Mental Illness Stigma: A Therapist’s Perspective

I can’t even count the number of times I’ve watched friends’ and family members’ facial expressions drop and felt a chilling silence upon mentioning various forms of mental illness.

These are open-minded people. They are willing to talk about politics, religion, drugs, and other controversial topics. But they withdraw when the topic of mental illness comes up.

I don’t start these conversations to cause a ruckus. Instead, I want to honestly talk about the impact mental illness has on individuals and society as a whole. Our mental health system is dysfunctional and we need to address it head-on if we hope to change anything. This entails embracing mental health as an acceptable and appropriate subject.

Our Avoidance and Fear of Mental Illness

We hide from mental illness. We fear that talking about it will somehow make it worse.

You hear people say:

• “He’s so bipolar.”
• “I don’t know ‘the right things’ to say so I try not to bring it up.”
• “She has issues.”
• “He just doesn’t handle stress well.”

These are the common sentiments peppered throughout our surface-level interactions. Because we approach it as taboo, misinformation and ignorance run rampant about depression, psychosis, anxiety, suicide, eating disorders, substance abuse, and other seriously painful disorders.

We are comfortable openly talking about many physical ailments, job stress, and natural disasters; but when it comes to internal distress, which we can’t see or fully understand, we clam up.

According to the Centers for Disease Control, 11% of Americans 12 years and older take antidepressant medications [1]. This doesn’t even include the people on antipsychotics, mood stabilizers, and anxiolytic medications.

To get a better idea of exactly what this looks like, picture this: you’re at a football game with over 60,000 people in the stands. With this statistic in mind, this means over 6,500 of them are on medication for depression alone!

In comparison, the lifetime prevalence rate of breast cancer in women is 12% [2] and we have a month dedicated to loudly fundraising for the cause. We wear t-shirts and pink ribbons to raise awareness and you can’t buy groceries without noticing the obvious magazine covers.

Compared to other diseases (such as breast cancer), mental illness has very few large, strong, or substantial public causes or organizations. Although September was Suicide Prevention Awareness Month and April is officially Stress Awareness Month, chances are high that unless you work in the mental health field or suicide or stress has personally impacted your life, you know very little about these important causes.

How the Stigma Hurts Us All

We are supposed to pretend that we don’t have feelings, that we’re all “fine”. It’s inevitable that each of us will experience suffering throughout our lives, yet as a society we bury our heads in the sand.

When we avoid this topic, we miss out on the opportunity to connect with each other. We don’t have the chance to relate to one another regarding our shared universal human experience: emotional pain.

Many studies show that the brain experiences physical and emotional pain in similar areas. One study from the journal Psychological Science showed that Tylenol actually reduced pain from social rejection [3]. We don’t hold it against someone when they writhe in pain after stubbing a toe; therefore it is not logical to judge someone for emotional pain either.

We can shift the paradigm around mental illness if we realize that it is a brain disorder. The brain (an organ!) is the central part of the human body. Depression, anxiety, and schizophrenia are chronic illnesses just as real and debilitating as diabetes, cancer, or ALS can be.

Mental illness gets worse when we don’t talk about it. Fewer resources are available when we look away, and this only fuels the fires of shame.

It’s hard to watch people suffer, but our own discomfort is not a good reason to avoid the problem. Silence only buries the self-deprecation deeper down into the mind of a person with a mental illness. The result of this repression is chronic discontentment, dulled enough to confuse even the most insightful of us.

Those who are ill-informed about manageable mental illness make incorrect assumptions and take harmful actions in response: My clients talk to their peers and colleagues about mental illness and their hours are arbitrarily cut at work, romantic partners prematurely end relationships, and family members dismiss their feelings as “crazy”. This leaves them in the lurch, wondering why sharing only one small part of them drastically changed the other person’s whole perspective.

However, talking more openly about mental illness not only makes change possible; it also significantly helps the healing process.

Examples include movements like the recent #itsoktotalk social media trend for men with depression and the suicide-awareness organization Project Semicolon. These groups facilitate conversation and increase camaraderie between those with and without mental illnesses.

