How Nice That You Don’t Grasp Mental Illness (Update)

The suicide of Robin Williams struck this country hard.  First, because he was so beloved. Second, that his suffering from depression, to the extent that he would take his own live, was unimaginable.  The latter reason isn’t a reflection on Robin Williams, but on us.  When it comes to mental illness, things like depression, anxiety, post-traumatic stress disorder and bi-polar disorder, we have maintained a national stupidity bordering on disgrace.

Robin Williams suffered from his own private demons.  That we don’t get it is because we suffer from ignorance.  And to be frank, it’s outrageous and unacceptable that we can perpetuate this national disgrace.  It’s time to grow up.

We persist in this inexplicable image of people who suffer from mental illness balled up in a corner, shaking, maybe drooling, with wild unkempt hair and crazy eyes, until they finally drop dead.  We do this because it gives us a visual image of how those people look, so we can distinguish them from the rest of us who aren’t crazy.

It comforts us to know that we’re not drooling, and our hair is combed, so that we can believe we’re not crazy.  We grasp as tightly as possible to this image born of ignorance so we can sleep at night. We do a lot of things for that reason.

Michelle Hynes, of the Scottish Solicitors Inksters, responded to my call for someone who suffers from depression to write about it, to try to give a clue to the clueless what it means to suffer from depression.  And she did.

Walking around in their normal lives, smart suits, smiles with deadlines met, clients happy and colleagues supported.  To look at them it is not possible to see what lies beneath the suit. What lies beneath the façade of normality is a silent, deadly and unacknowledged illness that makes everyday life, more of an effort for some.

If I had broken my leg I would have a cast on it. I would have a visible message for the world that I was injured. People would take care to walk carefully as they go about their business around me. Yet there are many facets to being human.

Unseen illnesses and disabilities are a part of being human.

How do mentally ill people behave?  How do they appear?  Do they have times when they’re doing better, and times when they’re completely incapable of negotiating their life?  But Robin Williams didn’t look depressed, did he?  Shouldn’t he have looked depressed?  Should we have been able to see something?

There are far better voices to explain this than me. I learned the brutal burden of trying to explain the unfathomable years ago, when I had to explain a child with an unusual learning disability, dyscalculia, to a group of teachers.  Oh, they understood all about learning disabilities, I was told. They didn’t.  They didn’t really have a clue.

Dyscalculia can manifest as a complete inability to perceive numbers, quantities, math.  It’s a tough one to grasp, as someone suffering from severe dyscalculia can look at a pile of things and, in answer to the question “guess how many are in the pile,” respond, “One? 567? 10 million?”  It’s all the same to them. Whatever connection ought to exist in their brain doesn’t.

Their solution was to try harder, practice, work at it. Would you tell a blind person to try harder to see? Would you tell a deaf person to try harder to hear?  It’s absurd, but there was an innate refusal to grasp the existence of something they couldn’t see, couldn’t easily wrap their heads around.

Mental illness is a medical diagnosis, not some guessing game to play with the neighbors based on what your brain trust thinks it ought to look like.  You don’t get to make up how they should behave, how they should feel and function, based on whatever bit of stupid pops into your head. Would you do that with cancer?  It’s a disease. You don’t play guessing games with disease.

Welcome to the wonderful world of mental illness. It’s the bane of the criminal defense lawyer, as so many people arrested suffer from some form of it, most of the time undiagnosed. It affects every aspect of their lives, and yet they don’t look mentally ill. They don’t appear “depressed,” in the sense that they’re unhappy, moping around the room, incapable of talking or smiling.

For some the demon is so powerful that it chains them to their bed. Isolates them from their friends and makes the sunrise a powerful reminder that they have not slept all night, again.

As others wander through a life dotted with joyous intervals of weekends, nights out, celebrations and fun they are consumed with an internal battle to beat the demon just an hour at a time. It is a hard task. It is exhausting.

Nothing to see here. Just a struggle with demons happening within a person’s head, while they keep on keeping on because they haven’t yet lost the battle.

