Comparing the Incomparable.

A teddy bear holding a tissue and thermometer sitting by a medicine bottle.

It is almost inevitable that during a discussion around mental health someone will bring up how much better the world would be if we treated mental illness the way we do physical illness, except that, if we’re being truly honest with ourselves, would anything change? Patients would still be dismissed as attention-seeking. Self-diagnosis would still be a necessity. Problems would still be left untreated until it was too late to act. It’s a poor comparison to make for many, many reasons.

First and foremost, the definitions of what constitutes a physical and a mental illness are unclear. Depression, among the most common of the mental illnesses, has been shown to have a measurable impact on particular chemicals and neurone activity in certain areas of the brain. Is that not physical? In that case, what distinguishes a mental illness from a physical one? It cannot be the fact that there is no known cause for a disease because all diseases have a cause, whether or not we are currently aware of it. The reality of the matter is that mental and physical illnesses are not the two distinct categories we traditionally think of them as.

Furthermore, stories of physical diseases being treated in exactly the way mental diseases are handled are all too common. It took five weeks, multiple visits to A&E, and a junior doctor not yet brain-washed into believing all patients were liars and drug addicts, to take my intense pain and over-whelming nausea seriously. I vomited so much I bled and couldn’t keep water down. As it transpired, I had gall stones, a very physical illness. It took eleven years, several GPs, and even more gynaecologists to persuade surgeons to perform a diagnostic surgery when I presented with symptoms such as extremely heavy and irregular periods, and pain throughout the cycle. I was clearly exaggerating the extent of things, except that I actually had endometriosis. After a decade of pain and fatigue so over-whelming I must use a wheelchair to go outside the house, surely I just needed a course of Cognitive Behavioural Therapy and I would be cured of my M.E.

There are plenty of stories of more immediately life-threatening issues being missed such as cancer or pulmonary embolisms, many of which resulted in the death of the patients, who are disproportionately people of colour. This is not an issue localised to a few select physical diseases which carry a stigma, but a wide range of easily-detectable and treatable conditions that were ignored because a doctor decided to believe that the patient was a hypochondriac instead.

Indeed, broken bones are commonly given as an example of a physical illness that would not be treated like a mental one, except of course for the medic who missed a hairline fracture in my mother’s x-ray and proceeding to apply physical therapy that made it worse. Any medicated trans individual dare not break a bone lest their hormones be removed from them, because of course it was hormones and not gravity that contributed to their injury. Plenty of sports players have been told to “walk it off” upon receiving an injury that transpired to be a broken ankle, which is about the last thing you should do on a freshly broken bone.

What all of the above shows is that we DO treat mental illnesses like physical ones. People are told to walk off a broken bone and their depressive episode. People have the virtues of CBT sung to them whether they have an inflammatory joint disease or OCD. I’m fairly certain that someone, somewhere, has been told to get pregnant as a means of curing their mental illness just like I was told to do for my endometriosis.

If we want to improve medicine we don’t need to start treating mental and physical illnesses in the same way; we need to start treating patients with the respect and care that being ill warrants.

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