Interview: Psychiatric Disabilities and Mental Health

People who live with psychiatric disabilities are often misunderstood, unseen, and dismissed. In this episode of The Access Aisle, MSW Intern Laura Browning and Advocacy Coordinator Tiffany Namey investigate the prevalence of psychiatric disabilities, speak on the difficulty and necessity of disability pride, and dispel some widely-held myths about people who live with these disabilities every day.

Disclaimer

Able South Carolina is providing this podcast as a public service, but it is neither a legal interpretation nor a statement of local, state, or federal legislation or policy. Reference to any specific product or entity does not constitute an endorsement or recommendation by Able South Carolina. The views expressed by guests are their own and their appearance on the program does not imply an Able South Carolina endorsement of them or any entity they represent. If you have any questions about this disclaimer, please contact our Director of Advocacy and Community Access at advocacy@able-sc.org

Episode Transcript:

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00:15 Laura: It has been 10,840 days since the Americans with Disabilities Act was passed and you are part in the Access Aisle.

00:24 Tiffany: And you are part in the Access Aisle.

00:25 Laura: Welcome, my name is Laura, I'm an intern here at Able South Carolina, I'm studying Social Work, and I'm going to be a future therapist.

00:34 Tiffany: My name is Tiffany Namey, I am the Advocacy Coordinator here at Able South Carolina. I just wanna make a quick statement. When we were deciding whether or not to disclose our specific diagnoses for this podcast, Laura and I talked a lot about the lack of disclosure and if that meant we had a lack of disability pride, and we have decided not to disclose our specific psychiatric disabilities, which will be the topic of this podcast. We want everyone out there to know that you cannot disclose your diagnosis, whether it be a psychiatric disability or a physical disability, and still have disability pride. You can be proud of all of the evolving you have done and the adapting you have done and the person that you are and the unique skill sets that you have and just being you, and the fact that your disability is part of who you are and still not disclose to anyone you don't wanna disclose to. And that was something that we struggled with yesterday, but that is what we decided and so we wanted to share that decision with you. [chuckle]

02:11 Laura: Absolutely, Tiffany and I, we're both really excited to be here and hosting this episode and we do both live with psychiatric disabilities. And disclosure is power, to be perfectly honest. No one needs to know about your disability diagnosis, except for you, your doctor and your boss, if you're looking for accommodations.

02:28 Tiffany: Yeah.

02:29 Laura: Well, in case you haven't guessed, our topic for today is psychiatric disabilities. We're so glad that you're listening today, and I hope you'll check out our previous episodes and our content from 2019. Make sure you subscribe to the Access Aisle, so you can get updates and podcast episodes as we release them. This topic really stuck out to us, because so-called mental illness is often not considered a disability by society at large. For instance, I really didn't know that that "mental illness" was a psychiatric disability until about a year ago. I didn't grow up hearing that terminology ever and I knew I needed accommodations, but I didn't know that's what they were and that you could even go about asking for those things.

03:10 Tiffany: I have multiple disabilities, I also have physical disabilities as well, and all of the disabilities I have are invisible disabilities, every single one of them, and I didn't realize as a person with invisible disabilities that any of my disabilities were disabilities until much later in life, because all of my disabilities manifested in our lessons and I have struggled a lot with recognizing that I need accommodation, so I think that is something that is very common. One of the issues that I see, is that despite the fact that the disability community is built on a cross-disability model, that we're all supposed to be here for each other, building power within our community and we're all supposed to be recognizing the fact that we may have different disabilities or multiple disabilities, we still have this kind of ingrained, inherent bias that there is this ranking system and it's a false ranking system, but it says, "Well, maybe my disability isn't quite as bad as their disability or maybe that person's disability is just a little bit worse than that person's disability."

04:41 Tiffany: And I think that is such a false and damaging perspective to people with psychiatric disabilities because it makes cognitive disabilities and physical disabilities "worse" than invisible disabilities, because they're something that's tangible, they're something we can see. And no one's disability is worse or better than anyone else's, it's about whether or not we can get the accommodations and the access that we need to be the people that we are, doing the things that we are supposed to be doing in society, based on what we want and need to be doing.