As a society we label our people with various labels all the way through life. The crazy ones, the loose canons, nut job, fighter, evangelist, book worm, recluse just a few labels that we use but is there anyone who can honestly say that they have no problems at all?

The unseen illnesses such as Post Traumatic Stress Disorder, Depression, Heart Disease, and Mental Illness have visual effects on your body often unnoticed but the psychological impact is destructive on the soul.

Michelle lapses into argument here, that people who suffer from mental illness are no worse than anyone else.  While that’s true, her argument is rationalization, not rationale.  Is there anyone who can honestly say that they have no problems at all? Of course not, but this isn’t about having “no problems at all,” but about suffering from unseen and intentionally misunderstood illness.

We all have problems, but that doesn’t mean we suffer from depression, turning problems into a debilitating, soul-killing, unseen illness.  You may not be able to see it, but it’s all around us, people who do suffer from mental illness.

Some function fine. Some don’t. Some can’t. Some can manage the façade, at least some of the time, while others can’t continue to fight the battle.  When they lose the battle, they can end up like Robin Williams.  Is that what has to happen to someone before you get your collective heads out of your asses and grasp the reality of mental illness?

If you have someone you love, suffer from depression, post-traumatic stress disorder, anxiety or other mental illness, you might be able to get it. Many of you do, but don’t know it. That’s because people who suffer from mental illness hide behind the façade so you don’t despise them for being “defective” and make them ball up in the corner and drool.  And yet, we continue to bask in our ignorance about mental illness rather than make the effort to understand it.

Update:  Rick Horowitz sent me a link to an article by Thomas Nagel, What is it like to be a bat?  To appreciate how this relates to the issues in the post, consider this:

Our own experience provides the basic material for our imagination, whose range is therefore limited. It will not help to try to imagine that one has webbing on one’s arms, which enables one to fly around at dusk and dawn catching insects in one’s mouth; that one has very poor vision, and perceives the surrounding world by a system of reflected high-frequency sound signals; and that one spends the day hanging upside down by one’s feet in an attic. In so far as I can imagine this (which is not very far), it tells me only what it would be like for me to behave as a bat behaves. But that is not the question. I want to know what it is like for a bat to be a bat. Yet if I try to imagine this, I am restricted to the resources of my own mind, and those resources are inadequate to the task. I cannot perform it either by imagining additions to my present experience, or by imagining segments gradually subtracted from it, or by imagining some combination of additions, subtractions, and modifications.

In simple language, this is a core dilemma that few can recognize, no less rise above. It’s genius.


31 thoughts on “How Nice That You Don’t Grasp Mental Illness (Update)

  1. Matt B

    I suffer from periodic depression, usually on the milder side but it’s absolutely paralyzed me at times. People. Just. Don’t. Get. It. I’m not just sad. Hell, I’m often not sad at all. I often don’t know I’m depressed. In fact, I’m often the last to know; I find out from friends, family. I often go out more, and engage in seemingly-fun social interaction, not because I feel energetic, but because I don’t want to be alone. I sometimes work harder (at first) because I need something to focus on.

    I don’t blame people for not getting it. I don’t always get it, and I’ve been through it around eight times now. I wish people didn’t think they understand when they don’t.

  2. ExEMT

    I know this will probably get whacked due to length, so I apologize in advance, and I hope you will consider using it. Sorry, but once I got to typing on this, well, the words just flew onto the keyboard. If nothing else, you will read it and have another perspective from the great beyond. Advice is always welcome.

    A huge Thank You for covering a topic that is not only tough, but is also one that is shrouded in mystery, fear, and downright stupidity. I have suffered from mental illness for many, many years. My diagnosis list is depression, bi-polar disorder, and schizophrenia. Yeah, try living with that every day. My daily routine alternates between hell on earth and the appearance of sanity. I am manic at times due to the bi-polar, and like Robin Williams (who has always been a hero in my life) I spend a lot of time being a “comedian” A lot of people with mental illness use comedy to help them. It is s shield as well as a crutch. We use it to deflect the items in our day that drag us down, but emotionally as well as mentally. It helps us to cope, and it serves to hide our disability from most of our friends and colleagues. If you ask the people around me if they thought I had a mental illness, after the requisite jokes I am confident that 99% of them would tell you no.

