"Deserved": on Meriting Mental Health Struggles

Edited by Jasmine Ryu Won Kang

(This article discusses mental health and specifically mentions depression and anxiety. In order to cater to a general audience at varying stages in their mental health journeys, descriptors like “struggles” and “diagnoses/ disorders” are both used, and the demarcation in terminology is not always precise and explicit. However, the ideas and implications they entail are NOT in reality interchangeable, and I would not like to suggest otherwise.)

In a study titled Do people with mental illness deserve what they get?, Rüsch et al. examine the relationship between mental health stigma and “meritocratic worldviews”; these ethical ideologies advocate a cause-and-effect rationale and emphasize personal responsibility for circumstance and experience. According to the study, there is a consistent correlation between ethical perspectives thus characterized and subscription to “guilt-related stereotypes about mental illness”: that I/ they (individuals living with mental disorders) get what I/ they deserve. Much of the efforts to combat stigma surrounding mental health have strived to shift the collective mindset away from the notion that mental health conditions are derived from, or reflective of, personal attributes; this necessary progression resists the dangerous assignment of unreasonable accountability and appeal to deservedness.

But what do we really mean when we conventionally speak about deserving? The word’s meaning is distinctly two-fold. On one hand, “deserve” invokes consequences and repercussions inflicted upon an individual as a result of some harm or atrocity for which they are responsible: the murderer deserves their jail sentence. It is this understanding of deservedness that has for a long time informed the malignant misconceptions about mental health and from which we must urgently depart. At the same time, “deserve” is also used to convey causally justified merits and rewards: we deserve the good result on the exam we have studied hard for. Here, the word takes on the ideas of qualification and justification; such contextualization of deservedness is less commonly examined against the backdrop of mental health, but it in fact also delineates a domain of pervasive, harmful misunderstandings.

Studies and personal anecdotes have revealed a resounding belief that mental health struggles should be grounded in, or justified by, objective circumstances – that diagnoses of depression or anxiety are somehow more legitimate if the external factors in which the conditions are rooted are identifiable and nameable. In one of her videos, YouTuber Anna Akana speaks about her sister’s death by suicide and how the grave – but incontrovertibly recognizable – tragedy at least supplied substantive grounds for her depression. As circumstances shifted and states of affairs “improved,” however, the elimination of some readily perceptible factor to be depressed about gave rise to the conflicting demand to re-evaluate the validity of her condition. It is clear that this ill-defined and arbitrary pressure to “earn” mental health struggles minimizes the impact and legitimacy of lived challenges, and erects barriers that frustrate the attempt to seek and receive help.

(It must be noted, however, that the “external justification” discussed here is not referring to clinical diagnostic criteria, for which stringency exists for obvious and necessary reasons. This is particularly so when we observe the unfortunate romanticization and co-option of mental disorders by mainstream media, etc.; this topic deserves (excuse me) its own important and lengthy discussion which must be reserved for another occasion.)

The socially imposed and commonly internalized pressure to ground mental health challenges and diagnoses in empirical circumstances is intricately connected with a different, albeit related misconception: that acknowledgement of – and gratitude for – one’s privilege is somehow incompatible with that of one’s mental health struggles. This sentiment is particularly prevalent among marginalized communities – BIPOC, women in higher learning institutions and leadership positions, LGBTQ+ folks – and among individuals who have defied circumstantial odds to attain “objective” success – children of immigrants, first-generation college students. Surveys have found that members of these communities often believe their “not having it that bad” renders them unentitled to claims of mental health diagnoses; there is also a consistent wariness that any recognition of existent problems and attempt to reach out would be construed as attention-seeking behavior.

Such fallacious judgement norms about mental health clearly and detrimentally contribute to stigmatization in a self-perpetuating cycle and exacerbate the alienation and silence around mental health hardships. A narrative emphasizing deservedness also implies that mental wellbeing is externally informed and therefore “adjustable” by fulfilling specific tasks on a specific checklist; the failure to feel a certain way, then, becomes due entirely to the failure to do something. This discounts the fundamental complexity of mental disorders and reinforces the harmful and unjustified assignment of personal responsibility to phenomena that are simply unattributable to individual choice or character.

While the collective awareness surrounding mental health and diagnosable conditions has made essential and heartening progress, society as a whole is still far from having fully reconciled its understandings of mental and (exclusively) physical wellbeing, and from affording the two comparable levels of empathy. It seems intuitively and indisputably true that just because I have not been laying in the Toronto snow without a coat – or otherwise able to pinpoint the circumstances that have contributed to my cold – does not make my health condition any less impactful or valid. How, then, could we rightfully demand this absurd justification for mental disorders (or even undiagnosed struggles), simply because they are less tangible and readily quantifiable?

 

References

Peterson, C. (2019, July 24). You don't have to earn your mental health struggles. Retrieved March 10, 2021, from https://theweek.com/articles/853321/dont-have-earn-mental-health-struggles

Rüsch, N., Todd, A. R., Bodenhausen, G. V., & Corrigan, P. W. (2010). Do people with mental illness deserve what they get? Links between meritocratic worldviews and implicit versus explicit stigma. European archives of psychiatry and clinical neuroscience, 260(8), 617–625. https://doi.org/10.1007/s00406-010-0111-4