5 ms·

> I think one of the issues here is that mental illness carries so much stigma. It's hard to even get help at times due to this I'm going to come off like an a

> I think one of the issues here is that mental illness carries so much stigma. It's hard to even get help at times due to this I'm going to come off like an arrogant ass, and perhaps I am, but... source? It's been my experience -- a whitebread, middle-class American in liberal California experience, granted -- that seeking treatment for mental health issues is met with waves of support and encouragement. Therapy and Prozac are ubiquitous in our pop culture.

steveklabnik 14y ago
So. I will spare you the Foucault/etc discussion about how 'mental illness' is even defined in the first place, and just assume the mainstream narrative on this. But that's one avenue for this discussion. Let's talk about that. I know someone who was diagnosed with a mental illness. They got medical care for their condition, but due to the way we discuss mental illness, it harmed more than it hurt. They gave me an account of how, once they started working with a different doctor, the change in language was revelatory towards resolving their symptoms. The first doctor (and the most 'normal' one) used language such as "You are a schizophrenic." This defines the person by the disease, and begins from a place where they are already limited. It's as though it's a life sentence, and they're just making time until they die. Even the small shift to "You are living with schizophrenia" did wonders for their condition: instead of being limited by the disease, they were just another person, working to limit a negative aspect of their life. The relationship was turned upside down. (to be clear, I am obscuring details to protect their identity.) Secondly, you are absolutely right that therapy and Prozac are ubiquitous. But the _representation_ of them is the issue. Therapy is for someone who's _crazy_. Someone who can't deal with life. Someone who's deviant. Nobody wants to admit that they are mentally ill. The image of someone who pops Prozac and goes to therapy is not a positive image; it's a profoundly negative one. Rather than celebrate taking steps to overcome a disease, they're just another drug-addicted loser who 'needs help.' The Protestant ideal is still quite alive in our culture. I'll also leave the issue about if drugs are even the best way to treat every instance of mental illness, and if doctors are too quick to write a 'script. Anyway, that's the TL;DR from my current understanding around this issue, both from study and discussion with people close to the issue.
- cscheid 14y ago
  I generally find that rephrasing "you are" to "you have" is powerful. "You've said something racist" vs. "You're a racist"; "This paper is written badly" vs. "The authors write badly"; "You have an addiction" vs. "You are an addict". etc. Separating the action from the actor seems to make us a lot more willing to quit/change our questionable actions.
  - steveklabnik 14y ago
    My experience is that this is true as well. It's hard not to equate the two in practice, given that it feels like shorthand.
  - Evbn 14y ago
    See also the Fundamental Attribution Error.
- Domenic_S 14y ago
  > But the _representation_ of them is the issue. Therapy is for someone who's _crazy_. I guess my own upbringing (which is irrelevant from a cultural perspective, I suppose) colored me differently on this. I see therapy as being on the same level as going to your family doctor -- when something is malfunctioning, go take care of it. And honestly, I don't see a lot of characterizations of therapy as "for the crazies", except from people who say we need to fight it. That could just be because of the way my sensors are tuned, I guess.
  - steveklabnik 14y ago
    That sounds like a very healthy attitude, I'm glad you've managed to escape from the broader societal one. :) Try this: pay attention to the things you say, and make a note every time you say one of these things: - That's nuts! - That's so crazy. - That's retarded. - She's hysterical! (double whammy: sexist and abelist!) - Wacky! - Wow, that schedule is insane. - That code is idiotic. - You're an imbecile. - You're a lunatic. - This place is a madhouse! - He's a psycho. - What a spaz. It might be my age or my speech patterns, but I say these things a lot. Working on it. But all of these phrases being common and acceptable is part of this issue. (abelism, if you're curious. Some of these bleed into mental capacity as well as health, I figured I'd include them anyway.)
ezy 14y ago
I don't have any sources, but I suspect you are correct only up to the certain point. People are largely ok with mental illness which doesn't impose on them. Depression, yes, Schizophrenia, no. My impression is that if the condition involves quiet angst, everyone will sympathize -- but if it's about real heavy duty craziness, no one wants to hear about it (or look at it or think about it, etc.).
- vacri 14y ago
  People aren't okay with depression. They don't care about depression because it doesn't affect them directly, but it still carries a stigma. Try having a casual office conversation about how you were sick last week. Compare the tenor of the conversation when the sickness is 'the flu' versus 'depressive episode'. Every mental illness is stigmatised, it's just that some are more stigmatised than others because they're 'louder'. Part of this is due to mental illness being really hard to understand if you've never been exposed to it (as a sufferer or a loved one of a sufferer).
  - ericd 14y ago
    The other part is that whereas the flu knocks you out, mental illness can make you harder to predict, which is potentially more dangerous. Some of that stigma is probably built in by evolution.
    - electronvolt 14y ago
      Particularly bad depressive episodes are similar to the flu/mono/etc.: you are incapacitated, feel like shit, and can't get anything done. Yes, they can flare up without warning: so can the flu. Yes, they can last a long time (DSM diagnosis requires more than 2 weeks): so can something like mono or cancer, which get sympathy, not fear. Stigma is almost entirely a cultural thing: I know of someone who's first manifestation of mania (bipolar disorder, type 1) was in a religious setting... so when she said she heard God talking to her, they were reportedly thrilled. It didn't come out that it was a problem until she was on the plane home and was blessing the passengers (edit: details slightly obscured/changed).
juridatenshi 14y ago
My anecdata on this is that level of stigma varies a lot based on the mental illness involved. Some mental illnesses (e.g. schizophrenia, bipolar disorder, borderline personality disorder) appear to be labeled very harshly by our culture and have a huge amount of stigma attached to them. I'll see if I can dig up any journal articles or research on this.
juridatenshi 14y ago
There is some limited info from the CDC below. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a3.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a3.htm
notsofastthere 14y ago
This should be common knowledge, but then again there are folks who believe we're a color blind society, so I'll assume it's just a simple lack of awareness on your part. If you google "psychiatric stigma" you'll get plenty of peer reviewed research on the topic dating back at least 50 years. Prior to that stigma was less of a concern because we simply locked these people up, outside of our collective view and societal awareness. Better than being burned at the stake I suppose (we also used to do that). Here's a good place to start: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/
d0mine 14y ago
People with schizophrenia are still perceived as dangerous and unpredictable, and these perceptions have increased in recent years. JD Hancock http://theconversation.com/either-mad-and-bad-or-jekyll-and-hyde-media-portrayals-of-schizophrenia-12391 http://theconversation.com/either-mad-and-bad-or-jekyll-and-...

