Hello!! Thank you so much. This is a GREAT question and I apologize for the delay in answering it. Though I have journaled a lot about this, and written publicly a little bit in the past, I didn’t want to just regurgitate the same response so I’ve been pondering. A mad scholar, Shayda Kafai, has a little footnote in her recent essay (“The Mad Border Body: A Political In-betweeness”) published in the Disability Studies Quarterly. She says this:
“I have chosen to use the term “madness” as opposed to “mental illness” for several reasons. Mental illness is language that is entrenched within the medical model. Madness on the other hand, while it was used as a derogatory term, has been reclaimed. Similar to the term queer, madness, in its reclamation and re-appropriation by individuals from within the community possesses agenic power.”
Which I think is a really good distinction between the terms!
I definitely identify as both mad and mentally ill, and also as “in and out of the attic.” I think a big part of the difference is what is being framed and how. mental illness is a term offered by the medical model, and it is part of a history of psychiatry which seeks to treat/cure illness, which sadly often has translated to punishing & disciplining mentally ill people. The psychiatric home of the term “mental illness” is involved with a very asymmetrical power relationship, with the doctors and professionals being the ultimate authority. Basically the mental-illness-narrative is authored by doctors treating the “insane” as what some people call “the known”, or as experiments. Madness is a reclamation of power, like the Disability rights movement’s favored political slogan, “nothing about us without us.”
Doctors historically have very cause-and-effect ideas about symptoms. An example of this might be like… abuse creates trauma which creates mental illness. While this is true for many people, its use as a medical narrative is actually very limiting for people. Solutions from the medical model often involve correcting a traumatized and mentally ill person’s symptoms because their symptom-expression is inconvenient for society, instead of social-justice based solutions, which involve changing society so people stop getting abused and traumatized. Signifying something outside of the medical paradigm is political. As a “mad” person I have more agency, I am reclaiming. As a mentally ill person I am constrained to a narrative in which I am an object of someone else’s study.
I also think that a mad identity is a dis-identification with sanity. Whereas a lot of stuff with mental illness is like… trying to get access to sanity. Identifying as mad is kind of like.. if sanity involves me being a specimen you are trying to “heal”, then i don’t want to be sane. I can be mad, healed, and love myself, all without being sane.
I truly support you embracing any stigmatized term! Both mental illness and madness are stigmatized. I’m mentally ill, but if I say mad it conjures up my symptoms, expressions, and politics at the same time, and I really like that.
I have further nuances with how I identify within a mental illness framework also. My constellation of symptoms and expressions has been interpreted in the medical model/ Diagnostic and Statistical Manual of Mental Disorders, as “bipolar II”. In addition, I feel that I AM bipolar II, I feel that I am manic depressive, and more specifically hypomanic. So I’m like ok, I’m bipolar II. However, I ALSO identify with the Borderline Personality Disorder community, though not actively AS borderline. This is because I was sent to a psychiatric lockdown facility as a teenage girl, and like most young girls-interrupted & sent to in-patient, I was diagnosed and given a treatment plan around my supposed borderline symptoms (and “Defiance Disorder Not Otherwise Specified” and several others over the course of my time there). So even though I do not agree that I am or have borderline, I identify very strongly with that community, and I have symptom overlap & treatment overlap with them. This is perhaps a bit tangential, but I wanted to illustrate how complicated a mad/mentally ill locations can truly be, and that it is OK for you to develop, research, edit, strengthen, whatever, the words you use to describe yourself.
I absolutely think mental illness is a disability. In fact, Lawrence Carter-Long, a disability advocate and activist with a physical disability, said something along the lines of madness is the final frontier of the disability movement during his representations-of-disability-in-film retrospective.
In short, I believe I have a disability because some things are ridiculously hard for me. I have joked: “come defeat me in a game of gin rummy and you will see” hahaha. But honestly more importantly, I believe I am disabled because societal structures pathologize my expressions. For example, my work ethic confronts capitalist notions of value, productivity, time, etc. I have been fired from or sometimes weirdly quit every job I’ve ever had. I’ve had terrible intrusive strange experiences with landlords in many of my living situations (which in a more socialized/socialist paradigm I’m pretty sure might qualify me for some help, but not really in the U.S.). As a result, I am not en-abled by society’s structures. In terms of physical disability, I really appreciate the anecdote that stairs en-able certain bodies, those able to walk up stairs, while dis-abling other bodies who are not able to walk up stairs. I feel structurally dis-abled because of my bipolar and so I feel that I am disabled/have a disability.
Nonetheless, I have uncomfortable amounts of internalized oppression issues over identifying specifically with having an active impairment which limits my life, because of my 15 months forced reform in confinement. This is a painful subject for me but maybe I will write more about this someday. This is something I am working on.:’( I really admire people like basketball player Royce White, who unapologetically identify with mental illness and thus as someone with the rights of a person with a disability under the ADA, Americans with Disabilities Act.
Depression, anxiety, and PTSD are real experiences with real challenges that deserve serious respect. Thank you so much for sharing that with me. I support you. <3 <3 I think it’s awesome that identifying with mental illness has been empowering for you. It has been for me too.
I hope this was helpful. Never hesitate to reach out to me :D
Sending you love and appreciation,
k. adelle / / miss diagnose
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p.s. “mental illness” is a term that has been used by many activists, usually for access to health/care. having a preference for “mad” doesn’t mean like.. all work being done around “mental illness” is a sham. it’s a certain way of framing that has been used by us, for us, strategically, with mixed results.
p.p.s. my mug right now says “getting old is for the birds” and all the birds have like little shawls and caps and canes it’s so cute.
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