    Why, you ask (at least I hope you ask)? It is because I am a “high functioning” in my mental illness. I have a high IQ, and I function in a highly demanding job (healthcare IT and management). I work on a number of projects at any given time on a local as well as a state level. I coordinate a number of activities at any given time, and have managed a large healthcare clinic for the last 15 years. Yet I suffer (and I mean that in every sense of the word) from mental illness. My depression makes it damn difficult to exist each and every day. I have days (more often than not) that I do not even want to get out of bed in the morning. Your next to last paragraph calls it a “debilitating, soul-killing, unseen illness”, and unless you fight hard against it, your mental illness can become all of those. It is an hour-by-hour struggle not to give into the demons that make your life a living hell. You spend a lot of time questioning “Why go on with life”, and for me personally, the coin flip has so far always come up in favor of life. That’s not to say that there have not been nights where you wonder why you even bother to exist. I have personally stared into the abyss that depression brings, wondering if there was a reason to see the dawn. As I stated, the hell of my mental illness is a struggle that haunts me, hampers me, and consumes me every hour of the day.

    I am ecstatic that your column has hit upon this weight that hangs around the neck of so many. This country does an absolute horrible job of taking care of mental illness. We tend to hide, ignore, and pretend that mental illness is not a problem. We do not admit to ourselves and to others that we not only have mental illness in America, that it is an epidemic of monstrous proportions. As a twist of fate, I sit on the Board of a Mental Health Association at the state level. Here are some facts

    One in four adults-approximately 61.5 million Americans-experiences mental illness in a given year. One in 17-about 13.6 million-live with a serious mental illness such as schizophrenia, major depression or bipolar disorder.

    Approximately 20 percent of state prisoners and 21 percent of local jail prisoners have “a recent history” of a mental health condition.

    Approximately 60 percent of adults with a mental illness received no mental health services in the previous year.

    Suicide is the tenth leading cause of death in the U.S. (more common than homicide) and the third leading cause of death for ages 15 to 24 years. More than 90 percent of those who die by suicide had one or more mental disorders.

    So it is with great appreciation that we thank you for expressing your thoughts and views on mental illness. For those of us that admit to mental illness, it is not easy talking about it or explaining it to others. We seldom have someone with your insight who will tackle the subject head-on. Mental illness is something talked about in hushed tones and “behind closed doors”. Yet I have to wonder, from not only the standpoint of Robin Williams, but of so many tragic deaths that occur from suicide each year, would we not save at least some of them if we talked about mental illness in the open? Hiding mental illness does nothing and solves nothing, it just masks the pain and the illness, and just allows the suffering to increase in magnitude until the pain become too great for that person to bear, and when that happens, well, we know what the result will be.

    1. SHG Post author

      Happy to offer a laboring oar, though I don’t know how I will have any better luck beating it into those dumbass heads than anyone else has had. Maybe someday we’ll treat mental illness as just another illness.

      The difference here is that most people who will write about this, like Michelle, will do so because they suffer from depression, so each has an agenda. I don’t suffer from depression (or anything else I’m aware of), but I have spent 30 years watching the perpetual parade of ignorance about it. I have no agenda other than to stop the stupid.

    2. Roger Bar

      Even if we did ‘understand”, “empathize with” or “recognize” mental illness, we have no valid diagnoses nor effective treatments. Our psychiatric and psychology professions are abject failures despite what the pharmaceutical companies would like you to believe. The DSM manual of mental illness has no scientific basis (biological or functional) for its diagnostic categories. Of course if one doesnt know what one is treating, how can an effective treatment be developed? And yet our society is thoroughly drugged with drugs whose side-effects include the vary problems they are meant to solve. These drugs are killing and maiming us, internally. The definition of insanity is doing the same thing over and over and expecting different results. By that definition the entire psychiatric profession and all of us that abet them are insane.

