The first time I heard the terms ‘high functioning’ and ‘low functioning’ was when I first applied for benefits a few years ago. This is the idea that although you have a disability, such as a mental illness, you’re either able or not able to look after yourself and live your daily life. I had never looked at my illness in this way before. My illness fluctuates weekly, sometimes even daily, and this has a direct effect on what my capabilities are. I can’t predict when I’m going to be low functioning, as much as anyone doesn’t know when they are going to have an accident and break their leg. The ESA and PIP system is based on a misunderstanding of what it means to be disabled. This callous lack of an attempt to understand is costing lives. The major problem here is how people are distinguished between high functioning and low functioning. The reality is for many disabled people, functioning changes across different days and across different activities.
I have bipolar. Some days I am high functioning. I can write, go out and see friends, cook, look after myself and do all the things that I want to be able to do. On other days I am low functioning. I may be manic where I’m angry and irrational, acting impulsively and a danger to myself. I may be depressed and unable to get out of bed, unable to get dressed, and suicidal. At all of these times I am ill, even if I seem as high functioning.
Another problem with the distinction between high/low functioning is everyone has areas of life they function better in. Some are more academic, some are more creative, others are better at socialising. It’s the same for people with mental health problems. Some people have a job, but their home life suffers. They can’t go out and socialise or clean the house. Other people might find socialising easy and not stressful but find employment too much to handle and exhausting.
Right now, I can’t work. The stress related to it and the physical and mental exertion triggers me into a manic or depressive episode. This has been the case for years. I tried to carry on working but the toll it took on my mental health left me repeatedly off sick and left me unable to do anything apart from work and sleep. On the other hand I can socialise without any problems. I have never found going out with my partner for a drink or seeing friends as stressful. People will see me on a night out and have no idea that I have a a serious mental illness.
Disabilities take their toll, but it manifests in so many ways. Functioning varies across time, situations and people. There is no low functioning or high functioning, there is simply people. People who are struggling everyday to live with and manage mental illness. Having to distinguish this at a PIP or ESA assessment is deeply frustrating and is often misunderstood by the assessor. They only see that you are capable of cooking a meal for yourself, or taking a journey on public transport on your own. They don’t take into account that these ‘good’ days can be few and far between. Months can go by before you feel well enough to complete simple tasks that people take for granted.
It’s not just the benefits system that uses this against the disabled. Many workplaces and individuals also only see what you can do, and not what’s realistic. I have to manage my mental illness, and that means I often have to say no. No I can’t work eight shifts in a row, no I can’t meet up this weekend. It can cause a strain on relationships and adds to the stress already related to being ill.
One thought on “Mental Illness and The Sometimes I Can, Sometimes I Can’t, High/Low Functioning Distinction”
Ah beautiful! Someone said it! lol
And I like what you said: there’s no high or low functioning. What honestly does it look to be “high” functioning or “low” functioning? So long as I’m not clinically dead, I’m functioning to some capacity, but to label it “high or low”? That’s the problem with clinical assessments, to be honest. It’s archaic language.