I Didn’t Have a Mental Illness — I Was Just Depressed.
The first time I saw my psychiatrist he referred to my depression as a mental illness. I was aghast. I didn’t have a mental illness! I was just depressed. I wasn’t like the other people sitting in the waiting room. I was just depressed.
But as time went on I learned that I was just like those other people in the waiting room. I was like so many other people with a mental illness. I just didn’t want to admit it because of the stigma attached to it.
According to the Lancet, ‘the stigma of mental illness can be defined as the negative attitude (based on prejudice and misinformation) that is triggered by a marker of illness — eg, odd behavior or mention of psychiatric treatment in a person’s curriculum vitae’. (Norman Sartorious, September 04, 2007.),
Mental illness can refer to a whole lot of disorders — anxiety, depression, bipolar disorder, post-traumatic stress disorder, personality disorders, addiction and impulse control disorders. Each has its own features and underlying causes.
Stigma still exists around mental illness despite the great leaps that have been taken in understanding and treatment in recent years, and it is stopping sufferers from seeking treatment. Sadly, because of the stigma, many people with a mental illness will suffer from self-doubt and shame. Some will see their illness as a personal weakness and believe they should be able to overcome it without help.
Public stigma has a major impact on many people with mental illness and may interfere with various aspects of life, including work, housing, health care, social life, and self-esteem.
Mental illness has a long history of being stigmatized in many societies around the globe. In times gone by, it has been thought of as the work of the devil or a punishment for bad deeds. The beliefs around the cause of mental illness have been wide-ranging. As a result, treatment has not always made scientific sense and has often been cruel and inhumane.
Unfortunately, despite the increased knowledge, we have today about the biochemical and genetic nature of mental illness, the stigma persists. It exists because of fear and lack of understanding. Stigma affects those who are mentally ill; their families; the establishments that provide treatment; therapeutic drugs; and mental health workers.
The stigma attached to mental illness is the main obstacle to the provision of care for people who need it. Many people who suffer from a mental illness will not seek help because they fear the stigma that will follow. They may worry about how it may affect their employment or future employment prospects. They may worry about what their family and friends may think.
People with mental illness want to be accepted as part of the larger community. But they are aware of the discrimination that surrounds mental illness and do not want to be seen as part of the “mentally ill” minority.
People with mental illness have a double challenge. On one hand, they need to deal with the symptoms that result from their illness. On the other hand, they are challenged by the stereotypes and prejudice that result from misconceptions about their condition.
According to the National Alliance on Mental Illness, 1 in 5 adults in America will experience mental illness in a given year. That is 20% of the population. We need to recognize that mental illness is not all that unusual. Think of the people where you work. Think of the people in your church congregation. Think of the people you travel with each day by bus or train. Think of the people at your school or university. One in five of those people will suffer from mental illness sometime in the year. But most of them will stay silent about it, because of the stigma involved. Even though many people suffer from mental illnesses, you often will only know someone has a mental illness if they tell you directly.
For much of the community mental illness still has all sorts of negative connotations attached to it — connotations of craziness and madness. Often the negative stereotypes involve the idea that people with mental illness are dangerous when in fact very little violence in society is caused by people who are mentally ill. Unfortunately, Hollywood often portrays mentally ill people as dangerous but people with a major mental illness are more likely to be victims of violence than perpetrators.
When I finally received treatment for my depression I didn’t tell people I was seeing a psychiatrist and a therapist. If I had to explain a psychiatrist’s appointment, I would just say I had a doctor’s appointment. Nobody questions you seeing your general practitioner, whereas seeing a psychiatrist raises eyebrows.
There needs to be equality between physical and mental illness. People must understand mental illness is just that — an illness. We accept that people with diabetes, heart disease or cancer are not responsible for their illness, yet we often think people with mental illness should be able to just pull themselves together. Maybe we should refer to mental illness as a brain disorder as mental illnesses are disorders of brain functioning.
I have suffered from a major depressive disorder since I was 10. I never talked about it and finally obtained professional help at the age of 40. Wanting to avoid the stigma attached to depression I changed pharmacies to buy my medication. I knew the local pharmacist quite well and didn’t want him to know I was suffering from depression, even though he is bound by rules of confidentiality. So I found a pharmacy a few suburbs away to buy my medication for depression. Meanwhile, I continued to buy other medications at my local pharmacist.
