Laziness and mental illness

People with mental illnesses may often be thought by others to be lazy, perhaps because they don’t always seem to do very much. There are many reasons for this – the illnesses themselves, the treatments and the wider consequences of being mentally ill.

Laziness is a word with a lot of negative emotion attached to it. Growing up, I was often told that I was lazy, and I think I came to believe it. Looking back, I am puzzled. I was a hard-working child, and I tried to do what was expected. But I really think it was too much at times, and the word lazy was used more to imply that I wasn’t doing what others wanted me to do. It was a cruel word in my family, one which was used to criticise, and I was well aware of this. Laziness can be fun, but not for us, it was more an indicator of lack of moral fibre.

I worked hard in my early twenties, often desperate for some time off from the draining rota of a junior doctor. But when I became pregnant and hit by depression (a bit of a double whammy), I was completely floored. Fatigue was my companion for several years, lifted only by agitation, which wasn’t much better. And there were many who simply didn’t understand this, who thought that if I could only make the effort, I would get better. The added guilt, and implication that this was my fault, that I wasn’t trying, was devastating.

When I did get better, I worked extraordinarily hard, too hard, to prove my worth. I wish sometimes that someone had been able to tell me that this wasn’t necessary. And perhaps I looked down on people with less ability to work and concentrate – I hope not, but I suspect that I didn’t understand how hard it was for others, despite going through it myself. Many years later, I’ve been through episodes of illness, had long periods off work, continue to take psychotropic medication, and I still worry that I’m lazy. I think I’m more forgiving of others, but far less of myself.

Every morning I find it hard to get up, and I wish I wasn’t on medication with sedative side effects. This morning was Saturday, and I didn’t have to get up early, but it’s lazy to lie in bed. Or is it? It might be bad for me, but not necessarily laziness. And this made me think – what is laziness? Or idleness, sloth? There are many words for it, which seems strange for a concept that is about doing nothing. To me it seems like a determination to do nothing, very different from the apathy of mental illness, but easier to criticise. To tell someone who is depressed that they are lazy adds strength to stigma.

Now that I am (a bit) more aware of my own moods, I can see that my ‘laziness’ levels are very much related to mood. When very unwell, it doesn’t seem to matter; but between episodes I can experience long periods of being mildly low (hypodepressed) or mildly high (hypomanic), and these are clearly marked by my energy and activity levels. I am very frustrated by the former, and see myself as lazy (self-stigma), whereas the latter is great, and I usually get a lot done. I don’t think either of these states would be considered illness and apologise for my use of the terms; but possibly I experience them as part of the spectrum of a mood disorder.

So does this mean that we should just ignore people with mental illness when they say that they can’t do things, just leave them to rest? No, I don’t think it does. I think that we need to put a lot more thought into why an individual can’t manage, particularly if this is a change for them. Sometimes rest is essential; but, instead of haranguing them, it may in any case be better to consider, or even ask them, what they can do. Or perhaps just help them to do the things they want to do. Treat them, get them better, and also consider their medication. If it’s sedating, which many drugs are, it is nigh impossible to be what you are without them. If you gain a lot of weight, just moving around may be hard, and morale may be low.

And please do speak to their families and friends, tell them that this is not laziness. I am lucky that my partner doesn’t seem to view me as lazy, but others in my family clearly did. Perhaps even more important, tell the person themselves. Beliefs many be long engrained in people and their families, but mental illness is hard to understand at the best of times, and reassurance that this is not their fault is vital.

Now I’m going to heave my weary self off the sofa and do – something. Later I’m going out, something of which I have become rather avoidant. It’s much easier for me to sit and read, often in a rather haphazard fashion, but what does it matter? I suggested to my partner that I start to cook once a week, and he looked what I can only describe as alarmed, but you’ve got to start somewhere (I haven’t yet).

Maybe I just need to abandon myself to the intermittent languor of mental illness, topped by the torpor of its treatment. Well, I might manage this, but only if I allow myself to do so, and I’m not sure that I ever will.