Overcoming the Stigma of Mental Illness

“Kanye West Is Hospitalized for ‘Psychiatric Emergency’ Hours After Canceling Tour” – nytimes.com

“Fort Lauderdale Airport Shooting Suspect Esteban Santiago Said He Heard Voices” – nbcnews.com

Suicide wave grips Columbia.” – nypost.com

 

These are headlines we’ve all seen in the last several months, but we’re still not talking about mental illness. So now I propose the question: Why is mental illness such a stigma? Why is it such a foreign concept the brain can get injured like any other organ? If the heart stops pumping causing a myocardial infarction (heart attack), we send flowers and get-well balloons. If someone has end stage renal disease and needs dialysis three times a week, we sit with them and hold their hand through the 4-hour process. Yet when someone complains of depression, we tell them to shrug it off and things will get better. If someone reports hearing voices, we exile them from our lives and communities.

So………I have a confession.

Prior to my psychiatry rotation, upon hearing terms like “schizophrenia,” “ADHD,” and “eating disorder,” I would immediately create a mental image of the affected person. Every psychiatric illness I was familiar with was subconsciously associated with certain characteristics; gender, race, socioeconomic status, etc. During the first day of my psych rotation, my attending told me to interview a bipolar female who had just been admitted. When I introduced myself to her, she said she was 24 and a PhD student. I’m ashamed to admit it, but I was shocked. This was so close to home. We were similar ages and at similar stages in our education, but she had just been committed to a psychiatric hospital for paranoia and auditory hallucinations. A week later, another bipolar patient who was an Ivy League graduate shared his difficulties dealing with his depression stages during his undergrad education. Because mental illness is so rarely discussed, I formed assumptions that I soon recognized had negative connotations. The worst part is I know I am not alone.

Until we normalize this topic, those who are affected will be ashamed to speak up when they start experiencing symptoms. Let’s start by tackling the most common psychiatric illness: DEPRESSION. Depression is the most common psychiatric disorder in the general population and only 50% of adults are diagnosed (1). Undiagnosed depression leads to decreased quality of life, increased risk of suicide, and a negative impact on family and friends. Only 25% of adults with mental health symptoms feel people are sympathetic to mental illness (2,3). We cannot allow individuals to feel alone, because when they feel isolated, suicidal thoughts begin to from and eventually lives are lost. How many lives will we allow to be taken that could have been prevented with a simple question?

“How are you really feeling?”

 

Let’s talk medicine:

1. Common Mental Illnesses

  • ·    Major Depressive Disorder
  • ·    Substance Abuse
  • ·    Anxiety Disorders
  • ·    Attention Deficit/Hyperactivity Disorder (ADHD)

  • ·    Schizophrenia
  • ·    Eating Disorders
  • ·    Post Traumatic Stress Disorder
  • ·    Sleep Disorders
  • ·    Personality Disorders
  • ·    Bipolar Disorder

 

 

 

 

 

 

2. Signs of depression:   SIG E CAPS

  • Sleep changes: increased sleep during day or decrease sleep at night
  • Interest: loss of interest in activities they previously enjoyed
  • Guilt: feelings of guilt or hopelessness
  • Energy: lack of energy
  • Cognition: reduced concentration
  • Appetite: usually decreased, occasionally increased
  • Psychomotor: anxiety or lethargic
  • Suicidal thoughts/plan

Many times these symptoms can occur in periods of times when people are expecting personality changes. (i.e teenage years, transition into college, times of financial hardship). If you see a change in behavior, take a minute to speak to the person and ask if they’re feeling these symptoms. Ask about possible recent traumatic events. Ask how you can help.

3. Don’t be fooled

Most antidepressant medications take 4-6 weeks to take effect. People who may have had suicidal ideations prior to beginning medications may not have had the energy to carry out the plan. Medication in combination with continued feelings of hopelessness, will give them the energy to carry out their plan. If you see any increase in energy or newfound happiness, stop and ask questions! Don’t assume they’re doing better.

Watch Devon and Marissa (RWJMS ’18) speak about their experience with mental illness. 

 

Sources

1. Kessler RC, Ormel J, Petukhova M, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 2011; 68:90.

2. Wahl OF. News media portrayal of mental illness: implications for public policy. Am Behav Scientist. 2003;46:1594-1600

3. Substance Abuse and Mental Health Services Administration. Developing a stigma reduction initiative. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; 2006.