Saturday, August 13, 2005

Stamping Out the Stigma of Mental Illness

I don’t get it.
It’s not a big deal.
I have depression.
I was diagnosed with it over twenty years ago.
I take medication to replenish my brain chemistry with serotonin and I have been in talk therapy too. My life is meaningful and I have a sense of contentedness because of the combination of these therapies. It’s not a mark of shame or a character flaw that I have depression. It’s a genetic, biochemical, physiology illness. I just wish the rest of the world could learn the facts correctly.

The Myths that Society Holds About Mental Illness [1]

Even though technological advances have proved that mental illness has physiological origins, much of the world continues to hold disparaging views on the subject. These myths need to be discredited so that those who experience mental illness can come out of the shadows and pursue the treatment(s) that will give them a greater quality of life.

MYTH: Mental illness is not a true medical illness like heart disease and diabetes. People who have a mental illness are just "crazy."
FACT: Mental illness is a physiological illness, like heart disease and diabetes. Research shows there are genetic and biological causes for mental health illnesses, and that they can be treated effectively.

MYTH: Mental illness does not strike the "average person."
FACT: Anyone can potentially develop a mental illness, no matter sex, age, race, or economic status.

MYTH: If someone looks or acts odd it means that you need to be concerned about the potential for violence.
FACT: Contrary to popular beliefs, individuals with mental illness are no more prone to violence than the general public, and in fact, are more likely to be the victims of violence than the perpetrators.

MYTH: Mental illness is a result from a personality weakness or character flaw, and people could just snap out of it if they tried hard enough.
FACT: Mental illness has nothing to do with being lazy or weak. It results from changes in brain chemistry or brain function. Medication and psychotherapy often help people to recover.

MYTH: Depression is a normal part of the aging process.
FACT: It is not normal for older adults to be depressed. Signs of depression in older people include loss of interest in activities, sleep disturbances and lethargy. Depression in the elderly is often undiagnosed, and it is important for seniors and their family members to recognize the problem and seek professional help.

MYTH: Depression and other illnesses, such as anxiety disorders, do not affect children or adolescents. Any problems they have are just a part of growing up.
FACT: Children and adolescents can develop mental illnesses. In the United States, one in ten children and adolescents has a disorder severe enough to cause impairment.

MYTH: Most people with a mental illness are receiving treatment.
FACT: Only 1 in 5 persons affected with a mental illness seeks treatment.

MYTH: If you have a mental illness, you can will it away. Being treated for a psychiatric disorder means an individual has in some way "failed" or is weak.
FACT: A serious mental illness cannot be willed away. Ignoring the problem does not make it go away, either. It takes courage to seek professional help.

MYTH: Mentally ill people cannot lead productive lives.
FACT: People with a mental illness who receive treatment with therapy and/or medication can live full, enjoyable and productive lives. In fact many high profile people, including Abraham Lincoln, Patty Duke, Sheryl Crow, Sir Isaac Newton, Lorraine Bracco, Buzz Aldrin, Ernest Hemingway, George Stephanopolous, Mariett Hartley, Michaelangelo, Jane Pauley, Harrison Ford, Brooke Shields, James Taylor, Rosie O’Donnell, Dick Cavett, Alma Powell, Halle Berry, Dick Clark, just to name a few, have been very successful in their chosen professions.

Effects of Stigma

It is the 21st century, and though evidence-based research has shown us that mental illness is a real medical disorder, stigma is on the rise instead of on the decline. David Satcher, Attorney General of the United States writes, “Stigma was expected to abate with increased knowledge of mental illness, but just the opposite occurred: stigma in some ways intensified over the past 40 years even though understanding improved. Knowledge of mental illness appears by itself insufficient to dispel stigma.” [2]

It is an undisputed fact that individuals who experience mental health issues are often faced with discrimination that results from misconceptions of their illness [3]. As a result, many people who would benefit from mental health services often do not seek treatment for fear that they will be viewed in a negative way. The World Health Organization agrees and says that in the 400 million people worldwide who are affected by mental illness, about twenty percent reach out for treatment [4]. The World Psychiatry Association began an international program to fight the stigma and discrimination many people hold toward individuals who have mental health issues. The 'Open the Doors' program has since been implemented in more than 20 countries and involved roughly 200 different anti-stigma interventions [5]. But more needs to be done.

Teachable Moments

I have spoken and written about the stigma of mental illness, offering my views professionally in the field and personally as an individual with depression. I have been grateful for the academic journals that have published my work, and the numerous media agencies that have reached out to me as an expert in this subject area. I have also consulted with writers and journalists to ensure that mental illness and psychological issues are properly depicted in fiction and non-fiction work. These venues are very signficant in educating the public about mental illness.

But there are many ordinary moments that allow me to correct ill-formed views. I find them at the bus stop, the supermarket, on the bank teller's line, at social gatherings, and even in professional conferences. Whenever I hear misinformation about mental illness, hear a joke or a derogatory remark, with tact and sensitivity I correct the situation. These teachable moments make me feel that my voice, though singular, can raise awareness. I don't hide in shame or recoil about my circumstances. Instead, I am confident and brim with information to help others realize what is so wrongly represented in our world about mental illness.

