Severe Chronic Illness and The Irrational Choice To Be Happy
We often see improving mental health as a rational choice, after all being depressed is not fun, why not be happy instead? While this is true, it can lead to awkward or hallow statements when it comes to chronic illness. Therefore, I argue acknowledging the irrationality of being happy when severely chronically ill is important for many people to be able to access positive mental health changes.*
*I am not a mental health expert or practitioner. This argument is based on my personal experience.
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What is "severe chronic illness"
While all chronic illness is a severe life-changing event, there are lots of forms of chronic illness where despite not meeting society's definition of success people have a lot of opportunities to pursue hobbies, interests, or an atypical career path.
When I talk about severe chronic illness in this post, I am referring to patients who are housebound and likely bedbound and who suffer severe pain and fatigue consistently. Their ability to pursue interests is extremely or completely curtailed and they may require extensive and/or painful medical treatments to survive.
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In severe illness what is rational?
I argue that human beings generally are not meant to survive in a state of severe illness chronically. Our bodies often interpret this level of illness as a near-death experience and our minds prepare accordingly. While you can argue that this is irrational as we have this modern technology to sometimes keep us alive now, you can also argue that in most circumstances this would be a rational response. Regardless it is certainly an understandable one.
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Acknowledging irrationality
In my experience, it can be much more helpful in this scenario to acknowledge the irrationality of trying to be happy in this situation than trying to rationalize a positive response to what is clearly a terrible situation. When someone suggests to me that I rationalize my situation as more positive, I am immediately defensive of the true extent of the suffering in severe chronic illness. In contrast, acknowledging that happiness is irrational allows me to consciously make a choice to be happy without minimizing my illness.
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Importance of Acknowledging Irrationality
There is also an importance of acknowledging the irrationality of happiness with this severity of illness because it extends empathy and understanding to those who do not choose or cannot access happiness with this level of illness. It takes a lot of mental fortitude to trick yourself into finding happiness is an extremely bleak circumstance and is an energy expenditure some may not have or may prefer to invest limited energy elsewhere. When the irrationality of this choice is explained it can better be understood that not everyone will want this irrational veil or be able to sustain it.
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Why wouldn't people want it?
Shouldn't people want to be happy regardless? While the traditional answer is yes, I argue people have the right to choose no because of irrationality. No one can force or require the happiness of people in a situation where depression is a rational response. To do so would be similar to forbidding someone to grieve following the death of a family member. Everyone has a right to rational emotions. By acknowledging the irrationality of happiness in severe illness we respect that right.
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What about people who want to be happy?
In this case, we should honor people's rational choice to choose an irrational emotion. While being happy itself might not be the rational response to the situation, choosing to pursue happiness despite its irrationality is a rational choice motivated by the desire to be happy. To be happy in the circumstance of extreme limitation and pain requires a level of delusion, but to decide to accept and pursue that delusion so you can be happy is a perfectly reasonable decision. It is one I make the majority of the time because it is simply a more pleasant way to pass the time.
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The important thing
The key point is that by acknowledging the irrationality of happiness in extremely negative circumstances we respect people's right to rational emotions and reactions to severe illness. It is not right to expect happiness from people in extreme suffering and we should acknowledge happiness in severely ill patients for the mental juggling act that it is. This does not stop people from choosing happiness, and choosing to pursue irrational happiness is still a rational decision.
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So should I be happy?
I am not your mental health practitioner and only they can help you directly with this question. But I can say this, you have a right to choose your own reactions. You don't have to be happy in a terrible situation. The choice to choose irrational happiness isn't going to disappear because you took time to grieve. But if you are ready to be irrationally happy know that you don't have to wait for something to change, emotions are highly valuable and you can find irrational happiness in many places where rational happiness is impossible.
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Disclaimer: I am not a mental health expert, the above slides and following argument is based on personal experience.
When I first received mental health treatment I was shocked by how much of it seemed to enforce delusions. I think there is a false idea that the goal of mental health treatment is always to enforce more rational thinking. In reality, treating depression often involves enforcing positive thinking, even when that thinking is irrational. This is especially true in the case of severe and chronic illness.
While there is nothing wrong with enforcing positive thinking, I argue it is extremely important in the case of severe chronic illness to acknowledge this irrationality. In doing so we
1.) Avoid dismissing the severity of peoples illness
2.) Allow respect for peoples rational emotions and grief
3.) Emphasize the choice necessary to be happy irrationally.
To be clear, I am not saying "you just have to choose to be happy" I personally think that is BS. But if you are at a point in the process of accepting your illness where you are able to be happy, there is still a choice involved in choosing irrational happiness.
For myself, I mostly choose to be happy. I frequently convince myself that today is a good day because of tiny things like I had dumplings for dinner or I found a new Netflix show, even if I could just as rationally choose to acknowledge that I had a terrible migraine or I slept 22 hours that day. I could be happier if I more completely ignored my illness but I don't want to do that, for me this level of irrational happiness is the sweet spot between rationality and acceptable mental health. But I also acknowledge and respect people who find other balances. I don't believe there is a right and a wrong place to land so long as you are able to care for yourself and your health.
What do you think? Is it irrational to be happy with severe chronic illness? Are you able to choose irrational happiness? Do you want to?
