Will The Mental Illness Stigma Ever Go Away?

No.

The mental illness stigma will never go away.

But that doesn’t mean we can’t try.

I live in a diverse world, with friends of varying sexual preferences, gender identities, races, and religions. Nearly every one of them has been stigmatised by one or another sector of society. We’ve all thankfully come to a place in our lives where we live openly and honestly. With pride.

Personally, I’ve faced the stigma of being a gay Jewish atheist in an interracial relationship. And I am able to speak about my identity with anyone, no matter their own personal beliefs.

Well, with one exception: I suffer from depression.

Now, unlike homosexuality, most cultures and belief systems do not reject the depressed. There is no verse in Leviticus saying that I should be put to death. So why is it still so hard to be open about the fact that I suffer from mental illness?

And why am I convinced the stigma will never completely go away?

It’s part of the illness

Because I’ve been out the closet for years now, I can say with pride that I am gay. There are a few reasons. I can logically understand that being gay is perfectly normal, and that embracing that identity has made my life better. I am also constantly around others who embrace that identity.

Most importantly, the dissenting voices came from the outside. I was told being gay is bad and shameful and immoral and so on.

Depression is, unfortunately, very different.

You can live in a society that is open about mental health and you can know others who suffer from mental illness, but still feel ashamed because of it. The reason is that the stigma is not coming (only) from the outside.

Underscoring just about all mental illness is the internalised belief that “I am not good enough”, “I am weak”, “The world is better off without me”. Those types of thoughts and the feelings associated with them are symptoms of the depression. They become so ingrained in us that we don’t even think to question them.

Which is part of the reason that, to this day, I am still ashamed that I suffer from depression. At this moment, my mind is still telling me that if I wasn’t so weak, I would never have reached the really low points punctuating my life.

BUT…

…even the societal stigmatisation of depression will never completely go away. And there’s a good reason for this too.

It is an illness

The ultimate acceptance of homosexuality is to view it as normal and not give it thought. To not have to pity the person or wish, for their sake, that they get “better”.

Mental illness is, by its very definition, completely different.

If I tell you I suffer from depression and you say, “that’s a perfectly normal and healthy lifestyle”, I’m going to look at you strangely. Mental illness should elicit sympathy from others. They want you to get better and to be free of the burden.

Yet, when you tell someone with a mental illness that you feel for them and hope they get better soon, they will take it as pity for their weakness. As I said above, that’s just part of the illness.

But it goes beyond that.

We stigmatise illness for practical reasons that, unfortunately, are compelling.

For example, would you start dating someone who you knew had cancer? Someone who you know you’d have to accompany to chemotherapy. Someone whose health needs would consume your life. Someone who might die on you way too early.

Some people will answer yes, but for most, the answer is no ways. You’re not judging the person for being ill, and if they were already in your life you would stick with them without a second thought.

But to take on that burden is to be a martyr.

Dating someone who suffers from a mental illness can be similar. Their depression or mania might well set the tone for the relationship. They might be in and out of hospital. And ultimately, they could kill themselves, leaving you to feel both terrible grief and unbearable guilt for not having saved them.

I’m not saying that there should be a stigma. Rather, it makes sense that others would want to know that the person was managing their illness well before getting involved.

There’s a difference between stigma and concern

The problem is that as humans, we tend to categorise things as good or bad and making all-too-easy associations. Since mental illness seems like a bad thing, people associated with it get a label too.

And that does not have to be the case.

There are things we can do to limit the stigma, and keep the focus on the illness rather than the individual.

Separate the illness from our/their identity

This applies to those who suffer from mental illness as well as those who do not. Part of recovering from depression (or anxiety, or bipolar, etc.) is to depersonalise it. Instead of saying “I’m depressed”, we have to learn to say “I feel depressed” or “I suffer from depression”.

We have to realise that mental illness is not an identity. Only then can we start to heal from it. Because we’re not trying to fix something broken in ourselves, but rather treating a disease.

People who do not suffer from mental illness need to recognise this as well. When someone they know is suffering from bipolar, they too can say “X suffers from bipolar” instead of “X is bipolar”.

ALSO…

…never call us crazy!

Ultimately, we can hope to lessen the stigma, but not only will it take time, it will also be an essential part of the healing process.

This Is Why Depressed People Hate Their Psychiatrists

“When can I see you?” I texted in desperation.

“I have an opening at 3PM,” Dr Lymeberger wrote back. “Come visit me at the clinic.”

I was in the midst of a major chemical depression, one that had been brought on in a misguided attempt to change my antidepressants. I had not needed to change my antidepressants. I was not feeling any worse than I had over the preceding year. But I was depressed nonetheless, and hoped that a chemical change might be just what I needed.

