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.
Very nice, Heather! I especially enjoyed the part about medications and the part brain structures. You’ve been Stumbled and linked.
Thank you! I worked on this off and on all weekend after having one of those “huh?” moments in encountering some odd attitudes.
Heather,
I just stumbled here…perhaps thanks to Sam’s link, and I just wanted to pass along some comments.
First, I have a mental illness – depression – and I have been suffering from it for a long time. In fact, I had my first episode at age 11 but it was some 27 years before I was diagnosed properly. I am perhaps unique in that I often talk about my illness in a very frank way. I have always wanted to try and give people some level of understanding, or at least help them gain a sense of empathy for a sickness that touches nearly everyone.
I appreciate people like yourself who has taken the time and trouble to create a web site that aims to promote education and understanding about a subject which is often talked about in whispers rather than a full voice.
Even my own mother believes that I need to stop taking my medication and “just deal with life”. If only one person gains some perspective from your site, then I would deem it a success.
Best wishes to you for health and happiness in your life.
Oh wow! This should be required reading for sooo many people. Fantastic post! Thank you.
Brilliant! I hope many people Stumble this and if they only read one paragraph they will be on the road to learning what mental illness really is.
Thank you.
Craig: It’s nice to meet someone else who’s in a position where they feel they can talk about their illness(es). It can be really hard sometimes, like when your mother thinks dealing with life would work better than medication, but you know it’s worth it when someone says, “oh, I didn’t realize that,” or, “thanks for being willing to stand up and say something.” Best wishes to you as well!
Bridget: Thank you! I wasn’t sure what kind of response this would get, so it’s nice to see such a positive one.
Caroline: Thank you so much for the kind words!
I just found this great article on helping someone who’s depressed through stumbleupon, so I thought I’d add the link here.
One thing I learned in college is that a license in psychiatry requires very little training in psychology. There are certainly admirable exceptions, but psychiatrists tend to diagnose and treat the body primarily while psychologists tend to diagnose and treat the mind primarily. The first sign of a good one (either profession) is that they refer you to the other profession so they’re sure they’re seeing the whole picture and covering all bases.
There are some disorders which are mostly psychological and some which are mostly physical, but the two are always tied in some way.
In my case, the psychiatrist advised against medication because it would be dangerous. His exact words were: “Anything I could give you would be just as likely to send you into psychosis.” I’m close enough to the edge and have enough combined issues that sticking to psychology is safer, but I still benefit from physical stuff like exercise, good food, and sunshine. My sister had to go through many medications before they found the ones that worked for her, because every person has a somewhat unique physiology (and lifestyle).
Disorders run down the line in my family, so we’re perfectly casual about it. We’ve always called each other crazy without any hard feelings. Honestly, sometimes things work out better if you just tell people your symptoms and don’t tell them it’s a mental illness, since that’s what draws a lot of the false assumptions out. I don’t blame folks for not trusting shrinks… I don’t trust doctors either!
I think you have made some good points but I would like to tackle this one for a moment:
“2. Very few people actually suffer from mental illnesses.”
You say it’s a myth and that studies show that as many as 1 in 10 people have mental illness. Be careful here. These studies are often “rigged” or interpreted with an agenda. I remember seeing a study that claimed “1 in 3” girls and “1 in 4 boys” under the age of 18 have been “sexually assaulted.” That’s just horrible, right? Well, it turns out this study was conducted by an advocacy group trying to “raise awareness” of sexual assault, so in the first place it was in their interest to have those numbers look as bad as possible (more money/press for them). In the second place, on their survey they asked “have you ever been sexually assaulted” and only 1 in 10 people said yes. Where’d they get the 1 in 3 then? Well, apparently 2 in 10 people have been assaulted but don’t know it. When you read the fine print it turns out that they consider things like some guy in a hard hat whistling at you from a construction site to be a “sexual assault” — which only this advocacy group would define that way, all other rational people on earth considering it to be just a whistle.
So, be careful with interpreting this “1 in X people have this” or “every X minutes someone dies from Y.” These numbers are often extrapolations from very little data, or gross generalizations of a very specific study, and therefore unreliable.
How many people have mental illness? No idea. But it would depend on how you define mental illness in the first place, which as you say even trained professionals don’t agree on. So if they can’t agree on what IS mental illness, how can anyone know how many people have it? You can’t.
Now, that is not to say that you’re incorrect and that hardly anyone has mental illness. As I say, I have no idea how many people do. But just be careful of studies like the one you quoted, because most of the time they are what in layman’s terms could only be referred to as “rigged.”
C
Aaron: Aye, there are some truly terrible mental health “professionals” out there, just as there are some truly terrible “doctors” out there (yes, deliberate use of quotation marks there). Luckily there are some good ones too!
Chess: The 1-in-10 number, if I recall correctly, is an older, more conservative one. I try to base my estimations on those things I remember learning in school, from actual researchers. You are correct, however, and that is precisely why I discard the 1-in-3 number as likely being overblown. From my own personal experience and observations, I tend to believe the 1-in-10 is much closer to the truth. While it’s true that the definitions of mental illness are fluid, as I said, many studies have shown specific biochemical, electrical and structural differences in the brains of people with various mental illnesses. So, while it’s true that the numbers can’t be known, it’s hardly a huge blank X. The fact that there are many unknowns in the field of psychiatry is not the same thing as saying that everything is an unknown.
I Stumbled here as well. This is some really good, solid information. Thanks.
I’m what you call a “pillar” of the community. Great job, family, education, etc. I’m also bipolar and nobody but my wife knows. It’s painful, very painful.
Bonnie: Thank you very much.
K: It’s hard to deal with these things, and even harder when you have to hide them and try to pretend everything’s “normal.” Have you looked into online support groups where you’d be able to maintain your anonymity?
Hi there. Great post! I can tell you that the number we’re using in Canada is 1 in 5 people are affected by mental illness. I believe it is similar to the U.S.
Oh yeessh-Haven’y you hit upon the topic of all topics!!! I have almost as many diagnosis’s as I have ex husbands and children…heee heee
I have been battling whatever has been chasing me all of my life-It chased my mom and apparently my grandmother too…I call it “IT”. I am at the place where some meds are working and spiritual work and general acceptance of my mentalness is all that keeps me in my life. I am a teacher for 24 mentally ill students who are ages 12-17. They are suffering much more than you and I, because they don’t understand their issues or that they may not always be the hostages,that they are today…The numbers are big and the numbers of who isn’t talking are even greater.
My mission-This should not be tabu or ugly…No one should have to suffer in silence and pain. Brain chemicals are brain chemicals and they must be treated when they aren’t right. Please keep raising awareness and keep pushing back.
Your are a blessing to many!
Hi, i found this blog to be very exciting and very frank. The myths you included were huge misconceptions have I have always noticed and tried to not listen to. In my class, we are making our own blogs and PSA. My blog is about helping people who are mentally ill get off of the streets and collect resources.
Anyone interested in looking at my blog(very unfinished blog) is more than welcome.
My link is
http://homelessmentallyillinla.blogspot.com/
and please feel free to leave comments and suggestions.
🙂
Wonderful post!
A very well written article. Unfortunately mental health isn’t openly discussed as much as it should be. Maybe one day it will be.
Some people are discriminated against at work and by friends and family because of these mental illnesses. I completely understand why people chose to keep it a secret from everyone around them. It could cost some their jobs and change turn their lives upside down in a flash, not to mention the embarrassment that goes along with it. Good post.