UNDERSTANDING THE STIGMA THAT SURROUNDS MENTAL HEALTH

- A middle aged woman revealed she hasn't even told her husband that she has intrusive thoughts that
their son will die because he once called her "crazy".
- Father of a 19 year old with Body Dysmoprphic Disorder expressed how he feels she'll get better if she
tried hard enough and did yoga and meditation.
- A 27 year old man shared that he doesn't feel comfortable talking about his problems with his friends
because they "judge" him for that and tell him he's weak.
-A man in his 30s needed a mental health certificate for his office but requested that it should mention
only "stress related issues" and not his actual diagnosis.
-A recently married woman's husband got her to India from the U.S to get her treated for her OCD. He
then went back and never came back for her because he felt that "she wouldn't get better ever".

These are some of the examples of patients I've seen as a psychotherapist over the years. These are the
patients who're still trying to seek treatment. Whereas there are many others who are suffering in silence
due to the stigma, prejudice and discrimination that surrounds mental health. So let's understand the
stigma a bit more.

Why is there stigma around mental health?

 Trickle down effect of past beliefs and attitudes - In ancient times, mental illness was associated
with being possessed by the devil or evil spirits. A few decades later, it simply started being
understood as criminal or anti-social behaviour. We may not hold those views today but some of
those beliefs and attitudes have crept in our current understanding of mental illness.

 Stigma breeds stigma- People generally don't open up about any psychological problems or
psychiatric issues that they may be facing. Statistics suggest that 1 in 4 people suffer from a
mental illness at least once in their lifetime. But when we look around us, we don't see as many
people who are dealing with mental illness. That's because everyone avoids opening up about it
for fear of being discriminated against. When people who are close to us, who we can relate with,
don't share their mental health struggles, we don't understand these closely. Mental illness
continues to be a mystical thing which we're not fully familiar with.

 Manifestations of mental illness- How is mental illness manifested? Its signs and symptoms show
up in thought, emotion, and behaviour. These are the three dimensions that make up our
personality. When someone's thoughts, emotions or actions change, we assume that the person
has changed. We criticize them for being a certain way. We may even think of their illness as a
character flaw. Because we associate their illness as a part of who they are, we aren't able to
encourage them to get the help they need.

 Impact of Media- For a long time, media has portrayed mental illness irresponsibly. Whether it is
glamorizing the illness of addiction, or showing mentally ill people as violent and unstable, it has
painted a picture that has led to multiple prejudices against people with mental illness. For every
few movies that get it right, there are several others that taint our understanding of mental health,
 ultimately establishing unhealthy stereotypes. Due to the reach and influence that media has in
our lives, the stigma it creates is quite pervasive.

 Lack of understanding- The use of the term "abnormal" that is often associated with mental
illnesses misguides us to believe that it's not normal to experience these. Also, not many people
come forward and talk about their mental health struggles. Since, there is so much talk about
physical illness all the time, people are very well aware and can easily identify these illnesses. On
the other hand, amongst mental illnesses, mostly people are aware only about depression, phobia,
OCD, etc. The fact is that there are 300+ psychiatric disorders. Of course, it's not possible to
identify or understand something you don't even know exists.

What are the consequences of stigma?

 Fewer people seeking treatment- This is by far the worst consequence of stigma. Like any other
illness, people suffering from mental illness need treatment. As they are aware of the society's
attitude towards people with mental illness, they may never come forward to seek treatment.
They may suffer silently and in fact, their problems might exacerbate when left untreated. Their
illness may also affect their self-care, their relationships, their livelihood, etc.

 Reduced social support for persons with mental illness - Many people experiencing mental illness
don't open up to family and friends for fear of being judged or being labeled "crazy", "mad",
"mental". Any psychiatric disorder is considered a biopsychosocial illness which means that even
the treatment needs to be in all these aspects. The lack of social support from family and the
larger community can prove to be an impediment in the person's recovery even if they do come
forward to seek treatment. Moreover, many psychotherapeutic techniques require family support
and encouragement which is also a hurdle.

 Fewer mental health professionals- Being a medical professional is considered a noble profession
in our country. It is celebrated and people motivate their children to become doctors. On the other
hand, many people actively discourage their children to take up mental health as a profession
because they fear that it'll have a negative influence on their mind. Because of fewer patients, this
is not considered a field which has a good scope. Many people aren't even aware that a separate
qualification is required to become a psychologist. Most are clueless about somethings as basic as
the difference between a psychiatrist and a psychologist.

 Fewer laws- People suffering from mental illness are at risk for exploitation, abuse and violation
of basic human rights. Though there have been reforms in laws and policies regarding mental
health care in recent times, these are not as comprehensive and water tight as those with regards
to physical care. This is simply because as a society, we are yet to focus clearly and decisively on
mental health issues. There are hardly any health insurances that cover mental illness. This again
discourages patients to seek help.

What can we do to reduce the stigma?

 Seeking help: Those experiencing mental health struggles need to come forward and seek help
through the right channels. This will go a long way in normalizing mental illness for those around
 them. When those who are close to us are experiencing mental health struggles, it's easier to
relate with and understand these.

 Educating oneself and others- Self advocacy is a trait that's helpful in many areas in life. It's also
one that can help reduce the stigma surrounding mental health. People who're dealing with mental
health issues need to educate themselves and those around them about what it means to have a
mental illness, the symptoms, causes and treatment needed for the illness, etc.

 Forming support groups- People with mental health struggles can stick together and provide each
other with the social support they need if it's missing in other areas in life. Together, they can also
take up the cause of mental health awareness by engaging in social media campaigns, writing
informative articles/blogs, planning mental health initiatives, etc.

 Not letting your illness define you- Your illness is a part of you, not your whole identity. People
should try to say they are suffering from depression rather than saying they're depressed. They
should say they have schizophrenia rather than saying they're schizophrenic. Mental health
professionals should follow the same.

 Not making jokes about mental illness - Mental illness is no joke, just like physical illness isn't.
Casually saying "I'm bipolar" or "I'm OCD" is not humorous. These are serious illnesses that
affect millions of people. Joking about it plays right into the faulty stereotypes created by the
society.

 Equating mental illness with physical illness - It seems like a no-brainer that any kind of illness is
an illness. But this can't be stressed enough when it comes to mental illnesses. Just like a fever, a
viral infection or a gastritis episode is not a character flaw; an episode of mental illness isn't as
well. We don't shy away from going to the doctor when we have an ear infection or an allergic
reaction. We might even post it on our social media and share that information with friends and
acquaintances alike. We need to do the same when it comes to mental illness. Whatever the
origin, an illness is an illness and needs to be treated as such.