Because I have a strong interest in psychology & mental illness (both through personal experience and through study—I was working on my degree in the field at Harvard before I moved away from the Boston area), and because such illness can affect pretty much all aspects of a mentally ill person’s life, it tends to come up when I discuss various issues with people. It’s a natural topic for me, like physical illness might be for a caregiver or for someone who spends much of their time battling physical illness.
Many people don’t feel comfortable discussing mental illness—particularly those who suffer from it—in large part because there are still so many misconceptions going around regarding the mentally ill. Various people have emailed me to thank me for being willing to discuss what it’s like to have a mental illness, because they feel they can’t; they know their family or friends wouldn’t understand, or they might be discriminated against or fired at work. Part of the reason I tend to be so open about my own illnesses is a desire to see this change. I want mental illness to be something that people don’t have to hide and be ashamed of.
Because I’m lucky enough to be surrounded by people who understand mental illness and those who suffer from it, I sometimes forget just how uncomprehending most people can be. Then the topic of mental illness will come up as a side note in some other conversation and I’ll get a brutal reminder of just how many mental illness myths remain in our society. So while this is hardly a comprehensive list of those myths, here are a few that tend to irk me, and my thoughts on them; I’m sure I’ll come back and add more later. I’m posting these here because I try so very hard not to hijack other people’s conversations.
Standard disclaimer: I’m not a professional. These are my own opinions. Blah, blah, etc.
1. You can recognize when someone has a mental illness. OR, It’s obvious when someone has a mental illness.
False, false, and SO very false. Even psychiatrists and psychologists often differ on whether a pattern of behavior should be classified as an illness and, if so, which one. If it were that easy there wouldn’t be a need for the damn profession. Also, symptoms are on a continuum, they aren’t either/or. Not to mention the fact that many symptoms, particularly when it comes to something like mood disorders or personality disorders, are normal behaviors taken to an abnormal extreme. Add to that the fact that many mentally ill people desperately try to hide the fact that this is what’s wrong with them, and in many cases you’ll have no idea that’s what’s going on with a person.
2. Very few people actually suffer from mental illnesses.
Wrong. The last time I heard a statistic, it stated that something like one in ten people suffer from a mood disorder alone, and mood disorders are only one variety of mental illness. I’m not sure I buy the statistic I’ve heard bantered about that one in three people suffers from some sort of mental illness, but the point is, it’s almost certainly more people than you think. Look around your circle of friends and relatives. Odds are very high several of them suffer and you don’t even know it.
3. Mentally ill people are fine when they’re on medication and you can tell when they’re off.
It isn’t that simple. It can take many tries to find the right medication, and some of those might partially work but not do the job well enough. Someone who’s normally fine on their meds might just have a particularly bad spell and suddenly their normal meds aren’t enough. Some illnesses are exacerbated by stress, and so things like deadlines, tests, breakups, family issues and so on might make things worse. Even then, a medication that works for a while might eventually stop working for whatever reason. Or it might help, but the side effects might not be tolerable. Similarly, medication that works beautifully for one person might not work well for the next. Psychiatry is a very inexact science, and there is no simple cure for mental illness.
4. Mentally ill people just use their illnesses as an excuse to avoid doing work.
Frankly, if someone wants to be lazy and use an excuse to avoid work, they’re going to find an excuse—whether or not they have mental illness to lean on in that department. There are plenty of people who have legitimate difficulties working for one reason or another due to their illnesses. Sure, many mental illnesses only sporadically act up enough to keep someone from working, but who’s going to want to hire someone who at any time could become too exhausted, distracted, weepy, or freaked out to get anything done?
Too many people don’t realize that there’s a difference between a reason and an excuse. An excuse is something you proffer to get out of blame or obligation. A reason is an understanding of why something happens that can help you to work around it, avoid a repeat of the same occurrence, or adjust your expectations. If more people would stop automatically assuming that people are using mental illness as an excuse and simply see it as a reason, then perhaps we could work together to find better ways to integrate mentally ill people into work, life, and school. Many mentally ill people would very much like to work and support themselves more than they currently do, but find it extremely difficult to do so for various reasons.
5. Mental illness is “all in your head.”
Hardly. Many mental illnesses are, in fact, genetic in origin or at least physical in cause. Studies have shown distinct differences in the brains of people with certain illnesses (even ADD/ADHD, which people like to claim all the time doesn’t exist)—unfortunately testing for these differences is too expensive to use as a diagnostic tool. Other mental illnesses that are caused by life circumstances can lead to changes in brain structure or function. Post-traumatic stress disorder (PTSD), for example, causes vast changes in the functioning of the body’s hormone release systems. It also has been shown to cause changes in the development of certain structures in the brain.
6. Psychiatrists and psychologists label people as mentally ill when they’re simply lazy or difficult.
It is true that not everyone is correctly diagnosed, and that some people are diagnosed who shouldn’t be. As I said earlier, psychiatry is an inexact science, and as in every profession there are idiots as well as great practitioners. However, what you need to realize is that one of the basic diagnostic criteria for a mental illness is that it must significantly interfere with an individual’s ability to carry on in their work, relationships, or home life in order to be considered an illness at all. A responsible and well-educated psychiatrist or psychologist will not diagnose someone with a mental illness unless the proper criteria are met. That doesn’t eliminate the possibility of mistakes, but it certainly helps.
7. People are drugged up by psychiatrists when they should just be made to buckle down and get over it.
If it were that easy to work around a mental illness we wouldn’t have so many problems with it. However, here’s an interesting tidbit for you that many people aren’t aware of. It has been shown that drugs alone are no more helpful in the treatment of mental illness overall than therapy alone. Treat someone with both together, however, and the effectiveness of treatment goes up substantially and quite noticeably. Why is this? Well, consider the problem from both directions in turn. Therapy alone isn’t enough because most mental illnesses are physical in origin; if you don’t attack the biochemical imbalances directly then you can’t do much to alter them. Drugs aren’t enough because while most mental illnesses are physical in origin, they cause a huge amount of stress and uproar in a person’s life. Therapy helps people to address these difficulties. A good therapist can also teach a person coping mechanisms for stress, reducing its impact on their treatment, and can teach various means of dealing with the practical effects of mental illness on a person’s life.
Thus, while it’s true that a person needs to make changes to his or her life (and put in some effort) to handle their illness, they can’t just “get over it.” Both medication and the educated advice of a good therapist make a huge difference in the course of an illness.
Hopefully this will give you some idea of which myths you might be unintentionally buying into without even realizing it.
Edited to add: A fantastic page I stumbled on, Ways to Insult Someone with Depression—all those things NOT to say to someone who’s depressed.