This will be the first of three posts I will do over the next three months. I want to examine some issues around mental illness – firstly some myths, secondly, mental illness and the Gospel and finally, a bit of a surprise (code for I’m still working on it!!!).
I think we have come a long way in understanding and dealing with mental illness in the past 20 years or so. We have a little way to go, but the days of frontal lobotomies, deep sleep therapy and acts such as the Dangerous Lunatic Act 1843 are behind us.
However the discrimination, for my view, has been the last to change. Misperceptions remain in the public domain and are perpetuated by many, including those who mean well. Discrimination, also, remains. Think of how it would be for you or those you know to approach your employer and disclose a mental illness.
So what are some common myths about mental illness? (Statistics will be from the National Institute of Mental Health (USA) and Mindframe (Australia))
Myth: True mental illnesses are actually quite rare
Reality: One in five of us this year will suffer a mental illness. Lifetime risk is one in two.
Myth: Most mental illnesses occur in older adults, not young people.
Reality: Prevalence of mental illness decreases with age, with prevalence greatest among 18-24 year olds.
Myth: People with mental illness are dangerous and violent.
Reality: There appears to be a weak statistical association between mental illness and violence. This seems to be concentrated in certain subgroups, for example – people not receiving treatment who have a history of violence, and those who abuse drugs or alcohol. However, the association between mental illness and violence is still weaker than the association between violence and alcohol abuse in general, or between violence and being a young male between 15 and 25 years of age.
Myth: Schizophrenia is a split personality
Reality: Schizophrenia is an illness marked by “positive” symptoms (hallucinations, delusions) and “negative” symptoms (flat affect, amotivation). Prevalence is about 1:100. A split personality is most often referring to what is now called Dissassociative Identity Disorder. It is marked by the presence of distinct personalities present in the same person and is often accompanied by amnesic states. Its prevalence varies greatly between cultures.
Misunderstanding about mental illness cause many people to say and do some pretty dumb things. I was working with a colleague one day and we were talking about various things, and the topic of mental illness arose. His comment, “Mental illness is just people bunging it on (Australian slang for pretending or not genuine. It’s just an attention seeking thing – mental illness does not exist”.
Come on gang – what is the dumbest thing you’ve ever heard anyone say about mental illness???
“Most folks are about as happy as they make up their minds to be. So just snap out of it and be happy.” Dude, if I could, I totally would. No one wants to feel so depressed every day that death seems like a more cheerful alternative. But I can’t snap out of depression anymore than my brother can snap out of MS.
Thanks for posting this. I am a physician and I get so tired of the pervasive attitudes so well illustrated above. It is amazing how hard it can be to persuade people to accept appropriate treatment for mental illnesses because of these cultural attitudes. There is so much unneeded suffering. You forgot the one where the friends tell the sufferer not to take medication because it is a “chemical” and instead take their unproven (or disproven!) “natural remedy” instead.
The list too long to even begin to pick a “dumbest.” However, all of the ones in your cartoon are certainly things I’ve heard!
I suppose the worst I’ve heard is along the lines of “Back in my day, we treated that with a swift kick in the pants, but now we coddle them. That’s what’s wrong with this country.”
It seems on this topic, the church is improving its empathy, at least as pertains to missionaries who are completing their missions early to maintain their mental health. It would be nice if there were natural breakpoints in missions every six months or so, then we could create even less stigma around shorter periods of service. One size does not fit all.
Let’s not forget this classic: “Despair cometh because of iniquity.”
AKA: “You’re sad because you’re bad!”
Happily, the Church has released some excellent advice to members and leaders re:mental illness.
https://www.lds.org/topics/disability/list/mental-illness
Today mental illness who’s genesis appears to be nurture can be greatly improved, even cured via psychotherapy. I have watched serious diagnosis’ dissolve in just a few hours of therapy using Davanloo’s Short-Term Dynamic Psychotherapy without going deeply into one’s uncomfortable childhood.
