An Introduction to Responsibility for the Person with a Severe Psychiatric Disability

From an adult lifetime of severe PTSD and often-severe Bipolar Disorder, I have noticed in myself deleterious behaviors that have seemed to be common also among those whom I’ve met along the way who seem to have been, or are, as impaired as I. These behaviors that I am noting cause dismay to employers, family, and friends alike. Thus, I have chosen as the topic of my fourth book (RESPONSIBILITY)  brief essays on ethics, which I am interspersing with autobiographical examples. I am drafting parts of the manuscript as Psychiatric DisABILITIES.blogspot.com blog posts. I would hope that some person similarly situated would take to heart an error or two of mine and craft a resolution from it for himself or herself.

Yes, my brain’s being scrambled is due to the expression of my genotype in the face of environmental influences—but, hey!—I have had a great deal to do with my failures in life. There do be character flaws typical of at least some people with such psychiatric disabilities as those I have. (These disabilities used to be called “severe and persistent mental illness,” but are now called simply “severe mental illness” out of respect for those who have recovered.)

The first set of blog posts describe employment; the second, family relationships.

But, it’s important before writing anything else to circumscribe the domain of my comments. If a person is ill enough to be in the hospital, that is no time to admonish him or her to buck up or to change his or her ethics. Nor for however long it may take for stabilization. This sub-acute care could go on for years—even decades--if further hospitalizations follow apace. Ditto when medications and other treatments need to be changed frequently.

Eventually, however, there comes a time when realistic limits and/or norms should be set for the disabled person, as they are for any other person. It is part and parcel of equality. Be certain, though, of my meaning. It is unrealistic to expect a person who has met the rigorous standards set by the United States Social Security Administration for the finding of a “mental impairment” (psychiatric disability) to be able to return to work, unless under medical guidance. And expecting a disabled person with a long psychiatric history to find work for which he or she has neither training nor experience is futile. It causes that person to resent the other, and frustration for the other.

(Specifically, if a disabled person overspends on credit, which is a typical problem for someone with severe Bipolar, it is sensible to encourage him or her to spend no more than income [from Social Security, for example.] No one will be pleased if someone tries to force him or her to be gainfully employed with remuneration at the net level of money that he or she is expending.) For that matter, as Charles Dickens wrote in David Copperfield, through the character of Mr Micawber, spending less than an income of twenty pounds has the “result [of] happiness,” but spending more has the “result [of] misery,” whether or not the spender happens to be a person with a psychiatric disability!

People are complicated, and just because someone may have a certain set of impairments does not at all mean that he or she has little or no capacity to give, produce, create, and love. Many talents, and even world-class genius, can be found in people with such disabilities as severe mental illness. Just consider Vincent Van Gogh!