One of the standard questions I ask every patient as a matter of course is this:

“What’s your normal day like? How do you spend your usual day?”

Now, think about how you would answer that question if I put it to you. 

If you’re a well-to-do type, you might spend an hour in the morning walking your standard-cut poodle around the block. Then you’d go to the club for some tennis, have lunch on the veranda afterward and clean up for an afternoon shopping trip into town. On arriving home, you’d tip the yard help and the pool guy for their services, go inside your air conditioned house, and catch up on the last week of soaps recorded on your TiVo. A nap would definitely be in order after that. 

If you’re a member of the wide but shrinking middle class, you’d do laundry and last night’s dishes in the morning, get dressed and strike out for the local Walmart, shop for specials for a couple of hours, then go past the frozen yogurt place and indulge in a sweet treat to beat the summer heat.

Either way, your affluence drives your lifestyle.

“I’m not affluent!” you protest, maybe a tad too loudly. 

Yeah, okay, whatever. I watch you respond to the ding of your iPhone like Pavlov’s dog, fish your Ray-Bans off the top of your head and walk outside to get into your shiny new Ford with sync, leather seats and optional moon roof. 

Maybe I overgeneralize just a tad. Maybe I put you in a box that you don’t exactly fit in, but you see my point here.

How about my psychiatric patients? The standard, run of the mill folk who come to see me for panic attacks, chronic depression and schizophrenia. Do I get the same pet-studded, iPhone spangled, new-car-smell answer from these guys?

“How do you spend your time? What do you do all day most days?”


“No, really, what do you do all day?”


I’m a little frustrated now. Do they not understand the question? Am I making this too hard? 

“Okay, let me change that a little. Do you have any activiites that you enjoy? Any hobbies?”

“I used to fish, maybe go play some bingo,” answers the obese lady with bad hair and worse clothes. She had bipolar disorder before bipolar disorder was cool. 

“I used to hunt, but I haven’t been in the woods since W was President,” says the man wearing faded jeans and a flannel shirt against the summer heat. 

“I just sit on the couch,” says the rail-thin woman with a penchant for Percocet. 

“Do you watch TV, or read, or crochet or anything?” I ask, searching my brain. 

Trailer Park Activities for two hundred, please, Alex.


“You just sit on the couch.”


“That’s it.”


“All day.”

“Yeah. All day.” 

You know, people-in-the-don’t-know usually think that those with mental illness scheme and connive to get their six hundred bucks a month free and easy disability money so that they can sit around and do nothing all day and live the good life. 

I’m here to tell you that the ones who sit around all day doing nothing, and that’s exactly what it appears that they do sometimes, are not happy with it. They’re not happily raking in the dough, pulling contentedly at the government teat and feeling smug and satisfied.

They’d much rather be like you and me, rushed to pick up the kids after school or planning birthday parties and taking the occasional drive up to the lake for a barbecue. Their schizophrenia and the voices that come with it tell them to sit tight. Their panic attacks are so bad that they never step outside the front door. The heavy wool cloak of depression draped over their shoulders is oppressively hot in the summertime and weighs them down to the point of furnertia. 

That is, they sit on the couch and do nothing.

Frustrated by the business and busyness of your day? Too much on your plate? Too many places to be today? 

It could be worse.

You could be doing nothing today.

And tomorrow.

And the next day.


10 thoughts on “G’day

  1. You are exactly right Greg. I thank God everyday for my health, my family and friends, my job, and everything else I’m blessed with. If not for the Grace of God, I might be one of the people you describe. I get SO tired of seeing all these posts on Facebook and also people talking about those who are receiving financial assistance. Most of these people have serious mental or physical problems. I know there are those who are truly not deserving of the help, but that’s for God to judge, not me. Thank you for writing about this. I think I’m going to share it on my FB page and see what kind of reactions it gets!!


  2. Absolutely right! I’ve been screaming ever since Reagan decimated the mental health system in this country. When Isee people living on the streets asking for change, they’re not happy or content.

    When I first came to NYC I lived in Central Harlem and one night, walking home, someone came up from behind me and asked if I wanted to buy an umbrella. It wasn’t raining and as I turned around I knew I wasn’t meeting a professional umbrella salesman. He was a young guy–probably in his mid twenties. I had my hand in my pocket (honestly, I always carry a few bucks to give people) and I stopped and looked into his eyes. “Dude, what’re you doing here? You’re smart. You’re young. It’s not too late.” He had tears in his eyes and apologized. I gave him a $5 bill and told him to reach deep down and grab the strength we both know is inside him and pursue help. He thanked me. I don’t know where that young man is today, but I sure as hell know he wasn’t happy then. I hope is happy today.