Mental illness who’s genesis appears to be either genetics or structural is generally “treated” with prescription drugs with varying (but mostly unimpressive) outcomes.
Excellent posts, all, especially the doctor “E” and his exasperation at folks that reject prescribed Rx in favor of ‘homeopathic’ remedies of dubious merit. I like the way #2 son (an engineer, like dear ol’ Dad and big Sis) puts it…”Can it be REPLICATED? If not, it’s mere anecdote, and therefore worthless.”
There seems to be a distinction between what the afflicted, be it physical or mental (due to the interaction, are they truly separate?), can do for themselves versus seeking treatment. I’m certain that treating mental illness as being completely solvable by a mere “attitude adjustment” is about as foolish advice as telling an overweight person to “just” excercise self-control. Having once more than resembled that latter remark, I can tell you that when a heavy dude I was probably exercising (literally, believe it or not) self-control at least as well if not better than my more svelte version today.
However, the trouble with the mental health as “illness” approach is that too many remove the role of personal responsibility. This, IMO, robs the afflicted person of his/her dignity, by in effect treating them as a helpless child.
Afficionados of the ‘Dr Demento’ show remember this little gem about mental illness…back when having a sense of humor was allowed.
The dumbest thing? Mental illness is the result of actions in the pre-existence, the individual’s or his/her parents’.
To list a few:
Just pull your socks up and get on with it.
Think positive.
Stop wallowing.
Get some grit.
“One in five of us this year will suffer a mental illness.” It’s scary to think that one of five mental health care providers is, himself, mentally ill. And if the lifetime risk is one in two, that means half the health care workers will suffer mental illness, too. Physician, heal thyself first, then help me.
I could never say that mental illness is non-existent nor something that should be treated lightly. However, my own personal experience has had 4 out of five of my children being diagnosed as “bi-polar” and medicated. It was clear they were having a tough time, but the medication caused many more problems than it resolved. 2 of them exhibit no symptoms of bi-polar tendencies, one controls his anxious moments by himself. And finally, my daughter is dead today as an indirect result of a mental illness diagnosis. So I am a bit skeptical of the epidemic diagnosis of depression and aggressive medication of our young adults.
Jeff, I’m so sorry for your loss. It’s impossible for me to know what happened in your daughter’s case, and I don’t pretend to be able to diagnose your children either. As a father and a human, I simply mourn. I can’t imagine what that must have been like.
Furthermore, I agree that medication is over-used these days, especially in an effort to make children more manageable in schools. We had an eye-opening experience with my youngest son in which his ADHD meds had the side-effect of making him more angry and aggressive. This happened at about the time young teenaged boys sometimes do that anyway, but it was quite a change for my goofy, grinning, runaway cyclone of a boy. He got in quite a bit of trouble – with legal ramifications – at school. We took him off the meds and the change in his behavior was amazing. Still hyper, still hard for him to focus, but no longer so angry and aggressive. We were lucky it wasn’t worse.
My own anti-depressants, which I believe have probably saved my life, have sometimes had a numbing effect on me. They keep me out of the depths, but they also reduce my sharpest highs, intellectually and emotionally. Sometimes I debate whether the price is worth it.
There are always trade-offs, it seems. It’s an area in which we’re never going to get much in the way of clear-cut answers. What we can do, I think, is avoid judgment – something I am singularly bad at doing, but am trying to learn.
Ah, found it! I knew I had read a decent blog post on this in the not too distant past. From the brilliant and very amusing author of “Just Say Amen Already,” the 800-pound gorilla of LDS gif blogs, comes the thoughtful What Not to Say. I think she’s got a good take on some of the questions the OP asks here.
#13 – for whatever reason, the hardest thing for any parent to do is to bury a child. Words fail to adequately express condolences and sympathies, but I do so anyway. Neither you or your children asked for what happened.
I’ve been affected by the mental sufferings of another, but legal concerns preclude discussion.