05:29 Laura: That's an important point because psychiatric disabilities, because you cannot see them and because they really exist on such a spectrum, it tends to be subjective and if you've never experienced it, you don't really get what it's like, which is tough for us to explain, or try to get help, or even just express ourselves and receive understanding. So let's go ahead and start dispelling the myth that people don't have psychiatric disabilities. [chuckle] For instance, Johns Hopkins tells us that one in four American adults lives with a diagnosable mental disorder or psychiatric disability every year. If you sit in a little cubicle group with four of your co-workers, one of them's probably got a psychiatric disability.

06:09 Tiffany: That's one person at the table when you go out to dinner.

06:12 Laura: Absolutely.

06:13 Tiffany: Yeah?

06:14 Laura: It's not uncommon, that is staggeringly common. [chuckle] We're everywhere.

06:19 Tiffany: About 18% of people ages 18 to 54 in a given year have an anxiety disorder. And anxiety disorders include panic disorders, obsessive compulsive disorders, Post-Traumatic Stress Disorder, generalized anxiety disorder, and phobias.

06:42 Laura: We've also got bipolar disorder, one of the more prominent disorders in the United States, it affects over 2.5% of American adults, and 9.5% of American adults live with a depressive disability, like major depression, persistent depressive disorder, mood disorders. One of the least understood. We've got mood disorders, personality disorders, other emotional and psychiatric disabilities, they're incredibly common. People do not like the word personality disorder.

07:08 Tiffany: Now, I remember the first time I heard that I was like, "There's a disorder with your personality? That's nice." You know?

07:18 Laura: It really does strike fear into some people's hearts.

07:20 Tiffany: Yeah, it's a terrible phrase.

07:21 Laura: Even the people... Especially the people who are diagnosed with it, they come into a diagnosis with just incredible amounts of fear and self-shame because you've really been condition to be afraid of like, "Oh my God, who am I now?" So personality disorder, not the most apt name.

07:37 Tiffany: And that's why we're trying to say psychiatric disability because it is a disability.

07:42 Laura: It's not the medical model version of an innate flaw in an individual. I know one specific personality disorder, Borderline Personality Disorder, has three million people in the United States living with it at any given time. And going off of the high rate of personally disorders, they also have one of the highest suicide rates of all psychiatric disorders. In the United States alone, the suicide rate for borderline is 10%. If you had a physical disability or a physical illness anything that had a one in 10 chance of you dying from it, you would hear about it all the time.

08:18 Tiffany: Yeah, that would be an epidemic.

08:19 Laura: It really would be.

08:20 Tiffany: But most people who die by suicide have a diagnosable mental disorder, and most commonly a depressive disorder or a substance abuse disorder, but people with mood and personality disorders are also one of the highest rates of suicide. And I think that's 'cause they feel a lot of really intense emotion, but also because they're not as likely to disclose as a lot of other mental and psychiatric disabilities. And see right there, we're conditioned to use so many words. Right now, I'm personally going through an issue where I'm trying to stop going, "That's crazy, that's insane."

09:11 Laura: Me too.

09:11 Tiffany: But I say it all the time. These are all social norms now that we're used to saying things to disparage people with disabilities and...

09:22 Laura: Even the people that have the disabilities themselves, we're just... Ourselves.

09:24 Tiffany: Right, we disparage ourselves. I think that that's part of the problem.

09:32 Laura: Yeah, one big thing that we live with as having psychiatric disabilities, is we just face some very pervasive and wrong assumptions about ourselves everywhere we go. Specifically, I'd like to focus on the stereotypes that follows in the workplace, in our personal relationship and like social lives. Number one, I would say, is that we need to be spotted and dealt with. I did some quick research just to see what the public perception is or to find it in writing, how to work with people who have mood disorders in the workplace, or how do you build relationships with people who have psychiatric disabilities, and all the more how to spot someone with a mood disorder, how to deal with employees that are unregulated. And that hurt. I'm certainly not unused to it but it's difficult to feel accepted and encouraged to do your best when there are a lot of workplace stereotypes about you being malicious, or needing to be controlled, or being a detriment to the productivity of the office that you need to be dealt with and put back in the line.