      1. SHG Post author

        I allow this drivel to post only because there is a tiny kernel of truth in there. Psychology is a very soft science, but that doesn’t mean it has no scientific basis or that “we have no valid diagnoses nor effective treatments.” That’s nonsense. Much remains to be learned about diagnosis and treatment of mental illness, but your extreme position is more wrong than right.

  3. AH

    I am in perhaps a unique (or maybe not, honestly I have no idea whether this is common) position to have suffered from what I now believe was depression as an adolescent without a twinge as an adult. One of the things I have tried to explain to people is that it doesn’t matter if you have what might be perceived as a “great life”. In my case, that actually made things worse, because I believed that if I wasn’t happy when I had so many things going for me, I would never be happy.

    My husband recently lost a friend with two young kids to suicide. Disappointingly, many comments were made by people along the lines of “how he could do that to his kids” or that they themselves would never do such a terrible thing to their kids. As I responded to my husband, how lucky those people are that they will never feel the pain that would drive them to do such a thing. They should be counting their blessings rather than judging others who have. No one would tell someone dying of cancer that they would never do the same to their own children.

    1. Matt B.

      Don’t you just love the completely unselfconscious irony there? “I would never do that!” Well, yeah. That’s kind of the point, isn’t it? People who do that are probably different then. So maybe you ought to feel a little sympathy for people who end up in a bad place you’re lucky enough to never see.

      1. AH

        I have no idea when “I would never do that” turned into “I would never do that and accordingly you are undeserving of any sympathy or understanding.”

  4. Charlesmorrison

    It’s difficult to understand mental illness, until it hits home – whether personally or professionally. I’m guilty of this.

    I’ll admit to not understanding or appreciating depression until someone very close to me that I respected, admired and loved finally confided in me that “I’m going to see someone….”

    My initial reaction at the time was something along the lines of: “hey, you just need a good night out, just relax, and we’ll get you feeling better. How can I help relieve some of your stress?”

    It’s not about stress. It’s not about “bad times.” It’s truly a disease that demands treatment. I learned.

    While this person was smart and successful, I came to know just how much of a Herculean grind it was to achieve the successes. I learned to admire the toughness.

    As for professionally, you can’t help but appreciate the pervasiveness of mental illness in what we do, as you noted. Those of us that take appointments come to recognize the frequent fliers in the system that are caught in a continuous cycle of (1) jail (2) release back on the streets with no tools to succeed (3) self-medicating activity (4) arrest for possession/disorderly conduct/assault/pretty theft (5) jail … Repeat.

    Even more sobering is that every CDL reading this has had the occasion to represent two different people living within a single body: the guy you first meet in jail, and then the guy that has taken his meds consistently for the first time in months. Night and day. Wow, what would this guy’s record be if he consistently addressed the mental illness?

    I was the A-hole that didn’t appreciate mental illness until I was “forced” to understand a bit about it, personally and professionally. I think things are getting better as far as general awareness, but it’s a slow process.

  5. Kevin OKeefe

    Robin Williams suicide was sad for all of us because we loved the guy and his work so much. It’s also been a wild ride to read about depression and mental illness for the last few days – especially for those of us who have had experience with depression.

    My wife, a nurse, may have said it best when she said that the cause of William’s death was not suicide, the cause was a brain injury. A brain injury he’s had since birth and one that he inherited from his parents.

    Depression is tough in so many ways. It’s especially tough for lawyers.

    More than us all understanding despression and mental health though is helping lawyers and other people who may be suffering from depression understand what they need to do to get help. Heck, maybe that means educating everyone like you say, Scott. 

    [Ed. Note: Balance of “lawyers get help” soap box speech deleted.]

  6. ExEMT

    I do not necessarily think that Scott goes on here looking for compliments, I also feel very strongly that we (as readers and commentators) have a duty and obligation to try and “rise above the rabble”, and not be mired down in the mud and muck so that we lose our humanity (Hey, we like legal stuff, so how much humanity can remain, right?) and forgot to offer a “Thank You” to Scott when he does an admirable job that goes above-and-beyond like he has done today with shining a bright light into the deep and dark crevices of the mental health situation in our Country, but most of all for getting us to look around in the Community and Neighborhood we live in with our families and friends.

