The Stigma of Mental Health

I know a woman who suffers from bipolar disorder.  She is indistinguishable from anyone else when she is on her medication, except for the fact that she is one of the most brilliant people I’ve ever met, steeped in creativity.  She is what everyday people call an “outside-the-box” thinker, able to see things from a slightly different perspective.  Of course, this makes her an excellent problem solver, a great teacher, a phenomenal creative writer.

And a target.

Gifted as she is, she is afraid to tell anyone of her condition, other than close friends, for fear of getting “the look.”  You know that look; people who suffer from any kind of mental illness get it all the time and, in fact, are used to it, if not all together comfortable with it.  It can be so disapproving that people who are beset with mental health disorders— bipolar, anxiety, obsessive-compulsive, post traumatic stress— and of course, chronic depression, are even apprehensive telling non-treating physicians about certain telltale medications they are taking, for fear of being labeled, even by the medical community.

I also know a man— a teacher, coincidentally— who suffered quietly under the yoke of mental illness for many years.  He had chronic depression, among other issues. He suffered quietly because of the stigma associated with suffering otherwise had he actually admitted he had such a problem.  Remember, how someone perceives something is the basis of their reality, whether anyone else perceives it that way or not.  He finally took his own life last spring.

The stigma associated with mental illness needs to go the way of calling someone who is developmentally disabled a “retard,” or someone who is physically disabled a “cripple.”

Usually, I am the first in line to scoff at people’s efforts to be politically correct (PC), as it seems more like keeping up with fads and trends rather than following sensible logic. Thanks to some serious effort by caregivers, educators, and the public in general, words like retard, stupid, dumb, idiot, feeble, moron, and simple, to describe someone who is developmentally disabled, have become politically incorrect.  As a result, the conditions associated with being developmentally disabled have received more positive attention over the past couple of decades.

It takes a gargantuan effort to change the way a society thinks and speaks.  Most of it is cultural, and imbued into the very laws we now use to enforce the rights of those in need.  For example, right up until 2007, California law said, “…idiots were one of six types of people who are not capable of committing crimes.” The word idiot was subsequently amended to read, “…persons who are mentally incapacitated...”

The same efforts went into changing our semantics for the words we used to use identify people with physical limitations and disabilities: handicapped, invalid, deformed, cripple, gimp, lame.  People today are not called by these idioms; rather, they are physically disabled, or PD, for the super savvy PC crowd.

Again, the results of this clean up of our semantics has included, among other things, laws that now require specific accommodations for those with physical disabilities.  The “Americans with Disabilities Act” became law in 1991, providing comprehensive civil rights protection for people with disabilities.

The developmentally disabled, mentally deficient, intellectually incapacitated, or physically disabled person is that way because of congenital defects, or the result of an accident or a disease.  Generally speaking, the overwhelming majority of people who fall into this category have not chosen to fall into this category.

Here is the [my] $64,000 question then:  why is it still ok to use words like disturbed, nuts, confused, psycho, spastic, crazy, mad, insane, loony, mental, schizo, thick, weird, freak, odd, problem, screw loose, demented, toys in the attic, whacky, and twisted, when describing someone who has a psychological or psychiatric deficiency, or mental illness?  Why does society in general still think that it’s acceptable at best, and funny at worst?

While it is tempting to compartmentalize diseases— and science does— putting them in predetermined categories for the sake of efficient classification (such as physical, mental, emotional), we have to remember that all systems are connected; all systems affect the other systems.

Did you know that the major difference between the onsets of an apparent physical disease such as cancer and an apparent mental disease such depression is that the chemical triggers that lead to cancer cause rogue cell growth, whereas the same chemical triggers that cause depression cause a precipitous dip in the brain’s serotonin levels?  Point is, both imbalances are caused by the chemistry in our bodies— yet one is treated as a disease, the other is treated as a pariah.

Neither condition is chosen by the victim.

Approximately 1 in 10 adults in the United Stated is considered “depressed.”  That is a staggering 25 million people.  According to save.org, a suicide watchdog group on the Internet, 15% of those who are diagnosed clinically depressed, or about 40,000 people, die by suicide.  Since the “success rate” of an attempted suicide is somewhere around 1 in 25, that means that around a million people try and “fail” to take their own lives.

Why is such a stigma affixed to mental illness in the United States?  Why is it still ok to say, “He’s nuts,” while tapping the forehead poignantly?  The answer might lie in gender roles.  More women will be diagnosed with some form of mental illness than will men, to the tune of 40%.  Is this because men in our society are expected to be “strong?”  To not admit to a weakness that in a man could be perceived as more of a character flaw?

It’s hard to diagnose and subsequently treat a person if they don’t tell anyone they’re suffering.  It’s ironic, in that this gender reversal is similar/opposite to the recently revealed studies that show that a woman complaining of chest pains is less likely to receive the urgency of care than a man does with the same complaints. In today’s world where both the male and the female have to work, both sexes now face almost identical stressors that would have been unheard of even thirty years ago.

In Conclusion, today we have huge campaigns urging us to get regular mammograms to avoid breast cancer, prostate exams to avoid prostate cancer, colonoscopies to avoid colon cancer.  We’re bombarded with commercials telling us what’s good for us, what’s bad for us, what has antioxidants, whole fiber, low fat.  What to eat, drink, wear, drive.

When was the last time you heard something about mental health screenings?  When was the last time you saw a movie or heard a song or read a book that didn’t use disturbed, nuts, confused, psycho, spastic, crazy, mad, insane, loony, mental, schizo, thick, weird, freak, odd, problem, screw loose, demented, toys in the attic, whacky, or twisted in a derogatory way about someone suffering from mental illness?

It’s not ok to call someone “crazy.”  It’s not ok to use the term “nuts” when not referring to a legume.

© Ray Cattie