Breaking The Silence: (Addressing The Stigma Around Mental Health) — Chapter Two
Written by Andi Bazaar | Sept 9, 2022
Fear of being judged can be very powerful especially in our culture, where what the group thinks of us can matter so much but denying a loved one an opportunity to get better simply to keep face is not a good reason.
Important issues are coming up here, so I thought I’d tell you some of the things I know. "What leads to suicide and how can we prevent it?" Occasionally suicide is related to situational factors but most people who attempt or complete suicide have a mental illness.
The major killers are: chronic depression, bipolar disorder and schizophrenia.
All of which can take people into states where they will take their own lives, that’s not saying that stress doesn’t matter as a key element in managing a mental illness is managing stress, a change in routine, a death in the family, a new job, can be deadly.
"Mental illness not only kills but it exacerbates income inequality, many of our homeless people are mentally ill and mental illness often coexists with substance abuse including opioid addiction but mental illness knows no boundaries."
It doesn't care what your wealth or income is, whether you have a PhD in economics or an 8th grade education. Most people know it exists somewhere in their own extended families but we don't talk about it a lot, my mother had bipolar disorder but she didn't tell her own sisters what was going on in her life at least in terms of mental health.
For people working in education or anybody, for that matter it's important to know where people can go to get help if they need it.
In the US, NAMI is an important resource, they have support groups for people with mental illness and for the families of people with mental illness plus are a very useful source of information.
Helping a family member or friend in need may involve knowing the law and knowing your way around the health care system, so be prepared.
Our students are at a particularly vulnerable stage in their lives, both graduates and undergraduates. Onset for many people can be late teens or early twenties, watch for changes in behavior.
a) "chronic depression" is very debilitating, at worst people with it can have a hard time performing basic functions and organizing their thoughts.
b) "bipolar disorder" has the depression but also periods of mania, hypomania can be a highly productive state, but can advance into more severe mania or psychosis, which is highly disordered.
c) "schizophrenia" can come with delusions, psychotic breaks, etc but that's only a rough outline.
d) "mental illness" can be very difficult to diagnose and treat but many people can live highly productive lives with it if they get treated and comply with the treatment which is another issue.
On campus find out what facilities are available, so you know where to send students if you encounter someone in trouble. Typical student health services have psychiatrists, for a person who is suicidal you need to act quickly as the best place for the person may be in the hospital at least temporarily.
"having suicidal thoughts is bad, having a plan for how to carry it out is worse and requires immediate help."
In part because of the stigma associated with mental illness, we tend to think it is associated with professional or personal failures or disappointments but many people suffering are highly functional and successful.
This makes it particularly insidious, as the ability to perform at high level may make it harder to seek treatment and for friends and family to detect there is a problem. The conflict between interior suffering and professional success may be very hard to manage.
I think one problem with high level academic research is that they are "totalitarian" in that research takes up the whole of your life, unlike most other professions there tends to be little distinction between the personal and the professional.
That’s probably why most of us love research but it takes a very real toll, which is hard to see if one is completely immersed in this world, at the same time being completely immersed is necessary to be successful. It is hard to maintain a balance.
PHYSICIAN MENTAL HEALTH AND STIGMA
Recently, I was told about an incident in clinic where our physicians were targeted by an irate patient.
The sentiment was that "physicians shouldn't take time off and they should be always available, they should be accessible 24-7. anything less is unacceptable."
One of our amazing docs managed to de-escalate the situation and while staff were shooken up, thankfully it ended peacefully.
However, this very sentiment and held by many including medical administrators, public also physicians themselves that we should be available 24-7 work as super-humans with very mortal limitations is the very reason we are in a physician mental health crisis.
Statistics show that physicians have amongst the highest rates of depression amongst professions, yet suffer in silence. The stigma associated with admitting one's mental health struggles, let alone seeking treatment continues to be pervasive.
In a culture that has not caught upto the idea that quantity does not mean quality, "how can we expect physicians to seek out the help they need?"
In a profession where we are writing letters and filling out forms for stress and mental health leaves for our patients, it is ironic how incredibly difficult it is actually to do for ourselves.
Because of shame, guilt and most frequently: "inability to find someone to cover your patients, we are at a time where physician morale in AB is at an all time low where locum requests are at an all time high, the thought of asking your colleagues to work more is unfathomable."
The culture needs to change, it needs to be okay to say you’re not okay. It needs to be feasible to access supports without stigma and physicians need to know they do not have to be superheroes.
“we are human and allowed to have human struggles too.”
I want to talk about medication stigma and why it is so big in our culture, given that most of our families have a pharmacy in their homes for every ailment imaginable.
“Why are meds for mental health so rejected?" let’s take a look!
First of all, when we are prescribed medications for something it becomes more real even with therapy our loved ones can simply convince themselves that we are going for self-improvement or an indulgence of the person attending therapy. The denial can continue.
It is much harder to continue that denial when meds are involved, it makes it more real and it also makes it more physical. Parents and loved ones cannot deny that as easily, therefore it is much easier to simply refuse it or try to stop people from trying it.
Then we have the argument that it is addictive, that’s because they may see online or in some people that they may take it for years but that’s not because it is addictive it is because it may be needed for that long. It is easier to simplify and say it is addictive.
The stigma is also an avoidance in terms of taking responsibility, if you recognize that your child needs meds in order to get better and you were a big source of that, then it becomes harder to deny it. That guilt can be too much to deal with.
Then there is the fear of others: "we are scared that the person taking meds may run into neighbours, extended family, members of the community when they go to the pharmacy or if the meds are just visible in the house because then others may judge us."
Fear of being judged can be very powerful especially in our culture, where what the group thinks of us can matter so much but denying a loved one an opportunity to get better simply to keep face is not a good reason. Medications literally save lives.
Then there is the responsibility that healthcare providers have, so many of them believe in that stigma and try to sway people who may needs meds away from them especially if they haven’t received adequate mental health training in their medical degree.
We all have relatives who are doctors and some of them may be too ignorant about mental health to give it much importance, they may be less likely to give medications as options because to them it likely much less important.
There are so many other factors that can contribute to this stigma but these ones are what I encountered the most when it comes to reasons why people were discouraged to explore medications to improve their mental health.
While it is true that meds may not be for everyone and that just like everything else, there are pros and a few cons it can be lifesaving and help us get out of severe mental health issues allowing us to function enough to get therapy and go back to work/school.
A big thank you to the wonderful Jwan Höffler Conwall for asking me to address this topic, hope you all have a great weekend x
A SPECIAL THANKS TO:
- Dr Oliver Schofield (Consulting)
- Dr Seth Gryffen (Consulting)
- Henrie Louis Friedrich (Analyst)
- Clayton Euridicé Schofield (Editor/Journalist)
- Timothée Freimann schofield (Photographed)
- José Schenkkan and Benjamin Schenkkan Joseph
- In appearance: Jwan Höffler Conwall (Model)