    I know I’m gonna get whacked, but I just need to let this flow from my heart and onward. Scott took on a VERY rough subject facing our Country right now, a subject where a lot of the smarter blogs (Sorry, Scott) have taken the chicken shit method and refused to address and discuss the harder questions we have faced in the last 3-4 days. Instead, Scott wrote an outstanding article that had massive amounts of insight. As someone who has been involved with mental health (outside my personal care and demons), Scott has an approach and method could easily be used as a benchmark on how tough times like this can be rationally and reasonably discussed. You cannot take suicide and simply sweep it under a rug, because then it has the potential for it to fester and become gangrenous. There has to be openness.

    And that openness has to come from everyone in the group. It has to come from discussion leaders and therapists and doctors, all of who are trained. But it must come from the people who are experienced problems and pressures in their life. If the people in the discussion have lost their will to live, then someone needs to try and catch that and find a way to intercede. It is a myth in some ways that “a person that is going to commit suicide will find a way”, because that does not portray the entire picture. Yes, if that person was allowed to be on their own with no intervention or counselling, then yes, there would be a sad instance of suicide. But since none of us live in a bubble cut-off by the rest of the world, there is a different understanding. The person who is focused on suicide can have that focus be changed, reflected, and even totally turned around, with just a little help from the right person.

    The number of people who literally WANT to kill themselves remains a very small member. That person, when given the choice between a solution to their problems and eternal suicide, many start thinking about their lives. It all boils down to values, both in the persons life, but also what type of value does that person feel they personally are giving back. And when you drag it all together, using all the various examples and compiling and comparing the epidemiology of all the patient moods and psyches and behavior, you end up with the conclusion that a lot of suicide comes from mental illness, and if we are being totally honest, mental illness scares the hell out of us!

    We are scared by people who are disabled and have serious mental illness, because their form of mental illness shows how different they are from others. These are people who suffer from mental illness in addition to other (unrelated) outward medical problems (Down’s Syndrome, Mental Retardation, Muscular Dystrophy etc). The types of mental illness scares us silly, because in our crass ignorance, we wonder “will I end up like them?” We get scared of mental illness that has no outward signs. These are people who are terribly suffering from their mental illness, and many of them are confined to a group home type living scenario. Therefore, they have zero normal social interactive skills, and little to no interpersonal skills for fellow home members. So what you end up with is a person who an indeterminate age who cannot speak with anyone around him without crying or screaming or becoming violent. He is locked in the prison of his mind, and the warden is not going to be able to fix him any time soon. The bottom line on the above list of people is that if WE think for even a SECOND that we might have some sort of “mental disease”, this little kernel of mental disease is going to get squashed and locked and shoved into a closet, NEVER to be seen again if at all possible. We are TERRIFIED that we could somehow end up a “mental” patient like (say this in a hushed tone)…one of THEM!

    As the night draws to a close and the proverbial shadows are well into their their slow and inexorable march to cause the daylight and sunshine to diminish and disappear, the mind and thoughts of people with mental diseases are not the slow-moving dullards you sometimes seen shown on TV or in the movies, rather the mind of a person with one or more forms of mental illness will find themselves racing “hell bent for leather” in so many aspects of their life. People with mental illness are frequently relentless, unstoppable, inescapable, inevitable, unavoidable, persistent, continuous, non-stop, steady, interminable, incessant, unceasing, unremitting, unrelenting. The people treating them will tell other care givers that the mental ill are (or can be) intransigent, unbending, unyielding, inflexible, adamant, obdurate, immovable, unshakable; implacable, severe, hard, unforgiving, unsparing, uncompromising, ruthless, relentless, pitiless, merciless