  3. Oh my goodness, you hit the nail on the head AGAIN!!! I HATE my depression, and I hate to see OTHERS depressed, but I have definitely gotten to the point that I know I can’t be without my meds, and I wish that others would be able to see that there is no shame in getting the help that they need. We are struggling with this in our family right now, with my husband. He’s military, and just wants to “tough it out”, which means plodding through his work day and coming home to sit on the couch and stare blankly at the TV. It’s getting better, but he’s spent a miserable 8 moinths. I just wish that the stigma was not still what it is. I swallow my Cymbalta twice a day, gladly, and cry when I need to and talk to the right people as much as I need to because I still have to live. Life could be so much better for so many struggling people, and that breaks my heart. Thank you for painting a picture of great clarity!!!!


  4. Penny,

    Yes, a lot of people try to tough it out, sometimes with great suffering over a long period of time that could be avoided.

    I think the stigma will always be with us unfortunately, though all of us are trying to fight that battle too.

    Glad you’re doing better with your own treatment and that you see it as something that is necessary and good for you to live your life better and less depressed.



  5. I do not know if you planned it this way but when I looked at “the couch” the rips in the upper cushions ( not psychotic promise)the openings pierced into me and look like the saddest eyes you could ever imagine.The couch when I saw those eyes made me cry because it put a picture,a really sad one,to what had happened to my life and I am sure so many countless others.Sadly after years of doing all these things your therapist tell you will replace the gut wrenching losses of your past and future life ( they do not ) I see myself heading to the couch.I am weary and tired and no one in the real world seems to want to understand .Yet there stands our buddy the couch even with his sad eyes who will not bitch at us,tell us to snap out of this, and once again with those sad eyes makes a place for you.That couch has done a number on me with those eyes of sadness and what the couch really represents.Still a great post and once again thank you for looking out for us because after reading some of the comments you get on Kevin MD that are vitriolic,demeaning,insulting to your own personal self we know you really care.Why else in the world would you put up with that crap? Thank you again Dr Greg



  6. Karen,

    I really hope you can make some peace with how you feel. Rest on the couch a while, but then get off of it and move on to more pleasant things!

    Thank you so much for your kind words. Some of those negative comments I just have to filter out the best I can and move on.



  7. Wow, this is exactly what it’s like to be disabled by chronic pain!

    Especially when it’s not visible, people think you’re just a lazy, scheming, loser. If I don’t use opiates every day, this is exactly what my life looks and feels like – all I do all day, every day is “lie on the couch” because it’s all I *can* do. Thank goodness I can still get opiate pain mgmt, but I’m worried the recent anti-opiate frenzy might change that and then my life will be essentially over.

    Thanks for pointing out this sad state of affairs for people with “invisible Disabilities”.


  8. Like Zyp Czyk I too have chronic pain! I hate have to be on my couch! Unfortunately too many Doctors and others think it is a jack pot! I would much rather have a job! I get put down because I take opiates, the only thing that gets me off the couch! I can buy groceries or do laundry. I usually don’t have the energy to do much more than survival stuff.
    I did have a job in 04, I asked for a simple ergonomic adjustment to my work area, I had the rug pulled out from under me. Someone told my Boss I just had “emotional Problems”.. I guess aggravating my pain everyday at the computer was emotionally disturbing. I have been misdiagnosed multiple times, ignored, ridiculed, and called a drug addict, even though I have never increased my dose or done anything improper!
    On another note as a Doctor you should be able to figure out people with Personality Disorders, and not paint everyone with the same brush! I also have had to move into subsidized housing, surrounded by Alcoholics, the mentally ill, and just downright depressing people. I am at a point where I am afraid to leave my apartment’.
    I still don’t have a comprehensive diagnosis, my PCP minimizes everything, and cant write a proper referral. It has been 12 years since my first surgery, for a ruptured disc that was initially diagnosed as “all in my head”. I still wonder what my life would be like if the pain had been taken seriously. I would have my Degree, and a life! Because of the misdiagnosed ruptured disc, I developed nerve damage, which makes it difficult to walk. I have cost the system thousand in unnecessary tests, MRIs that Doctors can’t be bothered to look at!


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