Berrak told friends that she hadn't slept in days and they advised her to stop drinking coffee. Her family told Berrak that she was depressed and she shouldn't be trying to medicate her way through life. Berrak, a 36 year-old woman from the Pacific Northwest suffering from bipolar II disorder and diagnosed depression, attempted to request accommodations such as working at home. She says she would be called out and forced to explain herself. To protect her privacy, I am referring to her as her first name. It was exhausting. She says that the disbelief, dismissal and distrust made her feel like she couldn't trust her own brain.AdvertisementPeople with psychiatric conditions are familiar with the symptoms of chronic doubt. They often find it a characteristic of difficult times. Britney Spears made the rare public statement last week about her conservatorship (which is managed by her father) that was ordered by a court. After being placed in temporary psychiatric hold several times, Spears lost her legal autonomy over her finances and life. She described the details of the arrangement at a court hearing last Wednesday. She was put on lithium against the will of her family and received a course and treatment she called abusive. She said that she was forced to visit a therapist's office even though she wanted to continue her treatment at home. This was to prevent paparazzi from harassing her and making her tearful. It was humiliating and demoralizing. Spears stated that this is the main reason why I have never spoken it out. It's not possible for me to believe anyone.AdvertisementAdvertisementAdvertisementAlthough the circumstances of Spears's case may not be typical, it is common for mental illness patients to be cast as an unreliable, untrustworthy, and incompetent narrator of their own lives and unable to make small decisions and errors. I looked for relevant research in academic journals to understand the frequency with which psychiatric patients are dismissed and doubted. It was surprising that I didn't find much, but it is not surprising that people are not listening. It is not a new phenomenon. I was told that I was too well-off and privileged to become mentally ill. I should not rely on my pills or psychiatry for my entire life. This has made me feel guilty about taking medication that makes me feel better. It is as though I had a problem with doing what's right for me. To find out more, I talked to others who had been in similar situations.AdvertisementKat Rendon learned from others that it was not helpful for her to speak out about her mental health problems.AdvertisementRendon, a Los Angeles resident aged 24, has been receiving psychiatric treatment since she was 15. She was in graduate school in New York City when she had her first manic episode. Rendon, now 24, found herself walking around Manhattan naked in a nightdress at 4 AM. It was a very difficult time. It was a difficult moment.Rendon and others shared their feelings with me. This reaction is repeated over time and across people and feeds into a hesitancy of telling people how they feel. This resistance eventually leads to a reluctance of reaching out, even if things turn bad. Rendon said that I have difficulty opening up to people. This puts me in a lonely place.AdvertisementPeople told me that I was making it up and that I was being silly. Kat RendonFor someone in need of psychiatric care, this can make it very difficult. It is not just a way to feel good and cathartic, but it allows us to share our feelings with others. This helps us gauge the relative gravity and strength of our mental and emotional states. James, a 34 year-old Los Angeles resident who suffered from depression and substance abuse disorder, said that holding it all in can mean sacrificing external references at the exact moment they could provide an anchor or refuge from inner turmoil. I am using his first name for privacy reasons.AdvertisementJames grew up in a family that told him he could not feel depressed. He learned the mental gymnastics to ignore his debilitating symptoms and still suffer under their weight. It's extremely othering. He says that you feel different from yourself. I felt the same way as many mentally ill people. That I was broken or that my character was flawed. Shame is a terrible thing. I am not taken seriously by anyone. They note that I have been treated with doubt and other symptoms. It made me feel weird. It made me feel miserable.AdvertisementIt can be especially dehumanizing when the outside doubt is from a mental healthcare professional. My reporting revealed stories about psychiatrists rushing to diagnose patients within minutes. Or prescribing drugs against patient protests. Arkee said that while they were receiving exposure therapy in a trauma rehabilitation center, the therapist made them go further than they felt comfortable with. In this instance, Arkee asked them to touch dirt. Exposure therapy is a method of pushing patients out of their comfort zone to make them less afraid of germs and grime. Arkee was certain they would die if the touched dirt and tried to convince the therapist that it was becoming too much. Arkee states that I was constantly telling Arkee, "No, Im not ready." She wouldn't listen to me. They began pushing me to do things faster and harder than I was capable.AdvertisementAdvertisementThis is a difficult problem in psychiatry. How can you provide objective care and trust a patient with their subjective narrative? The treatment they receive will help them to do so. Medical professionals can benefit from a healthy dose of skepticism when they are able to see the whole picture. This is especially important for patients suffering from delusions, psychosis or hallucinations. It can also lead to a loss of trust between patient and provider and a person abandoning treatment or never seeking it again. This tension is normal. Tanmoy das Lala, a New York City-based medical student and Ph.D. candidate, said that we are in a position where we approach patients with a feeling of doubt. She recently completed a formative rotation in psychiatry. If someone makes you feel like crap, you won't be coming back and you may not seek out care in the future.AdvertisementPatients need to feel valued and have an input in the treatment process. Arkee spent hours daily performing rituals that involved decontaminating their bodies with Neosporin and gauze. They felt that therapists approached their situation with curiosity, not compassion or seriousness. They explained that it felt like they were telling me I wasn't really in pain. Arkee said that they couldn't help but feel that their identity as a brown person, often mistaken for a woman, played a part in the therapists rejecting their requests to relieve OCD and panic disorder symptoms. I felt very dehumanized. It is hard to believe that you don't matter in so many ways.AdvertisementAdvertisementAdvertisementBerrak believes that professionals can listen to patients and offer treatment suggestions. She felt that she was being seen, understood, and recognized by professionals helped her get a diagnosis. She says it made her feel that I wasn't living with it.Britney Spears asked for permission to continue on the road to her restored health. She wanted to be heard, and not ignored. To be valued, but not demeaning; to be given agency, rather than being controlled. After the hearing, Britney Spears wrote an apology on Instagram for pretending that I've been okay the past two years. It was my pride, and I was ashamed to tell the world. There are many others who deserve it.Listen to this episode of What Next to learn more about #FreeBritney and the problems associated with conservatorship and guardianship.