steveklabnik 14y ago

So. I will spare you the Foucault/etc discussion about how 'mental illness' is even defined in the first place, and just assume the mainstream narrative on this. But that's one avenue for this discussion. Let's talk about that. I know someone who was diagnosed with a mental illness. They got medical care for their condition, but due to the way we discuss mental illness, it harmed more than it hurt. They gave me an account of how, once they started working with a different doctor, the change in language was revelatory towards resolving their symptoms. The first doctor (and the most 'normal' one) used language such as "You are a schizophrenic." This defines the person by the disease, and begins from a place where they are already limited. It's as though it's a life sentence, and they're just making time until they die. Even the small shift to "You are living with schizophrenia" did wonders for their condition: instead of being limited by the disease, they were just another person, working to limit a negative aspect of their life. The relationship was turned upside down. (to be clear, I am obscuring details to protect their identity.) Secondly, you are absolutely right that therapy and Prozac are ubiquitous. But the _representation_ of them is the issue. Therapy is for someone who's _crazy_. Someone who can't deal with life. Someone who's deviant. Nobody wants to admit that they are mentally ill. The image of someone who pops Prozac and goes to therapy is not a positive image; it's a profoundly negative one. Rather than celebrate taking steps to overcome a disease, they're just another drug-addicted loser who 'needs help.' The Protestant ideal is still quite alive in our culture. I'll also leave the issue about if drugs are even the best way to treat every instance of mental illness, and if doctors are too quick to write a 'script. Anyway, that's the TL;DR from my current understanding around this issue, both from study and discussion with people close to the issue.