I didn’t want anyone to know I was taking medication for depression. I was feeling fantastic, but over the years I had managed to cover my depression very well, so few people saw an outer change in me. On the inside, I was a new person.
For many years only a very small circle of people knew I suffered from depression and that I was on medication. Occasionally I would confide in someone if I knew it might be helpful to them. My dental hygienist had told me about her problems with depression so I shared my story with her. And I also shared my story with a colleague where I volunteered once a week at a soup kitchen. But these were special cases.
I didn’t want to be defined by my illness. There is a tendency in the community to equate someone with their illness — to say someone is bipolar, rather than more correctly saying that they suffer from bipolar disorder, or to say someone is a schizophrenic, rather than saying they have schizophrenia.
Mental illness wasn’t always considered a negative attribute. From 1500 to 1700, melancholy, or depression, was often seen as a necessary part of genius in Europe. John Dryden (1631–1700), England’s first Poet Laureate wrote: “Great wits are sure to madness near allied, and thin partitions do their bounds divide.”
Much has been made of Abraham Lincoln’s melancholy and depression, and back then it was often seen as a mark of genius or great reflectiveness.
And throughout history, some of the most creative and clever people have struggled with mental illness. Winston Churchill named his depression ‘the black dog’. Charles Darwin suffered from debilitating anxiety. Buzz Aldrin, the second man to step onto the moon, battled depression. The list goes on. Seneca (3 BC — 65 AD) wrote: “There is no great genius without a tincture of madness.”
There’s little doubt that the stigma accompanying mental illness has lessened in recent years. These days, many celebrities are making their battles with mental illness known. Sportsmen and women and actors are speaking out about their experiences with mental illness. Some celebrities — including Dwayne “The Rock” Johnson, Lady Gaga, Brooke Shields and Michael Phelps — have talked about their mental health issues publicly, and journalistic coverage of mental illness has opened up the discussion about it in the media.
Speaking out is the way we are eventually going to change the prejudice and discrimination against people with mental illness. We need to talk more openly about mental illness and we need wider education within the community.
For those who do speak out, there can be empowerment through increased self-esteem because they can feel they are helping others through their disclosure. Also, it can be freeing to no longer have to keep the secret of suffering from a mental illness. The problem is that with disclosure comes the risk of social judgment.
The judgment of others almost always stems from a lack of understanding. Education can make a big difference. Education in schools and vocational groups has proved to be effective. Research shows that the best way to challenge the negative stereotypes of mental illness is through the first-hand contact with people with experience of mental health problems. Contact with people with mental illness can help alleviate prejudice, so if we are suffering from a mental illness it may on occasion be worth letting people know.
Language matters. We mustn’t use mental illness as derogatory adjectives, for example saying someone is ‘schizo’. The joke about someone not taking their medication when they do something untoward is also based on mental health stereotypes and not found particularly funny by those who do take medication for a mental illness.
I worked for many years as a teacher but finally ended up on a disability pension. When people asked me what I did for a living, even though I was not quite retirement age, I used to tell them I was retired. I preferred to do this rather than explain that I was on a pension because I suffered from a mental illness. I suppose in this sense I was part of the problem. I should have been far more forthcoming. The more society begins to realize that so many of us suffer from a mental illness, the sooner the stigma will diminish.
These days I am far more open about my mental illness, but it has taken some time to get there. I understand it is not my fault. That I am not a weak person. I am a strong person because I have suffered from a major depressive disorder for so long, and even though I am on a pension now, I have been quite successful in life. Over the years, disclosure of my illness has helped me convince several people to seek professional help for their mental illnesses.
To support people with mental illness, successful long-term anti-stigma campaigns are necessary to reduce public stigma in society. In the US and many other countries, consumer groups have actively targeted stigma in an attempt to improve the lives of persons with mental illness.
While the stigma of mental illness has reduced in recent years, the pace of progress has not been quick enough. Although research has gone a long way in helping us understand the impact of mental illness, it has only recently begun to explain the place of stigma in mental illness. Far more work yet needs to be done to help us understand the extent of prejudice against people with a mental illness.
Mental illness is nobody’s fault. As scientists continue to learn more about the causes of mental illness and develop effective treatments, it is hoped that stigma will decline.