Please, Can We Just Move Beyond Judging People with Mental Illness?

When I was deciding about what specialty of medicine I wanted to go into, I was on the fence between pediatrics and psychiatry.  When I ultimately chose psychiatry, I had several people — even within my inner circle — challenge me on my decision...even and especially others within the field of medicine.  What this experience revealed to me is that there has been and still is a great deal of stigma around mental illness.  It also showed me that there are misconceptions about those who struggle against mental illness. 

So, if you’re new to me, I’m Dr. K Martin also known as Dr. K.  I’m both a child and adolescent psychiatrist and general psychiatrist based in the Southeast.  My goal with these brief posts is to provide you with quick and easy access to information about mental health.  Do note, however, this information is not meant to serve as a substitute for your personal mental health care.  Please talk to your provider before implementing any suggestions that I mention in these posts.  The topic of the post for today is the Stigma Around Mental Illness. 

First, I want to start with some basic definitions.  You may be wondering what exactly mental illness is.  Mental illness refers to a wide range of health conditions that negatively impact a person’s mood, thinking, or behavior.  Now, you may also be thinking to yourself, what exactly do you mean by stigma?  Stigma means — by definition — mark of shame.  Mark of shame.  And when I say that out loud, my heart breaks — when I consider that my patients, who I’ve deeply cared for, have been burdened with shame because of their mental health struggles. So, let me address this.  And I speak from the very bottom of my heart.  For those of you out there who are struggling against mental illness, I see you and I respect you, and I encourage you to keep up the fight until you overcome it.  

The patients with whom I’ve worked are some of the most noble people I know.  They are brave, and they are valiant.  They are intelligent and wise.  They are creative and brilliant beyond measure.  And they are hilarious, and I’ve enjoyed getting to know them and spending time with them.  They are fighters.  They are resilient.  And they are overcomers.  And, above all else, they are human.  They are human.  And this is one place where I want to offer a correction as far as societal perception goes.  People who are struggling against mental illness are not “those people over there.”  People who are struggling against mental illness are us and among us.  Mental illness is a lot more prevalent than many people believe.  One in five adults in the United States has struggled against some form of mental illness.  Approximately twenty percent of US adults report having an anxiety disorder within a given year and about ten percent of US adults will suffer from a depressive illness each year.  The World Health Organization has reported that depression is the single largest contributor to global disability.  We — as a family of humans —are struggling against mental illness.  

When I was in training, one of our supervisors always started the day by saying to us “Now let’s go stamp out mental illness.” Let’s.  As in let US.  We are all in the struggle against mental illness together.

I believe that at the core of the shame that shrouds mental illness is a fear of judgment.  Across cultures and generations mental illness has been attributed to emotional weakness, moral deficiency, flawed character, or just plain old poor parenting.  Let me remind you of something that is so strikingly obvious but that everyone — myself included — needs to keep at the forefront of their minds — no one asks to be mentally ill...at least that I know of.  I’ve never met a patient who truly wanted to be disruptive, disorganized, depressed, anxious, psychotic, or addicted.  No more than a person would want to have diabetes, arthritis, or high blood pressure.  Lifestyle choices and decisions can be factors that trigger or perpetuate mental illness.  But, what research has revealed over the last century or so is that there is a huge biological contribution to mental illness.  And what I mean by that is that people can inherit certain genes or traits or physical conditions that render them more vulnerable to mental illness.  

And, another point — some people think mental illness is synonymous with more severe illness like schizophrenia and bipolar disorder.  Schizophrenia and bipolar disorders are specific mental illnesses — and very serious ones.  I want you to remember that people with those conditions often suffer greatly.  Not only do they have to deal with significant mood shifts or problems with thinking, but their perceptions of reality can change in very frightening ways.  Imagine what that would be like — not being able to determine if something is truly happening or if your mind is only playing tricks on you. 

So, let me caution everyone against judging.  Just don’t.  Don’t judge.  I think I had a bit of a natural bend toward judging others prior to working as a psychiatrist, but my personal belief is that God placed me in this career so that He could effectively deal with me on the issue of judging others.  When you listen to the stories of those who struggle against mental illness — if you understand their entire backstories from beginning to end — I’m telling you judgment goes out the door.   Understanding weakens the propensity toward judgment.  Understanding weakens the propensity toward judgment. 

Folks, let’s make it our business to understand mental illness and those who struggle against mental illness.  I’m Dr. K, and this has been Mental Health | Plain Speak.  And remember, “Be kind, for everyone you meet is fighting a hard battle.”