(Reposting from the bad place)

Except for insurance purposes for therapy*, I've never been diagnosed with a mental health disorder. That's despite having some (but not all) symptoms of :attention deficit issues; anxiety disorders; hallucinations**; PTSD (complex or simple); attachment disorder; autism; gender identity disorder; mood disorders; others I've surely overlooked or forgotten.I've always felt a little grateful for that in a way, while also a little frustrated-bordering on resentful.

That means I've had decades to come up with strategies of coping or avoidance, to refine, tweak, and in some cases ignore, and to develop a pastiche of external personality that smooths over the cracks and valleys with mitigation and performance so that I don't look unstable, because fear of being assigned and then dismissed as "crazy"*** has been with me as long as I can remember. It really wasn't until I hit my 40s that I started to feel cascading success and awareness that my coping mechanisms really did help, and in some ways gave me advantages (though of course, at the cost of decades of suffering, experimentation, pain and failure). I know I'm incredibly privileged to have had that opportunity, and remain grateful to La Fortuna and spirits of luck (both metaphorically and sincerely).

But doing much of this on my own, and outside of the juridico-discursive power of the APA, AMA, etc., means that on one hand I've not been "helped" to a place within the mainstream, if at some accepted margins, for the low, low cost of my idiosyncrasies and particular modes of thought and interpretation, while on another hand I do not have the company of like-minded fellow travelers of disorder, dysfunction or dysphoria. I'm the half-feral hermit in a lot of circles, because I don't speak the accepted language or swallow the accepted meanings. Very few speak my dialect, and show little interest in my lexicon.

I have strong opinions about psychiatric care in the US, but I have strong opinions on a lot of things. In this case, I really think an analogy is useful; I feel about psychiatric care in the US the way I feel about Walmart. Let me explain.

I hate Walmart as a corporate entity. I think greed and self-interest drives everything they do, and there are not nearly enough social consequences everyone who profits from what they do to people. However, I in no way judge those who work at Walmart, or who have no option other than to shop there. Life is hard, capitalism wreaks its will on all of us, and monopoly power co-opts and coerces all of us in myriad ways.

Similarly, I do not trust either APA****. Greed, self- and guild interest, hubris and incuriosity have created a market driven machine to smooth out people and fit them into socially and economically acceptable shapes with little thought about long term social or personal consequences. At the same time, I do not judge people who are in pain and desperate to find some way to make it through the day, week, month. Drowning people need help.

I worry at great length about the long term iatrogenic effects of psychoactive substances (doctor or self prescribed); not nearly enough research has been done (and what has been done hasn't been sufficiently acknowledged; remember the story in the early 00s when psychiatrists admitted the brain chemical deficiency model was inaccurate, and they knew it for years? Probably not, if you missed the 6 month window in which it was news, because there's profit in SSRIs, and science be damned). But, and this is important, I don't want to take meds away from anyone. I want doctors and therapists to have to have realistic conversations with patients about short term benefit and long term side effects, diminishing returns, and homeostasis. I want an array of tools deployed for everyone suffering, in which medications are leveraged for the space-making window in which social, interpersonal, therapeutic and internal change can be learned and implemented. I want profit out, and humanity in, on mental health care. There is no one "normal"; there are many normals, and anyone who tells you otherwise is probably in marketing*****

One of the best advantages about consistently not dying is that I see people I've known and respected for decades (hopefully you know who you are) struggle openly with navigating the above issues, from the perspective of people differently enmeshed within the psychiatric/therapeutic hegemony of selves. My more reactionary stances have been eroded into nuanced heterodoxy. I want everyone, all of you, to be well and strong and yourselves, without having to fold, spindle or mutilate parts to fit within frameworks inimical to human life.

[I'm putting this in my Trans Issues filter because this is the kind of thing I think about, and write, here. Trans stuff is all over this for me. ]

*Gender Identity Disorder in the late 80s, and Unspecified Anxiety Disorder in the 2000s
**by general defintions; I'm more empirical/Lacanian-flavored about my sensory input
***yes I know this is a pejorative; this is the language the very old fear in my head is written in
****Psychological or Psychiatric, though if I had to choose, the latter is worse
*****I am very Hicksian on advertising (#St. Bill)