Diagnosing problems with a machine can be difficult when you live inside that machine. Whenever something goes wrong with our bodies, we have to address the issue as best as we can while also contending with its consequences, and all of the senses we have at our disposal to understand it also become suspect. This is tricky enough when it comes to, say, trying to guess whether you’ve actually got a cold or are just having allergy problems – but becomes much more so than when it comes to issues with the core sensory and cognitive apparatus itself, the mind.
Even understanding what is a mental problem worth diagnosing and trying to fix can be difficult. How many bad days does it take to add up to a systemic problem with the mind? How many overreactions, delusions, quirks, or foibles does it take to add up to a mental health issue? What’s the difference between the mental equivalent of bad allergies and that of having a simple cold – or of having a more serious ailment requiring more drastic actions to address? It can be especially difficult to get a clear view of these things when the diagnostic apparatus is being housed in the same thing being diagnosed
Even aside from this lack of perspective, there’s the problem of the mind concurrently taking input from the outside world, and processing it, and being affected by it. It’s unclear sometimes whether the input is the problem (when you’re being made unhappy or ineffective by your outside circumstances), or the processing is the problem (when everything seems bleak and hopeless even when your circumstances are materially fine).
The closest clear analogy in the realm of physical health is that of the digestive system. When you feel nauseous and tired, it may be a problem with something you ate. Even if it was something you ate, though, there’s a lot of other questions: Was it actually toxic? Or are you just allergic to it? Or is it that the food itself is fine but not nutritionally sufficient and you have malnutrition? Similarly, when we feel out of sorts mentally, we end up asking ourselves the same sorts of questions: Is it that the events or people in my life are actively toxic? Or do they just disagree with me? Or is it that they’re fine but they’re not providing what I need? Or, perhaps, do I just feel bad for reasons entirely outside of the context of my life due to some issue with how I process things?
These issues are not clear cut. An unrelated digestive issue could exacerbate a food allergy, and a bad day could make a cognitive impairment flare up destructively. This adds another layer of difficulty to diagnosing these issues, which is fun.
Just because a problem can be diagnosed doesn’t mean it can be solved. Say you find out you’re allergic to a food, or worse yet your food supply has been contaminated – that’s an easy fix in a lot of situations, but we don’t always have free rein in deciding what to eat. Maybe you can’t afford more food to replace the problematic supply, or maybe you’re in an area where it’s not easy to acquire more than a slender range of products. In most modernized countries this isn’t a huge issue, but there are still food deserts where it can be very difficult to get food that is uncontaminated and nutritionally sound, and having an allergic reaction to one of these can be very difficult – most notably, in the US, having an allergy to corn products can be a real issue, since most of our food supply is built around corn in one way or another.
Still, when it comes to food this is a relatively marginal issue. When it comes to mental health, though… If you can diagnose that your life situation is causing you issues, if you can diagnose that your job or your relationship is toxic, or that it doesn’t agree with you, or that it’s not providing you with what you need to survive and to thrive, there is very frequently nothing you can actually do about that. The material reality of living in a modern capitalist economy is such that you are often forced to maintain contact with things that you know are toxic, know are killing you, and then told to feel grateful for the opportunity to do so. Just as with a contaminated food supply, sometimes the choice comes to be between being poisoned bit by bit or simply starving.
Our ability to sustain physical deprivation is pitted up our ability to sustain mental deprivation, and it is taken as Just and Good that most people should either submit themselves to work that is crushing and painful, or to live with few if any material resources. These torturous circumstances are exacerbated based on social standing – racism and classism work to further tighten the screws, further justify the rightness and justness of a predatory system.
It is often challenging to see just how tenacious and widespread these issues are. Diagnosing problems with a machine can be difficult when you live inside that machine.