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Book Review: Mental Illness Is an Asshole: And Other Observations

“In a world where friends are assholes, parents are assholes, even adorable, little three-year-olds are assholes, there is no reason that psychological disorders get a pass,” writes Gabe Howard.

Howard, who hosts The Psych Central Show podcast and writes for Psych Central on the topics of bipolar and mental illness, is known for his fun, entertaining and eminently useful observations about mental illness.

He writes, “Bipolar, clinical depression, schizophrenia and the like have no respect for the people whose lives they impact.”

In his new book, Mental Illness Is an Asshole – And Other Observations, Howard offers a straightforward, nothing held back look at mental illness.

He begins by asking, “How do I know if I am crazy?”

As it turns out, it’s the wrong question.

Howard writes, “First we need to discuss that mental illness — or ‘crazy’ — exists on a spectrum, just as physical illness does. A person with stage four cancer and a person with a headache can both be described as physically ill, but there is a world of difference between the two.”

Howard goes on to explain that the general public doesn’t truly understand the depths of mental illness or how it can impact a person. “A person living with bipolar experiences depression, mania, rage, or some other undesirable outcome and those around us are quick to blame the person instead of the illness,” writes Howard.

Perhaps due to the social reception those with bipolar often receive, they typically feel as if they are to blame for their illness and seek forgiveness — a premise Howard rejects completely.

He writes, “We no more need forgiveness for an illness than we do for our hair color.”

However, Howard believes it is the bipolar individual’s responsibility to own up to their own actions during a bipolar episode, even if having the illness itself is unfair. “Remember bipolar is an explanation for what happened, not an excuse,” he writes.

While past indiscretions cannot be changed, focusing on the present — the things that are going well and the accomplishments and goals you are working toward — improves your outlook today and helps shape the future you desire.

To this end, Howard offers a wealth of tips and steps people with mental illness can take. For example, he suggests encouraging physical health through movement, watching what you eat, and maintaining a stable sleep schedule.

He writes, “Every day, depressed or not, make any small, positive step forward and you will be better off. Small changes absolutely lead to gigantic victories.”

For coping with the holidays, Howard offers tips for everything from surviving the holidays if you have panic and anxiety to making the holidays less blue and keeping New Years’ resolutions.

One interesting tip he gives is to stop listening to the media. He writes, “The media can play an important role in how we view the holidays. Pop culture loves to emphasize images that include large families lovingly gathered around a fire, feast, or other holiday festivity. Don’t compare your real life with the ‘picture perfect’ version of the holiday season.”

Howard also offers practical advice for caregivers and clinicians, including the idea that bipolar exists on a spectrum with typical moods and that it is important watch for telltale mania behaviors like insomnia, racing thoughts, and doing things in excess.

However, misconceptions and misunderstandings about mental illness color our ability to treat it appropriately. Howard reflects upon his own experience, saying, “My ignorance on the subject was so great that my failure to act on behalf of person’s living with mental illness almost made me a casualty. Two hours before going to the emergency room for suicidal ideation, delusions, and crippling depression, I steadfastly stood my ground and declared, ‘I do not need to go to a hospital. I am not sick. Only sick people go to hospitals.’”

Having experienced the depths of bipolar firsthand, Howard now works tirelessly to fight the stigma that surrounds mental illness. He writes, “Because of all of the misinformation out there, I honed my ability to explain to people what living with mental illness really means, replacing their fear with facts.”

Howard’s next bit of advice is just as applicable to someone with mental illness as it is to anyone taking on a worthwhile challenge. He writes, “There isn’t enough money, understanding or education to change the minds of an entire society overnight. Brace yourself; this is going to take a while.”

Encouraging, informative, and personal, Howard’s book reads like a letter from your best friend — only this best friend has been there and knows the way out.

Mental Illness Is an Asshole – And Other Observations

DGC Press, January 2019

Paperback, 369 pages

Book Review: Mental Illness Is an Asshole: And Other Observations

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Claire Nana

Claire Nana is a regular contributor and book reviewer for Psych Central.

APA Reference
Nana, C. (2019). Book Review: Mental Illness Is an Asshole: And Other Observations. Psych Central. Retrieved on September 30, 2020, from
Scientifically Reviewed
Last updated: 6 Mar 2019
Last reviewed: By a member of our scientific advisory board on 6 Mar 2019
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