The Stigma of the Mentally Ill

From time to time, I may post a topic that you may not find entertaining, but you will be informed. In these posts you will not see my usual wit and sassiness, but instead my passion.  There are certain things I feel strongly about, and reflect my commitment and desire to help those individuals who need/want to be helped.  

Recent events have led me to write about the stigma of mental illness, and the mentally ill.  I do not really need a current event to discuss this topic, but when a traumatic event occurs, this topic is brought right to the forefront.  The stigma placed on the mentally ill is as old as time.  In ancient times, mental illness was believed to be a supernatural phenomenon, caused by spiritual and demonic possession. The treatment at the time was a procedure called Trephining:  a hole chipped into the skull to create an opening to release the evil spirits and cure the person's psychiatric symptoms. The Greek physician Hippocrates later changed that belief by arguing that psychological symptoms had natural causes just like physical symptoms, specifically located in the brain.   

This is not an historical perspective on the stigma of mental illness, I just wanted to illustrate how far back this issue goes.

Mental Illness

The American Psychiatric Association defines mental illness as follows:
 Mental illnesses are health conditions involving changes in thinking, emotion or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. 


The Mayo Clinic defines mental illness as follows:
 

 Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. Many people have mental health concerns from time to time.   

Severe Mental Illness

SEVERE Mental Illness, as defined by NIMH (National Institute of Mental Health), as well as regulations from the Federal government is as follows:

 A condition that affects “persons aged 18 or older who currently or at any time in the past year have had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) of sufficient duration to meet diagnostic criteria specified within DSM-IV (APA, 1994) that has resulted in  serious functional impairment, which substantially interferes with or limits one or more major life activities” such as maintaining interpersonal relationships, activities of daily living, self-care, employment, and recreation.  

And lastly, the legal definition of "Severe mental illness":

 Mental disorders typically meeting criteria for severe mental illness include schizophrenia, schizoaffective disorder, psychotic disorders, major depressive disorders, bipolar disorders, and borderline personality disorder. Anxiety disorders (such as obsessive compulsive disorder and panic disorder) or eating disorders (such as anorexia nervosa and bulimia nervosa) can also meet criteria for serious mental illness. 
The American Psychiatric Association noted that nearly one in five adults (19%) experience some form of mental illness,  and one in 24 (4.1%) has a serious mental illness.  According to the WHO (World Health Organization), mental illness is the biggest economic burden of any health issue in the world, costing upwards of $2.5 trillion in 2010, with a projected cost of $6 trillion by 2030. (Michael Friedman, PhD., Psychology Today, 5/13/14)  

Unfortunately a great majority of people all over the world do not seek treatment because of the negative connotation associated with mental illness.  Often times the negative misperceptions made in public about the mentally ill paint a picture of violent perpetrators; crazy, weird dangerous people who should be kept away from mainstream society.   

Anyone who has been diagnosed with a mental illness already has negative feelings about what they are experiencing, but when they hear the negative comments they feel even worse.  They can become more socially isolated, start self-medicating with alcohol and drugs to mask the symptoms, or they could do worse by inflicting harm to themselves or even suicide.  They are more likely to cause harm on themselves then on others.  The impact mental illness has on our society is far-reaching; no socio-economic group, race, ethnicity, sex, or age is immune.

With all that information, knowing ANYONE can be affected by a mental illness, I still hear public figures and regular folk discriminating against the mentally ill, ignorantly using diagnostic terms incorrectly, and generalizing the mentally ill to illustrate whatever point they are trying to make. For example, when you say that a person seems like two different people to you "One minute he's my friend, the next he wants nothing to do with me....he's so SCHIZOPHRENIC!!!" Oh, so he has a chronic brain disorder and has auditory hallucinations and delusions??  Did you really mean Dissociative Identity Disorder (Multiple Personality Disorder)?  A rare serious condition where a person has two or more distinct personalities?  Or maybe you thought he was "BIPOLAR"...I hear that one a lot.  You forgot one possibility, maybe it's YOU!!! 

I am not one who generally likes to label or put a diagnostic tag on a person unless I have to for insurance purposes or reports; but when people indiscriminately use these terms to describe other people, they offend and disrespect those individuals who are actually suffering from these conditions.  No one asks to have a mental illness, it isn't something they "opted in" for.  If it was up to anyone with an anxiety disorder, or a depressive disorder, or a thought disorder, or even those with a personality disorder, they would choose not to have it...and most certainly "opt out" if they could.  ( Note:  This does not mean you should use the terms "madman", "psycho", "lunatic", or "deranged" instead by the way)  

When someone murders another person, is there a severe mental illness involved? YES! I mean how else does someone justify taking someone else's life?  I understand there are exceptions, like life-threatening self-defense situations, or times of war (With those situations, other mental illnesses may emerge due to the traumatic event(s))

OK, your eyes might be starting to glaze over at this point, with all the definitions and historica l information, but I would like you to go back and just read the highlighted information before you continue. 

HEY!  YOU'RE BACK!!

I have a mental illness diagnosis for you to think about, it's called Paranoid Personality Disorder.  The diagnostic criteria are as follows:
Paranoid Personality Disorder is characterized by a pervasive distrust and suspiciousness of other people. 

• People with this disorder assume that others are out to harm them, take advantage of them, or humiliate them in some way.
• They put a lot of effort into protecting themselves and keeping their distance from others.
• They are known to preemptively attack others whom they feel threatened by.
• They tend to hold grudges, are litigious, and display pathological jealously.
• Distorted thinking is evident. Their perception of the environment includes reading malevolent intentions into genuinely harmless, innocuous comments or behavior, and dwelling on past slights.
  • For these reasons, they do not confide in others and do not allow themselves to develop close relationships.
• Their emotional life tends to be dominated by distrust and hostility.

Does this sound like anyone you know?  Does this sound like any organizations you know?  I believe some of the leaders of such organizations may have a severe mental illness, it's called Paranoid Personality Disorder.  They use their mental illness to instill fear, anxiety, and worry (OH LOOK ANOTHER MENTAL ILLNESS!!!  This one is called Generalized Anxiety Disorder) in others so they are compelled to take action.  Even THEY shouldn't be discriminated against!  They need to know there is help out there for them too! 😏

Generalized Anxiety Disorder (GAD):   is characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. Individuals with GAD find it difficult to control their worry. They may worry more than seems warranted about actual events or may expect the worst even when there is no apparent reason for concern.   

So, you have some people with a severe mental illness inciting fear in those who have (or now have) GAD to behave in ways that may create more distress in other people's lives.  I am not going to say specifically who or what I am referring to, you can fill in the blanks yourself.  

The reason I had you re-read the highlighted material is because either you or someone you know meets the criteria of "mentally ill" in some capacity at some point in your life.  When the mentally ill are discriminated against or mistreated or not taken seriously we are talking about YOU or those closest to you.  Remember that.   

The stigma of mental illness has been around forever and does not look like it will go away any time soon.  With proper support, funding, and access to affordable behavioral health care, millions of people who meet the criteria of the definitions listed above can live healthy productive lives.  Their mental illness will no longer be a punchline or an excuse for not making common sense decisions, laws and regulations.  They will no longer hide in the shadows in shame or embarrassment because they don't think, feel, or act like "normal" people do.  They are US!!