10:40 Tiffany: I know for me that's something that I live in fear of because not only as a person with epilepsy do I have to worry about my physical disability distracting from the productivity of the workplace, but when I'm having symptoms from my psychiatric disability, it can also be disruptive. I know it can be disruptive, but I also know from a disability rights model that we tell people that the best way to learn how to relate to people with disabilities is to get to know people with disabilities. And when I'm having a hard time, when I'm having a moment where I'm having my symptoms, that's when you're getting to know me, 'cause that's me. It's who I am, it's a part of my life. I don't think that's having to deal with me. I think that's getting to know how to work with me. I read a Harvard medical school study, I think I shared that with you.

11:44 Laura: Yes.

11:46 Tiffany: It said that 60% of Americans thought that people with schizophrenia were likely to act violently towards someone else, and 32% of people thought that major depression, that those people were likely to do it as well. Now, if you think, one in four people has a mental illness. That's one person sitting in the booth, getting chicken wings with you. Now they're spontaneously gonna break out and be dangerous, right? People are living in fear of that happening. That same study found that 31% of those people also lumped in psychiatric disabilities with substance abuse. So not only did they think that we were violent, but they also thought that we were using drugs or using alcohol. And while that may be something that is happening, it may also not be. So it was just assumed, and they assumed that we were not going to treatment and we weren't taking our medication.

13:01 Laura: And that last one is really the one that resonates with me here. The biggest point that I want you to take away from this podcast episode is that people with psychiatric disabilities are capable adults. We take our medication, in most cases we go to therapy, we have our best interest at heart and the best interest of those around us that we care about. We're not helpless children and we know ourselves best. And just like anybody else, we try to meet our own needs, and get them met and do the things that help us function the best and build solid relationships and produce good things. So we don't need to be coddled or feared. We're worthy of respect and healthy boundaries just like anybody else, disorder or no. So thanks for bring that one up. Or one of the worst things or the most difficult parts of having a psychiatric disability, especially in the workplace, is dealing with the effects like disproportionate emotional reactions, big emotions if you'd wanna say. And that can be a real barrier to functioning in the workplace with other people who don't understand psychiatric disabilities. Any workplace interaction that might mean nothing to someone without a disability can really weigh on someone and distract a person with disability for hours.

14:20 Tiffany: It can and I think that's kind of what I was saying before about getting to know me. But I remembered reading an article a while back about being on a political campaign and there was some campaign manager and she was talking about whether or not it was okay to be a strong woman and cry. I went back and I tried to look for that and I couldn't find it, but what I did find literally terrified me. There was a woman from UC Davis Graduate School of Management, and she did a study, and NBC published an article about it called Is It Okay to Cry at Work? Now, I'm a workplace crier. It happens to me. I cry when I get frustrated, I cry when I get angry, I cry when I don't understand something, and I try really hard not to, but you'll see that I'll physically start shaking 'cause I'm trying not to cry and it will come out.

15:19 Tiffany: I'll go and I'll hide in my office or somebody else's office. And the article said that people like me were labeled by their co-workers as weak, unprofessional, unqualified and manipulative. They're considered to be treated with kid gloves by their colleagues and bosses, who are afraid to upset them or worried about the employee's ability to be tough. Another study that was referenced in the article found that tearful people, while seeming warmer, were less competent. Their bosses and fellow colleagues considered them less competent, simply because they cried. An article in The Atlantic that referenced the same UC Davis study interviewed 16 high-profile business women. All 16 of them said that showing strong emotion was a bad thing. The CEO of the Girl Scouts was one of those 16 women.

16:35 Laura: Ouch.

16:37 Tiffany: That says something right there. We're teaching young girls that having emotion is wrong.

16:43 Laura: Without a tweak.

16:45 Tiffany: And the president of CBS described crying as giving away your power.

16:55 Laura: I don't know about you all but crying is the number one step on my self-care plan if I'm feeling bad. That is a powerful self-care tool, you all.

