– A middle-aged woman revealed she hasn’t even told her husband that she has intrusive thoughts that their son will die because he once called her “crazy”.
The father of a 19-year-old with Body Dysmorphic Disorder expressed how he feels she’ll get better if she tries hard enough and does yoga and meditation.
– A 27-year-old man shared that he doesn’t feel comfortable talking about his problems with his friends because they “judge” him for that and tell him he’s weak.
-A man in his 30s needed a mental health certificate for his office but requested that it should mention only “stress-related issues” and not his actual diagnosis.
-A recently married woman’s husband got her to India from the U.S. to get her treated for her OCD. He then went back and never came back for her because he felt that “she wouldn’t get better ever”.
These are some of the examples of patients I’ve seen as a psychotherapist over the years. These are the patients who are still trying to seek treatment. Whereas many others are suffering in silence due to the stigma, prejudice and discrimination that surrounds mental health. So let’s understand the stigma a bit more.
Why is there a stigma around mental health?
The trickle-down effect of past beliefs and attitudes:
In ancient times, mental illness was associated with being possessed by the devil or evil spirits. A few decades later, it simply started being understood as criminal or anti-social behaviour. We may not hold those views today but some of those beliefs and attitudes have crept into our current understanding of mental illness.
Stigma breeds Stigma:
People generally don’t open up about any psychological problems or psychiatric issues that they may be facing. Statistics suggest that 1 in 4 people suffer from a mental illness at least once in their lifetime. But when we look around us, we don’t see as many people who are dealing with mental illness. That’s because everyone avoids opening up about it for fear of being discriminated against. When people who are close to us, who we can relate with, don’t share their mental health struggles, we don’t understand these closely. Mental illness continues to be a mystical thing that we’re not fully familiar with.
Manifestations of Mental Illness:
How is mental illness manifested? Its signs and symptoms show up in thought, emotion, and behaviour. These are the three dimensions that make up our personality. When someone’s thoughts, emotions or actions change, we assume that the person has changed. We criticize them for being a certain way. We may even think of their illness as a character flaw. Because we associate their illness as a part of who they are, we aren’t able to encourage them to get the help they need.
Impact of Media:
For a long time, media has portrayed mental illness irresponsibly. Whether it is glamorizing the illness of addiction, or showing mentally ill people as violent and unstable, it has painted a picture that has led to multiple prejudices against people with mental illness. For every few movies that get it right, several others taint our understanding of mental health, ultimately establishing unhealthy stereotypes. Due to the reach and influence that media has in our lives, the stigma it creates is quite pervasive.
Lack of Understanding:
The use of the term “abnormal” which is often associated with mental illnesses misguides us to believe that it’s not normal to experience these. Also, not many people come forward and talk about their mental health struggles. Since there is so much talk about physical illness all the time, people are very well aware and can easily identify these illnesses. On the other hand, among mental illnesses, most people are aware only of depression, phobia, OCD, etc. The fact is that there are 300+ psychiatric disorders. Of course, it’s not possible to identify or understand something you don’t even know exists.
What are the consequences of stigma?
Fewer People Seeking Treatment:
This is by far the worst consequence of stigma. Like any other illness, people suffering from mental illness need treatment. As they are aware of society’s attitude towards people with mental illness, they may never come forward to seek treatment. They may suffer silently and in fact, their problems might exacerbate when left untreated. Their illness may also affect their self-care, their relationships, their livelihood, etc.
Reduced social support for persons with Mental Illness:
Many people experiencing mental illness don’t open up to family and friends for fear of being judged or being labelled “crazy”, “mad”, or “mental”. Any psychiatric disorder is considered a biopsychosocial illness which means that even the treatment needs to be in all these aspects. The lack of social support from family and the larger community can prove to impede the person’s recovery even if they do come forward to seek treatment. Moreover, many psychotherapeutic techniques require family support and encouragement which is also a hurdle.
Fewer mental health Professionals:
Being a medical professional is considered a noble profession in our country. It is celebrated and people motivate their children to become doctors. On the other hand, many people actively discourage their children from taking up mental health as a profession because they fear that it’ll have a negative influence on their minds. Because of fewer patients, this is not considered a field that has a good scope. Many people aren’t even aware that a separate qualification is required to become a psychologist. Most are clueless about some things as basic as the difference between a psychiatrist and a psychologist.
Fewer laws:
People suffering from mental illness are at risk for exploitation, abuse and violation of basic human rights. Though there have been reforms in laws and policies regarding mental health care in recent times, these are not as comprehensive and watertight as those about physical care. This is simply because as a society, we are yet to focus clearly and decisively on mental health issues. There is hardly any health insurance that covers mental illness. This again discourages patients to seek help.
What can we do to reduce the stigma?
- Seeking help: Those experiencing mental health struggles need to come forward and seek help through the right channels. This will go a long way in normalizing mental illness for those around them. When those who are close to us are experiencing mental health struggles, it’s easier to relate with and understand these.
- Educating oneself and others: Self-advocacy is a trait that’s helpful in many areas of life. It’s also one that can help reduce the stigma surrounding mental health. People who’re dealing with mental health issues need to educate themselves and those around them about what it means to have a mental illness, the symptoms, causes and treatment needed for the illness, etc.
- Forming support groups: People with mental health struggles can stick together and provide each other with the social support they need if it’s missing in other areas of life. Together, they can also take up the cause of mental health awareness by engaging in social media campaigns, writing informative articles/blogs, planning mental health initiatives, etc.
- Not letting your illness define you: Your illness is a part of you, not your whole identity. People should try to say they are suffering from depression rather than saying they’re depressed. They should say they have schizophrenia rather than saying they’re schizophrenic. Mental health professionals should follow the same.
- Not making jokes about mental illness: Mental illness is no joke, just like physical illness isn’t. Casually saying “I’m bipolar” or “I’m OCD” is not humorous. These are serious illnesses that affect millions of people. Joking about it plays right into the faulty stereotypes created by society.
- Equating mental illness with physical illness: It seems like a no-brainer that any kind of illness is an illness. But this can’t be stressed enough when it comes to mental illnesses. Just like a fever, a viral infection or a gastritis episode is not a character flaw; an episode of mental illness isn’t as well. We don’t shy away from going to the doctor when we have an ear infection or an allergic reaction. We might even post it on our social media and share that information with friends and acquaintances alike. We need to do the same when it comes to mental illness. Whatever the origin, an illness is an illness and needs to be treated as such.
