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Stigma is no respecter of persons

12/15/2013

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How Stereotypes Stop the Mentally Ill from Getting Help

Piper Hoffman

Dec 6, 2013

6:00am

Contending with a mental disorder is hard enough, but people who have one face another hurdle: the stigma associated with their illness. There is a widespread aversion to the mentally ill that is made up of “ignorance, fear, and discrimination.” Catherine Zeta-Jones, who has bipolar disorder, says that the things people say about it “can be painful.” Those things include the belief that people who are depressed are indulging themselves and should snap out of it. Dolly Parton subscribes to this notion and says it worked for her: she claims she ended a bout of depression by telling herself, “Right, get off your fat butt, or if you really are suicidal, then go and shoot your brains out.’” She doesn’t take into account that she probably could not have done that if her depression hadn’t been running its course on its own.

Another popular conception is that successful people don’t get depressed. Winona Ryderbelieved this herself, but at a time in her life when she had it all, she was hit with depression. “I remember feeling, ‘I can’t complain about anything, because I’m so lucky, I’m so lucky,”” she says.

Depression isn’t the only mental disorder weighted with misconceptions. For instance, some other disorders are believed to make everyone who experiences them violent.

It is not an overstatement to say that this stigma, though it exists only as abstract attitudes in other people’s minds, has devastating health consequences for people who are mentally ill. The United States Surgeon General wrote in a 1999 report that the stigma

reduces patients’ access to resources and opportunities (e.g., housing, jobs) and leads to low self-esteem, isolation, and hopelessness. It deters the public from seeking, and wanting to pay for, care. In its most overt and egregious form, stigma results in outright discrimination and abuse. More tragically, it deprives people of their dignity and interferes with their full participation in society.

The worst news there in terms of medical outcomes is that people do not seek help because they do not want to admit to themselves or for others to learn that they have a mental disorder. Zeta-Jones wants that to change. By talking publicly about her condition, she says, “I hope I can help remove any stigma attached to it, and that those who didn’t have it under control will seek help with all that is available to treat it.”

The audience for her message is large. More than a quarter of the American population suffers from a mental disorder in any one year, according to the National Institute of Mental Health. Looking just at depression, the American Medical Association reports that up to 12% of men and 26% of women in the United States will experience it at some point in their lives.

That means that a whole lot of people are affected when the stigma prevents people from seeking treatment, especially considering the impact on the family, friends and colleagues of people with untreated disorders.

That is not to say that people are always affected by an afflicted relative’s or friend’s failure to seek care. With some illnesses, a person may be able to hide her condition despite devastating symptoms. A sampling of celebrities who have been or are mental ill shows that it is possible to conceal the suffering, at least part of the time. Dolly Parton, Jim Carrey, and Rosie O’Donnell all say they have had depression, belying their cheerful public personas. O’Donnell says that she had lived under “a dark cloud” since childhood, but didn’t get help until she was 37.

The stigma is particularly pronounced in certain sub-cultures. One of these is the military, which expects members and veterans to tough things out. Acknowledging and nurturing emotions probably isn’t that institution’s strong suit. That leaves veterans whose experiences in combat caused post-traumatic stress disorder (PTSD) isolated, sometimes shamed, and usually quietabout their suffering. In an article featuring the words of several veterans with PTSD, theMontreal Gazette notes that a “stubborn stigma…is rife in all ranks of the Canadian military.”

Sometimes religious communities also have trouble acknowledging mental illness in their leaders. A North Carolina Baptist minister’ssuicide, which shocked his congregation in 2009, was “a rare outcome to a common problem” among the clergy. One expert said, “We set the bar so high that most pastors can’t” reach it, leading to depression. An organization called CareNet operates 21 counseling centers for pastors in North Carolina alone. Its president, Steve Scoggin, said isolation and loneliness are the “greatest occupational hazards” for clergy. The fact that one state has 21 counseling centers just for pastors hints at the problem’s prevalence.

Another particularly vulnerable group isteenagers, who often do not seek help for fear of their families’ reactions.

The growing number of celebrities speaking publicly about their mental illnesses may help reduce the stigma that hurts so many. Education can help too. Informative resources include theNational Alliance on Mental Illnesses and Mental Health America.

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