    But as I open-up and admit my personal demons on mental illness (and I have already shocked the hell out of a few, but ya gotta do what ya gotta do), I know that I am going to face so many reactions. There will be push-back from those that disbelieve me, and there will be skepticism from those that know me and the level I function at. Mental illness is not a curse, a crutch, or an excuse, it is simply a manifestation of me and my psyche. Far more people who get treatment and lead better and more productive lives if they would only take that first step and ADMIT they they have some mental illness and they might need some help. This is not a request that everyone go out and buy a straight jacket right away (unless you live in Washington DC, any State Capital or a Governors House), it is simply something that is trying to tell ALL the people in the world that mental illness is REAL, and changes for the better only comes when we EMBRACE what we have RECOGNIZED. There is no sin in having some mental health issues, but it is tragic when those issues are ignored or repressed. Scott has opened the door for all of us to walk thru and see a better view because we can work harder at recognizing it. Will all of you take the step thru the doorway? I’m damn glad I did, and I owe Scott a serious debt for what he has done with all this. Man, what a guy!

    1. SHG Post author

      While I appreciate the love, please don’t do this again. If you think I’ve written something thoughtful and useful, then stick with the substance and leave me out of it. Trust me, I’ll write something that will piss you off soon enough. It’s about the ideas, not me.

      Man, what a guy!

      Yeah, I’m the ginchiest.

  7. Leslie

    Thanks for this post, Scott. While too many adults don’t understand depression in adults, even more cannot wrap their heads around a young child thinking about killing themselves – or actually trying to.

    I learned that the hard way years ago, when my 7 year-old became depressed and suicidal on a medication. Trying to get his school to understand was as successful as trying to get this Congress to function. Even today, I find that too many educators do not really know the symptoms and impact of depression in youth and may think the student is being lazy or irresponsible or oppositional when they’re actually depressed. And they may chastise parents who cannot get their children to get up and get to school on time.

    We have a long way to go.

    We also need to educate the public to understand that episodes of depression are not likely to resolve in days or weeks. Sometimes when people are depressed, others are initially supportive, but as the depression continues, people may become impatient and take a “snap out of it!” attitude. An episode of major depression can last 4-6 months (or longer) in an adult. Getting impatient or angry with the sufferer is an unconscionable blaming of the person. Depression is not a failure of will.

    Okay, I’ll get off my soapbox now. Keep trumpeting the message that our society needs to be better informed about mental health issues.

    1. SHG Post author

      Teachers are a particular problem. Some get it, but most are absolutely certain they know when they don’t, and refuse to learn because they’re professional educators and can’t possibly learn anything from mommies. Those who don’t get it are not only singularly resistant to learning, but antagonistic to what they perceive to be a challenge to their superiority.

  8. Kerwin White

    Go read Allie Brosh’s series on her battles with depression. It’s a better description (albeit with really bad MS Paint drawings) than I’ve seen anyone else write.

    Not linking it because of our esteemed host’s policy, but a google search of “Hyperbole And A Half Depression” will point you in the right direction.

    1. SHG Post author

      I struggled a bit with whether or not to let your comment post. It’s off-topic, but more importantly, whose view of depression to promote here is my choice, not yours. I have no real problem with Allie Brosh’s post, as I agree that it’s a good description, but this post isn’t about “what is depression” any more than it’s a call for “lawyers with depression should seek help.”

      It makes me feel like I’m being dick trashing comments that aren’t bad, but stray from the topic or use SJ to promote a reader’s favorite in lieu of my choices, so I’m letting this post. It would be really nice if I didn’t have to struggle with such questions and comments could actually be on topic.

      1. Kerwin White

        Apologies. This hits really hard for me, and I’m having an extremely difficult time processing and responding to a lot of stuff regarding the issue of depression and mental illness. Probably because it hits so close to home.

        I was diagnosed with bipolar disorder at sixteen. I’ve lived with it quite successfully for many years now, including through the three and a half years that I’ve been an attorney. I don’t advertise it, and I don’t make it a point to tell many people, as it’s none of their damn business and I get along just fine without them needing to know.

        There’s been times in my life where the darkness comes in. There were many situations where I thought to myself ending it all would have been a really good idea. There were times when I first got started in the profession that I seriously thought it would be a good idea too. It’s only due to an incredible support system and a real desire to swallow my pride and ask for help when I needed it that I made it to where I am right now.