cscheid 14y ago
I generally find that rephrasing "you are" to "you have" is powerful. "You've said something racist" vs. "You're a racist"; "This paper is written badly" vs. "The authors write badly"; "You have an addiction" vs. "You are an addict". etc. Separating the action from the actor seems to make us a lot more willing to quit/change our questionable actions.
- steveklabnik 14y ago
  My experience is that this is true as well. It's hard not to equate the two in practice, given that it feels like shorthand.
- Evbn 14y ago
  See also the Fundamental Attribution Error.
Domenic_S 14y ago
> But the _representation_ of them is the issue. Therapy is for someone who's _crazy_. I guess my own upbringing (which is irrelevant from a cultural perspective, I suppose) colored me differently on this. I see therapy as being on the same level as going to your family doctor -- when something is malfunctioning, go take care of it. And honestly, I don't see a lot of characterizations of therapy as "for the crazies", except from people who say we need to fight it. That could just be because of the way my sensors are tuned, I guess.
- steveklabnik 14y ago
  That sounds like a very healthy attitude, I'm glad you've managed to escape from the broader societal one. :) Try this: pay attention to the things you say, and make a note every time you say one of these things: - That's nuts! - That's so crazy. - That's retarded. - She's hysterical! (double whammy: sexist and abelist!) - Wacky! - Wow, that schedule is insane. - That code is idiotic. - You're an imbecile. - You're a lunatic. - This place is a madhouse! - He's a psycho. - What a spaz. It might be my age or my speech patterns, but I say these things a lot. Working on it. But all of these phrases being common and acceptable is part of this issue. (abelism, if you're curious. Some of these bleed into mental capacity as well as health, I figured I'd include them anyway.)

ezy 14y ago

I don't have any sources, but I suspect you are correct only up to the certain point. People are largely ok with mental illness which doesn't impose on them. Depression, yes, Schizophrenia, no. My impression is that if the condition involves quiet angst, everyone will sympathize -- but if it's about real heavy duty craziness, no one wants to hear about it (or look at it or think about it, etc.).

vacri 14y ago
People aren't okay with depression. They don't care about depression because it doesn't affect them directly, but it still carries a stigma. Try having a casual office conversation about how you were sick last week. Compare the tenor of the conversation when the sickness is 'the flu' versus 'depressive episode'. Every mental illness is stigmatised, it's just that some are more stigmatised than others because they're 'louder'. Part of this is due to mental illness being really hard to understand if you've never been exposed to it (as a sufferer or a loved one of a sufferer).
- ericd 14y ago
  The other part is that whereas the flu knocks you out, mental illness can make you harder to predict, which is potentially more dangerous. Some of that stigma is probably built in by evolution.
  - electronvolt 14y ago
    Particularly bad depressive episodes are similar to the flu/mono/etc.: you are incapacitated, feel like shit, and can't get anything done. Yes, they can flare up without warning: so can the flu. Yes, they can last a long time (DSM diagnosis requires more than 2 weeks): so can something like mono or cancer, which get sympathy, not fear. Stigma is almost entirely a cultural thing: I know of someone who's first manifestation of mania (bipolar disorder, type 1) was in a religious setting... so when she said she heard God talking to her, they were reportedly thrilled. It didn't come out that it was a problem until she was on the plane home and was blessing the passengers (edit: details slightly obscured/changed).

juridatenshi 14y ago

My anecdata on this is that level of stigma varies a lot based on the mental illness involved. Some mental illnesses (e.g. schizophrenia, bipolar disorder, borderline personality disorder) appear to be labeled very harshly by our culture and have a huge amount of stigma attached to them. I'll see if I can dig up any journal articles or research on this.

juridatenshi 14y ago

There is some limited info from the CDC below. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a3.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a3.htm

notsofastthere 14y ago

This should be common knowledge, but then again there are folks who believe we're a color blind society, so I'll assume it's just a simple lack of awareness on your part. If you google "psychiatric stigma" you'll get plenty of peer reviewed research on the topic dating back at least 50 years. Prior to that stigma was less of a concern because we simply locked these people up, outside of our collective view and societal awareness. Better than being burned at the stake I suppose (we also used to do that). Here's a good place to start: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/

d0mine 14y ago

People with schizophrenia are still perceived as dangerous and unpredictable, and these perceptions have increased in recent years. JD Hancock http://theconversation.com/either-mad-and-bad-or-jekyll-and-hyde-media-portrayals-of-schizophrenia-12391 http://theconversation.com/either-mad-and-bad-or-jekyll-and-...