17:03 Tiffany: I know people may label me as attention-seeking, and I know that's something I've been accused of my whole life...

17:09 Laura: Me too.

17:09 Tiffany: Since I was a little girl, of being attention seeking. Honestly, the last thing I want attention for is crying at work, [chuckle] or really crying anywhere, showing emotion anywhere. When you're crying at work not only are you afraid of attention, but you're afraid of attention and then the memories of that attention later that your colleagues and your bosses will have.

17:31 Laura: You're having difficult emotions at work is just part of the disability. We don't have them by choice and the consequences are real, along with being called attention seeking. People find these displays of emotion, even if we control them, even if we can hide our office and wait it out and use our tools to get past them, they can really change people's perception of us in the workplace as being impulsive, erratic, attention-seeking, incapable of making relationships. It really can be very alienating when people don't understand that big emotions, as a part of the mood disorder or depressive disorder, an anxiety disorder, any sort of psychiatric disability that comes with inflated and disproportionate reactions, that it's not a choice, there are symptoms of the disability that pervades our life.

18:18 Tiffany: And it doesn't only impact you in the work place either, when I have chosen to disclose or I've tried to explain to people that I've been dating, I have had people refuse to date me outright because they've understood my diagnosis to mean something that it didn't, or they have had bad experiences with past partners, who have had similar diagnoses, but you've had bad experiences with partners who didn't have similar diagnoses. So that would be like saying, "I'm not going to date any more women because I had a bad experience with a person who did not have a psychiatric disorder. So I'm not gonna date anyone who does not have a psychiatric disorder."

19:09 Laura: And that is just, it's one of the feared consequences of disclosure, which is unfortunate that we really do have to fear disclosure or be so careful with it.

19:17 Tiffany: Yeah.

19:17 Laura: And it's important that we protect ourselves in who we disclose to but it's still a barrier that we face in that there's always a risk in the workplace, in personal relationships of when you disclose of being rejected and shamed and that comes from not understanding what these disabilities look like, at the fact that they are disabilities and what they're born from. Many people who live with psychiatric disabilities, as my mental health professional says, they come by it honestly. Certain mood disorders are born directly out of trauma. They're research based to be survival skills, based in traumatic experiences that really helped someone survive in their past, but now just don't fit the circumstances anymore.

20:00 Tiffany: Right.

20:00 Laura: In my opinion, I think a psychiatric disability while it may be called a disability really shows our ability to adapt, shows our capability to be full humans who can thrive in their environment and just have a strong sense of fitting in where they are and being able to work with these disabilities, whether working in an environment, like in a workplace or just relating to other people, the qualities at the core of all of our disabilities are strengths really, and our ability to work with those disabilities is something to be proud of. Oh, do you have anything to add?

20:38 Tiffany: No, I was... It just made me start thinking of just kind of the beauty of neurodiversity, like we have... We just have this wide spectrum of neurodiversity in the disability community, whether it be from cognitive disabilities, or neurological disabilities like epilepsy or psychiatric disabilities. It's this wonderful rainbow of things and I think... I like to say unique skill sets all the time, but I think our unique skill sets or what we bring to the table, and you were just talking about that and it was just making me smile [chuckle]

21:20 Laura: I'm glad. And so just to reinforce we are everywhere. People with psychiatric disabilities are anywhere that people without psychiatric disabilities are. There are so many of us in the work place, and as I mentioned earlier I didn't grow up even into my late adolescence knowing that psychiatric disabilities are actually considered disabilities and have accommodations and have pathways to recourse and assistance and support, and I want all y'all listening to know that there are accommodations that you can rightfully ask for in your workplace and anywhere else you might... And in your education, especially, but anywhere you might need some support. I know a couple of the biggest and most prevalent psychiatric disabilities are depression and anxiety and some of the main symptoms of those are memory loss, difficulty focusing, and stress intolerance, which can be tough to navigate in the workplace. Okay, so we've got this resource it's called A-S-K J-A-N, askjan.org. It's the Job Accommodations Network. You can search A to Z through your disability and find reasonable accommodations for your job. If you, like me, had no real guidance in what a reasonable accommodation for what you need is that is just the number one resource to go to. I cannot recommend it enough.