It is my personal hope and my professional goal to keep the anti-stigma momentum going.

Resource Links

National Mental Health Association

National Stigma Clearinghouse

World Federation for Mental Health


[1] National Alliance for Research on Schizophrenia and Depression (2001).
[2] Satcher, D. (1999). Mental Health: A report from the Surgeon General. Washington: Department of Health and Human Services.
[3] Corrigan, P. & Lundin, R. (2001). Don’t call me nuts: Coping with the stigma of mental illness. Chicago: RecoveryPress.
[4] World Health Organization (2005). Mental health atlas.
[5] Lopez, J.J. (2002) The WPA and the fight against stigma because of mental disease. World Psychiatry, 1(1):30-32.


kath said...

Maybe its because it is hard to believe that an abyss has an escape hatch, because so many promises have actually been lies in the past?

scribble said...

thank you for this..
always an educational and comforting time to visit you here

(formerly of a blog named
grey matter oozing.)

Heidi said...

Your entries are always informative...It's been a few weeks since your last, I check daily. ..This was well worth the wait and thankyou...There is so much more I want to say...Debating if i should...What's others think..that's the problem.

kath said...

It is not what others think so much as what the drugs do.. I tried one once.. I was so far into the abyss I could barely work..

I felt like my psyche was wrapped in cotton .. my "feeling" "knowing" "intutuition" was turned off.. I felt blinded, and blindsided.. could barely reason..

nope.. not for me.. *flush*

I just try to have a ladder with me at all times..

Dr. Deborah Serani said...

Dear Georgia,
So glad you find this info helpful and comforting.

Dear Heidi,
Blogging is sharing as far I see it. So feel free to share your thoughts and feelings.

Dear Mckait,
Medication is not for everyone. Medication should never leave you feeling worse or "not yourself". Keeping a literal and figurative ladder is great!


I n g e r said...

Nice pic, Deborah! You're younger than I'd thought.

Love this topic, too. I take it as a personal point of pride that I've converted everyone in my family to believers in talk therapy and medication for depression. Think globally, act locally...

Dr. Deborah Serani said...


I'll be 45, but I feel "95" some days. Wish I could be "5" alot of days!!

Nancy said...

This was a good post Deborah. You got it all out there. My hub has been on meds for years and believe me, when he is off, it is obvious. I took Effexor for a few years and it helped so much. I no longer take it, but I know if I ever need it again, it will be there.
I have a brother who would benefit from antidepressants. He is the grumpiest 44 year old ever. He won't because of the off chance he may not be able to get an erection. Cuz, that's what he thinks with. It's a shame really. He used to be such fun. Now he is a stick in the mud!
Thanks for posting this, it was very imformative!

Radin said...

Interesting blog and thanks for it. I am Bipolar but personally do not care about what others say about mental problems anymore though I had my share of problems due to this stigma even from my very close family members and it has ruined many things. Many others are badly affected by it, too. It needs a global effort to make people aware of the facts but it is worth it because it is part of the treatment itself. Many people with problems like that can be better helped if there is more understanding from the public. Thanks for your efforts.

Dr. Deborah Serani said...

Dear Nancy,

It's hard to think of the compromises when medication &/or therapy are needed. Some people can make the choice easily while for others those trade-offs are not an option. I'm glad you had a good experience.

Dear Radin,

I agree more global efforts needs to occur. Stigma is so hard to break. Many people, even loved ones, still don't "get it". But, as I said, let's keep the momentum going.


duskydawn/blogaholic said...

hi dr.deb.
thank you for your kind comments over on my blog. i want to thank you for posing info that you post. unfortunately, i'm in a relationship where he dosen't believe in seeking help for any issues. it's very stressing to know your significant other will not support your efforts.he's especially into the one where it'll just go away if you want it bad enough. so misinformed he is. oh well

for_the_lonely said...

I am glad that I have found your blog through Annie's. I suffer from panic attacks ( have had them for 9 years now), and agoraphobia has kicked in hard since March. I have had bouts of agoraphobia since having my panic attacks, but this is the worst case yet. In the last five months, I have only been outside five times. There is a lot that I could tell you, a lot that I want to share with you...just trying to seek help and strength through the muck of it all...again, I am so glad that I have stopped by your blog. I feel that this will be of great help for me.


Dr. Deborah Serani said...

Dear DuskyDawn,

I know it can be tough to get someone you love to the therapy door &/or that they don't see the value in it as you move through therapy. Just keep doing what your doing!

Dear for_the_lonely,

Panic attacks and agoraphobia are so constricting. . . and terrible to endure. You should find a therapist in your state/count/town that specializes in these, so that you can find mastery and relief.


Sher said...

Enjoyed your topics, especially the 13 things about Health Insurance and your letter to Tom (did you get a reply?).

