What if Mental Health Was Treated The Way Physical Conditions Are?

If you’ve lived with a mental health condition then you’ve probably noticed people often say unhelpful things like “Time to move on & get over it” or “You don’t seem that sick” or “It’s just in your head”. You’ve probably thought to yourself, “No one is that mean to people with broken legs or food poisoning” and either wished they’d take you more seriously/fallen into a tasty vengeance fantasy/felt even worse than you did before. There is a good chance you’ve been shown this webcomic by Robot Hugs, often with this header attached, and nodded along:

A comic strip from Robot Hugs captures the differences between the way we treat physical health problems and mental illnesses.

I can see why you are nodding along, I’ve been there myself. People can be extremely hurtful when your problems are often invisible to the naked eye. The thing is, I really think this is the wrong way to go. In fact, I think it’s harmful and, comes from a position of privilage. “Why!?” I hear you cry. “This articulates the struggle many of us live with daily! How is that a problem?”. Well, I shall explain.

You are looking at things the wrong way

This comic strip, and the associated way of viewing things sets up mental health as something that’s treated worse than physical conditions. Which in some ways we know it most definitely is. I would argue though, that this isn’t one of those situations.

The problem is that this creates a comparison between the two and indulges in “I wish I was a wheelchair user because then people would do/be ……. to/for me” kind of tthoughts. Of course if you were a wheelchair user you’d hear that kind of statement and emit a hollow laugh, while possibly while feeling a bit offended. Do you know why that would happen? Because it’s not the case in the slightest, and the asumption shows your privilege in the matter. Because people say the same stuff to us wheelies that they do to people with mental health conditions and other invisible disablities. Maybe it’s phrased slightly differently but the jist is exactly the same. Don’t believe me? Then let’s have a look at what people with physical conditions don’t like hearing, we can start with those living with Crohns disease:

What about thyroid cancer? People are always great to folks with cancer, right? Wrong.


If you type into google “things not to say to someone with [insert condition here]” you’ll most likely find a quite a lot of people saying the same things over.

  • Don’t blame me
  • Don’t make moral judgements about me
  • Don’t assume you know my condition better than me
  • Don’t tell me to exercise more
  • Don’t tell me what/what not to eat
  • Don’t tell me I’m imagining it and just need to will myself better
  • Don’t act like if I just do “x” or “y” I’ll be better
  • Don’t get frustrated/angry/distant when I don’t get better
  • Don’t tell me I don’t look sick, because it sounds like you are accusing me of lying or you think that sick people can’t look awesome – neither is cool
  • Don’t tell me I’m attention seeking
  • Don’t tell me to get over it
  • Don’t keep asking me how much longer I’ll be like this
  • Don’t make me give you a full medical history before you are satisfied with my diagnosis

I’m sure you’ll notice that all those things are the same things that people with mental health problems contend with. And this is because we are all affected by the same stigma disablist stigma.

“Yeah, but people didn’t say that when I broke my ankle”

No they probably didn’t. Do you know why?

It’s because we’ve all been taught that when people get injured/sick that they get better in a few days – a few months. Then they are “back to normal” or, sometimes, stronger than before! It’s a very basic model that covers all the common short term conditions, be it food poisoning, a broken bone, an infection, the flu, appendicitis etc… These are called acute conditions, and most people have a working model for how to deal with them. You say nice things, let the person stay in bed, cook them dinner, come to visit, send them a card and put up with any moody/distant behaviour – it’s only for a few weeks after all.

For many of us with a long term that’s not what happens. We are born with or acquire an impairment, and instead of “recovering” many of us simply have to find ways to manage the condition and live with it. Others can recover, but instead of weeks or months, it can take years or decades and that recovery is not always full. These are chronic conditions. The model people use for dealing with acute illnesses doesn’t fit, with chronic conditions. Especially ones in which there is no sign of recovery in the future. It means people don’t know how to handle these situations and as a result they say the same stuff in a desperate attempt to make it fit with what they know about sickness. Which is frequently that:

  • There MUST be a cure
  • You MUST get better eventually
  • You are immune to all conditions if your lifestyle is perfect
  • It’s better to think the person is a lying/deluded about their condition rather than to acknowledge that sometimes people get sick/hurt and don’t get better
  • That there are loads of services to help you

Of course, this isn’t true and leads to well meaning people often behaving dismissively and causing hurt, when they intended to help. Which of course, brings us back to the start and that comic strip.

You’ll notice that actually, what is being compared is a chronic mental health condition (like depression) to a acute physical condition (like food poisoning). It’s a false equivalence. We know that people treat acute conditions differently to chronic ones, in fact we expect it. People with acute conditions don’t need to do the hard work of learning to live with their condition For example; if you mentally replace the person with an acute physical condition in the comic with someone in acute mental distress (because they have just been bereaved, or just experienced something highly traumatic) then most people wouldn’t say those things ether. No one with any social skills thinks it’s appropriate to say “I know you are at your partners funeral, but have you tried…. not being in a state of mental anguish?”.

This comic, and folks that think people with chronic physical condition get treated better are actually saying:

I want to express that it’s rubbish when people talk dismissively about mental health conditions, but because; a) I’m ignorant of the realities of life with a chronic physical condition/disability and b) I don’t know the difference between chronic and acute conditions I’m going to create a false equivalence and do the same to people with physical conditions.

Some extra food for thought

Now that’s not the only issue at play here. There are issues surrounding the fact that given all mental health conditions involve the brain; a physical organ, which is dynamic and changes in response to emotional as well as physical stimulus. Which makes all mental health conditions, physical conditions as well. The brain can also affect physical conditions, making them feel better or worse to a degree, depending on emotional state. The mind is the brain, and the brain is the body. There is little good outside of medical settings in sub-dividing conditions into mental or physical. There is a condition and that should be enough for anyone. By setting them against each other we waste time arguing amongst ourselves about which has more validity, or which gets better treatment. The simple truth is that regardless of condition, once it becomes long-term we are all treated more negatively by a society that isn’t equipped to cope with the reality of chronic conditions.

This is disablism* in action. Whilst you might not identify as being disabled, if you live with a long term condition, and your daily life is harder because of it then you’ll still be affected by it.

Love to you all x

*ableism if you use US language

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