I had an unpleasant experience several months ago with one of my oldest and best friends, and it’s been bothering me ever since.  I didn’t realize how much it was bothering me until recently, but that’s a perennial problem for me: not realizing something bothered me until long after the fact.

In this instance, my friend is a writer with a severe, incurable chronic physical illness and he’s writing about people’s lived experiences with chronic illness.  My husband and I were talking with he and his wife about his project and I mentioned that it would be a good idea to include a chapter on the lived experiences of those with chronic mental health issues, thinking he would agree.  I was wrong, and I was somewhat shocked at the ferocity of his response, which was very angry and defensive, as though I were trying to horn in on his territory or something.  I realized with a great deal of sadness and no small amount of anger that my friend, despite being a very intelligent, open-minded, progressive individual, had fallen prey to the same thinking that has driven a wedge between the mentally ill and virtually every other aspect of society.

I understand why this is so.  People fear all kinds of things in life, including sickness and death, but most of us understand these things will eventually come to us.  What people fear more than those things, even if they don’t consciously understand it, is losing their minds.  A person can lose all manner of physical functionality, but as long as they still have their minds, they still retain some manner of individuality and the ability to think, feel, and dream while keeping these things under control.  A person who has lost their  mental faculties no longer has these things.  What use is the control of one’s body if one has lost the mental capacity to govern it?

I have no doubt that if you were to sit the average person down with their favorite alcoholic beverage and ask them to choose between a chronic physical illness and a chronic mental illness, each with an equal likelihood of killing them early and reducing their remaining life functionality, they’d probably choose the physical illness because losing one’s mental faculties is one of humanity’s most frightening propositions.

I don’t say these things to try to make one kind of chronic illness more severe or superior to the other, because they’re not, which is really my point.  Physical illness does not deserve greater attention because it’s a physical condition, just as mental illness does not deserve less attention because it’s a mental condition.  My life expectancy and life functionality are just as reduced as someone with a chronic physical condition.  The medications I have to take to control my conditions reduce the human lifespan on average by 20 years.  I am now 51: that means that my end-of-life clock is ticking a lot more loudly than most people’s.  I could literally be dead tomorrow.  By the same token, I could live into my 80s, but I’m not sure I want to in a world where the mentally ill are relegated to the margins of society because people are so ignorantly frightened of us.

My life is also full of just as many limitations as someone with a chronic physical illness.  No, I may not have to use the handicap parking when I go to the store, but I have to live with a condition that may prevent me from going to the store at all because my brain won’t let me.  My social life is hampered because I can never tell when I’ll actually be in the mood to engage with other people.  I have communication difficulties with the people I love and live with because sometimes my brain just won’t let me see reality the same way they are, nor vice versa.  I live with a noise in my head that is so constant that one of my first thoughts of the day is often, “it’s a good thing I don’t own a gun or I’d blow my own head off”.  I spend the first hour or two of each day tamping down that noise so I can go about my life.

One of the biggest perception problems that leads to this false separation between the physically and the mentally ill is that mental illness is somehow not a physical illness, when it is.  I imagine this is a centuries-old holdover from Western civilization’s collective belief that mental problems were an indicator of having been “touched” by God, being possessed by demons, or that they were simply bad people.  It has only been in the last hundred years or so that science has been able to prove that the seat of the mind is in the brain, which is of course, part of the body.  In fact, the brain may be more a part of the body than any other organ because it is the core of the body’s nervous system, which controls everything.

Maybe a reason people are reluctant to think of mental illness as physical illness is because there are still many who think of mental illness as being something a person can control willfully.  Since most people think of themselves as being relatively in control of their lives, they unconsciously think themselves immune to the possibility of a mental health problem, whereas most of us know we are not immune to physical health problems.  By casting mental health issues as something personally controllable rather than something that is the product of a physical breakdown of the body, they make the world a safer place in their minds.  Getting people to admit that mental health IS physical health would force them to set aside their prejudices against the mentally ill and be more cognizant of the real causes of mental health issues, as well as force them to admit that a mental health issue can affect almost anyone, even them.

I am quite sure that my friend did not mean to be offensive or insulting.  The incident did illustrate to me, however, how misperceptions of what it means to be mentally ill infect even the most intelligent of us, unconsciously propagating harmful attitudes towards the mentally ill that effectively make us invisible.  It’s also harmful to people with physical chronic illnesses that do not readily show themselves, causing others to say those most hurtful of words, “you don’t look sick”.  Just because we can walk doesn’t mean we’re not in pain, and in the words of Quellcrist Falconer from Altered Carbon, “to the mind, pain is pain”.

I look forward to a day when our society is more inclusive and has larger umbrellas for people to stand together beneath, rather than an exclusive society in which the umbrellas are more numerous, but smaller.  We have much more in common than not in common, and it’s important not to create false divisions in the name of expressing our individuality.  If there is an enduring lesson in the world’s great stories, it is that we are stronger together than apart.