Thanks for the visit as well.

45? Look 37 to me!


Dr. Deborah Serani said...

Dear Sher,

Didn't hear back from Mr. Cruise, and didn't expect to...liberating to write the letter, though. Managed healthcare is a pet peeve for so many reasons.


Heidi said...

Dr. Deb/ Deborah..(not sure what u would prefer to be called.)

I was just wondering if you would be up to taking suggestions for your blog entries for topics of discussion?

Dr. Deborah Serani said...

Dear Heidi,

Please call me Deb or Deborah. I think your idea for topic suggestions from you and other posters would be great! What interest(s) do you have?

I write about things that are important to me and/or that I feel would widen the psychological scope for others. I am working on a post called the "Anniversary Effect," which focuses on conscious and unconscious awareness with dates throughout the calendar year.


Rue said...

Hi Deborah. Thatnks for your comments on my blog. I am sorry current events have made you so ill. I posted back if you care to go read what I said. Hang in there. I have to believe things will get better.

As to depression..I wish I could convince my common law husband to get assessed. I am convinced he suffers from this. His mother does and had only recently been medicated for it. *shudder* she's 75! I don't want to think that he and then of course, 'we' will suffer with this that long. I don't think anything I say will convince him he made need help. He has highs and then lows...very little balanced times. Sound familiar?

Heidi said...

Deborah I'm glad you approve of my suggestion :)

How about a topic of Body Image issues for woman...It's no secret that's a tad of a problem for me.


Sher said...


Yes, decisions. I'm stuck (as you read). And I'm sure you have people pouring their hearts out to you once they know what you do for a living, so I don't want to do that. Let's just say that I feel stiffled. Not fulfilled, not happy where I am in life. Mid Life crisis? I swore it wouldn't happen to me....Bonk! Hit me on the ol' noggin.

Angry that I didn't make other choices in life.

We'll see where this takes me...

Have a good weekend.


Dr. Deborah Serani said...

Dear Heidi,

I will do a post on body issues. Look for it in September.

Dear Sher,

I left you a comment on your blog, where I visited before.


Grumpy Old Man said...

Mental illness is so widespread that one would think it's either causes by an infectious agent or is an adaptive polymorphism--kept in the gene pool because people who have an unexpressed gene for it get some advantage from the gene.

Otherwise, it would die out.

(I'm a depressive myself. Miss hypomania, but not the depressive trough).


Dr. Deborah Serani said...

Dear grumpy old man,

Your theories hold great significance not only to me, but many researchers as well. I have never heard anyone say they miss depression over hypomania. BTW, you're not grumpy or old.


Jo said...

Hi I just came across your site recently and just read this post - so hopefully you will see it! I have depression and I'm going into clinical psychology. I think it is very courageous for a clinician to speak out about her personal experiences. If an employer asks whether you have a mental or physical conern that might potentially interfere with your work - what would you say? There is a tendency I find, even as a psych student, that people don't find you as "credible" when you tell them that you have a mental illness. Thanks!

Dr. Deborah Serani said...

Dear Jo,
I *did* find you. Sometimes I stroll down memory blog lane...

I have never been asked directly about mental illness but would probably say, "Dont' we all have something" to the interviewer. Becasue, we all do. I hope that you too will join in the fight to debunk stigma. There's nothing more comforting that sharing "the real story". It allows others to be unafraid and get the help they need (Save for Tom Cruise and other Scientologists).

Good luck in your pursuits!!!

Laura said...

I just discovered your blog and am finding it quite enjoyable and informative!

I, of course, have no argument with the facts on the stigma of mental illness, but the myth on "willing" ourselves out of depression made me think of other research on neuroplasticity. I find it fascinating that scientists are finding that we really can change our organic brain structure by using our brains differently. I think that there is some promising evidence in the treatment of schizophrenia? Have you done any posting on this? I'd love to see your take on it.

Please don't misunderstand me, I'm not suggesting this means that people can just will themselves out of depression because of this, but it opens up a lot of possibilities for new treatments.

And, to Grumpy Old Man,

This is another area of research I find fascinating. There ARE infectious agents that can cause mental illnesses. The studies on strep infections and OCD in children are particularly interesting and there is also research on the possibility of personality changes caused by toxoplasmosis infection.

Ron in Houston said...

Hey Dr. Deb -

Long time reader but never commented before.

I think that this is an area where much, much more needs to be done. Our culture still stigmatizes mental illness.

I've seen marriages saved by anti-depressants. I've seen people practically ruin their lives by persistent untreated depression. I've even had a client commit suicide.

I always tell people that you would take thyroid hormone or insulin to treat an metabolic imbalance, why won't you treat a serotonin imbalance?

Anyway, thanks for this post. I hope a lot of people read it.

Dr. Deb said...

Dear Laura,

Thanks for stopping by.

Dear Ron,
YEs, if one can wrap their mind around diabetes as an illness and take meds for it, why not a brain illness like depression, ocd, etc.


Joy said...

Stamp it out. Amen.