Education and support: It truly takes an entire village to end stigma
When I was 19, I was diagnosed with depression. I understood that this was an illness and spoke very openly to my friends, family and even publicly about my diagnosis. In my 20s, I was having trouble with friendships and co-workers. I didn’t understand why, so I talked to my doctor, and finally we discovered that I also had borderline personality disorder.
This changed things for me. I told no one. I was ashamed, and I was too afraid of their reactions. People understood depression, but BPD seemed so unreal. A “personality disorder?” What does this say about me? The stigma attached to BPD was so heavy, I feared I’d lose my job. I had done enough research to know that the reaction to people with BPD was not good, attaching words like manipulative, toxic and fearful of someone with BPD. I kept this diagnosis silent and lived in fear someone would find out.
Generations ago, the perception developed that mental illness was horrid, embarrassing and something to be ashamed of. Unfortunately, this still exists today, even though modern medicine, research, therapeutic techniques and evidence-based practices demonstrate that these are illnesses that respond to treatment. As a society, we have made great strides when it comes to inclusivity and sensitivity to those with disabilities. However, that is not necessarily true for those with an emotional disability.
For example, imagine yourself heading into the grocery store. You see someone attempting to enter with a leg in a cast and using crutches. What are your thoughts about him or her? Do you feel safe? Would you offer assistance? Now, let’s take that same scenario but as you are entering the store, you see someone who looks somewhat disheveled, has some body odor and is muttering to themselves. What are your thoughts about him or her? Do you feel safe? Would you offer assistance? If you are like most people, your answers to these two scenarios are very different. Why is it that we react differently in the presence of someone experiencing some type of emotional distress?
Even those coping with a mental health challenge struggle sometimes to understand that they have a treatable illness just like diabetes. Instead, fear and shame often get in the way of seeking treatment.
The notion that emotional distress is a part of all our lives, either directly or indirectly, must become part of our reality, and the stigma around mental illness must end. In fact, the term “stigma” is accurate only to the extent it addresses the shame that people with a mental illness feel. The reality is that we often use “stigma” when what we really should be talking about is “discrimination.” Stigma better relates to the thoughts and feelings we have around a particular illness or class of people. But how that plays out is better described as discrimination, or the actions we take based on our beliefs.
As the medical world understands the underlying structure of mental health more and more, and with the advent of proven medications and therapeutic strategies, we now know that the majority of people with mental illness have the ability to lead normal and productive lives, hold a steady job and connect with other people and their community. It is discriminatory to treat those with a mental illness in a way different from those who are mentally healthy. Two out of 10 people in a room have some level of emotional distress at any given time in their life. Whether it be the more common forms of emotional distress such as anxiety, depression, grief or the more chronic forms (and less common) such as bi-polar disorder or schizophrenia, varying levels of mental illness occur around us all the time.
This change will take time and concerted effort. It takes funding on the state and local levels to create accessibility for those needing immediate help when in crisis; and for those who are on a waiting list, waiting patiently for an opening with a therapist. It takes education, so that people feel supported in their community enough to be open and honest about their illness. The conversation then becomes mainstream, similar to talking about cancer or diabetes. As a society, we have the power to change perception and end the unfairness so profoundly attached to these illnesses. As a society, we must do this, so people feel they can get the help they need with no shame. Over time, together, we can change our culture and eliminate the discrimination that is attached to mental illness.
Brian Collins is executive director of Community Partners in Dover, https://communitypartnersnh.org.