22:46 Tiffany: I looked at it yesterday for the first time. It was pretty cool.

22:49 Laura: Yeah, so if you look down... If you are living with anxiety or depression, you're having trouble with memory loss, stress intolerance. Some of the reasonable accommodations that we've found on Ask JAN were having some extra time on projects or deadlines, getting break reminder software on your computer, having access to extra training refreshers, getting checklists along with deadlines and even using form generating software, and these are all things that you could talk with your supervisor about that could be provided through your company, or just worked around into your daily life as an employee with very little skin off of anybody's nose, and the big ticket here, if you have trouble with any sort of psychiatric disability that makes controlling extreme emotions really difficult for you, as a part of your disability, you are completely within your rights to talk to your boss about having a flexible work schedule, maybe having the ability to take short breaks, or telework kind of as needed because your psychiatric disability's symptoms are just as debilitating when they crop up as any physical disability symptoms.

23:49 Laura: I know, for one, when I'm at work it helps me a lot to have a private space to do my work. Working in a cubicle means I get incredibly distracted. I get overwhelmed by all the chatter happening and just by the conversations and it really gets to me and makes it hard for me to control my emotions sometimes. So having an office space or a white noise machine or some sound canceling headphones really just eliminates that problem. Other people might need a support animal or access to counseling or therapy through their workplace, and having one-on-one time with your supervisor with a really encouraging attitude. But some supervisors don't have a very open attitude but many, many do. If you talk to your supervisor and say, "Hey, I need you to encourage me to tell you when something's wrong, and when I do, please, I need you to react positively, so we can work through this together."

24:21 Tiffany: And just remember stigma is very alienating. It's difficult to have disability pride when we're frequently rejected and shamed for acknowledging our disability. I know day before yesterday I had a moment and I said, "This is not a disability pride day for Tiffany."

[chuckle]

24:21 Tiffany: But don't let stigma stand in the way of asking for what you need. You don't have to disclose to communicate with your friends and your family what reasonable accommodations you may need from them, but don't live in fear of saying, "This is what I need to make the world more accessible for me."

25:27 Laura: Exactly. Tiffany that was a seriously great point because here at Able, we really believe that people with disabilities have all the tools that they need to speak up for themselves and be self-advocates and ask for what would help them the best. Someone with a disability knows themselves better than anybody else ever will. So if you need something you can ask for it. You need to be able to identify what the problem is, what's gonna help you solve it, and be able to say it, and we know that you can.

25:54 Tiffany: You know what that reminds me of?

25:56 Laura: What?

25:57 Tiffany: Advocacy Day.

26:00 Laura: Yes. You know best.

26:00 Tiffany: Advocacy day is on April 1st, and...

26:04 Laura: Because disability rights are no joke.

26:07 Tiffany: Disability rights are civil rights.

26:09 Laura: They are.

26:10 Tiffany: That's true.

26:11 Laura: Like human rights.

26:12 Tiffany: Yes. We are gonna be gathering on the north steps of the South Carolina State Capital and we're going to be talking about that and more and having a bunch of fun doing it. So I hope that all of you listening out there in podcast land will come and join us for Advocacy Day.

26:34 Laura: Yep, go ahead and head to our website, able-sc.org to register for Advocacy Day and while you're there you can also follow us at Able SC on Facebook, Twitter, Instagram, and on LinkedIn if you wanna get fancy about it. Our website always has resources for you to dig in to volunteer and to plug into everything that we have going on to advance disability rights here at Able SC, and also look out for content in our hashtag access in SC for a positivity campaign and share some advocacy actions and updates leading up to Advocacy Day.

27:09 Tiffany: Awesome. Well are you ready?

27:13 Laura: I am.

27:14 Tiffany: Okay. You have been parked in the Access Aisle brought to you... [chuckle]

27:16 Laura: You have been parked in the Access Aisle a production... [chuckle] 

27:22 Tiffany: A production of Able South Carolina.

27:26 Laura: Production of Able South Carolina.

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