        I get sick of hearing “He/she has the bipolar” or “he/she is depressed” like it’s a contagious disease at the courthouse. I’m sick of people using those factors to make a person less than human, and to say that someone doesn’t deserve a second look because of a problem their brain has functioning like a “normal” person. Stigmatizing mental illness needs to stop, and yes, good sir Greenfield, lawyers who are struggling with that darkness need to know there’s help out there.

        Again, I will read more carefully and try harder to keep my next ill-timed remark on point. The last thing I want to do is vex you beyond posting. I enjoy your work here too much.

        1. SHG Post author

          We’re cool. I hope you see the difference between what I’ve tried to do and the “world through the eyes of a person with depression” post, of which there are many. I hope you see why I’ve taken a somewhat different path.

  9. Richard G. Kopf


    Set aside the question of insanity, the most interesting question* for me as a sentencing judge is this: When is mental illness a reason to impose a sentence less harsh than the typical sentence for an otherwise similar offender?

    How “bad” must it be? To what degree must it be proven that the mental illness played a substantial part in the offense of conviction? Does the type of mental illness matter (say a “personality disorder” (intractable and nasty))? If the mental illness is controllable through drugs (there is life after lithium) but the defendant while being “aware” of the need for it doesn’t take it, what significance should be given to the “refusal” to medicate? These are every day questions, but they remain hard ones.

    All the best.


    *For present purposes, I avoid the question of whether a federal sentencing judge–with a DSM (you pick the roman numeral) diagnosis of depression who is on medication for the illness–sentence mentally ill people?

    1. SHG Post author

      A few years ago, I did a sentence before a judge in SDNY (who had previously been a mag) with a defendant who suffered from bi-polar disorder. The defendant, who was fairly old and had already spent about 20 years of his life in serial visits to Club Fed, had never been diagnosed or treated. It became clear to me very quickly that he was ill, and I had him diagnosed. When he wasn’t going through an “episode,” he was quite a smart guy.

      I raised it at sentence (abbreviated version follows), and the judge responded with, “counsel, are you arguing that your client is incompetent, so that he had diminished capacity and didn’t appreciate the wrongfulness of his conduct?”

      “No, your honor. I’m arguing that his mental illness influenced his decision-making and impulse control, and that it’s a mitigating factor. He’s legally responsible. He knew what he did was wrong, but his moral culpability is impacted by his mental illness. It’s not the same as a person who doesn’t suffer from bi-polar disorder.”

      “Well, if he knew what he did was wrong, then mental illness has nothing to do with it.”

      So I ask the question in return: Does mental illness affect moral culpability? Does it matter that decades in custody without diagnosis and treatment matter? When the moment of a terrible decision happens, does it matter that a defendant made the wrong choice because mental illness prevented him from making what he knew to be the right choice?

      I think so.

      1. william doriss

        If a tree falls in the forest, and no one sees it or hears it, did it really fall? That is one of the oldest questions in Introductory Philosophy,… one of the worst majors any college student can pick. I should know! The answer is, we don’t know. We merely and simpley take it “on faith” that the tree fell–if it happens to be lying there on the ground. In the face of uncertainty and lack of confirmation, we “assume”.

        When you “assume”, you make an ass out of you and me, as a famous comedian once said.

        Compounding the problems discussed above is the question of the so-called mental health of the officials guarding the henhouse: the police officers, the bail commissioners, the prosecutors, the judges, and–last but not least–the mental health of the corrections and probation officers.
        Their various mental impairments may manifest themselves, or not. This is very problematical to me for the simple reason that my trial judge questioned my mental condition in open court, when there was no apparent reason for doing so. It was not part of the case, nor was it raised by the state or the defense table. She ordered an “examination”, which examination was not called-for. This was an outrageous abuse of judicial prerogative at the state level.

        (We complied. The report was glowing. The judge looked as foolish as she was, indeed.)