People assume mental illness is somehow their own fault; but no one would purposefully struggle with the emotional roller coaster of bipolar disorder or consciously choose a clinically anxious outlook. People commonly yearn for ease, relief, and a sense of self-worth. That’s all that underlies the label we place on any specific disorder: a desire for inner peace.

Anyone Can Suffer From Mental Illness

Therapists may also inadvertently perpetuate the myth that mental illness only plagues a select few unlucky individuals. With the understandable ambivalence surrounding self-disclosure, we may nonverbally provide the impression what we, as healthcare professionals, don’t struggle with mental illness.

Some of my clients are therapists. I have a therapist. And my therapist shares insights he learned from his personal therapy. I can only imagine the therapy tree grows upward from there, and my therapy clients may have clients that are therapists, too.

I’m a psychologist, but this does not mean that I have everything figured out.

Throughout my teen years and college, I struggled with several major losses and chronic grief, clinical depression, anxiety, and an eating disorder. Rather than one day waking up and being “better”, I spent (and continue to spend) years working hard in individual therapy, support groups, seeing psychiatrists and surrounding myself with supportive, health-minded people.

Over the years I consulted with a slew of healing professionals and personally benefited from the concrete results of seeking help. I learned a regimen of daily self-care activities and coping skills that I, too, still occasionally forget to use! I made painful and slow changes to my life and relationships.

Some of the members of my support network are also working through their own mental health obstacles. This does not make them any less effective or questionable as a positive influence in my life.

All demographics are susceptible to mental illness. Because it’s genetic, stress-induced, and sometimes seemingly random, even the most outwardly functional members of society have mental health challenges.

My clients come from hugely varied backgrounds. Some appear to be doing well on the surface: they are successful CEOs, bankers, scientists, and upper-level managers, while others are straight-A high school students. Most would never dare show the world what they share with me because they are judged, demoted, dismissed, given unsolicited advice, and ridiculed when they do.

The hidden cases are sometimes the most dangerous.

When someone who is struggling with their mental health presents as high functioning, they don’t feel like they can ask for the help they need. The people around them understandably expect a lot (without knowing it, we look for the status quo and ignore evidence that confirms otherwise), which pressures them to avoid professional guidance and support.

A client of mine recently shared her anxious thoughts with a select few friends and family members. Their responses included:

• “Don’t think that way!”
• “Just calm down. It’s not a big deal.”
• “Why are you so worried? Everything is going to be fine.”

While these reactions came from a caring place, they were not particularly helpful. All she really wanted was for someone to acknowledge how much pain she was feeling, to know that she was hurting and see her desperation to feel better.

That recognition has the power to noticeably reduce painful emotions. If she felt truly heard, she would also know her confidant cared and understood the experience of intense emotional discomfort.

On the other hand, there are people willing to speak openly about internal struggles. The problem is they tend to be the exception rather than the rule. Despite being open to these conversations, they might still ask someone to keep it “between them” once they venture outside of the smaller conversation into a group setting.

The idea that personal struggles lead to obvious personal growth pervades our everyday lives, yet we continue to ignore it in this context. Despite the fact that we can’t always prioritize both physical and mental health simultaneously, they are equally important. Anyone who tells you otherwise is missing information or just plain confused.

Mental illness is an explanation for behavior, personal limitations, and inner processes. It is not an excuse. It is not a weakness.

By openly discussing our own struggles with mental illness, we can dispel the myth that we are immune to pain. If we welcome the conversation, we inspire hope in each other by showing our loved ones there is a way through the agony – together.

References

[1] Pratt, L. A., PhD, Brody, D. J., MPH, & Gu, Q., MD PhD. (2011, October). Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008. Retrieved from http://www.cdc.gov/nchs/products/databriefs/db76.htm[2] U.S. Breast Cancer Statistics. (2016, June 23). Retrieved from http://www.breastcancer.org/symptoms/understand_bc/statistics[3] DeWall, C. N., MacDonald, G., Webster, G. D., Masten, C. L., Baumeister, R. F., Powell, C., . . . Eisenberger, N. I. (2010, June 14). Acetaminophen Reduces Social Pain: Behavioral and Neural Evidence. Psychological Science, 21(7), July 2010, 931-937. doi:10.1177/0956797610374741