It’s all well and good to quote Ether 12:27 – but to me it would seem like we’d have a real Jerk God to allow serious mental illness for purposes of growth. Since I don’t believe that our Heavenly Father could be characterized as a “Jerk”, I see it as rather a trial, not unlike plagues or other ‘physical’ afflictions. Too easily we attempt to compartmentalize human behavior, when the dynamics are so complex that only One as wise as the Savior Himself can sort it all out – e.g., HE knows the hearts of all (wo)men and can judge accordingly.
#10 – Idiat, that makes about as much sense as saying a doc with diabetes shouldn’t be allowed to treat anyone with diabetes. Would you also say a grief counselor should quit their job if they have a profound loss? I know a child psychologist who is very good at his job because he struggled with undiagnosed ADHD as a kid. His medical education plus his personal experience puts him in a unique position to determine if a kid really has a problem, or if it is something that could be fixed without medication. Often individuals are drawn to fields in which they’ve had past personal or family experience, precisely because they want to help and give hope to other people like themselves. There is also a big difference between undiagnosed/unmanaged mental illness versus receiving therapy and/or drugs to keep a condition in check. You seem to suggest that a mental illness disqualifies someone from acting in their professional capacity.
Mary Ann – Let’s see. The child psychologist went into the profession, learned all about his condition, and is now in the position to help others. Thanks for making my point. I think you’ve read way too much into my comment.
#10 and #14, I’ll second Mary Ann’s thinking here. In the chemical dependency/recovery field, a lot of addicts won’t lend the time of day to someone who isn’t themselves in recovery. For better or worse, the feeling is that they’ve just got “book larnin’,” not street cred.
My brother has schizophrenia and we’ve heard quite a few strange things. He started exhibiting symptoms as a teenager and at first people thought it was drug use or that he wanted to be like the guy from “A Beautiful Mind.” We also heard that he was lazy and needed a better work ethic. I’m grateful for a mother who persevered and got him diagnosed and treated as a minor because it has helped him get better care as an adult (even though his treatment still isn’t great). A few years ago a woman from church went up to my mom and told her that she thought my brother was possessed. My mom is a saint for what she has had to deal with. Mainly we roll our eyes or laugh now, but at first it was really frustrating that his illness was taken more seriously. Even now it’s tough to deal with. I could write an essay on what it’s like being a family member with someone so ill, but I’ll refrain.
That should have said *was not taken more seriously*
Thank you all for your comments. Jeff – I am likewise sorry for your loss. Experience tells me that a great deal more people than we think have stories like yours. Marie – the road you have travelled is one most people don’t even think about. And that’s why I think it is good to highlight the myths, the silly things that are said and the misconceptions people have. Because mental illness is likely to, at some stage, affect all of us…either directly or indirectly….I am fortunate enough to work in an industry here I am exposed to people in acute mental health crisis. I have pretty much see it all. I am of the feeling that, in the short time I am exposed to a person/family in crisis, that I can do good. The best thing I can do for people is to listen.
IDIAT – I apologize if I read your original comment the wrong way. With mental illness, many people can never be truly “healed.” The best they can hope for is to be able to manage it through types of therapy so that they can live a semi-normal life. True healing will only come at the resurrection. It’s one of the reasons why I used diabetes as an example. New Iconoclast’s example of recovering addicts is also applicable. In the case of the child psychiatrist (not pyschologist like I said before, he’s an MD), he still has ADHD, but he’s able to manage it and help others. In your statement I read the implication that someone who has a mental illness is unable to help others unless they’ve “gotten rid of it.”
Said to me while in a state of depression: “You should read The Power of Positive Thinking”.
BJohnson:
“Let’s not forget this classic: “Despair cometh because of iniquity.”
I realize that sadness can come from other things than badness but the Book of Mormon is of divine origin. Give it the benefit of the doubt. It might not be good for treating others, but it would seem to be very good for treating oneself, and, indirectly helping others who see you and apply it to themselves.
Instead of putting it down, Study it (Moroni 10:17 – the end of the chapter) and learn how to use it.