MENTAL HEALTH | May 1

The Face of Mental Illness is Not What You Think

Brianna Valleskey

THE FACE OF MENTAL ILLNESS

48.5 million. That’s number of Americans who suffer from some form of mental illness. One in five people. If you’re like me, then you’re the one. But that also means that at least one of your closest 10 friends has also experienced a mental health issue. More Americans experience mental health challenges than diabetes. Yet, despite this commonality, we tend to feel so alienated in our individual struggles with it.

How can this be? History is no stranger to mental illness. Documented accounts of Abraham Lincoln led modern clinicians to conclude that he suffered from depression most of his life. Vincent van Gogh’s letters to his brother Ted reveal his never-ending struggles with anxiety and depression. Many published works discuss the mental illness struggles of Sir Isaac Newton.

What’s more, public figures often share their experiences. Doing so not only demonstrates to the public that people with mental illnesses can be highly successful, according to Weill Cornell Medicine clinical psychiatry professor Richard Friedman, but also that mental illness is nothing to be ashamed of. In a 2008 viewpoint essay, Friedman cites Nobel Prizewinning economist John Forbes Nash (schizophrenia); actress Brooke Shields (postpartum depression); football great Herschel Walker (dissociative identity disorder); and public figures such as Betty Ford (alcohol and painkillers) and Tipper Gore (depression). Even more recently, celebrities like actress Carrie Fisher, model Chrissy Teigan and recording artist Kid Cudi have opened up about their challenges.

To better understand why the stigma around mental health exists, I spoke with Dr. Wendy Stanyon. A researcher and mental health nurse at the University of Ontario Institute of Technology, Dr. Stanyon believes being aware of mental illness is now a life skill. She gives presentations for governments, social services, police and even higher education institutions. Her goal is to normalize the topic.

“These people are your CEOs of Fortune 500 companies. They are probably your doctor, your lawyer, your child’s teacher,” she explains in her presentations. “It’s likely not the disheveled gentleman on the street corner who is mumbling to himself. He may or may not have a mental illness. But that is not the face of mental illness.”

A MISGUIDED MARK OF DISGRACE

Indeed, the face of mental illness has been largely misrepresented by both public and private entities. Misconceptions about mental illness and treatment are predicated by widespread myths and prejudice. Even the news media are not immune to it, according to researchers Susan G. Lazar, Glen O. Gabbard and Elizabeth K. Hersh in a 1993 report titled The Press’s Portrayal of Mental Illness.

“Both historically and more recently in the context of debate about national health care reform, the nature and magnitude of the nation's mental health needs have been grossly misunderstood by the general public,” they write.

People are scared by what they don’t understand. Like diabetes and hypertension, psychiatric disorders can be treated, but not cured. What makes mental illnesses different from physical ones, Richard Friedman explains, is that their symptoms are changes in thinking, feeling and behavior (as opposed to symptoms like a fever or rash).

“It’s frightening for people that we’re talking about our mind and our thoughts,” Dr. Stanyon said. “So they try to identify the face of mental illness and say, ‘That’s not me.’” She went on to say that while people are trying to protect themselves, having an “us vs. them” attitude only perpetuates the stigma.

Hollywood also has a part to play in telling the story of mental illness. Classics like Psycho and The Silence of the Lambs link mental illness to aggression, violence and criminality. National surveys show that 60-80% of Americans think people with schizophrenia would be violent toward others. In reality, studies have shown that only 18% of people with psychiatric disorders commit at least one act of violence in a year, and less than 3-5% of U.S. crimes involve people with mental illness. Instead, substance abuse and environmental factors contribute to violence much more often than a psychiatric disorder.

“The fact is that you have far more to fear from an intoxicated businessman in a suit than from a homeless schizophrenic man muttering on the street corner. This is not something most people know, because a drunken disorderly man in a suit is not deemed a newsworthy event, but the rare schizophrenic who acts violently and gets arrested is likely to find himself on the front page of a local newspaper,” writes Friedman.

Despite the evidence, the public’s perception is still skewed when it comes to mental illness, considering it a character flaw at best, and a mark of disgrace at worst. This stigma makes the challenge of mental illness twofold: a struggle to live with the disease, itself, and a struggle from the stereotypes and prejudice that result from the stigma.

HOW WE CAN REDUCE MENTAL HEALTH STIGMA

Dr. Stanyon tells her audiences that they don’t have to be a psychologist or a psychiatrist to help somebody who’s challenged with a mental health issue, just like they don’t need to be a cardiologist or heart disease specialist to compress someone’s heart between their breastbone and spine for CPR.

“If the average person can do that, then the average layperson can use their words to make a difference for [mentally ill] people,” she told me over the phone, adding that she encourages people to consider how they can learn to better interact with those who are challenged. Her strategy is effective. Research shows that people who better understand mental illness are less likely to endorse prejudice and discrimination.

Researchers, educators and mental health advocates do their best to normalize mental illness, but the real impact will come from us. I am one of the 48.5 million. And if you are, too, then this article is for you. Here’s what we can do to stamp out the stigma around mental illness.

Prioritize your mental health. More than 70% of people who suffer from mental illness receive no treatment. But research has proven both the efficacy and cost effectiveness of proactive mental health care. Dr. Stanyon also recommends a focus on mindfulness. Studies show that mindfulness can reduce stress, decrease emotional reactivity, increase cognitive flexibility and boost focus. Click here for free resources on mindfulness from the University of California, San Diego.

Recognize your strength. Research compiled by the American Psychological Association shows daily acts of self-care and stress management such as exercise and journaling about stressful events can positively affect your well-being. But even so, Lazar, Gabbard and Hersh explain that depressed patients experience more limitations on functioning than those with arthritis, diabetes, hypertension and heart disease. Dr. Stanyon believes most people with mental illness are stronger than many other people. “They’ve faced adversity. They have to do better. They have to succeed more than other people who don’t have a label,” she explained. Remember that you are stronger than you think.

Speak up. Dr. Stanyon encourages people -- when they can and when they feel strong enough -- to speak out about their challenges. Many people say that helps them, because they feel like they’re educating people on the reality of mental illness by coming out of the shadows and talking about it. We can address the issue head on by educating the public about the true face of mental illness. Our faces. Many may never get to a place where you feel comfortable to speak publicly, and that’s totally ok. You can also help by pointing out misrepresentations in the news and other media.

Find community. The National Alliance on Mental Illness offers free resources for finding support within your area. You can also utilize an app-based support network like Stigma, to connect with peers who are dealing with similar issues. Their mission is simply to help people optimize their mood through data and support, while simultaneously reducing the stigma around mental health. “Can someone do it absolutely, totally alone? No. We need to have much more of a sense of community,” Dr. Stanyon told me. Today, over 150,000 people have used Stigma to track their mood, write journal entries, and connect with supportive pen pals and support groups. Build your own circle of support, by whatever means you feel most comfortable with.

Know that you are not alone. We are with you. I am with you.