Understanding what mental illness is and is not

I’ve been featured twice recently in articles about the Affordable Care Act and its impact on mental healthcare- first by the Peninsula Press, and subsequently by Generation Progress, which is an offshoot of the Center for American Progress think tank. This wasn’t by accident- I approached the author of the first article, Maya Horowitz, during a county meeting on mental health. What prompted me is the serious lack of literacy in regards to what people with mental disorders are like and the challenges they face. The ACA is a good legislative step by eliminating these disorders from disqualifying individuals from quality insurance, nevertheless there still is societal stigma.

A place I return to time and time again is the largest bipolar community on reddit.com. To some extent, in a non-medical sense I’m already somewhat of an expert. Living with bipolar disorder for almost nine years now, I see my own early struggles in new people that show up. In the pre-ACA era there was what I described to the Peninsula Press as “a climate of fear.” Consequently most people stayed in the closet, and avoided disclosing their status to co-workers. It was dangerous to let insurance companies know too much about your chronic condition, and embarrassing to disclose in a social setting.

Polls show that a third of Americans think prayer alone can overcome serious mental illness. People who openly talk about their struggles will inevitably get condescending suggestions to ditch their medication in favor of alternative remedies, yoga, or positive thinking. Many can improve their mood with exercise, sunlight, and improved diet; but scientifically it is clear that medication is the primary answer for people with severe major depression:

The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms, and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial. (2010 study, source)

The public by and large does not understand major depression, or bipolar disorder, or schizophrenia are, how they present, are diagnosed, and are treated. This lack of tangible knowledge leads to one of the most offensive aspects of mental health in America.

That the media and special interest groups are lumping all violent behavior with mental illness, and erasing any distinction between violent individuals, those with mental disorders, and violent individuals with mental disorders.

A large portion of mass shootings lead to a blame game, and mental illness is always brought up as a hand-wave answer for why such things happen. This is reinforced by scary news features, along with TV and film portrayals of sadistic, insane villains. However, the link to violence is an illusion. Terrible crimes are committed routinely by people with no trace of mental illness; the more blame lumped onto mental health, the less vigilant people are about other at-risk groups.

Indeed several mass shooters had serious mental issues, but they also had warning signs that should have been picked up on. More stigmatization keeps people from seeking treatment, and leading to risky and destructive behavior.

The reason I volunteered to go on the record is because there need to be more voices with experience, even though it’s always awkward to talk about mental illness in public. Anti-stigma campaigns are being formulated and launched- my county now has a unified campaign with quality materials. One way I look at the 21st century is how there are a shrinking number of acceptance prejudices. In many ways those with mental health are not treated with the same empathy and respect as others. They should.

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