my arm I am more rational than a lot of other people I know. And that any rational fears, upsets or anger is obviously only part of that illness, because you cant just be scared, or sad, or furious any more without it being “just because of the way she is”. Just because a select group of individuals have done some horrific thing and blame their mental ailment, (which I have no doubt sometimes it might be, but a lot of the time it is just a crutch), does not mean the rest of us are capable of such things just because we fall under the same social categories. Hopefully one day the world will catch up with us, and see the rest of us for what we are, the people it has always known but now suffering from a mental illness, and that’s okay!

    Reply
  21. ArchibaldHukler

    I have Asperger’s and people sometimes even pick up on it. The weird thing is people in general love to hear me talk about things I know, praise my brain for my genius out of the box thinking, and say out of all the people they know they expect to see me as one of the most successful.
    Is it just me or does the media exposure of Asperger’s particularly media speculations about Bill Gates, Einstein, etc… turn this social category into an advantage in some ways? I read an article once about some companies even go out of the way to look for Asperger’s traits.
    Unrelated, I don’t get why the standard in insanity trials is lack of ability to judge “right and wrong”. The law is the law. It’s not about right and wrong or else hate speech would be illegal, there are more concerns besides right and wrong that go into law. Sometimes something is wrong but it’s also wrong to use the law against it because of the greater consequences that result from involving the government in certain things. Sometimes something isn’t inherently wrong but it’s right to use the law against it, for example someone might want their own tank just as a collector’s item. Not wrong in itself but we can’t make exceptions for laws against private tank ownership because everyone would claim that as an excuse.
    But I digress, “distortion of reality causing mistake of facts” should be the standard. If the person believed false things such as due to hallucinations which if true we would then consider their conduct defensible then I can understand an insanity defense. But otherwise whether in their opinion they were doing nothing wrong it’s still illegal, you still know that or you should (ignorance of the law is no excuse for breaking it). I would say even a person hearing the voice of God should be found guilty, because if that had been actually true the person would be guilty, even if God exists and tells you to do something the law is the law.
    Strangely enough you only ever see insanity pleas for things like murder. If God or Satan telling you to kill is an excuse why isn’t it an excuse for acts like disorderly conduct/unlicensed protests in cases where activists claim that God spoke to them and told them to protest (non-violently but disruptively) an issue. Should civil rights leaders some of whom for all we know may have been at least in their minds “talking to God” been able to claim insanity pleas? And if these people who did good(but illegal) things because of what they thought voices were telling them aren’t excused why excuse those people who did bad things?

    Reply
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  23. Dave

    The point isn’t that part of him knew what he was doing. The question is would he have done thus with the correct care and medication.

    To dismiss illness in the way you have shows a lack of understanding of mental health issues and the difference correct treatment can have.

    You mention having severe clinical depression, which I’m guessing was treated with drugs and forms of cbt? Think back to pre treatment and how differently you viewed the world. What has changed? Nothing, but you have been helped.

    Untreated, or unresolved mentally I’ll people deserve to be given a chance to get help.

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  24. Adenosine

    I have a mild variant of autism once known as Asperger’s syndrome. I mean mild in a relative sense—it has some positive aspects, but it could almost be considered a different form of humanity, if not an entirely dysfunctional one. It has shaped my development in ways I will never fully untangle, among which I count the dubious gift of viewing the world through the lens of an outsider. Garden-variety depression holds no candle to it, though particularly severe forms might.

    My social difficulties have improved over time, but I suffer from a set of executive impairments that combine the worst traits of ADHD with a deep layer of fatigue. I can focus acceptably well on an abstract, intellectual level, but the act of balancing different tasks is exhausting, and it forces my natural mind into a choice between sticking too sharply to one area and drowning in the complexity of the picture as a whole. This problem is easily worse than all of the autism’s primary symptoms, at least for me. It bears some resemblance to a permanent, low-level concussion, and in that sense I seem to lack responsibility for it. Yet, one could also consider the portion that involves impulse control a personality trait, as they could with anxiety or depression. On a neurological level, it can probably be traced back to some problem with motivation and reward, even though the subjective results feel more like confusion.

    I spent years blaming myself for this side of it, but if acknowledging your behavior holds some value, then screaming at myself only made it even worse. Because I did not physically understand how to act differently, all attempts at personal responsibility failed, until I finally got a comorbid ADHD diagnosis and an associated stimulant prescription. From that point onward, everything suddenly felt easier, even though I prefer not to take it every day. It is easier to push past your natural limits for forty-eight hours than sixteen consecutive years.

    In a conventional sense, I’m pretty sure that I’m responsible for some of this, as are the other sufferers of that widely-dismissed attentional ailment. I might even say the same for the negative (non-psychotic) symptoms of schizophrenia, since many of them resemble nothing so much as a severe case of attention deficit disorder. But scorn is often worthless, counterproductive to utility and willfully ignorant of basic realities. The legal system needs rigid, uncompromising standards of accountability; everyone else is faced with the task of admitting their faults without destroying themselves. Even the act of seeking therapy or treatment could be viewed as a cop-out, if you’re in a mind to.

    People with schizophrenia may suffer the effects of being feared or underestimated, but my worst experiences have been with people who wish me to deny what I see through my own eyes. Some of them mean well, but they treat basic analysis as a great moral failure, as if ignoring the truth could somehow evaporate it. At my most functional, I approach errors as learning opportunities, working to minimize them without expecting perfection. At my most neurotic, I become so remorseful that entire days go by without a drop of productivity in sight. Hardline perfectionism is nearly as destructive as complete irresponsibility, and even less rational.

    Can you mock someone for their delusions? You can, but I can also make fun of you for being depressed. Should you? Should I? I don’t know. I truly have no idea. The standards most people use to separate humor and insensitivity are fundamentally incoherent, held together more by the speaker’s mood and biases than anything rational or honest. My attempts to synthesize a more consistent set of rules have almost invariably led to results that are brittle and dogmatic, which has caused me a great deal of discomfort over the years.

    This is more a comment on the basic idea than your particular views on it, so if anything I’ve said seems like a strawman, it most likely isn’t aimed at you.

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