        My reaction is, and was: The First Law of Thermodynamics: Push and I will push back. I have just as much right to question the lady judge’s mental condition and stability as she does of mine.
        That would be on the sidewalk or in the local bar, but not in a court of law where it is not at issue. The problem is: She is the “judge” and I am the “defendant” [in a totally bogus criminal proceeding where everybody gets paid, except me].
        That is why I say: That judge is best who judges least. I used to watch Court TV addictively when it was on. There were judges, and there were judges. No two were alike. That is a v. instructive realization. You’re standing before someone who can do and say whatever she wants, arbitrarily, and I am denied reciprocity or the power to do anything about.
        All the best,

      2. Richard G. Kopf


        The judge you appeared before misunderstands federal law. See, for example, Guidelines section 5K2.13 (permitting downward departure for diminished capacity). Moreover, a person who knows he or she is breaking the law but who does so while mentally ill is frequently less culpable than an individual who is in every other respect similar. Thus, to avoid unwarranted sentencing disparity, the mentally ill person should typically receive a less severe sentence. Finally, bi-polar folks (we used to call them manic/depressives) are particularly likely to offend when manic and even a cursory examination of the literature will establish that beyond doubt. If you proved your guy was undiagnosed, but bipolar, and you could establish that he acted in the manic phase during the offense of conviction, I likely would have given your guy a lesser sentence compared to someone who was otherwise similarly situated.

        All the best.


        PS As you know, I was a mag. judge for over 5 years. Given your reference to the fact that the judge in your example had been a mag. judge, I don’t know whether my prior experience as an MJ is a bad thing or a good thing. Anyway, at least here, serving as a mag. judge will teach you a lot about mental illness because the magistrates frequently deal with with competency questions and the Bureau of Prisons. Now that I think about it, perhaps that’s where your judge got confused between the issue of competency and culpability. But these are pretty basic differences that you would expect any federal judge to recognize.

        1. SHG Post author

          But these are pretty basic differences that you would expect any federal judge to recognize.

          That’s what I thought, but then, Article III judges do not take kindly to being told they completely blew a basic call. Trust me on this (I once made Louis Freeh’s head explode). So you make your argument and pray there’s no whooshing sound in the courtroom.

          Edit: I have a fond memory of Kimba Wood interrupting me in the middle of argument, where I was asserting some basic law, to tell me: “You do realize I’m a federal judge and know this stuff, right?” Well, yes and no.

  10. Turk

    Perhaps one of the reasons for the ignorance is the significant disparity on what we see, and have seen. Some folks may think of the horrible images of Willowbrook or unmedicated mentally ill wandering the streets.

    Others may be, as some of your commenters are, high functioning, perhaps with some forms of psychotropic meds.

    Defendants who appear in court may be anyplace on the mental illness scale, with the caveat that the scale isn’t linear, exists merely as a bunch of diagnoses and is constantly changing.

    Toss on top of that the ignorance of our top docs to understand why this all happens.

    So stopping the stupid may be pretty damn tough (as your sentencing judge demonstrated in your example). On the other hand, we might be able to acknowledge that we all are stupid in this area…we can neither think like someone with mental illness nor do we know what causes it.

    Perhaps 100 years from now people will laugh at us and consider this the Dark Ages of mental illness. Or, perhaps, little will have changed.

    1. SHG Post author

      Yes, there is a wealth of possible excuses, but I fail to see how being more concerned about excuses for ignorance about mental illness aids those who suffer from it. Or did you just run out of “perhapses”?

  11. Fubar

    Relevant, I think, to the issue of ignorance, is the report I’ve now heard both from NPR and BBC: Robin Williams was suffering early stages of Parkinson’s disease. The sources quoted included both the coroner and Williams’ wife.

    Heretofore I think that was not known to the public.

    Parkinson’s disease destroys motor control, and can cause dementia in advanced stages. Depression is the most common psychiatric issue that it causes.

    It is not currently curable, but can be treated to reduce some symptoms in early stages.

    It may be speculation, but it is rational speculation, that such a diagnosis could affect one’s considerations, whether rational or irrational, in deciding whether or not to end one’s life.


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