Unfortunately, switching antidepressants can have unexpectedly disastrous effects, as happened when I switched from Cymgen to Cipralex. Both of them are SSRIs, working in almost exactly the same way. But, for some reason, I was plunged into a deep horror-show, which I would have given anything – literally anything – not to have gone through.

I wrote that text to Dr L at 11AM. 3PM seemed like an eternity away, but at least I had something to look towards. Some semblance of hope.

In the meantime, I decided to go for a run. It would release endorphins which might make me feel just a little bit better. It was a horrible idea, although curling up on my bed would have been just as bad an idea. As would anything else. I ran for what felt like hours of torment, but when I got back home only 10 minutes had past.

3 hours and 50 minutes left before my impromptu appointment with Dr L.

Throughout this week-long depression, Dr L had been readily available. He’d given me his personal cell number, which I phoned and texted over and over again. My mom even phoned him a few times. He had given me sleeping pills as well as anxiety pills to help me get through the chemical hell while my body adapted to the new drugs.

But up till then, the sleeping and anxiety pills had been his only solution. I’d been taking them during the day, making myself unconscious for a few hours. Only to wake up to the same suffering. Only to take more sleeping pills that would eventually just make me groggy instead of helping me sleep, leaving me both depressed and disoriented.

3PM finally came around and my mom drove me to my appointment with Dr L.

“I think we’d better stop the Cipralex,” he told me. “From tomorrow, take the Cymgen instead.”

That was all he had to offer. I was in infinite suffering, and all he had to offer was to tell me to abort his initial suggestion. Something I would do only the next morning. That my body would take time to get used to.

I needed something right then and there, but he had no good ideas. The long-awaited appointment lasted about as long as my earlier run. I hated him. I had to hate him.

Dr L is innocent

Doing their job

Psychiatrists are just doing their jobs

I’ll go back to that story at a later date. It was one of three major depressive episodes I’ve been through, each one progressively worse than the one before.

For now, I want to focus on my hatred of Dr L.

Technically, Dr L had done nothing wrong. When I first saw him, my chemical depression was under control. My life, however, was not going the way I wanted it to, and I did not know how to change that. So I asked him to try use medication to fix it.

Psychiatry is often hit and miss. Certain drugs will work for one person and not another. Some will do the opposite of what they were supposed to, like Cipralex seemed to do to me. Nonetheless, I have huge respect for the profession, and I have personal experience with the lifesaving potential of antidepressants when they work.

And yet, to this day, 5 years later, I still hate Dr L.

Why psychiatric patients hate our psychiatrists

Help me, doc

Blaming someone gives you a little bit of control

Mental illness is a unique kind of hell. It is unique in that there is not always an evident cause, which is why it can be impossible to treat. Sometimes it’s chemicals. Other times it’s unresolved feelings or traumas that you thought were behind you.

Whatever the case is, there seems to be nothing you can do in the moment to fix it (at least for those who have not learned techniques to manage their mental health). You have no control and it is terrifying.

Still, from within that deep chasm you look for anything to clutch onto. Anything that might give you some semblance of control in getting out of there. Since you cannot do anything yourself, the most instinctive option is to look to someone else.

And when that does not work, you have to blame them. Because as long as it’s their fault, there must be someone else who can fix the problem.

If only I had gone to another doctor, you say. Alternatively, you reject psychiatry as a whole. If only I hadn’t trusted these quacks and their unnatural chemicals, you say.

It gives you something to believe in. The tiniest hope that maybe you can get out of this darkness that you’d otherwise have to admit is your life itself.

Why we continue to hate

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We are terrified of getting lost again

Now, when we get out of that chasm – through some miracle of science or willpower or simple luck – we need assurance that we’re never going back.

Shortly after a major episode, it seems almost impossible to live knowing there’s a chance it might happen again. The memory of what has just happened is so bad that our minds force us to forget it so that we can get on with our lives in some sort of ignorance of what happened.

But how do we ensure that it doesn’t happen again? We need to either blame it on something, or find something else to save us. Or both.

So we blame our psychiatrists, we blame the meds, or we blame our own lifestyles. If we trick ourselves into thinking we can get rid of the problem, we can go on living.

This is why most blogs about how to beat depression are not milquetoast about anything. They are not only CERTAIN that they are RIGHT, but they have to convince everyone else, too. Because the possibility that they might be wrong and that someone else might have a better solution is just too much, man.

So, to Dr L, I’m sorry. I know my hate is unjustified, and that you were just trying to help me. But my mind is never going to forgive you entirely. Don’t expect to see me again anytime soon. And if anyone asks me for a referral, unfortunately they’re not coming your way.