By: Ragan Morrison, Spring 2019 HeLP Legal Services Clinic Intern
Divided from herself and her fair judgment,
Without the which we are pictures, or mere beasts…”
So remarks King Claudius in Act IV, scene 5 of Hamlet upon witnessing the horrific collapse into madness of Ophelia, Prince Hamlet’s erstwhile love interest. While the meaning and intended significance of her character have provided for spirited debate amongst readers and audiences of Shakespeare over the years, Ophelia has become something of a romantic symbol for youth afflicted with mental illness. Certainly, Shakespeare’s works are filled with poetic references to madness, all with an eye toward making sense of diseases of the mind.
While of course our scientific knowledge of the brain and its maladies has fundamentally improved since the early 17th century, the unfortunate truth is that we are still many years from the kind of medical understanding needed to truly remedy these disorders. And often lost in the cold data or medical reports of a child suffering from depression, or autism, or any of these insidious illnesses is an acknowledgment of the deep human tragedy belying them—all the more so when they afflict those so young.
Our work in the HeLP Clinic often puts us directly in front of children with mental health impairments and, as we and our medical partners try to help them, it has been meaningful to discuss and reflect upon the emotional reality of our cases. Unlike Shakespeare’s Ophelia, there is nothing romantic about the suffering caused by childhood psychological disorders. These illnesses torment not just the child, but the whole family. The drama and stress caused by a sick child, and the concomitant financial pressures, take a serious emotional toll on parents, siblings, and anyone close to the patient.
While this is the unfortunate reality of every sort of disease, there is an added, more veiled dimension to the pain caused by mental disability: the social stigma that clings to the child, and even to other family members. Though our society has made tremendous progress in how we view and care for the mentally ill, the hidden subtleties, complexities, and paucity of knowledge behind these diseases can leave their victims with a scarlet letter that compounds the inherent suffering.
As open-minded as we may be, human nature means there is sometimes silent judgment, and even incredulity, in how we regard a child with a psychological disorder. It isn’t hard to view a depressed child as simply sad or moody, or one with ADHD as merely hyper and unruly. The deceitful nature of psychological illness means that it is expressed through emotions, thoughts, or behaviors which are usually normal, healthy, and commonly experienced, yet warped and enhanced to the point of disability.
Thus, outwardly, the symptoms of mental diseases often appear ordinary—we have all been sad, hyper, anxious, angry, withdrawn, or distractible at some time or another. In the course of growing up, we learn to better regulate and control our feelings and actions, and then in turn teach our children how to do the same. This mundane reality can mean, however, that a deeply disturbed, mentally disabled eight-year-old may actually appear at first glance to just be an ordinary second-grade kid. It is then not a far step for those who don’t really know her to the assumption that she is acting out because she is just being “bad,” that it represents a character flaw, moral failure, or parental negligence, when in reality it is the symptom of disease.
I felt more aware of this reality while trying to help our clients apply for federal disability benefits on behalf of children with autism or bipolar disorder, because it was our job to convince a judge who has never met the child that he or she has a legitimate illness eligible for support. In some respects, this task can be trickier than in the case of a person with a more “physical” disease affecting a body system like the heart or lungs. In proving the existence of that sort of illness, we often have access to more hard data, like numbered readings from exacting medical measurements. Though there certainly are diagnostic tests for psychological disorders, they seem to depend more upon anecdote, observation, and interviews than on blood tests or x-rays.
Hopefully, as science progresses, it will become more common to have a brain scan that can show an actual image of the diseased mind. I think having access to this kind of proof—seeing the physical manifestation of a psychological disorder deep within the brain—will go a long way toward making the case that a given disability is real.
Indeed, this growing technology may help further reduce the social stigma of mental disease. In the meantime, however, I hope we can all try a bit harder to bear in mind the subtleties of these sorts of conditions, stay aware of our own reactions, and remember that a child afflicted with a sickness of the mind represents a human tragedy worthy not just of poetry and plays, but of our collective empathy and compassion.