On Stigma: World Mental Health Day

[VivaLasViejas, ASN, RN]

Today, October 10th, 2014, is World Mental Health Day--a day to acknowledge the importance of mental health, and a day to educate others about mental illness. Here's my contribution.

Today I'm going to talk about stigma. I've discussed it in my blog at times, but I've never really gone into it in depth because it is painful to acknowledge the fact that most of the world believes that people like me are crazy. That we are defective, weak, useless. That we are.....alien.

Stigma is pervasive and sneaky, although some people are openly prejudiced and even hostile toward those with mental illness. Others use MI as fodder for jokes, while still others employ it as political theatre (gun-control advocates in particular). But the social opprobrium is the worst, in my opinion. There is SO much judgmentalism out there, and nowhere is it more obvious than the working world.

I know, because I've lost jobs and had my work hours cut to the bone in others simply due to the fact that I have a mental illness and became symptomatic. The Americans with Disabilities Act may protect the diabetic who has to inject insulin at work, but it does nothing for the mentally ill worker who loses her job because she had to deal with a crisis. I've struggled my whole life with sticking to a job for a significant length of time, and I can't help believing that if I'd received some understanding and assistance from my employers, it might have turned out differently.

I'll never know for sure; it could merely be the nature of my disease. And of course, I didn't even realize I was sick until 2 1/2 years ago. But I am convinced that if I'd taken medical leave for a heart attack or become ill with pneumonia instead of bipolar disorder, we wouldn't even be having this conversation.

I am also certain that stigma exists in part because the average American is uneducated about mental illness, even though according to statistics, one in four of us lives with one or more such conditions. We are notorious for not seeking help even when we know something is wrong; in some studies, fewer than half of Americans with psychiatric issues are seeing a mental health professional. Why? Because we're afraid someone will find out and think we're crazy, psycho, nuts, loony. We are also reluctant to take medications; who wants their family or friends to see their prescriptions in the medicine cabinet, or their pharmacists to know how many meds they need to control their condition?

In addition, stigma exists because of the good old Puritan work ethic, which shames us for our "nonconformity". We are viewed as weak-willed, lazy, worthless, while at the same time we're expected to pull ourselves up by our bootstraps.....even when our illness has left us barefoot. Every depressed person has been told to "snap out of it" or "think positive thoughts" or "count your blessings". Every anxious person has heard "if you'd just calm down you wouldn't be so nervous". This is not helpful, people. Would you tell someone with cancer to "just get rid of that tumor, you'll be fine"?

On this World Mental Health Day, then, let us open the door to a real dialogue on mental illness and those who suffer. If you don't know anything about it, learn! If you have MI yourself or love someone who does, educate! There is no other way to erase stigma. I'm doing my part. We all must.....and not just today, but every day.